N.Y. Comp. Codes R. & Regs. tit. 11 § 153.3

Current through Register Vol. 46, No. 36, September 4, 2024

Section 153.3 - General requirements

(a) No group policy shall be issued or renewed in this State with respect to personal risk liability or any coverage subject to section 3425 of the Insurance Law.

(b) No quasi-group policy shall be issued or renewed in this State with respect to personal risk liability or any coverage subject to section 3425 of the Insurance Law, except to the extent permitted pursuant to Part 13 (Regulation No. 58) of this Title.

(c) Except in connection with a Federal purchasing group, no group policy shall be issued or renewed in this State, unless:

(1) the group is homogeneous in nature, based upon standards acceptable to the superintendent;

(2) the group is formed for purposes other than obtaining insurance;

(3) the group consists of at least ten group members engaged in similar activities giving rise to similar risks, based upon standards acceptable to the superintendent, except that a smaller number of members, but not less than five, may be covered on a group basis where each such member generates at least $5 million in annual revenues or annual premiums for such group total at least $500,000;

(4) group members are either public entities or nonprofit organizations; and

(5) coverage includes any kind of property/casualty insurance, but not a kind specified by section 1113 (a)(16) (17) (21) (22) (23) or (25) of the Insurance Law.

(d) Except in connection with a Federal purchasing group, no quasi-group policy shall be issued or renewed in this State, unless:

(1) the sponsoring entity (other than with respect to a safety group) is formed for purposes other than obtaining insurance;

(2) the sponsoring entity has at least ten participants engaged in similar activities giving rise to similar risks, based upon standards acceptable to the superintendent, except that a smaller number of participants, but not less than five, may be covered on a quasi-group basis where each such participant generates at least $5 million in annual revenues or annual premiums for such quasi-group total at least $500,000; and

(3) coverage includes any kind of property/casualty insurance, but not a kind specified by section 1113 (a)(16)(C) (D), and (E), (17), (21), (22), (23) or (25) of the Insurance Law.

(e) No policy issued on a group or quasi-group basis in connection with a Federal purchasing group shall provide:

(1) coverage other than liability insurance as defined by section 153.1(i)(2) of this Part;

(2) property coverage of any kind, including contractual obligations; or

(3) surety, warranty or guaranty coverage of any kind.

(f) An insurer issuing or renewing group or quasi-group policies shall maintain separate statistics tracking group loss and expense experience for each group or quasi-group program.

(g) Every group or quasi-group member, in the same rating classification or territory, meeting the insurer's underwriting requirements shall qualify for coverage under the group or quasi-group program.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 153.3