Bill Text: NY S06624 | 2017-2018 | General Assembly | Introduced
Bill Title: Relates to rating of individual and small group health insurance policies.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2018-01-03 - REFERRED TO INSURANCE [S06624 Detail]
Download: New_York-2017-S06624-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 6624 2017-2018 Regular Sessions IN SENATE June 7, 2017 ___________ Introduced by Sen. SEWARD -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the insurance law, in relation to rating of individual 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 subdivision (e) of 2 section 3231 of the insurance law, as amended by chapter 107 of the laws 3 of 2010 and as further amended by section 104 of part A of chapter 62 of 4 the laws of 2011, is amended to read as follows: 5 (A) An insurer desiring to increase or decrease premiums for any poli- 6 cy form subject to this section shall submit a rate filing or applica- 7 tion to the superintendent. 8 An insurer shall send written notice of the proposed rate adjustment, 9 [including the specific change requested,] to each policy holder and 10 certificate holder affected by the adjustment on or before the date the 11 rate filing or application is submitted to the superintendent. The 12 notice shall prominently include mailing and website addresses for both 13 the department of financial services and the insurer through which a 14 person may, within thirty days from the date the rate filing or applica- 15 tion is submitted to the superintendent, contact the department of 16 financial services or insurer to receive additional information or to 17 submit written comments to the department of financial services on the 18 rate filing or application. The superintendent shall establish a process 19 to post on the department's website, in a timely manner, all relevant 20 written comments received pertaining to rate filings or applications. 21 The insurer shall provide a copy of the notice to the superintendent 22 with the rate filing or application. The superintendent shall immediate- 23 ly cause the notice to be posted on the department of financial 24 services' website. The superintendent shall determine whether the filing 25 or application shall become effective as filed, shall become effective EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01676-01-7S. 6624 2 1 as modified, or shall be disapproved. The superintendent may modify or 2 disapprove the rate filing or application if the superintendent finds 3 that the premiums are unreasonable, excessive, inadequate, or unfairly 4 discriminatory, and may consider the financial condition of the insurer 5 when approving, modifying or disapproving any premium adjustment. [The] 6 Provided, however, any adjustment to a rate filing or application must 7 be in accordance with generally accepted actuarial principles and prac- 8 tices, and must be appropriate for the population to be covered and 9 services to be furnished under the policy. An initial determination [of] 10 regarding the rate filing or application shall be made by the super- 11 intendent [shall be supported by sound actuarial assumptions and meth-12ods, and shall be rendered in writing between] no later than thirty [and13sixty] days from the date the rate filing or application is submitted to 14 the superintendent. The superintendent's initial determination shall be 15 provided to an insurer in writing within the thirty day time period and 16 shall describe in detail the actuarial assumptions and methods used in 17 the superintendent's determination. Should the superintendent require 18 additional information from the insurer in order to make [a] an initial 19 determination, the superintendent shall require the insurer to furnish 20 such information, and in such event, the [sixty] thirty days shall be 21 tolled and shall resume as of the date the insurer furnishes the infor- 22 mation to the superintendent. [If the superintendent requests additional23information less than ten days from the expiration of the sixty days24(exclusive of tolling), the superintendent may extend the sixty day25period an additional twenty days to make a determination. The] Following 26 the issuance of the initial determination, an insurer shall have fifteen 27 days to appeal the determination in writing. If an initial rate determi- 28 nation is appealed, the superintendent shall have fifteen days to issue 29 a revised determination. If the initial determination is not appealed by 30 an insurer, it shall become final fifteen days after it is issued. All 31 final rate determinations shall be certified by an actuary designated by 32 the superintendent who meets the qualification standards established by 33 the American academy of actuaries and follow the practice standards 34 established by the actuarial standards board. Notwithstanding the fore- 35 going, the application or rate filing will be deemed approved if a 36 determination is not rendered within the time allotted under this 37 section. An insurer shall not implement a rate adjustment that is 38 approved by the superintendent unless the insurer provides at least 39 [sixty] thirty days advance [written] notice of the [premium rate40adjustment approved by the superintendent] adjustment, either through a 41 posting on its website or by written notice to each policy holder and 42 certificate holder affected by the rate adjustment. 