§ 92-A — Medical, surgical and hospital services or insurance for officers, employees and retired officers and employees of public corporations an...

§ 92-a. Medical, surgical and hospital services or insurance for\nofficers, employees and retired officers and employees of public\ncorporations and their families. 1. As used in this section, the term\n"public corporation" shall mean a municipal corporation, a district\ncorporation, a school district, a consolidated health district and a\ncounty or town special district or a joint special district, governed by\na separate board of commissioners. Officers, employees and retired\nofficers and employees of a county or town special district which is not\ngoverned by a separate board of commissioners shall be deemed to be\ncounty or town officers and employees, or retired officers and\nemployees, respectively.\n 1-a. As used in this section the term "retired officer" shall include\nany former school board member with twenty years or more service in such\nposition. The total cost of participation by such former school board\nmembers and their families shall be borne by such former members.\n 2. A public corporation may contract with a non-profit membership\ncorporation, organized under article forty-three of the insurance law\nand approved by the superintendent of financial services and the state\nboard of social welfare, or with any insurance company authorized to do\nbusiness in this state for the purpose of furnishing medical and\nsurgical services and hospital service as defined in such article\nforty-three, or medical and surgical and hospital insurance to persons\nwho contract with such non-profit membership corporation or insurance\ncompany, or who subscribe to a plan or plans, as hereinafter provided.\nAny such contract entered into by a public corporation shall permit any\nofficer or employee or group of officers or employees of an agency or\ndepartment of the public corporation voluntarily to subscribe to a plan\nor plans providing for medical and surgical and hospital insurance for,\nor medical and surgical services and hospital service to, such officers\nor employees and their families. Any such contract entered into by a\npublic corporation may, if authorized by the governing board or body and\nsubject to such conditions, limitations and eligibility requirements as\nmay be fixed by such board or body, permit any retired officers and\nemployees or group of retired officers and employees of an agency or\ndepartment of the public corporation voluntarily to subscribe to such a\nplan or plans to provide such insurance for or service to themselves and\ntheir families. The comptroller or other disbursing officer of the\npublic corporation, or of any fund out of which officers or employees of\nsuch public corporation are paid, is authorized to deduct from the wages\nor salary of such contracting or subscribing officer or employee, with\nhis prior consent, in writing, the sums required to be paid by such\nofficer or employee to such non-profit membership corporation or\ninsurance company. Such public corporation, if such contract or plan\nprovides that the employer shall contribute a share of the cost of such\nmedical and surgical services and hospital service, or medical and\nsurgical and hospital insurance, for its officers and employees or\nretired officers and employees, is authorized to appropriate a sum\nrequired to be paid under such contract by the public corporation as\nemployer. The sum to be paid by it under such contract, in the\ndiscretion of such public corporation, may be any percentage of the\ntotal cost including the whole thereof. Where the compensation of any\nofficer or employee whose position is covered by medical and surgical\nservices and hospital service or medical and surgical and hospital\ninsurance pursuant to this section is paid from a special or\nadministrative fund provided for by law, the contributions required to\nbe paid by the public corporation for such coverage shall be paid from\nsuch special or administrative fund. The public corporation shall be\nauthorized to pay directly to such non-profit membership corporation or\nto such insurance company, the total of such appropriation and of such\nofficer and employee deductions.\n 3. The authority conferred upon public corporations by this section\nshall be in addition to and in no way a limitation upon the authority\nconferred upon such public corporations to provide the same or similar\nbenefits for their officers and employees pursuant to article eleven of\nthe civil service law.\n 4. The provisions of this section shall apply to school board members,\nprovided however, that the total cost of participation by such school\nboard members and their families shall be borne by such members.\n 5. Any contract or contracts made pursuant to this section by a city\nwith a population of one million or more inhabitants and any plan or\nplans effectuated by any such contract or contracts shall be\nadministered by the department of personnel or the office of municipal\nlabor relations of such city, or if there be no such department or\noffice therein, by a department, agency, or officer thereof designated\nby the mayor of such city.