New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter XIV - Individual And Small Group Health Insurance
Part 360 - Rules To Assure An Orderly Implementation And Ongoing Operation Of Open Enrollment And Community Rating Of Individual And Small Group Health Insurance
Section 360.1 - Preamble

Universal Citation: 11 NY Comp Codes Rules and Regs ยง 360.1

Current through Register Vol. 46, No. 12, March 20, 2024

(a) Chapter 501 of the Laws of 1992 requires fundamental changes in the way health insurance is sold and rated by insurers, including HMOs, to both individuals and small groups in New York State.

(b) Chapter 501 and this Part are designed to achieve the following goals:

(1) to facilitate access to health insurance by all New York residents who wish to obtain it directly or as members of small groups; and

(2) to promote competition among insurers and health maintenance organizations on the basis of efficient claims handling, ability to manage health care services, consumer satisfaction, and low administrative costs; rather than on the basis of differing underwriting and rating practices which allowed some insurers to exclude higher risk applicants from coverage and caused unaffordable premium rates to those unable to meet selection standards.

(c) This Part sets forth rules clarifying various provisions of chapter 501 and includes interpretations designed to assist insurers in carrying out their responsibilities and obligations under the new law. The legislation specifically authorizes the superintendent to promulgate regulations to assure orderly implementation and ongoing operation of community rating and open enrollment.

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