A 1766: 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.

  
  STATE OF NEW YORK ________________________________________________________________________ 1766 2025-2026 Regular Sessions  IN ASSEMBLY January 14, 2025 ___________ Introduced by M. of A. STECK, BARRETT, BLANKENBUSH, COOK, DeSTEFANO, FRIEND, HAWLEY, HEVESI, JONES, LUPARDO, McMAHON, PALMESANO, PEOPLES-STOKES, REYES, STIRPE, WOERNER, BENDETT, MANKTELOW, TAGUE, BRABENEC -- read once and referred to the Committee on Insurance 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. Notwithstanding article 44 or 47 of the insurance law or 2 any other provision of law to the contrary, and subject to the require- 3 ments set forth in this section, a municipality is permitted, with the 4 consent of the county and the governing body of such municipality, to 5 join a county self-funded or self-insured health plan in any county in 6 which such municipality is located in whole or in part. Municipality is 7 defined as any city, town, village or any other municipal corporation, a 8 school district or any governmental entity operating a public school, 9 college or university, a public improvement or special district, a 10 public authority, commission, or public benefit corporation, or any 11 other public corporation, agency or instrumentality or unit of govern- 12 ment which exercises governmental powers under the laws of the state but 13 is not a part of, nor a department of, nor an agency of the state. In 14 order for a municipality or municipalities to join the county self-fund- 15 ed or self-insured health plan, the county shall file with the super- 16 intendent of financial services certification that, with inclusion of 17 the lives to be covered in the plan following admission of the munici- 18 pality or municipalities, the county self-funded or self-insured health 19 plan meets the following six requirements: 20 (a) That the county and any municipality or municipalities joining 21 such plan have mutually consented to join such plan. 22 (b) That it maintain a reserve fund, calculated as a percentage of 23 total annual incurred claims, of a minimum of 12% of claims. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04716-01-5 
 A. 1766 2 1 (c) That it has a surplus account, established and maintained for the 2 sole purpose of satisfying unexpected obligations of the benefit plan in 3 the event of termination or abandonment of the plan, which shall not be 4 less than 5% of the annualized earned premium equivalents during the 5 current fiscal year of the plan. 6 (d) That it has in effect a specific stop loss per individual claim 7 only, no aggregate, and with a minimum deductible of $200,000 to 8 $250,000. 9 (e) That it has a minimum of 1,000 covered lives including retirees, 10 but not including dependents. 11 (f) That joint and several liability of participating municipalities 12 for the obligations of the plan is hereby abolished, and such liability 13 shall be governed as follows: 14 1. If the plan does not have admitted assets, as defined in section 15 107 of the insurance law, at least equal to the aggregate of its liabil- 16 ities and reserves and minimum surplus as provided in subdivision (b) of 17 this section, the governing board of such plan shall, within 30 days 18 thereafter, order an assessment for the amount that will provide suffi- 19 cient funds to remove such impairment and collect from each municipal 20 corporation a pro rata share of such assessed amount. 21 2. Every municipal corporation that participated in the plan at any 22 time during the two-year period prior to the issuing of an assessment 23 order by the plan's governing board shall, if notified of such assess- 24 ment, pay its pro rata share of such assessment within 90 days after the 25 issuance of that assessment order. 26 3. A municipal corporation's pro rata share of any assessment shall be 27 determined by applying the ratio of (i) the total assessment to the 28 total contributions or premium equivalents earned during the period 29 covered by the assessment on all municipal corporations subject to 30 assessment to (ii) the contribution or premium equivalent earned during 31 such period attributable to such municipal corporation. 32 4. The contingent liability of municipal corporations for additional 33 premium equivalents or assessments shall not be included as an asset in 34 the financial statements of the self-funded or self-insured health plan. 35 The superintendent of financial services shall have the authority to 36 review such certification to determine that the six aforementioned 37 requirements have been met; provided, however, that in the absence of a 38 finding of the superintendent to the contrary within a six-month period 39 following the filing of such certification, the admission of the munici- 40 pality to the county self-funded or self-insured health plan shall take 41 effect. In January of every year following the initial filing of such 42 certification, the county shall file a subsequent certification that the 43 six aforementioned requirements remain in full force and effect. 44 § 2. This act shall take effect immediately.