New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter XIV - Individual And Small Group Health Insurance
Part 361 - Establishment And Operation Of Market Stabilization Mechanisms For Individual And Small Group Health Insurance And Medicare Supplement Insurance
Section 361.7 - Pool administration
Universal Citation: 11 NY Comp Codes Rules and Regs ยง 361.7
Current through Register Vol. 46, No. 12, March 20, 2024
(a) The pools shall be administered either directly by the superintendent, or in conjunction with a firm, performing at least the following functions:
(1) choosing a
firm or firms, other than a carrier participating in any of the pools, to
administer the pools, based on an evaluation of competitive bids;
(2) approval of the general systems and
procedures used by the firm or firms to administer the pools, including in
particular procedures to verify the appropriateness of payments from the pools
to carriers;
(3) payment of
reasonable fees from the pooling funds to the firm or firms for administration
of the pools;
(4) changing the
administrating firm or firms, or the administrative systems and procedures, if
necessary;
(5) the collection from
pool participants of the data needed to administer the pools;
(6) the arrangement for periodic audits of
the pools, including the participation of each carrier, and paying from the
pooling funds reasonable fees for such audits;
(7) the reporting to the carriers
participating in the pools a summary of the operations of the pools, on a
periodic basis, but in no event less often than annually; and
(8) establishing equitable assessments on
carriers participating in the pools as needed to make the payments from the
pools stated in paragraphs (3) and (6) of this subdivision, in sections
361.3(f),
361.4(c)
and (d) and
361.5(d)
of this Part.
(b) The superintendent may seek advice and recommendations regarding the functions listed above, or regarding other functions, from the Technical Advisory Committee, established in accordance with section 3233(b) of the Insurance Law.
(c) Carriers participating in the pools must respond to questions or objections raised by the superintendent or a designated pool administrator within 15 days.
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.
