Sec. 362-2.9. Healthy New York enrollment limitation


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  • (a) With respect to coverage effective on or after January 1, 2012, a health maintenance organization or a participating insurer may enroll new applicants in the Healthy New York Program only in the high deductible health plans set forth in section 362-2.8 of this Subpart.
    (b) With respect to existing enrollees who are in non-high deductible health plans with coverage effective prior to January 1, 2012, a health maintenance organization or a participating insurer shall:
    (1) permit qualifying individuals to add dependents to or remove dependents from their qualifying health insurance contracts; and
    (2) permit qualifying small employers to add employees and dependents to or remove employees and dependents from their qualifying health insurance contracts.
    (c) A health maintenance organization or participating insurer shall permit qualifying individuals and qualifying employers enrolled in non-high deductible plans to change their benefit packages to other non-high deductible plans with the same health maintenance organization or participating insurer at the time of annual recertification or a change in the premium rate.