Bill Text: NY S05469 | 2009-2010 | General Assembly | Introduced
Bill Title: Relates to the coverage for a dependent child; defines "dependent child" as an unmarried child through age 29 of an employee or member insured under a group contract.
Spectrum: Partisan Bill (Democrat 8-0)
Status: (Introduced - Dead) 2010-01-06 - REFERRED TO INSURANCE [S05469 Detail]
Download: New_York-2009-S05469-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 5469 2009-2010 Regular Sessions I N S E N A T E May 8, 2009 ___________ Introduced by Sens. BRESLIN, DUANE, ESPADA, HASSELL-THOMPSON, ONORATO, STAVISKY, STEWART-COUSINS -- (at request of the Governor) -- 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 coverage of a dependent child THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Section 3221 of the insurance law is amended by adding a 2 new subsection (r) to read as follows: 3 (R)(1) AS USED IN THIS SUBSECTION, "DEPENDENT CHILD" MEANS AN UNMAR- 4 RIED CHILD THROUGH AGE TWENTY-NINE OF AN EMPLOYEE OR MEMBER INSURED 5 UNDER A GROUP CONTRACT, REGARDLESS OF FINANCIAL DEPENDENCE, WHO IS NOT A 6 NAMED INSURED UNDER ANY OTHER GROUP CONTRACT OR GROUP REMITTANCE 7 CONTRACT AND WHO IS NOT ELIGIBLE FOR COVERAGE UNDER TITLE XVIII OF THE 8 UNITED STATES SOCIAL SECURITY ACT (MEDICARE). 9 (2) IN ADDITION TO THE CONVERSION PRIVILEGE AFFORDED BY SUBSECTION (E) 10 OF THIS SECTION AND THE CONTINUATION PRIVILEGE AFFORDED BY SUBSECTION 11 (M) OF THIS SECTION, EVERY GROUP CONTRACT DELIVERED OR ISSUED FOR DELIV- 12 ERY IN THIS STATE THAT PROVIDES HOSPITAL, SURGICAL OR MEDICAL COVERAGE 13 FOR OTHER THAN SPECIFIC DISEASES OR ACCIDENTS ONLY, AND WHICH PROVIDES 14 DEPENDENT COVERAGE THAT TERMINATES AT A SPECIFIED AGE, SHALL, UPON 15 APPLICATION OF THE EMPLOYEE, MEMBER OR DEPENDENT CHILD, AS SET FORTH IN 16 SUBPARAGRAPHS (B) OR (C) OF THIS PARAGRAPH, PROVIDE COVERAGE TO THE 17 DEPENDENT CHILD AFTER THAT SPECIFIED AGE AND THROUGH AGE TWENTY-NINE 18 WITHOUT EVIDENCE OF INSURABILITY, SUBJECT TO ALL OF THE TERMS AND CONDI- 19 TIONS OF THE GROUP CONTRACT AND THE FOLLOWING: 20 (A) AN EMPLOYER SHALL NOT BE REQUIRED TO PAY ALL OR PART OF THE COST 21 OF COVERAGE FOR A DEPENDENT CHILD PROVIDED PURSUANT TO THIS SUBSECTION; EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD12007-02-9 S. 5469 2 1 (B) AN EMPLOYEE, MEMBER OR DEPENDENT CHILD WHO WISHES TO ELECT CONTIN- 2 UATION OF COVERAGE PURSUANT TO THIS SUBSECTION MAY REQUEST THE CONTINUA- 3 TION IN WRITING: 4 (I) WITHIN SIXTY DAYS FOLLOWING