N.Y. Civil Service Law § 161: Health insurance

§ 161. Health insurance. 1. The president is hereby authorized and

directed to establish a health benefit 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 benefit 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.