N.Y. Insurance Law § 3217-f: Prohibition on lifetime and annual limits

§ 3217-f. Prohibition on lifetime and annual limits. (a) An insurer

shall not establish a lifetime limit on the dollar amount of essential

health benefits in an individual, group or blanket policy of hospital,

medical, surgical or prescription drug expense insurance.

(b) An insurer shall not establish an annual limit on the dollar

amount of essential health benefits in an individual, group or blanket

policy of hospital, medical, surgical or prescription drug expense

insurance for policy years beginning on and after January one, two

thousand fourteen.

(c) For policy years beginning prior to January one, two thousand

fourteen, an insurer may establish restricted annual limits on the

dollar amount of essential health benefits in an individual, group, or

blanket policy of hospital, medical, surgical or prescription drug

expense insurance consistent with section 2711 of the Public Health

Service Act, 42 U.S.C. § 300gg-11 or any regulations thereunder.

(d) The requirements of subsections (b) and (c) of this section shall

not be applicable to an individual policy that is a grandfathered health

plan. For purposes of this section, "grandfathered health plan" means

coverage provided by an insurer in which an individual was enrolled on

March twenty-third, two thousand ten for as long as the coverage

maintains grandfathered status in accordance with section 1251(e) of the

Affordable Care Act, 42 U.S.C. § 18011(e).

(e) For purposes of this section, "essential health benefits" shall

have the meaning ascribed by section 1302(b) of the Affordable Care Act,

42 U.S.C. § 18022(b).