reglab/statecodes huggingface dataset:
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 39 - Minimum Standards For The New York State Partnership For Long-term Care Program › Section 39.1 - Approval of qualified policies/certificates under the program

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
				  Policies/certificates sold in conjunction with the program must be approved by
				  the Superintendent of Financial Services of New York State as meeting the
				  minimum standards required under this Part and other pertinent authority as
				  required by law. Policies/certificates approved as meeting the requirements
				  stated herein shall be designated as qualified by the presence of a program
				  logo that shall be displayed on any products advertised, marketed, offered, or
				  sold. The program logo on each policy/certificate sold shall be numbered. In
				  addition, each approved policy/certificate sold will include a notice to the
				  insured stating that the policy/certificate qualifies under the
				  program.
(b) Except as otherwise
				  stated in this Part, all definitions, requirements, and regulations applicable
				  to the marketing, issuance, offering, administration, advertising, and
				  maintenance of long-term care insurance policies/certificates as contained in
				  Part 52 of this Title, the Insurance Law, and other statutes shall apply to a
				  policy/certificate sold under the program.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 39 - Minimum Standards For The New York State Partnership For Long-term Care Program › Section 39.2 - General conditions governing the program

Current through Register Vol. 46, No. 28, July 10, 2024
Participation in the program shall be open to residents of
					 New York State and insurers licensed to do business in the State. Qualified
					 policies/certificates sold under the program shall provide that benefits are
					 payable regardless of the insured's residence at the time of eligibility for
					 policy/certificate benefits subject to policy/certificate provisions relating
					 to limitations on coverage outside of the United States and its possessions.
					 However, the special eligibility for long-term care protection through the New
					 York State Medicaid program shall be void unless the insured is eligible to
					 receive approved services under the New York State Medicaid program when such
					 special eligibility occurs. This fact shall be prominently disclosed on the
					 face page of the policy/certificate.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 39 - Minimum Standards For The New York State Partnership For Long-term Care Program › Section 39.5 - Minimum benefit standards for qualified policies/certificates for the 4/4/100 plan design

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Basic
				  program minimum coverage requirements. All program participating insurers
				  issuing this plan design must offer a basic policy/certificate providing
				  minimum coverage under this section. Additional products which exceed the basic
				  policy/certificate minimum coverage will be permitted. The insurer selling a
				  policy/certificate providing minimum coverage under this section must offer a
				  policy/certificate providing the basic 2/2/100 minimum plan design and the
				  basic 1.5/3/50 minimum plan design under sections
				  39.4 and
				  39.6  of this Part to the
				  prospective insured at the same time.
(b) Minimum benefit standards for the 4/4/100
				  plan design. To be approved as a qualified policy/certificate under this
				  section a policy/certificate shall provide coverage on an expense incurred,
				  indemnity, prepaid, or other basis and shall provide at least all the benefits
				  in this section and:
(1) The
				  policy/certificate shall provide at least a lifetime maximum total of 48 months
				  coverage for each covered person. The policy/certificate may express the
				  requirement for at least a lifetime maximum total of 48 months coverage for
				  each covered person in monetary terms. The monetary expression shall be at
				  least a lifetime maximum total of 1,460 days of coverage for each covered
				  person multiplied by a daily benefit amount of at least $ 387 per day for
				  policies/certificates sold in 2024. The minimum daily benefit shall be
				  increased each year on the first day of January beginning in 2025.
				  Policies/certificates sold after January 1, 2025 shall provide benefits at the
				  increased minimum standard in the year sold. Minimum daily benefits for the
				  next 10 years shall be as follows:
(i)
				  January 1, 2024 - $ 387;
(ii)
				  January 1, 2025 - $ 401;
(iii)
				  January 1, 2026 - $ 415;
(iv)
				  January 1, 2027 - $ 430;
(v)
				  January 1, 2028 - $ 445;
(vi)
				  January 1, 2029 - $ 461;
(vii)
				  January 1, 2030 - $ 477;
(viii)
				  January 1, 2031 - $ 494;
(ix)
				  January 1, 2032 - $ 511;
(x)
				  January 1, 2033 - $ 529.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 39 - Minimum Standards For The New York State Partnership For Long-term Care Program › Section 39.6 - Minimum benefit standards for qualified policies/certificates for the 2/2/100 plan design

