What's happening
This bill requires health insurers to notify individuals automatically enrolled in new plans about any changes in reproductive health care coverage compared to their previous plan.
Why it matters
Ensures transparency about reproductive health benefits. The bill requires insurers to clearly outline differences in reproductive health care coverage between an individual’s previous plan and their new, automatically assigned plan, helping people understand if they are losing important benefits.
Protects against unintentional loss of coverage. By mandating notification, the bill aims to prevent individuals from unknowingly losing access to reproductive health services (such as contraception or abortion coverage) when automatically switched to a new plan.
Empowers individuals to make informed choices. The required comparison includes not only previous and current coverage but also what the law requires as “essential health benefits,” giving consumers the information needed to seek alternative coverage or appeal decisions if their needs aren’t met.
Applies retroactively and ensures timely notification. The bill covers those already auto-enrolled in 2017 as well as future enrollees, and sets a 30-day deadline for written notification, ensuring that affected individuals are informed promptly and can respond quickly if their health care needs are at risk.
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Who cares
Headline styles
Notify on Reproductive Coverage Changes
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
3394
2017-2018 Regular Sessions
IN ASSEMBLY
January 27, 2017
Introduced by M. of A. SIMOTAS -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law and the public health law, in relation to ensuring reproductive health care during auto enrollment
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The insurance law is amended by adding a new section 3242 to read as follows:
§ 3242. Ensuring reproductive health care during auto enrollment. (a) Upon the automatic enrollment of an individual by the department into a health insurance plan provided by a health insurance company that excludes coverage for reproductive health care services that were covered by the individual's previous health insurance plan, the health insurance company which provides the plan in which the individual was automatically enrolled shall notify the individual of the differences between each of the following:
(1) reproductive health care coverage they received through their previous plan;
(2) reproductive health care coverage they would receive under the plan in which they were automatically enrolled; and
(3) the requirements for reproductive health care coverage under the essential health benefits package.
(b) For the calendar year two thousand seventeen, an individual who was automatically enrolled in a health insurance plan provided by a health insurance company that excludes coverage for reproductive health care services that were covered by their previous health insurance plan shall be notified by the health insurance company which provides the plan in which the individual was automatically enrolled of the differences between each of the following:
(1) reproductive health care coverage they received through their previous plan;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04563-01-7
A. 3394 2
(2) reproductive health care coverage they would receive under the plan in which they were automatically enrolled; and
(3) the requirements for reproductive health care coverage under the essential health benefits package.
(c) For individuals who were automatically enrolled in a health insurance plan during the calendar year two thousand seventeen prior to the effective date of this section, this information shall be delivered to them in writing no later than thirty days after the effective date of this section; for individuals who are automatically enrolled in a health insurance plan after the effective date of this section, this information shall be delivered to them in writing no later than thirty days after automatic enrollment in the plan.
§ 2. The insurance law is amended by adding a new section 4329 to read as follows:
§ 4329. Ensuring reproductive health care during auto enrollment. (a) Upon the automatic enrollment of an individual by the department into a health insurance plan provided by a health insurance company that excludes coverage for reproductive health care services that were covered by the individual's previous health insurance plan, the health insurance company which provides the plan in which the individual was automatically enrolled shall notify the individual of the differences between each of the following:
(1) reproductive health care coverage they received through their previous plan;
(2) reproductive health care coverage they would receive under the plan in which they were automatically enrolled; and
(3) the requirements for reproductive health care coverage under the essential health benefits package.
(b) For the calendar year two thousand seventeen, an individual who was automatically enrolled in a health insurance plan provided by a health insurance company that excludes coverage for reproductive health care services that were covered by their previous health insurance plan shall be notified by the health insurance company which provides the plan in which the individual was automatically enrolled of the differences between each of the following:
(1) reproductive health care coverage they received through their previous plan;
(2) reproductive health care coverage they would receive under the plan in which they were automatically enrolled; and
(3) the requirements for reproductive health care coverage under the essential health benefits package.
(c) For individuals who were automatically enrolled in a health insurance plan during the calendar year two thousand seventeen prior to the effective date of this section, this information shall be delivered to them in writing no later than thirty days after the effective date of this section; for individuals who are automatically enrolled in a health insurance plan after the effective date of this section, this information shall be delivered to them in writing no later than thirty days after automatic enrollment in the plan.
§ 3. The public health law is amended by adding a new section 4415 to read as follows:
§ 4415. Ensuring reproductive health care during auto enrollment. 1. Upon the automatic enrollment of an individual by the department of financial services into a health insurance plan provided by a health maintenance organization that excludes coverage for reproductive health care services that were covered by the individual's previous health
A. 3394 3
insurance plan, the health maintenance organization which provides the plan in which the individual was automatically enrolled shall notify the individual of the differences between each of the following:
(a) reproductive health care coverage they received through their previous plan;
(b) reproductive health care coverage they would receive under the plan in which they were automatically enrolled; and
(c) the requirements for reproductive health care coverage under the essential health benefits package.
2. For the calendar year two thousand seventeen, an individual who was automatically enrolled in a health insurance plan provided by a health maintenance organization that excludes coverage for reproductive health care services that were covered by their previous health insurance plan shall be notified by the health maintenance organization which provides the plan in which the individual was automatically enrolled of the differences between each of the following:
(a) reproductive health care coverage they received through their previous plan;
(b) reproductive health care coverage they would receive under the plan in which they were automatically enrolled; and
(c) the requirements for reproductive health care coverage under the essential health benefits package.
3. For individuals who were automatically enrolled in a health insurance plan during the calendar year two thousand seventeen prior to the effective date of this section, this information shall be delivered to them in writing no later than thirty days after the effective date of this section; for individuals who are automatically enrolled in a health insurance plan after the effective date of this section, this information shall be delivered to them in writing no later than thirty days after automatic enrollment in the plan.
§ 4. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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