N.Y. Insurance Law § 4304: Individual contracts

§ 4304. Individual contracts. (a) Every corporation subject to the

provisions of this article may issue a contract to an individual the

premiums for which may be paid to the corporation directly by the

individual or by a remitting agent for the group to which the individual

belongs. If the premiums for a contract issued pursuant to this section

are paid to the corporation by a remitting agent, such contract shall be

subject to subsections (k) and (l) of section four thousand two hundred

thirty-five of this chapter, and for the purposes of these subsections,

the remitting agent shall be treated as the policyholder.

(b)(1) Any such contract shall be for a period not in excess of twelve

months, but no contract shall be made providing for the inception of

benefits at a date later than one year from the date of the contract.

(2) Any such contract shall provide that it will be automatically

renewed from year to year unless there shall have been one month's prior

written notice of termination by the subscriber.

(3) No corporation shall refuse to renew any such contract because of

the physical or mental condition or the health of any person covered

thereunder. The provisions of this subsection shall in no way diminish

the rights of individuals pursuant to section four thousand three

hundred seventeen of this article.

(c) Any such contract may be terminated in the following manner:

(1) At the option of the individual to whom the contract is issued,

upon not less than one month's prior written notice.

(2) At the option of the corporation, for one or more of the following

reasons:

(A) The individual has failed to pay premiums or contributions in

accordance with the terms of the contract or the corporation has not

received timely premium payments.

(B) The individual has performed an act or practice that constitutes

fraud or made an intentional misrepresentation of material fact under

the terms of the contract, upon not less than one month's prior written

notice.

(C) (i) Discontinuance of a class of contract upon not less than

ninety days' prior written notice. In exercising the option to

discontinue coverage pursuant to this item, the corporation must act

uniformly without regard to any health status-related factor of enrolled

individuals or individuals who may become eligible for such coverage and

must offer to subscribers or group remitting agents, as may be

appropriate, the option to purchase all other individual health

insurance coverage currently being offered by the corporation to

applicants in that market. Provided, however, the superintendent may,

after giving due consideration to the public interest, approve a request

made by a corporation for the corporation to satisfy the requirements of

this item through the offering of contracts at each level of coverage as

defined in subsection (b) of section four thousand three hundred six-h

of this article that contains the essential health benefits package

described in paragraph three of subsection (e) of section four thousand

three hundred six-h of this article by another corporation, insurer or

health maintenance organization within the corporation's same holding

company system, as defined in article fifteen of this chapter.

(ii) Discontinuance of all hospital, surgical or medical expense

coverage in the individual direct payment market in this state upon

written notice to the superintendent and to each subscriber not less

than one hundred eighty days prior to the date of the expiration of such

coverage. In the event of such a withdrawal from the individual direct

payment market, the corporation must also provide the superintendent

with a written plan to minimize potential disruption in the marketplace

occasioned by such withdrawal. In addition, the corporation may not

provide for the issuance of any hospital, surgical or medical expense

coverage in the individual direct payment market in this state during

the five-year period beginning on the date of the discontinuance of the

last health insurance coverage not so renewed.

(iii) Discontinuance of all individual hospital, surgical or medical

expense insurance contracts for which the premiums are paid by a

remitting agent of a group, in the small group market, or the large

group market, or both markets, in this state, in conjunction with a

withdrawal from the small group market, or the large group market, or

both markets, in this state. Withdrawal from the small group market, or

the large group market, or both markets, shall be governed by the

requirements of subparagraphs (E) and (F) of paragraph three of

subsection (j) of section four thousand three hundred five of this

article. For purposes of this item, "withdrawal" from a market means

that no coverage is offered or maintained in such market under contracts

issued pursuant to this section or contracts issued pursuant to section

four thousand three hundred five of this article.

(D) In the case of a corporation that offers health insurance in the

market through a network plan, the individual no longer resides, lives

or works in the service area (or in an area for which the corporation is

authorized to do business) but only if such coverage is terminated under

this paragraph uniformly without regard to any health status-related

factor of covered individuals. For the purposes of this subparagraph,

the term "network plan" means health insurance coverage of a corporation

organized under this article under which the financing and delivery of

health care (including items and services paid for as such care) are

provided, in whole or in part, through a defined set of providers under

contract either with the corporation or another entity that has

contracted with the corporation.

(E) In case of a contract for which the premiums are paid by a

remitting agent of a group, discontinuance of the individual's

membership in such group.

