2022 New York Laws
ISC - Insurance
Article 11 - Licensing of Insurers
1120 - Child Health Insurance Plan.

§ 1120. Child health insurance plan. (a) An authorized insurer subject
to  the  provisions  of  this chapter and organized to write the kind of
health insurance specified in  paragraph  three  of  subsection  (a)  of
section  one  thousand  one  hundred  thirteen  of  this  article, and a
corporation or health maintenance organization  authorized  pursuant  to
article forty-three of this chapter or a health maintenance organization
certified  pursuant  to article forty-four of the public health law, may
be authorized by the superintendent  to  issue  contracts  or  otherwise
enter  into  arrangements with approved organizations for the purpose of
providing child health insurance plan  policies  for  eligible  children
pursuant  to  title I-A of article twenty-five of the public health law.
Such contracts or arrangements shall satisfy the criteria set  forth  in
subsection  (b)  of  this  section and the superintendent shall make the
determinations set forth in subsection (e) of this section.
  (b) The superintendent may authorize such  contracts  or  arrangements
pursuant to the following criteria:
  (1) the provisions are not misleading or confusing;
  (2)  the  provisions are consistent with the needs of the child health
insurance plan; and
  (3) the materials describing the contract  or  arrangement  fully  and
clearly   state  the  benefits  and  limitations  of  such  contract  or
arrangement.
  (c) The duration of such contracts or arrangements and the  extent  of
exposure  thereunder  by  insurers,  article forty-three corporations or
health  maintenance   organizations   shall   be   determined   by   the
superintendent.
  (d)  Notwithstanding  any  provisions of this chapter or the financial
services law to the contrary, the superintendent may  waive,  modify  or
suspend  any  provisions  of this chapter, the financial services law or
regulations  promulgated  thereunder  as  applicable  to  the  insurers,
article  forty-three  corporations  or  health maintenance organizations
that issue coverage pursuant to  this  section,  provided  such  waiver,
modification  or  suspension  is  based  on  the  criteria  set forth in
subsection (e) of this section.
  (e) The superintendent may take the actions set forth  in  subsections
(a) and (d) of this section upon the superintendent's judgment that:
  (1)  the  contract  or  arrangement  is  a  reasonable and appropriate
approach to expand the availability of health care coverage to children;
  (2) the sources  of  funding  for  the  contract  or  arrangement  are
reasonably  related  to  the benefits provided and sufficient to support
the contract arrangement;
  (3) any waiver, modification or suspension of the provisions  of  this
chapter,   the   financial   services  law  or  regulations  promulgated
thereunder is essential to the operation of the child  health  insurance
plan  and  to  the  rational  development of programs to provide covered
services to children; and
  (4) any waiver, modification  or  suspension  of  provisions  of  this
chapter,   the   financial   services  law  or  regulations  promulgated
thereunder  will  not  impair  the  ability  of  the  insurer,   article
forty-three  corporation  or  health maintenance organization to satisfy
its existing and anticipated contracts and other obligations,  including
such standards as the superintendent shall prescribe concerning adequate
capital and financial requirements.
  (f)  Each  application  used  by an authorized insurer for purposes of
enrolling  eligible  children  into  the  child  health  insurance  plan
pursuant  to  this section and section twenty-five hundred eleven of the
public  health  law  shall  include  the  notice  required  pursuant  to
subsection (d) of section four hundred three of this chapter.