Legislative

Bill Drafting Commission 11754-03-1

IN SENATE
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IN SENATE--Introduced

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to the

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the New exchange)

York

State

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Pub Aut. New York Health Bene ex

AN ACT

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to amend the public authorities law, in relation to establishing the New York Health Benefit exchange in accordance with the federal Patient Protection and Affordable Care Act, as amended by the federal Health Care and Education Reconciliation Act of 2010; and to amend the state finance law, in relation to creating the New York state health benefit exchange fund

.086

Ca.stro

Hawley Hayes

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1) Single bouses). bill. 2) copies copies

House Bill

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OS/12/n

OS/20/11 The People of the State of York, represented in Senate Assembly, do enact as follows: New and

11754-03-1

OS/20/11

11754-03-1

1 2 3 4 5 6 7

Section

1.

Article

of

the

public authorities law is amended by

adding a new title 6-A to read as follows: TITLE 6-A NEW YORK STATE HEALTH BENEFIT EXCHANGE Section 2911. Short title. 2912. Definitions.
2913. Health benefit exchange.

B
9
10

2914. Powers of the exchange. 2915. Procurement. 2916. Reports by the exchange. 2917. Financing of the exchange.
2918. Actions against the exchange.

11 12
13

2919. Regional advisory committees. 2920. Relation·to other laws. S 2911. Short title. This title shall be known and may be cited as the "New York state health benefit exchange act". S 2912. Definitions. As used or referred to in this different meaning clearly appears from the context:
1.

14 15 16
17

title,

unless

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20 21

"Basic health plan" shall mean providing health insurance to uninthirty-three percent

sured persons with incomes of between one hundred

and two hundred percent of the federal poverty level pursuant to section 1331 of the Federal Act. 2. "Board" shall mean the board of directors described in section

22
23

24 25 26

twenty-nine hundred thirteen of this title. 3. "Exchange" shall mean the "New York state health benefit as created by this title. exchange"

OS/20/11

11754-03-1

.1

4.

"Superintendent" means

the superintendent of insurance or on and eleven, the superintendent of the

2 3 4 5 6 7 8 9
10

after October third, two thousand department of financial services.

5. "Commissioner" means the commissioner of the department of health. 6. "Federal act" shall mean the federal "Patient protection and "Health

Affordable Care Act," Pub.L. 111-148, as amended by the federal Care

and Education Reconciliation Act of 2010," Pub.L. 111-152, and any

amendments to, or regulation or guidance issued under those acts. 7. (a) "Health benefit plan" means an offered, delivered, insurance policy or contract

issued for delivery, renewed, amended or continued or reim-

11 12
13

in the state by a health carrier to provide, deliver, pay for burse any of the costs of health care services. (b) "Health benefit plan" does not include:

14 15 16
17

(i) Coverage only for accident, or disability income insurance, or any combination thereof~ (ii) Coverage issued as a supplement to liability insurance~ (iii) Liability insurance, including general liability insurance and

18 19 20
21

automobile liability insurance; (iv) Workers' compensation insurance~ (v) Automobile medical payment insurance~ (vi) Credit-only insurance; (vii) Coverage for on-site medical clinics; or (viii) Other issued pursuant similar insurance coverage specified in regulations

22
23 24

to the Health Insurance Portability and Accountability to time, under which

25 Act of 1996, P.L. 104-191, as amended from time 26

27

benefits

for

health care services are secondary or incidental to other

insurance benefits.

