N.Y. Insurance Law § 4237-A
Stop-loss insurance
Effective Jan 23, 2015
- (a) An insurer authorized to do the business of accident and health insurance in this state and a health service corporation organized under article forty-three of this chapter shall be authorized to issue stop-loss insurance as provided in this section.
- (b) "Stop-loss insurance" means an insurance policy whereby the insurer agrees to pay claims or indemnify an employer for losses incurred under a self-insured employee benefit plan or a student health plan as authorized by section one thousand one hundred twenty-four of this chapter in excess of specified loss limits for individual claims and/or for all claims combined, or any similar arrangement.
(c) A stop-loss insurance policy delivered, issued for delivery, or entered into in this state shall clearly describe:
- (1) the entire money or other consideration for the policy;
- (2) the time at which the insurance takes effect and terminates;
- (3) the specified per-claim, per-employee or, in the case of a student health plan under section one thousand one hundred twenty-four of this chapter, per student, or aggregate amount of claims above which payment or reimbursement is to be made by the insurer; and
- (4) the payments to be made by the insurer once the specified stop-loss thresholds have been exceeded.
- (d) No stop-loss insurance contract shall be issued or renewed if issuance of the policy would be prohibited by section two thousand six hundred thirteen, three thousand two hundred thirty-one, four thousand three hundred seventeen or four thousand three hundred twenty of this chapter.
- (e) The superintendent may promulgate such rules and regulations he deems necessary or desirable to establish financial requirements and standards for the form and content of stop-loss insurance policies authorized by this section.