This emergency measure implements EO 202.14 by amending 11 NYCRR 52, with respect to any policyholder or contract holder who does not make a timely premium payment and can demonstrate financial hardship as a result of the COVID-19 pandemic, by: (i) requiring an insurer, Insurance Law Article 43 corporation, health maintenance organization, or student health plan certified pursuant to Insurance Law Section 1124 (collectively, “issuers”) to extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 p.m. on June 1, 2020 for any small group or student blanket comprehensive health insurance policy or contract, or any child health insurance plan policy or contract where the policyholder or contract holder pays the entire premium, requiring issuers to be responsible for the payment of claims during such period, and prohibiting issuers from retroactively terminating the insurance policy or contract for non-payment of premium during such period, subject to the Superintendent of Financial Services’ consideration of an issuer’s liquidity and solvency; and (ii) prohibiting late fees and issuers reporting negative data to credit reporting agencies, requiring issuers to provide information to policyholders and contract holders regarding alternate policies and contracts available from the issuer, and requiring issuers to provide contact information for the NY State of Health.

To help ease the extensive financial and healthcare burdens brought about by the COVID-19 pandemic by ensuring New Yorkers continue to maintain their individual, small group, and student blanket comprehensive health insurance policies or contracts, and in compliance with EO 202.14, it is imperative that the Superintendent promulgate this emergency measure for the public’s health and general welfare.

(t)(1) On April 7, 2020, Governor Andrew M. Cuomo issued Executive Order 202.14, which temporarily modified Insurance Law sections 3216(d)(1)(C) and 4306(g), subject to consideration by the superintendent of the liquidity and solvency of the applicable insurer or HMO, to extend the period for the payment of premiums to the later of the expiration of the applicable contractual grace period and 11:59 p.m. on June 1, 2020 for any comprehensive health insurance policyholder or contract holder under an individual policy who is facing a financial hardship as a result of the COVID-19 pandemic; require that such insurer or HMO be responsible for the payment of claims during such period; and bar such insurer or HMO from retroactively terminating the insurance policy for non-payment of premium during such period.

(2) The Executive Order also granted the superintendent the authority to promulgate an emergency regulation, subject to consideration by the superintendent of the liquidity and solvency of the applicable insurer, HMO, or student health plan, to extend the period for the payment of premiums to the later of the expiration of the applicable contractual grace period and 11:59 p.m. on June 1, 2020 for any small group or student blanket comprehensive health insurance policy, or any child health insurance plan policy where the policyholder or contract holder pays the entire premium, for any policyholder or contract holder who is facing financial hardship as a result of the COVID-19 pandemic; require that such insurer, HMO, or student health plan be responsible for the payment of claims during such period; and bar such insurer, HMO, or student health plan from retroactively terminating the insurance policy for non-payment of premium during such period. Section 52.63 implements that directive.

(3) This subdivision and section 52.63 are promulgated pursuant to Executive Order 202.14 and for the duration specified therein, which may be extended.

Section 52.2 is amended by adding new subdivisions (z), (aa), (bb), (cc), (dd), and (ee) to read as follows:

A new section 52.63 is added as follows:

(1) shall not impose any late fees relating to such premium payment;

(2) shall not report the policyholder or contract holder to a credit reporting agency or refer the policyholder or contract holder to a debt collection agency with respect to such premium payment; and

(3) shall provide information to the policyholder or contract holder regarding alternate policies available from the insurer, HMO, or student health plan and provide contact information for the NY State of Health.

(1) mail or deliver, which may include email, written notice to every individual, small group, or student blanket comprehensive health insurance policyholder and contract holder of the provisions of this section and a toll-free number that the individual, small group, or student blanket comprehensive health insurance policyholder or contract holder may call to discuss billing and make alternative payment arrangements; and

(2) notify insurance producers and any third-party administrators with whom or which the insurer does business of the provisions of this section.

1. Statutory authority: Executive Law Section 29-a; Executive Order No. 202.14, dated April 7, 2020, promulgated thereunder; Financial Services Law Sections 202 and 302; Insurance Law Sections 301, 1120, 1124, 3216, 3221, 3240, 4305 and 4306.