OS/20/11 1 2 3 4 5 6 7

11754-03-1 benefits if

Cc) "Health benefit plan" does not include the following they are provided under a

separate insurance policy, certificate or

contract or are otherwise not an integral part of the plan:

(i) Limited scope dental or vision benefits;
(ii ~ Benefits

for long-term care, nursing hornecare, home health care,

community-based care or any combination thereof~ or (iii) Other similar, limited benefits specified in regulations issued Act of

8 pursuant to the Health Insurance Portability and Accountability 9 10 11 12 13 14 15 16 17 18 19

20

1996, P.L. 104-191, as amended from time to time. Cd) IIHealth benefit plan provided
ll

does not include the following benefits if a separate policy, certificate or

the benefits are

under

contract of insurance, there is no coordination between the provision of the benefits and any exclusion of benefits under any group health plan the benefits are paid with

maintained by the same plan sponsor, and

respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the

same plan sponsor: (i) Coverage only for a specified disease or illness; or (ii) Hospital indemnity or other fixed indemnity insurance.
ee)

"Health benefit plan" does not include the following if offered as

21 22 23 24 25 26 27

a separate policy, certificate or contract of insurance:

(i)

Medicare supplemental health insurance as

defined

under

section

1882(g)(1) of the Social Security Act~ (ii) Coverage supplemental to the coverage provided under chapter 5S

of title 10, United States Code; or

(iii)

Similar suppl.ementalcoverage provided to coverage under a group

health plan.

OS/20/11

11754-03-1

1 2 3 4 5 6 7 8 9
10 11

8. "Health carrier" or "carrier" means an entity subject to the insurance laws or article forty-four of the public health law, regulations of this state, or subject to the jurisdiction of the contracts for, or offers superintendent, that

to contract to provide, deliver, arrange for, pay

or reimburse any of the costs of health care services, including a organiza-

sickness and accident insurance company, a health maintenance tion,

a nonprofit hospital and health service corporation, or any other or health

entity providing a plan of health insurance, health benefits services. 9.

"Qualified dental plan" means a limited scope dental benefit plan

authorized according to the procedures developed under paragraph (b) of subdivision two of section twenty-nine hundred fourteen of this title.
10.

12
13 14 15

"Qualified

employer" means a small employer that elects to make

all of its full-time employees eligible for one or more qualified health plans or qualified dental plans offered through the small business

16 17 18 19
20 21

health options program exchange, and at the option of the employer, some or all of its part-time employees, provided the employer: (a) Has its prinCipal place of business in the state and elects to SHOP exchange to all of its eligible

provide coverage through the employees, wherever

employed;

for

purposes of this title, "principal where an employer

place of business" shall be the location in a state has its headquarters or

22
23 24 25

significant place of business and where the control authority over the business are

persons with direction and employed; or (b) Elects to provide

coverage

through

the small business health employees as defined

26

options program exchange to all of its

eligible

27 under applicable state law. 28 11. "Qualified individual" means an individual who:

OS/20/11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 (a)

11754-03-1

is seeking to enroll in a qualified health plan in the individual

market offered through the exchange, and resides in this state. (b) "Qualified individual" does not include an individual: (i) If, at the time of enrollment, the individual is incarcerated,

other than incarceration pending the disposition of charges; or (ii) If the individual is not, or is not reasonably for the entire period for which expected to be,

enrollment is sought, a citizen or

national of the United States or an alien lawfully present in the United States. 12. "Qualified health plan" means a health benefit plan effect a certification that the that has in

plan meets the criteria for certif-

ication described in sec,tion13ll(c) of the Federal Act. 13. "Secretary" means the secretary of the United States department of health and human services. 14. "SHOP exchange" means the small business established pursuant to paragraph (i) health options program

of subdivision two of section

twenty-nine hundred fourteen of this title. 15. "Small employer" means an employer that employed an average of not more than fifty employees during the preceding employs calendar year and who

at least one on the first day of the plan year. For purposes of

this title: (a) All persons treated as a single (c) , (m) or

( 0)

employer

under

subsection

(b) ,

of

section 414 of the Internal Revenue Code of 1986

shall be treated as a single employer;

( b)

An employer and any predecessor employer shall

be

treated

as

single employeri (e) If an employer was not in existence throughout the preceding employer is a small

calendar year, the determination of whether that

OS/20/11

11754-03-1

1 2 3 4 5 6 7 8

employer

shall

be

based

on

the

average number of employees that is days in the

reasonably expected that employer will employ on business current calendar year; and Cd)
An

employer

that

makes

enrollment

in

qualified health plans

offered in the small group market available to its employees through the exchange, and would cease to be a small employer by reason of an

increase in the number of its employees, shall continue to be treated as a small employer for purposes of this title as long as it continuously

9 makes enrollment in qualified health plans available to its employees.

