Authorizes the purchase of coverage under family health plus by voluntary employee benefit associations

1 Co-sponsor

• Susan John

BILL NUMBER:A9033

Title of bill

An act to amend the social services law, in relation to the purchase of coverage under family health plus by voluntary employee benefit associ- ations

Purpose

This bill authorizes voluntary employee benefit associations (VEBAs) throughout the State to "buy in" to Family Health Plus, allowing them to purchase Family Health Plus coverage for their members regardless of income eligibility.

Summary of provisions

Section 1 of the bill amends Social Services Law (SSL) § 369-ff to permit voluntary employee benefit associations (VEBAs) to "buy in" to Family Health Plus, regardless of income eligibility.

Section 2 of the bill provides that the bill would take effect imme- diately.

Existing law

SSL § 369-ee established the Family Health Plus program to provide comprehensive health care insurance for uninsured persons who have too much income or resources to qualify for Medicaid.

SSL § 369-ff authorizes employers and Taft-Hartley funds to "buy in" to Family Health Plus. Employers and Taft-Hartley funds are permitted to offer Family Health Plus to all employees or members, regardless of income eligibility. The employer/Taft-Hartley fund is responsible for payment of at least 70 percent of the premium, and the employee or member is responsible for the balance of the premium. For those employ- ees or members who are eligible for Family Health Plus, Child Health Plus or Medicaid, the State will pay for the employee's share of the premium through the Premium Assistance Program. The Commissioner of Health is authorized to subsidize the employer's or Taft-Hartley fund's share of the premium under specific conditions.

SSL § 369-ff also: (1) exempts individuals enrolled in the program in this manner from crowd-out provisions; (2) makes plans offered in this way community rated; (3) allows the Commissioner of Health (Commission- er) to require Family Health Plus plans to cover all benefits provided for in Child Health Plus for children under the age of 21; (4) directs employers/Taft-Hartley funds who choose to participate in the plan to provide information to all employees or members about employer sponsored health insurance or premium assistance; and (5) permits the Commissioner or the Commissioner's designee to act as a health plan coordinator to facilitate the offering of multiple health plans.

Public Health Law § 2511 (18) establishes a Premium Assistance Program to assist beneficiaries with the purchase of coverage that includes coverage of a child under Child Health Plus, Family Health Plus and Medicaid.

Statement in support

In 2007, the State enacted SSL § 369-ff to permit employers and Taft- Hartley funds that offer health coverage to "buy-in" to Family Health Plus, allowing workers to participate in employment-based health cover- age. This bill extends the ability to "buy-in" to Family Health Plus to a voluntary employee benefit association (VEBA) established in accord- ance with the requirements of § 501(c)(9) of the federal Internal Reven- ue Code.

Authorizing VEBAs to "buy-in" to Family Health Plus permits their members to receive traditional public health coverage, with the VEBA and the employee sharing the costs. This will make group health insurance coverage accessible to individuals who are currently uninsured, and in many instances may make it more affordable.

Legislative history

This is a new proposal.

Budget implications

This bill will not have any fiscal impact to the State in fiscal year 2009-10.

Effective date

The bill would be effective immediately.