Section 1101. Definitions; doing an insurance business. 1102. Insurer`s license required; issuance. 1103. Duration of licenses. 1104. Revocation or suspension of license; restriction of license authority or limitation on premiums written. 1105. Voluntarily ceasing to maintain license. 1106. Additional requirements for foreign or alien insurer`s license. 1107. Licenses for unincorporated insurers. 1108. Insurers exempt from licensing and other requirements. 1109. Limited exemption for health maintenance organizations. 1110. Charitable annuity societies exempt; special permits. 1111. Compulsory insurance; bonds of surety companies; certificates of qualification. 1112. Reciprocal provisions as to taxes, license fees, deposits, and other requirements. 1112-a. Reports. 1113. Kinds of insurance authorized. 1114. Reinsurance business. 1115. Limitation of risk, in general. 1116. Prepaid legal services plans and legal services insurance. 1117. Health insurance plans for long term care. 1118. Regional pilot projects for the uninsured. 1119. Limited exemption for continuing care treatment communities. 1120. Child health insurance plan. 1121. Voucher insurance program. S 1101. Definitions; doing an insurance business. (a) In this article: (1) "Insurance contract" means any agreement or other transaction whereby one party, the "insurer", is obligated to confer benefit of pecuniary value upon another party, the "insured" or "beneficiary", dependent upon the happening of a fortuitous event in which the insured or beneficiary has, or is expected to have at the time of such happening, a material interest which will be adversely affected by the happening of such event. (2) "Fortuitous event" means any occurrence or failure to occur which is, or is assumed by the parties to be, to a substantial extent beyond the control of either party. (3) "Contract of warranty, guaranty or suretyship" means an insurance contract only if made by a warrantor, guarantor or surety who or which, as such, is doing an insurance business. (b) (1) Except as provided in paragraph two, three or three-a of this subsection, any of the following acts in this state, effected by mail from outside this state or otherwise, by any person, firm, association, corporation or joint-stock company shall constitute doing an insurance business in this state and shall constitute doing business in the state within the meaning of section three hundred two of the civil practice law and rules: (A) making, or proposing to make, as insurer, any insurance contract, including either issuance or delivery of a policy or contract of insurance to a resident of this state or to any firm, association, or corporation authorized to do business herein, or solicitation of applications for any such policies or contracts; (B) making, or proposing to make, as warrantor, guarantor or surety, any contract of warranty, guaranty or suretyship as a vocation and not as merely incidental to any other legitimate business or activity of the warrantor, guarantor or surety; (C) collecting any premium, membership fee, assessment or other consideration for any policy or contract of insurance; (D) doing any kind of business, including a reinsurance business, specifically recognized as constituting the doing of an insurance business within the meaning of this chapter; (E) doing or proposing to do any business in substance equivalent to any of the foregoing in a manner designed to evade the provisions of this chapter. (2) Notwithstanding the foregoing, the following acts or transactions, if effected by mail from outside this state by an unauthorized foreign or alien insurer duly licensed to transact the business of insurance in and by the laws of its domicile, shall not constitute doing an insurance business in this state, but section one thousand two hundred thirteen of this chapter shall nevertheless be applicable to such insurers: (A) transactions by any life insurance company organized and operated, without profit to any private shareholder or individual, exclusively for the purpose of aiding any charitable, religious, educational or scientific institution organized and operated, without profit to any private shareholder or individual, by issuing insurance or annuity contracts directly from its home office, without agents or representatives in this state, only to or for the benefit of such institutions and to individuals engaged in their service; (B) transactions with respect to group life, group annuity, group accident and health or blanket accident and health insurance (other than any transaction with respect to a group annuity contract funding individual retirement accounts or individual retirement annuities, as defined in section four hundred eight of the Internal Revenue Code, funding annuities in accordance with subdivision (b) of section four hundred three of such code or providing a plan of retirement annuities under which the payments are derived wholly from funds contributed by the persons covered): (i) where such groups conform to the definitions of eligibility contained in; (I) the following paragraphs of subsection (b) of section four thousand two hundred sixteen of this chapter: (aa) paragraph (1) or (2); (bb) paragraph (3), if, with respect to those credit transactions entered into in this state, the policy fully conforms with the requirements of sections three thousand two hundred one, three thousand two hundred twenty and four thousand two hundred sixteen of this chapter; (cc) paragraphs (4), (5), (6), (7), (8), (9) and (10). (II) the following subparagraphs of paragraph (1) of subsection (c) of section four thousand two hundred thirty-five of this chapter: (aa) subparagraph (A), (B), (C) or (D); (bb) subparagraph (E), if, with respect to those credit transactions entered into in this state, the policy fully conforms with the requirements of sections three thousand two hundred one, three thousand two hundred twenty-one and four thousand two hundred thirty-five of this chapter; (cc) subparagraphs (F), (G) and (H). (III) section four thousand two hundred thirty-seven (except subparagraph (F) of paragraph three of subsection (a) thereof) or four thousand two hundred thirty-eight (except paragraphs six and seven of subsection (b) thereof) of this chapter; and (ii) where the master policies or contracts were lawfully issued without this state in a jurisdiction where the insurer was authorized to do an insurance business; (C) transactions involving the continuance or servicing of life or accident and health insurance policies or annuity contracts lawfully issued or delivered in this state by an authorized insurer and occurring subsequent to the termination of such insurer`s authority to do an insurance business in this state; (D) transactions with respect to policies or annuity contracts lawfully issued without this state occurring subsequent to issue, if, at the time of issue, such policies or contracts covered subjects of insurance or risks not resident or located in this state; (E) transactions with respect to policies of insurance on risks located or resident within or without this state (except master policies or contracts of group insurance which are subject to the requirements of subparagraph (B) hereof), which policies are principally negotiated, issued and delivered without this state in a jurisdiction in which the insurer is authorized to do an insurance business; (F) transactions authorized by section two thousand one hundred five of this chapter with respect to excess lines insurance; (G) transactions with respect to the reinsurance of risks of authorized insurers to the extent that such reinsurance is permitted by this chapter; (H) transactions with respect to insurance contracts negotiated or placed pursuant to subsection (b) or (c) of section two thousand one hundred seventeen of this chapter; (I) transactions with respect to any policy of insurance or annuity contract issued prior to September first, nineteen hundred seventy. (3) Notwithstanding the foregoing, the making of an agreement pursuant to which a lessor of personal property, a creditor making a loan or other credit transaction on personal property or, in the absence of a waiver by the lessor or creditor, the lessor`s or creditor`s assignee waives the obligation of the lessee or debtor for the gap amount, as such term is defined in paragraph fifty-two of subsection (a) of section one hundred seven of this chapter, shall not constitute, or be deemed to constitute, the doing of an insurance business if: (i) the lessor or creditor or, in the absence of a waiver by the lessor or creditor, the assignee waives any and all obligations of the lessee or debtor for the gap amount and the lessee or debtor is discharged from any and all further obligation to pay the gap amount; (ii) the waiver applies only in the event of a total loss of the personal property occasioned by its theft or physical damage; (iii) in the event the lessor, creditor or assignee purchases lessor or creditor gap insurance, the charge to the lessee or debtor for the waiver does not exceed the cost of the lessor or creditor gap insurance coverage; provided, however, that nothing contained herein shall be construed to prohibit the lessor from including the charge for the waiver in the capitalized cost as that term is defined in subdivision eleven of section three hundred thirty-one of the personal property law. (3-a) Notwithstanding the foregoing, the marketing, sale, offer for sale, issuance, making, proposing to make or administration of a service contract pursuant to article seventy-nine of this chapter or warranty, service contract or maintenance agreement conditioned upon or otherwise associated with the sale or supply of heating fuel shall not constitute doing an insurance business in this state. (4) In the application of this chapter, the fact that no profit is derived from the making of insurance contracts, agreements or transactions, or that no separate or direct consideration is received therefor, shall not be deemed conclusively to show that the making thereof does not constitute the doing of an insurance business. (5) Notwithstanding the foregoing, an unauthorized insurer, which (A) is affiliated with an insurer licensed in this state, and (B) has satisfied all applicable requirements for placements by excess line brokers as set forth in section two thousand one hundred eighteen of this chapter, may provide from an office within the state, services to support its insurance business. Such services shall not be deemed under this chapter as doing an insurance business in this state. For the purposes of this section these services include, but are not limited to, computer operations, clerical and staffing support, underwriting, negotiating contract terms, quoting premiums, binding coverage, drafting and issuing policies and claims handling, investigation and payment, among other incidental services. Such services shall not include the marketing, soliciting or advertising by the unauthorized insurer directly to policyholders. Notwithstanding paragraph two of subsection (a) of section two thousand one hundred twenty-two of this chapter, such unauthorized insurers shall be permitted to advertise to, and market and solicit through, excess line brokers licensed pursuant to section two thousand one hundred five of this chapter. All obligations of such a licensee under article twenty-one of this chapter shall remain in full force and effect. Any document issued by the unauthorized insurer that indicates any location within this state in which it conducts its operations shall include a prominent notice that the insurer is not licensed by the state of New York, in no smaller than 10 point type, in accordance with regulations as may be promulgated by the superintendent. S 1102. Insurer`s license required; issuance. (a) No person, firm, association, corporation or joint-stock company shall do an insurance business in this state unless authorized by a license in force pursuant to the provisions of this chapter, or exempted by the provisions of this chapter from such requirement. Any person, firm, association, corporation or joint-stock company which transacts any insurance business in this state while not authorized to do so by a license issued and in force pursuant to this chapter, or exempted by this chapter from the requirement of having such license, shall, in addition to any other penalty provided by law, forfeit to the people of this state the sum of one thousand dollars for the first violation and two thousand five hundred dollars for each subsequent violation. (b) No corporation organized under any law of this state shall do an insurance business outside this state unless so authorized pursuant to the provisions of this chapter or exempted by the provisions of this chapter from such requirement. (c) Every insurer organized prior to the first day of October, eighteen hundred ninety-two, as an insurer under any general or special law of this state which was doing an insurance business in this state immediately prior to the first day of January, nineteen hundred forty in compliance with the insurance law then in force and not as an organization exempted therefrom, shall be deemed licensed to do an insurance business in this state, subject to this chapter. (d) Except as otherwise provided in subsection (h) hereof, the superintendent may issue a license to any insurer to do in this state the kinds of insurance business for which such insurer is qualified under the provisions of this chapter and under its charter. Every such license shall contain the name of the licensee, its home office address, the state or country under whose laws it was organized, the kinds of insurance business, as defined in this chapter, which it is authorized to do in this state, and the term of such license. The superintendent may refuse to issue or renew any such license if in his judgment such refusal will best promote the interests of the people of this state. (e) (1) Before licensing any such corporation organized under section one thousand two hundred one of this chapter, to do any insurance business, the superintendent shall: (A) If such corporation be a stock corporation, cause an examination to be made into its affairs in accordance with the provisions of this chapter; and if it appears from the report upon such examination that the amount of capital and surplus required by law has been paid in and is possessed by the corporation in cash or in investments permitted by this chapter as minimum capital or minimum surplus to policyholder investments under section one thousand four hundred two of this chapter, the superintendent shall file such report in his office and notify the corporation thereof; (B) If such corporation be a mutual corporation, require proof (by statements of at least three incorporators subscribed and affirmed by such incorporators as true under the penalties of perjury, and by such investigation or examination of the affairs of such corporation as he may deem it expedient to make pursuant to the provisions of this chapter) that: (i) the corporation has fully complied with the applicable provisions of