10 11 12 13 14 15

S 2913. Health benefit exchange. 1. The New York state health exchange is hereby established

benefit

as a public authority pursuant to the

provisions of this chapter. 2. The exchange shall operate subject to the supervision of a board of directors. and control

It shall consist of eleven directors to be

appointed as provided in subdivision three of this section. 3. The board shall be comprised of the following directors: (a) Two non-voting ex officio directors: The commissioner or their designees; (b) Three directors shall be appointed by the governor;
(c)

16
17

superintendent

and

the

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19
20

Two directors shall be appointed by the temporary president of the

21

senate; (d) Two directors shall be appointed by the speaker of the assembly;
(e)

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24 25

One

director

shall

be

appointed by the minority leader of the

senate; (f) One director shall be appointed by assembly. 4. Directors of the board, other than an ex-officio director, shall be appointed for a term of four years, except that the initial appointments the minority leader of the

26 27 28

OS/2a/l1

9 temporary president

11754-03-1

1 2 3 4 5 6 7 8 9 10 11 12
13

by

the

of the senate and speaker of the assembly by the

shall be for a term of five years, and the initial appointments minority years. leaders

in the senate and assembly shall be for a term of two

Each director shall continue to serve until a successor has been

appointed and qualified. Vacancies shall be filled by appointment by the initial appointing authority for the unexpired term. Five voting direc-

tors shall constitute a quorum for the purpose of organizing the authority and conducting the business thereof. The board shall determine the the board shall

times, places and frequency of its meetings, however, meet at least quarterly. 5. A

chair shall be nominated by the governor among his or her alloconfirmation by the senate. Each

cated nominees and be subject to director shall

receive reimbursement for his or her actual and reason-

14 15 16 17 18 19
20

able expenses in the performance of his or her duties hereunder. 6. The board shall appoint a chief executive officer of the state health benefit exchange. The New York

chief executive officer shall be with section

subject to confirmation by the state senate in accordance twenty-eight hundred fifty-two of this article. 7. Appointments shall be made no

later than sixty days after the

effective date of this title. In the event that a particular appointment is not made within ~ixty days, the governor shall appoint an of his or her choosing to fill the vacancy. 8. Directors shall be subject to the provisions for removal prescribed in section twenty-eight hundred twenty-seven of this article. 9. To the extent practicable, directors appointed to the board shall individual

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23

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25

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collectively have demonstrated expertise in all of the following areas: (a) individual health care coverage; (b) small employer health care coverage;

OS/20/11 1 2
3

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11754-03-1

Cc) health benefits plan administration; Cd) health care finance or economics;
(e)

purchasing health plan coverage, including agents, brokers, cham-

4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

bers of commerce and other employer associations; and (f) delivery of health care services. 10. In making appointments to the board, shall take into consideration state so that the the the appointing authorities

cultural, ethnic and geographical board's composition accurately

diversity of the

reflects the various regions of the state. 11. The board shall adopt formal mechanisms to avoid conflicts of

interests by its directors or the staff of the exchange. 12. The exchange shall be subject to officers law. In the event the provisions of the public

regulatory subject to

authority is provided to the the state administrative

exchange, the exchange shall be procedure act.

