What's happening
This bill amends laws to improve long term care insurance by adding consumer education, limiting premium increases, and prohibiting exclusions for pre-existing conditions.
Why it matters
Expanding NY Connects to include insurance education. means consumers and families will now get not just general long-term care information, but also specific guidance on insurance products and providers, which could help people better understand and compare their options before committing to expensive policies.
Strict limits on premium increases. (capping annual hikes to the lower of 3% or the Consumer Price Index) provide much more predictability and affordability for policyholders, who often face rising costs as they age and are more likely to need long-term care coverage.
Banning all pre-existing condition exclusions. in long-term care insurance (not just limiting their duration) ensures that people with health histories are not denied coverage or forced to wait months before benefits kick in, making coverage more accessible and reliable for those who need it most.
Giving these new rules precedence over conflicting insurance laws. ensures that consumer protections in long-term care insurance are not undermined by loopholes or exceptions elsewhere in the law, strengthening the overall regulatory framework.
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Who cares
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Protect Pre-Existing Conditions Coverage
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History
- Held for consideration in aging
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Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4737
2017-2018 Regular Sessions
IN ASSEMBLY
February 3, 2017
Introduced by M. of A. WALTER -- read once and referred to the Committee on Aging
AN ACT to amend the elder law and the insurance law, in relation to long term care insurance education, premiums and prohibition of exclusions for pre-existing conditions
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 8 of section 203 of the elder law, as added by section 18 of part B of chapter 58 of the laws of 2007, is amended to read as follows:
8. The director, in consultation with the commissioner of health, shall establish a program to be known as the NY Connects: Choices for Long Term Care. The purpose of this initiative is to provide consistent, comprehensive, locally-based information and assistance on long term care services to consumers, caregivers and families to help them make educated choices. This program shall provide individuals, caregivers, and families with objective information and assistance about home, community-based and institutional long term care services, as well as information about long term care insurance products and providers. NY Connects will be available on a voluntary basis to consumers, caregivers and their families. There shall be an on-going education and outreach campaign to educate the public about long term care services available in their community and to assist consumers in preparing for their long term care needs.
§ 2. Section 1117 of the insurance law is amended by adding two new subsections (c-1) and (c-2) to read as follows:
(c-1) The premium rates for such contracts shall be level for the duration of the policy or certificate except where a rate increase is granted by the superintendent. No rate increase may be deemed approved if that increase, together with any other rate increase imposed on the same contract or certificate would cause the aggregate rate increase for
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04748-01-7
A. 4737 2
that contract or certificate to exceed the lesser of three percent or the percentage change in the consumer price index for all urban consumers published by the Bureau of Labor Statistics of the United States Department of Labor during any continuous twelve month period.
(c-2) The superintendent shall not authorize such a contract which includes an exclusion for pre-existing conditions.
§ 3. Subsection (d) of section 1117 of the insurance law, as amended by chapter 446 of the laws of 1996, is amended to read as follows:
(d) Contracts issued pursuant to the provisions of this section shall be subject to all other provisions of this chapter and the regulations promulgated thereunder applicable to the insurer, health maintenance organization, or fraternal benefit society which issues the contract, provided however that in order to permit the development of long term care plans, the superintendent may modify or suspend any such provision or regulation upon making the determinations set forth in subsection (f) of this section; and provided further that to the extent that the provisions of this section are inconsistent with the provisions of this chapter, the provisions of this section shall prevail.
§ 4. Subsection (b) of section 3229 of the insurance law, as amended by chapter 572 of the laws of 2008, is amended to read as follows:
(b) In establishing minimum benefit standards for insurance plans pursuant to this section, the superintendent shall seek to ensure the cost effectiveness of the partnership for long term care program established pursuant to section three hundred sixty-seven-f of the social services law, and may establish minimum permissible payments under such insurance plans. The superintendent shall not approve an insurance plan which includes an exclusion for pre-existing conditions [that exceeds six months], or which does not otherwise comply with [paragraph six of subsection (b) of] section one thousand one hundred seventeen of this chapter.
§ 5. This act shall take effect on the first of January next succeeding the date on which it shall have become a law.
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