NY Ins L § 4306 (2021)
2021 New York Laws ISC - Insurance Article 43 - Non-Profit Medical and Dental Indemnity, or Health and Hospital Service Corporations 4306 - Required Contract Provisions.

§  4306.  Required  contract  provisions. Every contract issued by any corporation pursuant to the provisions of section  four  thousand  three hundred  four  of  this article, shall be in writing and shall state the terms and conditions thereof. No such contract shall be made, issued  or delivered in this state unless it contains the following provisions:  (a)  a  statement  of  the  amount  payable  to the corporation by the individual to whom the contract is issued and the  times  at  which  and manner in which such amount is to be paid;  (b)  a statement of the nature of the benefits to be furnished and the period during which they  will  be  furnished;  and  if  there  are  any benefits to be excepted, a detailed statement of such exceptions printed as hereinafter specified;  (c)  a  statement  of the terms and conditions, if any, upon which the contract may be terminated at the option of the individual, or otherwise terminated at the option of either party as permitted by subsection  (b) or (c) of section four thousand three hundred four of this article;  (d)  a  statement  that the contract includes the endorsements thereon and attached papers, if any;  (e) a statement that no statement by the individual in his application for a contract shall  avoid  the  contract  or  be  used  in  any  legal proceeding  thereunder, unless such application or an exact copy thereof is included in or attached to  such  contract,  and  that  no  agent  or representative  of such corporation and no broker, other than an officer or officers designated therein, is authorized to change the contract  or waive any of its provisions;  (f)  a statement that if the individual defaults in making any payment under the contract, the  subsequent  acceptance  of  a  payment  by  the corporation  or  by  one  of  its  duly  authorized  agents or by a duly authorized broker shall reinstate the  contract,  but  with  respect  to sickness  and  injury,  only  to  cover  such  sickness  as may be first manifested more than ten days after the date of such acceptance;  (g) a statement of the period of  grace  which  will  be  allowed  the individual  for  making  any payment due under the contract which period shall not be less than ten days;  (h) a statement on the first page of  the  contract  or  in  a  notice attached  to  the contract that during a specified period of time, which shall not be less than ten days nor more than twenty days from the  date the  contract  is  delivered to the individual, it may be surrendered to the corporation together with a written request for cancellation of  the contract  and that in such event the corporation will refund any premium paid therefor including any contract fees or  other  charges;  provided, however,  that  a  contract  sold by mail order and a contract providing medicare supplemental insurance or long-term care insurance must contain a provision permitting the individual  a  thirty  day  period  for  such surrender;  (i)  the age limit or date or period, if any, after which the coverage provided by the contract will not be effective, or renewed, is stated in a renewal provision set forth on the first page of the contract or as  a separate  provision  bearing an appropriate caption on the first page on the contract or in a brief description in not less than  fourteen  point bold  face  type  set  forth  on the first page of the contract; nothing herein contained shall limit or restrict the right of the corporation to continue the contract after the age or period so stated;  (j) a statement under the caption "CONVERSION PRIVILEGE"  which  shall set  forth in substance the conversion privileges and related provisions required by subsections (d) and  (e)  of  section  four  thousand  three hundred four of this article;  (k)  the  exceptions  of  the  contract  shall  appear  with  the same prominence as the benefits to which they apply;  (l)  if  the  contract  contains  any provision purporting to make any portion of the articles, constitution or by-laws of  the  corporation  a part of the contract, such portion shall be set forth in full; and  (m)  in  every  such  contract made, issued or delivered in this state there shall be a brief description of the contract on its first page and on its filing back.  (n) a statement that a health care claim from a  subscriber  shall  be submitted  within  one  hundred  twenty  days  from the date of service; provided, however, that if  it  was  not  reasonably  possible  for  the subscriber  to  submit  the  claim within that timeframe, then the claim shall be submitted as soon as reasonably possible.