2013 New York Consolidated Laws
ISC - Insurance
Article 43 - (4301 - 4328) NON-PROFIT MEDICAL AND DENTAL INDEMNITY, OR HEALTH AND HOSPITAL SERVICE CORPORATIONS
4320 - Limitations on administrative services and stop-loss coverage.

 
    § 4320. 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.