New York Laws
Article 32 - Insurance Contracts - Life, Accident and Health, Annuities
3218 - Medicare Supplemental Insurance Policies.

(1) "Medicare" means the coverage of health care costs provided under
subchapter XVIII of the federal Social Security Act, 42 U.S.C. §§ 1395
et seq.
(2) "Medicare supplemental insurance" means any individual or group
accident and health policy issued for delivery in this state on or after
June tenth, nineteen hundred eighty, providing for the payment or
reimbursement for health care services not provided by medicare, except
that such terms shall not include a contract issued pursuant to
subsections (c) and (d) of section four thousand two hundred thirty-five
or section four thousand three hundred five of this chapter which covers
employees of firms doing business in more than one state or the benefit
structure of which was the subject of collective bargaining affecting
employees of firms doing business in more than one state.
(b) The superintendent shall promulgate rules and regulations which:
(1) Establish as a separate classification, medicare supplemental
insurance.
(2) Provide for minimum standards for medicare supplemental insurance
policies.
(3) Require the ratio of benefits to premiums to be not less than an
appropriate percentage determined by the superintendent and requiring
the annual filing of data that will demonstrate the insurer's
compliance.
(4) Provide a uniform system of designation for said policies which
indicates the type and scope of coverage afforded.
(5) Provide for full disclosure of coverage in a clear and coherent
manner using words with common everyday language.
(6) Prohibit the advertisement, sale, or solicitation of any accident
or health insurance policy as being supplemental to medicare coverage
unless it conforms to minimum standards for medicare supplemental
insurance policies provided by this section.
(7) Provide for the publication and dissemination of a consumer's
shopping guide for medicare supplemental insurance.
(c) No authorized insurer shall issue or deliver in this state any
medicare supplemental insurance policy other than a medicare
supplemental insurance policy which includes the minimum standards as
approved by the superintendent.
(d) (1) Every authorized insurer engaged in issuing for delivery in
this state, policies for medicare supplemental insurance as set forth in
this section shall file with the superintendent a report of all claims
experience for such coverage for each twelve month period preceding the
dates fixed by the superintendent for the filing of such reports. Such
reports shall be made in writing and on a form prescribed by the
superintendent not less than annually on dates determined by the
superintendent.
(2) The provisions of this subsection shall remain in force until
December thirty-first, nineteen hundred eighty-three.

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