New York Insurance Code § 4304

Individual contracts
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§ 4304. Individual contracts. (a) Every corporation subject to the\nprovisions of this article may issue a contract to an individual the\npremiums for which may be paid to the corporation directly by the\nindividual or by a remitting agent for the group to which the individual\nbelongs. If the premiums for a contract issued pursuant to this section\nare paid to the corporation by a remitting agent, such contract shall be\nsubject to subsections (k) and (l) of section four thousand two hundred\nthirty-five of this chapter, and for the purposes of these subsections,\nthe remitting agent shall be treated as the policyholder.\n  (b)(1) Any such contract shall be for a period not in excess of twelve\nmonths, but no contract shall be made providing for the inception of\nbenefits at a date later than one year from the date of the contract.\n  (2) Any such contract shall provide that it will be automatically\nrenewed from year to year unless there shall have been one month's prior\nwritten notice of termination by the subscriber.\n  (3) No corporation shall refuse to renew any such contract because of\nthe physical or mental condition or the health of any person covered\nthereunder. The provisions of this subsection shall in no way diminish\nthe rights of individuals pursuant to section four thousand three\nhundred seventeen of this article.\n  (c) Any such contract may be terminated in the following manner:\n  (1) At the option of the individual to whom the contract is issued,\nupon not less than one month's prior written notice.\n  (2) At the option of the corporation, for one or more of the following\nreasons:\n  (A) The individual has failed to pay premiums or contributions in\naccordance with the terms of the contract or the corporation has not\nreceived timely premium payments.\n  (B) The individual has performed an act or practice that constitutes\nfraud or made an intentional misrepresentation of material fact under\nthe terms of the contract, upon not less than one month's prior written\nnotice.\n  (C) (i) Discontinuance of a class of contract upon not less than\nninety days' prior written notice. In exercising the option to\ndiscontinue coverage pursuant to this item, the corporation must act\nuniformly without regard to any health status-related factor of enrolled\nindividuals or individuals who may become eligible for such coverage and\nmust offer to subscribers or group remitting agents, as may be\nappropriate, the option to purchase all other individual health\ninsurance coverage currently being offered by the corporation to\napplicants in that market. Provided, however, the superintendent may,\nafter giving due consideration to the public interest, approve a request\nmade by a corporation for the corporation to satisfy the requirements of\nthis item through the offering of contracts at each level of coverage as\ndefined in subsection (b) of section four thousand three hundred six-h\nof this article that contains the essential health benefits package\ndescribed in paragraph three of subsection (e) of section four thousand\nthree hundred six-h of this article by another corporation, insurer or\nhealth maintenance organization within the corporation's same holding\ncompany system, as defined in article fifteen of this chapter.\n  (ii) Discontinuance of all hospital, surgical or medical expense\ncoverage in the individual direct payment market in this state upon\nwritten notice to the superintendent and to each subscriber not less\nthan one hundred eighty days prior to the date of the expiration of such\ncoverage. In the event of such a withdrawal from the individual direct\npayment market, the corporation must also provide the superintendent\nwith a written plan to minimize potential disruption in the marketplace\noccasioned by such withdrawal. In addition, the corporation may not\nprovide for the issuance of any hospital, surgical or medical expense\ncoverage in the individual direct payment market in this state during\nt

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