BILL NUMBER: S5313A
SPONSOR: BAILEY
 
TITLE OF BILL:
An act to amend the insurance law, in relation to addressing non-covered
dental services
 
PURPOSE OR GENERAL IDEA OF BILL:
To prevent insurance companies from including in their contracts any
provisions that relate to or affect dental services that they do not
insure.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 prevents an insurance company from including in any insurance
contract any provisions that relate to or affect dental services that
are not covered by the contract.
Section 2 prevents a medical or dental expense indemnity corporation or
health service corporation from including in any insurance contract any
provisions that relate to or affect dental services that are not covered
by the contract.
 
JUSTIFICATION:
Section 4224(d) (1) of the New York State Insurance Law prohibits inter-
dependent sales whereby an insurer puts into its insurance policies
products or services that are not insured as a means of interdependently
selling that policy and the uninsured items to its insureds. Some insur-
ers, however, routinely include in their dental plans discounts on
dental services they do not insure and then require dentists to provide
such discounts in order to be a participating provider in the dental
insurance plan. In effect, the insurer is selling a discounted product
to patients as part of the insurance policy as an inducement to buy the
insurance policy. The bill makes clear that no insurer can place into
their contracts any provisions relating to dental services that they do
not insure. This bill is necessary to restore sensible enforcement of
the law against interdependent sales with respect to dental insurance
plans. Many other states have outlawed this practice directly in a
similar way, using the logic that dental insurers should not be influ-
encing the prices or other aspects of dental services that they do not
insure at all and never pay for. New York long ago prevented interde-
pendent, sales schemes in insurance plans and this law merely clarifies
that it applies to uninsured dental services as it would to any other
improper interdependent sales scheme. The law is timed to take effect on
January 1,2024, and only to apply to insurance or managed care contracts
issued or entered into on or after that date.
 
PRIOR LEGISLATIVE HISTORY:
2023-24: S7577A - Vetoed (A prior version of this bill was vetoed in
2017)
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
This act shall take effect on January 1, 2027, and apply to insurance
and managed care contracts issued or entered into on or after that date.

Statutes affected:
S5313: 4224 insurance law, 4303 insurance law, 4303(s) insurance law
S5313A: 3216 insurance law, 3216(c) insurance law, 3221 insurance law, 3221(a) insurance law, 4303 insurance law, 4303(s) insurance law