S T A T E O F N E W Y O R K
________________________________________________________________________
3784
2011-2012 Regular Sessions
I N A S S E M B L Y
January 27, 2011
___________
Introduced by M. of A. MORELLE -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the insurance law, in relation to premiums for individ-
ual and small group health insurance policies
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Subparagraph (A) of paragraph 1 of subsection (e) of
2 section 3231 of the insurance law, as amended by chapter 107 of the laws
3 of 2010, is amended to read as follows:
4 (A) An insurer desiring to increase or decrease premiums for any poli-
5 cy form subject to this section shall submit a rate filing or applica-
6 tion to the superintendent.
7 An insurer shall send written notice of the proposed rate adjustment,
8 including the [specific] change requested, to each policy holder [and
9 certificate holder] affected by the adjustment on or before the date the
10 rate filing or application is submitted to the superintendent. The
11 notice shall prominently include mailing and website addresses for both
12 the insurance department and the insurer through which a person may,
13 within thirty days from the date the rate filing or application is
14 submitted to the superintendent, contact the insurance department or
15 insurer to receive additional information or to submit written comments
16 to the insurance department on the rate filing or application. The
17 superintendent shall establish a process to post on the department's
18 website, in a timely manner, all relevant written comments received
19 pertaining to rate filings or applications. The insurer shall provide a
20 copy of the notice to the superintendent with the rate filing or appli-
21 cation. The superintendent shall immediately cause the notice to be
22 posted on the insurance department's website. The superintendent shall
23 determine whether the filing or application shall become effective as
24 filed, shall become effective as modified, or shall be disapproved. The
25 superintendent may modify or disapprove the rate filing or application
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05168-01-1
A. 3784 2
1 if the superintendent finds that the premiums are unreasonable, exces-
2 sive, inadequate, or unfairly discriminatory, and may consider the
3 financial condition of the insurer when approving, modifying or disap-
4 proving any premium adjustment. The determination of the superintendent
5 shall be supported by sound actuarial assumptions and methods, and shall
6 be rendered in writing between thirty and sixty days from the date the
7 rate filing or application is submitted to the superintendent. Should
8 the superintendent require additional information from the insurer in
9 order to make a determination, the superintendent shall require the
10 insurer to furnish such information, and in such event, the sixty days
11 shall be tolled and shall resume as of the date the insurer furnishes
12 the information to the superintendent. If the superintendent requests
13 additional information less than ten days from the expiration of the
14 sixty days (exclusive of tolling), the superintendent may extend the
15 sixty day period an additional twenty days to make a determination. The
16 application or rate filing will be deemed approved if a determination is
17 not rendered within the time allotted under this section. An insurer
18 shall not implement a rate adjustment unless the insurer provides at
19 least sixty days advance written notice of the premium rate adjustment
20 approved by the superintendent to each policy holder and certificate
21 holder affected by the rate adjustment.
22 S 2. Paragraph 2 of subsection (c) of section 4308 of the insurance
23 law, as amended by chapter 107 of the laws of 2010, is amended to read
24 as follows:
25 (2) A corporation desiring to increase or decrease premiums for any
26 contract subject to this subsection shall submit a rate filing or appli-
27 cation to the superintendent. A corporation shall send written notice of
28 the proposed rate adjustment, including the [specific] change requested,
29 to each contract holder [and subscriber] affected by the adjustment on
30 or before the date the rate filing or application is submitted to the
31 superintendent. The notice shall prominently include mailing and website
32 addresses for both the insurance department and the corporation through
33 which a person may, within thirty days from the date the rate filing or
34 application is submitted to the superintendent, contact the insurance
35 department or corporation to receive additional information or to submit
36 written comments to the insurance department on the rate filing or
37 application. The superintendent shall establish a process to post on the
38 department's website, in a timely manner, all relevant written comments
39 received pertaining to rate filings or applications. The corporation
40 shall provide a copy of the notice to the superintendent with the rate
41 filing or application. The superintendent shall immediately cause the
42 notice to be posted on the insurance department's website. The super-
43 intendent shall determine whether the filing or application shall become
44 effective as filed, shall become effective as modified, or shall be
45 disapproved. The superintendent may modify or disapprove the rate filing
46 or application if the superintendent finds that the premiums are unrea-
47 sonable, excessive, inadequate, or unfairly discriminatory, and may
48 consider the financial condition of the corporation in approving, modi-
49 fying or disapproving any premium adjustment. The determination of the
50 superintendent shall be supported by sound actuarial assumptions and
51 methods, and shall be rendered in writing between thirty and sixty days
52 from the date the rate filing or application is submitted to the super-
53 intendent. Should the superintendent require additional information from
54 the corporation in order to make a determination, the superintendent
55 shall require the corporation to furnish such information, and in such
56 event, the sixty days shall be tolled and shall resume as of the date
A. 3784 3
1 the corporation furnishes the information to the superintendent. If the
2 superintendent requests additional information less than ten days from
3 the expiration of the sixty days (exclusive of tolling), the superinten-
4 dent may extend the sixty day period an additional twenty days, to make
5 a determination. The application or rate filing will be deemed approved
6 if a determination is not rendered within the time allotted under this
7 section. A corporation shall not implement a rate adjustment unless the
8 corporation provides at least sixty days advance written notice of the
9 premium rate adjustment approved by the superintendent to each contract
10 holder and subscriber affected by the rate adjustment.
11 S 3. This act shall take effect immediately.