Relates to eligibility for health benefits; repealer

BILL NUMBER:S6253

Title of bill

An act to amend the civil service law, in relation to eligibility for health benefits; and to repeal certain provisions of such law relating thereto

Purpose

This bill is a chapter amendment to Chapter 547 of the Laws of 2013, and has been agreed to by the Senate, Assembly and Executive. Like Chapter 547, this bill would provide public employers participating in New York State Health Insurance Program (NYSHIP) with important utilization information relating to their benefits, claims and premium payments. The chapter amendment makes appropriate changes to streamline implementation.

Summary of provisions

Section 1: Repeals subdivision 9 of section 162 of the civil service law (as added by Chapter 547 of the Laws of 2013) relating to transparency in health insurance claims data for public employers participating in NYSHIP. Adds a new subdivision 9 requiring the department of civil service, upon request, to provide a standard report (no more frequently than semi-annually) to any participating employer containing data on the use of benefits by persons covered under the employer's plan. The report shall include premiums paid by month for each month covered in the report and paid claims by month, delineated by specific categories of services. Such report shall also contain individual claimant information, to the extent allowed by state and federal privacy laws, for those claims in excess of $50,000 paid in any of the months covered by the report. Sets forth a timeframe for the Department of Civil Service to provide a report requested by a participating employer.

Section 2: Establishes the effective date.

Justification

Local governments and school districts participating in the New York State Health Insurance Program (NYSHIP) are often not provided timely, meaningful claims information about their own claims and experience, even if they request it. This makes it difficult for them to calculate current and future health care costs. This legislation requires the Department of Civil Service, upon request, to provide NYSHIP participants with information relating to benefits, claims and premium payments, but no more frequently than semi-annually. The overall goal is to make NYSHIP more transparent for local governments and school districts participating in the program. This chapter amendment makes necessary changes to streamline implementation of Chapter 547 of the Laws of 2013.

Legislative history

2013: S.3788/A.481 - Passed both houses unanimously and approved (Chapter 547, L. 2013) 2012: S 7499-A/A.10333-A - Senate: Rules Committee, Assembly: Passed

Fiscal implications

None

Effective date

This act shall take effect immediately, provided however, it shall be deemed to have been in full force and effect on January 1, 2014.