Part 52 Minimum Standards for Form, Content and Sale of Health Insurance, Including Standards of Full and Fair Disclosure

• 11 CRR-NY III A 52 Notes
• s 52.1 Preamble.
• s 52.2 Definitions.
• s 52.5 Basic hospital insurance.
• s 52.6 Basic medical insurance.
• s 52.7 Major medical insurance.
• s 52.8 Disability income insurance.
• s 52.9 Accident insurance.
• s 52.10 Limited benefits health insurance.
• s 52.11 Medicare supplement insurance.
• s 52.12 Long term care insurance.
• s 52.13 Nursing home insurance only, home care insurance only, or nursing home and home care insurance.
• s 52.14 Medicare select policies and certificates.
• s 52.15 Specified disease coverage.
• s 52.16 Prohibited provisions and coverages.
• s 52.17 Rules relating to content of forms for individual insurance.
• s 52.18 Rules relating to content of forms for group insurance.
• s 52.19 Rules relating to the content of forms for franchise insurance.
• s 52.20 Rules relating to preexisting condition provisions and crediting requirements in policies which provide hospital, surgical or medical expense coverage.
• s 52.21 Rules relating to content of forms for blanket insurance.
• s 52.22 Volunteer firefighter enhanced cancer insurance.
• s 52.23 Coordination of benefits.
• s 52.24 Rules relating to coverage for the diagnosis and treatment of alcoholism and alcohol abuse in group (including group remittance policies issued by article 43 corporations) and school blanket health insurance policies.
• s 52.25 Rules relating to the content and sale of forms for long term care insurance, nursing home insurance only, home care insurance only, and nursing home and home care insurance.
• s 52.26 Rules relating to exclusion of Medicare benefits.
• s 52.27 Rules relating to the sale of health insurance and settlement of health insurance claims.
• s 52.28 Medicare supplement insurance reporting form and refund calculation form.
• s 52.29 Rules relating to the replacement of accident and health insurance coverage with individual long term care insurance, nursing home insurance only, home care insurance only, or nursing home and home care insurance policies and the purchase of mult
• s 52.30 Preliminary review.
• s 52.31 Preparation of forms for submission.
• s 52.32 Conditions for prefiled group coverage.
• s 52.33 Letter of submission.
• s 52.40 Procedures and requirements for filing of rates.
• s 52.41 Gross premium differentials based on sex.
• s 52.42 Health maintenance organization (HMO) contract forms and premium rates.
• s 52.43 Standards for maintaining experience data.
• s 52.44 Standards for annual filing of experience data.
• s 52.45 Minimum loss ratio standards.
• s 52.46 [Repealed[
• s 52.47 Monitoring of experience data submitted under section 52.44(a) of this Part.
• s 52.51 Applications.
• s 52.53 Conditional receipts and interim insurance agreements.
• s 52.54 Disclosure requirements.
• s 52.55 Required disclosure statement for policies meeting standards of section 52.5 of this Part.
• s 52.56 Required disclosure statement for policies meeting standards of section 52.6 of this Part.
• s 52.57 Required disclosure statement for policies meeting standards of both sections 52.5 and 52.6 of this Part.
• s 52.58 Required disclosure statement for policies meeting standards of section 52.7 of this Part.
• s 52.59 Required disclosure statement for policies meeting definition of section 52.10 of this Part.
• s 52.60 Required disclosure statement for policies meeting definition of section 52.8 of this Part.
• s 52.61 Required disclosure statement for policies meeting definition of section 52.9 of this Part.
• s 52.62 Required disclosure statement for policies meeting definition of section 52.10 of this Part.
• s 52.63 Extension of premium payment periods for individual, small group and student blanket comprehensive health insurance policies as a result of the COVID-19 pandemic; prohibited practices.
• s 52.64 [Repealed]
• s 52.65 Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part.
• s 52.66 Required disclosure statement for policies and certificates meeting definition of section 52.15 of this Part.
• s 52.70 Special rules for group, blanket and franchise insurance.
• s 52.69 Rules relating to the content of health insurance identification cards.
• s 52.71 Essential health benefits.
• s 52.72 Nondiscrimination on the basis of race, color, creed, national origin, sex, age, marital status, disability, or preexisting condition.
• s 52.73 Formulary exception process for medication for the detoxification or maintenance treatment of a substance use disorder.
• s 52.74 Coverage of contraceptive drugs, devices, or products.
• s 52.75 Prohibition on discrimination based on sexual orientation, gender identity or expression, or transgender status.
• s 52.76 Coverage for preventive care and screenings.
• s 52.80 State of New York Certified Surgical Fee Schedule.
• s 52.90 Applicability provisions.
• s 52.95 Separability provision.