New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter XIV - Individual And Small Group Health Insurance
Part 362 - The Healthy New York Program And The Direct Payment Stop Loss Relief Program
Subpart 362-2 - Rules Generally Applicable To The Healthy New York Program
Section 362-2.9 - Healthy new york enrollment limitation

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

(a) With respect to coverage effective on or after January 1, 2012, a health maintenance organization or a participating insurer may enroll new applicants in the Healthy New York Program only in the high deductible health plans set forth in section 362-2.8 of this Subpart.

(b) With respect to existing enrollees who are in non-high deductible health plans with coverage effective prior to January 1, 2012, a health maintenance organization or a participating insurer shall:

(1) permit qualifying individuals to add dependents to or remove dependents from their qualifying health insurance contracts; and

(2) permit qualifying small employers to add employees and dependents to or remove employees and dependents from their qualifying health insurance contracts.

(c) A health maintenance organization or participating insurer shall permit qualifying individuals and qualifying employers enrolled in non-high deductible plans to change their benefit packages to other non-high deductible plans with the same health maintenance organization or participating insurer at the time of annual recertification or a change in the premium rate.

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