Bill Text: NY S05192 | 2015-2016 | General Assembly | Amended

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Bill Title: Relates to authorizing the issuance of certain accident and health insurance policies to an institution of higher education; amends definition of student accident and health insurance not including policies or contracts meeting certain provisions of the public health service act.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2016-01-06 - REFERRED TO INSURANCE [S05192 Detail]

Download: New_York-2015-S05192-Amended.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        5192--A
           Cal. No. 687
                              2015-2016 Regular Sessions
                                   I N  S E N A T E
                                      May 6, 2015
                                      ___________
       Introduced  by  Sens.  SEWARD, LARKIN -- read twice and ordered printed,
         and when printed to be committed to  the  Committee  on  Insurance  --
         reported  favorably  from  said committee, ordered to first and second
         report, ordered to a third reading,  amended  and  ordered  reprinted,
         retaining its place in the order of third reading
       AN  ACT to amend the insurance law, in relation to authorizing the issu-
         ance of certain accident and health insurance policies to an  institu-
         tion of higher education
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Paragraph 1 of subsection (a) of section 3240 of the insur-
    2  ance law, as added by section 41 of part D of chapter 56 of the laws  of
    3  2013,  is  amended  and  two new paragraphs 5 and 6 are added to read as
    4  follows:
    5    (1)(A) "Student accident and  health  insurance"  means  a  policy  or
    6  contract  of  hospital, medical, or surgical expense insurance delivered
    7  or issued for delivery in this state on  or  after  January  first,  two
    8  thousand  fourteen, by an insurer or a corporation, to an institution of
    9  higher education covering students enrolled in the institution  and  the
   10  students' dependents.
   11    (B) "STUDENT ACCIDENT AND HEALTH INSURANCE" SHALL NOT INCLUDE:
   12    (I)  A POLICY OR CONTRACT THAT PROVIDES LIMITED SCOPE DENTAL OR VISION
   13  BENEFITS MEETING THE DEFINITION OF  "EXCEPTED  BENEFITS"  SET  FORTH  IN
   14  SECTION  2791 OF THE PUBLIC HEALTH SERVICE ACT, 42 U.S.C. S 300GG-91(C);
   15  OR
   16    (II) AN ACCIDENT POLICY OR CONTRACT THAT PROVIDES BENEFITS MEETING THE
   17  DEFINITION OF "EXCEPTED BENEFITS" SET  FORTH  IN  SECTION  2791  OF  THE
   18  PUBLIC  HEALTH  SERVICE  ACT,  42 U.S.C. S 300GG-91(C), IF THE POLICY OR
   19  CONTRACT:
   20    (I) IS LIMITED TO COVERAGE FOR INTERCOLLEGIATE SPORTS INJURIES ONLY;
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10900-03-5
       S. 5192--A                          2
    1    (II) PROVIDES BENEFITS  TO  DIAGNOSE  AND  TREAT  ANY  INTERCOLLEGIATE
    2  SPORTS  INJURY  AND DOES NOT INCLUDE A BENEFIT DOLLAR MAXIMUM AMOUNT PER
    3  INJURY THAT IS LESS THAN THE OVERALL BENEFIT DOLLAR MAXIMUM  AMOUNT  PER
    4  STUDENT UNDER THE INTERCOLLEGIATE SPORTS INJURY POLICY OR CONTRACT;
    5    (III) PROVIDES BENEFITS ON AN EXPENSE INCURRED BASIS;
    6    (IV)  PROVIDES  THAT  PREMIUMS  ARE PAID IN FULL BY THE INSTITUTION OF
    7  HIGHER EDUCATION;
    8    (V) INCLUDES PROMINENT DISCLOSURE TO THE  STUDENT  THAT  THE  ACCIDENT
    9  POLICY IS NOT A SUBSTITUTE FOR COMPREHENSIVE HOSPITAL AND MEDICAL COVER-
   10  AGE;
   11    (VI)  PROVIDES COVERAGE FOR INTERCOLLEGIATE SPORTS INJURIES PRIMARY TO
   12  ANY STUDENT ACCIDENT AND HEALTH INSURANCE  POLICY  OR  CONTRACT  OR  ANY
   13  STUDENT  HEALTH PLAN ISSUED PURSUANT TO SECTION ONE THOUSAND ONE HUNDRED
   14  TWENTY-FOUR OF THIS CHAPTER; AND
   15    (VII) INCLUDES A MAXIMUM BENEFIT AMOUNT  THAT  IS  NO  LESS  THAN  THE
   16  DEDUCTIBLE UNDER THE SEPARATE ATHLETIC ASSOCIATION POLICY OR CONTRACT IF
   17  DESIGNED  TO  COORDINATE WITH A SEPARATE POLICY OR CONTRACT ISSUED TO AN
   18  ATHLETIC ASSOCIATION THAT EXTENDS COVERAGE  FOR  INTERCOLLEGIATE  SPORTS
   19  INJURIES.
   20    (5)  "INTERCOLLEGIATE SPORT" MEANS A SPORT THAT HAS BEEN DESIGNATED AS
   21  AN INTERCOLLEGIATE SPORT BY THE INSTITUTION OF HIGHER EDUCATION IN WHICH
   22  A STUDENT IS ENROLLED AND THAT IS ORGANIZED OR SPONSORED BY AN  INSTITU-
   23  TION OF HIGHER EDUCATION.
   24    (6)  "INTERCOLLEGIATE  SPORTS  INJURY"  MEANS AN INJURY SUSTAINED BY A
   25  STUDENT MEMBER OF AN ATHLETICS TEAM DURING PARTICIPATION IN AN INTERCOL-
   26  LEGIATE SPORT.
   27    S 2. Section 3240 of the insurance law, as added by section 41 of part
   28  D of chapter 56 of the  laws  of  2013,  is  amended  by  adding  a  new
   29  subsection (j) to read as follows:
   30    (J)  WITH RESPECT TO BENEFITS FOR TREATMENT RELATING TO AN INTERCOLLE-
   31  GIATE SPORTS INJURY, AS DEFINED IN PARAGRAPH SIX OF  SUBSECTION  (A)  OF
   32  THIS SECTION, A POLICY OR CONTRACT OF STUDENT ACCIDENT AND HEALTH INSUR-
   33  ANCE  OR  A  STUDENT HEALTH PLAN ISSUED PURSUANT TO SECTION ONE THOUSAND
   34  ONE HUNDRED TWENTY-FOUR OF THIS CHAPTER SHALL BE SECONDARY TO A SEPARATE
   35  ACCIDENT POLICY OR CONTRACT MEETING  THE  REQUIREMENTS  OF  CLAUSES  (I)
   36  THROUGH  (VII)  OF  ITEM  (II)  OF  SUBPARAGRAPH (B) OF PARAGRAPH ONE OF
   37  SUBSECTION (A) OF THIS SECTION.
   38    S 3. This act shall take effect immediately and  shall  be  deemed  to
   39  have  been  in  full  force  and effect on the same date and in the same
   40  manner as section 41 of part D of chapter 56 of the laws  of  2013  took
   41  effect.