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Regulatory & Legislative Activities

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Part No.

 

11 NYCRR Reg. No.

CH. I.  GENERAL PROVISIONS

1

Definitions

1

2

Promulgation of Regulations; Opinions

1

3

Election of Directors in Domestic Life Insurance Companies

14-A

6

Electronic Filings and Submissions

195

7

Sale of Insurance Securities

44

8

Insider Trading of Insurance Securities

45

9

Distribution and Sale of Publications and Forms of the Department of Financial Services

46

10

Proxies, Consents and Authorizations of Domestic Stock Insurers

48

12

Agent Training Allowance Subsidies for Certain Life Insurance and Annuity Business

50

13

Mass Merchandising of Personal Property - Liability Insurance

58

15

Simplified Comprehensive Policies of Insurance

73

16

Special Risk Insurance

86

17

Standard Health Insurance Claims Forms for the Services of Physicians, Dentists and Hospitals

88

18

New York Insurance Exchange, Inc.
** Note the subparts in the three rows below. **

89, 89-A & 89-B

 

Subpart 18-1: General

89

 

Subpart 18-2: Investments in Underwriting Members, Broker Members and Associate Brokers

89-A

 

Subpart 18-3: Criteria for Eligibility for the Position of Public Governor

89-B

19

Homeowners Insurance; Applications for Withdrawal from Marketplace

154

CH. II.  AGENTS, BROKERS AND ADJUSTERS

20

Brokers, Agents and Certain Other Licensees--General

9, 18 & 29

21

Insurance Brokers and Excess Line Brokers

5

22

Agents: Life, Accident and Health

6

23

Agents: Fire, Marine, Casualty, Etc.

7

24

Officers and Employees of insurers

8

25

Public Adjusters

10

26

Independent Adjusters

25

27

Excess Line Placements Governing Standards

41

28

Professional Bail Agents

42

29

Special Prohibitions

87

30

Producer Compensation Transparency

194

31

Summary Suspension of insurance Law Licenses

94

32

Reinsurance Intermediaries

98

33

Managing General Agents

120

34

Requirements Pertaining to the Location of an Insurance Agent or Broker at Each Place of Insurance Business: Reporting Requirements

125

35

Title Insurance: Title Insurance Agents, Affiliated Relationships, and Required Disclosures

206

CH. III.  POLICY AND CERTIFICATE PROVISIONS

A.  Life, Accident and Health Insurance

39

Minimum Standards for the New York State Partnership for Long-Term Program

144

40

Group Annuity Contracts and Funding Agreements: Disclosure and Withdrawal Rules

139

41

Accelerated Payment of the Death Benefit Under a Life Insurance Policy

143

42

Term Life Issuance and Renewal Restrictions; Nonforfeiture Values for Certain Life Insurance Policies
** Note the subparts in the two rows below. **

149

 

Subpart 42-1: Term Life Issuance and Renewal Restrictions; Nonforfeiture Values for Certain Life Insurance Policies Issued on or after November 22, 1995 and before January 1, 2009

149

 

Subpart 42-2: Term Life Issuance and Renewal Restrictions; Nonforfeiture Values for Certain Life Policies Issued on or after January 1, 2008

149

43

Individual Life Insurance Market-Value Adjustment

136

44

Individual Deferred Annuities Market-Value Adjustments Withdrawal Charges, Availability of Cash Values

127

45

Applications for Life Insurance

19

46

Unemployment Lapse Protection Benefit for Life Insurance

174

47

Use of Gender-Blended Mortality Tables for Individual Life Insurance Policies by Life Insurers

112

48

Life Insurance and Annuity Non-Guaranteed Elements

210

49

Fraternal Benefit Societies

22

50

Separate Accounts and Separate Account Annuities

47

51

Replacement of Life Insurance Policies and Annuity Contracts

60

52

Minimum Standards for Form, Content, and Sale of Health Insurance, Including Standards of Full and Fair Disclosure

62

53

Life and Annuity Cost Disclosure and Sales Illustrations
** Note the subparts in the three rows below. **

74

 

