Text of Fourth Amendment to 11 NYCRR 362 (Regulation 171)

A new section 362-2.9 is added to read as follows:

§ 362-2.9 Healthy New York Enrollment Limitation

(a) With respect to coverage effective on or after January 1, 2012, a health maintenance organization or a participating insurer may enroll new applicants in the Healthy New York Program only in the high deductible health plans set forth in section 362-2.8 of this Part.

(b) With respect to existing enrollees who are in non-high deductible health plans with coverage effective prior to January 1, 2012, a health maintenance organization or a participating insurer shall:

(1) permit qualifying individuals to add dependents to or remove dependents from their qualifying health insurance contracts; and

(2) permit qualifying small employers to add employees and dependents to or remove employees and dependents from their qualifying health insurance contracts.

(c) A health maintenance organization or participating insurer shall permit qualifying individuals and qualifying employers enrolled in non-high deductible plans to change their benefit packages to other non-high deductible plans with the same health maintenance organization or participating insurer at the time of annual recertification or a change in the premium rate.