Relates to a special enrollment period

Section 1 of the bill also requires assistance eligible individuals that did not elect continuation upon initial eligibility to elect such coverage within 60 days of receiving the notice required by ARRA. Their group administrator (or other involved entity) must provide such individuals with notice of this special enrollment period within 60 days of the date of enactment of ARRA.

Section 1 of the bill further requires continuation coverage elected during the special enrollment period to be effective as of the first coverage period following the enactment of ARRA.

Section 1 of the bill additionally requires the period between the qualifying event which entitled the assistance eligible individual to state continuation coverage and the first date of coverage following the enactment of ARRA to be disregarded for the purposes of determining if a pre-existing condition waiting period is applicable.

Section 2 of the bill amends section Insurance Law § 4304 to extend the same special enrollment period and access to state continuation coverage to workers with state continuation options through group remittance contracts offered by not-for-profit corporations and health maintenance organizations (HMOs).

Section 3 of the bill amends Insurance Law § 430.5 to extend the same special enrollment period and access to state continuation coverage to workers with state continuation options through group contracts offered by not-for-profit corporations and HMO's.

Section 4 of the bill provides that the bill would take effect immediately.

Existing law

Insurance Law § 3221(m) permits individuals covered under group or blanket accident and health insurance policies that are not subject to federal COBRA law to elect to participate in state continuation coverage in the event of job loss. Such individuals must elect state continuation coverage within 60 days following the later of: (1) the event which qualifies them for coverage; or (2) receiving notice of right to elect such coverage.

Insurance Law § 4304(k) sets forth provisions similar to those of Insurance Law § 3221(m), permitting the election of state continuation coverage for individual contracts with a hospital service, health service or medical expense indemnity corporation for which the premiums are paid by a remitting agent of a group.

Insurance Law § 4305(e) sets forth provisions similar to those of Insurance Law § 3221(m), permitting the election of state continuation coverage for group contracts issued by a hospital service, health service or medical expense indemnity corporation.

Insurance Law §§ 3232 and 4318 pertain to pre-existing conditions for individual, group or blanket accident and health insurance policies.

Legislative history

This is a new bill.

Statement in support

The American Recovery and Reinvestment Tax Act of 2009 (ARRA) extended a nine-month subsidy for 65 percent of COBRA health insurance premiums for employees involuntarily terminated from their jobs between September 1, 2008 and December 31, 2009. The subsidy is administered through a payroll tax credit. Income limitations apply, with subsidies phasing out for those with annual incomes over $125,000 (single) or $250,000 (married).

New York State's "mini-COBRA" law requires small employers (with less than twenty employees) that are not impacted by federal COBRA requirements to offer a state continuation benefit. While ARRA extended the 65 percent premium subsidy to state continuation plans, it did not explicitly extend a "special election period" to those covered under state continuation laws. In order for New York to maximize the federal subsidies and ensure that New Yorkers employed by small firms have the same benefit as those who work for large firms, this bill amends the State's continuation law to include a special election period that mirrors the protections ARRA included for federal COBRA plans.

This bill extends a special election period for people laid off between September 1, 2008 and the date ARRA was signed into law (February 17, 2009) who did not elect state continuation benefits when initially eligible, most likely due to its cost. This provides a second opportunity to elect coverage now that federal premium assistance has become available. The group administrator must notify these people of the subsidy option within 60 days of the date ARRA was enacted and they must elect coverage within 60 days of when notice was provided.

The bill also requires the period beginning on the date that the enrollee was involuntarily terminated and ending when the coverage starts to be disregarded for the purpose of determining whether a pre-existing condition exclusion period applies to the state continuation coverage. This extends an additional protection to state continuation Coverage, consistent with the protections ARRA extended to federal COBRA plans. This protection will help those impacted by medical conditions arising prior to the effective date of the newly elected COBRA Coverage.

Budget implications

This bill will have no fiscal impact on the State.

Effective date

This bill would take effect immediately.