13. Except as expressly provided by this title, the board shall not: Ca) have the power to tax, assess, impose fees or impose assessments; Cb) have the power to issue bonds, notes, or any other debt obli-

gations; (c) exercise any additional powers, duties or functions with regard to the operation of the exchange unless the governor and the legislature

authorizes such additional powers, duties or functions through enactment of subsequent legislation; Cd) regulate health insurers, ance producers. 14. The board shall have a fiduciary relationship with the exchange. S 2914. Powers of the exchange. 1. Nothing contained in this title to exercise regulatory health insurance plans, or health insur-

shall be interpreted to authorize the eXChange

OS/20/11 1 2 3 4 5 6 7 S 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

11

11754-03-1

authority, unless and until expressly authorized by the legislature, and the powers of the exchange shall be limited to the following: (a) To appoint officers, agents and employees, ·prescribe their duties provisions

and qualifications and fix their compensation subject to the of the civil service law, including

the chief executive officer as hundr~d thirteen

referred to in subdivision six of section twenty-nine of this title.

(0)

ACquire,

lease,

purchase, own, manage, hold and dispose of real deal in or enter into agree-

and personal property, and lease, conveyor

ments with respect to such property on any terms necessary or incidental to the carrying out of these purposes. (c) To make and alter by-laws for its organization and management. (d) To enter into contracts subject fifteen of this title, and to to section twenty-nine hundred

execute all instruments necessary or

convenient. (e) To retain and employ private subject to section twenty-nine consultants hundred on a of contract basis,

fifteen

this title, for

rendering professional and technical assistance and advice. (f) To accept or apply for any gifts or any grant of funds or property from the federal government or from the state of New York or federal or state public body or any other

political subdivision or any other

person and to comply with the terms and conditions thereof. (g) To acquire, hold and dispose of personal property for rate purposes. (h) The exchange may enter into information-sharing agreements with carry out its its corpo-

federal and state agencies and other state eXChanges to responsibilities under this title provided such

agreements include

OS/20/11 I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

12

11754-03-1

adequate protections with respect to the confidentiality of the information shared and comply with all state and federal laws. 2. The exchange shall: (al Implement procedures for the certification, recertification and the secretary

decertification, consistent with guidelines developed by under

section l311(e) of the Federal act regarding health benefit plans

as qualified health plans. (b) Implement procedures for authorizing qualified dental offer limited scope dental benefits consistent plans that

with

section one

1311(d)(2)(B)(ii) of the Federal act, and provide that if at qualified

least

dental plan is authorized to be offered through the exchange, under

certification of a health benefit plan as a qualified health plan paragraph (a) of this subdivision, shall

not be denied because the benefits required of a

health benefit plan does not offer the dental qualified dental plan. (e) Provide for the operation

of a toll-free telephone hotline to

respond to requests for assistance. (d) Provide for enrollment periods, as provided under section

1311(c)(6) of the Federal act. (e) Maintain an internet web site through which enrollees and prospective enrollees of qualified health plans and qualified dental plans may

obtain standardized comparative information on such plans. (f) Publish the average costs of licensing, regulatory other fees and any

payments required by the exchange and the administrative costs of fraud and

the exchange, including information on monies lost to waste,

abuse, on an internet web site to educate individuals on such costs. (g) Inform individuals, in accordance with section 1413 of the Federal act, of eligibility requirements for the Medicaid program under Title

OS/20/11

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11754-03-1

1 2 3 4

XIX of the Social Security Act, as amended from time to time, the dren's Health Insurance Program

cni i-

(CHIP) under Title XXI of the Social time, or any applicable state

Security Act, as amended from time to public program

including Family Health Plus and HEALTHY NY, and enroll such program if the exchange determines, through

5 6 7 8 9
10

an individual in screening of

the

application by the exchange, that such individual is

eligible for any such program. (h) Establish and make available by electronic means a determine the calculator to

actual cost of coverage after application of any premium cost-

tax credit under section 36B of the Internal Revenue Code and any sharing reduction under section 1402 of the Federal act.

