2023 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