THE DATE COVERAGE WOULD OTHERWISE 5 TERMINATE DUE TO REACHING THE SPECIFIED AGE SET FORTH IN THE GROUP 6 CONTRACT; 7 (II) WITHIN SIXTY DAYS AFTER MEETING THE REQUIREMENTS FOR DEPENDENT 8 CHILD STATUS SET FORTH IN PARAGRAPH ONE OF THIS SUBSECTION WHEN COVERAGE 9 FOR THE DEPENDENT CHILD PREVIOUSLY TERMINATED; OR 10 (III) DURING AN ANNUAL THIRTY-DAY OPEN ENROLLMENT PERIOD, AS DESCRIBED 11 IN THE CONTRACT; 12 (C) FOR TWELVE MONTHS AFTER THE INITIAL EFFECTIVE DATE OF THIS 13 SUBSECTION, AN EMPLOYEE, MEMBER OR DEPENDENT CHILD MAY ELECT PROSPECTIVE 14 COVERAGE UNDER THIS SUBSECTION FOR A DEPENDENT CHILD WHOSE COVERAGE 15 TERMINATED UNDER THE TERMS OF THE GROUP CONTRACT PRIOR TO THE INITIAL 16 EFFECTIVE DATE OF THIS SUBSECTION; 17 (D) AN EMPLOYEE, MEMBER OR DEPENDENT CHILD ELECTING CONTINUATION AS 18 DESCRIBED IN THIS SUBSECTION MUST PAY TO THE GROUP CONTRACTHOLDER OR 19 EMPLOYER, BUT NOT MORE FREQUENTLY THAN ON A MONTHLY BASIS IN ADVANCE, 20 THE AMOUNT OF THE REQUIRED PREMIUM PAYMENT ON THE DUE DATE OF EACH 21 PAYMENT. THE WRITTEN ELECTION OF CONTINUATION, TOGETHER WITH THE FIRST 22 PREMIUM PAYMENT REQUIRED TO ESTABLISH PREMIUM PAYMENT ON A MONTHLY BASIS 23 IN ADVANCE, MUST BE GIVEN TO THE GROUP CONTRACTHOLDER OR EMPLOYER WITHIN 24 THE TIME PERIODS SET FORTH IN SUBPARAGRAPHS (B) AND (C) OF THIS PARA- 25 GRAPH. ANY PREMIUM RECEIVED WITHIN THE THIRTY-DAY PERIOD AFTER THE DUE 26 DATE SHALL BE CONSIDERED TIMELY; 27 (E) FOR ANY DEPENDENT CHILD ELECTING COVERAGE WITHIN SIXTY DAYS OF THE 28 DATE THE DEPENDENT CHILD WOULD OTHERWISE LOSE COVERAGE DUE TO REACHING A 29 SPECIFIED AGE, THE EFFECTIVE DATE OF THE CONTINUATION COVERAGE SHALL BE 30 THE DATE COVERAGE WOULD HAVE OTHERWISE TERMINATED. FOR ANY DEPENDENT 31 CHILD ELECTING TO RESUME COVERAGE DURING AN ANNUAL OPEN ENROLLMENT PERI- 32 OD OR DURING THE TWELVE-MONTH INITIAL OPEN ENROLLMENT PERIOD DESCRIBED 33 IN SUBPARAGRAPH (C) OF THIS PARAGRAPH, THE EFFECTIVE DATE OF THE CONTIN- 34 UATION COVERAGE SHALL BE PROSPECTIVE NO LATER THAN THIRTY DAYS AFTER THE 35 ELECTION AND PAYMENT OF FIRST PREMIUM; 36 (F) COVERAGE FOR A DEPENDENT CHILD PURSUANT THIS SUBSECTION SHALL 37 CONSIST OF COVERAGE THAT IS IDENTICAL TO THE COVERAGE PROVIDED TO THE 38 EMPLOYEE OR MEMBER PARENT. IF COVERAGE IS MODIFIED UNDER THE CONTRACT 39 FOR ANY GROUP OF SIMILARLY SITUATED EMPLOYEES OR MEMBERS, THEN THE 40 COVERAGE SHALL ALSO BE MODIFIED IN THE SAME MANNER FOR ANY DEPENDENT 41 CHILD; 42 (G) COVERAGE SHALL TERMINATE ON THE FIRST TO OCCUR OF THE