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Basic
				  program minimum coverage requirements. All program participating insurers
				  issuing this plan design must offer a basic policy/certificate providing
				  minimum coverage under this section. Additional products which exceed the basic
				  policy/certificate minimum coverage will be permitted, but less than a 3/3/100
				  (three years of nursing home coverage and three years of home and
				  community-based care coverage) plan design shall be offered under this section.
				  The insurer selling a policy/certificate providing minimum coverage under this
				  section must offer a policy/certificate providing the basic 1.5/3/50 minimum
				  plan design under section
				  39.4  of this Part to the
				  prospective insured at the same time.
(b) Minimum benefit standards for the 2/2/100
				  plan design. To be approved as a qualified policy/certificate under this
				  section a policy/certificate shall provide coverage on an expense incurred
				  basis and shall provide at least all the benefits in this section and:
(1) The policy/certificate shall provide at
				  least a lifetime maximum total of 24 months coverage for each covered person.
				  The policy/certificate may express the requirement for at least a lifetime
				  maximum total of 24 months coverage for each covered person in monetary terms.
				  The monetary expression shall be at least a lifetime maximum total of 730 days
				  of coverage for each covered person multiplied by a daily benefit amount of at
				  least $ 387 per day for policies/certificates sold in 2024. The minimum daily
				  benefit shall be increased each year on the first day of January beginning in
				  2025. Policies/certificates sold after January 1, 2025 shall provide benefits
				  at the increased minimum standard in the year sold. Minimum daily benefits for
				  the next 10 years shall be as follows:
(i)
				  January 1, 2024 - $ 387;
(ii)
				  January 1, 2025 - $ 401;
(iii)
				  January 1, 2026 - $ 415;
(iv)
				  January 1, 2027 - $ 430;
(v)
				  January 1, 2028 - $ 445;
(vi)
				  January 1, 2029 - $ 461;
(vii)
				  January 1, 2030 - $ 477;
(viii)
				  January 1, 2031 - $ 494;
(ix)
				  January 1, 2032 - $ 511;
(x)
				  January 1, 2033 - $ 529.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 40 - Group Annuity Contracts And Funding Agreements: Disclosure And Withdrawal Rules › Section 40.0 - Purpose

