New York State
(11 NYCRR 361)
FIRST AMENDMENT TO REGULATION NO. 146
ESTABLISHMENT AND OPERATION OF MARKET
MECHANISMS FOR INDIVIDUAL AND SMALL GROUP HEALTH
INSURANCE AND MEDICARE SUPPLEMENT INSURANCE
I, NEIL D. LEVIN, Superintendent of Insurance of the State of New York, pursuant to the authority granted by Sections 201, 301, 1109, 3201, 3217, 3231, 3232, 3233, 4235, Article 43 and Article 45 of the Insurance Law, Chapter 501 of the Laws of 1992 and Chapter 661 of the Laws of 1997, do hereby promulgate the following First Amendment to Part 361 of Title 11 of the Official Compilation of Codes, Rules and Regulations of the State of New York (Regulation No. 146), to take effect upon publication in the State Register to read as follows:
(NEW MATTER UNDERLINED; DELETED MATTER IN BRACKETS)
Section 361.2(o) is hereby amended to read as follows:
(o) Small group health insurance policy means a group remittance policy written by a carrier pursuant to section 4304 of the Insurance Law and a group health insurance policy covering from [three] two to 50 employees or members, exclusive of dependents and spouses, and policies issued to or through association groups as defined in section 360.2(a) of this Title. In determining the size of a small group, reference should be made to section 360.4(i) and (j) of this Title. [A small group health insurance policy also means a group health insurance policy covering individual proprietors and groups of two if the carrier does not offer policies of individual insurance.] Insurers may choose to classify individual proprietors within the small group category provided that any such classification is applied consistently to all individual proprietors. A small group health insurance policy does not include a policy covering only: long term care benefits, nursing home benefits, home care benefits, dental or vision care services, hospital or surgical indemnity benefits with specific dollar amounts, unless the dollar amounts exceed the amounts required to meet the definitions of basic hospital and basic medical insurance in sections 52.5 and 52.6 of this Title, accident only indemnity benefits, accidental death and dismemberment benefits, prescription drug benefits or disability income benefits.
I, Neil D. Levin, Superintendent of Insurance of the State of New York, do hereby certify that the foregoing First Amendment to Regulation No. 146 (11 NYCRR 361) was duly adopted by me on this day pursuant to the authority granted by Sections 201, 301, 1109, 3201, 3217, 3231, 3232, 3233, 4235, Article 43 and Article 45 of the Insurance Law, Chapter 501 of the Laws of 1992 and Chapter 661 of the Laws of 1997, to be effective upon publication in the State Register.
Pursuant to the provisions of the State Administrative Procedure Act, this First Amendment to Regulation No. 146 was previously adopted as an emergency measure on February 10, 1998 and on May 11, 1998. This regulation amendment supercedes the emergency measure without substantive change. The Notice of Proposed Rulemaking for this Amendment was published in the State Register on May 27, 1998. No other publication or prior notice is required by Statute.
Neil D. Levin
Superintendent of Insurance
July 14, 1998