Subpart 53-1: General Provisions

74

 

Subpart 53-2: Disclosure Requirements

74

 

Subpart 53-3: Life Illustrations and Reports

74

54

Variable Life Insurance

77

55

Notice to Employees Concerning Termination of Group and Health Insurance Policies

78

56

Health Insurance Claims Processing and Procedures

183

57

Smoker/Nonsmoker Mortality Tables and Underwriting Classifications

113

58

Minimum Standards for Form, Content and Sale of Medicare Supplement and Medicare Select Insurance, Including Standards of Full and Fair Disclosure

193

59

Minimum Standards for the Form, Content and Sale of Group and Blanket Insurance Certificates Deemed to Have Been Delivered in this State Pursuant to Section 3201(b) of the Insurance Law

123

B.  Property and Casualty Insurance

60

Minimum Provisions for Automobile Liability Insurance Policies and Supplementary Uninsured Motorists Insurance
** Note the Subparts in the three rows below. **

35-A, 35-D & 35-E

 

Subpart 60-1: Minimum Provisions for Automobile Liability Insurance Policies

35-A

 

Subpart 60-2: Supplementary Underinsured/Uninsured Motorists Insurance

35-D

 

Subpart 60-3: Transportation Network Companies; Minimum Provisions for Policies and Other Requirements

35-E

61

Assessment Corporations

23

62

Fire Insurance
** Note the Subparts in the five rows below. **

21 & 96

 

Subpart 62-1: Renewal Certificates for Fire Insurance

21 & 96

 

Subpart 62-2: Reports to Central Organization

21 & 96

 

Subpart 62-3: Standard Fire Claim Form

21 & 96

 

Subpart 62-4: Anti-Arson Application

21 & 96

 

Subpart 62-5: Supplemental Fire Claim Form

21 & 96

63

Reserve Requirements for Financial Guaranty Insurance In-Force Prior to the Effective Dale of Article 69 of the Insurance Law

61

64

Liability Insurance Covering Snowmobiles and All-Terrain Vehicles
** Note the Subparts in the two rows below. **

35-B & 35-C

 

Subpart 64-1: Liability Insurance Covering Snowmobiles

35-B

 

Subpart 64-2: Liability Insurance Covering All-Terrain Vehicles

35-C

65

Regulations Implementing the Comprehensive Motor Vehicle Insurance Reparations Act
** Note the Subparts in the five rows below. **

68

 

Subpart 65-1: Prescribed Policy Endorsements  

68-A

 

Subpart 65-2: Rights and Liabilities of Self-Insurers

68-B

 

Subpart 65-3: Claims for Personal Injury Protection Benefits

68-C

 

Subpart 65-4: Arbitration

68-D

 

Subpart 65-5: Unauthorized Providers of Health Services

68-E

66

Surety Bond Forms—Waiver of the Filing and Prior Approval Requirements of Section 2307 of the Insurance Law

76

67

Mandatory Underwriting Inspection Requirements for Private Passenger Automobiles

79

68

Charges for Professional Health Services

83

69

Mortgage Pool Insurance

91

70

Medical Malpractice Insurance Rate Modifications, Provisional Rates, Required Policy Provisions and Availability of Additional Coverages

101

71

Legal Defense Costs in Liability Policies

107

72

Indemnification of Directors and Officers

110

73

Claims-Made Policies; Scope of Application; Minimum Standards

121

74

Homeowners Insurance Disclosure Information and Other Notices

159

75

Standards for Insurance that Qualifies for the Environmental Remediation Insurance Tax Credit

181

CH. IV.   FINANCIAL CONDITION OF INSURER AND REPORTS TO SUPERINTENDENT

Rules of General Application

76

Commercial Crime Coverage Exclusions

209

77

Risk-Based Capital

220

78

Evaluation of Subsidiaries of Insurance Companies

59

79

Letters of Credit

133

80

Controlled Insurers
** Note the Subparts in the two rows below. **

52

 

Subpart 80-1: Holding Companies

52

 

Subpart 80-2: Minimum Standards for Producer-Controlled Insurers and Controlling Producers; Disclosure Requirements for Certain Other Producers

