2006 New York Code - Employer sponsored group personal excess insurance

 
    * § 3445*. Employer sponsored group personal excess insurance. (a) For
  purposes of this section, the following definitions shall apply:
    (1)  "Certificate"  or  "certificate  of  insurance" means any policy,
  contract or  other  evidence  of  insurance,  or  rider  or  endorsement
  thereto,  issued  to  a  group  member under an employer sponsored group
  personal excess insurance policy.
    (2) "Conditional renewal" means any change of limits, change  in  type
  of  coverage, reduction or elimination of coverage, increased deductible
  or addition of exclusion, or increased premiums in excess of ten percent
  (exclusive of any premium increase generated as a result  of  experience
  rating, loss rating or retrospective rating).
    (3)  "Employee"  means  an  individual  or partner who receives or has
  received income, wages or salaries from the employer.
    (4) "Employer" means  a  person,  partnership,  corporation  or  other
  entity  which  pays or has paid income, wages or salaries to a person or
  persons.
    (5) "Employer sponsored group personal excess insurance" means a group
  policy of insurance providing the kind of insurance defined in paragraph
  thirteen or fourteen of subsection  (a)  of  section  one  thousand  one
  hundred  thirteen  of  this  chapter,  written  as an excess policy with
  premiums remitted by the employer,  insuring  groups  of  active  and/or
  retired employees designated by the employer.
    (6)  "Group  member"  means  a  designated employee insured under this
  section.
    (7) "Group policy" means  employer  sponsored  group  personal  excess
  insurance written for the designated employees of an employer.
    (b)  Employer sponsored group personal excess insurance may be written
  in this state pursuant to this section.
    (c) The premium for the group policy may be paid by the employer  from
  funds contributed:
    (1) wholly by the employer;
    (2) wholly by the employees; or
    (3) jointly by the employer and employees.
    (d)  An employee shall have the right to refuse coverage offered by an
  employer under this section.
    (e) Each  policy  written  pursuant  to  this  section  shall  provide
  separate limits of coverage for each group member.
    (f)(1) The insurer shall be responsible for the mailing or delivery to
  the employer a group policy and certificates of insurance for each group
  member  insured  under  the  group  policy.  The  insurer  shall also be
  responsible for the mailing or delivery to the employer for  each  group
  member  any  amended  certificate  of  insurance,  or endorsement to the
  certificate, whenever there is a change of limits; addition,  reduction,
  or elimination of coverage; or addition of an exclusion, under the group
  policy or certificate.
    (2)  The certificate shall contain in substance all material terms and
  conditions of coverage afforded to the group member, including, but  not
  limited  to,  the disclosure in clear and easily understandable language
  of any limitations, exclusions or required underlying coverages,  unless
  the  group  policy  is incorporated by reference and a copy of the group
  policy accompanies the certificate.
    (g)(1) A group policy or certificate shall not be subject  to  section
  three  thousand  four hundred twenty-five or section three thousand four
  hundred twenty-six of this article.  The  following  requirements  shall
  apply to authorized insurers in regard to termination of coverage.
    (2)  A group policy or certificate may be cancelled by an insurer only
  if cancellation is based on one or more of  the  reasons  set  forth  in
  paragraph  one  of subsection (c) of section three thousand four hundred
  twenty-six of this article, provided, however, that an individual  group
  member  may  also  be canceled upon termination of his or her employment
  with the employer.
    (3)  An  insurer's cancellation of a group policy, or any certificate,
  shall not become effective until forty-five  days,  or  twenty  days  if
  based  upon  non-payment of premium, after the insurer mails or delivers
  written notice of cancellation to the employer at  the  mailing  address
  shown  in  the policy. The employer shall mail or deliver written notice
  of such cancellation to each affected group member within  ten  days  of
  receiving  a  cancellation  notice  from  the insurer advising the group
  member of the cancellation and the effective date of the cancellation.
    (h) An authorized insurer may nonrenew or conditionally renew a  group
  policy,  or  any  certificate,  under  this section, for any reason upon
  forty-five days written notice to the employer. The employer shall  mail
  or  deliver  written notice of such nonrenewal or conditional renewal to
  each affected group member within ten days of receiving such notice from
  the insurer.
    (i) An employer may cancel a group policy, or any certificate, for any
  reason upon thirty days written notice to the insurer and each  affected
  group member.
    (j)  Unless  a  group  policy provides for a longer policy period, the
  policy and all certificates shall be issued or renewed  for  a  one-year
  policy  period  commencing  with a common inception date. A new employee
  may be added to the group policy for less than one year to conform  with
  a common expiration date.
    (k)  No  policy  form  shall be delivered or issued for delivery by an
  authorized insurer unless it has been filed with the superintendent  and
  the  superintendent  has either approved it, or thirty days have elapsed
  and the superintendent has not disapproved such form  as  misleading  or
  violative  of public policy. The initial rate of filing pursuant to this
  section shall be subject to the prior approval  of  the  superintendent,
  and any subsequent rate filing shall not be subject to prior approval.
    * NB There are 2 § 3445's