2023 New York Laws › GMU - General Municipal › Article 5 - Powers, Limitations and Liabilities › 92-A - Medical, Surgical and Hospital Services or Insurance for Officers, Employees and Retired Officers and Employees of Public Corporations and Their Famil

§  92-a.  Medical,  surgical  and  hospital  services or insurance for
officers,  employees  and  retired  officers  and  employees  of  public
corporations  and  their  families. 1. As used in this section, the term
"public corporation" shall mean  a  municipal  corporation,  a  district
corporation,  a  school  district,  a consolidated health district and a
county or town special district or a joint special district, governed by
a separate board  of  commissioners.  Officers,  employees  and  retired
officers and employees of a county or town special district which is not
governed  by  a  separate  board  of commissioners shall be deemed to be
county  or  town  officers  and  employees,  or  retired  officers   and
employees, respectively.
1-a.  As used in this section the term "retired officer" shall include
any former school board member with twenty years or more service in such
position. The total cost of participation by such  former  school  board
members and their families shall be borne by such former members.
2.  A  public  corporation  may  contract with a non-profit membership
corporation, organized under article forty-three of  the  insurance  law
and  approved  by the superintendent of financial services and the state
board of social welfare, or with any insurance company authorized to  do
business  in  this  state  for  the  purpose  of  furnishing medical and
surgical services and  hospital  service  as  defined  in  such  article
forty-three,  or  medical and surgical and hospital insurance to persons
who contract with such non-profit membership  corporation  or  insurance
company,  or  who subscribe to a plan or plans, as hereinafter provided.
Any such contract entered into by a public corporation shall permit  any
officer  or  employee  or group of officers or employees of an agency or
department of the public corporation voluntarily to subscribe to a  plan
or  plans providing for medical and surgical and hospital insurance for,
or medical and surgical services and hospital service to, such  officers
or  employees  and  their  families. Any such contract entered into by a
public corporation may, if authorized by the governing board or body and
subject to such conditions, limitations and eligibility requirements  as
may  be  fixed  by  such  board or body, permit any retired officers and
employees or group of retired officers and employees  of  an  agency  or
department  of the public corporation voluntarily to subscribe to such a
plan or plans to provide such insurance for or service to themselves and
their families. The comptroller  or  other  disbursing  officer  of  the
public corporation, or of any fund out of which officers or employees of
such public corporation are paid, is authorized to deduct from the wages
or  salary  of such contracting or subscribing officer or employee, with
his prior consent, in writing, the sums required  to  be  paid  by  such
officer  or  employee  to  such  non-profit  membership  corporation  or
insurance company. Such public corporation, if  such  contract  or  plan
provides  that the employer shall contribute a share of the cost of such
medical and surgical services  and  hospital  service,  or  medical  and
surgical  and  hospital  insurance,  for  its  officers and employees or
retired officers and employees,  is  authorized  to  appropriate  a  sum
required  to  be  paid  under such contract by the public corporation as
employer. The sum  to  be  paid  by  it  under  such  contract,  in  the
discretion  of  such  public  corporation,  may be any percentage of the
total cost including the whole thereof. Where the  compensation  of  any
officer  or  employee  whose position is covered by medical and surgical
services and hospital service  or  medical  and  surgical  and  hospital
insurance   pursuant   to  this  section  is  paid  from  a  special  or
administrative fund provided for by law, the contributions  required  to
be  paid  by the public corporation for such coverage shall be paid from
such special or administrative fund. The  public  corporation  shall  be
authorized  to pay directly to such non-profit membership corporation or

