NY State Senate Bill 2025-S4122

Senate Bill S4122

2025-2026 Legislative Session

Clarifies that the New York state health insurance program remains subject to certain provisions of the financial services law

download bill text pdf

Current Bill Status - In Senate Committee Civil Service And Pensions Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Feb 03, 2025	referred to civil service and pensions

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2025-S4122 (ACTIVE) - Details

Current Committee:: Senate Civil Service And Pensions
Law Section:: Civil Service Law
Laws Affected:: Amd §§162 & 161-a, Civ Serv L
Versions Introduced in 2023-2024 Legislative Session:: S5639

2025-S4122 (ACTIVE) - Summary

Clarifies that the New York state health insurance program remains subject to certain provisions of the financial services law and coverage for usual and customary costs for out-of-network health care service.

2025-S4122 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S4122

SPONSOR: JACKSON
 
TITLE OF BILL:

An act to amend the civil service law, in relation to clarifying that
the New York state health insurance program remains subject to certain
provisions of the financial services law

 
PURPOSE:

The purpose of this bill is to ensure that participants in the New York
State Health Insurance Program (NYSHIP) that are not part of an approved
collective bargaining agreement will not have their health insurance
benefits diminished by order of the President of the New York State
Civil Service Commission.

 
SUMMARY OF PROVISIONS:

Section 1 amends subparagraph (i) of paragraph (b) of subdivision 1 of

Section 162 of the Civil Service Law to provide that NYSHIP covers at

least one plan to enrollees that reimburses out-of-network clinicians at
usual, customary, and reasonable rates set at the 80th percentile of the
FAIR Health benchmark.

Section 2 amends subdivision 1 of Section 161-a of the Civil Service Law
to prevent the Department of Civil Service from automatically applying
collectively bargained health plan changes to non-union represented
employees, retirees, and union represented municipal employees that have
not specifically memorialized NYSHIP benefits in a collective bargaining
agreement if the changes would decrease coverage and/or reimbursement.

Section 3 is the effective date.

 
JUSTIFICATION:

The purpose of this bill is to ensure that participants in the New York
State Health Insurance Program/The Empire Plan that have not been
subjected to an approved collective bargaining agreement will not have
their health insurance benefits diminished by order of the President of
the New York State Civil Service Commission. This bill also clarifies
Civil Service Law to ensure that the New York State Health Insurance
Program/The Empire Plan remains subject to Department of Financial
Services regulations and the New York State Emergency and Surprise Bills
Law.

This bill ensures that New York State dedicated public employees partic-
ipating in NYSHIP are fairly and equitably provided health insurance
options and that no such participant has their health insurance dimin-
ished in any capacity without first having been represented through
collective bargaining. New York State's dedicated public employees from
the municipal to state levels are the backbone of the State's commitment
to every resident. Recruitment and retention of public employees have
become increasingly more difficult. This bill will reaffirm its commit-
ment to all public servants and their families.

 
LEGISLATIVE HISTORY:

2023-2024: 5.5639 - Referred to Civil Service and Pensions

 
STATE AND LOCAL FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2025-S4122 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4122
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             February 3, 2025
                                ___________
 
 Introduced by Sens. JACKSON, BROUK, CLEARE, COMRIE, FERNANDEZ, HARCKHAM,
   HOYLMAN-SIGAL,  MARTINEZ,  MATTERA,  PALUMBO,  SEPULVEDA, WEBB -- read
   twice and ordered printed, and when printed to  be  committed  to  the
   Committee on Civil Service and Pensions
 
 AN  ACT  to  amend the civil service law, in relation to clarifying that
   the New York state health insurance program remains subject to certain
   provisions of the financial services law
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subparagraph  (i)  of  paragraph  (b) of subdivision 1 of
 section 162 of the civil service law, as amended by section 3 of part  T
 of chapter 56 of the laws of 2010, is amended to read as follows:
   (i) Any and all health insurance coverage mandated by any law, rule or
 regulation,  including  but not limited to coverage mandated pursuant to
 article forty-three of the insurance law, applicable  to  contracts  for
 health  insurance entered into under this section shall be provided in a
 manner assuring uninterrupted continuance of coverage  for  all  covered
 persons. HEALTH BENEFITS SHALL INCLUDE A REQUIREMENT THAT COVERED HEALTH
 CARE  SERVICES  PROVIDED  TO PLAN PARTICIPANTS WILL BE REIMBURSED AT THE
 LEVEL OF AT LEAST EIGHTY PERCENT OF THE USUAL AND CUSTOMARY COST OF EACH
 OUT-OF-NETWORK HEALTH   CARE SERVICE.  AS  USED  IN  THIS  SUBPARAGRAPH,
 "USUAL  AND  CUSTOMARY  COST" SHALL MEAN THE EIGHTIETH PERCENTILE OF ALL
 CHARGES FOR THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY  A  PROVIDER
 IN  THE  SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE SAME GEOGRAPHICAL
 AREA AS REPORTED IN A BENCHMARKING DATABASE MAINTAINED  BY  A  NONPROFIT
 ORGANIZATION  SPECIFIED BY THE SUPERINTENDENT OF FINANCIAL SERVICES. For
 the purposes of this paragraph "coverage" shall include but shall not be
 limited to all benefits, services,  rights,  privileges  and  guarantees
 allowed by law;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD06196-01-5
 S. 4122                             2

   §  2.  Subdivision  1  of  section  161-a of the civil service law, as
 amended by section 10 of part T of chapter 56 of the laws  of  2010,  is
 amended to read as follows:
   1.  Where,  and to the extent that, an agreement between the state and
 an employee organization entered into pursuant to  article  fourteen  of
 this  chapter provides for health benefits, the president, after receipt
 of written directions from the director  of  employee  relations,  shall
 implement  the  provisions  of  such agreement consistent with the terms
 thereof and to the extent necessary shall  adopt  regulations  providing
 for  the  benefits  to  be  thereunder provided. The president, with the
 approval of the director of the budget, may  extend  such  benefits,  in
 whole  or in part, PROVIDED THAT SUCH BENEFITS ARE NOT A DIMINISHMENT OF
 CURRENT EXISTING BENEFITS to employees not subject to the provisions  of
 such agreement.
   § 3. This act shall take effect immediately.

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