Requires insurance coverage for the influenza vaccine in certain circumstances

BILL NUMBER:S1709B

Title of bill

An act to amend the insurance law, in relation to requiring insurance coverage for the influenza vaccine in certain circumstances

Purpose

This bill would provide that health insurance policies that cover influenza vaccine and its administration would provide coverage when such vaccine is administered outside of a physician's office at a primary or secondary school.

Summary of specific provisions

Section 1 amends Subsection (i) of Section 3216 of the Insurance Law by adding a new paragraph 17-a to provide for coverage of influenza vaccine and its administration at primary or secondary schools authorized under current law when a health insurance plan includes coverage of influenza and its administration under the policy.

Section 2 amends Subsection (1) of Section 3221 of the Insurance Law by adding a new paragraph 8-a to provide for coverage of influenza vaccine and its administration at primary or secondary schools authorized under current law when a health insurance plan includes coverage of influenza and its administration under the policy.

Section 3 amends Section 4303 of the Insurance Law by adding a new subsection (k-a) to provide for coverage of influenza vaccine and its administration at primary and secondary schools authorized under current law when a health insurance plan includes coverage of influenza and its administration under the policy.

Section 4 provides that the act shall take effect 60 days after it shall have become law.

Justification

Influenza is a contagious respiratory illness that causes, on average, over 200,000 people in the US to be hospitalized each year, and over 36,000 people (primarily elderly) to die from related complications. The best way to help prevent seasonal influenza is by getting a vaccination each year. The Centers for Disease Control and Prevention (CDC) recommends annual seasonal influenza vaccination for all eligible persons, including children aged 6 months through 18 years of age. Unfortunately, vaccination rates for school-aged children 5 to 17 years of age remain very low, with only 35% of high risk children vaccinated and 25% of healthy children receiving the vaccine.

Increasing the vaccination rates of children is critical to protecting their health and preventing the spread of the virus to vulnerable individuals in the community such as the elderly and those with comprised immune systems. Children and young adults are three to four times more likely to be infected with influenza. They are the major vectors fox transmitting the virus to adults and elderly persons in the community.

Conducting influenza vaccination programs on-site in the schools has been shown to be an effective method of increasing vaccination rates. Studies show that mass vaccination programs in schools also help to reduce student absences and increase adult workdays.

This bill would facilitate the implementation of school-based influenza programs by providing insurance coverage for influenza vaccine and its administration at off-site locations such as schools. The bill only applies to insurance policies that already provide coverage for this benefit. Establishment of a school-located infrastructure for routine school influenza would enhance the public health and the State's pandemic preparedness.

Prior legislative history

None.

Fiscal implications

None to the State.

Effective date

This act shall take effect on the sixtieth day after it becomes law.