Bill Text: NY S06931 | 2019-2020 | General Assembly | Introduced

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Bill Title: Details policies or contracts which are not included in the definition of student accident health insurance.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed - Dead) 2020-02-05 - referred to insurance [S06931 Detail]

Download: New_York-2019-S06931-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          6931

                    IN SENATE

                                     January 6, 2020
                                       ___________

        Introduced  by  Sen. BRESLIN -- 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 policies or  contracts
          which  are  not  included  in  the  definition of student accident and
          health insurance

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Subparagraph  (B)  of  paragraph  1  of subsection (a) of
     2  section 3240 of the insurance law, as amended by chapter 461 of the laws
     3  of 2015, clause (ii) as amended by a chapter of the laws of 2019, amend-
     4  ing the insurance law relating to policies or contracts  which  are  not
     5  included  in the definition of student accident and health insurance, as
     6  proposed in legislative bills numbers S. 6197 and A. 492, is amended  to
     7  read as follows:
     8    (B) "Student accident and health insurance" shall not include:
     9    (i)  a policy or contract that provides limited scope dental or vision
    10  benefits meeting the definition of  "excepted  benefits"  set  forth  in
    11  section  2791 of the public health service act, 42 U.S.C. § 300gg-91(c);
    12  [or]
    13    (ii) [a] an accident policy or contract that provides benefits meeting
    14  the definition of "excepted benefits" set forth in section 2791  of  the
    15  public  health  service  act,  42 U.S.C. § 300gg-91(c), if the policy or
    16  contract [is limited to insurance coverage for personal  risks  incident
    17  to  planned  travel,  including sickness, accident, disability, or death
    18  occurring during travel, provided that  such  health  benefits  are  not
    19  offered on a stand-alone basis and are incidental to other coverage.
    20    (iii)  an  accident  policy or contract that provides benefits meeting
    21  the definition of "excepted benefits" set forth in section 2791  of  the
    22  public  health  service  act,  42 U.S.C. § 300gg-91(c), if the policy or
    23  contract]:
    24    (I) is limited to coverage for intercollegiate sports injuries only;
    25    (II) provides benefits  to  diagnose  and  treat  any  intercollegiate
    26  sports  injury  and does not include a benefit dollar maximum amount per

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05103-02-0
        S. 6931                             2

     1  injury that is less than the overall benefit dollar maximum  amount  per
     2  student under the intercollegiate sports injury policy or contract;
     3    (III) provides benefits on an expense incurred basis;
     4    (IV)  provides  that  premiums  are paid in full by the institution of
     5  higher education;
     6    (V) includes prominent disclosure to the  student  that  the  accident
     7  policy is not a substitute for comprehensive hospital and medical cover-
     8  age;
     9    (VI)  provides coverage for intercollegiate sports injuries primary to
    10  any student accident and health insurance  policy  or  contract  or  any
    11  student  health plan issued pursuant to section one thousand one hundred
    12  twenty-four of this chapter; except that a policy  or  contract  meeting
    13  the  requirements  of  this item may be excess or secondary to any other
    14  policy or contract of accident and health insurance; 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    (iii)  an  accident  policy or contract that provides benefits meeting
    21  the definition of "excepted benefits" set forth in section 2791  of  the
    22  public  health service act, 42 U.S.C. § 300gg-91(c)(1)(A), if the policy
    23  or contract:
    24    (I) is limited to transportation expenses  in  the  event  an  insured
    25  student  incurs a covered sickness or accident, including transportation
    26  expenses for a medical escort to travel with the student and transporta-
    27  tion expenses for returning the student to the student's domicile;
    28    (II) provides that premiums are paid in full  by  the  institution  of
    29  higher education;
    30    (III) covers students enrolled in the institution of higher education;
    31    (IV)  includes  prominent  disclosure to the student that the accident
    32  policy is not a substitute for comprehensive hospital and medical cover-
    33  age; and
    34    (V) provides coverage for a period of twelve months; or
    35    (iv) an insurance  policy,  contract,  or  certificate  that  provides
    36  hospital,  medical,  or  surgical  expense  coverage for a student while
    37  studying outside the United States for a period of twelve months or less
    38  that is issued to a student, provided that the student is  also  covered
    39  by  comprehensive hospital and medical coverage within the United States
    40  and the insurance policy, contract, or certificate:
    41    (I) is subject to the requirements of subsections (b), (c), (d),  (e),
    42  (h), and (i) of this section;
    43    (II)  meets the definition of "expatriate health plan" set forth in 42
    44  U.S.C. § 18014(d)(2);
    45    (III) excludes coverage within the United States;
    46    (IV) may offer coverage for global evacuation and repatriation in  the
    47  event of the insured student's sickness or accident; and
    48    (V)  may  offer  coverage  for  trip  cancellation, trip interruption,
    49  baggage,  personal  effects,  or  global  evacuation  and  repatriation,
    50  including  evacuation  in  the  event of a natural or man-made disaster,
    51  such as an epidemic, political event, war, terrorist act, riot, or civil
    52  insurrection, pursuant to section three thousand four hundred  fifty-two
    53  of this chapter.
    54    § 2. Clause (iii) of subparagraph (C) of paragraph 3 of subsection (a)
    55  of  section  4237 of the insurance law, as amended by chapter 461 of the
    56  laws of 2015, is amended to read as follows:
        S. 6931                             3

