New York Codes, Rules and Regulations › Title 11 - INSURANCE › Chapter III - Policy and Certificate Provisions › Subchapter A - Life, Accident and Health Insurance › Part 52 - Minimum Standards For Form, Content And Sale Of Health Insurance, Including Standards Of Full And Fair Disclosure › Section 52.66 - Required disclosure statement for policies and certificates meeting definition of section 52.15 of this Part

Current through Register Vol. 46, No. 28, July 10, 2024
(a) To comply with section
				  52.15 
				  of this Part, policies of individual insurance and certificates and policies of
				  group or blanket insurance meeting the definition of section
				  52.15 
				  of this Part that are issued to persons who are less than 65 years of age shall
				  use the following statement only, except that appropriate policy and
				  certificate identification may be included:
COMPANY NAME
SPECIFIED DISEASE COVERAGE ONLY
REQUIRED DISCLOSURE STATEMENT
This policy or certificate is (an individual policy of
					 insurance) (a group or blanket policy or certificate). This policy or
					 certificate provides specified disease coverage ONLY. This policy or
					 certificate does NOT provide basic hospital, basic medical or major medical
					 insurance, as defined by the New York State Department of Financial
					 Services.
(Accurately list benefits, exclusions, reductions
					 and limitations of the policy or certificate in a manner that does not
					 encourage misrepresentation of the actual coverage provided.)
This disclosure statement is a very brief summary of your
					 policy or certificate.
The policy or certificate itself sets forth the rights and
					 obligations of both you and the insurance company. It is therefore imperative
					 that you READ YOUR POLICY OR CERTIFICATE carefully.
The expected benefit ratio for this policy or certificate
					 is __%. This ratio is the portion of future premiums that the company expects
					 to return as benefits, when averaged over all people with this policy or
					 certificate.
(b) To comply
				  with section
				  52.15 
				  of this Part, policies of individual insurance and certificates and policies of
				  group or blanket insurance meeting the definition of section
				  52.15 
				  of this Part that are issued to persons who are age 65 or older shall use the
				  following statement only, except that appropriate policy and certificate
				  identification may be included:
COMPANY NAME
SPECIFIED DISEASE COVERAGE ONLY
REQUIRED DISCLOSURE STATEMENT
This policy or certificate is (an individual policy of
					 insurance) (a group or blanket policy or certificate). This policy or
					 certificate provides specified disease coverage ONLY. This policy or
					 certificate does NOT provide Medicare supplement insurance, long term care
					 insurance, nursing home insurance only, home care insurance only or nursing
					 home and home care insurance as defined by the New York State Department of
					 Financial Services. You may also contact your local social security office or
					 this company and obtain a copy of the Guide to Health Insurance for People with
					 Medicare.
(Accurately list benefits, exclusions, reductions
					 and limitations of the policy or certificate in a manner that does not
					 encourage misrepresentation of the actual coverage provided.)
This disclosure statement is a very brief summary of your
					 policy or certificate.
The policy or certificate itself sets forth the rights and
					 obligations of both you and the insurance company. It is therefore imperative
					 that you READ YOUR POLICY OR CERTIFICATE carefully.
The expected benefit ratio for this policy or certificate
					 is __%. This ratio is the portion of future premiums that the company expects
					 to return as benefits, when averaged over all people with this policy or
					 certificate.