| 1 | 1 | | <STYLE><!--U {color: Green}S {color: RED} I {color: DARKBLUE; background-color:yellow} P.brk {page-break-before:always}--></STYLE> <BASEFONT SIZE=3> <PRE WIDTH="108"> <FONT SIZE=5><B> STATE OF NEW YORK</B></FONT> ________________________________________________________________________ 3687--A 2025-2026 Regular Sessions <FONT SIZE=5><B> IN ASSEMBLY</B></FONT> January 30, 2025 ___________ Introduced by M. of A. WEPRIN, HEVESI, DAVILA, PAULIN, BROOK-KRASNY -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to addressing non-covered dental services <B><U>The People of the State of New York, represented in Senate and Assem-</U></B> <B><U>bly, do enact as follows:</U></B> 1 Section 1. Section 4224 of the insurance law is amended by adding a 2 new subsection (g) to read as follows: 3 <B><U>(g)(1) All contracts for dental services issued pursuant to this</U></B> 4 <B><U>section shall include the following disclosure: "IMPORTANT: If you opt</U></B> 5 <B><U>to receive services that are not covered services under this plan, a</U></B> 6 <B><U>participating provider may charge their normal fee for such services.</U></B> 7 <B><U>Prior to providing you with services that are not covered, a provider</U></B> 8 <B><U>will provide an estimated cost for each service."</U></B> 9 <B><U>(2) For purposes of this subsection, "covered services" shall mean</U></B> 10 <B><U>dental services for which reimbursement is available under an insured's</U></B> 11 <B><U>dental plan or for which a reimbursement would be available but for the</U></B> 12 <B><U>application of contractual limitations such as deductibles, copayments,</U></B> 13 <B><U>coinsurance, waiting periods, annual or lifetime maximums, frequency</U></B> 14 <B><U>limitations, alternative benefit payments, or any other limitation.</U></B> 15 § 2. Subsection (s) of section 4303 of the insurance law, as added by 16 chapter 293 of the laws of 1992, is amended to read as follows: 17 [<B><S>(s)</S></B>]<B><U>(s-1)(1)</U></B> Notwithstanding any provision of a contract issued by a 18 medical expense indemnity corporation, a dental expense indemnity corpo- 19 ration or health service corporation, every contract which provides 20 coverage for care provided through licensed health professionals who can 21 bill for services shall provide the same coverage and reimbursement for 22 such service provided pursuant to a clinical practice plan established EXPLANATION--Matter in <B><U>italics</U></B> (underscored) is new; matter in brackets [<B><S> </S></B>] is old law to be omitted. LBD07721-02-5 </PRE><P CLASS="brk"><PRE WIDTH="108"> A. 3687--A 2 1 pursuant to subdivision fourteen of section two hundred six of the 2 public health law. 3 <B><U>(2) All contracts for dental services issued pursuant to this section</U></B> 4 <B><U>shall include the following disclosure: "IMPORTANT: If you opt to</U></B> 5 <B><U>receive services that are not covered services under this plan, a</U></B> 6 <B><U>participating provider may charge their normal fee for such services.</U></B> 7 <B><U>Prior to providing you with services that are not covered, a provider</U></B> 8 <B><U>will provide an estimated cost for each service."</U></B> 9 <B><U>(3) For purposes of this subsection, "covered services" shall mean</U></B> 10 <B><U>dental services for which reimbursement is available under an insured's</U></B> 11 <B><U>dental plan or for which a reimbursement would be available but for the</U></B> 12 <B><U>application of contractual limitations such as deductibles, copayments,</U></B> 13 <B><U>coinsurance, waiting periods, annual or lifetime maximums, frequency</U></B> 14 <B><U>limitations, alternative benefit payments, or any other limitation.</U></B> 15 § 3. This act shall take effect January 1, 2027 and shall apply to all 16 insurance contracts issued or entered into on or after such date. |
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