FOLLOWING: 43 (I) THE DATE THE DEPENDENT CHILD NO LONGER MEETS THE REQUIREMENTS OF 44 PARAGRAPH ONE OF THIS SUBSECTION; 45 (II) THE END OF THE PERIOD FOR WHICH PREMIUM PAYMENTS WERE MADE, IF 46 THERE IS A FAILURE TO MAKE A REQUIRED PREMIUM PAYMENT WITHIN THE PERIOD 47 OF GRACE DESCRIBED IN SUBPARAGRAPH (D) OF THIS PARAGRAPH; OR 48 (III) THE DATE ON WHICH THE GROUP CONTRACT IS TERMINATED AND NOT 49 REPLACED BY COVERAGE UNDER ANOTHER GROUP CONTRACT; 50 (H) THE INSURER SHALL PROVIDE WRITTEN NOTIFICATION OF THE CONTINUATION 51 PRIVILEGE DESCRIBED IN THIS SUBSECTION AND THE TIME PERIOD IN WHICH TO 52 REQUEST CONTINUATION TO THE EMPLOYEE OR MEMBER: 53 (I) IN EACH CERTIFICATE OF COVERAGE; 54 (II) AT LEAST SIXTY DAYS PRIOR TO TERMINATION AT THE SPECIFIED AGE AS 55 PROVIDED IN THE CONTRACT; S. 5469 3 1 (III) AT LEAST THIRTY DAYS BEFORE THE ANNUAL OPEN ENROLLMENT PERIOD 2 PERMITTING AN EMPLOYEE, MEMBER OR DEPENDENT CHILD TO MAKE A WRITTEN 3 ELECTION FOR COVERAGE PURSUANT TO SUBPARAGRAPH (B) OF THIS PARAGRAPH; 4 AND 5 (IV) THIRTY DAYS OR LESS FROM THE INITIAL EFFECTIVE DATE OF THIS 6 SUBSECTION, WITH RESPECT TO INFORMATION CONCERNING A DEPENDENT CHILD'S 7 OPPORTUNITY, FOR TWELVE MONTHS AFTER THE EFFECTIVE DATE OF THIS 8 SUBSECTION, TO MAKE A WRITTEN ELECTION TO OBTAIN COVERAGE UNDER A 9 CONTRACT PURSUANT TO SUBPARAGRAPH (C) OF THIS PARAGRAPH; AND 10 (I) NOTWITHSTANDING THE COMMUNITY RATING REQUIREMENTS SET FORTH IN 11 SECTION THREE THOUSAND TWO HUNDRED THIRTY-ONE OF THIS ARTICLE AND 12 SECTION FOUR THOUSAND THREE HUNDRED SEVENTEEN OF THIS CHAPTER, AN INSUR- 13 ER SHALL ESTABLISH A DISTINCT PREMIUM FOR CONTINUATION COVERAGE PROVIDED 14 PURSUANT TO THIS SUBSECTION THAT REFLECTS THE LOWER MORBIDITY OF THE 15 POPULATION ELIGIBLE FOR COVERAGE PURSUANT TO THIS SUBSECTION. 16 (3) AN INSURER SHALL SUBMIT REPORTS, INCLUDING QUARTERLY ENROLLMENT 17 REPORTS AND SUCH OTHER INFORMATION AS THE SUPERINTENDENT MAY REQUIRE, NO 18 LATER THAN THIRTY DAYS FOLLOWING EACH CALENDAR QUARTER, IN A FORM AND 19 MANNER TO BE PRESCRIBED BY THE SUPERINTENDENT. 20 S 2. Section 4304 of the insurance law is amended by adding a new 21 subsection (m) to read as follows: 22 (M)(1) AS USED IN THIS SUBSECTION, "DEPENDENT CHILD" MEANS AN UNMAR- 23 RIED CHILD THROUGH AGE TWENTY-NINE OF AN EMPLOYEE OR MEMBER INSURED 24 UNDER A GROUP REMITTANCE CONTRACT, REGARDLESS OF FINANCIAL DEPENDENCE, 25 WHO IS NOT A NAMED INSURED UNDER ANY OTHER GROUP CONTRACT OR GROUP 26 REMITTANCE CONTRACT AND WHO IS NOT ELIGIBLE FOR COVERAGE UNDER TITLE 27 XVIII OF THE UNITED STATES SOCIAL SECURITY ACT (MEDICARE). 