S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    529
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 8, 2025
                                ___________
 
 Introduced  by M. of A. STECK, SANTABARBARA -- read once and referred to
   the Committee on Local Governments
 
 AN ACT in relation to establishing a pilot program for  a  county  self-
   funded or self-insured health plan in Albany and Schenectady counties

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. (a) The superintendent of financial services shall  author-
 ize a pilot program for a county self-funded or self-insured health plan
 in  Albany and Schenectady counties. Notwithstanding article 44 or 47 of
 the insurance law or any other provision of law  to  the  contrary,  and
 subject  to  the  requirements set forth in this section, a municipality
 located in such counties is permitted, with the consent  of  the  county
 and  the  governing body of such municipality, to join such county self-
 funded or self-insured health plan in the county in which  such  munici-
 pality  is  located  in whole or in part. Municipality is defined as any
 city, town,  village  or  any  other  municipal  corporation,  a  school
 district  or  any governmental entity operating a public school, college
 or university, a  public  improvement  or  special  district,  a  public
 authority,  commission,  or  public  benefit  corporation,  or any other
 public corporation, agency or  instrumentality  or  unit  of  government
 which  exercises  governmental powers under the laws of the state but is
 not a part of, nor a department of, nor an agency of the state. In order
 for a municipality or municipalities to join such county self-funded  or
 self-insured  health plan, the county shall file with the superintendent
 of financial services certification that, with inclusion of the lives to
 be covered in the plan following admission of the municipality or  muni-
 cipalities, such plan meets the following six requirements:
   1.  That the county and any municipality or municipalities joining the
 county self-funded or self-insured health plan have  mutually  consented
 to join such plan.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD01077-01-5
 A. 529                              2
 
   2. That the county self-funded or self-insured health plan maintains a
 reserve  fund,  calculated  as  a  percentage  of  total annual incurred
 claims, of a minimum of 12% of claims.
   3.  That  the  county  self-funded  or  self-insured health plan has a
 surplus account, established and maintained  for  the  sole  purpose  of
 satisfying  unexpected  obligations  of the benefit plan in the event of
 termination or abandonment of such plan, which shall not be less than 5%
 of the annualized earned premium equivalents during the  current  fiscal
 year of such plan.
   4.  That  the  county  self-funded  or self-insured health plan has in
 effect a specific stop loss per individual  claim  only,  no  aggregate,
 with a minimum deductible of $200,000 to $250,000.
   5. That the county self-funded or self-insured health plan has a mini-
 mum  of 1,000 covered lives including retirees, but not including depen-
 dents.
   6. That joint and several liability  of  participating  municipalities
 for  the  obligations  of  the county self-funded or self-insured health
 plan is hereby abolished,  and  such  liability  shall  be  governed  as
 follows:
   (i)  If  the plan does not have admitted assets, as defined in section
 107 of the insurance law, at least equal to the aggregate of its liabil-
 ities and reserves and minimum surplus as provided  in  paragraph  2  of
 this subdivision, the governing board of such plan shall, within 30 days
 thereafter,  order an assessment for the amount that will provide suffi-
 cient funds to remove such impairment and collect  from  each  municipal
 corporation a pro rata share of such assessed amount.
   (ii)  Every municipal corporation that participated in the plan at any
 time during the two-year period prior to the issuing  of  an  assessment
 order  by  the plan's governing board shall, if notified of such assess-
 ment, pay its pro rata share of such assessment within 90 days after the
 issuance of that assessment order.
   (iii) A municipal corporation's pro rata share of any assessment shall
 be determined by applying the ratio of (A) the total assessment  to  the
 total  contributions  or  premium  equivalents  earned during the period
 covered by the assessment  on  all  municipal  corporations  subject  to
 assessment  to  (B) the contribution or premium equivalent earned during
 such period attributable to such municipal corporation.
   (iv) The contingent liability of municipal corporations for additional
 premium equivalents or assessments shall not be included as an asset  in
 the financial statements of the plan.
   (b)  The superintendent of financial services shall have the authority
 to review such certification to determine that  the  six  aforementioned
 requirements  have been met; provided, however, that in the absence of a
 finding of the superintendent to the contrary within a six-month  period
 following the filing of such certification, the admission of the munici-
 pality  to the county self-funded or self-insured health plan shall take
 effect. In January of every year following the initial  filing  of  such
 certification, the county shall file a subsequent certification that the
 six aforementioned requirements remain in full force and effect.
   (c)  The  duration of a county self-funded or self-insured health plan
 undertaken by participating municipalities shall be at least  two  years
 and  shall be allowed to become permanent should either county determine
 the plan to be successful.
   (d) Thirty months after the effective date of this section, the super-
 intendent of financial services shall submit a report to  the  governor,
 the  temporary president of the senate, and the speaker of the assembly,
 A. 529                              3
 
 analyzing the data provided by participating municipalities, as well  as
 recommendations based on the data collected from the pilot program.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become a law.