Executive Law Section 29-a grants the Governor of New York the authority to temporarily suspend or modify any statute, local law, ordinance, order, rule, or regulation, or parts thereof, of any agency during a State disaster emergency, if compliance with such statute, local law, ordinance, order, rule, or regulation would prevent, hinder, or delay action necessary to cope with the disaster emergency or if necessary to assist with or aid in coping with such disaster.

Executive Order 202.14 issued on April 7, 2020, among other things, authorizes the Superintendent of Financial Services (“Superintendent”) to issue an emergency regulation in conformance with the Executive Order.

Financial Services Law Section 202 establishes the office of the Superintendent.

Financial Services Law Section 302 and Insurance Law Section 301, in pertinent part, authorize the Superintendent to prescribe regulations interpreting the Insurance Law and to effectuate any power granted to the Superintendent in the Insurance Law, Financial Services Law, or any other law.

Insurance Law Section 1120 sets forth criteria for child health insurance plan policies and authorizes the Superintendent, among other things, to determine the duration of the policies and the extent of exposure thereunder and waive, modify or suspend provisions of the Insurance Law, Financial Services Law, or regulations promulgated applicable to child health insurance plan policies.

Insurance Law Section 1124 permits an institution of higher education that obtains and maintains a certificate of authority from the Superintendent to establish, maintain or otherwise participate in a student health plan in New York State, and sets forth provisions and requirements related thereto. Section 1124(o) authorizes the Superintendent to “promulgate such regulations as the superintendent deems necessary to implement the provisions of [Section 1124] and to ensure that the plans established under this section are in the best interests of the students, students’ spouses, the students’ children, and other persons chiefly dependent upon the students for support, and maintenance.”

Insurance Law Section 3216 defines and sets forth the standard provisions for individual health insurance policies, including notification of cancellation and permissible reasons for non-renewal, and authorizes the Superintendent to promulgate rules and regulations concerning the procedure for the filing or submission of policies subject to the section.

Insurance Law Section 3221 sets forth the standard provisions for group, including small group, and blanket accident and health insurance policies.

Insurance Law Section 3240 (student accident and health insurance) in relevant part provides parameters of coverage for student accident and health insurance, sets forth conditions for termination or non-renewal of coverage, and authorizes the Superintendent to promulgate regulations regarding student accident and health insurance, including minimum standards for the form, content and sale of the policies and contracts.

Insurance Law Section 4305 sets forth the parameters by which a corporation subject to Article 43 may issue a group contract and the standard provisions for such group contract.

Insurance Law Section 4306 sets forth the provisions that are required to be included in a contract issued by a corporation under Insurance Law Section 4304, including statements regarding policy termination and the grace period allowed an individual for making any payment due under the contract.

2. Legislative objectives: The Legislature granted the Governor broad powers to take necessary action in cases of emergency that threaten the health, safety, and general welfare of New Yorkers. Specifically, Executive Law Section 29-a authorizes the Governor to temporarily suspend or modify statutes, rules and regulations, or parts thereof, during a State disaster emergency. Governor Andrew M. Cuomo did so when issuing Executive Order 202.14 on April 7, 2020. In addition, Insurance Law Sections 1120, 1124, 3216, 3221, 3240, 4305, and 4306 set forth the standard provisions for a child health insurance plan, student health plan, and individual and small group health insurance policies and contracts.

The regulation implements the Governor’s Executive Order 202.14 and accords with the public policy objectives the Legislature sought to advance in the foregoing Insurance Law sections, with respect to any policyholder or contract holder who does not make a timely premium payment and can demonstrate financial hardship as a result of the COVID-19 pandemic, by: (i) requiring insurers, Insurance Law Article 43 corporations, health maintenance organizations, and student health plans certified pursuant to Insurance Law Section 1124 (collectively, “issuers”) to extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 on June 1, 2020 for any small group or student blanket comprehensive health insurance policy, or child health insurance plan policy or contract where the policyholder or contract holder pays the entire premium, requiring issuers to remain responsible for the payment of claims during the entire period, and prohibiting issuers from retroactively terminating coverage for non-payment of premium during this time, subject to the Superintendent’s consideration of an issuer’s liquidity and solvency; and (ii) prohibiting late fees and issuers reporting negative data to credit reporting agencies and requiring issuers to provide information to policyholders and contract holders regarding alternate policies available to them from the issuer and to provide contact information for the NY State of Health.

