2012 New York Consolidated Laws
ISC - Insurance
Article 43 - (4301 - 4327) NON-PROFIT MEDICAL AND DENTAL INDEMNITY, OR HEALTH AND HOSPITAL SERVICE CORPORATIONS
4306-E - Prohibition on lifetime and annual limits.

 
    § 4306-e. Prohibition on lifetime and annual limits. (a) A corporation
  shall  not  establish a lifetime limit on the dollar amount of essential
  health benefits in an individual, group or blanket contract of hospital,
  medical, surgical or prescription drug expense insurance.
    (b) A corporation shall not establish an annual limit  on  the  dollar
  amount  of  essential health benefits in an individual, group or blanket
  contract of hospital, medical, surgical  or  prescription  drug  expense
  insurance  for  contract  years  beginning on and after January one, two
  thousand fourteen.
    (c) For contract years beginning prior to January  one,  two  thousand
  fourteen,  a  corporation  may establish restricted annual limits on the
  dollar amount of essential health benefits in an  individual,  group  or
  blanket  contract  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 any individual contract  that  is  a  grandfathered
  health  plan.  For purposes of this section, "grandfathered health plan"
  means coverage provided by a corporation  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).