A04902 Summary:

COSPNSRFinch, Raia, Oaks, Lawrence
MLTSPNSRMcDonough, Tenney
Amd S203, Eld L; amd SS1117 & 3229, Ins L
Relates to long term care insurance education; caps allowable increases in premiums; prohibits exclusions for pre-existing conditions.
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A04902 Actions:

02/09/2015referred to aging
01/06/2016referred to aging
04/11/2016held for consideration in aging
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A04902 Text:

                STATE OF NEW YORK
                               2015-2016 Regular Sessions
                   IN ASSEMBLY
                                    February 9, 2015
        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  Assem-
        bly, do enact as follows:
     1    Section 1.  Subdivision 8 of section 203 of the elder law, as added by
     2  section  18  of  part B of chapter 58 of the laws of 2007, is amended to
     3  read as follows:
     4    8. The director, in consultation  with  the  commissioner  of  health,
     5  shall  establish  a  program to be known as the NY Connects: Choices for
     6  Long Term Care. The purpose of this initiative is to provide consistent,
     7  comprehensive, locally-based information and  assistance  on  long  term
     8  care  services  to  consumers, caregivers and families to help them make
     9  educated choices. This program shall  provide  individuals,  caregivers,
    10  and  families  with  objective  information  and  assistance about home,
    11  community-based and institutional long term care services,  as  well  as
    12  information  about  long term care insurance products and providers.  NY
    13  Connects will be available on a voluntary basis to consumers, caregivers
    14  and their families. There shall be an on-going  education  and  outreach
    15  campaign  to  educate the public about long term care services available
    16  in their community and to assist consumers in preparing for  their  long
    17  term care needs.
    18    §  2.  Section  1117 of the insurance law is amended by adding two new
    19  subsections (c-1) and (c-2) to read as follows:
    20    (c-1) The premium rates for such contracts  shall  be  level  for  the
    21  duration  of  the  policy or certificate except where a rate increase is
    22  granted by the superintendent. No rate increase may be  deemed  approved
    23  if  that  increase, together with any other rate increase imposed on the
    24  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.

        A. 4902                             2
     1  that contract or certificate to exceed the lesser of  three  percent  or
     2  the  percentage change in the consumer price index for all urban consum-
     3  ers published by the Bureau of Labor Statistics  of  the  United  States
     4  Department of Labor during any continuous twelve month period.
     5    (c-2)  The  superintendent  shall  not authorize such a contract which
     6  includes an exclusion for pre-existing conditions.
     7    § 3. Subsection (d) of section 1117 of the insurance law,  as  amended
     8  by chapter 446 of the laws of 1996,  is amended to read as follows:
     9    (d)  Contracts issued pursuant to the provisions of this section shall
    10  be subject to all other provisions of this chapter and  the  regulations
    11  promulgated  thereunder  applicable  to  the insurer, health maintenance
    12  organization, or fraternal benefit society which  issues  the  contract,
    13  provided  however  that  in order to permit the development of long term
    14  care plans, the superintendent may modify or suspend any such  provision
    15  or regulation upon making the determinations set forth in subsection (f)
    16  of  this  section;  and  provided  further  that  to the extent that the
    17  provisions of this section are inconsistent with the provisions of  this
    18  chapter, the provisions of this section shall prevail.
    19    §  4.  Subsection (b) of section 3229 of the insurance law, as amended
    20  by chapter 572 of the laws of 2008, is amended to read as follows:
    21    (b) In establishing minimum  benefit  standards  for  insurance  plans
    22  pursuant  to  this  section, the superintendent shall seek to ensure the
    23  cost effectiveness of the partnership for long term care program  estab-
    24  lished  pursuant  to  section  three hundred sixty-seven-f of the social
    25  services law, and may establish minimum permissible payments under  such
    26  insurance  plans. The superintendent shall not approve an insurance plan
    27  which includes an exclusion for pre-existing  conditions  [that  exceeds
    28  six  months],  or which does not otherwise comply with [paragraph six of
    29  subsection (b) of] section one thousand one hundred  seventeen  of  this
    30  chapter.
    31    §  5. This act shall take effect on the first of January next succeed-
    32  ing the date on which it shall have become a law.
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