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12 13

(i) Establish a small business health options program (SHOP) exchange through which qualified employers may enroll in qualified health plans.

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17

The SHOP exchange shall provide employers the ability to select a health plan or plans through which their employees may enroll in coverage, or

at the option of the employer, allow each employee to enroll in any plan offered through the SHOP exchange at the level of coverage specified the employer. The exchange by

18 19
20

shall not have the authority to merge the The SHOP exchange shall operate

individual and small group markets. separate

and distinct from those activities of the exchange intended to

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facilitate the enrollment of individuals. (j) Grant a certification, subject to section 1411 of the Federal act, attesting that, for purposes of the under section
SOOOA

individual

responsibility

penalty

of

the

Internal

Revenue Code, an individual is

25 26
27

exempt from the individual responsibility requirement or from the penalty imposed by said section SODDA because: (i) There is no affordable qualified health plan available through the exchange, or the individual's employer, covering the individual; or

28

OS/20/11

14

11754-03-1

(ii)

The

individual meets

the

requirements

for

any

other

such

2 3 4 5 6 7 8 9
10 11

exemption from the individual responsibility requirement or penalty. (k) Provide to the secretary of the treasury of the United States the following: (i) A list of the individuals granted a certification under
(j)

paragraph

of this subdivision, including the name and taxpayer identification

number of each individual; (ii) The name and taxpayer identification number of each individual

who was an employee of an employer but who was determined to be eligible for the premium tax credit under section 36B of the Internal Revenue

Code because: (1) The employer did not provide coverage; or (2) The employer provided the minimum essential coverage but it was minimum essential health benefits

12
13

14 15 16
17

determined under section 36B(c)(2)(C) of the Internal Revenue Code to be unaffordable to the employee or did not actuarial value; and (iii) The name and taxpayer identification number of: (1) Each individual who notifies the exchange under section l41l(b)(4) of the Federal act that such individual has changed employers; and (2) Each individual who ceases coverage under a qualified health plan during a plan year and the effective date of that cessation. (1) Provide to each employer the name of each employee of the employer described in subparagraph (ii) of paragraph (k) of this subdivision, who ceases coverage under a qualified health plan during a plan year and the effective date of the cessation. (m) Perform duties required of, or delegated to, the exchange secretary by the provide the required minimum

18 19 20 21 22 23 24 25 26
27

28

or the secretary of the treasury of the United States related

OS/20/11

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11754-03-1

1 2 3 4

to determining or individual (n) Consult (i) health

eligibility responsibility

for premium requirement

tax credits, exemptions.

reduced

cost-sharing

with stakeholders, health care

including, consumers

but not limited

to: in qualified

Educated plans;

who are enrollees

5 6
7

(ii) Individuals ment in qualified

and entities health plans; of

with

experience

in facilitating

enroll-

8
9 10 11 12 13

{iii~ uals; and

Representatives

small employers

and self-employed

individ-

(iv) Advocates
(0)

for enrolling

hard-to-reach integrity of all

populations. requirements: activities, receipts and to

Meet

the following an accurate and annually

financial accounting submit

(i) Keep expenditures the

a report

concerning

such accountings the speaker

14
15 16 17 18 19 20 21 22 23 24 25 26 27 28

governor,

the temporary

president

of the senate,

of the of

assembly,

the minority

leader of the senate,

and the minority

leader

the assembly; (ii) Fully pursuant to cooperate the with any investigation authority with and under conducted by the secretary act and allow of the United of

secretary's

the Federal general

the secretary, States competent

in coordination of health to:

the inspector human

department

services

and any officers

jurisdiction,

(I) Investigate (2) Examine (3) Require

the affairs

of the exchange; and records of the exchange; and undertaken

the properties periodic

reports

in relation

to the activities

by the exchange; (iii) title, Not use any funds in carrying out its activities and operational giveaways, under this

