What's happening
This bill amends insurance law to clarify and expand which travel and intercollegiate sports accident policies are excluded from the definition of student accident and health insurance.
Why it matters
Clarifies which travel insurance policies are excluded from the definition of student accident and health insurance. , specifically limiting the exclusion to policies covering personal risks (like sickness, accident, disability, or death) that occur during planned travel and are not sold as stand-alone health insurance, making the law more precise about what is and isn’t covered.
Establishes detailed requirements for intercollegiate sports accident policies to be excluded. , such as requiring coverage to be limited to sports injuries, matching benefit maximums per injury and per student, and mandating that premiums are fully paid by the educational institution, which may affect how colleges structure their insurance offerings for student-athletes.
Requires clear disclosures to students that intercollegiate sports accident policies are not substitutes for comprehensive health coverage. , aiming to ensure students understand the limitations and do not mistakenly believe they have broader insurance protection.
Sets rules for how these sports accident policies coordinate with other student health insurance. , including when these policies are primary or secondary, and mandates minimum benefit levels, potentially improving financial protection for student-athletes and clarifying how claims are paid when multiple policies are involved.
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Who cares
Headline styles
Clarify Student Insurance Coverage
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Recommit, enacting clause stricken
- 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.
Clarify Student Insurance Coverage
Assembly Floor Calendar · Sponsor Barbara Lifton
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1884
2019-2020 Regular Sessions
IN SENATE
January 17, 2019
Introduced by Sen. O'MARA -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to policies or contracts which are not included in the definition of student accident and health insurance
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Clause (ii) of subparagraph (B) of paragraph 1 of subsection (a) of section 3240 of the insurance law, as amended by chapter 461 of the laws of 2015, is amended to read as follows:
(ii) [an accident] a policy or contract that provides benefits meeting the definition of "excepted benefits" set forth in section 2791 of the public health service act, 42 U.S.C. § 300gg-91(c), if the policy or contract is limited to insurance coverage for personal risks incident to planned travel, including sickness, accident, disability, or death occurring during travel, provided that such health benefits are not offered on a stand-alone basis and are incidental to other coverage.
(iii) an accident policy or contract that provides benefits meeting the definition of "excepted benefits" set forth in section 2791 of the public health service act, 42 U.S.C. § 300gg-91(c), if the policy or contract:
(I) is limited to coverage for intercollegiate sports injuries only;
(II) provides benefits to diagnose and treat any intercollegiate sports injury and does not include a benefit dollar maximum amount per injury that is less than the overall benefit dollar maximum amount per student under the intercollegiate sports injury policy or contract;
(III) provides benefits on an expense incurred basis;
(IV) provides that premiums are paid in full by the institution of higher education;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05103-01-9
S. 1884 2
(V) includes prominent disclosure to the student that the accident policy is not a substitute for comprehensive hospital and medical coverage;
(VI) provides coverage for intercollegiate sports injuries primary to any student accident and health insurance policy or contract or any student health plan issued pursuant to section one thousand one hundred twenty-four of this chapter; except that a policy or contract meeting the requirements of this item may be excess or secondary to any other policy or contract of accident and health insurance; and
(VII) includes a maximum benefit amount that is no less than the deductible under the separate athletic association policy or contract if designed to coordinate with a separate policy or contract issued to an athletic association that extends coverage for intercollegiate sports injuries.
§ 2. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to policies or contracts which are not included in the definition of student accident and health insurance
Purpose
This bill will clarify that New York State law does not prohibit the issuance of policies offering certain "excepted benefits," such as dental, vision, intercollegiate sports injury coverage, and travel insurance to institutions, of higher learning.
Summary of provisions
Section 1 amends clause (ii) of subparagraph (B) of paragraph 1 of subsection (a) of f 3240 of the insurance law to clarify that New York law does not prohibit the issuance of policies offering certain "excepted benefits," such as dental, vision, or intercollegiate sports injury coverage, and travel insurance to institutions of higher learn- ing.
§ 2 establishes the effective date.
Justification
New York has enacted law to conform its requirements for student health insurance to the requirements set forth in the Affordable Care Act ("ACA"), including the ACA requirement that student health insurance policies include a comprehensive set of "essential health benefits" which are not subject.to annual or lifetime dollar limitations. New York's laws are aimed at traditional student health insurance policies subject to ACA requirements. Such policies are typically offered by institutions of higher education as a comprehensive health. insurance option for students that do not have access to health insurance through a parent's plan. However, New York's laws do not distinguish between. traditional student health insurance policies and "excepted benefits" policies such as accident, dental, and vision policies, which are purchased by institutions of higher learning to address potential gaps in coverage.
New York has interpreted its ACA compliance obligations to require all policies issued to students of institutions of higher education to include comprehensive essential health benefits without annual or life- time dollar limitations. This interpretation has raised questions regarding whether it is permissible to issue student policies in the college market providing dental coverage, vision coverage, and other intercollegiate sports injury coverage recognized by the ACA as "excepted benefits." Such policies do not offer "essential health bene- fits" without limitation. Dental policies, for example, do not typically include maternity or mammography benefits because it falls outside of the intended scope of the policy. However, dental policies do provide students with important health coverage that may not be included in their comprehensive medical plan.
Relating to travel insurance, many institutions have in the past purchased coverage to take care of gaps in health insurance policies, such as high out-of-network deductibles for care received outside the United States or medical evacuation to transport a student home after they are stabilized, but still require hospital care.
New York has interpreted its ACA conforming law to prohibit insurers from issuing travel accident policies, as they do not provide all comprehensive essential health benefits. These are allowable in 49 other states.
The Department of Financial Services has directed companies to stop selling medical evacuation polices to institutions of higher education, making this needed coverage unavailable in NYS. DFS informed colleges and universities that this amendment is necessary to make such policies allowable.
Legislative history
New bill.
Fiscal implications
None to the state.
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.