A5939 — Relates to coverage of primary and preventive obstetric and gynecological care; repealer

Summary

Relates to coverage of primary and preventive obstetric and gynecological care.

Bill Text

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Compared against the New York Consolidated Laws as published AI-generated reading aid — verify against the official bill.

This bill amends 1 section(s) of the New York Consolidated Laws: Section 4303 of the insurance law.

• Section 4303 of the insurance law

  shall not shall not as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy women as may be deemed appropriate by the superinten- dent and as are consistent with those established for other benefits within a given contract → may may italics not people who have a cervix not and treatment and treatment (cc) Every contract which provides coverage for prescription drugs shall include coverage for the cost of contraceptive drugs or devices approved by the federal food and drug administration or generic equiv- alents approved as substitutes by such food and drug administration under the prescription of a health care provider legally authorized to prescribe under title eight of the education law. The coverage required by this section shall be included in contracts and certificates only through the addition of a rider. The per member premium rate for cover- age provided by this rider shall be the same for all contracts and certificates of an insurer or health maintenance organization to which the rider is attached, except that an insurer or health maintenance organization may rate the riders issued with its small group policies separately from the riders issued with its large group contracts. (1) Provided, however, if the group or entity, on whose behalf the contract is issued is operated, supervised or controlled by or in connection with a religious organization or denominational group or entity, then nothing in this subsection shall require the contract to cover any contraceptive drugs or devices that are contrary to the reli- gious tenets of such group or entity. If the insurer or health mainte- nance organization delivering the contract or issuing the contract for delivery in this state is operated, sponsored or controlled by or in connection with a religious organization or denominational group or entity, then nothing in this subsection shall require the contract to cover any contraceptive drugs or devices that are contrary to the reli- gious tenets of such insurer or health maintenance organization. (2)(A) Where a group contractholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with paragraph one of this subsection, each enrollee covered under the contract issued to that group contractholder shall have the right to directly purchase the rider required by this subsection from the insurer or health mainte- nance organization which issued the group contract. The enrollee's cost of purchasing such rider shall be the same as that which would have been applicable had the group contractholder not exercised such election not to purchase coverage. (B) Where a group contractholder makes an election not to purchase coverage for contraceptive drugs or devices in accordance with paragraph one of this subsection, the insurer or health maintenance organization that provides such coverage shall provide written notice to enrollees upon enrollment with the insurer or health maintenance organization of their right to directly purchase a rider for coverage for the cost of contraceptive drugs or devices. The notice shall also advise the enrol- lees of the additional premium for such coverage. (3) Such coverage may be subject to reasonable annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other drugs or devices covered under the policy. and treatment (16) Every group or blanket policy which provides coverage for prescription drugs shall include coverage for the cost of contraceptive drugs or devices approved by the federal food and drug administration or generic equivalents approved as substitutes by such food and drug admin- istration under the prescription of a health care provider legally authorized to prescribe under title eight of the education law. The coverage required by this section shall be included in policies and certificates only through the addition of a rider. The per member premi- um rate for coverage provided by this rider shall be the same for all policies and certificates of an insurer to which the rider is attached, except that an insurer may rate the riders issued with its small group policies separately from the riders

  amended

Action History

1. January 07, 2026

   REFERRED TO INSURANCE

2. February 25, 2025

   REFERRED TO INSURANCE

Sponsors

• Daniel Norber · Primary

Subjects