Current through Register Vol. 46, No. 28, July 10, 2024
The purpose of this Part is to prescribe the terms and
					 conditions under which certain group annuity contracts and funding agreements
					 may be delivered or issued for delivery in the State of New York. This Part
					 provides disclosure requirements, rules for contract withdrawals to pay certain
					 defined contribution plan benefits and rules relating to contract
					 terminations.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 40 - Group Annuity Contracts And Funding Agreements: Disclosure And Withdrawal Rules › Section 40.1 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Except as
				  otherwise provided, this Part shall apply to all group annuity contracts and
				  funding agreements delivered or issued for delivery in this State on or after
				  the effective date of this Part. However, section
				  40.3  of
				  this Part shall not be effective until December 1, 1990. This Part shall not
				  apply to:
(1) any group annuity contract
				  which is subject to or conforms with the provisions of section 4223  of the Insurance Law;
(2) the provisions of a group annuity
				  contract or funding agreement relating to a separate account which limits the
				  liability under any guarantees to the extent of the interest of the
				  contractholder in assets allocated to such separate account;
(3) any group annuity contract under which
				  the funds received by the insurance company are immediately applied to the
				  purchase of immediate or deferred annuities except that section
				  40.3  of
				  this Part, pertaining to disclosure, shall apply to any such group annuity
				  contract;
(4) any group annuity
				  contract or funding agreement which has been agreed to by the purchaser and a
				  full or initial purchase payment has been made to the insurance company before
				  the effective date of this Part, notwithstanding that the contract was not
				  delivered before the effective date;
(5) any funding agreement which is not issued
				  in connection with any employee benefit plan as defined in the Employee
				  Retirement Income Security Act of 1974,
				  29 U.S.C.
				  1001 et seq. or a governmental plan;
				  or
(6) the provisions of a group
				  annuity contract or funding agreement subject to any regulation promulgated
				  pursuant to section 4240 (a)(5)(iii)  of the
				  Insurance Law.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 40 - Group Annuity Contracts And Funding Agreements: Disclosure And Withdrawal Rules › Section 40.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Part, the following terms shall have the following meanings:
(a) Accumulation fund means the aggregate net considerations ( i.e., gross considerations less all deductions from such considerations) credited to the contract plus all additional amounts, including interest and dividends, credited to the contract less partial withdrawals (but not contract loans) and less all charges and fees imposed against the accumulated amount under the contract other than surrender charges and market value adjustments.
(b) Contract means a funding agreement or a group annuity contract.
(c) Defined contribution plan means a pension plan which provides for an individual account for each participant and for benefits based solely upon the amount contributed to the participant's account, and any income, expenses, gain and losses, and any forfeitures of accounts of other participants which may be allocated to such participant's account.
(d) Department means the Insurance Department of the State of New York and any employee of the department authorized to act on behalf of the department.
(e) Disability means the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or to be of long-continued and indefinite duration and can be expected to be for life.
(f) Discontinuance means the cessation of contributions under a contract.
(g) Funding agreement means a contract described in section 3222  of the Insurance Law.
(h) Governmental plan means a plan defined in section  414(d) of the Internal Revenue Code of 1986.
(i) Group annuity contract means any policy or contract described in section 4238  of the Insurance Law.
(j) Guaranteed interest contract means a contract which guarantees principal and either:
(1) provides a specified rate of interest on amounts deposited with an unqualified right to withdraw the accumulation fund upon the expiration of the time period for which the amount deposited and the specified rate of interest are guaranteed under the contract, either in a lump sum or in installments over a period less than five years with the amount and timing of each such installment specified in the contract; or
(2) provides an indeterminate rate of interest for an indefinite period with an unqualified right to withdraw the accumulation fund at least once a year in either a lump sum, subject to a surrender charge no greater than seven percent, or in substantially equal periodic, at least annual, installments over a period less than five years which does not reflect investment experience of the underlying assets.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 40 - Group Annuity Contracts And Funding Agreements: Disclosure And Withdrawal Rules › Section 40.5 - Contract terminations

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This
				  section shall be applicable to all unallocated amounts under group annuity
				  contracts to which section
				  40.1  of
				  this Part applies other than guaranteed interest contracts.
(b) The purpose of this section is to
				  require, with respect to unallocated amounts under group annuity contracts to
				  which this section applies, termination provisions that are fair and equitable
				  for the terminating contractholder, remaining contractholders and other
				  policyholders of the insurance company.
(c) Any group annuity contract to which this
				  section applies shall permit a contractholder to terminate or discontinue the
				  contract at least once each contract year upon providing the insurance company
				  with reasonable advance notice. The contract shall permit the contractholder,
				  upon the discontinuance or termination of any such contract, to withdraw
				  unallocated amounts credited to the accumulation fund on any basis or bases
				  provided for under the contract, provided that the contract contains in
				  substance:
(1) the withdrawal options
				  described in subdivisions (d) and (e) of this section;
(2) an option under which the contractholder
				  may withdraw all unallocated amounts of the accumulation fund in a lump sum; or
(3) corresponding options which in
				  the opinion of the superintendent are fair and equitable for the terminating
				  contractholder, remaining contractholders and other policyholders of the
				  insurance company. In determining whether a corresponding contract option
				  satisfies the requirements of this subdivision, the superintendent may
				  consider, among other factors, the degree to which the terms of such option
				  reflect the maturity characteristics (e.g., expected pattern of principal
				  repayments and investment yield to repayment) of those investments in the
				  insurance company's general account whose investment results are allocated to
				  the contract under the insurance company's method of investment income
				  allocation.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 40 - Group Annuity Contracts And Funding Agreements: Disclosure And Withdrawal Rules › Section 40.6 - Severability

Current through Register Vol. 46, No. 28, July 10, 2024
If any provision of this Part or the application thereof to
					 any person or circumstance is adjudged invalid by a court of competent
					 jurisdiction, such judgment shall not affect or impair the validity of the
					 other provisions of this Part or the application thereof to other persons and
					 circumstances.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.1 - Purpose

