N.Y. Comp. Codes R. & Regs. tit. 11 § 59.3

Current through Register Vol. 46, No. 45, November 2, 2024

Section 59.3 - Filing and approval of group insurance certificates delivered after january 1, 1986, where the master contract was delivered prior to january 1, 1986 and the solicitation of new york residents occurs prior to april l, 1986

(a) Certificates delivered prior to July 1, 1986 shall not be subject to sections 59.4, 59.5 and 59.7 of this Part, and shall be approved provided the following conditions are met:

(1) the insurer provides written certification to the Insurance Department that the certificates substantially comply with the standards applicable to group policies and certificates delivered in this State;

(2) a certification that the premium charged is reasonable in relation to the benefits provided, including a statement of the expected benefit ratio, except where the policyholder pays the entire premium; and

(3) a statement that the insurer will retroactively modify such certificates, to the extent necessary, should it be found by the superintendent that the certificate fails to meet the tests as certified above.

(b) In the event the superintendent determines, at the time of filing, that the certification is incomplete or the certificate fails to meet the tests as certified above, no approval under this section will be given.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 59.3