NY Pub Health L § 922 (2021)
2021 New York Laws PBH - Public Health Article 9-A - New York State Small Business Health Insurance Partnership Program 922 - New York State Small Business Health Insurance Partnership Program.

§  922.  New  York  state  small business health insurance partnership program. 1. The commissioner  is  authorized  to  the  extent  of  funds available therefor to establish the New York state small business health insurance partnership program.   2. New York state small business health insurance partnership program. (a)  A  small business health insurance partnership program shall assist eligible employers in purchasing small group health  insurance  policies for their full-time employees and dependents.  (b) An eligible employer may apply to the commissioner for approval in the small business health insurance partnership program by submitting an application  on  a  form prescribed by the commissioner. The information required on such application shall include, but not be limited to:  (i) the name and address  of  the  employer  and  the  nature  of  the business;  (ii) the names and salaries of the employer and employees;  (iii)  an  affidavit  by  the  employer  that employer-provided health insurance  benefits  have  not  been  provided  to  employees   in   the twelve-month period prior to the effective date of this article; and  (iv) such other information as the commissioner may require.  (c) Upon reviewing the applications from eligible small employers, the commissioner  shall,  within  the  amount appropriated for such purpose, award partnership certificates to employers which meet  the  eligibility requirements;  provided  however,  no  partnership  certificates will be awarded by the commissioner on and after January  first,  two  thousand. In  addition  to  evidencing  approval  of  an  eligible  employer,  the certificate shall state the amount of a small business health  insurance partnership incentive payment for a small group health insurance policy, which in no event may exceed forty-five percent of the premium costs for group health care coverage for employees and their dependents. Employees may  be  required  to make contributions to the payment of premium costs under this program at the option of the employer, but in no event  shall such contribution exceed ten percent of the premium costs. Premium costs incurred  by  an  employer for small group health insurance coverage for officers and directors of an employer and others with a  proprietary  or ownership  interest  in  the  employer  may be eligible for an incentive payment to offset premium  costs;  provided,  however,  that  the  gross household  income  of  such  officers  and  directors  or  others with a proprietary or ownership interest is at or below two hundred  twenty-two percent  of the non-farm federal poverty level and provided further that one or more employees and their dependents proposed  to  be  covered  by such  group  health  care  coverage  are  unrelated  to  such  officers, directors or other persons with a proprietary or ownership interest.  If after  joining the program an employer participating in a small business insurance partnership program hires more employees so that the  employer has  more  than  fifty full-time employees at any one time, the employer may continue in the program but the premium costs  attributable  to  the additional  employees  in excess of fifty or their families shall not be eligible for incentive payments.  (d) In approving partnership certificates for eligible small employers prior to January first, two thousand, the commissioner shall:  (i) first  approve  applications  from  eligible  employers  currently receiving  assistance  through a small business health insurance program created by the expanded health care coverage act authorized pursuant  to chapter   seven   hundred   three   of  the  laws  of  nineteen  hundred eighty-eight; and  (ii) give preference to eligible employers  with  the  lowest  average salaries and base the amount of the certificate on the salaries received  by  the  employer  and  employees in order to maximize the impact of the small business partnership premium payments.  (e)  Upon  receipt of a partnership certificate from the commissioner, an approved eligible employer may obtain a small group health  insurance policy  from the insurer, health maintenance organization or corporation of its choice. No  such  insurer,  health  maintenance  organization  or corporation  shall  refuse  to  accept  a small employer holding a valid partnership certificate and such insurer,  organization  or  corporation shall arrange for the payment of the small employer's share of the small group  health  insurance  policy  or  comprehensive health services plan premium. The approved applicant shall make available upon  request  from the  commissioner  information  regarding  continued  eligibility in the program.   The commissioner  shall,  within  amounts  available  therefor,  on  a competitive  bid  process,  contract  with organizations for purposes of public education,  outreach  and  recruitment  of  eligible  businesses, including  the  distribution  of  applications and information regarding enrollment. The organizations shall include,  but  not  be  limited  to: community  based  organizations  such  as  chambers of commerce or trade organizations, diagnostic and treatment centers,  hospitals,  and  other such organizations which engage in outreach and marketing activities. In no  event  shall  the  amount  available  for  education,  outreach, and recruitment exceed two percent of the total  amount  available  for  the purposes of this section.  (f)  The  commissioner,  by  rules  and  regulations,  adopted  by the commissioner  shall  establish  the   procedure   by   which   insurers, corporations  and  organizations  issuing  small  group health insurance policies under this article may redeem a certificate or certificates for the portion of the premium not paid by the employer,  but  in  no  event shall such redemption occur on less than a quarterly basis.   Any  business  which,  with  the  intent to obtain benefits, willfully misstates information required for application for participation in  the New  York  state health insurance partnership program or willfully fails to notify the commissioner or the commissioner's designee of any  change in  status  which  makes  the business ineligible for the program, shall repay such incentive payments paid on behalf of its employees or program participants for health coverage  through  the  New  York  state  health insurance partnership program.  (g) Notwithstanding any inconsistent provision of law or regulation to the  contrary,  benefits  under  the  small  business  health  insurance partnership program shall be considered secondary to any other  plan  of insurance or benefit program under which a person may have coverage.  (h)  On  or  before  April  first,  nineteen hundred ninety-seven, and annually thereafter through April first, two thousand, the  commissioner shall submit a report on the small business health insurance partnership program  to  the  governor, the speaker of the assembly and the majority leader of the senate. Such report shall include, but not be limited to:  (i) the number of employers and employees able to purchase small group health insurance policies under the program;  (ii) the location and the nature of the business  of  such  employers; and  (iii) recommendations for any changes which would improve the program.