Directs the attorney general to be an advocate for health insurance consumers, to assist consumers in choosing among options, provide assistance to enrollees, etc.

2 Co-sponsors

• Ruben Diaz
• Kevin S. Parker

Title of bill

An act to amend the executive law, in relation to the powers and duties of the attorney general with respect to consumers of health insurance

Purpose

To expand public education, counseling and advocacy activities on behalf of New Yorkers in their dealings with health insurers.

Summary of provisions

Section 1. Amends Section 63 of the executive law by adding four new subdivisions, 16, 17, 18, and 19 to expand the authority of the Attorney General: to advocate for health insurance consumers by monitoring consumers' access to comprehensive, accurate information on health insurance coverage options and responding to consumers' complaints about coverage and claims settlement determinations by health insurers; to assist consumers in choosing among health insurance coverage options; to provide counseling and assistance to enrollees dissatisfied with their treatment by health insurers in regard to their coverage and in the filing of complaints and appeals regarding determinations under such coverage; and to investigate instances of improper treatment of enrollees by health insurers and to bring such instances to the attention of the applicable state authority.

Justification

In the rapidly-changing, highly-competitive health care marketplace, consumers need an advocate -- a place to turn for help in understanding the complexities of their health insurance options, and an adviser who can help to navigate the system when it malfunctions and denies individuals the benefits and payments to which they are entitled. Although other State agencies, namely the Departments of Health and Insurance, have responsibilities related to health plans' and health insurers' business activities, consumers need one central entity which will represent their interests alone and will make the system as user-friendly as possible.

Legislative history

03/07/07 REFERRED TO INVESTIGATIONS AND GOVERNMENT OPERATIONS 01/09/08 REFERRED TO INVESTIGATIONS AND GOVERNMENT OPERATIONS

Fiscal implications

Any additional costs to the Attorney General will be subject to annual budget negotiations.

Effective date

This act shall take effect immediately.