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 52.33 - Letter of submission

Current through Register Vol. 46, No. 39, September 25, 2024

A letter of submission in duplicate (single copy for individual forms intended for delivery by domestic insurers exclusively outside New York) shall be included in the filing, signed by a representative of the company authorized to submit forms for filing or approval, containing the following:

(a) the identifying form number of each form submitted;

(b) if the form is a policy, the kind of accident and health by reference to the statutory and regulatory authority therefor; and the kind of policy as defined in section 52.5, 52.6, 52.7, 52.8, 52.9, 52.10 or 52.11 of this Part;

(c) a statement whether the form is new or supersedes an approved or filed form or forms;

(d) if the form supersedes an approved or filed form, the form number and date of approval or filing of the superseded form and any material differences from the superseded form. If approval of the superseded form is still pending, the form number, control number assigned by the department and the submission date;

(e) if the form had previously been submitted for preliminary review, a reference to the previous submission and a statement setting out either:

(1) that the form agrees precisely with the previous submission; or

(2) the differences from the form submitted for preliminary review;

(f) if the form is submitted in accordance with subdivision (c) of section 52.32 of this Part, identification of the prefiled group coverage;

(g) if the form is other than a policy, give the form number and approval date of the policy or policies with which it will be used; however, if the form is for general use, the department may accept a description of the type of policy with which it may be used in lieu of the form number and approval date;

(h) if the form is a policy, the form numbers and dates of approval of any applications previously approved to be used with the policy unless the application is required to be attached to the policy upon submission;

(i) if the policy is designed to be used with insert page forms, a statement of the insert page forms which must always be included in the policy and a list of all optional pages, together with an explanation of their use;

(j) if the form of a domestic insurer is intended for delivery exclusively outside New York:

(1) a statement explaining differences in provisions and premiums, if any, from substantially comparable forms submitted or approved for delivery in New York or a statement that the form is not readily comparable to any form submitted or approved for delivery in New York; and

(2) the name of each state or jurisdiction in which the form is to be delivered. Prompt notice shall be given to the department by a domestic insurer whenever a form issued for delivery exclusively outside New York is disapproved or approval is withdrawn by any state or jurisdiction.

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