Current through Register Vol. 46, No. 28, July 10, 2024
The purpose of this Part is to establish rules for the
					 accelerated death benefit provisions under an individual or group life
					 insurance policy or fraternal benefit certificate. This Part provides
					 advertising and disclosure requirements, benefit levels, benefit eligibility
					 and actuarial requirements. This Part also provides the requirements for
					 accelerated death benefits pursuant to Insurance Law section
					 1113(a)(1)(C) and (D),
					 which must be tax qualified in order to meet the definition of life insurance
					 under the Insurance Law. In addition to the requirements set forth in this
					 Part, it is the insurer's responsibility to ensure that Insurance Law section
					 1113(a)(1)(C) and (D)
					 accelerated death benefit policies, on a standalone basis, meet the applicable
					 requirements of the Internal Revenue Code and regulations thereunder for
					 Federal tax qualification.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Part, the following terms shall have the following meanings:
(a)
Accelerated death benefit
means proceeds payable in part or in full under a life insurance policy to a policyowner or certificateholder during the lifetime of the insured:
(1) upon the diagnosis of terminal illness that would result in a life expectancy as specified in the contract not to exceed 12 months;
(2) upon the diagnosis of a medical condition requiring extraordinary medical care or treatment regardless of life expectancy;
(3) upon certification by a licensed health care practitioner of any condition that requires continuous care for the remainder of the insured's life in an eligible facility or at home when the insured is chronically ill, provided the accelerated payments qualify under section  101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment;
(4) upon certification by a licensed health care practitioner that the insured is chronically ill, provided the accelerated payments qualify under section  101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment;
(5) upon the insured's having been a resident of a nursing home for a period of three months or more and upon certification by a licensed health care practitioner that there is an expectation that the insured will remain a resident of a nursing home until death; or
(6) upon the insured's having been the recipient of end of life or palliative care for a period of three months or more at a residential health care facility, home care services or hospice, and upon certification by a licensed health care practitioner that there is an expectation that the insured will continue to require the services until death.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.3 - Advertising

Current through Register Vol. 46, No. 28, July 10, 2024
In addition to complying with the provisions of Part 219 of
					 this Title (Regulation No. 34-A), any advertisements for accelerated death
					 benefits shall be subject to the following:
(a) all advertising material shall include a
				  statement that receipt of the accelerated death benefits may affect eligibility
				  for public assistance programs;
(b)
				  all advertising material for accelerated death benefits under Insurance Law
				  section
				  1113(a)(1)(A), (B), (C) or
				  (D) shall include a statement that receipt of
				  the accelerated death benefits may be taxable, and all advertising material for
				  accelerated death benefits under Insurance Law section
				  1113(a)(1)(E) or (F) shall
				  include a statement that receipt of these types of accelerated death benefits
				  is not expected to receive the same favorable tax treatment as the receipt of
				  other types of accelerated death benefits that may be available to the
				  policyowner or certificateholder;
(c) no advertisement shall refer to life
				  insurance policies providing for accelerated death benefits as long-term care
				  insurance, nursing home insurance, home care insurance, or long-term care
				  insurance provided under the partnership for long-term care program, as defined
				  in Social Services Law section
				  367-f and Insurance Law section
				  3229, or as an alternative to such types of
				  insurance, except as otherwise provided in section
				  41.8 
				  of this Part;
(d) no advertisement
				  shall indicate or imply that the accelerated death benefit provision is the
				  only means for providing access to the policy's values; and
(e) no advertisement shall indicate or imply
				  that the accelerated death benefit is being provided without cost unless the
				  insurer can demonstrate otherwise to the superintendent.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.4 - Disclosure