(F) Such other reasons as the superintendent may approve and

authorized by the Health Insurance Portability and Accountability Act of

1996, Public Law 104-191, and any later amendments or successor

provisions, or by any federal regulations or rules that implement the

provisions of the Act, upon not less than one month's prior written

notice.

(3) Every notice of termination shall be in a form satisfactory to the

superintendent and shall include a statement of the conversion

privileges, if any, upon such termination.

(4) In the event of termination of a contract, the corporation shall

return the unearned portion of the premium.

(d) (1) (A) No contract issued pursuant to this section shall entitle

more than one person to benefits except that a contract issued and

marked as a "family contract" may provide that benefits will be

furnished to the contract holder, spouse, dependent child or children,

or other person chiefly dependent upon the contract holder provided

that:

(i) A "family contract" may provide coverage to any child or children

not over nineteen years of age, provided that an unmarried student at an

accredited institution of learning may be considered a dependent until

the child becomes twenty-three years of age, and provided also that the

coverage of any such "family contract" may include, at the option of the

corporation, any unmarried child until attaining age twenty-five.

However, a "family contract" of hospital, medical, surgical, or

prescription drug expense insurance that provides coverage for dependent

children shall provide such coverage to a married or unmarried child

until attainment of age twenty-six without regard to financial

dependence, residency with the contract holder, student status, or

employment.

(ii) The coverage of any such "family contract" shall include any

other unmarried child, regardless of age, who is incapable of

self-sustaining employment by reason of mental illness, developmental

disability, as defined in the mental hygiene law, or physical handicap

and who became so incapable prior to attainment of the age at which

coverage would otherwise terminate.

(B) In addition to the requirements of subparagraph (A) of this

paragraph, every corporation issuing a contract of hospital, medical or

surgical expense insurance that provides coverage for children must make

available and if requested by the contractholder, extend coverage under

the contract to an unmarried child through age twenty-nine, without

regard to financial dependence who is not insured by or eligible for

coverage under any employer health benefit plan as an employee or

member, whether insured or self-insured, and who lives, works or resides

in New York state or the service area of the corporation. Such coverage

shall be made available at the inception of all new contracts, and for

group remittance contracts at any anniversary date. Written notice of

the availability of such coverage shall be delivered to the

contractholder prior to the inception of such contract, and for group

remittance contracts annually thereafter.

(C) Notwithstanding any rule, regulation or law to the contrary, any

"family contract" shall provide that coverage of newborn infants,

including newly born infants adopted by the subscriber if such

subscriber takes physical custody of the infant upon such infant's

release from the hospital and files a petition pursuant to section one

hundred fifteen-c of the domestic relations law within thirty days of

birth; and provided further that no notice of revocation to the adoption

has been filed pursuant to section one hundred fifteen-b of the domestic

relations law and consent to the adoption has not been revoked, shall be

effective from the moment of birth for injury or sickness including the

necessary care and treatment of medically diagnosed congenital defects

and birth abnormalities including premature birth, except that in cases

of adoption, coverage of the initial hospital stay shall not be required

where a birth parent has insurance coverage available for the infant's

care. This provision regarding coverage of newborn infants shall not

apply to two person coverage. In the case of individual or two person

coverages the corporation must also permit the person to whom the

contract is issued to elect such coverage of newborn infants from the

moment of birth. If notification and/or payment of an additional premium

or contribution is required to make coverage effective for a newborn

infant, the coverage may provide that such notice and/or payment be made

within no less than thirty days of the day of birth to make coverage

effective from the moment of birth. This election shall not be required

in the case of student insurance or where the group remitting agent's

plan does not provide coverage for children.

(2) Every "family contract" under which coverage of a dependent spouse

or contract holder would terminate upon such spouse or contract holder

attaining the age prescribed in subchapter XVIII of the Social Security

Act, 42 U.S.C. § 1395 et seq ("Medicare"), as the age of first

eligibility for the benefits provided by such law shall not so

terminate, if such dependent spouse is not eligible for all of such

benefits, for as long as the contract remains in force and such

dependent spouse remains ineligible to receive any of such "medicare"

benefits, provided proof of such ineligibility is submitted to the

corporation within thirty-one days of the date notice of termination of

coverage is mailed by the corporation to the last known address of the

such spouse or contract holder.

