2021 New York Laws
ISC - Insurance
Article 11 - Licensing of Insurers
1109 - Limited Exemption for Health Maintenance Organizations.

§ 1109. Limited exemption for health maintenance organizations. (a) An
organization  complying with the provisions of article forty-four of the
public health law may operate without being licensed under this  chapter
and without being subject to any provisions of this chapter, except: (1)
to  the extent that such organization must comply with the provisions of
this chapter by virtue of  such  article,  and  (2)  the  provisions  of
sections  three  hundred  eight,  one  thousand  three  hundred one, one
thousand three hundred  two,  one  thousand  three  hundred  seven,  one
thousand  three  hundred  twenty-two,  with regard to health maintenance
organizations  that  are  domiciled  in  this  state  and  certified  or
operating  in  at least one other state, two thousand one hundred three,
two thousand one hundred twelve, two thousand one hundred fourteen,  two
thousand  one  hundred  fifteen, two thousand one hundred seventeen, two
thousand one hundred twenty-three, two thousand six hundred eight-a, two
thousand six hundred twelve, three thousand two  hundred  twenty-four-a,
four   thousand   three  hundred  eight,  four  thousand  three  hundred
seventeen, four thousand three hundred  eighteen,  four  thousand  three
hundred  twenty,  four  thousand three hundred twenty-one, four thousand
three hundred twenty-two and four thousand three hundred twenty-three of
this chapter.
  (b) An organization which provides health care services for a periodic
fee paid in advance but which does not comply  with  the  provisions  of
article  forty-four  of  the  public  health  law  shall be deemed to be
engaged in the business of insurance and may not operate  without  being
licensed under this chapter.
  (c)  An organization referred to in subsection (a) or (b) hereof shall
be subject to article seventy-four of this chapter.
  (d)  A  health  maintenance  organization  may  make  any   investment
permitted for a health service corporation organized pursuant to article
forty-three  of  this  chapter  provided  that the superintendent, after
consultation with the commissioner of health, may modify such investment
requirements, if such modification would permit the organization to more
effectively implement its program without incurring undue  risk  to  its
subscribers.
  (e)  The superintendent may promulgate regulations in effectuating the
purposes and provisions of this chapter and article  forty-four  of  the
public  health  law  and  may  modify  requirements  applicable  to  the
contracts between a health maintenance organization and its subscribers,
subject to such limitations as the superintendent shall  deem  necessary
or proper to insure the performance of such contracts.