§ 221-a. Health insurance for jockeys. 1. 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. Any portion of such funding to the account unused
during a calendar year, less an amount sufficient to cover anticipated
premium liabilities over the next sixty days, shall be returned on a pro
rata basis in accordance with the amounts originally contributed and
shall be used for the purpose of enhancing purses at such tracks.
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.
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.