New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter A - Life, Accident and Health Insurance
Part 52 - Minimum Standards For Form, Content And Sale Of Health Insurance, Including Standards Of Full And Fair Disclosure
- Section 52.1 - Preamble
- Section 52.2 - Definitions
- Section 52.5 - Basic hospital insurance
- Section 52.6 - Basic medical insurance
- Section 52.7 - Major medical insurance
- Section 52.8 - Disability income insurance
- Section 52.9 - Accident insurance
- Section 52.10 - Limited benefits health insurance
- Section 52.11 - Medicare supplement insurance
- Section 52.12 - Long term care insurance
- Section 52.13 - Nursing home insurance only, home care insurance only, or nursing home and home care insurance
- Section 52.14 - Medicare select policies and certificates
- Section 52.15 - Specified disease coverage
- Section 52.16 - Prohibited provisions and coverages
- Section 52.17 - Rules relating to content of forms for individual insurance
- Section 52.18 - Prohibited provisions and coverages
- Section 52.19 - Rules relating to the content of forms for franchise insurance
- Section 52.20 - Rules relating to preexisting condition provisions and crediting requirements in policies which provide hospital, surgical or medical expense coverage
- Section 52.21 - Rules relating to content of forms for blanket insurance
- Section 52.22 - Volunteer firefighter enhanced cancer insurance
- Section 52.23 - Coordination of benefits
- Section 52.24 - Rules relating to coverage for the diagnosis and treatment of alcoholism and alcohol abuse in group (including group remittance policies issued by article 43 corporations) and school blanket health insurance policies
- Section 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
- Section 52.26 - Rules relating to exclusion of medicare benefits
- Section 52.27 - Rules relating to the sale of health insurance and settlement of health insurance claims
- Section 52.28 - Medicare supplement insurance reporting form and refund calculation form
- Section 52.29 - Rules relating to the replacement of accident and health insurance coverage with individual long term care insurance, nursing home insurance only, home care insurance only, or nursing home and home care insurance policies and the purchase of multiple accident and health policies
- Section 52.30 - Preliminary review
- Section 52.31 - Preparation of forms for submission
- Section 52.32 - Conditions for prefiled group coverage
- Section 52.33 - Letter of submission
- Section 52.40 - Procedures and requirements for filing of rates
- Section 52.41 - Gross premium differentials based on sex
- Section 52.42 - Health maintenance organization (HMO) contract forms and premium rates
- Section 52.43 - Standards for maintaining experience data
- Section 52.44 - Standards for annual filing of experience data
- Section 52.45 - Minimum loss ratio standards
- Section 52.46
- Section 52.47 - Monitoring of experience data submitted under section 52.44(a) of this part
- Section 52.51 - Applications
- Section 52.53 - Conditional receipts and interim insurance agreements
- Section 52.54 - Disclosure requirements
- Section 52.55 - Required disclosure statement for policies meeting standards of section 52.5 of this part
- Section 52.56 - Required disclosure statement for policies meeting standards of section 52.6 of this part
- Section 52.57 - Required disclosure statement for policies meeting standards of both sections 52.5 and 52.6 of this part
- Section 52.58 - Required disclosure statement for policies meeting standards of section 52.7 of this part
- Section 52.59 - Required disclosure statement for policies meeting definition of section 52.10 of this Part
- Section 52.60 - Required disclosure statement for policies meeting definition of section 52.8 of this part
- Section 52.61 - Required disclosure statement for policies meeting definition of section 52.9 of this part
- Section 52.62 - Required disclosure statement for policies meeting definition of section 52.10 of this part
- Section 52.63
- Section 52.64
- Section 52.65 - Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part
- Section 52.66 - Required disclosure statement for policies and certificates meeting definition of section 52.15 of this Part
- Section 52.69 - Rules relating to the content of health insurance identification cards
- Section 52.70 - Special rules for group, blanket and franchise insurance
- Section 52.71 - Essential health benefits
- Section 52.72 - Nondiscrimination on the basis of race, color, creed, national origin, sex, age, marital status, disability, or preexisting condition
- Section 52.73 - Formulary exception process for medication for the detoxification or maintenance treatment of a substance use disorder
- Section 52.74 - Coverage of contraceptive drugs, devices, or products
- Section 52.75 - Prohibition on discrimination based on sexual orientation, gender identity or expression, or transgender status
- Section 52.76 - Coverage for preventive care and screenings
- Section 52.77 - Payment when an issuer provides inaccurate network status information
- Section 52.80 - State of New York Certified Surgical Fee Schedule
- Section 52.90 - Applicability provisions
- Section 52.95 - Separability provision
Current through Register Vol. 46, No. 39, September 25, 2024
Statutory authority: Insurance Law, §§201, 301, 1109, 1117, 2104, 2119, 2601, 3103, 3201, 3216, 3217, 3218, 3221, 3231, 3232, 3233, 3234, 4224, 4235, 4237, 4303, 4304, 4305, 4308, 4321, 4322, 4326, 4512, 4802, arts. 43, 49; L. 1992, ch. 501; L. 1997, ch. 661; L. 2005, ch. 645; Federal Social Security Act, 42 U.S.C. § 1395 ss; Correction Law, §168-b
Disclaimer: These regulations may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
