N.Y. Insurance Law § 3218: Medicare supplemental insurance policies

§ 3218. Medicare supplemental insurance policies. (a) In this section:

(1) "Medicare" means the coverage of health care costs provided under

subchapter XVIII of the federal Social Security Act, 42 U.S.C. §§ 1395

et seq.

(2) "Medicare supplemental insurance" means any individual or group

accident and health policy issued for delivery in this state on or after

June tenth, nineteen hundred eighty, providing for the payment or

reimbursement for health care services not provided by medicare, except

that such terms shall not include a contract issued pursuant to

subsections (c) and (d) of section four thousand two hundred thirty-five

or section four thousand three hundred five of this chapter which covers

employees of firms doing business in more than one state or the benefit

structure of which was the subject of collective bargaining affecting

employees of firms doing business in more than one state.

(b) The superintendent shall promulgate rules and regulations which:

(1) Establish as a separate classification, medicare supplemental

insurance.

(2) Provide for minimum standards for medicare supplemental insurance

policies.

(3) Require the ratio of benefits to premiums to be not less than an

appropriate percentage determined by the superintendent and requiring

the annual filing of data that will demonstrate the insurer's

compliance.

(4) Provide a uniform system of designation for said policies which

indicates the type and scope of coverage afforded.

(5) Provide for full disclosure of coverage in a clear and coherent

manner using words with common everyday language.

(6) Prohibit the advertisement, sale, or solicitation of any accident

or health insurance policy as being supplemental to medicare coverage

unless it conforms to minimum standards for medicare supplemental

insurance policies provided by this section.

(7) Provide for the publication and dissemination of a consumer's

shopping guide for medicare supplemental insurance.

(c) No authorized insurer shall issue or deliver in this state any

medicare supplemental insurance policy other than a medicare

supplemental insurance policy which includes the minimum standards as

approved by the superintendent.

(d) (1) Every authorized insurer engaged in issuing for delivery in

this state, policies for medicare supplemental insurance as set forth in

this section shall file with the superintendent a report of all claims

experience for such coverage for each twelve month period preceding the

dates fixed by the superintendent for the filing of such reports. Such

reports shall be made in writing and on a form prescribed by the

superintendent not less than annually on dates determined by the

superintendent.

(2) The provisions of this subsection shall remain in force until

December thirty-first, nineteen hundred eighty-three.