BILL NUMBER: S5354
SPONSOR: COMRIE
 
TITLE OF BILL:
An act to amend the insurance law, in relation to life, accident and
health insurance; discriminating and rebating; prohibited inducements
and independent sales
 
PURPOSE:
To modernize the insurance law to allow licensed brokers, agents and
benefit consultants to assist insurers and employers in the interpreta-
tion, management and communication of the insurance policy and its
resulting costs, and to assist insurers and employers in the development
and implementation of care coordination services and other incidental or
ancillary programs and services.
 
SUMMARY OF PROVISIONS:
Section 1 of the bill would amend subsection (f) of § 4224 of the insur-
ance law by adding a new paragraph (3) thereto, to allow licensed insur-
ance producers without charging a service fee, or in the case of
licensed insurance brokers for a separate service fee, to provide
certain services to assist insurers and policyholders in the interpreta-
tion, management and communication of health insurance policies and
plans and their costs, including risk assessment, insurance consultation
and advice, insurance-related regulatory & legislative updates, claims
assistance services, tax preparations services related to IRS Form 5500
Schedule A (Annual Return/Report of Employee Benefit Plan) , insurance
plan information, forms, administration, employee & subscriber enroll-
ment services, websize links/employee benefit portals, answers to FAQs,
COBRA administration services, and HIPAA compliance services.
Section 2 of the bill would provide for an immediate effective date.
 
JUSTIFICATION:
The fast-paced and competitive insurance marketplace continues to
evolve, and insurance producers must change with it. Integral to this is
the modernization of certain statutory restrictions that are old and
outmoded. Chief amongst these are the anti-rebating and inducement laws
that were originally designed to protect insurance producers and consum-
ers alike from offering and accepting illegal inducements for the sale
of insurance products. In today's sophisticated health insurance market,
licensed insurance producers, including brokers, agents and benefits
consultants, must be able to offer a full value-added services platform,
such as providing benefits concierge, employee communications, 'benefits
web sites and help desks, benefits statements, compliance support, in
order to attract business and close the sale. Employer groups of all
sizes are increasingly looking not only for traditional advice in
selecting health plan benefits design and coverage options, underwriting
to reduce claims losses, and claims servicing and policyholder advocacy,
but are also demanding back-office human resources support. The statuto-
ry exceptions and allowanced prescribed in this bill would modernize the
insurance law with respect to health insurance, and allow insurance
producers to keep abreast of the market, by lawfully providing such
services within the scope of their licensure and practice, without
charging a service fee, or in the case of licensed insurance brokers for
a separate service fee.
Moreover, this bill would codify the incidental services excepted from
the insurance anti-rebating and inducement laws listed in NYS Insurance
Department Circular Letter No. 9 (2009)
http://www.ins.state.ny.us/circltr/ 2009/0109 09.htm
 
LEGISLATIVE HISTORY:
S.3555 of 2023-24
S.4058 of 2021-22;
S.3624 of 2019-20;
S.4546 of 2017-18;
S.1672 of 2015-16;
S.7299 of 2014
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
Immediately.

Statutes affected:
S5354: 4224 insurance law, 4224(f) insurance law