28 (2) IN ADDITION TO THE CONVERSION PRIVILEGE AFFORDED BY SUBSECTION (E) 29 OF THIS SECTION AND THE CONTINUATION PRIVILEGE AFFORDED BY SUBSECTIONS 30 (E) AND (K) OF THIS SECTION, A HOSPITAL SERVICE, HEALTH SERVICE OR 31 MEDICAL EXPENSE CORPORATION OR HEALTH MAINTENANCE ORGANIZATION THAT 32 PROVIDES COVERAGE FOR WHICH THE PREMIUMS ARE PAID BY THE REMITTING AGENT 33 OF A GROUP THAT PROVIDES DEPENDENT COVERAGE THAT TERMINATES AT A SPECI- 34 FIED AGE SHALL, UPON APPLICATION OF THE EMPLOYEE, MEMBER OR DEPENDENT 35 CHILD, AS SET FORTH IN SUBPARAGRAPH (B) OR (C) OF THIS PARAGRAPH, 36 PROVIDE COVERAGE TO THE DEPENDENT CHILD AFTER THAT SPECIFIED AGE AND 37 THROUGH AGE TWENTY-NINE WITHOUT EVIDENCE OF INSURABILITY, SUBJECT TO ALL 38 OF THE TERMS AND CONDITIONS OF THE GROUP REMITTANCE CONTRACT AND THE 39 FOLLOWING: 40 (A) AN EMPLOYER SHALL NOT BE REQUIRED TO PAY ALL OR PART OF THE COST 41 OF COVERAGE FOR A DEPENDENT CHILD PROVIDED PURSUANT TO THIS SUBSECTION; 42 (B) AN EMPLOYEE, MEMBER OR DEPENDENT CHILD WHO WISHES TO ELECT CONTIN- 43 UATION OF COVERAGE PURSUANT TO THIS SUBSECTION MAY REQUEST THE CONTINUA- 44 TION IN WRITING: 45 (I) WITHIN SIXTY DAYS FOLLOWING THE DATE COVERAGE WOULD OTHERWISE 46 TERMINATE DUE TO REACHING THE SPECIFIED AGE SET FORTH IN THE GROUP 47 CONTRACT; 48 (II) WITHIN SIXTY DAYS AFTER MEETING THE REQUIREMENTS FOR DEPENDENT 49 CHILD STATUS SET FORTH IN PARAGRAPH ONE OF THIS SUBSECTION WHEN COVERAGE 50 FOR THE DEPENDENT CHILD PREVIOUSLY TERMINATED; OR 51 (III) DURING AN ANNUAL THIRTY-DAY OPEN ENROLLMENT PERIOD AS DESCRIBED 52 IN THE CONTRACT; 53 (C) FOR TWELVE MONTHS AFTER THE INITIAL EFFECTIVE DATE OF THIS 54 SUBSECTION, AN EMPLOYEE, MEMBER OR DEPENDENT CHILD MAY ELECT PROSPECTIVE 55 CONTINUATION COVERAGE UNDER THIS SUBSECTION FOR A DEPENDENT CHILD WHOSE S. 5469 4 1 COVERAGE TERMINATED UNDER THE TERMS OF THE GROUP REMITTANCE CONTRACT 2 PRIOR TO THE INITIAL EFFECTIVE DATE OF THIS SUBSECTION; 3 (D) AN EMPLOYEE, MEMBER OR DEPENDENT CHILD ELECTING CONTINUATION AS 4 DESCRIBED IN THIS SUBSECTION MUST PAY TO THE GROUP REMITTING AGENT OR 5 EMPLOYER, BUT NOT MORE FREQUENTLY THAN ON A MONTHLY BASIS IN ADVANCE, 6 THE AMOUNT OF THE REQUIRED PREMIUM PAYMENT ON THE DUE DATE OF EACH 7 PAYMENT. THE WRITTEN ELECTION OF CONTINUATION, TOGETHER WITH THE FIRST 8 PREMIUM PAYMENT REQUIRED TO ESTABLISH PREMIUM PAYMENT ON A MONTHLY BASIS 9 IN ADVANCE, MUST BE GIVEN TO THE GROUP