Authorizes superintendent of insurance to approve a demonstration program where an eligible insurer issues group health insurance policies to eligible associations

1 Co-sponsor

• Thomas K. Duane

Title of bill

An act to amend the insurance law, in relation to a health insurance demonstration program for independent workers and providing for the repeal of such provisions upon expiration thereof

Purpose or general idea of bill

The bill authorizes the superintendent of Insurance to permit a health insurance Company primarily owned or controlled by a tax exempt association of independent workers to provide group health insurance coverage exclusively to the association's members.

Summary of specific provisions

Subdivision (a) describes the purposes of the demonstration program.

Subdivision (b) defines the terms "eligible association," "eligible insurer," "independent worker" and "group health insurance."

Subdivision (c) authorizes the Superintendent of Insurance to approve a demonstration program under which an eligible insurer that is primarily owned or controlled by a tax exempt eligible association of independent workers issues group health insurance policies solely to the eligible association, which makes the coverage available to independent workers who are members of the eligible association. Under the demonstration, the eligible insurer would not be obligated to offer coverage to any other group. The eligible insurer would be required to comply with all other applicable requirements of the Insurance Law and the Insurance Department's regulations, including but not limited to, solvency and mandated benefit requirements. The Superintendent of Insurance may authorize only one eligible insurer to Participate in the demonstration program. The Superintendent of Insurance may revoke his or her approval if the eligible insurer violates any requirements of the bill. The eligible insurer must submit periodic reports to enable the Superintendent of Insurance to evaluate the effectiveness of the demonstration program.

Subdivision (d) provides that the bill sunsets on December 31, 2013.

Justification

Independent contractors, part-time workers, temporary workers and other individuals who perform work outside the scope of a full-time employment relationship with an employer frequently lack access to employment-based group health insurance coverage. As a result, these independent workers, who comprise a growing portion of the workforce, are more likely than traditional employees to be uninsured. The demonstration program authorized by this bill is intended to test new models for enabling independent workers to create their own health insurance programs that meet their special needs, while ensuring compliance with solvency requirements, benefit mandates and other obligations imposed on insurers under this chapter and any regulations issued by the superintendent. The demonstration program will enable the legislature and the superintendent to evaluate whether these new models for delivering health insurance benefits to independent workers are effective and should be expanded to other segments of the population that lack access to employment-based health insurance.

Prior legislative history

New Bill.

Fiscal implications

None.

Effective date

This act shall take effect immediately and shall expire and be deemed repealed December 31, 2013.