Part 52 - Minimum Standards For Form, Content And Sale Of Health Insurance, Including Standards Of Full And Fair Disclosure

  1. § 52.1 - Preamble
  2. § 52.2 - Definitions
  3. § 52.5 - Basic hospital insurance
  4. § 52.6 - Basic medical insurance
  5. § 52.7 - Major medical insurance
  6. § 52.8 - Disability income insurance
  7. § 52.9 - Accident insurance
  8. § 52.10 - Limited benefits health insurance
  9. § 52.11 - Medicare supplement insurance
  10. § 52.12 - Long term care insurance
  11. § 52.13 - Nursing home insurance only, home care insurance only, or nursing home and home care insurance
  12. § 52.14 - Medicare select policies and certificates
  13. § 52.15 - Specified disease coverage
  14. § 52.16 - Prohibited provisions and coverages
  15. § 52.17 - Rules relating to content of forms for individual insurance
  16. § 52.18 - Prohibited provisions and coverages
  17. § 52.19 - Rules relating to the content of forms for franchise insurance
  18. § 52.20 - Rules relating to preexisting condition provisions and crediting requirements in policies which provide hospital, surgical or medical expense coverage
  19. § 52.21 - Rules relating to content of forms for blanket insurance
  20. § 52.22 - Volunteer firefighter enhanced cancer insurance
  21. § 52.23 - Coordination of benefits
  22. § 52.24 - Rules relating to coverage for the diagnosis and treatment of alcoholism and alcohol abuse in group (including group remittance policies issued by article 43 corporations) and school blanket health insurance policies
  23. § 52.25 - Rules relating to the content and sale of forms for long term care insurance, nursing home insurance only, home care insurance only, and nursing home and home care insurance
  24. § 52.26 - Rules relating to exclusion of medicare benefits
  25. § 52.27 - Rules relating to the sale of health insurance and settlement of health insurance claims
  26. § 52.28 - Medicare supplement insurance reporting form and refund calculation form
  27. § 52.29 - Rules relating to the replacement of accident and health insurance coverage with individual long term care insurance, nursing home insurance only, home care insurance only, or nursing home and home care insurance policies and the purchase of multiple accident and health policies
  28. § 52.30 - Preliminary review
  29. § 52.31 - Preparation of forms for submission
  30. § 52.32 - Conditions for prefiled group coverage
  31. § 52.33 - Letter of submission
  32. § 52.40 - Procedures and requirements for filing of rates
  33. § 52.41 - Gross premium differentials based on sex
  34. § 52.42 - Health maintenance organization (HMO) contract forms and premium rates
  35. § 52.43 - Standards for maintaining experience data
  36. § 52.44 - Standards for annual filing of experience data
  37. § 52.45 - Minimum loss ratio standards
  38. § 52.46 - [Repealed]
  39. § 52.47 - Monitoring of experience data submitted under section 52.44(a) of this part
  40. § 52.51 - Applications
  41. § 52.53 - Conditional receipts and interim insurance agreements
  42. § 52.54 - Disclosure requirements
  43. § 52.55 - Required disclosure statement for policies meeting standards of section 52.5 of this part
  44. § 52.56 - Required disclosure statement for policies meeting standards of section 52.6 of this part
  45. § 52.57 - Required disclosure statement for policies meeting standards of both sections 52.5 and 52.6 of this part
  46. § 52.58 - Required disclosure statement for policies meeting standards of section 52.7 of this part
  47. § 52.59 - Required disclosure statement for policies meeting definition of section 52.10 of this Part
  48. § 52.60 - Required disclosure statement for policies meeting definition of section 52.8 of this part
  49. § 52.61 - Required disclosure statement for policies meeting definition of section 52.9 of this part
  50. § 52.62 - Required disclosure statement for policies meeting definition of section 52.10 of this part
  51. § 52.63 - [Repealed]
  52. § 52.64 - [Repealed]
  53. § 52.65 - [Effective until 6/2/2024] Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part
  54. § 52.65 - [Effective 6/2/2024] Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part, version 2
  55. § 52.66 - Required disclosure statement for policies and certificates meeting definition of section 52.15 of this Part
  56. § 52.69 - Rules relating to the content of health insurance identification cards
  57. § 52.70 - Special rules for group, blanket and franchise insurance
  58. § 52.71 - Essential health benefits
  59. § 52.72 - Nondiscrimination on the basis of race, color, creed , national origin, sex, age, marital status, disability, or preexisting condition
  60. § 52.73 - Formulary exception process for medication for the detoxification or maintenance treatment of a substance use disorder
  61. § 52.74 - Coverage of contraceptive drugs, devices, or products
  62. § 52.75 - Prohibition on discrimination based on sexual orientation, gender identity or expression, or transgender status
  63. § 52.76 - Coverage for preventive care and screenings
  64. § 52.77 - Payment when an issuer provides inaccurate network status information
  65. § 52.80 - State of New York Certified Surgical Fee Schedule
  66. § 52.90 - Applicability provisions
  67. § 52.95 - Separability provision

Notes

Statutory authority: Insurance Law, §§201, 301, 1109, 1117, 2104, 2119, 2601, 3103, 3201, 3216, 3217, 3218, 3221, 3231, 3232, 3233, 3234, 4224, 4235, 4237, 4303, 4304, 4305, 4308, 4321, 4322, 4326, 4512, 4802, arts. 43, 49; L. 1992, ch. 501; L. 1997, ch. 661; L. 2005, ch. 645; Federal Social Security Act, 42 U.S.C. § 1395 ss; Correction Law, §168-b

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