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
(1) The preliminary information required
				  pursuant to Insurance Law section
				  3209(d) and all sales
				  illustrations for the accelerated payment of death benefits pursuant to
				  Insurance Law section
				  1113(a)(1)(A) or (B) shall
				  at the insurer's option provide for either:
(i) an individualized illustration based on
				  the policy being purchased or considered for purchase. The illustration shall
				  demonstrate the acceleration based on 50 percent of the maximum benefit
				  specified in the policy as available for acceleration, illustrate by numerical
				  example the effect on the policy's face amount, specified amount, death
				  benefit, accumulation account, cash values, loan balance, premium payments,
				  availability of policy loans and partial withdrawals. The illustration shall
				  demonstrate the benefit as being paid as of the earlier of 10 years from the
				  date of issue or at the insured's age 75 but in no event earlier than five
				  years from the date of issue. The illustration shall be accompanied by a brief
				  description of the benefit and the qualifying events for payment of benefits;
				  or
(ii) a generic illustration
				  demonstrating the manner in which the benefit operates. The illustration shall
				  demonstrate the acceleration based on 50 percent of the maximum benefit as
				  permitted by the insurer for acceleration, illustrate by numerical example the
				  effect on the policy's face amount, specified amount, death benefit,
				  accumulation account, cash values, loan balance, premium payments, availability
				  of policy loans and partial withdrawals. The illustration shall demonstrate the
				  benefit for an issue age of 45 with acceleration at age 55. The illustration
				  shall be accompanied by a brief description of the benefit and the qualifying
				  events for payment of benefits.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.5 - Benefit levels, payment criteria, and policy provisions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) An insurer may establish a minimum policy issue amount for which accelerated death benefits will be made available.
(b) A policy shall set forth, if applicable, the minimum amount and the maximum amount that may be accelerated.
(c) The present value of the amounts to be accelerated shall not exceed the death benefit of the policy and the death benefit shall be reduced each time an accelerated payment is made by the amount of death benefit accelerated. Any additional accelerated death benefits pursuant to Insurance Law section 1113(a)(1)(C) and (D) payable in excess of the death benefit may only be provided if there are no premium requirements for such benefits once those benefits are being paid.
(1) The present value of the amounts accelerated pursuant to Insurance Law section 1113(a)(1)(A) and (B) shall be calculated using interest only at a rate not exceeding the rate specified in subdivision (j) of this section.
(2) The present value of the amounts accelerated pursuant to Insurance Law section 1113(a)(1)(C) and (D) shall be calculated using the underlying pricing assumptions as to interest, mortality and morbidity but in no event in excess of the lesser of the amount produced by using a monthly discount of 1.125 percent and twice the death benefit at the time of the first accelerated payment.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.6 - Benefit eligibility

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
(1) The life insurance policy shall provide
				  for the accelerated payment of death benefits pursuant to Insurance Law section
				  1113(a)(1)(A), based on
				  the occurrence of the qualifying event of a diagnosis of terminal illness where
				  the life expectancy will not exceed 12 months or a shorter period as specified
				  in the contract.
(2) The policy may
				  also provide for payment pursuant to:
(i)
				  Insurance Law section
				  1113(a)(1)(B), based on
				  the qualifying event of a diagnosis of a medical condition requiring
				  extraordinary medical care or treatment regardless of life
				  expectancy;
(ii) Insurance Law
				  section
				  1113(a)(1)(C) or (D), as
				  provided in section
				  41.8 
				  of this Part; and
(iii) Insurance
				  Law section
				  1113(a)(1)(E) or
				  (F).
(3) Any policy may specify whether benefits
				  may be accelerated pursuant to Insurance Law section
				  1113(a)(1)(A), (B), (C), (D), (E) or
				  (F) singly or in combination. However, any
				  policy providing benefits pursuant to Insurance Law section
				  1113(a)(1)(E) or (F) shall
				  provide that the death benefit will first be accelerated under any Insurance
				  Law section
				  1113(a)(1)(A), (B), (C) or
				  (D) triggers for which the policyowner or certificateholder qualifies under the
				  same policy. A policy that provides for accelerated payment of the death
				  benefit pursuant to Insurance Law section
				  1113(a)(1)(B), (C), (D),
				  (E) or (F) shall also provide that the death benefit may be accelerated
				  pursuant to Insurance Law section
				  1113(a)(1)(A).
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.7 - Actuarial requirements

