3240 – Unclaimed Benefits.
* § 3240. Unclaimed benefits. (a) Definitions. For the purposes of this section: (1) “Account” means: (A) any mechanism, whether denoted as a retained asset account or otherwise, whereby the settlement of proceeds payable to a beneficiary under a policy is accomplished by the insurer or an entity acting on behalf of the insurer placing […]
3240*2 – Student Accident and Health Insurance.
* § 3240. Student accident and health insurance. (a) In this section: (1)(A) “Student accident and health insurance” means a policy or contract of hospital, medical, or surgical expense insurance delivered or issued for delivery in this state on or after January first, two thousand fourteen, by an insurer or a corporation, to an institution […]
3241 – Network Coverage.
§ 3241. Network coverage. (a) (1) An insurer, a corporation organized pursuant to article forty-three of this chapter, a municipal cooperative health benefit plan certified pursuant to article forty-seven of this chapter, or a student health plan established or maintained pursuant to section one thousand one hundred twenty-four of this chapter, that issues a health […]
3242 – Prescription Drug Coverage.
§ 3242. Prescription drug coverage. (a) Every insurer that delivers or issues for delivery in this state a policy that provides coverage for prescription drugs shall, with respect to the prescription drug coverage, publish an up-to-date, accurate, and complete list of all covered prescription drugs on its formulary drug list, including any tiering structure that […]
3243 – Discrimination Because of Sex or Marital Status in Hospital, Surgical or Medical Expense Insurance.
§ 3243. Discrimination because of sex or marital status in hospital, surgical or medical expense insurance. (a) With regard to an accident and health insurance policy that provides hospital, surgical, or medical expense coverage or a policy of student accident and health insurance, as defined in subsection (a) of section three thousand two hundred forty […]
3244 – Explanation of Benefits Forms Relating to Claims Under Certain Accident and Health Insurance Policies.
§ 3244. Explanation of benefits forms relating to claims under certain accident and health insurance policies. (a) Every insurer, including health maintenance organizations operating under article forty-four of the public health law or article forty-three of this chapter and any other corporation operating under article forty-three of this chapter, is required to provide the insured […]
3245 – Liability to Providers in the Event of an Insolvency.
§ 3245. Liability to providers in the event of an insolvency. In the event an insurance company authorized to do an accident and health insurance business in this state is deemed insolvent, as provided in section one thousand three hundred nine of this chapter, no insured covered under a policy delivered or issued for delivery […]
3238 – Pre-Authorization of Health Care Services.
§ 3238. Pre-authorization of health care services. (a) An insurer, corporation organized pursuant to article forty-three of this chapter, municipal cooperative health benefits plan certified pursuant to article forty-seven of this chapter, or health maintenance organization and other organizations certified pursuant to article forty-four of the public health law (“health plan”) shall pay claims for […]
3239 – Wellness Programs.
§ 3239. Wellness programs. (a) An insurer licensed to write accident and health insurance, a corporation organized pursuant to article forty-three of this chapter, a health maintenance organization certified pursuant to article forty-four of the public health law and a municipal cooperative health benefits plan may establish a wellness program in conjunction with its issuance […]
3231 – Rating of Individual and Small Group Health Insurance Policies; Approval of Superintendent.
* § 3231. Rating of individual and small group health insurance policies; approval of superintendent. (a) (1) No individual health insurance policy and no group health insurance policy covering between one and fifty employees or members of the group or between one and one hundred employees or members of the group for policies issued or […]