New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter IV - Financial Condition Of Insurer and Reports to Superintendent
Subchapter B - Life Insurers
Part 101 - Standards For Financial Risk Transfer Between Insurers And Health Care Providers
Section 101.10 - Exemptions
Current through Register Vol. 46, No. 39, September 25, 2024
A financial risk transfer agreement whereby the health care provider receives projected innetwork capitation from an individual insurer, during any consecutive 12-month period, of no more than $250,000, shall be exempt from the provisions of this Part. A financial risk transfer agreement whereby the health care provider receives projected in-network capitation from an individual insurer, during any consecutive 12-month period, of more than $250,000 but less than $1,000,000, shall only be exempt from the following provisions of this Part:
(a) the need for the superintendent's approval of the financial risk transfer agreement, including the need to demonstrate to the superintendent the financial responsibility of the health care provider, as set forth in section 101.4(c) of this Part; and
(b) the provisions of section 101.9(a)(3) of this Part as respects the requirements for the filing of the health care provider's financial statement and the CPA opinion thereon with the superintendent.
