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History
- Referred to insurance
- Referred to insurance
Full text
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Title of bill
An act to amend the insurance law and the public health law, in relation to requiring the insurance department to hold public hearings prior to approving the merger of certain health insurers
Purpose
This bill requires that the Insurance Department conduct a public hearing before approving certain mergers of large health insurers.
Summary of provisions
Section 1: Adds Insurance Law section 3240 to require that certain large health insurers covered or regulated by Article 32 that merge with other health insurers or Health Maintenance Organizations (HMOs) need to comply with the public hearing requirements provided for in new bill section 7104-a.
Section 2: Adds Insurance Law section 4328 to require that certain large health insurers covered or regulated by Article 43 that merge with other large health insurers or HMOs need to comply with the public hearing requirements provided for in new bill section 7104-a.
Section 3: Adds Insurance Law section 7104-a which requires that certain mergers of large health insurers can only be approved after a public hearing is conducted by the Insurance Department. Further, that mergers shall be approved only after the criteria contained in this section has been satisfied. A public hearing would be required if the aggregate gross premium value of each insurer in the merger has over $200,000,000 in gross premium value or if one health insurer has gross premium value in excess of $350,000,00 and the other has over $100,000,000.
The bill provides for time frames when a public hearing must be held and when a final decision on the merger approval must be issued. The standards that the Insurance Department must used in granting a merger approval are as follows:
- would the merger inordinately affect patient's access to health care services.
- would the merger inordinately affect a health care provider's ability to negotiate with the merged health insurance because such new insurer has a near monopoly in the service market area.
- does the merger address premium rate increases or rate stabilization.
- does the merger destabilize the health insurance market.
- does the merged insurer have inordinate market share in a sizable area of the State.
Section 4: Adds Public Health Law section 4415 to require HMOs covered by Article 44 that merge with other health insurers can only merge after a public hearing is conducted by the Insurance Department.
Existing law
None.
Justification
This bill will ensure that the mergers of large health insurers can only occur after the Insurance Department has conducted a public hearing to obtain public comment on such a merger. Further, it establishes a set of criteria that should be used in granting or denying any application for such a merger.
Legislative history
S.2983 of 2007/2008
Fiscal implications
None.
Local fiscal implications
None.
Effective date
On January 1st after such bill shall have become law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.