this chapter, (ii) it has the required initial surplus in cash or investments as prescribed in this chapter, (iii) it has the required number and amount of bona fide applications for insurance as prescribed in this chapter, (iv) the membership list is genuine, and (v) every member has paid in cash the required premium on the insurance applied for and will take the policies as agreed within sixty days after a license has been issued to such corporation. If the superintendent finds such proof of the foregoing facts to be sufficient, he shall file it in his office and notify the corporation thereof; (C) Upon payment of the appropriate fees by such corporation, cause a copy of its declaration and charter, certified by him, to be filed and recorded in the office of the clerk of the county in which such corporation has its principal office. (2) The superintendent may refuse a license to any such corporation if he finds, after notice and hearing, that any proposed incorporator or director of a stock corporation, or any director of a mutual corporation, has been convicted of any crime involving fraud, dishonesty, or like moral turpitude, or is an untrustworthy person. (3) The corporation, on receiving notice from the superintendent that it has complied with this subsection, shall thereupon deposit with the superintendent such monies or securities as may be required by law. (4) Upon compliance with this section and any other lawful prerequisites for the issuance of an insurer`s license, the superintendent may, pursuant to this section, issue a license to such corporation to do the kind or kinds of business specified in its charter; provided that this subsection shall not apply to co-operative fire insurance companies, fraternal benefit societies, or corporations organized under article forty-three of this chapter. (f) Except as may be otherwise provided in this chapter, every license to do an insurance business shall be issued to a single licensee, who shall be either an individual or corporation. (g) (1) No license to do an insurance business, or to act as an insurance agent, agency or broker, shall be granted to any person, firm, association, corporation, or joint-stock company proposing to do business under a name identical with, or so similar to as to be likely to deceive or mislead the public, the name of any insurer then licensed or authorized to do any kind of insurance business within this state, or of any proposed domestic insurance corporation whose name has been approved pursuant to section one thousand two hundred one of this chapter within six months preceding the application for such license, or of any domestic corporation, organized but not yet licensed, which has not forfeited its charter because of non-use; provided, the superintendent may, in his discretion, upon satisfactory proof of an appropriate resolution of any insurance corporation`s board of directors, grant a license to do any different kind of insurance business to another person, firm, association, joint-stock company, insurance agent, agency or broker, or insurance corporation, having a similar, but not identical, name. Notwithstanding any other provision of this article, the superintendent may refuse to grant a license to do an insurance business, or to act as an insurance agent, agency or broker, to any person, firm, association, corporation or joint-stock company proposing to do business under a name which is likely to deceive or mislead the public in this state. (2) The provisions of this subsection shall not apply to a license renewal for a foreign or alien insurer, or to any corporation formed as part of a plan, approved by the superintendent and by the court, for rehabilitation of a domestic insurance corporation pursuant to article seventy-four of this chapter. A domestic corporation, formed by reincorporation, reorganization or consolidation of other corporations, or upon the sale of the property or franchises of another corporation, or a corporation acquiring or becoming possessed of all of the estate, property, rights, privileges and franchises of any other corporation or corporations by merger, may have a name identical with, or similar to, that of any corporation to whose franchises it has succeeded, if such other corporation was then licensed to do the business of insurance in this state. (h) No license to transact any kind of insurance business in this state shall be issued or renewed to any foreign or alien insurer or issued or continued in effect to any domestic insurer which is controlled by another state of the United States or by a foreign government or by any political subdivision of either, or which is an agency of any such state, government or subdivision, unless: (1) such insurer was so controlled or constituted, and was authorized to do business in this state, on or prior to January first, nineteen hundred fifty-six; or (2) such insurer is not authorized to transact the kinds of insurance specified in paragraph one, two or three of subsection (a) of section one thousand one hundred thirteen of this article and the superintendent determines that: (A) such insurer does not receive a subsidy or other competitive advantage, as a result of such control or status, that would enable it to compete unfairly with similarly situated authorized insurers which are not so controlled or constituted; (B) such insurer is not entitled to claim sovereign immunity as a result of such control or status, or has waived the sovereign immunity; (C) the use of such insurer would not be detrimental to the interests of the people of this state; and (D) such insurer otherwise satisfies all applicable requirements for the issuance or renewal of such license. S 1103. Duration of licenses. (a) Every license issued to a domestic insurer shall be for an indefinite term and shall expire with the expiration or termination of its corporate existence. (b) Every license, including every renewal license, issued to a foreign or alien insurer shall be for a term expiring on June thirtieth following the date of issuance, except that at any time after a licensed foreign or alien insurer has filed its annual statement pursuant to section three hundred seven of this chapter the superintendent may issue to such insurer a renewal license for the next year. S 1104. Revocation or suspension of license; restriction of license authority or limitation on premiums written. (a) The superintendent may revoke any license issued to any foreign or alien insurer to do an insurance business in this state if, after notice to and hearing, he finds that such insurer has failed to comply with any requirement imposed upon it by the provisions of this chapter and if in his judgment such revocation is reasonably necessary to protect the interests of the people of this state. The superintendent may in his discretion reinstate any such license if he finds that a ground for such revocation no longer exists. (b) The superintendent shall revoke the certificate of authority of any corporation or agent convicted of violating section two thousand six hundred three of this chapter. (c) The superintendent may suspend the license, restrict the license authority, or limit the amount of premiums written in this state of any accident and health insurance company, property/casualty insurance company, co-operative property/casualty insurance company, title insurance company, mortgage guaranty insurance company, reciprocal insurer, Lloyds underwriters or nonprofit property/casualty insurance company, except those insurers subject to the provisions of subsection (c) of section two thousand three hundred forty-three of this chapter, if after a hearing on a record, unless waived by the affected insurer, the superintendent determines that such insurer`s surplus to policyholders is not adequate in relation to the insurer`s outstanding liabilities or to its financial needs. All matters pertaining to a proceeding or determination pursuant to this subsection shall be confidential and not subject to subpoena or public inspection under article six of the public officers law or any other statute, except to the extent that the superintendent finds release of information necessary to protect the public. The hearing shall be initiated within twenty days after written notice to the insurer. Any determination pursuant to this subsection shall contain findings specifying the factors deemed significant in regard to the particular insurer, and shall set forth the reasons supporting the suspension, restriction or limitation ordered by the superintendent. The following factors shall be considered by the superintendent in making such determination: (1) the size of the insurer as measured by its admitted assets, capital and surplus to policyholders, reserves, premium writings, insurance in force and other appropriate criteria, with such surplus to policyholders for foreign insurers adjusted in accordance with section one thousand four hundred thirteen of this chapter; (2) the extent to which the insurer`s business is diversified among the several kinds of insurance; (3) the number and size of risks insured in each kind of insurance and the insurer`s loss experience in regard to such risks; (4) the extent of geographical dispersion of the insurer`s risks; (5) the nature and extent of the insurer`s reinsurance program; (6) the quality, diversification and liquidity of the insurer`s investment portfolio; (7) the recent past and projected future trends in regard to the insurer`s loss experience and in the size of the insurer`s surplus to policyholders; (8) the surplus to policyholders maintained by other comparable insurers; (9) the adequacy of the insurer`s reserves; and (10) the quality and liquidity of investments in subsidiaries made pursuant to this chapter. (d) The superintendent shall identify and review those licensed property/casualty insurers needing immediate or targeted regulatory attention, and shall include the number of insurers so identified in the report required by section three hundred thirty-four of this chapter. Such report shall also include the name of each licensed property/casualty insurer placed in formal conservatorship, rehabilitation or liquidation during the preceding year. Nothing herein shall be construed to restrict or diminish any right or power of the superintendent under any other provision of this chapter. S 1105. Voluntarily ceasing to maintain license. When an authorized insurer proposes to cease to maintain its existing licensing status in this state, the insurer shall at least forty-five days prior to such proposed action submit to the superintendent a plan to protect the interests of the people of this state. Such proposed action shall not become effective without the approval of such plan by the superintendent. The plan shall include requirements and procedures for meeting the insurer`s contractual obligations, providing security protection in the event of a subsequent insolvency, and meeting any applicable statutory obligations, including its obligations pursuant to articles fifty-three, fifty-four and fifty-five of this chapter. Such plan shall be in compliance with a regulation to be promulgated by the superintendent. In order to protect the interests of the people of this state, the superintendent may require the deposit of securities in this state, in trust, in the name of the superintendent. S 1106. Additional requirements for foreign or alien insurer`s license. (a) Before issuing a license to do business, except by way of a renewal license, to any foreign or alien insurer the superintendent in addition to the requirement set forth in subsection (b) hereof: (1) shall require it to submit for filing a certified copy of its charter, and of its by-laws, if any, currently in force, and such other documents necessary to show the kinds of business which it is empowered to do, and a full statement, subscribed and affirmed as true under the penalties of perjury by two officers or responsible representatives in such manner as the superintendent shall prescribe, showing its assets, liabilities and financial condition; and (2) may require a full statement of its income, disbursements, business done, and other facts required to be shown in its annual statement; and (3) may either make an examination of the insurer`s affairs at its principal office within the United States, or accept a report of an examination made by the insurance department or other insurance supervisory official of any other state or of any government outside the United States. (b) (1) Before issuing any new or renewal license to any foreign or alien insurer, the superintendent may require satisfactory proof, either in the insurer`s charter or by an agreement evidenced by a duly certified resolution of its board of directors, or otherwise as the superintendent may require, that such insurer will not engage in any insurance business in contravention of the provisions of this section or not authorized by its charter. (2) The superintendent shall issue a renewal license to any foreign or alien insurer if satisfied, by such proof as he may require, that such an insurer is not delinquent with respect to any requirement imposed by this chapter and that its continuance in business in this state will not be hazardous or prejudicial to the best interests of the people of this state. (c) No foreign insurer shall be licensed to do in this state any kind of insurance business, or combination of kinds of insurance business, which are not permitted to be done by domestic insurers hereafter to be licensed under the provisions of this chapter. No foreign insurer shall be authorized to do business in this state if it does in this state or elsewhere any kind of business, other than an insurance business and such business as is necessarily or properly incidental to the kind or kinds of insurance business which it is licensed to do in this state. (d) No alien insurer shall be licensed to do in this state any kind of insurance business, or any combination of kinds of insurance business, which are not permitted to be done by domestic insurers hereafter to be licensed under the provisions of this chapter. No alien insurer shall be authorized to do an insurance business in this state if it does anywhere within the United States any kind of business other than an insurance business and such business as is necessarily or properly incidental to the kind or kinds of insurance business which it is authorized to do in this state. (e) Except as otherwise specifically provided in this chapter no foreign insurer and no United States branch of an alien insurer shall be or continue to be authorized to do an insurance business in this state if it fails to comply substantially with any requirement or limitation of this chapter, applicable to similar domestic insurers hereafter to be organized, which in the judgment of the superintendent is reasonably necessary to protect the interests of the people of this state. (f) No foreign insurer and no United States branch of an alien insurer which does outside of this state any kind or combination of kinds of insurance business not permitted to be done in this