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
				  statement of self-support required by Insurance Law section
				  4228(h) shall indicate
				  that the cost of providing accelerated death benefits was considered in the
				  demonstration of self-support.
(b)
				  A nonforfeiture memorandum signed by a qualified actuary shall be submitted
				  with the policy form filing. The memorandum shall include a discussion of any
				  impact, both before and after acceleration, on nonforfeiture values due to the
				  existence of the accelerated death benefit provision. If there is no impact,
				  then the memorandum shall include an explanation as to why there is no impact.
(1) Policies and certificates or portions
				  thereof that are not subject to the exemption in Insurance Law section
				  4240(d)(3) shall be in
				  compliance with Insurance Law section
				  4221(l).
(2) Policies and certificates or portions
				  thereof that are subject to the exemption in Insurance Law section
				  4240(d)(3) shall be in
				  compliance with Part 54 of this Title.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.8 - Additional requirements for accelerated death benefits pursuant to Insurance Law section 1113(a)(1)(C) or (D)

Current through Register Vol. 46, No. 28, July 10, 2024
Unless otherwise specifically indicated in this section a policy or certificate that provides for the accelerated payment of the death benefit pursuant to Insurance Law section 1113(a)(1)(C) or (D) shall meet the following standards:
(a) Pursuant to Insurance Law section 1113(a)(1)(C) accelerated payment of the death benefit shall be based on the qualifying event of certification by a licensed health care practitioner of any condition which requires continuous care for the remainder of the insured's life in an eligible facility or at home when the insured is chronically ill, provided that any such accelerated payments shall qualify under section  101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment.
(b) Pursuant to Insurance Law section 1113(a)(1)(D) accelerated payment of the death benefit shall be based on the qualifying event of certification by a licensed health care practitioner that the insured is chronically ill, provided that any such accelerated payments shall qualify under section  101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment.
(c) A policy or certificate intended to be a qualified long-term care insurance contract for Federal tax purposes shall:
(1) meet the applicable requirements of section  4980C of the Internal Revenue Code for a qualified long-term care insurance carrier;
(2) meet all the applicable requirements of section  7702B of the Internal Revenue Code, as amended for a qualified long-term care insurance contract or payments; and
(3) state that it is intended to be a qualified long-term care insurance contract under section  7702B of the Internal Revenue Code. Such statement shall be qualified by the disclosure to the effect that "This is not a health insurance (policy)(certificate) and is not subject to the minimum requirements of New York Law pertaining to Long-Term Care Insurance and does not qualify for the New York State Long-Term Care Partnership Program and is not a Medicare Supplement Policy. The (policy)(certificate) is intended to be a qualified long-term care insurance contract for Federal tax law only."
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy › Section 41.9 - Separability provision

Current through Register Vol. 46, No. 28, July 10, 2024
If any provision of this Part or the application thereof to
					 any person or circumstance is adjudged invalid by a court of competent
					 jurisdiction, such judgment shall not affect or impair the validity of the
					 other provisions of this Part or the application thereof to other persons and
					 circumstances.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-1 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies Issued On Or After November 22, 1995 And Before January 1, 2009 › Section 42-1.1 - Purpose

