NEW YORK STATE
INSURANCE DEPARTMENT

FIRST AMENDMENT TO REGULATION 164
(11 NYCRR 101)

STANDARDS FOR FINANCIAL RISK TRANSFER BETWEEN INSURERS
AND HEALTH CARE PROVIDERS

 I, Gregory V. Serio, Superintendent of Insurance of the State of New York, pursuant to the authority granted by Sections 201, 301, 1102, 1109, Articles 32, 41, 42 and 43 of the Insurance Law and Section 4403(1)(c) of the Public Health Law, do hereby promulgate the following First Amendment to part 101 of the Official Compilation of Codes, Rules and Regulations of the State of New York (Regulation 164) to take effect upon publication in the State Register, to read as follows:

(Matter in brackets is deleted; new matter is underlined)

Paragraph (2) of section 101.5(c) is amended to read as follows:

(2) In the case of a health care provider under contract with one or more insurance companies, including the non-HMO business written by article 43 corporations, the financial statements of the health care provider, as required by section [101.9(c)] 101.9(a)(3) of this Part, evidences that the amount of liquid assets (cash and marketable securities) and the net worth of the health care provider or the consolidated liquid assets and net worth of the parent corporation of the health care provider, in cases where the health care provider’s obligations have been guaranteed by the parent corporation, is equal or exceeds: i) in the case of liquid assets, five percent of the health care provider’s total estimated annual in-network capitation revenue from all insurance companies, and ii) in the case of net worth, 12.5 percent of the health care provider’s total estimated annual in-network capitation revenue from all insurance companies; or

I, Gregory V. Serio, Superintendent of Insurance, do hereby certify that the foregoing is the First Amendment to 11 NYCRR 101 (Regulation 164), promulgated by me on January 14, 2002 pursuant to the authority granted by Sections 201, 301, 1102, 1109, Articles 32, 41, 42 and 43 of the Insurance Law and Section 4403(1)(c) of the Public Health Law, to take effect upon publication in the State Register.

Pursuant to the provisions of the State Administrative Procedure Act, prior notice of the proposed amendment was published in the State Register on November 14, 2001. No other publication or prior notice is required by statute.

 

_____________________________
Gregory V. Serio
Superintendent of Insurance

January 14, 2002