NY Ins L § 1120 (2021)
2021 New York Laws ISC - Insurance Article 11 - Licensing of Insurers 1120 - Child Health Insurance Plan.

§ 1120. Child health insurance plan. (a) An authorized insurer subject to  the  provisions  of  this chapter and organized to write the kind of health insurance specified in  paragraph  three  of  subsection  (a)  of section  one  thousand  one  hundred  thirteen  of  this  article, and a corporation or health maintenance organization  authorized  pursuant  to article forty-three of this chapter or a health maintenance organization certified  pursuant  to article forty-four of the public health law, may be authorized by the superintendent  to  issue  contracts  or  otherwise enter  into  arrangements with approved organizations for the purpose of providing child health insurance plan  policies  for  eligible  children pursuant  to  title I-A of article twenty-five of the public health law. Such contracts or arrangements shall satisfy the criteria set  forth  in subsection  (b)  of  this  section and the superintendent shall make the determinations set forth in subsection (e) of this section.  (b) The superintendent may authorize such  contracts  or  arrangements pursuant to the following criteria:  (1) the provisions are not misleading or confusing;  (2)  the  provisions are consistent with the needs of the child health insurance plan; and  (3) the materials describing the contract  or  arrangement  fully  and clearly   state  the  benefits  and  limitations  of  such  contract  or arrangement.  (c) The duration of such contracts or arrangements and the  extent  of exposure  thereunder  by  insurers,  article forty-three corporations or health  maintenance   organizations   shall   be   determined   by   the superintendent.  (d)  Notwithstanding  any  provisions of this chapter or the financial services law to the contrary, the superintendent may  waive,  modify  or suspend  any  provisions  of this chapter, the financial services law or regulations  promulgated  thereunder  as  applicable  to  the  insurers, article  forty-three  corporations  or  health maintenance organizations that issue coverage pursuant to  this  section,  provided  such  waiver, modification  or  suspension  is  based  on  the  criteria  set forth in subsection (e) of this section.  (e) The superintendent may take the actions set forth  in  subsections (a) and (d) of this section upon the superintendent's judgment that:  (1)  the  contract  or  arrangement  is  a  reasonable and appropriate approach to expand the availability of health care coverage to children;  (2) the sources  of  funding  for  the  contract  or  arrangement  are reasonably  related  to  the benefits provided and sufficient to support the contract arrangement;  (3) any waiver, modification or suspension of the provisions  of  this chapter,   the   financial   services  law  or  regulations  promulgated thereunder is essential to the operation of the child  health  insurance plan  and  to  the  rational  development of programs to provide covered services to children; and  (4) any waiver, modification  or  suspension  of  provisions  of  this chapter,   the   financial   services  law  or  regulations  promulgated thereunder  will  not  impair  the  ability  of  the  insurer,   article forty-three  corporation  or  health maintenance organization to satisfy its existing and anticipated contracts and other obligations,  including such standards as the superintendent shall prescribe concerning adequate capital and financial requirements.  (f)  Each  application  used  by an authorized insurer for purposes of enrolling  eligible  children  into  the  child  health  insurance  plan pursuant  to  this section and section twenty-five hundred eleven of the public  health  law  shall  include  the  notice  required  pursuant  to subsection (d) of section four hundred three of this chapter.