Current through Register Vol. 46, No. 28, July 10, 2024
The purpose of this Subpart is:
(a) to provide rules pertaining to
					 limitations on the issuance, renewal or continuation of term life insurance;
					 and
(b) to prescribe rules and
					 guidelines for determining minimum cash values on certain increasing premium
					 life insurance policies, including policies under section 4221 (1)(3)  of the
					 Insurance Law, which states cash surrender values and paid-up nonforfeiture
					 benefits provided by certain policies must not be less than the minimum values
					 and benefits required for the policy computed by a method consistent with
					 section 4221  of the Insurance Law, as determined by
					 the superintendent.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-1 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies Issued On Or After November 22, 1995 And Before January 1, 2009 › Section 42-1.2 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This Subpart
					 shall apply to policies delivered, issued for delivery or deemed to be
					 delivered in this State by any authorized life insurance company or fraternal
					 benefit society.
(b) The minimum
					 cash surrender value requirements of this Subpart shall apply to term life and
					 whole life policies with increasing (at advancing duration) gross premium
					 scales, whether fixed premium or indeterminate premium, which are subject to
					 section 4221, except policies subject to section 4232(b) or certificates
					 subject to section 4518  of the Insurance Law.
(c) Except as stated in the next sentence,
					 this Subpart shall apply to all policies issued on or after the effective date
					 of this Subpart and before the operative date of Subpart 42-2 of this Part. For
					 policies issued under policy forms which were approved prior to the effective
					 date of this Subpart, the minimum cash surrender value requirements of this
					 Subpart shall apply one year after the effective date of this Subpart; however,
					 if any such policy form is modified by endorsement or amendment after the
					 effective date of this Subpart, such requirements shall apply to all such
					 policies subsequently issued prior to the operative date of Subpart 42-2 of
					 this Part under such policy form.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-1 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies Issued On Or After November 22, 1995 And Before January 1, 2009 › Section 42-1.3 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Subpart, the following terms shall have
						the following meanings:
(a) The word
					 policy shall include riders, endorsements, supplemental provisions,
					 certificates of fraternal benefit societies, and certificates evidencing group
					 insurance where such certificate is delivered or deemed to be delivered in this
					 State under section 3201 (b)(1)  of the
					 Insurance Law and subject to the approval of the superintendent.
(b) Indeterminate premium policy means an
					 individual life insurance policy, whether participating or non-participating,
					 providing for prospective readjustment of the rate of premium as specified in
					 section 4231 (g)(1)(D)  of the
					 Insurance Law, or any comparable policy.
(c) Gross premium scale as used in this
					 section means either:
(1) the initial current
					 gross premium scale; or
(2) the
					 guaranteed gross premium scale.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-1 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies Issued On Or After November 22, 1995 And Before January 1, 2009 › Section 42-1.4 - Term life insurance

Current through Register Vol. 46, No. 28, July 10, 2024
(a) No
					 policy of term life insurance shall be issued, renewed or continued beyond age
					 80 of the insured unless one of the following applies:
(1) both benefits and premium rates remain
					 level after age 80;
(2) the entire
					 premium cost is paid by the employer under an individual policy which utilizes
					 a sex distinct mortality basis for premium rates and cost of insurance
					 charges;
(3) the entire premium
					 cost is paid by the employer under an individual policy which is issued as part
					 of a qualified pension plan which does not permit assignment of the policy to
					 the employee, and the policy utilizes a unisex mortality basis;
(4) the entire premium costs are paid from
					 the policy's dividends or previously purchased paid-up additions or the entire
					 cost of insurance charges are paid from additional amounts credited to the
					 policy;
(5) the group policyholder
					 pays the entire premium for all eligible lives covered under the group policy
					 without any contribution from such eligible lives; or
(6) the group policyholder pays a portion of
					 the premium for active employees aged 80 and older covered under a group policy
					 issued to a group recognized under section 4216 (b)(1)  of the
					 Insurance Law.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-1 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies Issued On Or After November 22, 1995 And Before January 1, 2009 › Section 42-1.5 - Minimum guaranteed cash surrender value requirements

Current through Register Vol. 46, No. 28, July 10, 2024
(a) General.
(1) This section shall not apply to the
					 following:
(i) policies subject to section 4232 (b) or
					 4518  of the Insurance Law;
(ii) one year term life insurance coverage
					 funded by dividends or other additional amounts credited to a policy.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-2 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Policies Issued On Or After January 1, 2008 › Section 42-2.1 - Purpose

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose of
					 this Subpart is to prescribe rules and guidelines for minimum nonforfeiture
					 values on individual life insurance policies other than policies subject to
					 section
					 54.7(b) 
					 of this Title or policies subject to section 4221(n-1) of the Insurance Law.
					 Section 4221  of the Insurance Law sets forth the
					 nonforfeiture standards for individual life insurance policies.
(b) Section 4221 (l)(3)  of the
					 Insurance Law requires that "the cash surrender values and paid-up
					 nonforfeiture benefits provided by such plan must not be less than the minimum
					 values and benefits required for the plan computed by a method consistent with
					 the principles of this section, as determined by the superintendent." Such
					 plans include those which provide for future premium determination, the amounts
					 of which are to be determined by the insurer or fraternal benefit society based
					 on then estimates of future experience, and plans which are of such a nature
					 that minimum values cannot be determined by the methods described in section 4221  of the Insurance Law.
(c) Other than for policies subject to
					 section 4221(n-1) of the Insurance Law, section 4221  of the Insurance Law sets forth the
					 minimum requirements for the end of each policy year assuming annual premiums
					 specified in the policy are paid. In practice, premiums are paid on a variety
					 of modes and policies may be allowed to surrender or lapse at times other than
					 on policy anniversaries. In addition, the benefits may not be level during each
					 policy year and the death benefit may be affected by the premium mode used.
					 Section 4221(m)(1) requires that any cash surrender value and any paid-up
					 nonforfeiture benefit, available under any such policy or contract in the event
					 of default in the payment of any premium or stipulated payment due at any time
					 other than on the policy or contract anniversary, shall be calculated with
					 allowance for the lapse of time and the payment of fractional premiums or
					 stipulated payments beyond the beginning of the policy or contract year in
					 which the default occurs.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-2 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Policies Issued On Or After January 1, 2008 › Section 42-2.2 - Applicability

