N.Y. Racing, Pari-Mutuel Wagering and Breeding Law § 221-a: Health insurance for jockeys

§ 221-a. Health insurance for jockeys. 1. a. A franchised corporation

shall, as a condition of racing, establish a program to administer the

purchase of health insurance for eligible jockeys.

Such program shall be funded through the deposit of one and one-half

percent of the gross purse enhancement amount from video lottery gaming

at a thoroughbred track pursuant to paragraph two of subdivision b and

paragraph one of subdivision f of section sixteen hundred twelve of the

tax law. The franchised corporation shall establish a segregated account

for the receipt of these monies and these monies shall remain separate

from any other funds. Any corporation or association licensed pursuant

to this article shall pay into such account any amount due within ten

days of the receipt of revenue pursuant to section sixteen hundred

twelve of the tax law.

b. Any portion of such funding to the account, outlined in paragraph a

of this subdivision, unused during a calendar year, less an amount

sufficient to cover anticipated premium liabilities over the next sixty

days, shall be either (i) returned on a pro rata basis in accordance

with the amounts originally contributed to be used for the purpose of

enhancing purses at such tracks, (ii) deposited into the account

established in paragraph c of this section, or (iii) distributed via a

combination of both purposes outlined in subparagraphs (i) and (ii) of

this paragraph. The distribution of such unused funding described in

this paragraph shall be determined and agreed upon by the franchised

corporation and the jockey's organization that represents at least

fifty-one percent of eligible jockeys. Provided, however, if a

corporation or association licensed pursuant to this article provides an

alternative source of funding for this program, an amount equal to this

alternative funding, but not in excess of the amount originally

contributed during the year from the gross purse enhancement amount from

video lottery gaming attributable to such corporation or association,

shall be returned to the corporation or association and used for the

purpose of enhancing purses at such track. Provided, further, any such

alternative source of funding must be approved by the commission.

c. An additional segregated account may be established with such

monies as a reserve fund for the payment of premiums not yet paid. The

amount paid into such fund during any calendar year, if any, shall be

determined upon the agreement between the franchised corporation and the

jockey's organization that represents at least fifty-one percent of

eligible active jockeys outlined in paragraph b of this subdivision. If,

after the establishment of such fund, a determination and agreement is

made between the franchised corporation and the jockey's organization

that represents at least fifty-one percent of eligible jockeys that such

fund is no longer needed, the monies remaining in such fund shall be

returned on a pro rata basis in accordance with the amounts originally

contributed and shall be used for the purposes of enhancing purses at

such tracks.

2. The franchised corporation shall enter into a memorandum of

understanding with the jockey's organization that represents at least

fifty-one percent of eligible active jockeys establishing a plan of

operation for the program, provided that such memorandum of

understanding shall be approved by the commission upon a determination

that such memorandum of understanding meets the statutory requirements

of this section and is in the best interest of racing and shall include,

but not be limited to, the following conditions:

a. health insurance policies must be purchased on an American health

benefit exchange established pursuant to 42 U.S.C. § 18031(b) by the

insured;

b. health insurance policies eligible to be purchased under the

program shall be any policy that is silver level of coverage or lower as

defined by 42 U.S.C.§18022(d). Provided, however, the insured may elect

to purchase a gold level or platinum level of coverage as defined by 42

U.S.C. § 18022(d) if the insured pays the difference in premiums between

such policy and the premium for the silver level policy offered by the

same insurer. Such payments shall be paid into the account established

in subdivision one of this section and shall be governed by the terms of

the memorandum of understanding required by this section;

c. notwithstanding the conditions set forth in paragraphs a and b of

this subdivision, a memorandum of understanding with the jockeys

organization that represents at least fifty-one percent of the eligible

active jockeys may be approved by the commission upon a determination

that such memorandum of understanding is in the best interest of racing

that creates a jockeys health trust to be administered by the franchised

corporation for the purpose of obtaining jockey health benefits from a

health insurance provider that covers jockeys and their dependents with

a health insurance policy that is not purchased on an American health

benefit exchange established pursuant to 42 U.S.C. § 18031(b) but does

provide silver level coverage or lower as defined by 42 U.S.C. §

18022(d);

d. the payment of premiums pursuant to this section shall be made on

behalf of eligible jockeys pursuant to paragraph e of this subdivision

by the franchised corporation from monies in the account established in

subdivision one of this section directly to the health plan selected

pursuant to paragraph b or c of this subdivision;

e. to be eligible to receive health insurance through this program, an

individual must meet one of the following requirements:

(i) have ridden in at least two hundred fifty races conducted by the

franchised corporation during the prior calendar year or in at least one

hundred fifty races conducted by any other corporation or association

licensed pursuant to this article during the prior calendar year;

provided, however, if an individual qualified for coverage in any prior

year and fails to meet the qualification due to an injury not resulting

in a permanent disability, that individual shall be deemed to have met

the qualification; or

(ii) have retired from racing on or after January first, two thousand

ten after having ridden in at least seventy-five hundred races conducted

by any corporation or association licensed pursuant to this article. For

the purposes of this section, an individual shall be considered retired

from racing if they have ridden in fewer than fifty races at any track

in the nation licensed to conduct thoroughbred racing during the

calendar year; or

(iii) have become permanently disabled due to a racing accident while

eligible to receive benefits or would become eligible to receive

benefits in the following year pursuant to subparagraph (i) of this

paragraph; provided, however, if an individual fails to meet the

qualification of such subparagraph (i) due to an injury resulting in a

permanent disability, that individual shall be deemed to have met the

qualification; and

f. the commission shall have the following powers:

(i) to rule on eligibility in the event of a denial of coverage

pursuant to paragraph e of this subdivision. In the event of a denial of

coverage, such individual denied eligibility may appeal to the

commission;

(ii) to make a determination if an individual would have qualified

pursuant to subparagraph (i) of paragraph e of this subdivision in the

event that the individual suffers an injury and contends that he or she

would have qualified had they not suffered such injury; and

(iii) to audit the books and records of the program.