N.Y. Comp. Codes R. & Regs. Tit. 11 § 58.5 - Required disclosure statement for policies and certificates meeting definition of sections 52.11 and 52.14 of this title issued with an effective date for coverage on or after june 1, 2010
(a) The disclosure statement required by an
issuer of policies and certif- icates of Medicare supplement insurance meeting
the standards of sections 52.11 and
52.14 of this Title and sections
58.1 and 58.4 of thi s 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
not less than 12-point type. All benefit plans "A" thr ough "D", "F", "F+",
"G", "G+", and "K" through "N" shall be shown on the cover page, and the
plan(s) that are offered by the issuer shall be p rominently 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 issuer.
(c) Every issuer of a certificate of Medicare
supplement insurance delivered or issued for delivery in this State shall
provide the applicant for the 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. The 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 not less than
12-point type, immediately above the company name:
"NOTICE: Read
(e)
Attached is an appendix (Appendix 12B, infra) containing the items that shall
be included in the disclosure statement in the order prescribed
therein.
Notes
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