Section 161. Health insurance  


Latest version.
  • 1. The president is hereby authorized and
      directed to establish a health insurance plan  for  state  officers  and
      employees  and  their dependents and officers and employees of the state
      colleges of agriculture, home economics, industrial labor relations  and
      veterinary  medicine,  the  state  agricultural  experiment  station  at
      Geneva, and any other institution or agency  under  the  management  and
      control  of  Cornell  university  as  the representative of the board of
      trustees of the state university of New York, and the state  college  of
      ceramics  under  the  management and control of Alfred university as the
      representative of the board of trustees of the state university  of  New
      York   and  their  dependents  which,  subject  to  the  conditions  and
      limitations contained in this article, and in  the  regulations  of  the
      president,  will provide for group hospitalization, surgical and medical
      insurance against  the  financial  costs  of  hospitalization,  surgery,
      medical  treatment  and  care,  and  may  include,  among  other  things
      prescribed drugs, medicines, prosthetic appliances, hospital  in-patient
      and out-patient service benefits and medical expense indemnity benefits.
        2.  Such health insurance shall not include expenses incurred by or on
      account of an individual prior to the effective date of the plan  as  to
      him or her; cosmetic surgery or treatment except to the extent necessary
      for  correction  of  damage caused by accidental injury while covered by
      the plan or as direct result of diseases covered by the  plan;  services
      received because of illness or injury arising out of or in the course of
      employment  and  entitling  the  individual to benefits under a workers'
      compensation  or  occupational  disease  law;  services  received  in  a
      hospital  owned or operated by the United States government for which no
      charge is made; services received for injury or sickness due to  war  or
      any  act of war, whether declared or undeclared, which war or act of war
      shall have occurred after the effective date of this plan; expenses  for
      which  the  individual  is not required to make payment; expenses to the
      extent of benefits provided under any employer  group  plan  other  than
      this  plan, and such other expenses as may be excluded by regulations of
      the president.
        3. The health insurance plan shall be designed by the president (1) to
      provide a reasonable relationship between  the  hospital,  surgical  and
      medical  benefits  to  be  included,  and  the  expected distribution of
      expenses of each such type to be incurred by the covered  employees  and
      dependents,  and  (2)  to include reasonable controls, which may include
      deductible and coinsurance provisions applicable to some or all  of  the
      benefits,  to  reduce  unnecessary  utilization of the various hospital,
      surgical and medical services to be provided and to  provide  reasonable
      assurance  of  stability in future years of the plan, and (3) to provide
      benefits on a non-discriminatory basis to the extent possible, to active
      members throughout the state, wherever located.