REMITTING AGENT OR EMPLOYER WITH- 10 IN THE TIME PERIODS SET FORTH IN SUBPARAGRAPHS (B) AND (C) OF THIS PARA- 11 GRAPH. ANY PREMIUM RECEIVED WITHIN THE THIRTY-DAY PERIOD AFTER THE DUE 12 DATE SHALL BE CONSIDERED TIMELY; 13 (E) FOR ANY DEPENDENT CHILD ELECTING COVERAGE WITHIN SIXTY DAYS OF THE 14 DATE THE DEPENDENT CHILD WOULD OTHERWISE LOSE COVERAGE DUE TO REACHING A 15 SPECIFIED AGE, THE EFFECTIVE DATE OF THE CONTINUATION COVERAGE SHALL BE 16 THE DATE COVERAGE WOULD HAVE OTHERWISE TERMINATED. FOR ANY DEPENDENT 17 CHILD ELECTING TO RESUME COVERAGE DURING AN ANNUAL OPEN ENROLLMENT PERI- 18 OD OR DURING THE TWELVE-MONTH INITIAL OPEN ENROLLMENT PERIOD DESCRIBED 19 IN SUBPARAGRAPH (C) OF THIS PARAGRAPH, THE EFFECTIVE DATE OF THE CONTIN- 20 UATION COVERAGE SHALL BE PROSPECTIVE NO LATER THAN THIRTY DAYS AFTER THE 21 ELECTION AND PAYMENT OF FIRST PREMIUM; 22 (F) COVERAGE FOR A DEPENDENT CHILD PURSUANT TO THIS SUBSECTION SHALL 23 CONSIST OF COVERAGE THAT IS IDENTICAL TO THE COVERAGE PROVIDED TO THE 24 EMPLOYEE OR MEMBER PARENT. IF COVERAGE IS MODIFIED UNDER THE CONTRACT 25 FOR ANY GROUP OF SIMILARLY SITUATED EMPLOYEES OR MEMBERS, THEN THE 26 COVERAGE SHALL ALSO BE MODIFIED IN THE SAME MANNER FOR ANY DEPENDENT 27 CHILD; 28 (G) COVERAGE SHALL TERMINATE ON THE FIRST TO OCCUR OF THE FOLLOWING: 29 (I) THE DATE THE DEPENDENT CHILD NO LONGER MEETS THE REQUIREMENTS OF 30 PARAGRAPH ONE OF THIS SUBSECTION; 31 (II) THE END OF THE PERIOD FOR WHICH PREMIUM PAYMENTS WERE MADE, IF 32 THERE IS A FAILURE TO MAKE PAYMENT OF A REQUIRED PREMIUM PAYMENT WITHIN 33 THE PERIOD OF GRACE DESCRIBED IN SUBPARAGRAPH (D) OF THIS PARAGRAPH; OR 34 (III) THE DATE ON WHICH THE GROUP REMITTANCE CONTRACT IS TERMINATED 35 AND NOT REPLACED BY COVERAGE UNDER ANOTHER GROUP REMITTANCE CONTRACT. 36 (H) THE CORPORATION OR HEALTH MAINTENANCE ORGANIZATION SHALL PROVIDE 37 WRITTEN NOTIFICATION OF THE CONTINUATION PRIVILEGE DESCRIBED IN THIS 38 SUBSECTION AND THE TIME PERIOD IN WHICH TO REQUEST CONTINUATION TO THE 39 EMPLOYEE OR MEMBER: 40 (I) IN EACH CERTIFICATE OF COVERAGE; 41 (II) AT LEAST SIXTY DAYS PRIOR TO TERMINATION AT THE SPECIFIED AGE AS 42 PROVIDED IN THE CONTRACT; 43 (III) AT LEAST THIRTY DAYS BEFORE THE ANNUAL OPEN ENROLLMENT PERIOD 44 PERMITTING AN EMPLOYEE, MEMBER OR DEPENDENT CHILD TO MAKE A WRITTEN 45 ELECTION FOR COVERAGE PURSUANT TO SUBPARAGRAPH (B) OF THIS PARAGRAPH; 46 AND 47 (IV) THIRTY DAYS OR LESS FROM THE INITIAL EFFECTIVE DATE OF THIS 48 SUBSECTION, WITH RESPECT TO INFORMATION