52

81

Subsidiaries of Insurance Companies
** Note the Subparts in the two rows below. **

53 & 115

 

Subpart 81-1: Subsidiaries of Insurance Companies Subject to the Provisions of Section 1403(c) of the Insurance Law

53

 

Subpart 81-2: Subsidiaries of Life Insurance Companies, Retirement Systems and Article 43 Corporations  

115

82

Enterprise Risk Management and Own Risk and Solvency Assessment; Group-Wide Supervision

203

83

Financial Statement Filings and Accounting Practices and Procedures

172

84

Reporting of Financial Condition Under Generally Accepted Accounting Principles

69

85

Allowance of Aircraft as an Admitted Asset

80

86

Reports of Suspected Insurance Frauds to Criminal Investigations Unit; Required Warning Statements

95

87

Insurer Name Approval

104

88

Requirements of or Plan of Authorized Insurer Proposing to Cease to Maintain or Change its Existing Licensing Status in this State

109

89

Audited Financial Statements

118

90

Corporate Governance

215

Life Insurers

    91

    Allocation of Income (Receipts) and Expenses

    33

    92

    Valuation of Policies and Annuities

    11

    93

    Aircraft Reinsurance by Life Insurers

    63

    94

    Valuation of Individual and Group Accident and Health Insurance Reserves

    56

    95

    Regulations Governing an Actuarial Opinion and Memorandum

    126

    96

    Surplus Management Account

    138

    97

    Market Value Separate Accounts Funding Guaranteed Benefits; Separate Accounts Operations and Reserve Requirements

    128

    98

    Valuation of Life Insurance Reserves

    147

    99

    Valuation of Annuity, Single Premium Life Insurance, Guaranteed Interest Contract and Other Deposit Reserves

    151

    100

    Recognition of the 2001 CSO Mortality Table and the 2017 CSO Mortality Table for use in Determining Minimum Reserve Liabilities and Nonforfeiture Benefits and Recognition and Application of Preferred Mortality Tables for use in Determining Minimum Reserve Liabilities

    179

    101

    Standards for Financial Risk Transfer between Insurers and Health Care Providers

    164

    102

    Minimum Standards for Determining Reserve Liabilities and Nonforfeiture Values for Preneed Life Insurance

    192

    103

    Principle-Based Reserving

    213

    C.  Fire, Marine, Casualty and Surety Insurers

    105

    Operating Expense Classification for Annual Statement Purposes

    30

    106

    Allocation of Joint Expenses to Companies

    30

    107

    Composition of, and Allocation to, Expense Groups

    30

    108

    Allocation to Lines of Business

    30

    109

    Allocation of Salaries and Other Expenses

    30

    110

    Installment Premiums

    13-A

    111

    Statement of Actuarial Opinion and Actuarial Opinion Summary for Property/Casualty Insurers

    207

    112

    Loss Portfolio Transfers

    108

    D.  Reinsurance

    125

    Credit for Reinsurance

    17, 20 & 20-A

    126

    Trust Agreements

    114

    127

    Reinsurance Transactions by Authorized Life Insurers and Certain Other Authorized Insurers

    102

    128

    Commutation of Reinsurance Agreements

    141

    E.  Property/Casualty Insurance Security Fund

    130

    Property/Casualty Insurance Security Fund; Contributions to Fund and Applicability of Income of Fund

    55

    F.  Public Retirement Systems

    136

    Public Retirement Systems
    ** Note the Subparts in the two rows below. **

    85

     

    Subpart 136-1: Standards for Certain Actuarially Funded Public Retirement System

    85

     

    Subpart 136-2: Standards for the New York State and Local Employees' Retirement System, the New York State and Local Police and Fire Retirement System and the New York State Common Retirement Fund

    85

    CH. V. RATES AND RATING ORGANIZATIONS

    A.  Automobile Statistical Plan

    140

    Private Passenger Automobile and Commercial Automobile Statistical Plans

    32-A

    145

    Implementation of Private Passenger Automobile Insurance Statistical Data Monitoring System