43 § 2. Paragraph 2 of subdivision (c) of section 4308 of the insurance 44 law, as amended by chapter 107 of the laws of 2010 and as further 45 amended by section 104 of part A of chapter 62 of the laws of 2011, is 46 amended to read as follows: 47 (2) A corporation desiring to increase or decrease premiums for any 48 contract subject to this subsection shall submit a rate filing or appli- 49 cation to the superintendent. A corporation shall send written notice of 50 the proposed rate adjustment, [including the specific change requested,] 51 to each contract holder and subscriber affected by the adjustment on or 52 before the date the rate filing or application is submitted to the 53 superintendent. The notice shall prominently include mailing and website 54 addresses for both the department of financial services and the corpo- 55 ration through which a person may, within thirty days from the date the 56 rate filing or application is submitted to the superintendent, contactS. 6624 3 1 the department of financial services or corporation to receive addi- 2 tional information or to submit written comments to the department of 3 financial services on the rate filing or application. The superintendent 4 shall establish a process to post on the department's website, in a 5 timely manner, all relevant written comments received pertaining to rate 6 filings or applications. The corporation shall provide a copy of the 7 notice to the superintendent with the rate filing or application. The 8 superintendent shall immediately cause the notice to be posted on the 9 department of financial services' website. The superintendent shall 10 determine whether the filing or application shall become effective as 11 filed, shall become effective as modified, or shall be disapproved. The 12 superintendent may modify or disapprove the rate filing or application 13 if the superintendent finds that the premiums are unreasonable, exces- 14 sive, inadequate, or unfairly discriminatory, and may consider the 15 financial condition of the corporation in approving, modifying or disap- 16 proving any premium adjustment[. The]; provided, however, any adjustment 17 to a rate filing or application must be in accordance with generally 18 accepted actuarial principles and practices, and must be appropriate for 19 the population to be covered and services to be furnished under the 20 contract. An initial determination [of] regarding the rate of filing or 21 application shall be made by the superintendent [shall be supported by22sound actuarial assumptions and methods, and shall be rendered in writ-23ing between] no later than thirty [and sixty] days from the date the 24 rate filing or application is submitted to the superintendent. The 25 superintendent's initial determination shall be provided to a corpo- 26 ration in writing within the thirty day time period and shall describe 27 in detail the actuarial assumptions and methods used in the superinten- 28 dent's determination. Should the superintendent require additional 29 information from the corporation in order to make [a] an initial deter- 30 mination, the superintendent shall require the corporation to furnish 31 such information, and in such event, the [sixty] thirty days shall be 32 tolled and shall resume as of the date the corporation furnishes the 33 information to the superintendent. [If the superintendent requests addi-34tional information less than ten days from the expiration of the sixty35days (exclusive of tolling), the superintendent may extend the sixty day36period an additional twenty days, to make a determination. The] Follow- 37 ing the issuance of the initial determination, a corporation shall have 38 fifteen days to appeal the determination in writing. If an initial rate 39 determination is appealed, the superintendent shall have fifteen days to 40 issue a revised determination. If the initial determination is not 41 appealed by a corporation, it shall become final fifteen days after it 42 is issued. All final rate determinations shall be certified by an actu- 43 ary designated by the superintendent who meets the qualification stand- 44 ards established by the American academy of actuaries and follow the 45 practice standards established by the actuarial standards board. 46 Notwithstanding the foregoing, the application or rate filing will be 47 deemed approved if a determination is not rendered within the time 48 allotted under this section. A corporation shall not implement a rate 49 adjustment that is approved by the superintendent unless the corporation 50 provides at least [sixty] thirty days advance [written] notice of the 51 [premium rate adjustment approved by the superintendent] adjustment, 52 either through a posting on its website or by written notice to each 53 contract holder and subscriber affected by the rate adjustment. 54 § 3. This act shall take effect immediately.
