Bill Text: NY A01908 | 2021-2022 | General Assembly | Introduced


Bill Title: Authorizes municipalities and districts to enter into cooperative agreements for the provision of centralized public employee administrative and personnel services; provides for health insurance coverage of municipal employees pursuant to standardized health insurance contracts; authorizes the provision of reduced premiums for municipal health insurance plans which offer wellness programs.

Spectrum: Slight Partisan Bill (Democrat 2-1)

Status: (Introduced - Dead) 2022-01-05 - referred to local governments [A01908 Detail]

Download: New_York-2021-A01908-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          1908

                               2021-2022 Regular Sessions

                   IN ASSEMBLY

                                    January 11, 2021
                                       ___________

        Introduced  by  M.  of  A.  ZEBROWSKI,  WALLACE, NORRIS -- read once and
          referred to the Committee on Local Governments

        AN ACT to amend the general municipal law, in  relation  to  authorizing
          cities,  towns,  villages,  school  districts,  boards  of cooperative
          educational services, library districts, fire  districts,  improvement
          districts  and  special districts to enter into cooperative agreements
          for the provision of centralized public  employee  administrative  and
          personnel  services;  and  to  amend the insurance law, in relation to
          authorizing reduction of premiums  for  municipal  cooperative  health
          benefit plans which offer employee wellness programs

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

     1    Section 1. Section 92-a of the general municipal  law  is  amended  by
     2  adding a new subdivision 8 to read as follows:
     3    8. The provisions of this section shall not apply to any public corpo-
     4  ration  which  provides  health  insurance  benefits to its officers and
     5  employees pursuant to article forty-seven of the insurance law.
     6    § 2. Subdivision a of section 119-n of the general municipal  law,  as
     7  amended  by  chapter  413  of  the  laws  of 1991, is amended to read as
     8  follows:
     9    a. The term "municipal corporation" means a county outside the city of
    10  New York, a city, a town, a village, a board of cooperative  educational
    11  services, a public library as defined in section two hundred fifty-three
    12  of the education law, a fire district or a school district.
    13    §  3.  Subdivision  2 of section 119-o of the general municipal law is
    14  amended by adding a new paragraph b-1 to read as follows:
    15    b-1.   The establishment  of  a  centralized  office  to  collectively
    16  provide:
    17    (i)  employee  payroll,  time, attendance and personnel administration
    18  services;
    19    (ii) participation in the New York state health insurance program;

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05150-01-1

        A. 1908                             2

     1    (iii) a personnel office to provide  information  on  employee  health
     2  insurance and other employee benefits;
     3    (iv)  employee  health  insurance  benefits  from more than one health
     4  insurance carrier or organization, which grants each employee the choice
     5  of which health insurance plan which will provide coverage;
     6    (v) employee participation in tax deferred  retirement  plans,  health
     7  care plans and child care plans;
     8    (vi)  municipal  cooperative  health benefit plans pursuant to article
     9  forty-seven of the insurance law;
    10    (vii) adequate and ongoing financial controls  and  security  arrange-
    11  ments  to  ensure  that  the  participating  municipal  corporations and
    12  districts remain solvent;
    13    (viii) the preparation and dissemination of informational  and  solic-
    14  itation  materials  to  facilitate  comparison  of  the various employee
    15  health insurance plans offered by  the  participating  municipal  corpo-
    16  rations and districts;
    17    (ix)   for   the  enrollment,  billing,  premium  collection,  premium
    18  disbursement and  reconciliation,  commission  disbursement,  and  other
    19  processing  services for health insurance benefits provided to municipal
    20  employees;
    21    (x) contracting with qualified third parties for the provision of  any
    22  service necessary to carry out such office's powers and duties; and
    23    (xi) negotiation with participating health insurers and health mainte-
    24  nance  organizations  with regard to the administrative expenses portion
    25  of premium rates charged for health care coverage offered  to  municipal
    26  employees by such office.
    27    §  4. Subsections (a) and (f) of section 4702 of the insurance law, as
    28  added by chapter 689 of  the  laws  of  1994,  are  amended  and  a  new
    29  subsection (i-1) is added to read as follows:
    30    (a) "Community rating" means a rating methodology in which the premium
    31  equivalent  rate  for  all persons covered under a municipal cooperative
    32  health benefit plan is the same, based upon the experience of the entire
    33  pool of risks covered under the plan, without regard to age, sex, health
    34  status or occupation and such that refunds, rebates,  credits  or  divi-
    35  dends  based  upon  age,  sex,  health  status  or  occupation  are  not
    36  permitted; provided, however, that,  subject  to  the  approval  of  the
    37  superintendent,   such  plan  may  provide  an  actuarially  appropriate
    38  reduction in premium rates in return  for  an  enrollee's  or  insured's
    39  adherence  to a bona fide wellness program. A bona fide wellness program
    40  is either a risk management system that identifies  at-risk  populations
    41  or any other systematic program or course of medical conduct which helps
    42  to  promote  good  health, helps to prevent or mitigate acute or chronic
    43  sickness or disease, or which minimizes adverse health consequences  due
    44  to  lifestyle.  Such wellness program shall demonstrate actuarially that
    45  it encourages the general good health  and  well-being  of  the  covered
    46  population. Such plan shall not require specific outcomes as a result of
    47  an enrollee's or insured's adherence to the approved wellness program.
    48    (f) "Municipal corporation" means within the state of New York, a city
    49  [with  a  population  of less than one million or], a county outside the
    50  city of New  York,  town,  village,  board  of  cooperative  educational
    51  services, school district, a fire district, a public library, as defined
    52  in section two hundred fifty-three of the education law, or district, as
    53  defined in section one hundred nineteen-n of the general municipal law.
    54    (i-1)  "Stop-loss  insurance"  means  an  insurance policy whereby the
    55  insurer agrees to pay claims or indemnify a  municipal  corporation  for
    56  losses  incurred  under  a  municipal cooperative health benefit plan in

