2012 New York Consolidated Laws
ISC - Insurance
Article 32 - (3201 - 3239) INSURANCE CONTRACTS - LIFE, ACCIDENT AND HEALTH, ANNUITIES
3217-F - Prohibition on lifetime and annual limits.

 
    §  3217-f.  Prohibition  on lifetime and annual limits. (a) An insurer
  shall not establish a lifetime limit on the dollar amount  of  essential
  health  benefits  in an individual, group or blanket policy of hospital,
  medical, surgical or prescription drug expense insurance.
    (b) An insurer shall not establish  an  annual  limit  on  the  dollar
  amount  of  essential health benefits in an individual, group or blanket
  policy of hospital,  medical,  surgical  or  prescription  drug  expense
  insurance  for  policy  years  beginning  on  and after January one, two
  thousand fourteen.
    (c) For policy years beginning prior  to  January  one,  two  thousand
  fourteen,  an  insurer  may  establish  restricted  annual limits on the
  dollar amount of essential health benefits in an individual,  group,  or
  blanket  policy  of  hospital,  medical,  surgical  or prescription drug
  expense insurance consistent with section  2711  of  the  Public  Health
  Service Act, 42 U.S.C. § 300gg-11 or any regulations thereunder.
    (d)  The requirements of subsections (b) and (c) of this section shall
  not be applicable to an individual policy that is a grandfathered health
  plan. For purposes of this section, "grandfathered  health  plan"  means
  coverage  provided  by an insurer in which an individual was enrolled on
  March twenty-third, two  thousand  ten  for  as  long  as  the  coverage
  maintains grandfathered status in accordance with section 1251(e) of the
  Affordable Care Act, 42 U.S.C. § 18011(e).
    (e)  For  purposes  of this section, "essential health benefits" shall
  have the meaning ascribed by section 1302(b) of the Affordable Care Act,
  42 U.S.C. § 18022(b).