N.Y. Comp. Codes R. & Regs. Tit. 11 § 58.3 - Required disclosure statement for policies and certificates meeting definition of section 52.11 or 52.14 of this title issued with an effective date for coverage prior to june 1, 2010
(a) The disclosure statement required by
insurers issuing policies and certificates of Medicare supplement insurance
meeting the standards of sections 52.11 and
52.14 of this Title and sections
58.1 and 58.2 of this Part shall consist of
four parts: a cover page, premium information, disclosure pages, and charts
displaying the features of each benefit plan offered by the issuer. The
disclosure statement shall be in the language and format prescribed below in no
less than 12-point type. All benefit plans "A" through "L" shall be shown on
the cover page, and the plan(s) that are offered by the issuer shall be
prominently identified. Premium information for plans that are offered shall be
shown on the cover page or immediately following the cover page and shall be
prominently displayed. The premium and mode shall be stated for all plans that
are offered to the prospective applicant. All possible premiums for the
prospective applicant shall be illustrated.
(b) No individual accident and health
insurance policy shall be delivered or issued for delivery in this State,
unless the appropriate disclosure form in this section is provided to the
applicant at the time that the application is presented to the prospective
applicant and, except for direct response insurance, written acknowledgment of
receipt of the requisite disclosure statement shall be obtained from the
applicant by the insurer.
(c)
Insurers issuing certificates of Medicare supplement insurance for delivery in
this State shall provide all applicants for such coverage with a disclosure
statement in the form prescribed in this section except that all references to
"policy " shall be replaced with "certificate ," where appropriate. Such
disclosure statement must be provided at the time that the application is
presented to the prospective applicant and, except in the case of direct
response insurance, written acknowledgment of receipt of the requisite
disclosure statement shall be obtained from the applicant by the
insurer.
(d) If the Medicare
supplement insurance policy or certificate is issued on a basis that would
require revision of the disclosure statement , then a substitute disclosure
statement properly describing the policy or certificate shall accompany such
policy or certificate when it is delivered and contain the following statement,
in no less than 12-point type, immediately above the company name:
"NOTICE: Read
(e)
Attached is an appendix (Appendix 12A, infra) containing the items that shall
be included in the disclosure statement in the order prescribed
therein.
Notes
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