Section 92-A. Medical, surgical and hospital services or insurance for officers, employees and retired officers and employees of public corporations and their families  


Latest version.
  • 1. As used in this section, the term  "public corporation" shall mean  a  municipal  corporation,  a  district
      corporation,  a  school  district,  a consolidated health district and a
      county or town special district or a joint special district, governed by
      a separate board  of  commissioners.  Officers,  employees  and  retired
      officers and employees of a county or town special district which is not
      governed  by  a  separate  board  of commissioners shall be deemed to be
      county  or  town  officers  and  employees,  or  retired  officers   and
      employees, respectively.
        1-a.  As used in this section the term "retired officer" shall include
      any former school board member with twenty years or more service in such
      position. The total cost of participation by such  former  school  board
      members and their families shall be borne by such former members.
        2.  A  public  corporation  may  contract with a non-profit membership
      corporation, organized under article forty-three of  the  insurance  law
      and  approved  by the superintendent of insurance and the state board of
      social welfare, or with any insurance company authorized to do  business
      in  this  state  for  the  purpose  of  furnishing  medical and surgical
      services and hospital service as defined in such article forty-three, or
      medical and surgical and hospital insurance to persons who contract with
      such non-profit membership corporation  or  insurance  company,  or  who
      subscribe to a plan or plans, as hereinafter provided. Any such contract
      entered  into  by  a  public  corporation  shall  permit  any officer or
      employee or group of officers or employees of an agency or department of
      the public corporation voluntarily to  subscribe  to  a  plan  or  plans
      providing  for  medical  and  surgical  and  hospital  insurance for, or
      medical and surgical services and hospital service to, such officers  or
      employees and their families. Any such contract entered into by a public
      corporation  may,  if  authorized  by  the  governing  board or body and
      subject to such conditions, limitations and eligibility requirements  as
      may  be  fixed  by  such  board or body, permit any retired officers and
      employees or group of retired officers and employees  of  an  agency  or
      department  of the public corporation voluntarily to subscribe to such a
      plan or plans to provide such insurance for or service to themselves and
      their families. The comptroller  or  other  disbursing  officer  of  the
      public corporation, or of any fund out of which officers or employees of
      such public corporation are paid, is authorized to deduct from the wages
      or  salary  of such contracting or subscribing officer or employee, with
      his prior consent, in writing, the sums required  to  be  paid  by  such
      officer  or  employee  to  such  non-profit  membership  corporation  or
      insurance company. Such public corporation, if  such  contract  or  plan
      provides  that the employer shall contribute a share of the cost of such
      medical and surgical services  and  hospital  service,  or  medical  and
      surgical  and  hospital  insurance,  for  its  officers and employees or
      retired officers and employees,  is  authorized  to  appropriate  a  sum
      required  to  be  paid  under such contract by the public corporation as
      employer. The sum  to  be  paid  by  it  under  such  contract,  in  the
      discretion  of  such  public  corporation,  may be any percentage of the
      total cost including the whole thereof. Where the  compensation  of  any
      officer  or  employee  whose position is covered by medical and surgical
      services and hospital service  or  medical  and  surgical  and  hospital
      insurance   pursuant   to  this  section  is  paid  from  a  special  or
      administrative fund provided for by law, the contributions  required  to
      be  paid  by the public corporation for such coverage shall be paid from
      such special or administrative fund. The  public  corporation  shall  be
      authorized  to pay directly to such non-profit membership corporation or
    
