Bill Text: NY A10653 | 2009-2010 | General Assembly | Introduced

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Bill Title: Requires group and blanket health and accident insurers to provide 30 days prior written notice to insureds of the termination of such insurance coverage; extends the conversion privilege to forty-five days after notice of termination is received by the employee; requires notice of termination of coverage to be mailed by the insurer to each certificate holder's last known residential address.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2010-05-18 - held for consideration in insurance [A10653 Detail]

Download: New_York-2009-A10653-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         10653
                                 I N  A S S E M B L Y
                                    April 13, 2010
                                      ___________
       Introduced  by  M.  of  A.  MONTESANO  --  read once and referred to the
         Committee on Insurance
       AN ACT to amend the insurance law, in relation  to  requiring  insurance
         carriers to provide persons under a group health insurance policy with
         thirty days notice of the termination of such policy
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. Subsection (a) of section 3221  of  the  insurance  law  is
    2  amended by adding a new paragraph 16 to read as follows:
    3    (16)  (A)  THAT  THE  INSURER  UPON  TERMINATION  OF A GROUP POLICY OR
    4  CONTRACT OF HEALTH, OR ACCIDENT AND HEALTH INSURANCE ISSUED TO A POLICY-
    5  HOLDER, COVERING INDIVIDUALS WHO BECAUSE OF THEIR EMPLOYEE OR MEMBERSHIP
    6  STATUS ARE CERTIFICATE HOLDERS UNDER A GROUP POLICY, SHALL PROVIDE  EACH
    7  CERTIFICATE  HOLDER  WITH WRITTEN NOTICE OF SUCH TERMINATION OF COVERAGE
    8  THIRTY DAYS PRIOR TO SUCH TERMINATION, AND  NO  SUCH  TERMINATION  SHALL
    9  BECOME EFFECTIVE UNTIL THIRTY DAYS AFTER SUCH NOTICE OF TERMINATION.
   10    (B)  IN  ITS  NOTICE OF TERMINATION OF COVERAGE, THE INSURER SHALL SET
   11  FORTH, IN FULL, THE RIGHTS OF THE CERTIFICATE HOLDER UNDER THE TERMINAT-
   12  ING POLICY AS TO COVERAGE FOR ILLNESS, ACCIDENT AND TREATMENT  OCCURRING
   13  PRIOR  TO  AND SUBSEQUENT TO THE TERMINATION DATE, AND SUCH OTHER RIGHTS
   14  OF CERTIFICATE HOLDERS AS MAY EXIST UNDER  THE  CONTRACT  OR  POLICY  OR
   15  PURSUANT TO PARAGRAPH ONE OF SUBSECTION (E) OF THIS SECTION.
   16    (C)  NOTICE  OF TERMINATION OF COVERAGE SHALL BE MAILED BY THE INSURER
   17  TO EACH CERTIFICATE HOLDER'S LAST KNOWN RESIDENTIAL ADDRESS.
   18    S 2. Paragraph 1 of subsection (e) of section 3221  of  the  insurance
   19  law,  as  amended by chapter 306 of the laws of 1987, is amended to read
   20  as follows:
   21    (1) A group policy providing hospital or  surgical  expense  insurance
   22  for other than specific diseases or accident only, shall provide that if
   23  the  insurance  on  an employee or member insured under the group policy
   24  ceases because of termination of (I) employment or of membership in  the
   25  class  or  classes  eligible  for  coverage under the policy or (II) the
   26  policy, for any reason whatsoever, unless the policyholder has  replaced
   27  the group policy with similar and continuous coverage for the same group
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD01536-01-9
       A. 10653                            2
    1  whether  insured  or  self-insured, such employee or member who has been
    2  insured under the group policy for at least three months shall be  enti-
    3  tled to have issued to him by the insurer without evidence of insurabil-
    4  ity  upon  application  made to the insurer within forty-five days after
    5  such termination OF EMPLOYMENT OR MEMBERSHIP IN  THE  CLASS  OR  CLASSES
    6  ELIGIBLE  FOR  COVERAGE  UNDER  THE  POLICY OR WITHIN FORTY-FIVE DAYS OF
    7  NOTIFICATION BY THE INSURANCE CARRIER  TO  THE  EMPLOYEE  OR  MEMBER  OF
    8  TERMINATION  OF  THE  POLICY,  and  payment of the quarterly, or, at the
    9  option of the employee or member, a less frequent premium applicable  to
   10  the  class  of risk to which the person belongs, the age of such person,
   11  and the form and amount of insurance, an individual policy of insurance.
   12  The insurer may, at its option elect to provide the  insurance  coverage
   13  under  a group insurance policy, delivered in this state, in lieu of the
   14  issuance of a converted individual policy of insurance. Such  individual
   15  policy,  or group policy, as the case may be is hereafter referred to as
   16  the converted policy.  The benefits provided under the converted  policy
   17  shall  be  those required by subsection (f), (g), (h) or (i) [hereof] OF
   18  THIS SECTION, whichever is applicable and, in the event  of  termination
   19  of  the  converted  group  policy  of insurance, each insured thereunder
   20  shall have a right of conversion to a  converted  individual  policy  of
   21  insurance.
   22    S 3. This act shall take effect immediately.