        A. 1908                             3

     1  excess of specified loss limits for individual  claims  and/or  for  all
     2  claims combined, or any similar arrangement.
     3    §  5.  Paragraphs  2  and  3  of subsection (a) of section 4704 of the
     4  insurance law, paragraph 2 as amended by section 3 of part A of  chapter
     5  494  of  the laws of 2009 and paragraph 3 as added by chapter 689 of the
     6  laws of 1994, are amended to read as follows:
     7    (2) except for any plan that provided medical, surgical  and  hospital
     8  services  on  or  before  January  first,  nineteen hundred ninety-three
     9  pursuant to a municipal cooperation agreement, the number  of  municipal
    10  corporations  participating  in the municipal cooperative health benefit
    11  plan shall be at least [three] two;
    12    (3) except for any plan that provided medical, surgical  and  hospital
    13  services  to  at  least three hundred fifty covered employees (including
    14  retirees and not including dependents) on or before January first, nine-
    15  teen hundred ninety-three pursuant to a municipal cooperation agreement,
    16  the number of covered employees (including retirees  and  not  including
    17  dependents)  of  municipal  corporations  participating in the municipal
    18  cooperative health benefit plan shall be at least  [two  thousand]  five
    19  hundred;
    20    §  6. Subsection (b) of section 4704 of the insurance law, as added by
    21  chapter 689 of the laws of 1994, is amended to read as follows:
    22    (b) The superintendent shall refuse to grant a certificate of authori-
    23  ty to an applicant that fails to meet the requirements of this  section.
    24  Notice  of refusal shall be in writing and shall set forth the basis for
    25  the refusal. If the applicant submits a written request within  [thirty]
    26  sixty  days  after  receipt of the notice of refusal, the superintendent
    27  shall promptly conduct a hearing to give the applicant  the  opportunity
    28  to show cause why the refusal should not be made final.
    29    §  7.  Paragraphs  1, 2 and 5 of subsection (d) of section 4705 of the
    30  insurance law, paragraphs 1 and 5 as added by chapter 689 of the laws of
    31  1994 and paragraph 2 as amended by chapter 681 of the laws of 2002,  are
    32  amended to read as follows:
    33    (1)  shall design the plan or plans of benefits provided or offered by
    34  the municipal cooperative health benefit plan and prepare the plan docu-
    35  ment and summary plan description in accordance with section four  thou-
    36  sand  seven  hundred  nine of this article, and shall include a wellness
    37  program option;
    38    (2) may enter into an agreement with a contract administrator or other
    39  service provider, determined by the governing board to be qualified,  to
    40  receive,  investigate,  recommend,  audit,  approve  or  make payment of
    41  claims under the municipal cooperative health  benefit  plan  or  plans,
    42  provided that:
    43    (A)  the  charges,  fees  and  other  compensation  for any contracted
    44  services shall be clearly  stated  in  written  administrative  services
    45  contracts  as required in subdivision six of section ninety-two-a of the
    46  general municipal law;
    47    (B) payment for contracted services shall  be  made  only  after  such
    48  services are rendered; and
    49    (C)  no  member  of  the  plan's governing board or any member of such
    50  member's immediate family shall be an owner, officer, director, partner,
    51  or employee of any contract administrator retained by the plan[; and
    52    (D) all such agreements shall comply with the requirements of subdivi-
    53  sion six of section ninety-two-a of the general municipal law].
    54    (5) shall prepare an  annual  budget  for  the  municipal  cooperative
    55  health  benefit  plan  to  determine  the  premium  equivalent rates for

        A. 1908                             4

     1  participating municipal corporations to be deposited in the plan's joint
     2  fund or funds during the fiscal year, provided that:
     3    (A)  the  governing board shall designate the bank or trust company in
     4  which joint funds, including reserve funds,  are  to  be  deposited  and
     5  which  shall  be located in this state, duly chartered under federal law
     6  or the laws of this state; and
     7    (B) the governing board shall establish premium equivalent  rates  for
     8  participating municipal corporations on the [bases] basis of a community
     9  rating methodology filed with and approved by the superintendent and, in
    10  determining the annual premium equivalent rates, the governing board:
    11    (i) may contract for necessary actuarial services to estimate expected
    12  plan expenditures during the fiscal year;
    13    (ii)  shall  maintain  reserves  in  amounts equal to or exceeding the
    14  minimum amounts required by section four thousand seven hundred  six  of
    15  this article; and
    16    (iii)  shall  maintain  a  stop-loss policy or policies, to the extent
    17  required by section four thousand seven hundred seven of this article;
    18    § 8. Subparagraphs (A) and (B) of paragraph 5  of  subsection  (a)  of
    19  section  4706  of the insurance law, as added by chapter 689 of the laws
    20  of 1994, are amended to read as follows:
    21    (A) five percent of the annualized earned premium  equivalents  during
    22  the  current  fiscal year of a municipal cooperative health benefit plan
    23  which consists of [five] two  or  more  participating  municipal  corpo-
    24  rations  and  covers  [two  thousand] five hundred or more employees and
    25  retirees; or
    26    (B) seven percent of the annualized earned premium equivalents  during
    27  the current fiscal year of the municipal cooperative health benefit plan
    28  which  consists  of  [four]  two or fewer participating municipal corpo-
    29  rations or covers fewer than [two thousand] five hundred  employees  and
    30  retirees.
    31    §  9. This act shall take effect on the first of January next succeed-
    32  ing the date on which it shall have become a law.
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