§ 4701. Legislative findings. (a) Cooperative health risk-sharing agreements allow public entities to: share, in whole or part, the costs of self-funding employee health benefit plans; provide municipal corporations, school districts and other public employers with an alternative approach to stabilize health claim costs; lower per unit administration costs; and enhance negotiating power with health […]
§ 4702. Definitions. As used in this article: (a) “Community rating” means a rating methodology in which the premium equivalent rate for all persons covered under a municipal cooperative health benefit plan is the same, based upon the experience of the entire pool of risks covered under the plan, without regard to age, sex, health […]
§ 4703. Application for certificate of authority. (a) No municipal corporation shall establish, maintain or otherwise participate in a municipal cooperative health benefit plan in this state which provides benefits, in whole or part, on a shared-funding basis, unless the municipal cooperative health benefit plan: (1) obtains and maintains a certificate of authority from the […]
§ 4704. Conditions for issuance of certificate of authority. (a) The superintendent shall issue a certificate of authority to a municipal cooperative health benefit plan if all of the following conditions, after examination and investigation, have been met to the superintendent’s satisfaction: (1) a complete application has been filed with the superintendent in accordance with […]
§ 4705. Municipal cooperation agreements. (a) The municipal cooperation agreement, under which the municipal cooperative health benefit plan is established and maintained, and any amendment thereto, shall be approved by each participating municipal corporation by majority vote of each such corporation’s governing body, and shall: (1) specify all municipal corporations participating in the municipal cooperative […]
§ 4706. Reserve and surplus requirements. (a) Notwithstanding any provision of law, the governing board of a municipal cooperative health benefit plan shall establish a reserve fund, and the plan’s chief fiscal officer shall cause to be paid into the reserve fund the amounts necessary to satisfy all contractual obligations and liabilities of the plan, […]
§ 4707. Stop-loss requirements. (a) The governing board of a municipal cooperative health benefit plan shall obtain and maintain on behalf of the plan a stop-loss insurance policy or policies delivered in this state and issued by a licensed insurer, providing: (1) aggregate stop-loss coverage with an annual aggregate retention amount or attachment point not […]
§ 4708. Contingent liability. (a) The municipal cooperation agreement and the plan document delivered to each participating municipal corporation shall provide that every municipal corporation participating in the municipal cooperative health benefit plan shall be liable in the event of an order issued pursuant to subsection (b) of this section for an assessment, in addition […]
§ 4709. Plan benefits and disclosure. (a) The governing board of the municipal cooperative health benefit plan shall deliver or cause to be delivered the plan document to all participating municipal corporations and to unions which are the exclusive collective bargaining representatives of employees covered by the plan and the summary plan description to every […]
§ 4710. Additional filing requirements and annual report. (a) The governing board of the municipal cooperative health benefit plan shall: (1) file for approval with the superintendent a description of material changes in any information provided in the application for certificate of authority in the form and manner prescribed by the superintendent; (2) annually, not […]
§ 4711. Examinations. (a) The superintendent may examine the affairs of a municipal cooperative health benefit plan as often as deemed necessary, but not less than once in every three years, except that the superintendent may extend the three-year interval to no more than five years upon determining that the three-year requirement is not necessary […]
§ 4712. Suspension or revocation of certificate of authority. (a) The superintendent may suspend or revoke a certificate of authority issued to a municipal cooperative health benefit plan under the following circumstances: (1) for any cause that would be a basis for denial of an initial application for such a certificate, provided that the superintendent […]
§ 4713. Plan dissolution. (a) In any case in which the governing board of a municipal cooperative health benefit plan determines that there is reason to believe that the plan will terminate, the governing board shall so inform the superintendent and submit a plan for the superintendent’s approval for winding up the plan’s affairs in […]
§ 4714. Transition. For municipal cooperative health benefit plans that provided medical, surgical or hospital services on or before January first, nineteen hundred ninety-three pursuant to a municipal cooperation agreement authorized under article five-G of the general municipal law, the reserve and surplus requirements in section four thousand seven hundred six of this article may […]
