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November 27, 2015

New York State & Federal Government Reach Agreement To Increase Oversight of Employer's Health Care Offerings

According to a release from the Associated Press on October 6th, the New York State Attorney General and the United States Employee Benefits Security Administration have entered into a five year memorandum, giving each entity greater ability to investigate, and potentially regulate health care offerings by New York State employers.  This agreement in effect remedies New York State’s prior inability to enforce state laws against self-insured health plans as well as the federal government’s inability to regulate private health insurers. The memorandum allows state and federal authorities to share information between the two agencies in an effort to address violations of laws covering health insured benefits.  It further allows them to conduct joint investigations as well as assist each other with enforcement of state and federal laws, regardless of whether the offered plan is self or privately insured.

The end-result may be greater scrutiny for employers concerning their offered health benefits to their employees.  Whereas prior to this agreement there was an apparent demarcation concerning the reach of the federal government into private healthcare plan offerings in New York, this will now, in essence, allow federal investigations into potential insurer violations.  Likewise, this agreement will allow the Attorney General to more closely examine self-insured health plan options for potential violations of New York State law, thereby adding another layer of compliance to self-insurers.  It is unclear from the reports whether any penalties imposed will still be issued by the traditional regulating entity, or whether dual penalties could be imposed for potential violations.  Another potential result could be greater scrutiny by the private insurers concerning health plan offerings to potential employer clients. Suffice it to say, this appears to be another step in the direction towards greater federal regulation of New York health care plan offerings and a way for New York State to monitor large self-insured entities.

To access the Associated Press release, please click this link.

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