state by similar domestic insurers hereafter organized, shall be or continue to be authorized to do an insurance business in this state, unless in the judgment of the superintendent the doing of such kind or combination of kinds of insurance business will not be prejudicial to the best interests of the people of this state. (g) Subsections (e) and (f) hereof shall not affect the requirements of section one thousand one hundred two of this article or section four thousand two hundred five of this chapter with respect to business done within this state. (h) Notwithstanding the provisions of subsection (c) hereof any foreign insurance company licensed to do the business of life insurance in this state continuously since January first, nineteen hundred twenty may continue to be licensed, in the discretion of the superintendent, to do the kinds of insurance business it was authorized to do immediately prior to January first, nineteen hundred forty. (i) (1) Notwithstanding any other provisions of this chapter, any foreign licensed mutual life insurer which intends to reorganize or convert to a stock life insurer shall file with the superintendent a copy of its plan of reorganization or conversion at least ninety days prior to the date of any public hearing required to be held on such a plan by the state of domicile of the insurer, or the proposed effective date of the reorganization or conversion, whichever is earlier. (2) If, after examining the plan, the superintendent finds that the plan is not fair or equitable to the New York policyholders of such insurer he shall set forth the reasons for such findings and at least fifteen days prior to such hearing, or the proposed effective date of the reorganization or conversion, whichever is earlier, notify the commissioner, superintendent or director of the state of domicile and the insurer of such findings and such reasons and advise of any requirements he finds necessary for the protection of current New York policyholders in order to permit the insurer to continue to do business in New York as a stock insurer after such reorganization or conversion. S 1107. Licenses for unincorporated insurers. (a) No individual shall be or remain licensed to write fidelity and surety insurance who, in any court of this state having criminal jurisdiction or in any criminal action or proceeding, deposits money or property as bail for another or executes as surety any bail bond. (b) No individual shall be or remain licensed to do an insurance business, as an insurer unless he is a resident of this state, complies with all requirements of this chapter as to capital, surplus, reserves, liabilities, investments, deposits and other financial requirements imposed upon insurers doing the same kinds of insurance business, confines his business exclusively to such insurance business and business authorized pursuant to the provisions of this chapter as incidental thereto, and in all respects conforms to all requirements imposed upon such insurance companies, except as to corporate existence and requirements incidental thereto. No individual insurer shall do business under a corporate or fictitious name or under any name, style or title other than the true name of such individual. (c) This section shall not affect the authority to do an insurance business conferred upon a reciprocal insurer or Lloyds underwriters pursuant to article sixty-one of this chapter. S 1108. Insurers exempt from licensing and other requirements. The following insurers, their officers, agents, representatives and employees shall be exempt from licensing and other requirements imposed by the provisions of this chapter (except article seventy-four hereof) to the extent specified below: (a) Any charitable annuity society which complies with the requirements of section one thousand one hundred ten of this article, to the extent therein stated. (b) Any fraternal benefit society, membership corporation or other organization exempted under the provisions of article forty-five of this chapter, to the extent therein stated. (c) The state insurance fund of this state, except as to the provisions of subsection (d) of section two thousand three hundred thirty-nine, section three thousand one hundred ten, subsection (a), paragraph one of subsection (b), paragraph three of subsection (c) and subsection (d) of section three thousand two hundred one, sections three thousand two hundred two, three thousand two hundred four, subsections (a) through (d) of section three thousand two hundred twenty-one, subsections (b) and (c) of section four thousand two hundred twenty-four, section four thousand two hundred twenty-six and subsections (a) and (b) and (g) through (j) of section four thousand two hundred thirty-five of this chapter and except as otherwise specifically provided by the laws of this state. (d) Any corporate trustee or board of trustees acting pursuant to the banking law in relation to the fund for insurance of deposits in savings banks or the fund for insurance of shares of savings and loan associations. (e) Any corporation, organized under the laws of any state, solely to provide gratuitously for support or relief of the priests, clergy or ministers of any religious denomination, or their dependents, is exempt from all provisions of this chapter, except that any such corporation, created by special act of incorporation of this state, which by the provisions of such act is subject to the requirement of examination by, and making annual reports to, the superintendent, shall be subject to the provisions of article three of this chapter relating to examinations and statements or reports by insurers. (f) Any retirement system or pension fund that was doing business on January first, nineteen hundred forty under the education law, the civil service law, the mental hygiene law, any special act of incorporation of this state, or any municipal charter adopted under the laws of this state, exclusively for the benefit of the members of such system or fund or for all or any classes of the employees of this state or any municipality thereof, shall be exempt from the provisions of this chapter, except that if the law under which such system or fund was organized subjects it to examination by, and the making of annual reports to, the superintendent, such system or fund shall be subject to the provisions of article three of this chapter relating to examinations and statements or reports by insurers. (g) Any membership corporation or voluntary association organized and operating in this state prior to January first, nineteen hundred thirty-nine and its members may act as indemnitors of a licensed property/casualty insurance company in respect to surety bonds or policies of insurance required to be filed by such members pursuant to section three hundred seventy of the vehicle and traffic law and are exempted from the requirement of having an insurer`s license; but no such membership corporation or association shall become a surety on any such bond or otherwise do an insurance business. (h) Any relief department or pension plan of any common carrier subject to the the Railroad Retirement Act of 1974 (45 U.S.C. S 31), whose privileges and membership are confined to employees or former employees of such carrier or its affiliated or subsidiary companies, or to any association of such common carriers which administers any such department or plan. (i) Every blood credit system established by a city, pursuant to section twenty-one-d of the general city law. S 1109. Limited exemption for health maintenance organizations. (a) An organization complying with the provisions of article forty-four of the public health law may operate without being licensed under this chapter and without being subject to any provisions of this chapter, except: (1) to the extent that such organization must comply with the provisions of this chapter by virtue of such article, and (2) the provisions of sections three hundred eight, three hundred thirteen, three hundred thirty-two, one thousand three hundred one, one thousand three hundred two, one thousand three hundred seven, two thousand one hundred three, two thousand one hundred twelve, two thousand one hundred fourteen, two thousand one hundred fifteen, two thousand one hundred seventeen, two thousand one hundred twenty-three, two thousand six hundred eight-a, three thousand two hundred twenty-four-a, four thousand three hundred eight, four thousand three hundred seventeen, four thousand three hundred eighteen, four thousand three hundred twenty, four thousand three hundred twenty-one, four thousand three hundred twenty-two and four thousand three hundred twenty-three of this chapter. (b) An organization which provides health care services for a periodic fee paid in advance but which does not comply with the provisions of article forty-four of the public health law shall be deemed to be engaged in the business of insurance and may not operate without being licensed under this chapter. (c) An organization referred to in subsection (a) or (b) hereof shall be subject to article seventy-four of this chapter. (d) A health maintenance organization may make any investment permitted for a health service corporation organized pursuant to article forty-three of this chapter provided that the superintendent, after consultation with the commissioner of health, may modify such investment requirements, if such modification would permit the organization to more effectively implement its program without incurring undue risk to its subscribers. (e) The superintendent may promulgate regulations in effectuating the purposes and provisions of this chapter and article forty-four of the public health law and may modify requirements applicable to the contracts between a health maintenance organization and its subscribers, subject to such limitations as the superintendent shall deem necessary or proper to insure the performance of such contracts. S 1110. Charitable annuity societies exempt; special permits. (a) The superintendent may, in his discretion, issue a special permit to make annuity agreements with donors to any duly organized domestic or foreign non-stock corporation or association conducted without profit and engaged in active operation for at least ten years prior thereto solely in bona fide charitable, religious, missionary, educational or philanthropic activities. The permit shall authorize such corporation or association to receive gifts of money conditioned upon, or in return for, its agreement to pay an annuity to the donor, or his nominee, and to make and carry out such annuity agreement. Every such corporation or association shall, before making such agreement, file with the superintendent copies of its forms of agreements with annuitants and a schedule of its maximum annuity rates, which shall be computed on the basis of the annuity standard adopted by it for calculating its reserves so as to return to it upon the annuitant`s death a residue at least equal to one-half the original gift or other consideration for such annuity. (b) Every such domestic corporation or association shall maintain admitted assets at least equal to the greater of (i) the sum of its reserves on its outstanding agreements, calculated in accordance with section four thousand two hundred seventeen of this chapter, and a surplus of ten per centum of such reserves, or (ii) the amount of one hundred thousand dollars. In determining such reserves a deduction shall be made for all or any portion of an annuity risk which is reinsured by a life insurance company authorized to do business in this state. The required admitted assets shall be invested in accordance with the prudent investor standard as defined in section 11-2.3 of the estates, powers and trusts law and shall not be subject to the investment limitations set forth in this chapter. Such assets shall be segregated as separate and distinct funds, independent of all other funds of such corporation or association, and shall not be applied to pay its debts and obligations or for any purpose except the aforesaid annuity benefits. (c) No such corporation or association organized under the laws of another state shall be permitted to make such annuity agreements in this state unless it complies with all requirements of this section imposed upon like domestic corporations or associations. (d) No such corporation or association shall make or issue in this state any annuity contract before obtaining a permit issued in accordance with the provisions of this section except that if its requisite reserve on its outstanding annuity agreements computed in accordance with section four thousand two hundred seventeen of this chapter does not exceed the amount of five hundred thousand dollars, it may make gift annuity agreements in this state and shall be exempted from securing a permit provided it maintains the reserve required by section four thousand two hundred seventeen of this chapter and a surplus of at least twenty-five per centum of such reserve. If the superintendent finds, after notice and hearing, that any such corporation or association, having such a permit, has failed to comply with the requirements of this section, he may revoke or suspend such permit or order it to cease making new annuity contracts until it complies. The superintendent may, in his discretion, either dispense with the requirement of annual statements by such corporations or associations or accept a sworn statement by two or more of its principal officers, in such form as will satisfy the superintendent that the requirements of this section are being complied with. (e) Except as provided in this section every such corporation or association shall be exempt from the provisions of this chapter, other than articles one, two, three, twenty-five and seventy-four of this chapter. S 1111. Compulsory insurance; bonds of surety companies; certificates of qualification. (a) Whenever by any law of this state any policy or contract of insurance is required, or is acceptable in lieu of any other requirement imposed by such law, the superintendent may, upon written request containing such information as he deems necessary, issue to any person a certificate of qualification, stating the qualification of any insurer authorized to do such business in this state if he finds that, as shown by the insurer`s last filed annual statement or last filed report on examination, whichever is later, the insurer is solvent, responsible and otherwise qualified to make policies or contracts of the kind required. No insurer authorized to do business in this state shall issue or make any policy or contract of insurance or surety bond to owners or operators of motor vehicles as required by the provisions of the vehicle and traffic law of this state, unless the superintendent shall have certified to the commissioner of motor vehicles that such insurer is qualified to issue such policy or contract, in the manner specified herein. (b) (1) Whenever by any law of this state a bond, undertaking, recognizance, guaranty or like obligation is required, permitted, authorized or allowed, or the performance of any act, duty or