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maintaining experience data.52.44Standards for annual filing of experience data.52.45Minimum loss ratio standards.52.46[Repealed[52.47Monitoring of experience data submitted under section 52.44(a) of this Part.52.51Applications.52.53Conditional receipts and interim insurance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