Establishes the Chautauqua County Chamber of Commerce health insurance pool demonstration program for businesses and municipalities employing 100 or less

Summary of provisions

Adds a new article (42-A) to the insurance law authorizing and directing the establishment and administration of the Chautauqua County Chamber of Commerce health insurance pool demonstration program for eligible businesses for the purpose of providing health and accident insurance coverage and benefits to their employees.

Provides that the Chamber shall appoint an administrator and employ appropriate personnel as needed to administer and operate the program.

Provides that the Chamber shall undertake any activities necessary to administer the program, including marketing and publicizing the program and ensuring compliance with its requirements.

Establishes a financial relationship directly with agents or brokers to provide coverage and benefits pursuant to the program, and a mechanism to collect premiums from eligible employers and pay participating insurers.

Authorizes the Chamber, in consultation and cooperation with the superintendent, to contract with health and accident insurers for the coverage and benefits to be provided under the program, including, but not limited to, hospital and physician visits, prescription drug benefits, mental health services, and durable medical equipment. Such coverage shall, subject to the supervision of the superintendent, be issued on an experience rated basis with a community rating based on five thousand lives insured.

The premiums paid by participating eligible employers and employees shall include a surcharge sufficient to cover the costs of the program, but not to exceed one percent of the premium.

Neither the chamber nor any participating eligible employer shall be deemed to be ineligible for any federal subsidy or tax credit established pursuant to the Patient Protection and Affordable Care Act of 2010.

The Chamber shall submit an annual report on the program to the superintendent on or before November fifteenth. This report shall include, but not be limited to, data trends including business and municipal corporation participation, and any such other information as the superintendent shall deem necessary.

In addition, on June first, two thousand thirteen, the superintendent shall submit a report on the program to the Governor, the Temporary President of the Senate, and the Speaker of the Assembly including the superintendent's findings and conclusions related to the costs of savings from and participation in the program.

Justification

This program would improve the access of small businesses and governmental units of 100 employees or less to affordable health insurance in Chautauqua County. Small businesses and governmental units are finding it increasingly difficult to access the health insurance market. The vast majority of employees in Chautauqua County are employed by organizations with less than 50 employees. According to New York State Department of Labor statistics there are approximately 3,328 reporting employer units in Chautauqua County, approximately 115 of which have more than 50 employees. This means that over 96 percent of the employers in Chautauqua County are subject to the community rated health insurance market only, which is an insurance market that is no longer affordable to small businesses. This demonstration program seeks to create a new model in which small businesses and small governmental units can band together and purchase benefits. Also, the continuous monitoring of data related to the experience of this program will help to ensure its successful operation.

Legislative history

New bill.

Fiscal implications

None.

Effective date

This act shall take effect December 1, 2010, and shall expire and be deemed repealed December 1, 2013.