obligation, or the refraining from any act, is required, permitted, authorized or allowed to be secured or guaranteed, such bond or like obligation, or such security or guaranty, may be executed by any insurance company authorized to do in this state the business of executing such instruments and empowered by its charter to execute them. The insurer`s execution of such instrument by its officer, attorney-in-fact or other authorized representative shall be accepted as, and in all respects shall be, a full compliance with every law or other requirement, now or hereafter in force, that any such obligation be given or accepted or that it be executed by one or more sureties, or that such sureties be residents, householders or freeholders, or possess any other qualifications. (2) The superintendent may on written application issue to any company his certificate of qualification stating the company`s capital and surplus as shown by its last annual statement or its last filed report on examination, whichever is later, and that such capital and surplus complies with the requirements of this chapter. The certificate shall further indicate the limitation upon the amount of a single risk which such company is authorized to assume. (c) The superintendent may refuse to issue any certificate pursuant to subsection (a) or (b) hereof if in his judgment refusal will best promote the interests of the people of this state. Such certificate, or a copy certified by the superintendent, shall be conclusive evidence, as of its date and thereafter until revoked, of either the insurer`s qualification to issue the policy, contract of insurance or surety bond, if issued pursuant to subsection (a) hereof, or the company`s qualification, and its sufficiency under any law of this state as surety or guarantor, and of the propriety of accepting and approving it as such, if issued pursuant to subsection (b) hereof, and this certification shall be in lieu of any justification required of the insurer by any law of this state or any requirement pursuant thereto. (d) If after notice to and hearing of any insurer the superintendent finds the insurer is no longer entitled to obtain a certificate, he may revoke it by filing an order of revocation in his office. He shall thereupon serve a copy of such order on the insurer and shall give notice of the revocation to any state official or board to whom the certificate was issued. The superintendent may publish notice of such revocation in such newspapers of general circulation in this state as he may deem proper in the public interest. No insurer and no officer, attorney-in-fact or other representative thereof shall, after receiving notice of revocation, make or execute, or hold itself out as authorized to make or execute, in this state, any policy, contract of insurance, bond or like obligation, or security or guaranty specified in subsection (a) or (b) hereof, as long as such revocation continues in effect. S 1112. Reciprocal provisions as to taxes, license fees, deposits, and other requirements. (a) (1) If, by the laws, or the action of any public official, of any other state, any insurer organized or domiciled in this state, or its duly authorized agents, shall be, required to deposit securities in such other state to protect policyholders or for any other purpose, or shall be required to pay taxes, fines, penalties, fees for licenses or certificates of authority or any other sum for the privilege of doing business in such other state, or shall be subjected to any restrictions, obligations, conditions or penalties, imposed for such privilege, and such requirements are greater than those required of similar insurers organized or domiciled in such other state by the laws of this state for the privilege of doing business herein, then all similar insurers organized or domiciled in such other state and their duly authorized agents in this state shall make like deposits for like purposes with the superintendent, and pay him for taxes, fines, penalties, fees for licenses or certificates of authority or for any other requirement for the privilege of doing business in this state, an amount determined in the manner prescribed by such other state, and shall be subjected to such greater requirements imposed by such other state upon similar insurers of this state and their duly authorized agents. (2) (i) For the amount due under this subsection for the calendar year nineteen hundred eighty-nine, an initial payment shall be made by each insurer subject to this subsection of an amount equal to the lesser of (a) ninety percent of the amount finally determined to be due under this subsection for the calendar year nineteen hundred eighty-seven or (b) eighty percent of the amount finally determined to be due under this subsection for the calendar year nineteen hundred eighty-nine. Such initial payment shall be made on or before March fifteenth, nineteen hundred ninety. (ii) For the amount due under this subsection for calendar years after nineteen hundred eighty-nine, an estimated payment shall be due and payable on or before the fifteenth day of December. This payment shall be equal to the lesser of (a) ninety percent of the amount finally determined to be due under this subsection for the second preceding calendar year or (b) eighty percent of the amount finally determined to be due under this subsection for the calendar year. * (iii) If any insurer fails to pay all or any part of the initial payment or estimated payment due pursuant to subparagraph (i) or (ii) of this paragraph, it shall be deemed to have made an underpayment. There shall be added to the amount due pursuant to paragraph one of this subsection, an amount at the rate set for underpayments by the commissioner of taxation and finance pursuant to section one thousand ninety-six of the tax law, or if no rate is set, at the rate of six percent per annum upon the amount of the underpayment for the period of the underpayment. In computing the amount of any interest required to be paid, such interest shall not be compounded. The amount of the underpayment shall be, with respect to the initial payment or any estimated payment, the excess of the amount required to be paid over the amount, if any, paid on or before the last day prescribed for such payment. If the superintendent demands payment of the initial payment or any estimated payment, and if such amount is paid within ten days after the date of such demand, interest on the amount so paid shall not be imposed for the period after the date of such demand. No portion of the interest imposed pursuant to this subparagraph may be waived. * NB Effective until April 1, 2003 * (iii) If any insurer fails to pay all or any part of the initial payment or estimated payment due pursuant to subparagraph (i) or (ii) of this paragraph, it shall be deemed to have made an underpayment. There shall be added to the amount due pursuant to paragraph one of this subsection, an amount at the rate set for underpayments by the commissioner of taxation and finance pursuant to section one thousand ninety-six of the tax law, minus two percentage points, or if no rate is set, at the rate of six percent per annum upon the amount of the underpayment for the period of the underpayment. In computing the amount of any interest required to be paid, such interest shall not be compounded. The amount of the underpayment shall be, with respect to the initial payment or any estimated payment, the excess of the amount required to be paid over the amount, if any, paid on or before the last day prescribed for such payment. If the superintendent demands payment of the initial payment or any estimated payment, and if such amount is paid within ten days after the date of such demand, interest on the amount so paid shall not be imposed for the period after the date of such demand. No portion of the interest imposed pursuant to this subparagraph may be waived. * NB Effective April 1, 2003. Applies to interest chargeable on or after April 1, 2003 (iv) Notwithstanding the provisions of section sixteen of the state finance law, interest shall be allowed and paid at the rate set for overpayments by the commissioner of taxation and finance pursuant to section one thousand ninety-six of the tax law, or if no rate is set, at the rate of six percent per annum upon any overpayment, from the date payment was due to a date (to be determined by the superintendent) preceding the date of a refund check by not more than thirty days. In the case of a payment which is made after the last date prescribed for payment of such payment, no interest shall be allowed or paid for any day before the date on which the payment was made. In computing the amount of interest required to be paid, such interest shall not be compounded. No interest shall be allowed or paid if the amount thereof is less than one dollar. (v) If the period for which the amount is imposed pursuant to paragraph one of this subsection is less than twelve months, every insurer shall make estimated payments in accordance with regulations of the superintendent. (b) If the superintendent finds that by the laws or official acts of any foreign country, insurers organized in this state are arbitrarily denied the privilege of doing business in such foreign country, or are subjected to unreasonable requirements therein, he may revoke the licenses of all insurers of such country doing business in this state, and may refuse to issue licenses to every insurer of such country thereafter applying for a license to do business in this state, or in lieu thereof, he may impose like requirements upon every insurer of such country, until he shall find that such arbitrary denial or unreasonable requirements no longer apply. (c) If, by the existing or future laws of any other state, any broker resident within this state and duly licensed as such under this chapter may not be licensed as a broker in such other state, then no broker resident in such other state shall be licensed as a broker within this state, anything in this chapter to the contrary notwithstanding. If a license fee exceeding twenty dollars per annum is imposed by any other state for issuing a license to a broker resident within this state, or the amount of commissions which may be paid to such broker on premiums on risks located in any other state shall be limited under the laws of such state, then, all brokers resident in such other state shall upon being licensed in this state pay a like fee in lieu of that prescribed by this chapter, and insurance companies authorized to transact business in this state shall not pay to any such nonresident broker any commissions on premiums on risks located in this state exceeding those which the laws of such other state permit brokers of this state to receive on premiums on risks located in such other state. * (d) (1) Should the insurance department, commissioner, director, or other similar insurance regulatory official of any other state or territory of the United States impose any sanctions, fines, penalties, financial or deposit requirements, prohibitions, restrictions, regulatory requirements, or other obligations of any kind upon any insurance company organized or chartered in this state and licensed to transact business in such other state or territory, because of the failure of the New York insurance department to obtain, maintain, or receive accreditation certification or any similar form of approval, compliance, or acceptance from, by, or as a member of the National Association of Insurance Commissioners, or any committee, task force, working group, or advisory committee thereof, or because of the failure of the department to comply with any directive, financial annual statement requirement, model act or regulation, market conduct or financial examination report or requirement, or any report of any kind of the National Association of Insurance Commissioners, or any committee, task force, working group, or advisory committee thereof, the superintendent shall without exception or exclusion, impose upon any and all insurance companies organized or chartered in such other state or territory and licensed to do business in this state the same sanctions, fines, penalties, financial or deposit requirements, prohibitions, restrictions, regulatory requirements, or other obligations imposed upon the insurance companies of this state. (2) To the extent that it would be detrimental to the adequate and proper regulation of insurance in this state to use existing employees or resources of the department in order to comply in a timely manner with paragraph (1) of this subsection, the superintendent may engage such other qualified persons and services as may be necessary. The superintendent shall recover all of the costs of such compliance in the manner prescribed in section 313 of the insurance law. * NB Expired March 31, 1995 * (e) The provisions of this section shall not apply to insurance companies organized or domiciled in a state or country whose laws do not impose retaliatory taxes or other charges or which grant, on a reciprocal basis, exemptions therefrom to insurance companies organized or domiciled in this state. * NB Expired March 31, 1995, relettering expired on such date is actually (d) from 367/84 on such date S 1112-a. Reports. On or before March first of each year the superintendent shall report the amounts imposed and required to be paid pursuant to section twenty-eight hundred seven-t of the public health law that are allowed on returns filed during the preceding calendar year as credits in assessing the taxes imposed by section one thousand one hundred twelve of this chapter. Such report shall also include the amount, if any, by which taxes due and owing pursuant to such section one thousand one hundred twelve have been reduced because of the allowance of such credits. Such report shall be provided to the director of the budget and the commissioner of health. S 1113. Kinds of insurance authorized. (a) The kinds of insurance which may be authorized in this state, subject to other provisions of this chapter, and their scope, are set forth in the following paragraphs. The power to do any kind of insurance against loss of or damage to property shall include the power to insure all lawful interests in such property and to insure against loss of use and occupancy, rents and profits resulting therefrom. No kind of insurance shall include life insurance, title insurance or insurance against legal liability for personal injury or death unless specified in this section. In addition to any power specifically conferred by this chapter to engage in any other kind of business than an insurance business, any insurer authorized to do business in this state may engage in other kinds of business to the extent necessarily or properly incidental to the kinds of insurance business it is authorized to do in this state. (1) "Life Insurance," means every insurance upon the lives of human beings, and every insurance appertaining thereto, including the granting of endowment benefits, additional benefits in the event of death by accident, additional benefits to safeguard the contract from