     1    (iii) as described in item (ii), (iii) or (iv) of subparagraph (B)  of
     2  paragraph  one  of  subsection (a) of section three thousand two hundred
     3  forty of this chapter.
     4    §  3.  Paragraphs  3, 4 and 5 of subsection (a) of section 3452 of the
     5  insurance law, as added by chapter 318 of the laws of 2008, are  amended
     6  to read as follows:
     7    (3) The policy may be issued to:
     8    (A)  any  railroad  company, steamship company, carrier by air, public
     9  bus carrier, or other common  carrier  of  passengers,  which  shall  be
    10  deemed the policyholder, where the policy insures its passengers; [or]
    11    (B) an institution of higher education as provided in paragraph two of
    12  subsection (a) of section three thousand two hundred forty of this chap-
    13  ter; or
    14    (C) any other group where the superintendent has determined in a regu-
    15  lation  that  the members are engaged in a common enterprise, or have an
    16  economic or social affinity or relationship, and that  the  issuance  of
    17  the policy would not be contrary to the best interests of the public.
    18    (4)  [The] (A) Except as provided in subparagraph (B) of paragraph one
    19  of subsection (a) of section three thousand two hundred  forty  of  this
    20  chapter,  the  policy  may  provide coverage for trip cancellation, trip
    21  interruption, baggage, and personal effects when limited to  a  specific
    22  trip.  The  policy  shall  be  sold  in  connection  with transportation
    23  provided by the common carrier or,  with  respect  to  other  groups  as
    24  permitted  by  the  superintendent in accordance with subparagraph [(B)]
    25  (C) of paragraph three of this subsection, subject to  such  limitations
    26  provided in the regulation promulgated by the superintendent.
    27    (B) A policy issued to an institution of higher education shall comply
    28  with  clause  (V)  of  item (iv) of subparagraph (B) of paragraph one of
    29  subsection (a) of section three thousand two hundred forty of this chap-
    30  ter.
    31    (5) Coverage under the policy shall be limited to the  group  member's
    32  risks  with  respect  to a particular trip, except a policy issued to an
    33  institution of higher education shall comply with item (iv) of  subpara-
    34  graph  (B)  of paragraph one of subsection (a) of section three thousand
    35  two hundred forty of this chapter.
    36    § 4. Paragraph 1 of subsection (c) of section 3452  of  the  insurance
    37  law,  as added by chapter 318 of the laws of 2008, is amended to read as
    38  follows:
    39    (1) Unless the group policy provides for a longer policy  period,  the
    40  policy shall be issued or renewed for a one-year policy period, except a
    41  policy  issued  to an institution of higher education shall be issued or
    42  renewed for a period consistent with item (iv) of  subparagraph  (B)  of
    43  paragraph  one  of  subsection (a) of section three thousand two hundred
    44  forty of this chapter.
    45    § 5. Subparagraph (B) of paragraph 7 of subsection (c) of section 3452
    46  of the insurance law, as added by chapter 318 of the laws  of  2008,  is
    47  amended to read as follows:
    48    (B) The coverage shall terminate as provided in the certificate, which
    49  shall  in  no  event  be  later  than the conclusion of the trip, except
    50  coverage under a policy issued to an institution of higher education  as
    51  provided in item (iv) of subparagraph (B) of paragraph one of subsection
    52  (a)  of  section  three thousand two hundred forty of this chapter shall
    53  terminate in accordance with the provisions of that section.
    54    § 6. This act shall take effect on the  same  date  and  in  the  same
    55  manner  as  a  chapter  of  the laws of 2019, amending the insurance law
    56  relating to policies or contracts which are not included  in  the  defi-
        S. 6931                             4

     1  nition of student accident and health insurance, as proposed in legisla-
     2  tive bills numbers S. 6197 and A. 492, takes effect.