STATE OF NEW YORK ________________________________________________________________________ 2006 2025-2026 Regular Sessions IN ASSEMBLY January 14, 2025 ___________ Introduced by M. of A. STIRPE -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to the approval of policy forms The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 6 of subsection (c) of section 3201 of the insur- 2 ance law, as amended by chapter 341 of the laws of 2006, is amended to 3 read as follows: 4 (6) [(a) The] (A) Except as otherwise provided for in subsection (e) 5 of this section, the superintendent may disapprove any policy form spec- 6 ified in paragraph two of subsection (b) of this section issued by a 7 domestic life insurer or fraternal benefit society for delivery outside 8 the state if its issuance would be prejudicial to the interests of its 9 policyholders or members. 10 [(b)] (B) Except for the policy forms specified in paragraph two of 11 subsection (b) of this section, every domestic life insurer and frater- 12 nal benefit society shall file annually with the superintendent a list 13 identifying and describing the policy forms issued by the insurer or 14 fraternal benefit society for delivery outside the state in a form 15 prescribed by the superintendent. If the superintendent determines that 16 the issuance of a policy form has been or may be prejudicial to the 17 interests of policyholders or members, the superintendent may take any 18 action [he or she] such superintendent deems appropriate, including 19 issuing an order, after a hearing, to cease and desist issuing the poli- 20 cy form. 21 (C) Any insurer or fraternal benefit society who shall issue a policy 22 form which shall be exempt from the filing and approval requirements of 23 paragraphs one and two of subsection (b) of this section, shall file 24 annually with the superintendent a list identifying and describing such EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD03535-01-5
A. 2006 2 1 policy forms in a manner prescribed by the superintendent pursuant to 2 paragraph one of subsection (e) of this section. 3 § 2. Section 3201 of the insurance law is amended by adding a new 4 subsection (e) to read as follows: 5 (e)(1) For purposes of this section, the following terms shall have 6 the following meanings: 7 (A) "Large group policyholder" shall mean a group with a minimum of 8 five hundred employees or members that either employ or contract with a 9 qualified benefits manager that shall satisfy the criteria set forth in 10 this subsection. 11 (B) (i) "Qualified benefits manager" means an individual that: 12 a. is a fiduciary under the Employee Retirement Income Security Act of 13 1974 (ERISA); 14 b. holds a bachelor's degree or higher from an accredited college or 15 university; 16 c. has a minimum of five years' experience analyzing, designing, or 17 advising groups defined herein regarding group benefit programs that 18 include, but are not limited to, life insurance, accident and health 19 insurance or annuity products; or 20 d. has a designation as a certified benefit plan administrator, certi- 21 fied employee benefit specialist from the international foundation of 22 employee benefit plans, certified benefits professional from world at 23 work, retirement plan professional issued by the american society of 24 pension professionals and actuaries, any other similar designation 25 issued by an accredited college or university, chartered life underwrit- 26 er (C.L.U.), or is a licensed insurance agent or broker pursuant to 27 article twenty-one of the this chapter; and 28 (ii) A qualified benefits manager shall not include an individual that 29 shall be employed by the insurer or fraternal benefit society issuing 30 the group policy or any person in the insurers' or fraternal benefit 31 society's holding company system. 32 (2) Notwithstanding anything in this section to the contrary, policy 33 forms delivered or issued for delivery in the state, policy forms deemed 34 to have been delivered in the state regardless of the place of actual 35 delivery, or policy forms specified in paragraph two of subsection (b) 36 of this section which shall have been issued to a large group policy- 37 holder as defined in subparagraph (A) of paragraph one of this 38 subsection and that are issued to groups defined in section three thou- 39 sand two hundred twenty-two of this article, except an agreement provid- 40 ing for periodic payments in satisfaction of a claim, section four thou- 41 sand two hundred sixteen of this chapter, other than policy forms to be 42 issued pursuant to paragraph three or fourteen of subsection (b) of such 43 section, and section four thousand two hundred thirty-eight of this 44 chapter are exempt from filing and approval under paragraph one of 45 subsection (b) of this section and filing for delivery outside this 46 state under paragraph two of subsection (b) of this section. 47 (3) The superintendent shall not have the authority to disapprove any 48 such policy form, but shall have the authority, after notice and a hear- 49 ing shall have been given to the insurer or fraternal benefit society 50 which issued any such policy form, to issue a cease and desist order to 51 such insurer or fraternal benefit society if the use of such form is 52 contrary to the requirements of this chapter or inconsistent with law at 53 the time of such order. 54 (4) The superintendent shall have authority to issue a cease and 55 desist order to such insurer of fraternal benefit society in the case of 56 any such policy form:
A. 2006 3 1 (A) pertaining to life insurance, annuity contract, group annuity 2 certificate, or funding agreement for a policy form issued for delivery 3 outside the state, if its issuance would be prejudicial to the interests 4 of policyholders or members; 5 (B) pertaining to life insurance, annuity contract, group annuity 6 certificate, or funding agreement for a policy form delivered or issued 7 for delivery within the state, if such form contains provisions which 8 are unjust, unfair or inequitable; or 9 (C) pertaining to certificates deemed to be delivered in this state 10 regardless of the place of actual delivery, if such certificate fails to 11 afford insureds protections substantially similar to those which shall 12 be provided by certificates delivered in the state. 13 (5) Any such cease and desist order shall be effective not less than 14 ninety days after such order is issued. 15 (6) Notwithstanding anything in this article or article forty-two of 16 this chapter to the contrary, any schedule of premium rates, commissions 17 or fees which shall relate to a group identified in this subsection and 18 are required to be filed pursuant to such articles, may immediately be 19 used by an insurer upon the mailing of such schedule to the superinten- 20 dent. 21 (7) Notwithstanding anything in this section to the contrary, any 22 group policy form which shall be exempt from filing or approval under 23 paragraph two of this subsection, may contain provisions which are, at 24 the minimum, as favorable as the provisions required by this article and 25 article forty-two of this chapter as determined by the issuer of such 26 group policy form. 27 (8) Every policy issued pursuant to this subsection shall contain a 28 notice to the group policyholder that such policy forms shall not be 29 subject to the filing and approval requirements of the state. 30 § 3. This act shall take effect on the thirtieth day after it shall 31 have become a law.