Current through Register Vol. 46, No. 28, July 10, 2024
(a) This Subpart
					 shall apply to individual life insurance policies delivered or issued for
					 delivery in this State after the operative date of this Subpart by any
					 authorized life insurance company or fraternal benefit society other than
					 policies subject to section
					 54.7(b) 
					 of this Title or policies subject to section 4221(n-1) of the Insurance
					 Law.
(b) This Subpart shall apply
					 to all amendments, endorsements or other similar modifications made after the
					 operative date of this Subpart to individual life insurance policies delivered
					 or issued for delivery in this State by any authorized life insurance company
					 or fraternal benefit society other than amendments, endorsements or other
					 similar modifications subject to section
					 54.7(b) 
					 of this Title or subject to section 4221(n-1) of the Insurance Law.
(c) Any insurer authorized in this State may
					 file with the superintendent a written notice of the election to comply, with
					 respect to any policy, with the provisions of this Subpart as of a specified
					 date on or after the effective date of this Subpart and prior to January 1,
					 2009. That date shall be the operative date of this Subpart for that policy of
					 insurance for such life insurance company or certificate of insurance for such
					 fraternal benefit society. The operative date of this Subpart for all policies
					 of a life insurance company and all certificates of a fraternal benefit society
					 where such written election was not made shall be January 1, 2009.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-2 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Policies Issued On Or After January 1, 2008 › Section 42-2.3 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Subpart, the following terms shall have
						the following meanings:
(a) Policy
					 form means any policy, certificate, and any application therefor, or rider or
					 endorsement thereto, affording benefits of life insurance.
(b) Policy means every policy, rider or
					 endorsement that collectively constitute the agreement between the insurer and
					 insured.
(c) Indeterminate premium
					 policy means an individual life insurance policy, whether participating or
					 non-participating, providing for prospective readjustment of the rate of
					 premium as specified in section 4231 (g)(1)(D)  of the
					 Insurance Law, or any comparable policy.
(d) Initial current gross premium scale for
					 an indeterminate premium policy means the schedule of gross premiums, based on
					 the initial (current) pricing assumptions that would be payable if there were
					 no prospective premium readjustments.
(e) Guaranteed gross premium scale for an
					 indeterminate premium policy means the schedule of gross premiums guaranteed by
					 policy provision to be the maximum premium that can be charged under the
					 prospective readjustment of premium provision.
New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 42 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Insurance Policies › Subpart 42-2 - Term Life Issuance And Renewal Restrictions; Nonforfeiture Values For Certain Life Policies Issued On Or After January 1, 2008 › Section 42-2.4 - Rounding

Current through Register Vol. 46, No. 28, July 10, 2024
Minimum nonforfeiture values may be rounded to the
						nearest dollar. If the requirement for a table of cash values appearing in the
						policy form is satisfied by using a rate per $1,000 of insurance then
						multiplying the rate per $1,000 times the face amount divided by 1,000 must
						result in a cash value that equals or exceeds the minimum nonforfeiture values.
						For example, a form provides cash values in dollars per $1,000 of face. If the
						actual minimum required cash value for a given class at a specific anniversary
						is $12.12 per $1,000 then the cash value of a $4,000 policy could be shown as
						$12 per thousand ($48.48 rounded to $48), but the cash value of a $5,000 policy
						could not be shown as $12 per thousand ($60.60 can be rounded to $61.00 but not
						to $60.00).