S 5556: Relates to gender indication on insurance claim forms; provides policies shall not exclude coverage if gender indication is different from sex assigned at birth or gender otherwise recorded.

  
  STATE OF NEW YORK ________________________________________________________________________ 5556 2025-2026 Regular Sessions  IN SENATE February 25, 2025 ___________ Introduced by Sens. HOYLMAN-SIGAL, WEBB -- read twice and ordered print- ed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to prohibiting the exclu- sion of coverage based upon gender indication on claim forms The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 41 to read as follows: 3 (41) Every policy that provides coverage for hospital, surgical or 4 medical care shall not exclude coverage for screening, diagnosis and 5 treatment of medical conditions, or services otherwise covered by the 6 policy solely on the basis of the gender indicated on a claim form, or 7 that the gender indicated on a claim form is different from the 8 insured's sex assigned at birth or gender otherwise recorded, or that 9 the insured is not of the gender to whom a service is provided. Nothing 10 herein shall limit the insurer's ability to take reasonable steps, 11 including requesting additional information, to determine whether the 12 insured is eligible for the services, to review the claim for potential 13 fraud, or to review the claim for clinical appropriateness. 14 § 2. Subsection (l) of section 3221 of the insurance law is amended by 15 adding a new paragraph 24 to read as follows: 16 (24) Every policy that provides coverage for hospital, surgical or 17 medical care shall not exclude coverage for screening, diagnosis and 18 treatment of medical conditions, or services otherwise covered by the 19 policy solely on the basis of the gender indicated on a claim form, or 20 that the gender indicated on a claim form is different from the 21 insured's sex assigned at birth or gender otherwise recorded, or that 22 the insured is not of the gender to whom a service is provided. Nothing 23 herein shall limit the insurer's ability to take reasonable steps, 24 including requesting additional information, to determine whether the EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD07854-02-5 
 S. 5556 2 1 insured is eligible for the services, to review the claim for potential 2 fraud, or to review the claim for clinical appropriateness. 3 § 3. Section 4303 of the insurance law is amended by adding a new 4 subsection (ww) to read as follows: 5 (ww) Every contract that provides coverage for hospital, surgical or 6 medical care shall not exclude coverage for screening, diagnosis and 7 treatment of medical conditions, or services otherwise covered by the 8 contract solely on the basis of the gender indicated on a claim form, or 9 that the gender indicated on a claim form is different from the 10 insured's sex assigned at birth or gender otherwise recorded, or that 11 the insured is not of the gender to whom a service is provided. Nothing 12 herein shall limit the insurer's ability to take reasonable steps, 13 including requesting additional information, to determine whether the 14 insured is eligible for the services, to review the claim for potential 15 fraud, or to review the claim for clinical appropriateness. 16 § 4. This act shall take effect on the first of January next succeed- 17 ing the date on which it shall have become a law and shall apply to 18 policies and contracts issued, renewed, modified, altered or amended on 19 or after such effective date.