N.Y. Comp. Codes R. & Regs. tit. 9 § 9610.6

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

Section 9610.6 - Notification

(a) Applicants have the right to adequate notice of their determination of eligibility.

(1) Notification shall be given within three days of the decision to accept or deny an application (except during the 120-day period beginning July 1, 1987, when notification of denial shall be given within 10 days of a decision to deny.)

(2) Notification of denial shall clearly set forth the decision of the contractor and the specific reason why the application was denied. Notification of acceptance shall clearly set forth the decision and the cost-sharing responsibilities of the applicant.

(b) Participants are entitled to timely and adequate notice of any change affecting their coverage, except for mass changes.

(c) Participants are entitled to adequate notice of any adjustment to the copayment schedule 30 days prior to the effective date of the change.

(d) Participants also have the right to adequate notice 30 days prior to the due date of any quarterly or annual registration fee or premium. The notice shall state the amount due, the date on which payment is to be received and that his/her coverage shall expire 30 days after the due date if payment is not received.

N.Y. Comp. Codes R. & Regs. Tit. 9 § 9610.6