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New York Codes Rules Regulations (Last Updated: March 27,2024) |
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TITLE 11. Insurance |
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Chapter III. Policy and Certificate Provisions |
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Subchapter A. Life, Accident and Health Insurance |
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Part 52. Minimum Standards for Form, Content and Sale of Health Insurance, Including Standards of Full and Fair Disclosure |
Part 52. Minimum Standards for Form, Content and Sale of Health Insurance, Including Standards of Full and Fair Disclosure
| 11 CRR-NY III A 52 Notes |
| Sec. 52.1. Preamble |
| Sec. 52.2. Definitions |
| Sec. 52.5. Basic hospital insurance |
| Sec. 52.6. Basic medical insurance |
| Sec. 52.7. Major medical insurance |
| Sec. 52.8. Disability income insurance |
| Sec. 52.9. Accident insurance |
| Sec. 52.10. Limited benefits health insurance |
| Sec. 52.11. Medicare supplement insurance |
| Sec. 52.12. Long term care insurance |
| Sec. 52.13. Nursing home insurance only, home care insurance only, or nursing home and home care insurance |
| Sec. 52.14. Medicare select policies and certificates |
| Sec. 52.15. Specified disease coverage |
| Sec. 52.16. Prohibited provisions and coverages |
| Sec. 52.17. Rules relating to content of forms for individual insurance |
| Sec. 52.18. Rules relating to content of forms for group insurance |
| Sec. 52.19. Rules relating to the content of forms for franchise insurance |
| Sec. 52.20. Rules relating to preexisting condition provisions and crediting requirements in policies which provide hospital, surgical or medical expense coverage |
| Sec. 52.21. Rules relating to content of forms for blanket insurance |
| Sec. 52.22. Volunteer firefighter enhanced cancer insurance |
| Sec. 52.23. Coordination of benefits |
| Sec. 52.25. Rules relating to the content and sale of forms for long term care insurance, nursing home insurance only, home care insurance only, and nursing home and home care insurance |
| Sec. 52.26. Rules relating to exclusion of Medicare benefits |
| Sec. 52.27. Rules relating to the sale of health insurance and settlement of health insurance claims |
| Sec. 52.28. Medicare supplement insurance reporting form and refund calculation form |
| Sec. 52.30. Preliminary review |
| Sec. 52.31. Preparation of forms for submission |
| Sec. 52.32. Conditions for prefiled group coverage |
| Sec. 52.33. Letter of submission |
| Sec. 52.40. Procedures and requirements for filing of rates |
| Sec. 52.41. Gross premium differentials based on sex |
| Sec. 52.42. Health maintenance organization (HMO) contract forms and premium rates |
| Sec. 52.43. Standards for maintaining experience data |
| Sec. 52.44. Standards for annual filing of experience data |
| Sec. 52.45. Minimum loss ratio standards |
| Sec. 52.46. [Repealed[ |
| Sec. 52.47. Monitoring of experience data submitted under section 52.44(a) of this Part |
| Sec. 52.51. Applications |
| Sec. 52.53. Conditional receipts and interim insurance agreements |
| Sec. 52.54. Disclosure requirements |
| Sec. 52.55. Required disclosure statement for policies meeting standards of section 52.5 of this Part |
| Sec. 52.56. Required disclosure statement for policies meeting standards of section 52.6 of this Part |
| Sec. 52.57. Required disclosure statement for policies meeting standards of both sections 52.5 and 52.6 of this Part |
| Sec. 52.58. Required disclosure statement for policies meeting standards of section 52.7 of this Part |
| Sec. 52.59. Required disclosure statement for policies meeting definition of section 52.10 of this Part |
| Sec. 52.60. Required disclosure statement for policies meeting definition of section 52.8 of this Part |
| Sec. 52.61. Required disclosure statement for policies meeting definition of section 52.9 of this Part |
| Sec. 52.62. Required disclosure statement for policies meeting definition of section 52.10 of this Part |
| Sec. 52.63. Extension of premium payment periods for individual, small group and student blanket comprehensive health insurance policies as a result of the COVID-19 pandemic; prohibited practices |
| Sec. 52.64. [Repealed] |
| Sec. 52.65. Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part |
| Sec. 52.66. Required disclosure statement for policies and certificates meeting definition of section 52.15 of this Part |
| Sec. 52.70. Special rules for group, blanket and franchise insurance |
| Sec. 52.69. Rules relating to the content of health insurance identification cards |
| Sec. 52.71. Essential health benefits |
| Sec. 52.72. Nondiscrimination on the basis of race, color, creed, national origin, sex, age, marital status, disability, or preexisting condition |
| Sec. 52.73. Formulary exception process for medication for the detoxification or maintenance treatment of a substance use disorder |
| Sec. 52.74. Coverage of contraceptive drugs, devices, or products |
| Sec. 52.75. Prohibition on discrimination based on sexual orientation, gender identity or expression, or transgender status |
| Sec. 52.76. Coverage for preventive care and screenings |
| Sec. 52.80. State of New York Certified Surgical Fee Schedule |
| Sec. 52.90. Applicability provisions |
| Sec. 52.95. Separability provision |