New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter V - Rates And Rating Organizations
Subchapter B - Commercial And Industrial Risks
Part 153 - Property/casualty Insurance Group And Quasi-group Standards
Section 153.4 - Group policy minimum standards

Universal Citation: 11 NY Comp Codes Rules and Regs ยง 153.4

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

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.

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