CONCERNING A DEPENDENT CHILD'S 49 OPPORTUNITY, FOR TWELVE MONTHS AFTER THE EFFECTIVE DATE OF THIS 50 SUBSECTION, TO MAKE A WRITTEN ELECTION TO OBTAIN COVERAGE UNDER A 51 CONTRACT PURSUANT TO SUBPARAGRAPH (C) OF THIS PARAGRAPH; AND 52 (I) NOTWITHSTANDING THE COMMUNITY RATING REQUIREMENTS SET FORTH IN 53 SECTION THREE THOUSAND TWO HUNDRED THIRTY-ONE OF THIS CHAPTER AND 54 SECTION FOUR THOUSAND THREE HUNDRED SEVENTEEN OF THIS ARTICLE, A CORPO- 55 RATION OR HEALTH MAINTENANCE ORGANIZATION SHALL ESTABLISH A DISTINCT 56 PREMIUM FOR CONTINUATION COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION S. 5469 5 1 THAT REFLECTS THE LOWER MORBIDITY OF THE POPULATION ELIGIBLE FOR COVER- 2 AGE PURSUANT TO THIS SUBSECTION. 3 (3) A CORPORATION OR HEALTH MAINTENANCE ORGANIZATION SHALL SUBMIT 4 REPORTS, INCLUDING QUARTERLY ENROLLMENT REPORTS AND SUCH OTHER INFORMA- 5 TION AS THE SUPERINTENDENT MAY REQUIRE, NO LATER THAN THIRTY DAYS 6 FOLLOWING EACH CALENDAR QUARTER, IN A FORM AND MANNER TO BE PRESCRIBED 7 BY THE SUPERINTENDENT. 8 S 3. Section 4305 of the insurance law is amended by adding a new 9 subsection (l) to read as follows: 10 (L)(1) AS USED IN THIS SUBSECTION, "DEPENDENT CHILD" MEANS AN UNMAR- 11 RIED CHILD THROUGH AGE TWENTY-NINE OF AN EMPLOYEE OR MEMBER INSURED 12 UNDER A GROUP CONTRACT, REGARDLESS OF FINANCIAL DEPENDENCE, WHO IS NOT A 13 NAMED INSURED UNDER ANY OTHER GROUP CONTRACT OR GROUP REMITTANCE 14 CONTRACT AND WHO IS NOT ELIGIBLE FOR COVERAGE UNDER TITLE XVIII OF THE 15 UNITED STATES SOCIAL SECURITY ACT (MEDICARE). 16 (2) IN ADDITION TO THE CONVERSION PRIVILEGE AFFORDED BY SUBSECTION (D) 17 OF THIS SECTION AND THE CONTINUATION PRIVILEGE AFFORDED BY SUBSECTION 18 (E) OF THIS SECTION, A HOSPITAL SERVICE, HEALTH SERVICE OR MEDICAL 19 EXPENSE CORPORATION OR HEALTH MAINTENANCE ORGANIZATION THAT PROVIDES 20 GROUP COVERAGE UNDER WHICH DEPENDENT COVERAGE TERMINATES AT A SPECIFIED 21 AGE SHALL, UPON APPLICATION OF THE EMPLOYEE, MEMBER OR DEPENDENT CHILD, 22 AS SET FORTH IN SUBPARAGRAPH (B) OR (C) OF THIS PARAGRAPH, PROVIDE 23 COVERAGE TO THE DEPENDENT CHILD AFTER THAT SPECIFIED AGE AND THROUGH AGE 24 TWENTY-NINE WITHOUT EVIDENCE OF INSURABILITY, SUBJECT TO ALL OF THE 25 TERMS AND CONDITIONS OF THE GROUP CONTRACT AND THE FOLLOWING: 26 (A) AN EMPLOYER SHALL NOT BE REQUIRED TO PAY ALL OR PART OF THE COST 27 OF COVERAGE FOR A DEPENDENT CHILD PROVIDED PURSUANT TO THIS SUBSECTION; 28 (B) AN EMPLOYEE, MEMBER OR DEPENDENT CHILD WHO WISHES TO ELECT CONTIN- 29 UATION OF