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

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         5192
                              2015-2016 Regular Sessions
                                   I N  S E N A T E
                                      May 6, 2015
                                      ___________
       Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
         printed to be committed to the Committee on Insurance
       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) and subsection (d) of section
    2  3240  of  the insurance law, as added by section 41 of part D of chapter
    3  56 of the laws of 2013, are amended to read as follows:
    4    (1) "Student accident and health insurance" means a policy or contract
    5  of hospital, medical, or surgical expense insurance delivered or  issued
    6  for delivery in this state on or after January first, two thousand four-
    7  teen, by an insurer or a corporation, to an institution of higher educa-
    8  tion  covering  students  enrolled  in the institution and the students'
    9  dependents. HOWEVER, FOR THE PURPOSES OF THIS SECTION, "STUDENT ACCIDENT
   10  AND HEALTH INSURANCE" DOES  NOT  INCLUDE  A  POLICY  OR  CONTRACT  WHICH
   11  PROVIDES:    LIMITED  SCOPE  DENTAL OR VISION BENEFITS MEETING THE DEFI-
   12  NITION OF "EXCEPTED BENEFITS" SET FORTH IN SECTION 2791  OF  THE  PUBLIC
   13  HEALTH  SERVICE  ACT, 42 U.S.C. S 300GG-91(C). ALSO, FOR THE PURPOSES OF
   14  THIS SECTION, "STUDENT ACCIDENT AND HEALTH INSURANCE" SHALL NOT  INCLUDE
   15  AN ACCIDENT POLICY OR CONTRACT WHICH PROVIDES BENEFITS MEETING THE DEFI-
   16  NITION  OF  "EXCEPTED  BENEFITS" SET FORTH IN SECTION 2791 OF THE PUBLIC
   17  HEALTH SERVICE ACT, 42 U.S.C. S 300GG-91(C) IF SUCH POLICY OR  CONTRACT:
   18  (A) IS LIMITED TO INTERCOLLEGIATE SPORTS INJURIES; (B) INCLUDES COVERAGE
   19  FOR  TREATMENT  RELATING  TO  THE  INTERCOLLEGIATE  SPORTS  INJURY;  (C)
   20  PROVIDES BENEFITS ON AN EXPENSE INCURRED BASIS; (D) PROVIDES THAT PREMI-
   21  UMS ARE PAID IN  FULL  BY  THE  INSTITUTION  OF  HIGHER  EDUCATION;  (E)
   22  INCLUDES  PROMINENT DISCLOSURE THAT THE ACCIDENT POLICY IS NOT A SUBSTI-
   23  TUTE FOR COMPREHENSIVE  HOSPITAL  AND  MEDICAL  COVERAGE;  (F)  PROVIDES
   24  COVERAGE FOR INTERCOLLEGIATE SPORTS INJURIES PRIMARY TO ANY ACCIDENT AND
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10900-02-5
       S. 5192                             2
    1  HEALTH  INSURANCE POLICY OR SELF-FUNDED HEALTH BENEFIT PLAN ISSUED TO OR
    2  PROVIDED BY AN INSTITUTION OF HIGHER EDUCATION WHEN SUCH POLICY OR  PLAN
    3  EXCLUDES  COVERAGE  FOR  INTERCOLLEGIATE  SPORTS INJURIES AND WHERE SUCH
    4  POLICY  OR  PLAN IS AVAILABLE TO ALL ENROLLED STUDENTS AND PROVIDES THAT
    5  ONE HUNDRED PERCENT OF THE PREMIUM IS PAID BY THE ENROLLED STUDENT;  AND
    6  (G)  IF DESIGNED TO COORDINATE WITH A SEPARATE POLICY OR CONTRACT ISSUED
    7  TO AN ATHLETIC ASSOCIATION WHICH EXTENDS  COVERAGE  FOR  INTERCOLLEGIATE
    8  SPORTS  INJURIES,  INCLUDES  A  MAXIMUM BENEFIT THAT IS NO LESS THAN THE
    9  DEDUCTIBLE UNDER THE SEPARATE ATHLETIC ASSOCIATION POLICY OR CONTRACT.
   10    (d) A student accident and health insurance policy or  contract  shall
   11  provide  coverage  for  essential  health benefits as defined in section
   12  1302(b) of the affordable care act, 42 U.S.C. S 18022(b).  STUDENT ACCI-
   13  DENT AND HEALTH POLICIES MAY EXCLUDE OR LIMIT BENEFITS FOR INTERCOLLEGI-
   14  ATE SPORTS INJURIES TO THE EXTENT THAT THOSE BENEFITS ARE PROVIDED UNDER
   15  A SEPARATE ACCIDENT POLICY MEETING THE CONDITIONS SET FORTH IN  SUBPARA-
   16  GRAPHS  (A)  THROUGH  (G)  OF  PARAGRAPH  ONE  OF SUBSECTION (A) OF THIS
   17  SECTION.
   18    S 2. This act shall take effect immediately and  shall  be  deemed  to
   19  have  been  in  full  force  and effect on the same date and in the same
   20  manner as section 41 of part D of chapter 56 of the laws of  2013,  took
   21  effect.