New York Laws
Article 43 - Non-Profit Medical and Dental Indemnity, or Health and Hospital Service Corporations
4309 - Limitation on Expenses.

(1) For hospital service corporations: fifteen per centum reduced by
one per centum for each five million dollars or fraction thereof above
one million dollars of premiums received to ten per centum.
(2) All other corporations: twenty per centum reduced by one per
centum for each five million dollars or fraction thereof above one
million dollars of premiums received to fifteen per centum except that
for any corporation which derives more than fifty per centum of its
premiums received from the sale of contracts which provide hospital
service benefits: seventeen and one-half per centum reduced by one per
centum for each five million dollars or fraction thereof above one
million dollars of premiums received to twelve and one-half per centum.
(3) Upon written application, the superintendent may waive the
limitations in paragraph one or two of this subsection for any
corporation which has not attained the level of enrollment which it
needs to attain a break-even position. The break-even position is
attained when the amount of annual losses and expenses incurred by the
corporation is equal to the amount of premiums earned during this
period. Such corporation shall be subject to such limitations in the
calendar year following the year in which it attains a break-even
position.
(b) If any such corporation shall in any calendar year make or incur
expenses as hereinabove defined in excess of its expense limit the
superintendent may, upon written application of such corporation and a
showing that such corporation has taken steps in accordance with a plan
submitted by the corporation and approved by the superintendent which
will enable it to comply with the provisions of this section during the
next calendar year, suspend the expense limit for such corporation for
the calendar year in which the excess was incurred but the
superintendent shall not suspend the expense limit for any such
corporation for more than two calendar years in succession.

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