LegalFix

1120 - Child Health Insurance Plan.

NY Ins L § 1120 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(b) The superintendent may authorize such contracts or arrangements pursuant to the following criteria:

(1) the provisions are not misleading or confusing;

(2) the provisions are consistent with the needs of the child health insurance plan; and

(3) the materials describing the contract or arrangement fully and clearly state the benefits and limitations of such contract or arrangement.

(c) The duration of such contracts or arrangements and the extent of exposure thereunder by insurers, article forty-three corporations or health maintenance organizations shall be determined by the superintendent.

(d) Notwithstanding any provisions of this chapter or the financial services law to the contrary, the superintendent may waive, modify or suspend any provisions of this chapter, the financial services law or regulations promulgated thereunder as applicable to the insurers, article forty-three corporations or health maintenance organizations that issue coverage pursuant to this section, provided such waiver, modification or suspension is based on the criteria set forth in subsection (e) of this section.

(e) The superintendent may take the actions set forth in subsections (a) and (d) of this section upon the superintendent's judgment that:

(1) the contract or arrangement is a reasonable and appropriate approach to expand the availability of health care coverage to children;

(2) the sources of funding for the contract or arrangement are reasonably related to the benefits provided and sufficient to support the contract arrangement;

(3) any waiver, modification or suspension of the provisions of this chapter, the financial services law or regulations promulgated thereunder is essential to the operation of the child health insurance plan and to the rational development of programs to provide covered services to children; and

(4) any waiver, modification or suspension of provisions of this chapter, the financial services law or regulations promulgated thereunder will not impair the ability of the insurer, article forty-three corporation or health maintenance organization to satisfy its existing and anticipated contracts and other obligations, including such standards as the superintendent shall prescribe concerning adequate capital and financial requirements.

(f) Each application used by an authorized insurer for purposes of enrolling eligible children into the child health insurance plan pursuant to this section and section twenty-five hundred eleven of the public health law shall include the notice required pursuant to subsection (d) of section four hundred three of this chapter.

LegalFix

Copyright ©2024 LegalFix. All rights reserved. LegalFix is not a law firm, is not licensed to practice law, and does not provide legal advice, services, or representation. The information on this website is an overview of the legal plans you can purchase—or that may be provided by your employer as an employee benefit or by your credit union or other membership group as a membership benefit.

LegalFix provides its members with easy access to affordable legal services through a network of independent law firms. LegalFix, its corporate entity, and its officers, directors, employees, agents, and contractors do not provide legal advice, services, or representation—directly or indirectly.

The articles and information on the site are not legal advice and should not be relied upon—they are for information purposes only. You should become a LegalFix member to get legal services from one of our network law firms.

You should not disclose confidential or potentially incriminating information to LegalFix—you should only communicate such information to your network law firm.

The benefits and legal services described in the LegalFix legal plans are not always available in all states or with all plans. See the legal plan Benefit Overview and the more comprehensive legal plan contract during checkout for coverage details in your state.

Use of this website, the purchase of legal plans, and access to the LegalFix networks of law firms are subject to the LegalFix Terms of Service and Privacy Policy.

We have updated our Terms of Service, Privacy Policy, and Disclosures. By continuing to browse this site, you agree to our Terms of Service, Privacy Policy, and Disclosures.
1120 - Child Health Insurance Plan.