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0 chapters · 1,072 sections in this title.
N.Y. Insurance Law § 4233 Annual statements of life insurance companies
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§ 4233. Annual statements of life insurance companies. (a) In addition\nto any other matter which may be required to be stated therein, either\nby law or by the superintendent pursuant to law, every annual statement\nof every life insurance company doing business in this state s…
N.Y. Insurance Law § 4235 Group accident and health insurance
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§ 4235. Group accident and health insurance. (a) (1) Any policy of\ninsurance against death or injury resulting from an accident which\ncovers more than one person, except blanket accident insurance policies\nas defined in section four thousand two hundred thirty-seven of this\n…
N.Y. Insurance Law § 4236 Joint underwriting of group health insurance for persons aged sixty-five and over
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§ 4236. Joint underwriting of group health insurance for persons aged\nsixty-five and over. (a) It is the concern of the legislature that many\nresidents of this state of advanced years do not have readily available\nto them health insurance adequate to their needs. It is the\nl…
N.Y. Insurance Law § 4237 Blanket accident and health insurance
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§ 4237. Blanket accident and health insurance. (a) (1) Any policy or\ncontract of insurance against death or injury resulting from accident\nwhich insures a group of persons conforming to the requirements of one\nof the subparagraphs (A) through (F) of paragraph three hereof sha…
N.Y. Insurance Law § 4237-A Stop-loss insurance
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§ 4237-a. Stop-loss insurance. (a) An insurer authorized to do the\nbusiness of accident and health insurance in this state and a health\nservice corporation organized under article forty-three of this chapter\nshall be authorized to issue stop-loss insurance as provided in this…
N.Y. Insurance Law § 4238 Group annuity contracts
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§ 4238. Group annuity contracts. (a) Any policy or contract, except a\njoint, reversionary or survivorship annuity contract, whereby annuities\nare payable dependent upon the continuance of the lives of more than one\nperson, shall be deemed a group annuity contract. The party o…
N.Y. Insurance Law § 4239 Allocation and reporting of income and expenses of life insurers
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§ 4239. Allocation and reporting of income and expenses of life\ninsurers. (a) In order to enable the superintendent to determine\ncompliance with this chapter, he may issue reasonable regulations\nprescribing standards for the equitable allocation of income and\nexpenses as amo…
N.Y. Insurance Law § 4240 Separate accounts; fixed and variable life insurance and annuities and funding agreements
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§ 4240. Separate accounts; fixed and variable life insurance and\nannuities and funding agreements. (a) In accordance with paragraphs one,\ntwo and three of subsection (a) of section one thousand one hundred\nthirteen and section three thousand two hundred twenty-two of this\nch…
N.Y. Insurance Law § 4241 Penalty for violation of filing requirements
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§ 4241. Penalty for violation of filing requirements. (a) Any\nauthorized insurer, representative of such insurer, licensed insurance\nagent or licensed insurance broker wilfully violating any of the\nprovisions of this article or of articles thirty-one or thirty-two of\nthis ch…
N.Y. Insurance Law § 4301 Organization of corporation; purposes; board of directors
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§ 4301. Organization of corporation; purposes; board of directors. (a)\nA corporation may be organized under the not-for-profit corporation law,\nand a consumers' cooperative stock corporation may be organized under\narticle two of the cooperative corporations law, for the purpo…
N.Y. Insurance Law § 4302 Permit and license to do business
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§ 4302. Permit and license to do business. (a) Corporations subject to\nthis article shall not solicit the purchase of, or enter into, any\ncontract with any individual or group until it has obtained from the\nsuperintendent a permit so to do. Such permit shall be issued by the\…
N.Y. Insurance Law § 4303 Benefits
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§ 4303. Benefits. (a) Every contract issued by a hospital service\ncorporation or health service corporation which provides coverage for\nin-patient hospital care shall also provide coverage:\n (1) For preadmission testing performed in hospital facilities prior to\nscheduled sur…
N.Y. Insurance Law § 4303-A Prescription synchronization
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§ 4303-a. Prescription synchronization. (a) Every hospital service\ncorporation and health service corporation providing prescription drug\ncoverage when applicable to permit synchronization shall permit and\napply a daily pro-rated cost-sharing rate to prescriptions that are\nd…