that are intended

for the administrative promotional

expenses excessive

of the exchange,

for staff retreats,

05/20/11

16

11754-03-1

1 2 3 4 5 6
7

executive

compensation or promotion of federal or state legislative and

regulatory modifications. (p) As authorized under section

1312(e)

of

the Federal act, the

exchange shall permit agents and brokers to: (i) enroll qualified individuals and qualified employers in any qua1ified health plans offered in the exchange; and
(ii)

assist qualified individuals and qualified employers in

applying

8 9 10 11 12 13
14

for premium tax credits and cost-sharing reductions for plans offered in the exchange. S 2915. Procurement. 1. Information technology contracts resulting in

a sole technology platform entered into by the exchange under the amount of one million dollars shall be exempt from the competitive bid pursuant to process

sections one hundred twelve and one hundred sixty-three of

the state finance law and any other law to the contrary.
2. Information technology contracts resulting

15 16 17 18 19 20 21 22 23 24 25 26 27 28

in

sole

technology

platform

in

the amount of one million dollars or more, entered into by or request for

the exchange, shall be exempt from the competitive bid

proposal process pursuant to sections one hundred twelve and one hundred sixty-three of the state finance law and any other law to the contrary;

provided, however: (a) the exchange shall post on its website, or otherwise able, for a period not less than sixty days:
(1)

make

avai1-

description

of the of proposed services to be provided by the

contractor and any related services; (ii) the criteria for selection of a contractor or contractors; (iii) the period of time during which prospective contractors may seek selection, which shall be no less than thirty days after tion is first posted on the website; and such informa-

OS/20/11

17

11754-03-1

1 2 3 4 5 6 7 8 9
10

(iv)

the

manner

by

which

prospective

contractor may seek such

selection, which may include submission by electronic means; (b) all reasonable and responsive submissions that are received from

prospective contractors shall be reviewed by the exchange; and (c) the exchange shall select such contractor or contractors that, in

its discretion, have demonstrated the ability to effectively, efficiently, and economically implement the requirements necessary and consistent with the criteria established by this title and the Federal act; have that

the requisite expertise and financial resources; have demonstrated their directors, members, managers, partners or

operators have the industry, and are

11
12 13 14 15

requisite character, competence and standing in the best suited to serve the purposes of this title. 3. Contracts entered into

by the exchange pursuant to this section hundred thirty-nine-j of the state

shall be subject to section finance law. S 2916. Reports

one

16 17 18 19
20

by the exchange. 1. On or before January first, two the gove~nor, the

thousand twelve, the board shall submit a report to temporary president of the senate,

the speaker of the assembly, the assembly,

minority leader of the senate, and the minority leader of the which shall include, but is not

limited to, recommendations on the

21 22
23 24 25

following: (a) Establishment of a basic health plan; (b) How to establish a separate individual health insurance market and a small employer health insurance market within the exchange; (c) Advantages and disadvantages of revising the definition of employer" prior to "small

26 27

the date required by the federal act from not more hundred employees based on

than fifty employees to not more than one

OS/20/11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 actuarial

18

11754-03-1

analyses of projected impacts on premium rates for both indi-

viduals and small employers: (d) Evaluation of requiring qualified health plans to provide the section 1302(a} of

essential health benefits package, as described in the Federal

act, along with specific costs of including state mandated finance the costs of such

benefits and recommendations as to how to additional benefits; ee} Value

of allowing large employers to participate in the exchange

beginning in two thousand seventeen; (f) Whether health savings accounts should be offered in the and in what manner young adults will benefit exchange

from health savings

accounts: (g) The efficacy of merging the individual and small insurance markets and employer health

the subsequent effect on premium rates based on

actuarial analyses for each of the health plan options under the Federal Act: (h) A process to determine coverage in accordance each qualified health plan's level of

with regulations issued by the secretary under

section 1302(d}(2}(A} of the Federal act; (i) Steps to implement the assignment of a rating to each qualified

health plan offered through the exchange in accordance with the criteria developed by the secretary under section 1311(c}(3) of the Federal act;
(j)

