11 CRR-NY 363.10NY-CRR

OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 11. INSURANCE
CHAPTER XIV. INDIVIDUAL AND SMALL GROUP HEALTH INSURANCE AND FAMILY LEAVE BENEFITS COVERAGE
PART 363. MINIMUM STANDARDS FOR THE FORM AND RATING OF FAMILY LEAVE BENEFITS COVERAGE, INCLUDING THE ESTABLISHMENT AND OPERATION OF A RISK ADJUSTMENT MECHANISM
11 CRR-NY 363.10
11 CRR-NY 363.10
363.10 Authority of the superintendent.
(a) In addition to the audit authority under sections 363.5(h) and 363.8(b) of this Part, the superintendent shall utilize all additional statutory and regulatory authority to ensure compliance with this Part and all other provisions of part SS of chapter 54 of the Laws of 2016.
(b) In accordance with Workers’ Compensation Law section 226(9) and section 363.6(a) of this Part, every policy shall include coverage for both disability and family leave benefits coverage. Every issuer shall separately maintain its experience for family leave benefits and for disability benefits provided pursuant to Workers’ Compensation Law article 9. Where an issuer’s experience for its disability benefits results in a loss ratio below that required by section 52.45(f) of this Title (Insurance Regulation 62), the superintendent may take into account the special and unique value to the public of the combined policy for disability and family leave benefits in considering whether the standards of section 52.45(f) may be modified pursuant to section 52.45(g) of this Title.
11 CRR-NY 363.10
Current through December 31, 2020
End of Document