(3) Coverage of an unmarried dependent child who is incapable of

self-sustaining employment by reason of mental illness, developmental

disability, as defined in the mental hygiene law, or physical handicap

and who became so incapable prior to attainment of the age at which

coverage would otherwise terminate and who is chiefly dependent upon the

contract holder for support and maintenance, shall not terminate while

the contract remains in force and the child remains in such condition,

if the contract holder has within thirty-one days of such child's

attainment of the limiting age submitted proof of such child's

incapacity as described herein.

(e) (1) (A) If any such contract is terminated in accordance with the

provisions of paragraph one of subsection (c) of this section, or any

such contract is terminated because of a default by the remitting agent

in the payment of premiums not cured within the grace period and the

remitting agent has not replaced the contract with similar and

continuous coverage for the same group whether insured or self-insured,

or any such contract is terminated in accordance with the provisions of

subparagraph (E) of paragraph two of subsection (c) of this section, or

if an individual other than the contract holder is no longer covered

under a "family contract" because the individual is no longer within the

definition set forth in the contract, or a spouse is no longer covered

under the contract because of divorce from the contract holder or

annulment of the marriage, or any such contract is terminated because of

the death of the contract holder, then such individual, former spouse,

or in the case of the death of the contract holder the surviving spouse

or other dependents of the deceased contract holder covered under the

contract, as the case may be, shall be entitled to convert, without

evidence of insurability, upon application therefor and the making of

the first payment thereunder within sixty days after the date of

termination of such contract, to a contract that contains the essential

health benefits package described in paragraph three of subsection (e)

of section four thousand three hundred six-h of this article.

(B) The corporation shall offer one contract at each level of coverage

as defined in subsection (b) of section four thousand three hundred

six-h of this article. The individual may choose any such contract

offered by the corporation. Provided, however, the superintendent may,

after giving due consideration to the public interest, approve a request

made by a corporation for the corporation to satisfy the requirements of

this paragraph through the offering of contracts that comply with this

paragraph by another corporation, insurer or health maintenance

organization within the corporation's same holding company system, as

defined in article fifteen of this chapter.

(C) The effective date of the coverage provided by the converted

direct payment contract shall be the date of the termination of coverage

under the contract from which conversion was made.

(2) The corporation shall not be required to issue any such converted

individual direct payment contract if its issuance would result in

overinsurance or duplication of benefits according to standards on file

with the superintendent and approved by the superintendent with regard

to such contracts.

(3) In addition to the right of conversion herein, the employee or

member insured under a contract for which the premiums are paid by a

remitting agent of a group shall at his option, as an alternative to

conversion, be entitled to have his coverage continued under the group

remittance contract in accordance with the conditions and limitations

contained in subsection (k) of this section, and have issued at the end

of the period of continuation an individual direct payment conversion

contract subject to the terms of this subsection. The effective date for

the conversion contract shall be the day following the termination of

insurance under the group remittance contract, or if there is a

continuation of coverage, on the day following the end of the period of

continuation.

(4) For purposes of this subsection, the term "dependent" shall

include a child as described in subsection (d) of this section.

(f) No such corporation shall require as a condition for renewal or

for failure to cancel any individual contract any rider, endorsement or

other attachment which shall limit the nature or extent of the benefits

thereunder, except that a corporation may at any time upon at least

thirty days' prior written notice amend such contract to provide a

different level of benefits thereunder if approved by the superintendent

on finding, upon application by the corporation at least four months

before the proposed effective date, that such level would exceed, in the

aggregate, the level of benefits theretofore provided and would be in

the best interests of the corporation and the persons covered under such

contracts.

