S 4719 NY

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Bill No.: Summary Actions Committee&nbspVotes Floor&nbspVotes Memo Text LFIN Chamber&nbspVideo/Transcript S04719 Summary: BILL NO S04719B &nbsp SAME AS SAME AS A01766-B

&nbsp SPONSOR FAHY &nbsp COSPNSR JACKSON &nbsp MLTSPNSR &nbsp

&nbsp Authorizes all municipalities, with the consent of the county and the governing body of such municipality, to join a county self-funded or self-insured health plan; requires certification.

Go to top S04719 Text:

STATE OF NEW YORK ________________________________________________________________________

4719--B

2025-2026 Regular Sessions

IN SENATE

February 12, 2025 ___________

Introduced by Sens. FAHY, JACKSON -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- commit- tee discharged, bill amended, ordered reprinted as amended and recom- mitted to said committee -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee

AN ACT authorizing municipalities to join a county self-funded or self- insured health plan

The People of the State of New York, represented in Senate and Assem- bly, do enact as follows:

1 Section 1. A municipality is permitted, with the consent of the county 2 and the governing body of such municipality, to join a county self-fund- 3 ed or self-insured health plan in any county in which such municipality 4 is located in whole or in part. For the purposes of this act, a munici- 5 pality shall be defined as any city, town, or village. In order for a 6 municipality or municipalities to join the county self-funded or self- 7 insured health plan, the governing board of the municipality shall adopt 8 a resolution indicating that they consent to joining such plan and the 9 county shall file with the superintendent of financial services certif- 10 ication that, with inclusion of the lives to be covered in the plan, 11 prior to the admission of the municipality or municipalities, that the 12 county self-funded or self-insured health plan meets the following six 13 requirements: 14 (a) That the county and any municipality or municipalities joining 15 such plan have mutually consented to join such plan. 16 (b) That it maintain a reserve fund, calculated as a percentage of 17 total annual incurred claims, of a minimum of 12% of claims. 18 (c) That it has a surplus account, established and maintained for the 19 sole purpose of satisfying unexpected obligations of the benefit plan in 20 the event of termination or abandonment of the plan, which shall not be

EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04716-05-6

S. 4719--B 2

1 less than 5% of the annualized earned premium equivalents during the 2 current fiscal year of the plan. 3 (d) That it has in effect a specific stop loss per individual claim 4 only, no aggregate, and with a minimum deductible of $200,000 to 5 $250,000. 6 (e) That it has a minimum of 1,000 covered lives including retirees, 7 but not including dependents. 8 (f) That joint and several liability of participating municipalities 9 for the obligations of the plan is hereby abolished, and such liability 10 shall be governed as follows: 11 1. If the plan does not have admitted assets, as defined in section 12 107 of the insurance law, at least equal to the aggregate of its liabil- 13 ities and reserves and minimum surplus as provided in subdivision (b) of 14 this section, the governing board of such plan shall, within 30 days 15 thereafter, order an assessment for the amount that will provide suffi- 16 cient funds to remove such impairment and collect from each municipal 17 corporation a pro rata share of such assessed amount. 18 2. Every municipal corporation that participated in the plan at any 19 time during the two-year period prior to the issuing of an assessment 20 order by the plan's governing board shall, if notified of such assess- 21 ment, pay its pro rata share of such assessment within 90 days after the 22 issuance of that assessment order. 23 3. A municipal corporation's pro rata share of any assessment shall be 24 determined by applying the ratio of (i) the total assessment to the 25 total contributions or premium equivalents earned during the period 26 covered by the assessment on all municipal corporations subject to 27 assessment to (ii) the contribution or premium equivalent earned during 28 such period attributable to such municipal corporation. 29 4. The contingent liability of municipal corporations for additional 30 premium equivalents or assessments shall not be included as an asset in 31 the financial statements of the self-funded or self-insured health plan. 32 § 2. Any county that seeks to admit a municipality or municipalities 33 to its self-insured or self-funded health plan shall utilize the 34 services of an actuary approved by the superintendent of financial 35 services who shall certify that the criteria set forth above have been 36 complied with. Certification by an actuary approved by the superinten- 37 dent of financial services shall establish a presumption that the muni- 38 cipality or municipalities shall be admitted to the county self-insured 39 or self-funded health plan. Provided, however, that the superintendent 40 of financial services may, before the passage of one year from the date 41 of certification, may reject such certification stating the grounds 42 therefor and any requirements to assure that must be met to assure that 43 the proposal is approved. 44 § 3. This act shall take effect immediately.

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