N.Y. Insurance Law § 4304 Individual contracts
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§ 4304. Individual contracts. (a) Every corporation subject to the\nprovisions of this article may issue a contract to an individual the\npremiums for which may be paid to the corporation directly by the\nindividual or by a remitting agent for the group to which the individual\n…
N.Y. Insurance Law § 4305 Group contracts
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§ 4305. Group contracts. (a) A corporation subject to the provisions\nof this article may issue a group contract, provided the group of\npersons thereby covered conforms to the requirements of subsections (c)\nand (d) of section four thousand two hundred thirty-five or of\nsubpa…
N.Y. Insurance Law § 4306 Required contract provisions
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§ 4306. Required contract provisions. Every contract issued by any\ncorporation pursuant to the provisions of section four thousand three\nhundred four of this article, shall be in writing and shall state the\nterms and conditions thereof. No such contract shall be made, issued …
N.Y. Insurance Law § 4306-A Health insurance coverage for full-time students on medical leaves of absence
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§ 4306-a. Health insurance coverage for full-time students on medical\nleaves of absence. (a) Every contract issued by a medical expense\nindemnity corporation, hospital service corporation or health service\ncorporation that provides coverage for dependent children who are\nful…
N.Y. Insurance Law § 4306-B Primary and preventive obstetric and gynecologic care
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§ 4306-b. Primary and preventive obstetric and gynecologic care. (a)\nNo corporation subject to the provisions of this article shall by\ncontract, written policy or procedure limit a female subscriber's direct\naccess to primary and preventive obstetric and gynecologic services,…
N.Y. Insurance Law § 4306-C Grievance procedure and access to specialty care
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§ 4306-c. Grievance procedure and access to specialty care. (a) A\ncorporation, including a municipal cooperative health benefits plan\ncertified pursuant to article forty-seven of this chapter, that issues a\ncomprehensive contract that utilizes a network of providers and is no…
N.Y. Insurance Law § 4306-D Choice of health care provider
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§ 4306-d. Choice of health care provider. A corporation that is\nsubject to the provisions of this article and requires or provides for\ndesignation by a subscriber of a participating primary care provider\nshall permit the subscriber to designate any participating primary care\…
N.Y. Insurance Law § 4306-E Prohibition on lifetime and annual limits
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§ 4306-e. Prohibition on lifetime and annual limits. (a) A corporation\nshall not establish a lifetime limit on the dollar amount of essential\nhealth benefits in an individual, group or blanket contract of hospital,\nmedical, surgical or prescription drug expense insurance.\n (…
N.Y. Insurance Law § 4306-F Maternal depression screenings
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§ 4306-f. Maternal depression screenings. To the extent a contract\nprovides coverage for maternal depression screening, no corporation\nsubject to this article shall by contract, written policy or procedure\nlimit a patient insured's direct access to screening and referral for\…
N.Y. Insurance Law § 4306-G Telehealth delivery of services
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§ 4306-g. Telehealth delivery of services. * (a) (1) A corporation\nshall not exclude from coverage a service that is otherwise covered\nunder a contract that provides comprehensive coverage for hospital,\nmedical or surgical care because the service is delivered via\ntelehealth…
N.Y. Insurance Law § 4306-H Essential health benefits package and limit on cost-sharing
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§ 4306-h. Essential health benefits package and limit on cost-sharing.\n(a) (1) For purposes of this article, "essential health benefits" shall\nmean the following categories of benefits:\n (A) ambulatory patient services;\n (B) emergency services;\n (C) hospitalization;\n (D) m…
N.Y. Insurance Law § 4306-I Coverage for medically fragile children
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§ 4306-i. Coverage for medically fragile children. A corporation that\nis subject to the provisions of this article shall have procedures for\ncoverage of medically fragile children consistent with section three\nthousand two hundred seventeen-j of this chapter.\n
N.Y. Insurance Law § 4307 Providers of services
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§ 4307. Providers of services. (a) Any hospital service corporation or\nhealth service corporation may provide benefits for the rendering of\nhospital service to persons covered under its contracts (i) by hospitals\nmaintained by the state or any of its political subdivisions, o…