(g) The provisions of this section with respect to limitations on the

termination of an individual contract shall not apply to a contract or

an endorsement or rider thereto which is issued by a corporation subject

to the provisions of this article pursuant to a plan providing for

experimentation in new forms of benefits in the field of health

insurance protection, which plan shall be submitted in writing to the

superintendent. The superintendent shall approve such plan if he finds

that the benefits are of the type heretofore described and that the

issuance of such contract, endorsement or rider is in the public

interest. Approval of such contract, rider or endorsement shall be

subject to any conditions which may be prescribed by the superintendent,

including, but not limited to, the maximum period during which the

exemption from the provisions of this section with respect to

termination shall continue. The superintendent may, for good cause

shown, extend such period of exemption. Any termination of such

contract, rider or endorsement during the period of exemption, other

than for non-payment of premium and fraud in applying for the contract,

shall be subject to the approval of the superintendent. Upon termination

of such contract, or termination of a rider or endorsement providing

experimental benefits, as aforesaid, the contract holder thereunder who

has at the time of such termination been covered continuously

immediately preceding such termination for a period of two years or more

under one or more contracts of the corporation shall be entitled to have

issued to him by the corporation, without evidence of insurability, upon

application therefor and the making of the first payment thereunder

within thirty-one days after the date of termination, an individual

direct payment contract of the type and class which the superintendent

shall determine provides benefits most nearly comparable to those

currently provided other individuals. If the corporation does not

terminate such contract or a rider or endorsement thereto providing

experimental benefits as aforesaid during the period of exemption, or

any extended period provided herein, such contract shall thereafter be

subject to the provisions of this section with respect to termination as

of the original effective date of such contract.

(h) Any contract, other than one issued in fulfillment of the

continuing care responsibilities of an operator of a continuing care

retirement community in accordance with article forty-six of the public

health law, made available because of residence in a particular

facility, housing development, or community shall contain the following

notice in twelve point type in bold face on the first page:

"NOTICE - THIS CONTRACT DOES NOT MEET THE REQUIREMENTS OF A CONTINUING

CARE RETIREMENT CONTRACT. AVAILABILITY OF THIS COVERAGE WILL NOT QUALIFY

A RESIDENTIAL FACILITY AS A CONTINUING CARE RETIREMENT COMMUNITY."

(i) Any persons covered by the contract who are also members of a

reserve component of the armed forces of the United States, including

the National Guard, shall be entitled, upon written request, to have

their coverage suspended during a period of active duty as described

herein. The contract shall provide that the insurer will refund any

unearned premiums for the period of such suspension. Persons covered by

the contract shall be entitled to resumption of coverage, upon written

application and payment of the required premium within sixty days after

the date of termination of the period of active duty, with no

limitations or conditions imposed as a result of such period of active

duty except as set forth in paragraphs one and two herein. Coverage

shall be retroactive to the date of termination of the period of active

duty. Such right of resumption provided for herein shall be in addition

to other existing rights granted pursuant to state and federal laws and

regulations and shall not be deemed to qualify or limit such rights in

any way. No exclusion or waiting period may be imposed in connection

with coverage of a health or physical condition of a person entitled to

such right of resumption, or a health or physical condition of any other

person who is covered by the contract unless:

(1) the condition arose during the period of active duty and the

condition has been determined by the secretary of veterans affairs to be

a condition incurred in the line of duty; or

(2) a waiting period was imposed and had not been completed prior to

the period of suspension; in no event, however, shall the sum of the

waiting periods imposed prior to and subsequent to the period of

suspension exceed the length of the waiting period originally imposed.

(j) To be entitled to the right defined in subsection (i) of this

section a person must be a member of a reserve component of the armed

forces of the United States, including the National Guard, who either:

(1) voluntarily or involuntarily enters upon active duty (other than

for the purpose of determining his or her physical fitness and other

than for training), or

(2) has his or her active duty voluntarily or involuntarily extended

during a period when the president is authorized to order units of the

ready reserve or members of a reserve component to active duty, provided

that such additional active duty is at the request and for the

convenience of the federal government, and

(3) serves no more than four years of active duty.

(k) A contract for which the premiums are paid by a remitting agent of

a group issued by a hospital service, health service or medical expense

indemnity corporation shall provide that if all or any portion of the

insurance on an employee or member insured under the contract ceases

because of termination of employment or membership in the class or

classes eligible for coverage under the contract, such employee or

member shall be entitled without evidence of insurability upon

application to continue his or her insurance for himself or herself and

his or her eligible dependents, subject to all of the group remittance

contract's terms and conditions applicable to those forms of benefits

and to the following conditions:

(1) Continuation shall not be available for: (A) any person who is

covered, becomes covered or could be covered by title XVIII of the

United States Social Security Act (Medicare) as amended or superseded;

or (B) an employee, member or dependent who is covered, becomes covered

or could become covered as an employee, member or dependent by any other

insured or uninsured arrangement which provides hospital, surgical or

medical coverage for individuals in a group which does not contain any

exclusion or limitation with respect to any pre-existing condition of

such employee, member or dependent, except the group insurance or group

remittance contract conversion option of this section shall not be

considered as such an arrangement under which an employee, member or

dependent could become covered.

(2) (A) An employee or member who wishes continuation of coverage must

request such continuation in writing within the sixty day period

following the later of: (i) the date of such termination; or (ii) the

date the employee is given notice of the right of continuation by either

his employer or the group remitting agent.

