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Sponsors
No co-sponsors yet.
History
- Vetoed memo.292
- Delivered to governor
- Returned to senate
- Passed assembly
- Ordered to third reading rules cal.421
- Substituted for A10469
- Referred to insurance
- Delivered to assembly
- Passed senateVote 61–1
- Ordered to third reading cal.1793
- Committee discharged and committed to rules
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Relates to adjusting claims on behalf of municipal cooperative health benefit plans
Assembly Floor Calendar · Sponsor Kevin Cahill
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to adjusting claims on behalf of municipal cooperative health benefit plans
Purpose
This bill excepts health insurers adjusting claims on behalf of a municipal cooperative health benefit plan from the definition of "independent adjuster."
Summary of provisions
Section one amends subsection (B) of section (1) of paragraph (g) of section 2101 of the insurance law to provide that a health insurer is not acting as an independent adjuster when it adjusts claims on behalf of a municipal cooperative health benefit plan certified pursuant to article forty seven of the insurance law.
Section 2 sets the effective date.
Justification
Article 47 of the insurance law includes a number of provisions that together permit municipalities to form a cooperative health benefit plan. Of particular significance is the requirement that the municipal cooperative health benefit plan be "fully insured." Section 4702 of the Insurance Law provides that "fully insured means that all benefits payable pursuant to a municipal cooperative health benefit plan are guaranteed under a contract of policy of insurance delivered in this state and issued by an insurance company authorized to do accident and health insurance in this state, an article forty-three corporation, or a health maintenance organization."
The Department of Financial Services has taken the position that when a health insurer adjusts claims on behalf of a municipal cooperative health benefit plan certified pursuant to Article 47 of the Insurance Law, the health insurer is acting as an independent adjuster and must be licensed as such. To require a health insurer to be separately licensed as an independent adjuster in order to adjust claims under a fully insured contract issued by the health insurer is an unreasonable and unnecessary result. This bill would clarify that a health insurer issuing a fully insured contract to a municipal cooperative health benefit plan need not be licensed as an independent adjuster in order to adjust claims under its own contract.
Legislative history
New bill.
Fiscal implications
None.
Effective date
This act shall take effect immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.