COVERAGE PURSUANT TO THIS SUBSECTION MAY REQUEST THE CONTINUA- 30 TION IN WRITING: 31 (I) WITHIN SIXTY DAYS FOLLOWING THE DATE COVERAGE WOULD OTHERWISE 32 TERMINATE DUE TO REACHING THE SPECIFIED AGE SET FORTH IN THE GROUP 33 CONTRACT; 34 (II) WITHIN SIXTY DAYS AFTER MEETING THE REQUIREMENTS FOR DEPENDENT 35 CHILD STATUS SET FORTH IN PARAGRAPH ONE OF THIS SUBSECTION WHEN COVERAGE 36 FOR THE DEPENDENT CHILD PREVIOUSLY TERMINATED; OR 37 (III) DURING AN ANNUAL THIRTY-DAY OPEN ENROLLMENT PERIOD, AS DESCRIBED 38 IN THE CONTRACT; 39 (C) FOR TWELVE MONTHS AFTER THE INITIAL EFFECTIVE DATE OF THIS 40 SUBSECTION, AN EMPLOYEE, MEMBER OR DEPENDENT CHILD MAY ELECT PROSPECTIVE 41 CONTINUATION COVERAGE UNDER THIS SUBSECTION FOR A DEPENDENT CHILD WHOSE 42 COVERAGE TERMINATED UNDER THE TERMS OF THE GROUP CONTACT PRIOR TO THE 43 INITIAL EFFECTIVE DATE OF THIS SUBSECTION; 44 (D) AN EMPLOYEE, MEMBER OR DEPENDENT CHILD ELECTING CONTINUATION AS 45 DESCRIBED IN THIS SUBSECTION MUST PAY TO THE GROUP CONTRACTHOLDER OR 46 EMPLOYER, BUT NOT MORE FREQUENTLY THAN ON A MONTHLY BASIS IN ADVANCE, 47 THE AMOUNT OF THE REQUIRED PREMIUM PAYMENT ON THE DUE DATE OF EACH 48 PAYMENT. THE WRITTEN ELECTION OF CONTINUATION, TOGETHER WITH THE FIRST 49 PREMIUM PAYMENT REQUIRED TO ESTABLISH PREMIUM PAYMENT ON A MONTHLY BASIS 50 IN ADVANCE, MUST BE GIVEN TO THE GROUP CONTRACTHOLDER OR EMPLOYER WITHIN 51 THE TIME PERIODS SET FORTH IN SUBPARAGRAPHS (B) AND (C) OF THIS PARA- 52 GRAPH. ANY PREMIUM RECEIVED WITHIN THE THIRTY-DAY PERIOD AFTER THE DUE 53 DATE SHALL BE CONSIDERED TIMELY; 54 (E) FOR ANY DEPENDENT CHILD ELECTING COVERAGE WITHIN SIXTY DAYS OF THE 55 DATE THE DEPENDENT CHILD WOULD OTHERWISE LOSE COVERAGE DUE TO REACHING A 56 SPECIFIED AGE, THE EFFECTIVE DATE OF THE CONTINUATION COVERAGE SHALL BE S. 5469 6 1 THE DATE COVERAGE WOULD HAVE OTHERWISE TERMINATED. FOR ANY DEPENDENT 2 CHILD ELECTING TO RESUME COVERAGE DURING AN ANNUAL OPEN ENROLLMENT PERI- 3 OD OR DURING THE TWELVE-MONTH INITIAL OPEN ENROLLMENT PERIOD DESCRIBED 4 IN SUBPARAGRAPH (C) OF THIS PARAGRAPH, THE EFFECTIVE DATE OF THE CONTIN- 5 UATION COVERAGE SHALL BE PROSPECTIVE NO LATER THAN THIRTY DAYS AFTER THE 6 ELECTION AND PAYMENT OF FIRST PREMIUM; 7 (F) COVERAGE FOR A DEPENDENT CHILD PURSUANT TO THIS SUBSECTION SHALL 8 CONSIST OF COVERAGE THAT IS IDENTICAL TO THE COVERAGE PROVIDED TO THE 9 EMPLOYEE OR MEMBER PARENT. IF COVERAGE IS MODIFIED UNDER THE CONTRACT 10 FOR ANY GROUP OF SIMILARLY SITUATED EMPLOYEES OR MEMBERS, THEN THE 11 