N.Y. Insurance Law Section 4318-A
Certification of creditable coverage by corporations organized under this article


(a)

Every corporation subject to the provisions of this article that issues individual health insurance contracts or group or blanket accident and health insurance contracts shall provide covered individuals with written certification, in a form as the superintendent may approve, of:

(1)

the period of creditable coverage, as defined in § 4318 (Pre-existing condition provisions)section four thousand three hundred eighteen of this article, of the individual under such contract and under any continuation coverage pursuant to state or federal law; and

(2)

any waiting period or affiliation period (if applicable) imposed with respect to the individual for coverage under any such contract.

(b)

The corporation shall provide such certification:

(1)

at the time an individual ceases to be covered under the contract, including any period of time the individual was covered pursuant to any right of continuation under the contract; and

(2)

on the request on behalf of an individual made not later than twenty-four months after the date of cessation of the coverage described in paragraph one of this subsection.

(c)

In the event of an election by an insurer or a group health plan to count the period of creditable coverage based on coverage of benefits within classes or categories of benefits as provided in state or federal law, if that insurer or group health plan enrolls an individual for coverage under its contract or plan and the individual provides a certification of coverage of the individual under subsection (a) of this section, then upon request of such insurer or group health plan, any corporation subject to the provisions of this article that issued the certification of coverage provided by the individual shall promptly disclose to such requesting insurer or group health plan information on coverage of classes and categories of health benefits available under the corporation’s contract. The corporation may charge the requesting plan or insurer for the reasonable cost of disclosing such information.

(d)

A corporation that issues group or blanket accident and health insurance contracts is deemed to have satisfied the requirements of subsection (a) of this section if the contract holder by written agreement with the corporation actually provides the written certification in accordance with this section.

Source: Section 4318-A — Certification of creditable coverage by corporations organized under this article, https://www.­nysenate.­gov/legislation/laws/ISC/4318-A (updated Sep. 22, 2014; accessed Dec. 21, 2024).

4301
Organization of corporation
4302
Permit and license to do business
4303
Benefits
4303‑A
Prescription synchronization
4304
Individual contracts
4305
Group contracts
4306
Required contract provisions
4306‑A
Health insurance coverage for full-time students on medical leaves of absence
4306‑B
Primary and preventive obstetric and gynecologic care
4306‑C
Grievance procedure and access to specialty care
4306‑D
Choice of health care provider
4306‑E
Prohibition on lifetime and annual limits
4306‑F
Maternal depression screenings
4306‑G
Telehealth delivery of services
4306‑H
Essential health benefits package and limit on cost-sharing
4306‑I
Coverage for medically fragile children
4307
Providers of services
4308
Supervision of superintendent
4309
Limitation on expenses
4310
Investments
4312
Employment of solicitors
4313
Applicability of other provisions of this chapter
4314
Not to affect provisions of workers’ compensation law
4315
Arbitration
4316
Individual contracts
4317
Rating of individual and small group health insurance contracts
4318
Pre-existing condition provisions
4318‑A
Certification of creditable coverage by corporations organized under this article
4320
Limitations on administrative services and stop-loss coverage
4321
Standardization of individual enrollee direct payment contracts offered by health maintenance organizations prior to October first, two t...
4321‑A
Fund for standardized individual enrollee direct payment contracts
4322
Standardization of individual enrollee direct payment contracts offered by health maintenance organizations which provide out-of-plan ben...
4322‑A
Fund for standardized individual enrollee direct payment contracts which provide out-of-plan benefits
4323
Marketing materials
4324
Disclosure of information
4325
Prohibitions
4326
Standardized health insurance contracts for qualifying small employers and individuals
4327
Stop loss funds for standardized health insurance contracts issued to qualifying small employers and qualifying individuals
4328
Individual enrollee direct payment contracts offered by health maintenance organization on and after October first, two thousand thirteen
4329
Prescription drug coverage
4330
Discrimination because of sex or marital status in hospital, surgical or medical expense insurance

Accessed:
Dec. 21, 2024

Last modified:
Sep. 22, 2014

§ 4318-A’s source at nysenate​.gov

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