Bill Text: NY S05145 | 2019-2020 | General Assembly | Introduced

---

Bill Title: Relates to the designation of an independent consumer assistance program.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Engrossed - Dead) 2020-12-28 - COMMITTED TO RULES [S05145 Detail]

Download: New_York-2019-S05145-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________
                                          5145
                               2019-2020 Regular Sessions
                    IN SENATE
                                     April 11, 2019
                                       ___________
        Introduced  by  Sen.  RIVERA -- 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  an
          independent consumer assistance program
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. The insurance law is amended by adding a new section 211 to
     2  read as follows:
     3    § 211. Independent consumer assistance program. The superintendent, in
     4  consultation with the commissioner of health, shall designate  an  inde-
     5  pendent consumer assistance program that will have the following duties:
     6    (a) The independent consumer assistance program shall:
     7    (1)  assist  consumers  with  the  filing  of  complaints and appeals,
     8  including filing appeals with the internal appeal or  grievance  process
     9  of  the  group  health  plans  or  health insurance issuers involved and
    10  providing information about and assisting consumers  with  the  external
    11  appeals and administrative hearing process;
    12    (2) collect, track, and quantify problems and inquiries encountered by
    13  consumers;
    14    (3)  educate  consumers  on  their  rights  and  responsibilities with
    15  respect to group health plans and health insurance coverage;
    16    (4) assist consumers with enrollment in a group health plan or  health
    17  insurance coverage by providing information, referral, and assistance;
    18    (5)  resolve problems with obtaining premium tax credits under section
    19  36B of the Internal Revenue Code of 1986;
    20    (6) assist consumers with disputes eligible for resolution under arti-
    21  cle six of the financial services law;
    22    (7) assist uninsured, insured, or underinsured consumers in  accessing
    23  appropriate  health  care services, hospital financial assistance or the
    24  resolution of their health care bills; and
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11109-01-9
        S. 5145                             2
     1    (8) provide assistance to health consumers on any  additional  matters
     2  related to accessing health insurance coverage and health care services.
     3    (b)  All  New  York  state regulated health plans shall be required to
     4  list the name, phone number, address and email of the state  independent
     5  consumer assistance programs on notices to consumers of adverse determi-
     6  nations  and  explanation  of  benefits and in the subscriber agreement,
     7  member handbook and any additional consumer facing materials  as  deter-
     8  mined by the superintendent and the commissioner of health.
     9    § 2. This act shall take effect immediately.