STATE OF NEW YORK ________________________________________________________________________ 771 2025-2026 Regular Sessions IN ASSEMBLY (Prefiled) January 8, 2025 ___________ Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the social services law, in relation to requiring coverage for early egg and peanut allergen introduction dietary supplements The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 40 to read as follows: 3 (40) (A) For purposes of this paragraph: 4 (i) "Dietary supplement" shall have the same meaning as in section 5 three hundred twenty-one of the federal food, drug, and cosmetic act. 6 (ii) "Early egg allergen introduction dietary supplement" means a 7 dietary supplement that is prescribed to an infant by a health care 8 practitioner and contains sufficient infant-safe, well-cooked egg prote- 9 in to reduce the risk of food allergies. 10 (iii) "Early peanut allergen introduction dietary supplement" means a 11 dietary supplement that is prescribed to an infant by a health care 12 practitioner and contains sufficient infant-safe peanut protein to 13 reduce the risk of food allergies. 14 (iv) "Health care practitioner" means an individual licensed, certi- 15 fied or otherwise authorized to practice, and legally authorized to 16 prescribe, under title eight of the education law. 17 (v) "Infant" means a child who has not attained the age of one year. 18 (B) (i) All individual health insurance policies, contracts, or 19 certificates that are delivered, issued for delivery, renewed, extended 20 or modified in this state shall provide coverage for at least one of 21 each of the following: 22 (1) an early egg allergen introduction dietary supplement; and 23 (2) an early peanut allergen introduction dietary supplement. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD02568-01-5
A. 771 2 1 (ii) The coverage required pursuant to item (i) of this subparagraph 2 shall be provided at no cost to a covered individual, including deduct- 3 ible payments and cost-sharing amounts charged once a deductible is met. 4 (C) Except as provided under subparagraph (B) of this paragraph, noth- 5 ing in this paragraph shall prevent the operation of a policy provision 6 required by this paragraph as a deductible, coinsurance, allowable 7 charge limitation, coordination of benefits, or a provision restricting 8 coverage to services by a licensed, certified, or carrier-approved 9 provider or facility. 10 (D) (i) This paragraph shall not apply to accident only, specified 11 disease, hospital indemnity, Medicare supplement, long term care, disa- 12 bility income or other limited benefit health insurance policies. 13 (ii) The cost-sharing limitation under item (ii) of subparagraph (B) 14 of this paragraph shall not apply to a catastrophic health plan to the 15 extent such cost-sharing limitation would cause such plan to fail to be 16 treated as a catastrophic plan under subsection (e) of section thirteen 17 hundred two of the patient protection and affordable care act. 18 (iii) (1) The cost-sharing limitation under item (ii) of subparagraph 19 (B) of this paragraph shall not apply to a high deductible health plan 20 to the extent such cost-sharing limitation would cause such plan to fail 21 to be treated as a high deductible health plan under paragraph two of 22 subsection (c) of section two hundred twenty-three of the internal 23 revenue code. 24 (2) If the cost-sharing limitation under item (ii) of subparagraph (B) 25 of this paragraph would result in an enrollee becoming ineligible for a 26 health savings account under federal law, such cost-sharing limitation 27 shall only apply to a qualified high deductible health plan after such 28 enrollee's deductible has been met. 29 § 2. Section 3221 of the insurance law is amended by adding a new 30 subsection (v) to read as follows: 31 (v) (1) For purposes of this subsection: 32 (A) "Dietary supplement" shall have the same meaning as in section 33 three hundred twenty-one of the federal food, drug, and cosmetic act. 34 (B) "Early egg allergen introduction dietary supplement" means a 35 dietary supplement that is prescribed to an infant by a health care 36 practitioner and contains sufficient infant-safe, well-cooked egg prote- 37 in to reduce the risk of food allergies. 38 (C) "Early peanut allergen introduction dietary supplement" means a 39 dietary supplement that is prescribed to an infant by a health care 40 practitioner and contains sufficient infant-safe peanut protein to 41 reduce the risk of food allergies. 42 (D) "Health care practitioner" means an individual licensed, certified 43 or otherwise authorized to practice, and legally authorized to 44 prescribe, under title eight of the education law. 45 (E) "Infant" means a child who has not attained the age of one year. 46 (2) (A) All group health insurance policies, contracts, or certif- 47 icates that are delivered, issued for delivery, renewed, extended or 48 modified in this state shall provide coverage for at least one of each 49 of the following: 50 (i) an early egg allergen introduction dietary supplement; and 51 (ii) an early peanut allergen introduction dietary supplement. 52 (B) The coverage required pursuant to subparagraph (A) of this para- 53 graph shall be provided at no cost to a covered individual, including 54 deductible payments and cost-sharing amounts charged once a deductible 55 is met.