lapse, accelerated payments of part or all of the death benefit or a special surrender value upon (A) diagnosis of terminal illness defined as a life expectancy of twelve months or less, (B) diagnosis of a medical condition requiring extraordinary medical care or treatment regardless of life expectancy, (C) 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 as defined by Section 7702(B) of the Internal Revenue Code and regulations thereunder, 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, or (D) certification by a licensed health care practitioner that the insured is chronically ill as defined by Section 7702 (B) of the Internal Revenue Code and regulations thereunder, 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 and the insurer that issues such policy is a qualified long term care insurance carrier under Section 4980c of the Internal Revenue Code or provide a special surrender value, upon total and permanent disability of the insured, and optional modes of settlement of proceeds. "Life insurance" also includes additional benefits to safeguard the contract against lapse in the event of unemployment of the insured. Amounts paid the insurer for life insurance and proceeds applied under optional modes of settlement or under dividend options may be allocated by the insurer to one or more separate accounts pursuant to section four thousand two hundred forty of this chapter. (2) "Annuities," means all agreements to make periodical payments for a period certain or where the making or continuance of all or some of a series of such payments, or the amount of any such payment, depends upon the continuance of human life, except payments made under the authority of paragraph one hereof. Amounts paid the insurer to provide annuities and proceeds applied under optional modes of settlement or under dividend options may be allocated by the insurer to one or more separate accounts pursuant to section four thousand two hundred forty of this chapter. (3) "Accident and health insurance," means (i) insurance against death or personal injury by accident or by any specified kind or kinds of accident and insurance against sickness, ailment or bodily injury, including insurance providing disability benefits pursuant to article nine of the workers` compensation law, except as specified in item (ii) hereof; and (ii) non-cancellable disability insurance, meaning insurance against disability resulting from sickness, ailment or bodily injury (but excluding insurance solely against accidental injury) under any contract which does not give the insurer the option to cancel or otherwise terminate the contract at or after one year from its effective date or renewal date. (4) "Fire insurance," means insurance against loss of or damage to any property resulting from fire, including loss or damage incident to the extinguishment of a fire or to the salvaging of property in connection therewith. (5) "Miscellaneous property insurance," means loss of or damage to property resulting from: (A) lightning, smoke or smudge, windstorm, tornado, cyclone, earthquake, volcanic eruption, rain, hail, frost and freeze, weather or climatic conditions, excess or deficiency of moisture, flood, the rising of the waters of the ocean or its tributaries; (B) insects, or blights, or disease of such property except animals; (C) electrical disturbance causing or concomitant with a fire or an explosion in public service or public utility property; (D) bombardment, invasion, insurrection, riot, civil war or commotion, military or usurped power, any order of a civil authority made to prevent the spread of a conflagration, epidemic or catastrophe, vandalism or malicious mischief, strike or lockout, collapse from any cause, or explosion; but excluding any kind of insurance specified in paragraph nine hereof, except insurance against loss of or damage to property resulting from: (i) explosion of pressure vessels (except steam boilers of more than fifteen pounds pressure) in buildings designed and used solely for residential purposes by not more than four families, (ii) explosion of any kind originating outside of the insured building or outside of the building containing the property insured, (iii) explosion of pressure vessels which do not contain steam or which are not operated with steam coils or steam jackets, or (iv) electrical disturbance causing or concomitant with an explosion in public service or public utility property; or (E) lateral or vertical subsidence of the earth caused by past or present mining operations. (6) "Water damage insurance," means insurance against loss or damage by water or other fluid or substance to any property resulting from the breakage or leakage of sprinklers, pumps or other apparatus erected for extinguishing fires or of water pipes or other conduits or containers, or resulting from casual water entering through leaks or openings in buildings or by seepage through building walls, but excluding loss or damage resulting from flood or the rising of the waters of the ocean or its tributaries; and including insurance against accidental injury of such sprinklers, pumps, fire apparatus, conduits or containers.
(7) "Burglary and theft insurance," means: (A) Insurance against loss of or damage to any property resulting from burglary, theft, larceny, robbery, forgery, fraud, vandalism, malicious mischief, confiscation or wrongful conversion, disposal or concealment by any person, or from any attempt thereof; (B) Insurance against loss of or damage to moneys, coins, bullion, securities, notes, drafts, acceptances or any other valuable papers or documents, resulting from any cause, except while in the custody or possession of and being transported by any carrier for hire or in the mail; and (C) Insurance of individuals by means of an all-risk type of policy commonly known as the "Personal Property Floater" against any kind and all kinds of loss of or damage to, or loss of use of, any personal property other than merchandise. (8) "Glass insurance," means insurance against loss of or damage to glass and its appurtenances resulting from any cause. (9) "Boiler and machinery insurance," means insurance against loss of or damage to any property of the insured, resulting from explosion of or injury to: (A) any boiler, heater or other fired pressure vessel; (B) any unfired pressure vessel; (C) pipes or containers connected with any such boilers or vessels; (D) any engine, turbine, compressor, pump or wheel; (E) any apparatus generating, transmitting or using electricity; or (F) any other machinery or apparatus connected with or operated by any such boilers, vessels or machines; and including the incidental power to make inspections of, and issue certificates of inspection upon, any such boilers, apparatus, and machinery, whether insured or otherwise. (10) "Elevator insurance," means insurance against loss of or damage to any property of the insured, resulting from ownership, maintenance or use of elevators, except loss or damage by fire. (11) "Animal insurance," means insurance against loss of or damage to any domesticated or wild animal resulting from any cause. (12) "Collision insurance," means insurance against loss of or damage to any property of the insured resulting from collision of any other object with such property, but excluding collision to or by elevators, or to or by vessels, craft, piers or other instrumentalities of ocean or inland navigation. (13) "Personal injury liability insurance," means insurance against legal liability of the insured, and against loss, damage or expense incident to a claim of such liability (including the insurer`s obligation to pay medical, hospital, surgical and disability benefits to injured persons, and funeral and death benefits to dependents, beneficiaries or personal representatives of persons who are killed, irrespective of legal liability of the insured), arising out of death or injury of any person, or arising out of injury to the economic interests of any person, as the result of negligence in rendering expert, fiduciary or professional service, but excluding any kind of insurance specified in paragraph fifteen except insurance to protect an insured against liability for indemnification or contribution to a third party held responsible for injury to the insured`s employee arising out of and in the course of employment when such insurance is written pursuant to this paragraph and not written pursuant to paragraph fifteen of this subsection. (14) "Property damage liability insurance," means insurance against legal liability of the insured, and against loss, damage or expense incident to a claim of such liability, arising out of the loss or destruction of, or damage to, the property of any other person, but not including any kind of insurance specified in paragraph thirteen, fifteen or twenty-eight of this subsection. (15) "Workers` compensation and employers` liability insurance," means insurance against the legal liability, under common law or statute or assumed by contract, of any employer for the death or disablement of, or injury to, his employee, including volunteer firefighters` benefit insurance provided pursuant to the volunteer firefighters` benefit law and including volunteer ambulance workers` benefit insurance provided pursuant to the volunteer ambulance workers` benefit law. (16) "Fidelity and surety insurance," means: (A) Guaranteeing the fidelity of persons holding positions of public or private trust; and indemnifying banks, thrifts, brokers and other financial institutions against loss of money, securities, negotiable instruments, other specified valuable papers and tangible items of personal property caused by larceny, misplacement, destruction or other stated perils including loss while being transported in an armored motor vehicle or by messenger; and insurance for loss caused by the forgery of signatures on, or alteration of, specified documents and valuable papers; (B) Insurance against losses that financial institutions become legally obligated to pay by reason of loss of customers` property from safe deposit boxes; (C) Any contract bond; including a bid, payment or maintenance bond or a performance bond where the bond is guaranteeing the execution of any contract other than a contract of indebtedness or other monetary obligation; (D) An indemnity bond for the benefit of a public body, railroad or charitable organization; a lost security or utility payment bond; (E) Becoming surety on, or guaranteeing the performance of, any lawful contract, not specifically provided for in this paragraph, except (i) mortgage guaranty insurance, which may only be written by an insurer authorized to write such insurance pursuant to article sixty-five of this chapter, (ii) a contract that falls within the definition of financial guaranty insurance as set forth in paragraph one of subsection (a) of section six thousand nine hundred one of this chapter, (iii) any insurance contract unless such guaranty is authorized pursuant to subsection (c) of section one thousand one hundred fourteen of this article; or (iv) service contract reimbursement insurance as specified in paragraph twenty-eight of this subsection; (F) Becoming surety on, or guaranteeing the performance of, bonds and undertakings required or permitted in all judicial proceedings or otherwise by law allowed, including surety bonds accepted by states and municipal authorities in lieu of deposits as security for the performance of insurance contracts; and (G) Becoming surety on, or guaranteeing the performance of, a bond, which shall not exceed a period greater than five years, that guarantees the payment of a premium, deductible, or self-insured retention to an insurer issuing a workers` compensation or liability policy. In this chapter "fidelity" insurance shall have the meaning set forth in subparagraphs (A) and (B) of this paragraph. (17) "Credit insurance," means: (A) Indemnifying merchants or other persons extending credit against loss or damage resulting from non-payment of debts owed to them, for goods and services provided in the normal course of their business, including the incidental power to acquire and dispose of debts so insured, and to collect any debts owed to such insurer or to the insured, but no insurance may be written as credit insurance if it falls within the definition of financial guaranty insurance as set forth in paragraph one of subsection (a) of section six thousand nine hundred one of this chapter; (B) Indemnifying any person for expenses disbursed or to be disbursed under a contract in connection with the cancellation of a catered affair; (C) Indemnifying any person for tuition expenses disbursed or to be disbursed under a contract in connection with his dismissal or withdrawal from an educational institution; or indemnifying elementary or secondary schools, whether public, private, profit or non-profit, providing education in consideration of a tuition charge or fee against loss or damage in the event of non-payment of the tuition charges or fees of a student or pupil dismissed, withdrawn or leaving before the end of the school year for which the insurance is written. An educational institution may not require any person responsible for the payment of a student`s or pupil`s tuition charge or fee to pay for tuition refund insurance; (D) Indemnifying an adoptive parent for verifiable expenses not prohibited under the law paid to or on behalf of the birth mother when either one or both of the birth parents of the child withdraw or withhold their consent to adoption. Such expenses may include maternity-connected medical or hospital expenses of the birth mother, necessary living expenses of the birth mother preceding and during confinement, travel expenses of the birth mother to arrange for the adoption of the child, legal fees of the birth mother, and any other expenses which an adoptive parent may lawfully pay to or on behalf of the birth mother. For the purposes of this section "adoptive parent" means the parent or his or her spouse seeking to adopt a child, "birth mother" means the biological mother of the child, "birth parent" means the biological mother or biological father of the child; or (E) Indemnifying professional sports participants (including any person who participates or expects to participate as a player, coach, manager, trainer, physician or other person directly associated with a player or a team) under contract or the teams with which the contract is made, entertainers under contract to perform or the entities with which the contract is made, or business executives under an employment contract or the entities with which the contract is made, where contracts between such persons and teams or entities cannot be fulfilled due to a sports participant`s, entertainer`s or business executive`s death, personal injury by accident, sickness, ailment or bodily injury that causes disability, where such indemnification is for the amount of financial loss that is sustained by the insured party or parties due to the inability to fulfill the terms of the contract. (18) "Title insurance," means insuring owners of, and other persons lawfully interested