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- Referred to insurance
- Referred to insurance
Full text
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Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to requiring accident and health insurers and non-profit health plans to provide coverage of unmarried children until age twenty-six and directing the superintendent of insurance to order a study thereof; and providing for the repeal of such provisions upon expiration thereof
Purpose
This bill requires that health insurers must offer to families covered by such insurers the ability to include their unmarried dependent children under the age of 26. While insurers under this bill must offer this new coverage, this coverage will be offered through a contract rider so that the only insureds that accept the terms of such rider will receive its benefits and pay for its cost. In addition, for employers that purchase such rider, they may share the cost of such rider with those employees that wish to obtain the benefits of this new dependent care rider.
Summary of provisions
Sections 1 and 2: Amends Insurance Law section 3216 to require that health insurers that offer individual accident and health insurance policies must offer to their policyholders the ability to include their children after reaching the age of20 until such child becomes 26. Under this bill, an insurer must allow a family to keep covering that family's dependent children until the age of 26. Any family that continues coverage of an unemancipated child up to the age of 26 would need to pay an additional charge for such coverage either in the family rate or by a insurance contract rider. This provision would not alter the benefits that certain children up to the age of 23 currently receive if they are in college or those dependent children who are incapable of self-sustaining employment due to mental illness. Those employers that provide health insurance for their employees can enter into separate premium cost sharing arrangements for those employees that wish to have this new dependent care rider for their unemancipated children. Sections 3 and 4: Amends Insurance Law section 3221 to require that insurers that offer small group health insurance must offer families the option to continue to provide coverage to unemancipated children under the age of26. As stated above, this provision does not mean that all small group policies must contain this expanded benefit for dependent children up to the age of 26 as is currently the case for college students up to age 23 or for dependent children who are incapable of self-sustaining employment due to mental illness. It simply means that insurers must offer the coverage and policy holders that accept such offer must pay for the cost of this new policy rider. Further, the insurer could require increased premiums by altering the family premium rate or by assessing a separate insurance contract rider premium rate.
Read the full memo (1,089 words)
Section 5 and 6: Adds a new Insurance Law section 4302-a and amends section 4304 to mandate that Article 43 health insurers must offer the same dependent care coverage as provided in Article 32 to include children under the age of 26 under a family policy or via a policy rider.
Section 7: Adds Insurance Law section 214 to have the Superintendent of Insurance conduct a study of the utilization trends and experience and rate and premium impact to health insurance consumers of the additional insurance coverage of dependent care provided for under this bill. This study must be conducted by September 1, 2011 so that the state Legislature has ample time to review this report and use it in its deliberations to extend the provisions of this act which sunset on December 31, 2012.
Section 8: This bill sunsets on December 31, 2012.
Existing law
Under current law, an unemancipated child over the age of 19 must be dropped from a family's health insurance coverage unless such child is in college or is incapable of self-sustaining employment.
Justification
Under current law, certain unemancipated child are allowed to retain health insurance coverage under their family's plan. This includes college students until reaching the age of 23. It seems unfair that an unemancipated child living at home who instead of going to college seeks employment cannot be covered by the same family health insurance policy. The institution of community rating in assigning health insurance premiums encouraged younger and healthier persons to drop their coverage because they were paying the same rate as older persons, healthier.
Enacting this bill should encourage younger people to retain health insurance coverage and get them use to the idea they need such coverage and derive benefits by retaining this coverage. Once a child is dropped from coverage, it is much more difficult to entice such a person to regain health insurance unless it is offered by an employer. More and more, employers are no longer offering health insurance benefits to its employees, so there is a diminishing ability for persons between the age of 19 and under 26 to secure health insurance benefits.
The idea for this bill came from the work of the Task Force on the Future of Health Insurance created by the Commonwealth Fund. That Task Force issued a report entitled "Job-Based Health Insurance in the Balance: Employer Views of Coverage in the Work Place" dated March 2004.
There is a growing trend to requiring insurers to offer extended coverage for dependent children under an individual's family policy. Currently, 18 states have enacted similar bills that either require insurers to provide coverage for dependent children up to pages as old as 30 years old. This bill is more modest in its scope because each insured that accepts this added coverage must pay an additional premium rider cost. The states that have adopted this extended dependent child coverage are New Jersey, Colorado, Connecticut, Delaware, Idaho, Indiana, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Mexico, Rhode Island, South Dakota, Texas, Utah, West Virginia, and Washington.
Legislative history
The previously un-amended Senate Bill 575 which allowed insurers to offer coverage, but did not mandate them to do so became law under a Budget Bill, Chapter 58 of the Laws of 2007, Part A, sections 65-d and 65-e.
Fiscal implications
Encouraging more dependent children to retain health insurance coverage under their family plans may reduce uncompensated care that is provided for at our State's hospitals.
Local fiscal implications
None. EFFECTIVE DATE : On the January 1st next succeeding this bills enactment and shall apply to all policies issued, renewed or amended after such date. Such law would sunset on December 31, 2013.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.