Recommendations

on

how to avoid duplicative oversight functions

with other state agencies and entities. (k) The impact on the Healthy NY program: (1) The advantages and disadvantages of the exchange to serve as an

active purchaser, a selective contractor, or clearinghouse of insurancej

OS/20/11

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11754-03-1

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

(m)

The

role

of

insurance associations

producers, within to

agents,

brokers,

chambers

of

commerce (n) Federal

(0)

and employer

the exchange: meet the requirements of the

Risk act;

adjustment

methodologies

A plan

to

award

Navigator act;

grants

in

accordance

with

section

13l1(i) (p)

of the Federal Ways to ensure

that the exchange fifteen,

is financially

self-sustainable act: loss

by the year (q) ratio (r)

two thousand of ways

as required the

by the Federal of

An analysis
in a manner

to conform

definitions

medical

that is consistent of regional

with the Federal variations in the

act: and operation of the

An

analysis and their

exchange

incorporation

within

the exchange. neither set forth overt nor applied to

2. The exchange implement

shall have no authority on the issues statutory the

recommendations without shall

in subdivision

one of

this section

further

authority. developed to section by the

3. The board regional

consider committees,

recommendations pursuant

advisory

established

twenty-

nine hundred required

nineteen

of this title,

when developing

the recommendations

by this

section. of the exchange. The board shall ensure that the

S 2917. Financing establishment, do not exceed other general

operation, the combination fund

and administrative of federal funds,

functions private

of the exchange donations, and

non-general fund money

moneys

available

for

this purpose. under

No state withor

shall be used

for any purpose No liability

this title

out a subsequent any

appropriation.

incurred

by the exchange moneys

of its officers

or employees

may be satisfied shall fund. be

using

from the to the

general general

fund. No funds from the exchange fund or any other special revenue

transferred

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11754-03-1

1 2 3 4 5 6 7 8 9 10 11
12 13 14 15

2918.

Actions

against

the

exchange. Neither any director of the agent of the exchange, while

exchange nor any officer, employee, or acting within the scope of

their authority, shall be subject to any

personal liability resulting from the exercise or carrying out of any of the exchange's purposes or powers. S 2919. Regional advisory committees. 1. There shall be eight regional advisory committees. There shall be six members of each regional adviSuch regional advisory committees shall provide exper-

sory committee. tise

and recommendations to the board. The regional advisory committees region including

shall be comprised of individuals from the geographic carriers, producers, agents, brokers,

chambers of commerce, employer employers, and consumers.

associations, health care providers, Members

small

of each regional advisory committee shall be apPointed in equal and the

numbers by the governor, the temporary president of the senate speaker of the assembly.

The appointing officers shall submit to the committees no later

16
17 18 19 20 21

board their appointments to the regional advisory than sixty days

after the effective date of this title.

In the event gover-

that a particular appointment is not made within sixty days, the nor shall appoint an individual of

his or her choosing to fill the commence their duties

vacancy. The regional advisory committees shall

sixty days after the effective date of this title. 2. There shall be the following eight regions: (a) Long Island, consisting of Nassau and Suffolk counties; (b) New York city; (c) Hudson Valley, consisting of Ulster, Duchess, Orange, Putnam,

22
23 24 25

26 Rockland, and Westchester counties;

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11754-03-1

1 2 3 4 5 6 7 8 9
10 11 12 13 14 15

Cd) Capital District, consisting of Albany, Columbia, Fulton, Montgomery, Rensselaer, Saratoga,

Greene,

Schenectady, Schoharie, Warren, and

Washington counties; (e) Central, consisting of Cayuga, Cortland, Herkimer, Madison, Oneida, Onondaga, Oswego, Seneca, and Tompkins counties; (f) North Country, consisting of Clinton, Essex, Jefferson, Lewis, and st. Lawrence counties; (g) Western, consisting of Chautauqua, Erie, Genesee, Livingston, Franklin, Hamilton,