COVERAGE SHALL ALSO BE MODIFIED IN THE SAME MANNER FOR ANY DEPENDENT 12 CHILD; 13 (G) COVERAGE SHALL TERMINATE ON THE FIRST TO OCCUR OF THE FOLLOWING: 14 (I) THE DATE THE DEPENDENT CHILD NO LONGER MEETS THE REQUIREMENTS OF 15 PARAGRAPH ONE OF THIS SUBSECTION; 16 (II) THE END OF THE PERIOD FOR WHICH PREMIUM PAYMENTS WERE MADE, IF 17 THERE IS A FAILURE TO MAKE PAYMENT OF A REQUIRED PREMIUM PAYMENT WITHIN 18 THE PERIOD OF GRACE DESCRIBED IN SUBPARAGRAPH (D) OF THIS PARAGRAPH; OR 19 (III) THE DATE ON WHICH THE GROUP CONTRACT IS TERMINATED AND NOT 20 REPLACED BY COVERAGE UNDER ANOTHER GROUP CONTRACT; 21 (H) THE CORPORATION OR HEALTH MAINTENANCE ORGANIZATION SHALL PROVIDE 22 WRITTEN NOTIFICATION OF THE CONTINUATION PRIVILEGE DESCRIBED IN THIS 23 SUBSECTION AND THE TIME PERIOD IN WHICH TO REQUEST CONTINUATION TO THE 24 EMPLOYEE OR MEMBER: 25 (I) IN EACH CERTIFICATE OF COVERAGE; 26 (II) AT LEAST SIXTY DAYS PRIOR TO TERMINATION AT THE SPECIFIED AGE AS 27 PROVIDED IN THE CONTRACT; 28 (III) AT LEAST THIRTY DAYS BEFORE THE ANNUAL OPEN ENROLLMENT PERIOD 29 PERMITTING AN EMPLOYEE, MEMBER OR DEPENDENT CHILD TO MAKE A WRITTEN 30 ELECTION FOR COVERAGE PURSUANT TO SUBPARAGRAPH (B) OF THIS PARAGRAPH; 31 AND 32 (IV) THIRTY DAYS OR LESS FROM THE INITIAL EFFECTIVE DATE OF THIS 33 SUBSECTION, WITH RESPECT TO INFORMATION CONCERNING A DEPENDENT CHILD'S 34 OPPORTUNITY, FOR TWELVE MONTHS AFTER THE EFFECTIVE DATE OF THIS 35 SUBSECTION, TO MAKE A WRITTEN ELECTION TO OBTAIN COVERAGE UNDER A 36 CONTRACT PURSUANT TO SUBPARAGRAPH (C) OF THIS PARAGRAPH; AND 37 (I) NOTWITHSTANDING THE COMMUNITY RATING REQUIREMENTS SET FORTH IN 38 SECTION THREE THOUSAND TWO HUNDRED THIRTY-ONE OF THIS CHAPTER AND 39 SECTION FOUR THOUSAND THREE HUNDRED SEVENTEEN OF THIS ARTICLE, A CORPO- 40 RATION OR HEALTH MAINTENANCE ORGANIZATION SHALL ESTABLISH A DISTINCT 41 PREMIUM FOR CONTINUATION COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION 42 THAT REFLECTS THE LOWER MORBIDITY OF THE POPULATION ELIGIBLE FOR COVER- 43 AGE PURSUANT TO THIS SUBSECTION. 44 (3) A CORPORATION OR HEALTH MAINTENANCE ORGANIZATION SHALL SUBMIT 45 REPORTS, INCLUDING QUARTERLY ENROLLMENT REPORTS AND SUCH OTHER INFORMA- 46 TION AS THE SUPERINTENDENT MAY REQUIRE, NO LATER THAN THIRTY DAYS 47 FOLLOWING EACH CALENDAR QUARTER, IN A FORM AND MANNER TO BE PRESCRIBED 48 BY THE SUPERINTENDENT. 49 S 4. This act shall take effect July 1, 2009 and shall apply to 50 contracts issued, renewed, modified, altered or amended on or after such 51 date.