§ 4407. Health maintenance organizations; employer requirements. 1.
All employers subject to the provisions of the unemployment insurance
law, except for those employers with fewer than twenty-five employees,
shall include in any health benefits plan offered to their employees,
the option of membership in a health maintenance organization which
provides or offers a comprehensive health services plan in accordance
with the provisions of this article, but only if such plan serves an
area in which twenty-five of such employer's employees reside and the
organization has been issued a certificate of authority by the
commissioner.

2. For those employees of an employer represented by a bargaining
representative, the offer of the health maintenance organization
alternative shall be subject only to the collective bargaining process;
for those employees not represented by a bargaining representative, the
offer of the health maintenance organization alternative shall be made
directly to the employee.

3. (a) If there is more than one health maintenance organization
engaged in the provision of health services in the area in which the
employees of the employer reside, and if:

(i) one or more of such organizations provides more than one-half of
its comprehensive health services through physicians or other health
professionals who are members of the staff of the organization or of a
medical group (or groups) which contracts with the organization, and

(ii) one or more of such organizations provides its comprehensive
health services through contracts with an individual practice
association (or associations), individual physicians and other health
professionals under contract directly with the organization, or a
combination of an individual practice association (or associations),
medical group (or groups), physicians who are members of the staff of
the organization, and individual physicians and other health
professionals under contract directly with the organization,
then the employer shall, in accordance with regulations of the
commissioner, be required to offer the option of enrollment in at least
one organization described in subparagraph (i) of this paragraph and at
least one organization described in subparagraph (ii) of this paragraph
if the employer has twenty-five or more but fewer than two hundred
employees. If the employer has two hundred or more employees and the
employer's principal office in this state is located outside of the
metropolitan region then the employer shall be required to offer the
option of enrollment in at least two organizations described in
subparagraph (i) of this paragraph and at least two organizations
described in subparagraph (ii) of this paragraph. If the employer has
two hundred or more employees and the employer's principal office in
this state is located within the metropolitan region then the employer
shall be required to offer the option of enrollment in at least two
organizations described in subparagraph (i) of this paragraph and at
least two organizations described in subparagraph (ii) of this paragraph
and an additional organization from either subparagraph. For the
purposes of this section the metropolitan region is defined as the
counties of Westchester, Rockland, New York, Kings, Queens, Richmond,
Bronx, Nassau and Suffolk.

(b) If within any particular area of the state in which at least
twenty-five of such employer's employees reside there are fewer health
maintenance organizations described in subparagraph (i) or (ii) of
paragraph (a) of this subdivision than the employer is required to
offer, then additional health maintenance organizations from
subparagraph (i) or (ii) of paragraph (a) of this subdivision shall be
offered; provided, however, that no employer with fewer than two hundred
employees shall be required to offer more than a total of two health
maintenance organizations, and no employer with two hundred or more
employees shall be required to offer more than a total of four health
maintenance organizations (or five such organizations if the employer's
principal office is located within the metropolitan region) in any
particular area of the state. In the event fewer than the required
total minimum number of health maintenance organizations are available
in an area, the employer shall offer all health maintenance
organizations then certified to issue subscriber contracts in that area.
Nothing in this subdivision shall be deemed to prohibit an employer from
choosing to offer more health maintenance organizations to its employees
than are required under this subdivision.

4. No employer shall be required to pay more for health benefits as a
result of the application of this section than would otherwise be
required by any prevailing collective bargaining agreement or other
legally enforceable contract for the provision of health benefits
between an employer and his employees.