    103

    B.   Commercial and Industrial Risks

    151

    Workers’ Compensation Insurance
    ** Note the Subparts in the seven rows below. **

    119

     

    Subpart 151-1: Rate Filings Prior Approval

    119

     

    Subpart 151-2: Industry Standard Rate for Aggregate Trust Fund

    119

     

    ubpart 151-3: Workplace Safety and Loss Prevention Incentive Program

    119

     

    Subpart 151-4: Reserves for Special Disability Fund Claims

    119

     

    Subpart 151-5: Independent Livery Driver Benefit Fund

    119

     

    Subpart 151-6: Workers’ Compensation Insurance Assessments

    119

     

    Subpart 151-7: Workers’ Compensation Safe Patient Handling Program

    119

    152

    Physicians and Surgeons Professional Insurance Merit Rating Plan

    124

    153

    Property/Casualty Insurance Group and Quasi-Group Standards

    135

    154

    Private Passenger Motor Vehicle Insurance Multi-Tier Programs

    150

    D.  Rate Regulation and Promotion of Competition

    160

    Responsibilities in Construction and Application of Rates

    57

    161

    Flexible-Rating System; Rating Plans; Tort Reform Refiling Requirements

    129

    163

    Flexible Rating for Nonbusiness Automobile Insurance Policies

    153

    E.  Methodologies for Measuring the Profitability of Property and Liability Insurance Lines

    165

    Methodologies for Measuring the Profitability of Property and Liability Insurance Lines Written in New York State

    70

    F.  Treatment of Excess Profits in Motor Vehicle Insurance

    166

    Treatment of Excess Profits in Motor Vehicle Insurance
    ** Note the Subparts in the seven rows below. **

    105

     

    Subpart 166-1: General Rules

    105

     

    Subpart 166-2: Discussion of General Rules

    105

    G.  Noncommercial Automobile Insurance Rates for Inexperienced Operators

    168

    Noncommercial Private Passenger Automobile Insurance Rates for Inexperienced Principal Operators

    92

    H.  Noncommercial Insurance Merit Rating Plans

    169

    Noncommercial Motor Vehicle Insurance Merit Rating Plans

    100

    CH. VI.   AUTHORIZED INVESTMENTS

    171

    Investment in Stock of Federal National Mortgage Association by Title Insurance Corporations

    37

    172

    Fraternal Benefit Societies: Investment in Real Estate

    12

    173

    Revenue Bonds

    31

    176

    Investments in "Medium Grade" and "Lower Grade" Obligations by Domestic Life Insurers

    130

    178

    Derivative Transactions

    163

    CH. VII.  CREDIT AND CREDITOR INSURANCE

    185

    Credit Life Insurance and Credit Accident and Health Insurance

    27-A

    186

    Insurance Covering Debtors or Personal Property Purchased on Installment or Deferred Payment Plans

    27-B

    187

    Credit Unemployment Insurance

    27-C

    CH. VIII.  EMPLOYEE WELFARE FUNDS

    200

    Annual Reports

    36

    201

    Notice of Changes Affecting Employee Welfare Funds

    38

    202

    Compensation to Agents and Fees or Other Allowances Payable for Individual Life Insurance Issued on a Mass Merchandising Basis Under Plans Sponsored by Union-Management Welfare Funds

    65

    CH. IX.  UNFAIR TRADE PRACTICES

    215

    Advertisements of Accident and Health Insurance

    34

    216

    Unfair Claims Settlement Practices and Claim Cost Control Measures

    64

    217

    Processing of Health Insurance Claims

    178

    218

    Prohibition Against Geographical Redlining and Discriminating in Certain Property/Casualty Policies

    90

    219

    Rules Governing Advertisements of Life Insurance and Annuity Contracts

    34-A

    220

    Holocaust Victims Insurance Claims and Reports

    160

    221

    Limitations Upon and Requirements for the Use of Credit Information for Personal Lines Insurance

    182

    223

    Insurance Sales Practices on Military Installations or Involving Military Personnel