      to such insurance company, the total of such appropriation and  of  such
      officer and employee deductions.
        3.  The  authority  conferred upon public corporations by this section
      shall be in addition to and in no way a limitation  upon  the  authority
      conferred  upon  such public corporations to provide the same or similar
      benefits for their officers and employees pursuant to article eleven  of
      the civil service law.
        4. The provisions of this section shall apply to school board members,
      provided  however,  that  the total cost of participation by such school
      board members and their families shall be borne by such members.
        5. Any contract or contracts made pursuant to this section by  a  city
      with  a  population  of  one million or more inhabitants and any plan or
      plans  effectuated  by  any  such  contract  or   contracts   shall   be
      administered  by  the department of personnel or the office of municipal
      labor relations of such city, or if  there  be  no  such  department  or
      office  therein,  by a department, agency, or officer thereof designated
      by the mayor of such city.
        6. (a) Notwithstanding any  general,  special  or  local  law  to  the
      contrary,  the  governing board of a public corporation that, in lieu of
      contracting pursuant to subdivision  two  of  this  section,  self-funds
      medical,  surgical  or hospital benefits, may enter into agreements with
      duly qualified contract administrators or  other  service  providers  to
      receive,  investigate,  make  recommendations on, audit, approve or make
      payment of claims for such benefits. Such agreements  shall  be  entered
      into  pursuant  to competitive bidding, or written request for proposals
      in accordance with the procurement policies and procedures of the public
      corporation adopted pursuant to  section  one  hundred  four-b  of  this
      chapter.
        (b)  In  order to authorize the payment of claims for benefits audited
      and approved by a contract administrator or other service  provider,  an
      agreement  entered  into  pursuant  to this subdivision may provide that
      after claims have been audited by the contract  administrator  or  other
      service  provider,  the contract administrator or other service provider
      shall periodically inform the public corporation  of  the  total  amount
      payable  in  satisfaction  of  the audited and approved claims, together
      with such other supporting information as  the  public  corporation  may
      require,  and  the public corporation may transfer moneys in that amount
      to the contract administrator or other service provider for disbursement
      to the claimants entitled thereto. Any such agreement shall provide that
      if a check  issued  by  the  contract  administrator  or  other  service
      provider  in  satisfaction  of  a claim remains unpaid after one hundred
      eighty days, the moneys payable in satisfaction of that claim  shall  be
      returned to the public corporation.
        (c)  Any  agreement  entered  into  pursuant to this subdivision shall
      contain, at a minimum, the following:
        (i) a clear statement of the charges, fees or other  compensation  for
      the services provided under the agreement;
        (ii)  a  statement  that  payment  for the services provided under the
      agreement shall be made only after the services are rendered;
        (iii) a provision stating that the  contract  administrator  or  other
      service provider to which functions are delegated shall be liable to the
      public  corporation  for  all  loss  or  damage that may result from any
      failure by the contract  administrator  or  other  service  provider  to
      discharge  their  duties, or from any improper or incorrect discharge of
      those duties, and a provision that  expressly  reserves  to  the  public
      corporation  all  legal rights of set-off. The contract administrator or
      service provider shall save the public  corporation  free  and  harmless
    
      from  any  and  all loss occasioned by or incurred in the performance of
      services under an agreement pursuant to this subdivision;
        (iv) a provision requiring the contract administrator or other service
      provider  to  furnish  a  surety  bond,  irrevocable letter of credit or
      equivalent security, in a form and amount acceptable  to  the  governing
      board  of the public corporation, to secure the contract administrator's
      or other service provider's performance under the agreement;
        (v) a  provision  requiring  the  contract  administrator  or  service
      provider  to  establish,  maintain  and  retain  for  a specified period
      complete and accurate books,  records,  documents,  accounts  and  other
      evidence  pertinent  to  performance  under the agreement, and to submit
      quarterly and annual reports, in a  form  acceptable  to  the  governing
      board  of  the  public  corporation, detailing the payment of claims and
      other activities of the contract administrator or other service provider
      during the relevant period. The auditing body or official of the  public
      corporation  shall  have  access to and may examine such books, records,
      documents, accounts and other evidence pertinent  to  performance  under
      the  agreement  upon  reasonable notice to the contract administrator or
      service provider;
        (vi) a provision requiring an annual audit, and opinions  thereon,  by
      an independent certified public accountant, of the accounting procedures
      and  internal  control procedures of the contract administrator or other
      service provider;
        (vii) a provision by which the contract administrator or other service
      provider agrees to maintain the confidentiality of  medical  records  in
      its possession and that such confidentiality may only be waived upon the
      written consent of the covered person; and
        (viii)  a  provision  by  which  the  contract  administrator or other
      service provider acknowledges that those records maintained on behalf of
      the public corporation are subject to the provisions of article  six  of
      the public officers law.
        (d)  A  contract  entered into pursuant to this section shall be for a
      term not to exceed five years,  except  that  it  shall  be  subject  to
      cancellation  by the municipal corporation at any time upon thirty days'
      notice.
        7. The  provisions  of  this  section  shall  apply  for  coverage  of
      volunteer  firefighters,  as  defined  in section three of the volunteer
      firefighters' benefit law, and volunteer ambulance workers,  as  defined
      in  subdivision one of section three of the volunteer ambulance workers'
      benefit law, provided however, that the total cost of  participation  by
      such volunteers and their families shall be borne by such volunteers.