New York A 7553: Expands coverage for developmentally disabled persons past twenty-six years of age

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A07553 Summary:

BILL NOA07553 

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SAME ASSAME AS S08326

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SPONSORSantabarbara

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COSPNSRColton, DeStefano, Weprin

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MLTSPNSR

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Amd §§3216, 4304 & 4305, add §§3246, 3247, 4331 & 4332, Ins L

&nbsp

Expands coverage for developmentally disabled persons past twenty-six years of age; prohibits insurance companies from wrongfully terminating contracts of developmentally disabled persons; requires recertification of such developmentally disabled person's condition once every five years.

Go to top A07553 Actions:

BILL NOA07553 

&nbsp

04/01/2025referred to insurance

01/07/2026referred to insurance

Go to topA07553 Committee&nbspVotes:

Go to topA07553 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA07553 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 7553

 2025-2026 Regular Sessions

 IN ASSEMBLY

 April 1, 2025
 ___________

 Introduced by M. of A. SANTABARBARA -- read once and referred to the
 Committee on Insurance

 AN ACT to amend the insurance law, in relation to requiring health
 insurance contracts provide coverage to developmentally disabled
 persons beyond twenty-six years of age

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

 1 Section 1. Subparagraph (C) of paragraph 4 of subsection (a) of
 2 section 3216 of the insurance law, as amended by chapter 219 of the laws
 3 of 2011, is amended to read as follows:
 4 (C) In addition to the requirements of subparagraphs (A) and (B) of
 5 this paragraph, every insurer issuing a policy of hospital, medical, or
 6 surgical expense insurance pursuant to this section that provides cover-
 7 age for dependent children must make available and, if requested by the
 8 policyholder, extend coverage under the policy to an unmarried child
 9 through age twenty-nine, without regard to financial dependence who is
 10 not insured by or eligible for coverage under an employer health benefit
 11 plan as an employee or member, whether insured or self-insured, and who
 12 lives, works or resides in New York state or the service area of the
 13 insurer. Such coverage shall be made available at the inception of all
 14 new policies. Written notice of the availability of such coverage shall
 15 be delivered to the policyholder [thirty days] six months prior to the
 16 inception of such policy. Where an unmarried dependent child is incapa-
 17 ble of self-sustaining employment by reason of mental illness, or devel-
 18 opmental disability as defined in the mental hygiene law, or physical
 19 handicap and who became so incapable prior to the age at which dependent
 20 coverage would otherwise terminate such coverage shall be extended
 21 indefinitely past age twenty-six.
 22 § 2. Subparagraph (B) of paragraph 5 of subsection (c) of section 3216
 23 of the insurance law, as amended by chapter 479 of the laws of 2022, is
 24 amended to read as follows:

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD10447-01-5

 A. 7553 2

 1 (B) Written notice of entitlement to a conversion policy shall be
 2 given by the insurer to the policyholder at least [fifteen and not more
 3 than sixty days] six months prior to the termination of coverage due to
 4 the initial limiting age of the covered dependent. Such notice shall
 5 include an explanation of the rights of the dependent with respect to
 6 the dependent being enrolled in an accredited institution of learning or
 7 [his or her] such dependent's incapacity for self-sustaining employment
 8 by reason of mental illness, developmental disability as defined in the
 9 mental hygiene law or physical [handicap] disability.
 10 § 3. The insurance law is amended by adding a new section 3246 to read
 11 as follows:
 12 § 3246. Certain individual accident and health insurance policy
 13 provisions for developmentally disabled persons. 1. Any corporation
 14 subject to the provisions of this article offering any individual policy
 15 or contract covering the kind or kinds of insurance for an unmarried
 16 dependent child who is incapable of self-sustaining employment by reason
 17 of mental illness, or developmental disability as defined in the menta