N.Y. Comp. Codes R. & Regs. tit. 11 § 153.4

Current through Register Vol. 46, No. 36, September 4, 2024

Section 153.4 - Group policy minimum standards

Every group policy issued or renewed in this State on risks or operations in this State, under section 3435 or in connection with a Federal purchasing group, shall comply with the following minimum policy standards:

(a) Certificates issued under a group master policy shall contain all material terms and conditions of coverage affecting a group member, unless the group master policy is incorporated by reference, in which event a copy of such master policy shall accompany the certificate or shall be promptly provided to a group member upon request.

(b) No group policy, master policy or certificate shall contain any deductible or self-insured retention shared among group members or applicable to the group itself, and certificates under a master policy may provide for a deductible or self-insured retention only if applicable to a group member strictly on an individual basis.

(c) No group policy, master policy or certificate shall be subject to a group or sub-group aggregate liability limit of any kind at any time, and any liability limit applicable to a group member shall:

(1) be separate and apart from any liability limit to which any other group member insured under the group policy may be subject; and

(2) operate unaffected by the experience of any other group member or the overall experience of the group itself.

(d) Every group policy, master policy and certificate shall constitute a "covered policy" subject to the applicable standards governing cancellation, nonrenewal and conditional renewal prescribed by section 3426 of the Insurance Law.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 153.4