(B) An employee or member who wishes continuation of coverage under

subparagraph (D) of paragraph four of this subsection must give notice

to the employer or group remitting agent within sixty days of the

determination under title II or title XVI of the United States Social

Security Act that such employee or member was disabled at the time of

termination of employment or membership or at any time during the first

sixty days of continuation of coverage.

(3) An employee or member electing continuation must pay to the group

remitting agent or his employer, but not more frequently than on a

monthly basis in advance, the amount of the required premium payment,

but not more than one hundred two percent of the group rate for the

benefits being continued under the group remittance contract on the due

date of each payment. The employee's or member's written election of

continuation, together with the first premium payment required to

establish premium payment on a monthly basis in advance, must be given

to the group remitting agent or employer within sixty days of the date

the employee's or member's benefits would otherwise terminate.

(4) Subject to paragraph one of this subsection, continuation of

benefits under the group remittance contract for any person shall

terminate at the first to occur of the following:

(A) The date thirty-six months after the date the employee's or

member's benefits under the contract would otherwise have terminated

because of termination of employment or membership; or

(B) The end of the period for which premium payments were made, if the

employee or member fails to make timely payment of a required premium

payment; or

(C) In the case of an eligible dependent of an employee or member, the

date thirty-six months after the date such person's benefits under the

contract would otherwise have terminated by reason of:

(i) the death of the employee or member;

(ii) the divorce or legal separation of the employee or member from

his or her spouse;

(iii) the employee or member becoming entitled to benefits under title

XVIII of the United States Social Security Act (Medicare); or

(iv) a dependent child ceasing to be a dependent child under the

generally applicable requirements of the contract; or

(D) The date on which the group remittance contract with that

remitting agent is terminated or, in the case of an employee, the date

his employer terminates participation under the group remittance

contract. However, if this clause applies and the coverage ceasing by

reason of such termination is replaced by similar coverage under another

group or group remittance contract, the following shall apply:

(i) The employee or member shall have the right to become covered

under that other group or group remittance contract, for the balance of

the period that he would have remained covered under the prior group

remittance contract in accordance with this subparagraph had a

termination described in this subparagraph not occurred, and

(ii) The minimum level of benefits to be provided by the other group

or group remittance contract shall be the applicable level of benefits

of the prior group remittance contract reduced by any benefits payable

under that prior group remittance contract, and

(iii) The prior group remittance contract shall continue to provide

benefits to the extent of its accrued liabilities and extension of

benefits as if the replacement had not occurred.

(5)(A) Special enrollment period. An individual who does not have an

election of continuation coverage as described in this subsection in

effect on the effective date of the American Recovery and Reinvestment

act of 2009, but who would be an assistance eligible individual under

Title III of such act if such election were in effect, may elect

continuation coverage pursuant to this subsection. Such election must be

made no later than sixty days after the date the administrator of the

group health plan (or other entity involved) provides the notice

required by section 3001(a)(7) of the American Recovery and Reinvestment

act of 2009. The administrator of the group health plan (or other entity

involved) shall provide such individuals with additional notice of the

right to elect coverage pursuant to this paragraph within sixty days of

the date of enactment of the American Recovery and Reinvestment act of

2009.

(B) Continuation coverage elected pursuant to subparagraph (A) of this

paragraph shall commence with the first period of coverage beginning on

or after the date of the enactment of the American Recovery and

Reinvestment act of 2009 and shall not extend beyond the period of

continuation coverage that would have been required if the coverage had

instead been elected pursuant to paragraph two of this subsection.

(C) With respect to an individual who elects continuation coverage

pursuant to subparagraph (A) of this paragraph, the period beginning on

the date of the qualifying event and ending on the date of the first

period of coverage on or after the enactment of the American Recovery

and Reinvestment act of 2009 shall be disregarded for purposes of

determining the sixty-three day period referred to in section four

thousand three hundred eighteen of this article.

(6) A contract for which premiums are paid by a remitting agent for a

group issued by a hospital service, health service or medical expense

indemnity corporation shall offer an employee or member who has

exhausted continuation coverage pursuant to Chapter 18 of the Employee

Retirement Income Security Act, 29 U.S.C. § 1161 et seq. or Chapter 6A

of the Public Health Service Act, 42 U.S.C. § 300 bb - 1 et seq. the

opportunity to continue coverage for up to thirty-six months from the

date the employee's or member's continuation coverage began if the

employee or member is entitled to less than thirty-six months of

continuation benefits.

