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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 to any other matter which may be required to be stated therein, either by law or by the superintendent pursuant to law, every annual statement of every life insurance company doing business in this state shal…
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 insurance against death or injury resulting from an accident which covers more than one person, except blanket accident insurance policies as defined in section four thousand two hundred thirty-seven of this arti…
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 sixty-five and over. (a) It is the concern of the legislature that many residents of this state of advanced years do not have readily available to them health insurance adequate to their needs. It is the legis…
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 contract of insurance against death or injury resulting from accident which insures a group of persons conforming to the requirements of one of the subparagraphs (A) through (F) of paragraph three hereof shall …
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 business of accident and health insurance in this state and a health service corporation organized under article forty-three of this chapter shall be authorized to issue stop-loss insurance as provided in this se…
N.Y. Insurance Law § 4238 Group annuity contracts
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§ 4238. Group annuity contracts. (a) Any policy or contract, except a joint, reversionary or survivorship annuity contract, whereby annuities are payable dependent upon the continuance of the lives of more than one person, shall be deemed a group annuity contract. The party or p…
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 insurers. (a) In order to enable the superintendent to determine compliance with this chapter, he may issue reasonable regulations prescribing standards for the equitable allocation of income and expenses as among l…
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 authorized insurer, representative of such insurer, licensed insurance agent or licensed insurance broker wilfully violating any of the provisions of this article or of articles thirty-one or thirty-two of this chapte…
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) A corporation may be organized under the not-for-profit corporation law, and a consumers' cooperative stock corporation may be organized under article two of the cooperative corporations law, for the purpose …
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 this article shall not solicit the purchase of, or enter into, any contract with any individual or group until it has obtained from the superintendent a permit so to do. Such permit shall be issued by the sup…
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 corporation and health service corporation providing prescription drug coverage when applicable to permit synchronization shall permit and apply a daily pro-rated cost-sharing rate to prescriptions that are dispe…
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 of this article may issue a group contract, provided the group of persons thereby covered conforms to the requirements of subsections (c) and (d) of section four thousand two hundred thirty-five or of subparagr…
N.Y. Insurance Law § 4306 Required contract provisions
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§ 4306. Required contract provisions. Every contract issued by any corporation pursuant to the provisions of section four thousand three hundred four of this article, shall be in writing and shall state the terms and conditions thereof. No such contract shall be made, issued or …
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 leaves of absence. (a) Every contract issued by a medical expense indemnity corporation, hospital service corporation or health service corporation that provides coverage for dependent children who are full-ti…
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) No corporation subject to the provisions of this article shall by contract, written policy or procedure limit a female subscriber's direct access to primary and preventive obstetric and gynecologic services, in…
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 corporation, including a municipal cooperative health benefits plan certified pursuant to article forty-seven of this chapter, that issues a comprehensive contract that utilizes a network of providers and is not a…
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 subject to the provisions of this article and requires or provides for designation by a subscriber of a participating primary care provider shall permit the subscriber to designate any participating primary care pro…
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 shall not establish a lifetime limit on the dollar amount of essential health benefits in an individual, group or blanket contract of hospital, medical, surgical or prescription drug expense insurance. (b) A …
N.Y. Insurance Law § 4306-F Maternal depression screenings
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§ 4306-f. Maternal depression screenings. To the extent a contract provides coverage for maternal depression screening, no corporation subject to this article shall by contract, written policy or procedure limit a patient insured's direct access to screening and referral for mat…
N.Y. Insurance Law § 4306-G Telehealth delivery of services
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§ 4306-g. Telehealth delivery of services. * (a) (1) A corporation shall not exclude from coverage a service that is otherwise covered under a contract that provides comprehensive coverage for hospital, medical or surgical care because the service is delivered via telehealth, as…
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 is subject to the provisions of this article shall have procedures for coverage of medically fragile children consistent with section three thousand two hundred seventeen-j of this chapter.
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 the provisions of this article shall enter into any contract unless and until it shall have filed with the superintendent a copy of the contract or certificate and of all applications, riders and endorsements f…
N.Y. Insurance Law § 4309 Limitation on expenses
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§ 4309. Limitation on expenses. (a) No corporation subject to the provisions of this article shall, during any one year, disburse more than the percentages hereafter prescribed of the aggregate amount of the premiums received during such year as expenditures for expenses, which,…
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 corporation subject to the provisions of this article may employ solicitors or accept business from agents and brokers on a commission basis, but all solicitors shall be paid on a salary basis only. It is expressly pr…
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 as otherwise provided and except as the context otherwise requires, every medical expense indemnity corporation, dental expense indemnity corporation, health service corporation, and hospital service corporati…
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 provisions of this article or any contract issued by a corporation subject to the provisions of this article shall in any way affect the operation of the workers' compensation law.
N.Y. Insurance Law § 4315 Arbitration; judicial review
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§ 4315. Arbitration; judicial review. (a) Any dispute arising between a hospital service corporation or health service corporation subject to the provisions of this article and any hospital with which such corporation has a contract for hospitalization may, pursuant to an agreem…
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. Under individual contracts for which premiums are paid directly to the corporation by the individual, if the death of the insured or a covered dependent occurs during a period for which the premium has been paid, …
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 contracts. (a) (1) No individual health insurance contract and no group health insurance contract covering between one and fifty employees or members of the group, or between one and one hundred employees or members o…
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 organized under this article. (a) Every corporation subject to the provisions of this article that issues individual health insurance contracts or group or blanket accident and health insurance contracts shall provid…
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. No insurer, subsidiary of an insurer, or controlled person of a holding company system may act as an administrator or claims paying agent, as opposed to an insurer, on behalf of a group which denies or limits…
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 issued a certificate of authority under article forty-four of the public health law or licensed under this article shall prepare, in conjunction with the superintendent, and shall participate in and share the …
N.Y. Insurance Law § 4324 Disclosure of information
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§ 4324. Disclosure of information. The requirements of this section shall apply to all comprehensive, expense-reimbursed contracts; managed care products; or any other contract or product for which the superintendent deems such disclosure appropriate. (a) Each health service, ho…
N.Y. Insurance Law § 4325 Prohibitions
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§ 4325. Prohibitions. (a) No corporation organized under this article shall by contract, written policy or written procedure prohibit or restrict any health care provider from disclosing to any subscriber, designated representative or, where appropriate, prospective subscriber, …
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, surgical or medical expense insurance. (a) With regard to a contract issued by a corporation subject to the provisions of this article that provides hospital, surgical, or medical expense coverage or a contract…