in, real property and chattels real against loss by reason of defective titles and encumbrances and insuring the correctness of searches for all instruments, liens or charges affecting the title to such property, including power to procure and furnish information relative thereto, and such other incidental powers as are specifically granted in this chapter. (19) "Motor vehicle and aircraft physical damage insurance," means insurance against loss of or damage to motor vehicles or aircraft and their equipment resulting from any cause; and insurance reimbursing a driver for costs including replacement car rental, commercial transportation and accommodations resulting from an automobile accident or mechanical breakdown occurring fifty miles or more from the driver`s principal place of residence or garaging. (20) "Marine and inland marine insurance," means insurance against any and all kinds of loss of or damage to: (A) Vessels, hulls, craft, aircraft, cars, automobiles, trailers and vehicles of every kind, and all goods, freights, cargoes, merchandise, effects, disbursements, profits, moneys, bullion, precious stones, securities, choses in action, evidences of debt, valuable papers, bottomry and respondentia interests and all other kinds of property and interests therein, in respect to, appertaining to or in connection with any and all risks or perils of navigation, transit, or transportation, including war risks, on or under any seas or other waters, on land or in the air, or while being assembled, packed, crated, baled, compressed or similarly prepared for shipment or while awaiting the same or during any delays, storage, transshipment, or reshipment incident thereto, including marine builder`s risks and all personal property floater risks; (B) Person or property in connection with or appertaining to marine, inland marine, transit or transportation insurance, including liability for loss of or damage to either, arising out of or in connection with the construction, repair, operation, maintenance or use of the subject matter of such insurance (but not including life insurance or surety bonds nor insurance against loss by reason of bodily injury to the person arising out of ownership, maintenance or use of automobiles); (C) Precious stones, jewels, jewelry, gold, silver and other precious metals, whether used in business or trade or otherwise and whether the same be in course of transportation or otherwise; and (D) Bridges, tunnels and other instrumentalities of transportation and communication (excluding buildings, their improvements and betterments, furniture and furnishings, fixed contents and supplies held in storage), including auxiliary facilities and equipment attendant thereto; piers, wharves, docks and slips; other aids to navigation and transportation, including dry docks and marine railways. In this chapter "inland marine" insurance shall not include insurance of vessels, crafts, their cargoes, marine builders` risks, or other similar risks, commonly insured only under ocean marine insurance policies. (21) "Marine protection and indemnity insurance," means insurance against, or against legal liability of the insured for, loss, damage or expense arising out of, or incident to, the ownership, operation, chartering, maintenance, use, repair or construction of any vessel, craft or instrumentality in use in ocean or inland waterways, including liability of the insured for personal injury, illness or death or for loss of or damage to the property of another person. (22) "Residual value insurance" means insurance issued in connection with a lease or contract which sets forth a specific termination value at the end of the term of the lease or contract for the property covered by such lease or contract, and which insures against loss of economic value of tangible personal property or real property or improvements thereto except loss due to physical damage to property, excluding any lease or contract that falls within the definition of financial guaranty insurance as set forth in paragraph one of subsection (a) of section six thousand nine hundred one of this chapter. (23) "Mortgage guaranty insurance," means the kind of insurance specified in section six thousand five hundred one of this chapter. (24) "Credit unemployment insurance" means insurance on a debtor in connection with a specified loan or other credit transaction within the state to provide payments to a creditor in the event of unemployment of the debtor for the installments or other periodic payments becoming due while a debtor is unemployed. (25) "Financial guaranty insurance," means the kind of insurance defined in paragraph one of subsection (a) of section six thousand nine hundred one of this chapter. (26) "Gap insurance" means insurance covering the gap amount which is payable upon the total loss of personal property, which is the subject of a lease or loan or other credit transaction occasioned by its theft or physical damage. The kinds of gap insurance are: (A) "Motor vehicle lessor/creditor gap insurance" which insures the lessor, creditor, or the lessor`s or creditor`s assignee, under a motor vehicle lease or loan or other credit transaction pursuant to which the lessor, creditor, or, in the absence of a waiver by the lessor or creditor, the assignee has waived the obligation of the lessee or debtor for the gap amount; (B) "Motor vehicle lessee/debtor gap insurance" which insures the lessee or debtor under a motor vehicle lease or loan or other credit transaction pursuant to which the lessor, creditor, or the lessor`s or creditor`s assignee has not waived the obligation of the lessee or debtor for the gap amount; (C) "Non-motor vehicle lessor/creditor gap insurance" which insures the lessor, creditor, or the lessor`s or creditor`s assignee, under a lease or loan or other credit transaction covering personal property other than a motor vehicle pursuant to which the lessor, creditor, or, in the absence of a waiver by the lessor or creditor, the assignee, has waived the obligation of the lessee or debtor for the gap amount; and (D) "Non-motor vehicle lessee/debtor gap insurance" which insures the lessee or debtor under a lease or loan or other credit transaction covering personal property other than a motor vehicle pursuant to which the lessor, creditor, or the lessor`s or creditor`s assignee has not waived the obligation of the lessee or debtor for the gap amount. (27) "Prize indemnification insurance," means insurance against financial loss by reason of payment of any sum or item awarded to a participant in any lawful contest or sports related event. (28) "Service contract reimbursement insurance" means insurance issued to a provider pursuant to article seventy-nine of this chapter whereby the insurer agrees, for the benefit of service contract holders, to discharge the obligations and liabilities of such provider under the terms of the service contracts issued by such provider, including the return of unearned provider fees upon any termination or cancellation of service contracts, in the event of non-performance of any such obligations or liabilities by such provider. Such insurance may also include insurance issued to a provider to indemnify the provider for losses sustained by reason of the performance of such provider`s obligations under service contracts issued pursuant to article seventy-nine of this chapter. (29) "Legal services insurance" means insurance providing legal services or reimbursement of the cost of legal services. (30) "Substantially similar kind of insurance," means such insurance which in the opinion of the superintendent is determined to be substantially similar to one of the foregoing kinds of insurance and thereupon for the purposes of this chapter shall be deemed to be included in that kind of insurance. (b) Nothing herein contained shall require any insurer to insure every kind of risk which it is authorized to insure. S 1114. Reinsurance business. (a) Any domestic stock or mutual insurance corporation or reciprocal insurer may reinsure only the kinds of insurance business which it is licensed to do in this state or which it is otherwise authorized to reinsure by the terms of its license. Any such corporation may confine its business to reinsurance. (b) Any foreign or alien stock or mutual insurance corporation or reciprocal insurer may engage in this state in reinsurance of the kinds of insurance which it is licensed to do in this state. Any such corporation may confine its business to reinsurance. (c) An insurer authorized by any provision of this chapter to engage in fidelity and surety insurance or reinsurance business may also guarantee performance of a contract insuring against physical damage to property in favor of mortgagees or other loss payees named in such contract, provided: (1) It is authorized to engage in the kinds of insurance included in such contract; (2) It has assumed reinsurance on the guaranteed contract in whole or in part; (3) It is charged with such amount as part of its unearned premium reserve as may be prescribed by regulation of the superintendent not exceeding the amount it would be required to maintain in accordance with the provisions of this chapter if it were the direct insurer of the guaranteed risks; and (4) If the property is located in this state, the ceding insurer is licensed to engage in the kinds of insurance included in such contracts. (d) An insurer authorized by any provision of this chapter to do business of the kinds referred to in paragraph one, two or three of subsection (a) of section one thousand one hundred thirteen of this article may also reinsure, by itself, or together with other insurance companies subject to any regulations of the superintendent, any risk referred to in such subsection arising from, related to, or incident to the manufacture, ownership or operation of aircraft. (e) Any health service corporation organized under article forty-three of this chapter is authorized to engage in reinsurance of policies of: (1) any other corporation organized under article forty-three of this chapter; (2) any health maintenance organization organized under article forty-four of the public health law; and (3) long term care insurance issued by accident and health insurers organized under article forty-two of this chapter. S 1115. Limitation of risk, in general. (a) Except as otherwise provided in this chapter, no insurer doing business in this state shall expose itself to any loss on any one risk in an amount exceeding ten percent of its surplus to policyholders. In determining the amount of risk, any portion reinsured in an assuming insurer authorized to do such business in this state or in an accredited reinsurer, as defined in subsection (a) of section one hundred seven of this chapter, shall be deducted. In determining the limitation of risk under any provision of this chapter, "surplus to policyholders" shall include voluntary reserves, or any part thereof, not required by law, and be determined from the insurer`s last sworn statement on file with the superintendent, or the last report on examination filed by the superintendent, whichever is more recent at the time the risk is assumed. In applying the limitation under any provision of this chapter to alien insurers, such provision shall be deemed to refer to the exposure to risk and to the surplus to policyholders of the United States branch of such alien insurer. (b) This section shall not apply to the insurance of marine risks, marine protection and indemnity risks, workers` compensation, employers` liability risks, mortgage guaranty risks, financial guaranty risks, risks insured for any dollar level of first party benefits provided pursuant to article fifty-one of this chapter, certificates of title, guaranties of title or policies of title insurance. (c) (1) An insurer, selling residual value insurance in this state must at all times maintain surplus to policyholders in the aggregate amount of no less than: (i) 0.3333 percent or 1/300th of the aggregate net liability under guaranties of commercial real estate; (ii) 0.6666 percent or 1/150th of the aggregate net liability under guaranties of commercial transportation, to include, but not inclusively, aircraft, helicopters, vessels and railcars; (iii) one percent or 1/100th of the aggregate net liability under guaranties of commercial industrial equipment; (iv) with regard to all other residual value guarantees, four percent or 1/25th of the aggregate net liability under such guarantees. For purposes of subparagraphs (i) through (iv) of this paragraph residual value is defined as set forth in paragraph twenty-two of subsection (a) of section one thousand one hundred thirteen of this article including financial transactions demonstrated to the satisfaction of the superintendent to be the functional equivalent thereof. (2) An insurer, selling residual value insurance in this state shall limit its exposure on any one risk, net of collateral and reinsurance to an amount not to exceed ten percent of the aggregate of the insurer`s surplus to policyholders. For the purposes of this section reinsurance must be placed with an authorized or accredited reinsurer in New York state. The credit for collateral shall not exceed fifty percent of the appraised value of the underlying asset at the date in the future that the value of the property is guaranteed. S 1116. Prepaid legal services plans and legal services insurance. (a) (1) An authorized insurer subject to the provisions of this chapter (except an insurer organized to write the kinds of insurance specified in paragraph eighteen, twenty-three or twenty-five of subsection (a) of section one thousand one hundred thirteen of this article or any corporation licensed or organized pursuant to article sixty-six of this chapter) may, if licensed to transact legal services insurance, as defined in paragraph twenty-nine of subsection (a) of section one thousand one hundred thirteen of this article, be authorized by the superintendent to issue contracts of legal services in connection with a prepaid legal services plan, if such plans satisfy the criteria set forth in subsection (b) of this section and the superintendent makes the determinations set forth in subsection (g) of this section. The provisions of this section shall be applicable to a corporation organized pursuant to article forty-three of this chapter only if the proposed plan and method of operations have been approved by a vote of at least two-thirds of the corporation`s board of directors before the plan is submitted to the superintendent. (2) A prepaid legal services plan may include legal services insurance as part of the plan, provided however, not more than an incidental amount of the premium with respect to such prepaid legal services plan shall be attributable to legal services for defense only coverages for commercial or other business related lawsuits or arbitration proceedings commenced against the business entity that purchased the policy. (3) Legal services insurance may not be written except (i) in conjunction with prepaid legal services plans as authorized in this section, or (ii) pursuant to