3. Needs and benefits: The Governor of New York has declared a state of emergency to help New York more quickly and effectively contain the spread of COVID-19. An increasing number of individuals and businesses are experiencing sizeable disruptions to their everyday lives and operations. The economic impact to individuals and businesses around the globe is considerable. As businesses across New York decrease their workforces or close, individuals and businesses may struggle to continue to pay their health insurance premiums on time.

As a result, the Governor issued Executive Order 202.14 on April 7, 2020 that, among other things, authorizes the Superintendent to promulgate an emergency regulation to: (i) require issuers to extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 p.m. on June 1, 2020 for any small group or student blanket comprehensive health insurance policy or contract or any child health insurance plan policy or contract where the policyholder or contract holder pays the entire premium, for any policyholder or contract holder who can demonstrate financial hardship as a result of the COVID-19 pandemic; require issuers to be responsible for the payment of claims during such period; and prohibit issuers from retroactively terminating the insurance policy or contract for non-payment of premium during such period, subject to the Superintendent’s consideration of an issuer’s liquidity and solvency; and (ii) prohibit late fees and issuers reporting negative data to credit reporting agencies with regard to a policyholder or contract holder who does not make a timely premium payment and can demonstrate financial hardship as a result of the COVID-19 pandemic.

4. Costs: The regulation will impose costs on issuers subject to its requirements and prohibitions because it will require them to extend the period for premium payments; maintain responsibility for paying claims throughout the period; refrain from retroactively terminating coverage for non-payment of premium during this time; mail or deliver, which may include e-mail transmission, notice of the provisions of the regulation and a toll-free number that a policyholder or contract holder may call to discuss billing and make alternative payment arrangements; provide information to policyholders and contract holders regarding alternate policies available from the issuer; provide contact information for the NY State of Health to policyholders and contract holders; and notify insurance producers and any third-party administrators with whom or which the issuer does business of the regulation’s provisions. Additionally, a licensed insurance producer who procured the coverage for the policyholder or contract holder must mail or deliver, which may include e-mail transmission, notice to the policyholder or contract holder of the regulation’s provisions.

However, any cost is an unavoidable consequence of the overwhelming need to assist policyholders and contract holders during the COVID-19 pandemic.

The regulation will not impose any costs on the Department of Financial Services or any state or local government.

5. Local government mandates: The regulation does not impose any program, service, duty or responsibility on any county, city, town, village, school district, fire district or other special district.

6. Paperwork: The regulation will require additional paperwork because issuers subject to its requirements and prohibitions must mail or deliver, which may include e-mail transmission, notice of the regulation’s provisions to any policyholder or contract holder who did not make a timely premium payment and who can demonstrate financial hardship as a result of the COVID-19 pandemic. The notice must include a toll-free number for the policyholder or contract holder to call to discuss billing and to make alternative payment arrangements. The regulation also requires the subject issuers to provide information to policyholders and contract holders regarding alternate policies available from the issuer and contact information for the NY State of Health. Additionally, subject issuers must notify insurance producers and any third-party administrators with whom or which the issuer does business of the regulation’s provisions. Licensed insurance producers who procured the coverage for the policyholders and contract holders must mail or deliver, which may include e-mail transmission, notice to the policyholder or contract holder of the regulation’s provisions.

No state or local government should incur additional paperwork to comply with this amendment.

7. Duplication: This regulation does not duplicate or conflict with any existing state or federal rules or other legal requirements.

8. Alternatives: There were no significant alternatives to consider.

9. Federal standards: The regulation does not exceed any minimum standards of the federal government for the same or similar subject areas.

10. Compliance schedule: The regulation will take effect immediately upon filing of the Notice of Emergency Adoption with the Secretary of State.