N.Y. Insurance Law § 4308 Supervision of superintendent
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§ 4308. Supervision of superintendent. (a) No corporation subject to\nthe provisions of this article shall enter into any contract unless and\nuntil it shall have filed with the superintendent a copy of the contract\nor certificate and of all applications, riders and endorsement…
N.Y. Insurance Law § 4309 Limitation on expenses
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§ 4309. Limitation on expenses. (a) No corporation subject to the\nprovisions of this article shall, during any one year, disburse more\nthan the percentages hereafter prescribed of the aggregate amount of the\npremiums received during such year as expenditures for expenses, whi…
N.Y. Insurance Law § 4310 Investments; financial conditions; reserves
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§ 4310. Investments; financial conditions; reserves. (a) Every\ncorporation subject to the provisions of this article shall annually on\nor before the first day of March file in the office of the\nsuperintendent a statement, verified by at least two of the principal\nofficers of…
N.Y. Insurance Law § 4312 Employment of solicitors; pension plans
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§ 4312. Employment of solicitors; pension plans. (a) 1. Every\ncorporation subject to the provisions of this article may employ\nsolicitors or accept business from agents and brokers on a commission\nbasis, but all solicitors shall be paid on a salary basis only. It is\nexpressl…
N.Y. Insurance Law § 4313 Applicability of other provisions of this chapter
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§ 4313. Applicability of other provisions of this chapter. (a) Except\nas otherwise provided and except as the context otherwise requires,\nevery medical expense indemnity corporation, dental expense indemnity\ncorporation, health service corporation, and hospital service\ncorpo…
N.Y. Insurance Law § 4314 Not to affect provisions of workers' compensation law
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§ 4314. Not to affect provisions of workers' compensation law. No\nprovisions of this article or any contract issued by a corporation\nsubject to the provisions of this article shall in any way affect the\noperation of the workers' compensation law.\n
N.Y. Insurance Law § 4315 Arbitration; judicial review
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§ 4315. Arbitration; judicial review. (a) Any dispute arising between\na hospital service corporation or health service corporation subject to\nthe provisions of this article and any hospital with which such\ncorporation has a contract for hospitalization may, pursuant to an\nag…
N.Y. Insurance Law § 4316 Individual contracts; premium refund at death of insured
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§ 4316. Individual contracts; premium refund at death of insured.\nUnder individual contracts for which premiums are paid directly to the\ncorporation by the individual, if the death of the insured or a covered\ndependent occurs during a period for which the premium has been pai…
N.Y. Insurance Law § 4317 Rating of individual and small group health insurance contracts
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§ 4317. Rating of individual and small group health insurance\ncontracts. (a) (1) No individual health insurance contract and no group\nhealth insurance contract covering between one and fifty employees or\nmembers of the group, or between one and one hundred employees or\nmembe…
N.Y. Insurance Law § 4318 Pre-existing condition provisions
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§ 4318. Pre-existing condition provisions. Every individual health\ninsurance contract and every group or blanket accident and health\ninsurance contract issued or issued for delivery in this state which\nincludes a pre-existing condition provision shall contain in substance\nth…
N.Y. Insurance Law § 4318-A Certification of creditable coverage by corporations organized under this article
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§ 4318-a. Certification of creditable coverage by corporations\norganized under this article. (a) Every corporation subject to the\nprovisions of this article that issues individual health insurance\ncontracts or group or blanket accident and health insurance contracts\nshall pr…
N.Y. Insurance Law § 4320 Limitations on administrative services and stop-loss coverage
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§ 4320. Limitations on administrative services and stop-loss coverage.\nNo insurer, subsidiary of an insurer, or controlled person of a holding\ncompany system may act as an administrator or claims paying agent, as\nopposed to an insurer, on behalf of a group which denies or lim…
N.Y. Insurance Law § 4321 Standardization of individual enrollee direct payment contracts offered by health maintenance organizations prior to October first, two t...
