Bill Text: NY S02268 | 2015-2016 | General Assembly | Introduced
Bill Title: Authorizes an insured to designate a third party to receive cancellation notification.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2016-11-14 - SIGNED CHAP.424 [S02268 Detail]
Download: New_York-2015-S02268-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 2268 2015-2016 Regular Sessions I N S E N A T E January 22, 2015 ___________ Introduced by Sen. GOLDEN -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to the designation of third parties to receive notification of cancellation THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Paragraph 6 of subsection (b) of section 1117 of the insur- 2 ance law, as added by chapter 572 of the laws of 2008, is amended to 3 read as follows: 4 (6) prior to the earlier of the execution of a policy or certificate 5 in connection with a plan providing a home care benefit and/or a nursing 6 home benefit, or the payment of any premium or fee related to such a 7 policy or certificate, the authorized insurer, corporation, health main- 8 tenance organization or fraternal benefit society shall provide the 9 prospective insured or his or her representative with a disclosure 10 statement, which contains the following: 11 (A) The maximum daily and lifetime benefit levels, if applicable, 12 provided by the policy or certificate for home care services and nursing 13 home services; 14 (B) The percentage of coverage provided for home care services and 15 nursing home services, if applicable, and an explanation of the method- 16 ology on which the reasonable charge used in conjunction with such 17 percentage amount is based; 18 (C) A description of any inflation protection feature included in or 19 available for purchase under the policy or certificate and the addi- 20 tional premium required to purchase such option or options; 21 (D) (i) If available and accessible by the insurer or other entity 22 from the department of health, the most recently-published average, 23 statewide rate for care in a nursing home, as well as the average rates 24 for care in nursing homes for both the New York city-metropolitan and 25 upstate regions of the state; or EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00936-01-5 S. 2268 2 1 (ii) If available and accessible by the insurer or other entity from 2 the department of health, the most recently-published map of the esti- 3 mated average regional rates in New York state for nursing home care; 4 [and] 5 (E) A graphic demonstration of the maximum daily nursing home benefit 6 level provided by the policy or certificate, and the impact that the 7 selection of any inflation protection options would have on such maximum 8 daily nursing home benefit level[.]; AND 9 (F) THE RIGHT OF THE PROSPECTIVE INSURED, UPON ATTAINING THE AGE OF 10 SIXTY-FIVE YEARS, TO DESIGNATE A THIRD PARTY WHO WILL RECEIVE A COPY OF 11 ANY NOTICES OF NONPAYMENT OF PREMIUMS DUE OR NOTICE OF CANCELLATION FOR 12 NONPAYMENT OF PREMIUMS THAT IS SENT TO THE PROSPECTIVE INSURED. 13 For the purpose of this paragraph, "home care services" shall have the 14 same meaning as defined in subdivision one of section thirty-six hundred 15 two of the public health law. The prospective insured, or his or her 16 representative, shall acknowledge that the required disclosure has been 17 made by signing the disclosure statement prior to or contemporaneously 18 with the effective date of the policy or certificate. 19 Failure to provide information required by subparagraph (D) of this 20 paragraph shall not be construed as a violation of this section if such 21 information has not been made available by the department of health. 22 S 2. Subsection (e) of section 3111 of the insurance law, as added by 23 section 30 of part B of chapter 58 of the laws of 2004, is amended to 24 read as follows: 25 (e) Every insurer that has in force a long-term care insurance policy 26 as defined in section one thousand one hundred seventeen of this chapter 27 the premiums for which are paid directly to the insurer by the senior 28 citizen insured, except a policy that qualifies as a long-term care 29 insurance contract as defined in Section 7702B of the Internal Revenue 30 Code, shall permit senior citizen insureds to designate a third party to 31 whom the insurer shall transmit notices of nonpayment of premiums due or 32 notice of cancellation for nonpayment of premiums[, as determined by the 33 insurer]; PROVIDED THAT NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM 34 SHALL BE SENT NO LATER THAN THIRTY DAYS BEFORE THE EFFECTIVE DATE OF 35 SUCH CANCELLATION. The senior [citizens] CITIZEN INSURED shall notify 36 the insurer that a third party has been so designated. Such notification 37 shall be delivered to the insurer EITHER IN THE SAME ENVELOPE AS THE 38 SENIOR CITIZEN INSURED'S PREMIUM PAYMENT OR by certified mail, return 39 receipt requested, and shall be effective not later than ten business 40 days from the date of receipt by the insurer. The notification must 41 contain, in writing, an acceptance by the third party designee to 42 receive such notices of cancellation. Should the third party designee 43 desire to terminate his or her status as a third party designee, such 44 designee shall provide written notice to both the insurer and the senior 45 citizen insured. Should the senior citizen insured desire to terminate 46 the third party designation, the insured shall provide written notice to 47 the insurer. The transmission to the third party designee of any such 48 notice of cancellation shall be in addition to a copy of such document 49 transmitted to the senior citizen insured and when a third party is so 50 designated all such notices shall be mailed in an envelope clearly 51 marked on its face with the following: "IMPORTANT INSURANCE POLICY 52 INFORMATION: OPEN IMMEDIATELY". Designation as a third party shall not 53 constitute acceptance of any liability on the third party for services 54 provided to such senior citizen. The insurer shall notify its senior 55 citizen insureds NOT LESS THAN annually in writing of the availability 56 of the third party designee notice procedure and provide information on S. 2268 3 1 how the insured can commence this procedure[; however, such notice need 2 not be provided once a senior citizen has made a designation]. IF A 3 SENIOR CITIZEN INSURED HAS NOT MADE A THIRD PARTY DESIGNATION, THE 4 INSURER SHALL INCLUDE A COPY OF THE THIRD PARTY DESIGNATION FORM WITH 5 EACH PREMIUM STATEMENT SENT TO THE SENIOR CITIZEN INSURED. IF A SENIOR 6 CITIZEN INSURED HAS MADE A DESIGNATION, THE INSURER SHALL CONFIRM WITH 7 THE SENIOR CITIZEN INSURED THAT THE THIRD PARTY DESIGNEE'S CONTACT 8 INFORMATION IS CORRECT. UPON RECEIPT OF A DESIGNATION OR TERMINATION OF 9 A DESIGNATION, THE INSURER SHALL VERIFY THE DESIGNATION OR CANCELLATION 10 OF DESIGNATION WITH THE SENIOR CITIZEN INSURED. SUCH VERIFICATION MAY, 11 BUT IS NOT REQUIRED TO BE, WRITTEN AND THE INSURER MAY USE TELEPHONY TO 12 OBTAIN AN ORAL CONFIRMATION FROM THE SENIOR CITIZEN INSURED SO LONG AS 13 THE INSURER PROVIDES THE SENIOR CITIZEN INSURED WITH WRITTEN CONFIRMA- 14 TION OF THE ORAL VERIFICATION. 15 S 3. This act shall take effect on the sixtieth day after it shall 16 have become a law.