Accident and Health Product Filing

Student Vision Model Language


  • The following is model language for insurers writing student vision insurance pursuant to Chapter 461 of the Laws of 2015.
  • The documents available in this table are in Word format.


SubjectModel Language Date
SAV Cover Page03/03/2023
SAV Table of Contents12/13/2022
SAV Definitions12/13/2022
SAV How This Coverage Works12/13/2022
SAV Access to Care and Transitional Care12/13/2022
SAV Cost-Sharing Expenses and Allowed Amount12/13/2022
SAV Who Is Covered12/21/2023
SAV Routine Vision Care12/13/2022
SAV Exclusions12/13/2022
SAV Claim Determinations12/21/2023
SAV Grievance12/13/2022
SAV Utilization Review12/13/2022
SAV External Appeal12/13/2022
SAV Termination12/21/2023
SAV Extension of Benefits12/21/2023
SAV Temporary Suspension Rights for Members of the Armed Forces12/13/2022
SAV General Provisions12/13/2022
SAV Schedule of Benefits12/13/2022