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§ 4321. Standardization of individual enrollee direct payment\ncontracts offered by health maintenance organizations prior to October\nfirst, two thousand thirteen. (a) On and after January first, nineteen\nhundred ninety-six, and until September thirtieth, two thousand thirteen…
N.Y. Insurance Law § 4321-A Fund for standardized individual enrollee direct payment contracts
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§ 4321-a. Fund for standardized individual enrollee direct payment\ncontracts. (a) The superintendent shall establish a fund from which\nhealth maintenance organizations may receive reimbursement, to the\nextent of funds available therefor, for claims paid by such health\nmainte…
N.Y. Insurance Law § 4322 Standardization of individual enrollee direct payment contracts offered by health maintenance organizations which provide out-of-plan ben...
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§ 4322. Standardization of individual enrollee direct payment\ncontracts offered by health maintenance organizations which provide\nout-of-plan benefits prior to October first, two thousand thirteen. (a)\nOn and after January first, nineteen hundred ninety-six, and until\nSeptem…
N.Y. Insurance Law § 4322-A Fund for standardized individual enrollee direct payment contracts which provide out-of-plan benefits
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§ 4322-a. Fund for standardized individual enrollee direct payment\ncontracts which provide out-of-plan benefits. (a) The superintendent\nshall establish a fund from which health maintenance organizations may\nreceive reimbursement, to the extent of funds available therefor, for…
N.Y. Insurance Law § 4323 Marketing materials
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§ 4323. Marketing materials. (a) All health maintenance organizations\nissued a certificate of authority under article forty-four of the public\nhealth law or licensed under this article shall prepare, in conjunction\nwith the superintendent, and shall participate in and share t…
N.Y. Insurance Law § 4324 Disclosure of information
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§ 4324. Disclosure of information. The requirements of this section\nshall apply to all comprehensive, expense-reimbursed contracts; managed\ncare products; or any other contract or product for which the\nsuperintendent deems such disclosure appropriate.\n (a) Each health servic…
N.Y. Insurance Law § 4325 Prohibitions
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§ 4325. Prohibitions. (a) No corporation organized under this article\nshall by contract, written policy or written procedure prohibit or\nrestrict any health care provider from disclosing to any subscriber,\ndesignated representative or, where appropriate, prospective subscribe…
N.Y. Insurance Law § 4326 Standardized health insurance contracts for qualifying small employers and individuals
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§ 4326. Standardized health insurance contracts for qualifying small\nemployers and individuals. (a) A program is hereby established for the\npurpose of making standardized health insurance contracts available to\nqualifying small employers as defined in this section. Such progr…
N.Y. Insurance Law § 4327 Stop loss funds for standardized health insurance contracts issued to qualifying small employers and qualifying individuals
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§ 4327. Stop loss funds for standardized health insurance contracts\nissued to qualifying small employers and qualifying individuals. (a) The\nsuperintendent shall establish a fund from which health maintenance\norganizations, corporations or insurers may receive reimbursement, …
N.Y. Insurance Law § 4328 Individual enrollee direct payment contracts offered by health maintenance organization on and after October first, two thousand thirteen
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§ 4328. Individual enrollee direct payment contracts offered by health\nmaintenance organization on and after October first, two thousand\nthirteen. (a) On and after October first, two thousand thirteen, every\nhealth maintenance organization issued a certificate of authority un…
N.Y. Insurance Law § 4329 Prescription drug coverage
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§ 4329. Prescription drug coverage. * (a) Every corporation subject to\nthe provisions of this article that issues a contract that provides\ncoverage for prescription drugs shall, with respect to the prescription\ndrug coverage, publish an up-to-date, accurate, and complete list…
N.Y. Insurance Law § 4330 Discrimination because of sex or marital status in hospital, surgical or medical expense insurance
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§ 4330. Discrimination because of sex or marital status in hospital,\nsurgical or medical expense insurance. (a) With regard to a contract\nissued by a corporation subject to the provisions of this article that\nprovides hospital, surgical, or medical expense coverage or a contr…