NY Soc Serv L § 369-HH (2021)
2021 New York Laws SOS - Social Services Article 5 - Assistance and Care Title 11-D - Basic Health Program 369-HH - Extended Post-Partum Insurance Coverage.

§ 369-hh. Extended post-partum insurance coverage. 1. Definitions. For purposes of this section:  (a)  "Qualified  individual"  shall  mean  a person who is eligible to enroll in a qualified health plan according to the definition  found  in subdivision  nine  of  section  two  hundred sixty-eight-a of the public health law.  (b) "Qualified health plan" shall mean a health  plan  as  defined  in subdivision  seven  of  section  two hundred sixty-eight-a of the public health law.  (c) "Silver level qualified health plan" means a qualified health plan that has an actuarial value in accordance with the levels established by the marketplace for qualified individuals with  an  income  between  two hundred and two hundred fifty percent of the federal poverty level.  (d)  "Advanced  premium  tax  credits" means payment of the tax credit authorized by 26 U.S.C. 36B and its implementing regulations, which  are provided  on  an  advance  basis  to qualified individuals enrolled in a qualified health plan through the New York state of health, the official health plan marketplace  in  accordance  with  section  1412(a)  of  the Affordable Care Act, 42 U.S.C. § 18082(c)(2).  (e)  "Health care services" means the services and supplies as defined by the commissioner in consultation with the superintendent of financial services, and shall be consistent with  and  subject  to  the  essential health  benefits  as  defined by the commissioner in accordance with the provisions of the patient  protection  and  affordable  care  act  (P.L. 111-148) and consistent with the benefits provided by the reference plan selected by the commissioner for purposes of defining such benefits.   2.  Authorization.  The commissioner of health is authorized, with the approval of the director of the budget, to establish a program  for  the subsidization   of   extended  post-partum  insurance  coverage  to  the individuals eligible under this section.   3. Eligibility. (a) A person  is  eligible  to  receive  coverage  for health care services pursuant to this title if they:  (i)  Are a qualified individual pursuant to subdivision ten of section two hundred sixty-eight-a of the public health law;  (ii) Were  eligible  for  medical  assistance  following  a  pregnancy pursuant  to  subparagraph  one  of paragraph (b) of subdivision four of section three hundred sixty-six of this article; and  (iii) Have income which exceeds two  hundred  percent,  but  does  not exceed two hundred and twenty-three percent, of the federal poverty line for  the applicable family size, which shall be calculated in accordance with guidance issued by the secretary of the United States department of health and human services.  (b) A person eligible under this subdivision  remains  eligible  until the end of the twelfth month following the end of a pregnancy.   4.   Enrollment.   (a)  On  the  first  day  of  the  month  following disenrollment from medical assistance, pursuant to subparagraph  one  of paragraph  (b) of subdivision four of section three hundred sixty-six of this article, persons eligible under this section will be enrolled in  a state-subsidized silver level qualified health plan.  (b)  Enrollment  shall  be  subject to eligible individuals under this section applying for and enrolling with the maximum advance premium  tax credit amount available to them.   5.  Premiums.  The  state shall pay an eligible individual's remaining premium  obligation  directly  to  their  qualified  health  plan  after applying  the  individual's  maximum  premium  assistance  amount, under section 1401(a) of the Patient Protection and Affordable  Care  Act,  26 U.S.C. § 36B(b)(2) and (3).