2006 New York Code - Stop-loss Insurance.



 
    §  4237-a.  Stop-loss  insurance.  (a) An insurer authorized to do the
  business of accident and health insurance in this  state  and  a  health
  service  corporation organized under article forty-three of this chapter
  shall be authorized to issue stop-loss insurance  as  provided  in  this
  section.
    (b)  "Stop-loss  insurance"  means  an  insurance  policy  whereby the
  insurer agrees to  pay  claims  or  indemnify  an  employer  for  losses
  incurred  under  a  self-insured  employee  benefit  plan  in  excess of
  specified loss limits  for  individual  claims  and/or  for  all  claims
  combined, or any similar arrangement.
    (c)  A  stop-loss  insurance policy delivered, issued for delivery, or
  entered into in this state shall clearly describe:
    (1) the entire money or other consideration for the policy;
    (2) the time at which the insurance takes effect and terminates;
    (3) the specified per-claim,  per-employee,  or  aggregate  amount  of
  claims  above  which  payment  or  reimbursement  is  to  be made by the
  insurer; and
    (4) the payments  to  be  made  by  the  insurer  once  the  specified
  stop-loss thresholds have been exceeded.
    (d)  No  stop-loss  insurance  contract  shall be issued or renewed if
  issuance of the policy would be prohibited by section two  thousand  six
  hundred  thirteen,  three thousand two hundred thirty-one, four thousand
  three hundred seventeen or four thousand three hundred  twenty  of  this
  chapter.
    (e)  The  superintendent  may promulgate such rules and regulations he
  deems necessary or desirable to  establish  financial  requirements  and
  standards  for  the  form  and  content  of stop-loss insurance policies
  authorized by this section.

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