What's happening
This bill requires health insurers in New York to accept premium and cost-sharing payments from certain third parties, including nonprofits and government programs.
Why it matters
Improves access to health insurance for vulnerable groups. By requiring insurers to accept payments from nonprofits, tribes, and government programs, the bill helps people who might otherwise lose coverage due to inability to pay premiums or cost-sharing.
Prevents discrimination based on health status. The bill mandates that nonprofit assistance must be based on financial need, not health condition, reducing the risk that insurers or aid organizations selectively support only healthy or less costly individuals.
Supports continuity of care for those with chronic or serious conditions. Programs like the Ryan White HIV/AIDS program and tribal health organizations can directly pay insurers, helping patients maintain uninterrupted treatment and avoid gaps in coverage.
Limits potential for insurers to refuse lawful payments. By making it illegal for insurers to reject third-party payments in the individual market, the law closes loopholes that could be used to drop high-cost enrollees or create administrative hurdles for those needing help.
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Who cares
Headline styles
Let Third Parties Pay Premiums
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
144
2019-2020 Regular Sessions
IN ASSEMBLY (Prefiled)
January 9, 2019
Introduced by M. of A. CAHILL -- read once and referred to the Committee on Insurance
AN ACT to amend the public health law and the insurance law, in relation to requiring health insurers to accept third party payments for coverage
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 4406-c of the public health law is amended by adding a new subdivision 10 to read as follows:
10. With regard to a subscriber contract offered through the individual market, a health maintenance organization shall not by contract or in any other manner refuse to accept premium or any required cost sharing payments from third parties if made by (a) an Indian tribe, tribal organization, urban Indian organization, or any state or federal government program or grantee (such as the Ryan White HIV/AIDS program) on behalf of an enrollee, or (b) a private, not-for-profit foundation, on behalf of an enrollee who satisfies defined criteria that are based on financial status and do not consider health status, and the payment covers the entire policy year.
§ 2. Section 3217-b of the insurance law is amended by adding a new subsection (l) to read as follows:
(l) With regard to an insurance policy offered through the individual market, an insurer shall not by contract or in any other manner refuse to accept premium or any required cost sharing payments from third parties if made by (1) an Indian tribe, tribal organization, urban Indian organization, or any state or federal government program or grantee (such as the Ryan White HIV/AIDS program) on behalf of an insured, or (2) a private, not-for-profit foundation, on behalf of an insured who satisfies defined criteria that are based on financial status and do not consider health status, and the payment covers the entire policy year.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00077-01-9
A. 144 2
§ 3. Section 4325 of the insurance law is amended by adding a new subsection (m) to read as follows:
(m) With regard to an insurance contract offered through the individual market, a corporation organized under this article shall not by contract or in any other manner refuse to accept premium or any required cost sharing payments from third parties if made by (1) an Indian tribe, tribal organization, urban Indian organization, or any state or federal government program or grantee (such as the Ryan White HIV/AIDS program) on behalf of a subscriber, or (2) a private, not-for-profit foundation, on behalf of a subscriber who satisfies defined criteria that are based on financial status and do not consider health status, and payment covers the entire policy year.
§ 4. This act shall take effect January 1, 2021.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.