to such insurance company, the total of such appropriation and  of  such
officer and employee deductions.
3.  The  authority  conferred upon public corporations by this section
shall be in addition to and in no way a limitation  upon  the  authority
conferred  upon  such public corporations to provide the same or similar
benefits for their officers and employees pursuant to article eleven  of
the civil service law.
4. The provisions of this section shall apply to school board members,
provided  however,  that  the total cost of participation by such school
board members and their families shall be borne by such members.
5. Any contract or contracts made pursuant to this section by  a  city
with  a  population  of  one million or more inhabitants and any plan or
plans  effectuated  by  any  such  contract  or   contracts   shall   be
administered  by  the department of personnel or the office of municipal
labor relations of such city, or if  there  be  no  such  department  or
office  therein,  by a department, agency, or officer thereof designated
by the mayor of such city.
6. (a) Notwithstanding any  general,  special  or  local  law  to  the
contrary,  the  governing board of a public corporation that, in lieu of
contracting pursuant to subdivision  two  of  this  section,  self-funds
medical,  surgical  or hospital benefits, may enter into agreements with
duly qualified contract administrators or  other  service  providers  to
receive,  investigate,  make  recommendations on, audit, approve or make
payment of claims for such benefits. Such agreements  shall  be  entered
into  pursuant  to competitive bidding, or written request for proposals
in accordance with the procurement policies and procedures of the public
corporation adopted pursuant to  section  one  hundred  four-b  of  this
chapter.
(b)  In  order to authorize the payment of claims for benefits audited
and approved by a contract administrator or other service  provider,  an
agreement  entered  into  pursuant  to this subdivision may provide that
after claims have been audited by the contract  administrator  or  other
service  provider,  the contract administrator or other service provider
shall periodically inform the public corporation  of  the  total  amount
payable  in  satisfaction  of  the audited and approved claims, together
with such other supporting information as  the  public  corporation  may
require,  and  the public corporation may transfer moneys in that amount
to the contract administrator or other service provider for disbursement
to the claimants entitled thereto. Any such agreement shall provide that
if a check  issued  by  the  contract  administrator  or  other  service
provider  in  satisfaction  of  a claim remains unpaid after one hundred
eighty days, the moneys payable in satisfaction of that claim  shall  be
returned to the public corporation.
(c)  Any  agreement  entered  into  pursuant to this subdivision shall
contain, at a minimum, the following:
(i) a clear statement of the charges, fees or other  compensation  for
the services provided under the agreement;
(ii)  a  statement  that  payment  for the services provided under the
agreement shall be made only after the services are rendered;
(iii) a provision stating that the  contract  administrator  or  other
service provider to which functions are delegated shall be liable to the
public  corporation  for  all  loss  or  damage that may result from any
failure by the contract  administrator  or  other  service  provider  to
discharge  their  duties, or from any improper or incorrect discharge of
those duties, and a provision that  expressly  reserves  to  the  public
corporation  all  legal rights of set-off. The contract administrator or
service provider shall save the public  corporation  free  and  harmless

from  any  and  all loss occasioned by or incurred in the performance of
services under an agreement pursuant to this subdivision;
(iv) a provision requiring the contract administrator or other service
provider  to  furnish  a  surety  bond,  irrevocable letter of credit or
equivalent security, in a form and amount acceptable  to  the  governing
board  of the public corporation, to secure the contract administrator's
or other service provider's performance under the agreement;
(v) a  provision  requiring  the  contract  administrator  or  service
provider  to  establish,  maintain  and  retain  for  a specified period
complete and accurate books,  records,  documents,  accounts  and  other
evidence  pertinent  to  performance  under the agreement, and to submit
quarterly and annual reports, in a  form  acceptable  to  the  governing
board  of  the  public  corporation, detailing the payment of claims and
other activities of the contract administrator or other service provider
during the relevant period. The auditing body or official of the  public
corporation  shall  have  access to and may examine such books, records,
documents, accounts and other evidence pertinent  to  performance  under
the  agreement  upon  reasonable notice to the contract administrator or
service provider;
(vi) a provision requiring an annual audit, and opinions  thereon,  by
an independent certified public accountant, of the accounting procedures
and  internal  control procedures of the contract administrator or other
service provider;
(vii) a provision by which the contract administrator or other service
provider agrees to maintain the confidentiality of  medical  records  in
its possession and that such confidentiality may only be waived upon the
written consent of the covered person; and
(viii)  a  provision  by  which  the  contract  administrator or other
service provider acknowledges that those records maintained on behalf of
the public corporation are subject to the provisions of article  six  of
the public officers law.
(d)  A  contract  entered into pursuant to this section shall be for a
term not to exceed five years,  except  that  it  shall  be  subject  to
cancellation  by the municipal corporation at any time upon thirty days'
notice.
7. The provisions of this section shall permit a public corporation to
provide coverage for volunteer firefighters, as defined in section three
of the volunteer firefighters'  benefit  law,  and  volunteer  ambulance
workers, as defined in subdivision one of section three of the volunteer
ambulance workers' benefit law, provided however, that the total cost of
participation  by  such  volunteers and their families shall be borne by
such volunteers.