Monroe, Niagara, Ontario, Orleans, Wayne, Wyoming and Yates counties; (h) Southern Tier, consisting of Allegany, Cattaraugus, Broome,

Chemung,

Chenango,

Delaware,

Otsego, Schuyler, Steuben, Sullivan, and

Tioga counties.
3. Each regional advisory committee shall develop recommendations -for

the

establishment,

implementation, and operation of the New York state recommendations for regional vari-

health benefit exchange including

16
17

ations in the operation of the exchange. a regional advisory committee shall

In carrying out its functions, foster discussions among, and to solicit

18 19
20 21

conduct formal public hearings with requisite public notice input from,

local stakeholder interests, including but not limited to, providers, cham-

carriers, insurance producers, consumers, health care bers

of commerce and other employer associations, small businesses, and thou-

22 23
24 25

community-based organizations. Not later than December first, two sand eleven,

and annually thereafter, each regional advisory committee

shall transmit to the board a report containing its recommendations. The failure of any regional advisory committee to perform the duties imposed by this section shall not affect the obligation of the board to perform

26
27

the duties imposed by section twenty-nine hundred sixteen of this title.

OS/20/11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 S 2920.

22

11754-03-1

Relation to other laws. Nothing in this title, and no action title, shall be construed to

taken by the exchange pursuant to this

preempt or supersede the authority of the superintendent to regulate the business sioner of insurance within this state or the authority of the commisto regulate entities certified pursuant to article forty-four of

the public health law. S 2. The state finance law is amended by adding a new section to read as follows: S 97-kkkk. New York state health benefit exchange fund. 1. There is 97-kkkk

hereby established in the joint custody of the comptroller and the chair of the board of directors of the New York state health benefit exchange, a special fund to be exchange fund". 2. Such fund shall consist of all monies received by the state for known as the "New York state health benefit

purposes of establishing and operating the New York state health benefit exchange act established in title six-A of article nine of the public

authorities law, pursuant to the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any acts.

amendments thereto, or regulations or guidance issued under those Any interest earned

by the investment of moneys in such fund shall be and be used for the

added to such fund, become a part of such fund, purpose of such fund. 3.

Moneys of the New York state health benefit exchange fund shall be of of the New York state health benefit

made available to the" chair exchange for the purpose

establishing and operating the New York

state health benefit exchange fund.

OS/20/11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

23

11754-03-1 hereby

4. Notwithstanding any law to the contrary, the comptroller is

authorized and directed to transfer all the unencumbered balance for the purposes of establishing and operating the New York state health benefit exchange Act pursuant to the federal Patient Protection and Affordable Care Law 111-148), as amended by the federal Health Care and 2010 (Public Law 111-152), and any

(Public

Education Reconciliation Act of amendments

thereto, or regulations or guidance issued under those acts, Account to the New York state

in the Medical Assistance and Survey

health benefit exchange fund in state fiscal year two thousand eleven -two thousand twelve. S 3. Severability clause. If any clause, sentence, paragraph, subdiany court of

vision, section or part of this act shall be adjudged by competent jurisdiction to

be invalid, such judgment shall not affect, be confined in

impair, or invalidate the remainder thereof, but shall its operation

to the clause, sentence, paragraph, subdivision, section

or part thereof directly involved in the controversy in which such judgment shall have been rendered.'It is hereby declared to be the intent of the legislature that.this act would invalid provisions had not have been enacted even if such

been included herein, except in the event Affordable

that, if any provision of the federal Patient Protection and Care

Act or the federal Health Care and Education Reconciliation Act of Supreme Court

2010 is held to be unconstitutional by the United States or is repealed by

the United States Congress, then this act shall be

null and void. S 4. This act shall take effect immediately.