(1) legal liability, up to fifty thousand dollars because of bodily injury to or death of one person in any one accident and, subject to such limit for one person, up to one hundred thousand dollars because of bodily injury to or death of two or more persons in any one accident, and up to ten thousand dollars because of injury to or destruction of property of others in any one accident; and

(2) loss or damage to an automobile insured under a policy, up to ten thousand dollars actual cash value, subject to a deductible of not less than one hundred dollars; provided, however, that the physical damage insurance for a private passenger automobile shall be subject to all of the provisions of sections two thousand three hundred thirty-seven, three thousand four hundred eleven and three thousand four hundred thirty-two of this chapter; and

(3) medical payments with respect to private passenger motor vehicles not for hire, irrespective of the legal liability of the insured, because of bodily injury to or death of any person insured thereunder, up to one thousand dollars; and

(4) supplementary uninsured motorists insurance, as defined in subsection (f) of section three thousand four hundred twenty of this chapter.

(b) Any such plan shall provide for availability to applicants of twice the dollar level of first party benefits prescribed in section five thousand one hundred three of this chapter; and commensurate first party benefits for personal injury arising out of the use or operation of a motor vehicle in any other state or Canadian province.

(c) Such plan shall provide for the method of classifying risks, establishing territories and making rates applicable thereto. Such rates, except with respect to rates for the minimum limits of insurance required by article six or seven of the vehicle and traffic law, shall be based upon loss and expense experience of the risks insured pursuant to the plan.