Chapter XIV. Individual and Small Group Health Insurance

Part 360. Rules to Assure an Orderly Implementation and Ongoing Operation of Open Enrollment and Community Rating of Individual and Small Group Health Insurance

• Part 360. Rules to Assure an Orderly Implementation and Ongoing Operation of Open Enrollment and Community Rating of Individual and Small Group Health Insurance [Details]
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.1 Preamble
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.2 Definitions
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.3 Eligibility For Individual and Small Group Health Insurance Policies
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.4 Open Enrollment For Individual and Small Group Health Insurance Policies
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.5 Prohibited Underwriting Practices and Eligibility Rules Affecting Individual and Small Group Health Insurance
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.6 Pre-Existing Condition Waiting Periods
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.7 Continuation of Health Insurance Benefits
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.8 Group Health Insurance Policies Issued to Association Groups
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.9 Prohibition On Insurers Providing Administrative Services Or Stop-Loss, Catastrophic Or Reinsurance Coverages to Self-Insured Arrangements, Including Small Groups and Association Groups
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.10 Filing and Approval of Rates By Commercial Insurers Intending to Change to a Community Rating Methodology
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.11 Community Rates Applicable to Commercial Insurers, Article 43 Corporations, and Hmos
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.12 Applicability
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.13 [Repealed]
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 360.20 Severability

Part 361. Establishment and Operation of Market Stabilization Mechanisms For Individual and Small Group Health Insurance and Medicare Supplement Insurance

• Part 361. Establishment and Operation of Market Stabilization Mechanisms For Individual and Small Group Health Insurance and Medicare Supplement Insurance [Details]
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.1 Preamble
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.2 Definitions
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.3 Pooling of Variations In Costs Attributable to Variations In Demographics
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.4 Pooling of the Cost of Treating Specified Medical Conditions Prior to January 1, 1999
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.5 Pooling of Variations In Costs Attributable to Variations In Specified Medical Conditions (Smc) Beginning In 1999 Through 2006
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.6 Pooling of Variations of Costs Attributable to High Cost Claims Beginning In 2006 Through 2013 For Individual and Small Group Policies, Other Than Medicare Supplement and Healthy New York Policies
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.7 Pool Administration
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.8 Review of Pool Operations
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.9 Market Stabilization Pools For the Small Group Health Insurance Market For the 2017 Plan Year
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 361.10 Market Stabilization Pools For the Individual and Small Group Health Insurance Markets For Plan Years 2018 and Thereafter

Part 362. The Healthy New York Program and the Direct Payment Stop Loss Relief Program

• Part 362. The Healthy New York Program and the Direct Payment Stop Loss Relief Program [Details]
• Subpart 362-1. Preamble
• Subpart 362-2. Rules Generally Applicable to the Healthy New York Program
• Subpart 362-3. Rules Relating to Small Employer Participation (Other Than Individual Proprietors)
• Subpart 362-4. Rules Relating to Working Uninsured Individuals and Individual Proprietor Participation
• Subpart 362-5. Rules Relating to the Direct Payment Market Stop Loss Relief Program and State Funded Stop Loss Relief For the Healthy New York Program

Part 363. Unprofessional Conduct

• Part 363. Unprofessional Conduct [Details]
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.1 Preamble
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.2 Applicability
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.3 Definitions
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.4 Community Rating and Procedures For Establishing Rates
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.5 Risk Adjustment
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.6 Rules Relating to the Content and Sale of Policy Forms For Family Leave Benefits Coverage
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.7 Maximum Employee Contribution
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.8 Data Collection
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.9 Exemptions From Electronic Filing and Submission Requirements
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 363.10 Authority of the Superintendent

Part 364. Paid Family Leave Risk Adjustment Fund

• N.Y. Comp. Codes R. & Regs. Tit. 11 § 364.1 Preamble
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 364.2 Risk Adjustment Fund

Part 365. Paid Family Leave Covid- 19 Risk Adjustment Mechanism

• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.0 Introduction
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.1 Covid-19 Risk Adjustment Mechanism
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.2 Immediate Relief Payments From the Covid-19 Risk Adjustment Pool
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.3 Funding the Covid-19 Immediate Relief Payments
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.4 Recoupment of Costs of Covid-19 Claims
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.5 Collection and Redistribution of Funds From an Adjustment
• N.Y. Comp. Codes R. & Regs. Tit. 11 § 365.6 Covid-19 Risk Adjustment Pool