a regulation promulgated by the superintendent permitting legal services insurance to be written as part of a policy of liability insurance covering related risks and, provided further, that legal services for defense only coverages for commercial or other business related lawsuits or arbitration proceedings commenced against the business entity that purchased the policy is not more than an incidental part of such liability insurance. (b) The superintendent may, in accordance with the provisions of article twenty-three of this chapter, authorize the issuance of contracts in connection with a prepaid legal services plan when such plan satisfies the following criteria: (1) its provisions are not misleading, confusing or inconsistent with the needs of the public; (2) it avoids interference with judicial supervision over the professional and public obligations of lawyers; (3) it provides for prompt resolution of grievances concerning benefits; (4) it does not restrict the beneficiary`s choice of attorney, provided, however, that compensation by the plan for attorneys not participating in the plan shall be subject to the schedule of benefits and fee structure set forth in the applicable contract and, provided further, that nothing herein shall be construed as prohibiting an attorney who is not participating in the plan from charging a fee for services provided in excess of the schedule of benefits or fee structure set forth in the applicable contract; (5) it provides for a broad range of legal services, through personal and telephone consultations, such as wills, residential real estate matters and domestic relations matters, provided nothing herein shall require or prohibit the offering of a particular type of legal services by a prepaid legal services plan; (6) it provides for written disclosure to contract holders, including a description of the schedule of benefits, fee structure, exclusions or other limitations on benefits, and an explanation of a covered person`s financial responsibility for the payment of premiums, co-payments, deductibles or amounts charged in excess of the schedule of benefits or fee structure by attorneys not participating in a plan; (7) unless it provides for a shorter period, as provided in a paragraph two of subsection (d) of section three thousand four hundred twenty-six of this chapter, or for a longer period, the plan shall be issued or renewed for a one-year policy period; (8) it 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 chapter upon no less than fifteen days written notice to a contract holder and shall include no less than a fifteen-day grace period in the event of a cancellation based on non-payment of premium, provided, however, in the event a contract is issued on a group basis, an individual group member may be canceled upon termination of his or her employment with or membership in the group contract holder; (9) it may be nonrenewed by an insurer for any reason upon at least forty-five, but not more than sixty, days written notice to a contract holder; and (10) it may be cancelled by a contract holder for any reason upon thirty days written notice to an insurer. (c) The contracts may be issued on a group basis subject to regulations promulgated by the superintendent. (d) Such contracts shall be subject to all other applicable provisions of this chapter and regulations thereunder. (e) The superintendent may permit an authorized insurer subject to the provisions of this section to enter into contracts with any corporation or other organization, which provides or sponsors a prepaid legal services plan not subject to this chapter, to administer such plan if the plan satisfies the criteria set forth in subsection (b) of this section and provided the superintendent makes the determinations set forth in subsection (g) of this section. Such administration may include, but need not be limited to, marketing, actuarial, data processing, accounting, claims and other related services. Such contracts shall provide for the payment of a reasonable fee for such administrative services. (f) The superintendent may permit an authorized insurer subject to the provisions of this chapter to reinsure the risk of any prepaid legal services plan as if it were legal services insurance if the plan satisfies the criteria set forth in subsection (b) of this section, provided the superintendent makes the determinations set forth in subsection (g) of this section. Such reinsurance agreements shall provide for the payment of a reasonable premium. (g) The superintendent may take the actions set forth in subsections (a), (e) and (f) of this section only if the superintendent determines, with respect to each such action, that: (1) the sponsors and other participants in the plan can reasonably be anticipated to be able to carry out their responsibilities under the plan, and (2) the plan attempts to address the problem that desired legal services are unavailable to some citizens of this state because some individuals and families who are not eligible for government subsidized programs cannot afford the cost of those services, and (3) the proposed activity by the authorized insurer will not cause or constitute an impairment of the insurer`s ability to satisfy its existing and anticipated contracts and other obligations, including such standards as the superintendent prescribes concerning adequate capital and financial requirements. (h) The superintendent shall promulgate such regulations that are necessary to implement the provisions of this section. S 1117. Health insurance plans for long term care. (a) An authorized insurer subject to the provisions of this chapter and organized to write the kind of insurance specified in paragraph three of subsection (a) of section one thousand one hundred thirteen of this article, a corporation or health maintenance organization authorized pursuant to article forty-three of this chapter or article forty-four of the public health law, and a fraternal benefit society organized under article forty-five of this chapter, may be authorized by the superintendent to issue contracts in connection with plans providing benefits for long term care, provided such plans satisfy the criteria set forth in subsection (b) of this section and the superintendent has made the determinations set forth in subsection (f) of this section. (b) The superintendent may authorize such contracts in connection with a plan for long term care pursuant to the following criteria: (1) the plan`s provisions are not misleading or confusing; (2) the plan`s provisions are not inconsistent with the needs of the public; (3) the plan`s benefit structure provides options for use of long term care services; (4) the plan, the contract and other materials describing the plan fully and clearly state the benefits and limitations of such plan; and (5) the authorized insurer, health maintenance organization, or fraternal benefit society agrees to provide such reports of the experience of the plan as may be requested by the superintendent. The superintendent may prepare abstracts and summaries of such reports at the request of other government agencies for purposes of research and studies related to long term care financing, provided however that the insurer, health maintenance organization, or fraternal benefit society may request that specified information included in the report be considered confidential. (c) The duration of such contracts and the extent of exposure thereunder by insurers, health maintenance organizations or fraternal benefit societies shall be in the discretion of the superintendent. (d) Contracts issued pursuant to the provisions of this section shall be subject to all other provisions of this chapter and the regulations promulgated thereunder applicable to the insurer, health maintenance organization, or fraternal benefit society which issues the contract, provided however that in order to permit the development of long term care plans, the superintendent may modify or suspend any such provision or regulation upon making the determinations set forth in subsection (f) of this section. (e) The superintendent may permit an authorized insurer, health maintenance organization, or fraternal benefit society subject to the provisions of this chapter to reinsure the risk of any long term care services plan, provided such plan satisfies the requirements of this section. Such reinsurance agreements shall provide for the payment of a reasonable premium. (f) The superintendent may take the actions set forth in subsections (a), (d) and (e) of this section only if the superintendent determines that: (1) the plan is a legitimate approach to expand the availability of insurance coverage for long term care services; (2) any proposed modification or suspension of a provision of this chapter or a regulation promulgated thereunder is essential to the development of long term care plans pursuant to this section, and is directly related to the essential features of such plans; (3) the premium rates for the long term care plan are reasonably related to the benefits provided, and are self-supporting; and (4) the plan proposed by the insurer, health maintenance organization, or fraternal benefit society, and any proposed modification or suspension pursuant to subsection (d) of this section, will not cause or constitute an impairment of the insurer`s, health maintenance organization`s, or fraternal benefit society`s ability to satisfy its existing and anticipated contracts and other obligations, including such standards as the superintendent shall prescribe concerning adequate capital and financial requirements. (g) (1) Except for certain group contracts described in paragraph four of this subsection, in order for premium payments for long-term care insurance to qualify for purposes of section one hundred ninety, subdivision twenty-five-a of section two hundred ten, subsection (aa) of section six hundred six, subsection (k) of section one thousand four hundred fifty-six and subsection (m) of section one thousand five hundred eleven of the tax law, the long-term care insurance must be approved by the superintendent pursuant to this subsection. Prior to approving any such insurance, the superintendent shall conclude that it meets minimum standards, including minimum loss ratio standards under this section or section three thousand two hundred twenty-nine of this chapter and is a qualified long-term care insurance contract as defined in section 7702B of the internal revenue code. (2) (A) No insurer, agent, broker, person, business or corporation doing business in or into this state shall in any manner state, advertise or claim that a long-term care insurance policy qualifies for purposes of the above-referenced provisions of the tax law unless either: (i) the superintendent has issued a letter or other written instrument to the insurer stating that the policy has been determined to qualify under this subsection, or (ii) the policy qualifies under paragraph four of this subsection without the need for approval by the superintendent. (B) Any policy which is held out or purported to be a long-term care insurance policy by any insurer, agent, broker, person, business or corporation doing business in or into this state which has not been determined by the superintendent to qualify and which does not qualify under paragraph four of this subsection for purposes of the above referenced provisions of the tax law shall so state clearly, legibly and in close physical proximity to any description of the policy as a long-term care insurance policy that it does not so qualify. This subsection shall also be deemed to cover any statement, advertisement or claim concerning such policy by any insurer, agent, broker, person, business or corporation doing business in or into this state. (C) Violation of this paragraph shall be considered a misrepresentation under section twenty-one hundred twenty-three of this chapter. (3) The superintendent shall maintain an ongoing list of those policies requiring approval of the superintendent that are found eligible for purposes of the above-referenced provisions of the tax law. (4) Group contracts delivered or issued for delivery outside of the state, but which are qualified long-term care insurance contracts as defined in section 7702B of the internal revenue code shall be deemed to qualify for purposes of the provisions of the tax law specified in paragraph one of this subsection without the need to seek the approval of the superintendent pursuant to this subsection. Provided that they otherwise meet the requirements of this paragraph, such group contracts include, but are not limited to, those offered: (a) by professional associations and societies, membership organizations and not-for-profit groups, or by a subsidiary or affiliated entity of any of the foregoing, to the members of the association, society, organization or group, and (b) by employers to their employees. S 1118. Regional pilot projects for the uninsured. (a) An authorized insurer subject to the provisions of this chapter and organized to write the kind of insurance specified in paragraph three of subsection (a) of section one thousand one hundred thirteen of this article, and a health maintenance organization authorized pursuant to article forty-three of this chapter or article forty-four of the public health law, may be authorized by the superintendent to issue contracts or otherwise enter into arrangements with approved organizations in connection with regional pilot projects to test models for the purpose of providing insurance and equivalent coverage mechanisms for the uninsured. Such plans must satisfy the criteria set forth in subsection (b) of this section and the superintendent shall make the determinations set forth in subsection (e) of this section. For the purpose of this section, regional pilot projects shall mean projects authorized pursuant to the expanded health care coverage act of nineteen hundred eighty-eight. (b) The superintendent may authorize such contracts or arrangements for regional pilot projects pursuant to the following criteria: (1) the plan`s provisions are not misleading or confusing; (2) the plan`s provisions are consistent with the needs of the regional pilot projects; and (3) the plan, the contract and other materials describing the plan fully and clearly state the benefits, limitations of the plan. (c) The duration of such contracts and the extent of exposure thereunder by insurers or health maintenance organizations shall be determined by the superintendent. (d) Notwithstanding any provisions of the insurance law to the contrary, the superintendent may waive, modify or suspend any provision of the insurance law or insurance department regulations as applicable to the insurers or health maintenance organizations which conduct the regional pilot projects, except as to mandatory benefits, provided such waiver, modification or suspension is based on the criteria set forth in subsection (e) of this section. (e) The superintendent may take the actions set forth in subsections (a) and (d) of this section upon the superintendent`s judgment that: (1) the