(7) For purposes of this subsection, the term "dependent" shall

include a child as described in subsection (d) of this section.

(l) A corporation shall not offer individual hospital, medical, or

surgical expense insurance contracts unless the contracts meet the

requirements of subsection (b) of section four thousand three hundred

twenty-eight of this article. Such contracts that are offered within the

health benefit exchange established by this state also shall meet any

requirements established by the health benefit exchange. To the extent

that a holder of a special purpose certificate of authority issued

pursuant to section four thousand four hundred three-a of the public

health law offers individual hospital, medical, or surgical expense

insurance contracts, the contracts shall meet the requirements of

subsection (b) of section four thousand three hundred twenty-eight of

this article.

(m) (1) As used in this subsection, "child" means an unmarried child

through age twenty-nine of an employee or member insured under a group

remittance contract of hospital, medical or surgical expense insurance,

regardless of financial dependence, who is not insured by or eligible

for coverage under any employer health benefit plan as an employee or

member, whether insured or self-insured, and who lives, works or resides

in New York state or the service area of the corporation and who is not

covered under title XVIII of the United States Social Security Act

(Medicare).

(2) In addition to the conversion privilege afforded by subsection (e)

of this section and the continuation privilege afforded by subsections

(e) and (k) of this section, a hospital service, health service or

medical expense corporation or health maintenance organization that

provides hospital, medical or surgical expense insurance coverage for

which the premiums are paid by the remitting agent of a group that

provides coverage of a child that terminates at a specified age shall,

upon application of the employee, member or child, as set forth in

subparagraph (B) of this paragraph, provide coverage to the child after

that specified age and through age twenty-nine without evidence of

insurability, subject to all of the terms and conditions of the group

remittance contract and the following:

(A) An employer shall not be required to pay all or part of the cost

of coverage for a child provided pursuant to this subsection;

(B) An employee, member or child who wishes to elect continuation of

coverage pursuant to this subsection shall request the continuation in

writing:

(i) within sixty days following the date coverage would otherwise

terminate due to reaching the specified age set forth in the group

contract;

(ii) within sixty days after meeting the requirements for child status

set forth in paragraph one of this subsection when coverage for the

child previously terminated; or

(iii) during an annual thirty-day open enrollment period as described

in the contract.

(C) An employee, member or child electing continuation as described in

this subsection shall pay to the group remitting agent or employer, but

not more frequently than on a monthly basis in advance, the amount of

the required premium payment on the due date of each payment. The

written election of continuation, together with the first premium

payment required to establish premium payment on a monthly basis in

advance, shall be given to the group remitting agent or employer within

the time periods set forth in subparagraph (B) of this paragraph. Any

premium received within the thirty-day period after the due date shall

be considered timely;

(D) For any child electing coverage within sixty days of the date the

child would otherwise lose coverage due to reaching a specified age, the

effective date of the continuation coverage shall be the date coverage

would have otherwise terminated. For any child electing to resume

coverage during an annual open enrollment period, the effective date of

the continuation coverage shall be prospective no later than thirty days

after the election and payment of first premium;

(E) Coverage for a child pursuant to this subsection shall consist of

coverage that is identical to the coverage provided to the employee or

member parent. If coverage is modified under the contract for any group

of similarly situated employees or members, then the coverage shall also

be modified in the same manner for any child;

(F) Coverage shall terminate on the first to occur of the following:

(i) the date the child no longer meets the requirements of paragraph

one of this subsection;

(ii) the end of the period for which premium payments were made, if

there is a failure to make payment of a required premium payment within

the period of grace described in subparagraph (C) of this paragraph; or

(iii) the date on which the group remittance contract is terminated

and not replaced by coverage under another group or group remittance

contract; and

(G) The corporation or health maintenance organization shall provide

written notification of the continuation privilege described in this

subsection and the time period in which to request continuation to the

employee or member:

(i) in each certificate of coverage; and

(ii) at least sixty days prior to termination at the specified age as

provided in the contract.

(3)(A) Corporations and health maintenance organizations shall submit

such reports as may be requested by the superintendent to evaluate the

effectiveness of coverage pursuant to this subsection including, but not

limited to, quarterly enrollment reports.

(B) The superintendent may promulgate regulations to ensure the

orderly implementation and operation of the continuation coverage

provided pursuant to this subsection, including premium rate

adjustments.