NY Ins L § 3453-3 (2021)
2021 New York Laws ISC - Insurance Article 34 - Insurance Contracts-Property/casualty 3453*3 - Employer Sponsored Group Personal Excess Insurance.

* §  3453. Employer sponsored group personal excess insurance. (a) For purposes of this section, the following definitions shall apply:  (1) "Certificate" or "certificate  of  insurance"  means  any  policy, contract  or  other  evidence  of  insurance,  or  rider  or endorsement thereto, issued to a group member  under  an  employer  sponsored  group personal excess insurance policy.  (2)  "Conditional  renewal" means any change of limits, change in type of coverage, reduction or elimination of coverage, increased  deductible or addition of exclusion, or increased premiums in excess of ten percent (exclusive  of  any premium increase generated as a result of experience rating, loss rating or retrospective rating).  (3) "Employee" means a director of the employer, or an  individual  or partner  who receives or has received income, wages or salaries from the employer.  (4) "Employer" means  a  person,  partnership,  corporation  or  other entity  which  pays or has paid income, wages or salaries to a person or persons.  (5) "Employer sponsored group personal excess insurance" means a group policy of insurance providing the kind of insurance defined in paragraph thirteen or fourteen of subsection  (a)  of  section  one  thousand  one hundred  thirteen  of  this  chapter,  written  as an excess policy with premiums remitted by the employer,  insuring  groups  of  active  and/or retired employees designated by the employer.  (6)  "Group  member"  means  a  designated  active or retired employee insured under this section and also may include the employee's  domestic partner  or  any  person  related  to  the  employee by blood, marriage, adoption, or operation  of  law,  who  resides  in  the  same  household (including  a  ward or foster child) or who is a dependent child away at school.  (7) "Group policy" means  employer  sponsored  group  personal  excess insurance  written  for the designated employees of an employer or other group members as defined in this section.  (b) Employer sponsored group personal excess insurance may be  written in this state pursuant to this section.  (c)  The premium for the group policy may be paid by the employer from funds contributed:  (1) wholly by the employer;  (2) wholly by the employees or group members; or  (3) jointly by the employer and employees or group members.  (d) An employee or  group  member  shall  have  the  right  to  refuse coverage offered by an employer under this section.  (e)  Each  policy  written  pursuant  to  this  section  shall provide separate limits of coverage for each group member.  (f)(1) The insurer shall be responsible for the mailing or delivery to the employer a group policy and certificates of insurance for each group member insured under  the  group  policy.  The  insurer  shall  also  be responsible  for  the mailing or delivery to the employer for each group member any amended certificate  of  insurance,  or  endorsement  to  the certificate,  whenever there is a change of limits; addition, reduction, or elimination of coverage; or addition of an exclusion, under the group policy or certificate.  (2) The certificate shall contain in substance all material terms  and conditions  of coverage afforded to the group member, including, but not limited to, the disclosure in clear and easily  understandable  language of  any limitations, exclusions or required underlying coverages, unless the group policy is incorporated by reference and a copy  of  the  group policy accompanies the certificate.  (g)(1)  A  group policy or certificate shall not be subject to section three thousand four hundred twenty-five or section three  thousand  four hundred  twenty-six  of  this  article. The following requirements shall apply to authorized insurers in regard to termination of coverage.  (2)  A group policy or certificate may be cancelled by an insurer only if cancellation is based on one or more of  the  reasons  set  forth  in paragraph  one  of subsection (c) of section three thousand four hundred twenty-six of this article, provided, however, that an individual  group member  may  also  be canceled upon termination of his or her employment with the employer.  (3) An insurer's cancellation of a group policy, or  any  certificate, shall  not  become  effective  until  forty-five days, or twenty days if based upon non-payment of premium, after the insurer mails  or  delivers written  notice  of  cancellation to the employer at the mailing address shown in the policy. The employer shall mail or deliver  written  notice of  such  cancellation  to each affected group member within ten days of receiving a cancellation notice from  the  insurer  advising  the  group member of the cancellation and the effective date of the cancellation.  (h)  An authorized insurer may nonrenew or conditionally renew a group policy, or any certificate, under this  section,  for  any  reason  upon forty-five  days written notice to the employer. The employer shall mail or deliver written notice of such nonrenewal or conditional  renewal  to each affected group member within ten days of receiving such notice from the insurer.  (i) An employer may cancel a group policy, or any certificate, for any reason  upon thirty days written notice to the insurer and each affected group member.  (j) Unless a group policy provides for a  longer  policy  period,  the policy  and  all  certificates shall be issued or renewed for a one-year policy period commencing with a common inception date.  A  new  employee may  be added to the group policy for less than one year to conform with a common expiration date.  (k) No policy form shall be delivered or issued  for  delivery  by  an authorized  insurer unless it has been filed with the superintendent and the superintendent has either approved it, or thirty days  have  elapsed and  the  superintendent  has not disapproved such form as misleading or violative of public policy. The initial rate of filing pursuant to  this section  shall  be  subject to the prior approval of the superintendent, and any subsequent rate filing shall not be subject to prior approval.   * NB There are 3 § 3453's