STATE OF NEW YORK ________________________________________________________________________ 3543 2023-2024 Regular Sessions IN SENATE January 31, 2023 ___________ Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to the approval of policy forms The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 6 of subsection (c) of section 3201 of the insur- 2 ance law, as amended by chapter 341 of the laws of 2006, is amended to 3 read as follows: 4 (6) [(a) The] (A) Except as otherwise provided for in subsection (e) 5 of this section, the superintendent may disapprove any policy form spec- 6 ified in paragraph two of subsection (b) of this section issued by a 7 domestic life insurer or fraternal benefit society for delivery outside 8 the state if its issuance would be prejudicial to the interests of its 9 policyholders or members. 10 [(b)] (B) Except for the policy forms specified in paragraph two of 11 subsection (b) of this section, every domestic life insurer and frater- 12 nal benefit society shall file annually with the superintendent a list 13 identifying and describing the policy forms issued by the insurer or 14 fraternal benefit society for delivery outside the state in a form 15 prescribed by the superintendent. If the superintendent determines that 16 the issuance of a policy form has been or may be prejudicial to the 17 interests of policyholders or members, the superintendent may take any 18 action he or she deems appropriate, including issuing an order, after a 19 hearing, to cease and desist issuing the policy form. 20 (C) Any insurer or fraternal benefit society who shall issue a policy 21 form which shall be exempt from the filing and approval requirements of 22 paragraphs one and two of subsection (b) of this section, shall file 23 annually with the superintendent a list identifying and describing such 24 policy forms in a manner prescribed by the superintendent pursuant to 25 paragraph one of subsection (e) of this section. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00377-01-3
S. 3543 2 1 § 2. Section 3201 of the insurance law is amended by adding a new 2 subsection (e) to read as follows: 3 (e)(1) For purposes of this section, the following terms shall have 4 the following meanings: 5 (A) "Large group policyholder" shall mean a group with a minimum of 6 five hundred employees or members that either employ or contract with a 7 qualified benefits manager that shall satisfy the criteria set forth in 8 this subsection. 9 (B) (i) "Qualified benefits manager" means an individual that: 10 a. is a fiduciary under the Employee Retirement Income Security Act of 11 1974 (ERISA); 12 b. holds a bachelor's degree or higher from an accredited college or 13 university; 14 c. has a minimum of five years' experience analyzing, designing, or 15 advising groups defined herein regarding group benefit programs that 16 include, but are not limited to, life insurance, accident and health 17 insurance or annuity products; or 18 d. has a designation as a certified benefit plan administrator, certi- 19 fied employee benefit specialist from the international foundation of 20 employee benefit plans, certified benefits professional from world at 21 work, retirement plan professional issued by the american society of 22 pension professionals and actuaries, any other similar designation 23 issued by an accredited college or university, chartered life underwrit- 24 er (C.L.U.), or is a licensed insurance agent or broker pursuant to 25 article twenty-one of the this chapter; and 26 (ii) A qualified benefits manager shall not include an individual that 27 shall be employed by the insurer or fraternal benefit society issuing 28 the group policy or any person in the insurers' or fraternal benefit 29 society's holding company system. 30 (2) Notwithstanding anything in this section to the contrary, policy 31 forms delivered or issued for delivery in the state, policy forms deemed 32 to have been delivered in the state regardless of the place of actual 33 delivery, or policy forms specified in paragraph two of subsection (b) 34 of this section which shall have been issued to a large group policy- 35 holder as defined in subparagraph (A) of paragraph one of this 36 subsection and that are issued to groups defined in section three thou- 37 sand two hundred twenty-two of this article, except an agreement provid- 38 ing for periodic payments in satisfaction of a claim, section four thou- 39 sand two hundred sixteen of this chapter, other than policy forms to be 40 issued pursuant to paragraph three or fourteen of subsection (b) of such 41 section, and section four thousand two hundred thirty-eight of this 42 chapter are exempt from filing and approval under paragraph one of 43 subsection (b) of this section and filing for delivery outside this 44 state under paragraph two of subsection (b) of this section. 45 (3) The superintendent shall not have the authority to disapprove any 46 such policy form, but shall have the authority, after notice and a hear- 47 ing shall have been given to the insurer or fraternal benefit society 48 which issued any such policy form, to issue a cease and desist order to 49 such insurer or fraternal benefit society if the use of such form is 50 contrary to the requirements of this chapter or inconsistent with law at 51 the time of such order. 52 (4) The superintendent shall have authority to issue a cease and 53 desist order to such insurer of fraternal benefit society in the case of 54 any such policy form: 55 (A) pertaining to life insurance, annuity contract, group annuity 56 certificate, or funding agreement for a policy form issued for delivery
S. 3543 3 1 outside the state, if its issuance would be prejudicial to the interests 2 of policyholders or members; 3 (B) pertaining to life insurance, annuity contract, group annuity 4 certificate, or funding agreement for a policy form delivered or issued 5 for delivery within the state, if such form contains provisions which 6 are unjust, unfair or inequitable; or 7 (C) pertaining to certificates deemed to be delivered in this state 8 regardless of the place of actual delivery, if such certificate fails to 9 afford insureds protections substantially similar to those which shall 10 be provided by certificates delivered in the state. 11 (5) Any such cease and desist order shall be effective not less than 12 ninety days after such order is issued. 13 (6) Notwithstanding anything in this article or article forty-two of 14 this chapter to the contrary, any schedule of premium rates, commissions 15 or fees which shall relate to a group identified in this subsection and 16 are required to be filed pursuant to such articles, may immediately be 17 used by an insurer upon the mailing of such schedule to the superinten- 18 dent. 19 (7) Notwithstanding anything in this section to the contrary, any 20 group policy form which shall be exempt from filing or approval under 21 paragraph two of this subsection, may contain provisions which are, at 22 the minimum, as favorable as the provisions required by this article and 23 article forty-two of this chapter as determined by the issuer of such 24 group policy form. 25 (8) Every policy issued pursuant to this subsection shall contain a 26 notice to the group policyholder that such policy forms shall not be 27 subject to the filing and approval requirements of the state. 28 § 3. This act shall take effect on the thirtieth day after it shall 29 have become a law.