Bill Text: NY A00310 | 2019-2020 | General Assembly | Amended

Bill Title: Authorizes all municipalities, with the consent of the county and the governing body of such municipality, to join a county self-funded or self-insured health plan; requires certification.

Spectrum: Slight Partisan Bill (Democrat 29-12)

Status: (Introduced) 2019-04-22 - print number 310a [A00310 Detail]

Download: New_York-2019-A00310-Amended.html

                STATE OF NEW YORK
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                     January 9, 2019
        Introduced  by  M.  of  A. STECK, PEOPLES-STOKES, FAHY, ARROYO, GUNTHER,
          sored by -- M. of A.  BARCLAY,  CROUCH,  LAVINE,  SCHIMMINGER,  SIMON,
          THIELE  --  read  once  and  referred to the Committee on Insurance --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted to said committee
        AN  ACT authorizing municipalities to join a county self-funded or self-
          insured health plan
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Notwithstanding  article 44 or 47 of the insurance law or
     2  any other provision of law to the contrary, and subject to the  require-
     3  ments  set  forth in this section, a municipality is permitted, with the
     4  consent of the county and the governing body of  such  municipality,  to
     5  join  a  county self-funded or self-insured health plan in any county in
     6  which such municipality is located in whole or in part. Municipality  is
     7  defined as any city, town, village or any other municipal corporation, a
     8  school  district  or  any governmental entity operating a public school,
     9  college or university, a  public  improvement  or  special  district,  a
    10  public  authority,  commission,  or  public  benefit corporation, or any
    11  other public corporation, agency or instrumentality or unit  of  govern-
    12  ment which exercises governmental powers under the laws of the state but
    13  is  not  a  part of, nor a department of, nor an agency of the state. In
    14  order for a municipality or municipalities to join the county self-fund-
    15  ed or self-insured health plan, the county shall file  with  the  super-
    16  intendent  of  financial  services certification that, with inclusion of
    17  the lives to be covered in the plan following admission of  the  munici-
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        A. 310--A                           2
     1  pality  or municipalities, the county self-funded or self-insured health
     2  plan meets the following six requirements:
     3    (a)  That  the  county  and any municipality or municipalities joining
     4  such plan have mutually consented to join such plan.
     5    (b) That it maintain a reserve fund, calculated  as  a  percentage  of
     6  total annual incurred claims, of a minimum of 12% of claims.
     7    (c)  That it has a surplus account, established and maintained for the
     8  sole purpose of satisfying unexpected obligations of the benefit plan in
     9  the event of termination or abandonment of the plan, which shall not  be
    10  less  than  5%  of  the annualized earned premium equivalents during the
    11  current fiscal year of the plan.
    12    (d) That it has in effect a specific stop loss  per  individual  claim
    13  only,  no  aggregate,  and  with  a  minimum  deductible  of $200,000 to
    14  $250,000.
    15    (e) That it has a minimum of 1,000 covered lives  including  retirees,
    16  but not including dependents.
    17    (f)  That  joint and several liability of participating municipalities
    18  for the obligations of the plan is hereby abolished, and such  liability
    19  shall be governed as follows:
    20    1.  If  the  plan does not have admitted assets, as defined in section
    21  107 of the insurance law, at least equal to the aggregate of its liabil-
    22  ities and reserves and minimum surplus as provided in subdivision (b) of
    23  this section, the governing board of such plan  shall,  within  30  days
    24  thereafter,  order an assessment for the amount that will provide suffi-
    25  cient funds to remove such impairment and collect  from  each  municipal
    26  corporation a pro rata share of such assessed amount.
    27    2.  Every  municipal  corporation that participated in the plan at any
    28  time during the two-year period prior to the issuing  of  an  assessment
    29  order  by  the plan's governing board shall, if notified of such assess-
    30  ment, pay its pro rata share of such assessment within 90 days after the
    31  issuance of that assessment order.
    32    3. A municipal corporation's pro rata share of any assessment shall be
    33  determined by applying the ratio of (i)  the  total  assessment  to  the
    34  total  contributions  or  premium  equivalents  earned during the period
    35  covered by the assessment  on  all  municipal  corporations  subject  to
    36  assessment  to (ii) the contribution or premium equivalent earned during
    37  such period attributable to such municipal corporation.
    38    4. The contingent liability of municipal corporations  for  additional
    39  premium  equivalents or assessments shall not be included as an asset in
    40  the financial statements of the self-funded or self-insured health plan.
    41    The superintendent of financial services shall have the  authority  to
    42  review  such  certification  to  determine  that  the six aforementioned
    43  requirements have been met; provided, however, that in the absence of  a
    44  finding  of the superintendent to the contrary within a six-month period
    45  following the filing of such certification, the admission of the munici-
    46  pality to the county self-funded or self-insured health plan shall  take
    47  effect.  In  January  of every year following the initial filing of such
    48  certification, the county shall file a subsequent certification that the
    49  six aforementioned requirements remain in full force and effect.
    50    § 2. This act shall take effect immediately.