A. 771 3 1 (3) Except as provided under paragraph two of this subsection, nothing 2 in this subsection shall prevent the operation of a policy provision 3 required by this subsection as a deductible, coinsurance, allowable 4 charge limitation, coordination of benefits, or a provision restricting 5 coverage to services by a licensed, certified, or carrier-approved 6 provider or facility. 7 (4) (A) This subsection shall not apply to accident only, specified 8 disease, hospital indemnity, Medicare supplement, long term care, disa- 9 bility income or other limited benefit health insurance policies. 10 (B) The cost-sharing limitation under subparagraph (B) of paragraph 11 two of this subsection shall not apply to a catastrophic health plan to 12 the extent such cost-sharing limitation would cause such plan to fail to 13 be treated as a catastrophic plan under subsection (e) of section thir- 14 teen hundred two of the patient protection and affordable care act. 15 (C) (i) The cost-sharing limitation under subparagraph (B) of para- 16 graph two of this subsection shall not apply to a high deductible health 17 plan to the extent such cost-sharing limitation would cause such plan to 18 fail to be treated as a high deductible health plan under paragraph two 19 of subsection (c) of section two hundred twenty-three of the internal 20 revenue code. 21 (ii) If the cost-sharing limitation under subparagraph (B) of para- 22 graph two of this subsection would result in an enrollee becoming ineli- 23 gible for a health savings account under federal law, such cost-sharing 24 limitation shall only apply to a qualified high deductible health plan 25 after such enrollee's deductible has been met. 26 § 3. Section 4303 of the insurance law is amended by adding a new 27 subsection (ww) to read as follows: 28 (ww) (1) For purposes of this subsection: 29 (A) "Dietary supplement" shall have the same meaning as in section 30 three hundred twenty-one of the federal food, drug, and cosmetic act. 31 (B) "Early egg allergen introduction dietary supplement" means a 32 dietary supplement that is prescribed to an infant by a health care 33 practitioner and contains sufficient infant-safe, well-cooked egg prote- 34 in to reduce the risk of food allergies. 35 (C) "Early peanut allergen introduction dietary supplement" means a 36 dietary supplement that is prescribed to an infant by a health care 37 practitioner and contains sufficient infant-safe peanut protein to 38 reduce the risk of food allergies. 39 (D) "Health care practitioner" means an individual licensed, certified 40 or otherwise authorized to practice, and legally authorized to 41 prescribe, under title eight of the education law. 42 (E) "Infant" means a child who has not attained the age of one year. 43 (2) (A) Every policy which provides hospital, medical or surgical 44 coverage shall provide coverage for at least one of each of the follow- 45 ing: 46 (i) an early egg allergen introduction dietary supplement; and 47 (ii) an early peanut allergen introduction dietary supplement. 48 (B) The coverage required pursuant to paragraph two of this subsection 49 shall be provided at no cost to a covered individual, including deduct- 50 ible payments and cost-sharing amounts charged once a deductible is met. 51 (3) Except as provided under paragraph two of this subsection, nothing 52 in this subsection shall prevent the operation of a policy provision 53 required by this subsection as a deductible, coinsurance, allowable 54 charge limitation, coordination of benefits, or a provision restricting 55 coverage to services by a licensed, certified, or carrier-approved 56 provider or facility.
A. 771 4 1 (4) (A) This subsection shall not apply to accident only, specified 2 disease, hospital indemnity, Medicare supplement, long term care, disa- 3 bility income or other limited benefit health insurance policies. 4 (B) The cost-sharing limitation under subparagraph (B) of paragraph 5 two of this subsection shall not apply to a catastrophic health plan to 6 the extent such cost-sharing limitation would cause such plan to fail to 7 be treated as a catastrophic plan under subsection (e) of section thir- 8 teen hundred two of the patient protection and affordable care act. 9 (C) (i) The cost-sharing limitation under subparagraph (B) of para- 10 graph two of this subsection shall not apply to a high deductible health 11 plan to the extent such cost-sharing limitation would cause such plan to 12 fail to be treated as a high deductible health plan under paragraph two 13 of subsection (c) of section two hundred twenty-three of the internal 14 revenue code. 15 (ii) If the cost-sharing limitation under subparagraph (B) of para- 16 graph two of this subsection would result in an enrollee becoming ineli- 17 gible for a health savings account under federal law, such cost-sharing 18 limitation shall only apply to a qualified high deductible health plan 19 after such enrollee's deductible has been met. 20 § 4. Subdivision 2 of section 365-a of the social services law is 21 amended by adding a new paragraph (nn) to read as follows: 22 (nn) (i) at least one early egg allergen introduction dietary supple- 23 ment and at least one early peanut allergen introduction dietary supple- 24 ment at no cost. 25 (ii) as used in this paragraph, the following terms shall have the 26 following meanings: 27 (1) "Early egg allergen introduction dietary supplement" means a 28 dietary supplement that is prescribed to an infant by a health care 29 practitioner and contains sufficient infant-safe, well-cooked egg prote- 30 in to reduce the risk of food allergies. 31 (2) "Early peanut allergen introduction dietary supplement" means a 32 dietary supplement that is prescribed to an infant by a health care 33 practitioner and contains sufficient infant-safe peanut protein to 34 reduce the risk of food allergies. 35 § 5. This act shall take effect on the first of January next succeed- 36 ing the date on which it shall have become a law and shall apply to all 37 policies and contracts issued, renewed, modified, altered, or amended on 38 or after such date.