New York Laws
Article 47 - Municipal Cooperative Health Benefit Plans
4707 - Stop-Loss Requirements.

(1) aggregate stop-loss coverage with an annual aggregate retention
amount or attachment point not greater than one hundred twenty-five
percent of the amount certified by a qualified actuary to represent the
expected claims of the plan for the current fiscal year; and
(2) specific stop-loss coverage with a specific retention amount or
attachment point not greater than four percent of the amount certified
by a qualified actuary to represent the plan's expected claims for the
current fiscal year.
(b) Upon application of the governing board, the superintendent may
waive the requirement for the stop-loss insurance, in whole or part, or
modify the maximum retention amounts or attachment points for stop-loss
insurance, provided that:
(1) the plan maintains reserves and surplus equal to or greater than
one hundred fifty percent of the amounts specified in paragraphs one and
five of subsection (a) of section four thousand seven hundred six of
this article; or
(2) the superintendent is satisfied that such waiver or modification
of retention amounts or attachment points would not be detrimental to
the plan's solvency and stability, after considering such factors as
availability and affordability of stop-loss insurance, the plan's past
and expected experience, plan size, reserves, surplus, and premium
equivalent rates, and the contingent liability of participating
municipal corporations.
(c) As an alternative to suspension or revocation pursuant to section
four thousand seven hundred twelve of this article, the superintendent
may reduce the aggregate or specific stop-loss retention amounts or
attachment points specified in subsection (a) of this section for any
municipal cooperative health benefit plan that fails to maintain
required reserves and surplus.