Sec. 153.4. Group policy minimum standards  


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  • Every group policy issued or renewed in this State on risks or operations in this State, under section 3435 or in connection with a Federal purchasing group, shall comply with the following minimum policy standards:
    (a) Certificates issued under a group master policy shall contain all material terms and conditions of coverage affecting a group member, unless the group master policy is incorporated by reference, in which event a copy of such master policy shall accompany the certificate or shall be promptly provided to a group member upon request.
    (b) No group policy, master policy or certificate shall contain any deductible or self-insured retention shared among group members or applicable to the group itself, and certificates under a master policy may provide for a deductible or self-insured retention only if applicable to a group member strictly on an individual basis.
    (c) No group policy, master policy or certificate shall be subject to a group or sub-group aggregate liability limit of any kind at any time, and any liability limit applicable to a group member shall:
    (1) be separate and apart from any liability limit to which any other group member insured under the group policy may be subject; and
    (2) operate unaffected by the experience of any other group member or the overall experience of the group itself.
    (d) Every group policy, master policy and certificate shall constitute a “covered policy” subject to the applicable standards governing cancellation, nonrenewal and conditional renewal prescribed by section 3426 of the Insurance Law.