1. Effect of the rule: This regulation affects insurers, Article 43 corporations, health maintenance organizations, and student health plans certified pursuant to Insurance Law Section 1124 (collectively, “issuers”) and licensed insurance producers, who or which may be small businesses. The rulemaking implements Executive Order 202.14 issued by Governor Andrew M. Cuomo, dated April 7, 2020, by providing certain relief to policyholders and contract holders of individual, small group and student blanket comprehensive health insurance policies, and child health insurance plan policies or contracts where the policyholder or contract holder pays the entire premium, who do not make a timely premium payment to an issuer and can demonstrate financial hardship as a result of the novel coronavirus (“COVID-19”) pandemic, by: (i) requiring issuers to extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 p.m. on June 1, 2020 for any small group or student blanket comprehensive health insurance policy or contract, or any child health insurance plan policy or contract where the policyholder or contract holder pays the entire premium, require issuers to be responsible for the payment of claims during such period, and prohibiting issuers from retroactively terminating the insurance policy or contract for non-payment of premium during such period, subject to the Superintendent of Financial Services’ consideration of an issuer’s liquidity and solvency; and (ii) prohibiting late fees and issuers reporting negative data to credit reporting agencies, requiring issuers to provide information to policyholders and contract holders regarding alternate policies available from the issuer, and requiring issuers to provide contact information for the NY State of Health to policyholders and contract holders. This amendment does not affect local governments.

2. Compliance requirements: This rulemaking amends 11 NYCRR 52 by requiring issuers, including issuers that are small businesses, to: extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 on June 1, 2020 for certain health insurance policies and contracts; maintain responsibility for paying claims throughout the period; refrain from retroactively terminating coverage for non-payment of premium during this time; mail or deliver, including e-mail transmission, notice of the provisions of the regulation and a toll-free number that a policyholder or contract holder may call to discuss billing and make alternative payment arrangements; refrain from charging late fees and reporting negative data to credit reporting agencies with regard to a policyholder or contract holder who does not make a timely premium payment; provide information to policyholders and contract holders regarding alternate policies available from the issuer; provide contact information for the NY State of Health to policyholders and contract holders; and notify insurance producers and any third-party administrators with whom or which the issuer does business of the regulation’s provisions.

Additionally, any licensed insurance producer who or which procured the coverage for the policyholder or contract holder must mail or deliver, which may include e-mail transmission, notice to the policyholder or contract holder of the regulation’s provisions.

No local government is subject to any compliance requirements because the rulemaking does not apply to any local government.

3. Professional services: No issuer or licensed insurance producer subject to the regulation who or which may be a small business will need professional services to comply with this amendment. The rulemaking does not apply to any local government.

4. Compliance costs: This emergency measure will impose costs on issuers and licensed insurance producers that are subject to the regulation, including those that may be small businesses. The regulation will impose costs on issuers subject to its requirements and prohibitions because it will require them to extend the period for premium payments for certain health insurance policies or contracts; maintain responsibility for paying claims throughout the period; refrain from retroactively terminating coverage for non-payment of premium during this time; mail or deliver, including e-mail transmission, notice of the provisions of the regulation and a toll-free number that a policyholder or contract holder may call to discuss billing and make alternative payment arrangements; provide information to policyholders and contract holders regarding alternate policies available from the issuer; provide contact information for the NY State of Health to policyholders and contract holders; and notify insurance producers and any third-party administrators with whom or which the issuer does business of the regulation’s provisions.

Additionally, a licensed insurance producer, who or which may be a small business, that procured the coverage for the policyholder or contract holder must mail or deliver, including e-mail transmission, notice to the policyholder or contract holder of the regulation’s provisions.

However, any cost is an unavoidable consequence of the overwhelming need to assist policyholders and contract holders during the COVID-19 pandemic.

No local government will incur any costs to comply with this regulation because the regulation does not apply to any local government.

5. Economic and technological feasibility: No issuer or licensed insurance producer subject to the regulation should experience any economic or technological impact as a result of the regulation. The regulation does not apply to any local government.

6. Minimizing adverse impact: This regulation should not have an adverse impact on an issuer or licensed insurance producer who or which is a small business subject to the regulation because the regulation uniformly affects all issuers and licensed insurance producers that are subject to the regulation equally. There will not be an adverse impact on any local government because the regulation does not apply to any local government.

7. Small business and local government participation: Issuers and licensed insurance producers who or which are small businesses will have an opportunity to participate in the rulemaking process when the regulation is published in the State Register and posted on the Department of Financial Services’ website.

1. Types and estimated numbers of rural areas: Insurers, Article 43 corporations, health maintenance organizations, student health plans certified pursuant to Insurance Law Section 1124 (collectively, “issuers”) and licensed insurance producers affected by this regulation operate in every county in this State, including rural areas as defined by State Administrative Procedure Act Section 102(10).