    186

    224

    Suitability in Annuity Transactions

    187

    225

    Use of Senior-Specific Certifications and Professional Designations in the Sale of Life Insurance and Annuities

    199

    226

    "https://govt.westlaw.com/nycrr/Browse/Home/NewYork/NewYorkCodesRulesandRegulations?guid=I01dd4300d73211e193ca0000845b8d3e&originationContext=documenttoc&transitionType=Default&contextData=(sc.Default)">Unclaimed Life Insurance Benefits and Policy Identification

    200

    227

    Regulation of Force-Placed Insurance

    202

    230

    Mental Health and Substance Abuse Disorder Parity Compliance Program

    218

    CH. X.  RECORDS

    240

    Confidentiality of Information Furnished by Social Services Agencies

    106

    242

    Access to Personal Information

    116

    243

    Standards of Records Retention by Insurance Companies

    152

    244

    Confidentiality Protocols for Victims of Domestic Violence and Endangered Individuals

    168

    CH. XI.  PREPAID LEGAL SERVICES PLANS AND LEGAL SERVICES INSURANCE

    261

    Prepaid Legal Services Plans

    161

    262

    Legal Services Insurance

    162

    CH. XII.   GROUP PROPERTY/CASUALTY INSURANCE

    301

    Purchasing Groups

    134

    310

    Product or System Group Insurance Policies

    167

    CH. XIII.  CONTINUING CARE RETIREMENT COMMUNITIES

    350

    Continuing Care Retirement Communities

    140

    CH. XIV. INDIVIDUAL AND SMALL GROUP HEALTH INSURANCE AND FAMILY LEAVE BENEFITS COVERAGE

    360

    Rules to Assure an Orderly Implementation and Ongoing Operation of Open Enrollment and Community Rating of Individual and Small Group Health Insurance

    145

    361

    Establishment and Operation of Market Stabilization Mechanisms for Certain Health Insurance Markets

    146

    362

    The Healthy New York Program and the Direct Payment Stop Loss Relief Program
    ** Note the Subparts in the five rows below. **

    171

     

    Subpart 362-1: Preamble

    171

     

    Subpart 362-2: Rules Generally Applicable to the Healthy New York Program

    171

     

    Subpart 362-3: Rules Relating to Small Employer Participation (Other Than Individual Proprietors)

    171

     

    Subpart 362-4: Rules Relating to Working Uninsured Individuals and Individual Proprietor Participation

    171

     

    Subpart 362-5: Rules Relating to the Direct Payment Market Stop Loss Relief Program and State Funded Stop Loss Relief for the Healthy New York Program

    171

    363

    Minimum Standards for the Form and Rating of Family Leave Benefits Coverage, Including the Establishment and Operation of a Risk Adjustment Mechanism

    211

    364

    Paid Family Leave Risk Adjustment Fund

    214

    365

    Paid Family Leave COVID-19 Risk Adjustment Mechanism

    217

    CH. XV.  LIFE SETTLEMENTS

    380

    Viatical Settlements

    148

    381

    Life Settlements

    198

    CH. XVI.  SERVICE CONTRACTS

    390

    Service Contracts

    155

    CH. XVII.  CERTIFIED CAPITAL COMPANIES UNDER SECTION 11 OF THE TAX LAW

    400

    Certified Capital Companies Under Section 11 of the Tax Law

    156

    CH. XVIII.  EXTERNAL APPEALS OF ADVERSE DETERMINATIONS OF HEALTH CARE PLANS

    410

    External Appeals of Adverse Determinations of Health Care Plans

    166

    CH. XIX.  PRIVACY OF CONSUMER FINANCIAL AND HEALTH INFORMATION

    420

    Privacy of Consumer Financial and Health Information

    169

    421

    Standards for Safeguarding Customer Information

    173

    CH. XX.  MEDICAL MALPRACTICE RESIDUAL MARKET

    430

    Mechanism for the Equitable Distribution of Insureds Unable to Obtain Medical Malpractice Insurance

    170

    CH. XXII.  OFFICE OF PHARMACY BENEFITS

    450

      Office of Pharmacy Benefits

    219