Part 52 - Minimum Standards For Form, Content And Sale Of Health Insurance, Including Standards Of Full And Fair Disclosure

Section 52.1 - Preamble
Section 52.2 - Definitions
Section 52.5 - Basic hospital insurance
Section 52.6 - Basic medical insurance
Section 52.7 - Major medical insurance
Section 52.8 - Disability income insurance
Section 52.9 - Accident insurance
Section 52.10 - Limited benefits health insurance
Section 52.11 - Medicare supplement insurance
Section 52.12 - Long term care insurance
Section 52.13 - Nursing home insurance only, home care insurance only, or nursing home and home care insurance
Section 52.14 - Medicare select policies and certificates
Section 52.15 - Specified disease coverage
Section 52.16 - Prohibited provisions and coverages
Section 52.17 - Rules relating to content of forms for individual insurance
Section 52.18 - Prohibited provisions and coverages
Section 52.19 - Rules relating to the content of forms for franchise insurance
Section 52.20 - Rules relating to preexisting condition provisions and crediting requirements in policies which provide hospital, surgical or medical expense coverage
Section 52.21 - Rules relating to content of forms for blanket insurance
Section 52.22 - Volunteer firefighter enhanced cancer insurance
Section 52.23 - Coordination of benefits
Section 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
Section 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
Section 52.26 - Rules relating to exclusion of medicare benefits
Section 52.27 - Rules relating to the sale of health insurance and settlement of health insurance claims
Section 52.28 - Medicare supplement insurance reporting form and refund calculation form
Section 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 multiple accident and health policies
Section 52.30 - Preliminary review
Section 52.31 - Preparation of forms for submission
Section 52.32 - Conditions for prefiled group coverage
Section 52.33 - Letter of submission
Section 52.40 - Procedures and requirements for filing of rates
Section 52.41 - Gross premium differentials based on sex
Section 52.42 - Health maintenance organization (HMO) contract forms and premium rates
Section 52.43 - Standards for maintaining experience data
Section 52.44 - Standards for annual filing of experience data
Section 52.45 - Minimum loss ratio standards
Section 52.46 - [Repealed]
Section 52.47 - Monitoring of experience data submitted under section 52.44(a) of this part
Section 52.51 - Applications
Section 52.53 - Conditional receipts and interim insurance agreements
Section 52.54 - Disclosure requirements
Section 52.55 - Required disclosure statement for policies meeting standards of section 52.5 of this part
Section 52.56 - Required disclosure statement for policies meeting standards of section 52.6 of this part
Section 52.57 - Required disclosure statement for policies meeting standards of both sections 52.5 and 52.6 of this part
Section 52.58 - Required disclosure statement for policies meeting standards of section 52.7 of this part
Section 52.59 - Required disclosure statement for policies meeting definition of section 52.10 of this Part
Section 52.60 - Required disclosure statement for policies meeting definition of section 52.8 of this part
Section 52.61 - Required disclosure statement for policies meeting definition of section 52.9 of this part
Section 52.62 - Required disclosure statement for policies meeting definition of section 52.10 of this part
Section 52.63 - [Repealed]
Section 52.64 - [Repealed]
Section 52.65 - [Effective until 6/2/2024] Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part
Section 52.65 - [Effective 6/2/2024] Required disclosure statement for policies and certificates meeting definition of sections 52.12 and 52.13 of this Part
Section 52.66 - Required disclosure statement for policies and certificates meeting definition of section 52.15 of this Part
Section 52.69 - Rules relating to the content of health insurance identification cards
Section 52.70 - Special rules for group, blanket and franchise insurance
Section 52.71 - Essential health benefits
Section 52.72 - Nondiscrimination on the basis of race, color, creed , national origin, sex, age, marital status, disability, or preexisting condition
Section 52.73 - Formulary exception process for medication for the detoxification or maintenance treatment of a substance use disorder
Section 52.74 - Coverage of contraceptive drugs, devices, or products
Section 52.75 - Prohibition on discrimination based on sexual orientation, gender identity or expression, or transgender status
Section 52.76 - Coverage for preventive care and screenings
Section 52.77 - Payment when an issuer provides inaccurate network status information
Section 52.80 - State of New York Certified Surgical Fee Schedule
Section 52.90 - Applicability provisions
Section 52.95 - Separability provision