2. Reporting, recordkeeping, and other compliance requirements; and professional services: This rulemaking amends 11 NYCRR 52 to provide certain protections to policyholders and contract holders of individual, small group and student blanket comprehensive health insurance policies, and child health insurance plan policies or contracts where the policyholder or contract holder pays the entire premium, who do not make a timely premium payment to an issuer and can demonstrate financial hardship as a result of the novel coronavirus (“COVID-19”) pandemic, by: (i) requiring issuers to extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 p.m. on June 1, 2020 for certain policies or contracts, requiring issuers to be responsible for the payment of claims during such period, and prohibiting issuers from retroactively terminating the insurance policy or contract for non-payment of premium during such period, subject to the Superintendent of Financial Services’ consideration of an issuer’s liquidity and solvency; and (ii) prohibiting late fees and issuers reporting negative data to credit reporting agencies, requiring issuers to provide information to policyholders and contract holders regarding alternate policies available from the issuer, and requiring issuers to provide contact information for the NY State of Health.

Additionally, any licensed insurance producer who procured the coverage for the policyholder or contract holder must mail or deliver, which may include e-mail transmission, notice to the policyholder or contract holder of the regulation’s provisions.

No issuer or licensed insurance producer subject to the regulation, including those in a rural area, should need to retain professional services, such as lawyers or auditors, to comply with this regulation.

3. Costs: This emergency measure will impose costs on issuers and licensed insurance producers who or which are subject to the regulation, including those in rural areas. The regulation will impose costs on issuers subject to its requirements and prohibitions because it will require them to extend the period for premium payments for certain kinds of policies or contracts; maintain responsibility for paying claims throughout the period; refrain from retroactively terminating coverage for non-payment of premium during this time; mail or deliver, including e-mail transmission, notice of the provisions of the regulation and a toll-free number that a policyholder or contract holder may call to discuss billing and make alternative payment arrangements; provide information to policyholders and contract holders regarding alternate policies available from the issuer; provide contact information for the NY State of Health to policyholders and contract holders; and notify insurance producers and any third-party administrators with whom or which the issuer does business of the regulation’s provisions.

Additionally, a licensed insurance producer who or which procured the coverage for the policyholder or contract holder must mail or deliver, including e-mail transmission, notice to the policyholder or contract holder of the regulation’s provisions.

However, any cost is an unavoidable consequence of the overwhelming need to assist the policyholders and contract holders during the COVID-19 pandemic.

4. Minimizing adverse impact: This regulation uniformly affects issuers and licensed insurance producers who or which are located in both rural and non-rural areas of New York State. The regulation should not have an adverse impact on rural areas.

5. Rural area participation: Issuers and licensed insurance producers in rural areas will have an opportunity to participate in the rulemaking process when the regulation is published in the State Register and posted on the Department of Financial Services’ website.

This emergency measure should not adversely affect jobs or employment opportunities in New York State.

The rulemaking complies with Executive Order 202.14, signed by Governor Andrew M. Cuomo on April 7, 2020, by amending 11 NYCRR 52 to: (i) require an insurer, Insurance Law Article 43 corporation, health maintenance organization, and student health plan certified pursuant to Insurance Law Section 1124 (collectively, “issuers”) to extend the period for the payment of premiums to the later of the expiration of the contractual grace period and 11:59 p.m. on June 1, 2020 for any small group or student blanket comprehensive health insurance policy or contract, or any child health insurance plan policy or contract where the policyholder or contract holder pays the entire premium, for any policyholder or contract holder who can demonstrate financial hardship as a result of the COVID-19 pandemic, require issuers to be responsible for the payment of claims during such period, and prohibit issuers from retroactively terminating the insurance policy or contract for non-payment of premium during such period, subject to the Superintendent’s consideration of an issuer’s liquidity and solvency; and (ii) prohibit late fees and issuers reporting negative data to credit reporting agencies with regard to a policyholder or contract holder who does not make a timely premium payment and can demonstrate financial hardship as a result of the COVID-19 pandemic.

Therefore, the amendment should not cause any adverse impact on jobs or employment opportunities, and should help individuals and small businesses maintain their health insurance during this extraordinary health crisis.