\n 6. (a) Notwithstanding any general, special or local law to the\ncontrary, the governing board of a public corporation that, in lieu of\ncontracting pursuant to subdivision two of this section, self-funds\nmedical, surgical or hospital benefits, may enter into agreements with\nduly qualified contract administrators or other service providers to\nreceive, investigate, make recommendations on, audit, approve or make\npayment of claims for such benefits. Such agreements shall be entered\ninto pursuant to competitive bidding, or written request for proposals\nin accordance with the procurement policies and procedures of the public\ncorporation adopted pursuant to section one hundred four-b of this\nchapter.\n (b) In order to authorize the payment of claims for benefits audited\nand approved by a contract administrator or other service provider, an\nagreement entered into pursuant to this subdivision may provide that\nafter claims have been audited by the contract administrator or other\nservice provider, the contract administrator or other service provider\nshall periodically inform the public corporation of the total amount\npayable in satisfaction of the audited and approved claims, together\nwith such other supporting information as the public corporation may\nrequire, and the public corporation may transfer moneys in that amount\nto the contract administrator or other service provider for disbursement\nto the claimants entitled thereto. Any such agreement shall provide that\nif a check issued by the contract administrator or other service\nprovider in satisfaction of a claim remains unpaid after one hundred\neighty days, the moneys payable in satisfaction of that claim shall be\nreturned to the public corporation.\n (c) Any agreement entered into pursuant to this subdivision shall\ncontain, at a minimum, the following:\n (i) a clear statement of the charges, fees or other compensation for\nthe services provided under the agreement;\n (ii) a statement that payment for the services provided under the\nagreement shall be made only after the services are rendered;\n (iii) a provision stating that the contract administrator or other\nservice provider to which functions are delegated shall be liable to the\npublic corporation for all loss or damage that may result from any\nfailure by the contract administrator or other service provider to\ndischarge their duties, or from any improper or incorrect discharge of\nthose duties, and a provision that expressly reserves to the public\ncorporation all legal rights of set-off. The contract administrator or\nservice provider shall save the public corporation free and harmless\nfrom any and all loss occasioned by or incurred in the performance of\nservices under an agreement pursuant to this subdivision;\n (iv) a provision requiring the contract administrator or other service\nprovider to furnish a surety bond, irrevocable letter of credit or\nequivalent security, in a form and amount acceptable to the governing\nboard of the public corporation, to secure the contract administrator's\nor other service provider's performance under the agreement;\n (v) a provision requiring the contract administrator or service\nprovider to establish, maintain and retain for a specified period\ncomplete and accurate books, records, documents, accounts and other\nevidence pertinent to performance under the agreement, and to submit\nquarterly and annual reports, in a form acceptable to the governing\nboard of the public corporation, detailing the payment of claims and\nother activities of the contract administrator or other service provider\nduring the relevant period. The auditing body or official of the public\ncorporation shall have access to and may examine such books, records,\ndocuments, accounts and other evidence pertinent to performance under\nthe agreement upon reasonable notice to the contract administrator or\nservice provider;\n (vi) a provision requiring an annual audit, and opinions thereon, by\nan independent certified public accountant, of the accounting procedures\nand internal control procedures of the contract administrator or other\nservice provider;\n (vii) a provision by which the contract administrator or other service\nprovider agrees to maintain the confidentiality of medical records in\nits possession and that such confidentiality may only be waived upon the\nwritten consent of the covered person; and\n (viii) a provision by which the contract administrator or other\nservice provider acknowledges that those records maintained on behalf of\nthe public corporation are subject to the provisions of article six of\nthe public officers law.\n (d) A contract entered into pursuant to this section shall be for a\nterm not to exceed five years, except that it shall be subject to\ncancellation by the municipal corporation at any time upon thirty days'\nnotice.\n 7. The provisions of this section shall permit a public corporation to\nprovide coverage for volunteer firefighters, as defined in section three\nof the volunteer firefighters' benefit law, and volunteer ambulance\nworkers, as defined in subdivision one of section three of the volunteer\nambulance workers' benefit law, provided however, that the total cost of\nparticipation by such volunteers and their families shall be borne by\nsuch volunteers.\n