2006 New York Code - Limitations on administrative services and stop-loss coverage

 
    * §   3234.  Limitations  on  administrative  services  and  stop-loss
  coverage. No insurer, subsidiary of an insurer, or controlled person  of
  a  holding  company  system may act as an administrator or claims paying
  agent, as opposed to an insurer, on behalf of a group  which  denies  or
  limits  benefits  for a specific disease or condition or for a procedure
  or treatment unique to a specific disease or condition in a manner which
  would be inconsistent with this chapter or  regulations  promulgated  by
  the  superintendent  had  the  group  purchased  insurance.  No insurer,
  subsidiary of an insurer, or controlled person of a holding company  may
  provide  stop loss, catastrophic or reinsurance coverage to groups which
  deny or limit benefits for a specific disease  or  condition  or  for  a
  procedure  or  treatment  unique to a specific disease or condition in a
  manner which would be inconsistent  with  this  chapter  or  regulations
  promulgated  by  the superintendent had the group purchased insurance. A
  limit, maximum, or other mechanism that controls total coverage  without
  regard  to  a specific disease or condition shall not be deemed one that
  denies or limits benefits for a specific disease or condition, or for  a
  procedure  or  treatment  unique  to  a  specific  disease or condition.
  Nothing herein shall be construed to mandate the inclusion of  specified
  benefits  in  an employer group plan, if such plan is not subject to the
  provisions of this chapter.
    * NB There are 3 § 3234's