plan is a reasonable and appropriate approach to expand the availability of health care coverage or equivalent coverage mechanisms for the uninsured; (2) the premium rates and other sources of funding for the regional pilot project is reasonably related to the benefits provided and sufficient to support the program; (3) any waiver, modification or suspension of provisions of the insurance law or insurance department regulations is essential to the operation of the regional pilot project and to the rational development of programs to provide health care coverage or equivalent coverage mechanisms to the uninsured; and (4) any waiver, modification or suspension of provisions of the insurance law or insurance department regulations will not impair the ability of the insurer or health maintenance organization to satisfy its existing and anticipated contracts and other obligations, including such standards as the superintendent shall prescribe concerning adequate capital and financial requirements. S 1119. Limited exemption for continuing care retirement communities. (a) An organization complying with the provisions of article forty-six of the public health law may operate without being licensed under this chapter and without being subject to any provisions of this chapter, except to the extent that such organization must comply with the provisions of this chapter by virtue of such article, and such organization must comply with rules and regulations of the superintendent relating to: (1) financial feasibility of the continuing care retirement community, (2) actuarial principles established relating to such communities, (3) approval of continuing care retirement contracts and the rates and rating system, if any, for such contracts. (b) The superintendent may promulgate regulations in effectuating the purposes and the provisions of this chapter and article forty-six of the public health law, which may include requirements applicable to the contracts between a continuing care retirement community and its residents. (c) Such organization shall be subject to the provisions of article seventy-four of this chapter. Prior to commencing action under article seventy-four, the superintendent shall consult with the continuing care retirement community council established pursuant to section forty-six hundred two of the public health law. S 1120. Child health insurance plan. (a) An authorized insurer subject to the provisions of this chapter and organized to write the kind of health insurance specified in paragraph three of subsection (a) of section one thousand one hundred thirteen of this article, and a corporation or health maintenance organization authorized pursuant to article forty-three of this chapter or a health maintenance organization certified pursuant to article forty-four of the public health law, may be authorized by the superintendent to issue contracts or otherwise enter into arrangements with approved organizations for the purpose of providing child health insurance plan policies for eligible children pursuant to title I-A of article twenty-five of the public health law. Such contracts or arrangements shall satisfy the criteria set forth in subsection (b) of this section and the superintendent shall make the determinations set forth in subsection (e) of this section. (b) The superintendent may authorize such contracts or arrangements pursuant to the following criteria: (1) the provisions are not misleading or confusing; (2) the provisions are consistent with the needs of the child health insurance plan; and (3) the materials describing the contract or arrangement fully and clearly state the benefits and limitations of such contract or arrangement. (c) The duration of such contracts or arrangements and the extent of exposure thereunder by insurers, article forty-three corporations or health maintenance organizations shall be determined by the superintendent. (d) Notwithstanding any provisions of the insurance law to the contrary, the superintendent may waive, modify or suspend any provisions of the insurance law or insurance department regulations as applicable to the insurers, article forty-three corporations or health maintenance organizations which issue coverage pursuant to this section, provided such waiver, modification or suspension is based on the criteria set forth in subsection (e) of this section. (e) The superintendent may take the actions set forth in subsections (a) and (d) of this section upon the superintendent`s judgement that: (1) the contract or arrangement is a reasonable and appropriate approach to expand the availability of health care coverage to children; (2) the sources of funding for the contract or arrangement are reasonably related to the benefits provided and sufficient to support the contract arrangement; * (3) any waiver, modification or suspension of the provisions of the insurance law or insurance regulations is essential to the operation of the child health insurance plan and to the rational development of programs to provide covered services to children; and * NB Effective until July 1, 2003 * (3) any waiver, modification or suspension of provisions of the insurance law or insurance regulations is essential to the operation of the child health insurance plan and to the rational development of programs to provide primary and preventive health care coverage and inpatient health care services coverage to children; and * NB Effective July 1, 2003 (4) any waiver, modification or suspension of provisions of the insurance law or insurance department regulations will not impair the ability of the insurer, article forty-three corporation or health maintenance organization to satisfy its existing and anticipated contracts and other obligations, including such standards as the superintendent shall prescribe concerning adequate capital and financial requirements. (f) Each application used by an authorized insurer for purposes of enrolling eligible children into the child health insurance plan pursuant to this section and section twenty-five hundred eleven of the public health law shall include the notice required pursuant to subsection (d) of section four hundred three of this chapter. S 1121. Voucher insurance program. (a) The superintendent, in consultation with the commissioner of health, is authorized to conduct a program on a demonstration basis to the extent of funds available therefor, through contractual arrangements with approved organizations, to assist individuals and families residing in specified urban, rural or suburban areas in purchasing health care coverage through insurers, health maintenance organizations and integrated delivery systems. (b) The superintendent shall designate the urban, rural or suburban areas to be served by the voucher insurance program. The superintendent shall determine the overall amount of funding to be allocated for vouchers issued in designated urban, rural or suburban areas. (c) The superintendent, in consultation with the commissioner of health, shall establish guidelines for the submission of proposals by organizations for the purposes of administering the voucher insurance program including, but not limited to the following: (1) standards for enrollment of eligible persons, including mechanisms for determining eligibility, and annual recertification; (2) standards for monitoring the performance of insurers, health maintenance organizations and integrated delivery systems participating in the voucher program; and (3) such other criteria which may be deemed necessary. (d) A proposal submitted by an organization to administer the voucher program shall include the following: (1) a designation of the geographic area to be served; (2) an estimation of the number of persons who will be eligible for the program and the estimated number of actual participants in the program in the specified geographic area; (3) a description of the procedures for enrollment of eligible individuals and families in the voucher program; (4) a demonstration of the availability and accessibility of offices where individuals and families could obtain information and enroll in the voucher program; (5) a description of the mechanisms for preventing fraudulent enrollment; (6) a description of the procedure for issuance of the voucher and for monitoring individual and family enrollment in health maintenance organizations, integrated delivery systems and insurers participating in the voucher program; (7) a description of the mechanisms for monitoring the performance of health maintenance organizations, integrated delivery systems and insurers participating in the program; (8) a description of the procedures for marketing the voucher program and the proposed community outreach activities including the identification of any subcontractor who will perform these activities; (9) a detailed description of the estimated expenses, including personnel costs and other types of administrative expenses which will be incurred in the development and implementation of the voucher program; (10) a demonstration of the applicant`s ability to meet the data analysis and reporting requirements of the program; (11) a demonstration of the financial feasibility of the program; and (12) such other information as the superintendent may deem appropriate. (e) The superintendent, in consultation with the commissioner of health, shall make a determination whether to approve, disapprove or recommend modification to the proposal of an applicant to administer the voucher program. (f) An organization approved to administer the voucher program shall submit reports to the superintendent in such form and at times as may be required in order to facilitate evaluation of the operations and results of the voucher program. (g) The superintendent may approve more than one organization to administer the voucher program in all or part of a geographic area. (h) The superintendent shall determine the amount of funds to be allocated to an approved organization to administer the voucher program within such funds which are available for purposes of the voucher program. (i) The superintendent shall review the marketing, community outreach activities and recruitment efforts of an organization administering the voucher program and may provide financial incentives if certain enrollment targets are met. (j) An organization approved to administer the voucher program may be subject to financial penalties established by the superintendent for violating the standards of the voucher program. Organizations administering the program shall also be required to repay to the state all voucher payments issued on account of ineligible individuals or families. An organization approved to administer the voucher program may be removed by the superintendent as an approved organization and must cooperate in the orderly transition of services to other approved organizations. The superintendent shall provide due notice and an opportunity for a hearing to an approved organization prior to implementing this subsection. (k) Vouchers shall be issued by the organization administering the voucher program to eligible individuals and families residing in designated urban, suburban or rural areas. Individuals and families shall submit such vouchers to participating insurers, integrated delivery systems and health maintenance organizations for the purpose of obtaining insurance coverage. (l) The superintendent shall establish, for those individuals and families eligible, the voucher amounts by regulation, and shall consider household size, gross annual income, the cost of obtaining health care coverage through a participating insurer, integrated delivery system or health maintenance organization and overall funding available for the voucher program. (m) An insurer organized to write the kind of health insurance specified in paragraph three of subsection (a) of section one thousand one hundred thirteen of this article, and a corporation or health maintenance organization authorized pursuant to article forty-three of this chapter or a health maintenance organization or integrated delivery system certified pursuant to article forty-four of the public health law may submit a proposal for participation in the voucher program to the superintendent who shall consult with the commissioner of health. Such proposal shall include: (1) a description of the standards for provider enrollment if applicable; (2) a description of the geographic area to be served, an estimate of the eligible and actual enrollees in such designated area; and a demonstration of the benefits to the community; (3) a demonstration of access to and delivery of high quality health care services and, if applicable, that any network of health care providers includes sufficient numbers of geographically accessible providers to service program participants; (4) a demonstration of the manner in which primary and preventive care and medical treatment will be emphasized or substituted for hospital inpatient or emergency room services in order to provide more appropriate care and more cost effective use of general hospitals. (5) a description of the procedures for marketing the program, if applicable; (6) a description of health care provider payment methodologies; (7) a description of the premium in relation to the benefit package; (8) a description of the estimated expenses including personnel costs and other types of administrative expenses which will be incurred in the program; (9) a description of the quality assurance and utilization review mechanisms to be implemented; (10) a description of the provisions for arranging for or offering conversion coverage in the event of termination of coverage; (11) a demonstration of an ability to meet data analysis and reporting requirements of the program; and (12) such other information as the superintendent may deem appropriate. (n) The superintendent, in consultation with the commissioner of health, shall make a determination whether to approve, disapprove or recommend a modification to an insurer`s, integrated delivery system`s or health maintenance organization`s proposal to participate in the voucher program. (o) The superintendent, in consultation with the commissioner of health, shall ensure, to the extent possible, that the voucher program is available in designated urban, suburban or rural areas. The superintendent may approve more than one insurer, integrated delivery system or health maintenance organization to serve all or part of a geographic area. (p) An approved insurer, integrated delivery system or health maintenance organization shall submit reports to the superintendent and to the organization administering the voucher program in such form and at times as may be reasonably required in order to evaluate the operations and results of such program. (q) An approved insurer, integrated delivery system or health maintenance organization may be removed from participation in the voucher program provided, however, that eligible persons shall continue to receive coverage of services until such time as the orderly transition to other approved insurers, integrated delivery systems and health maintenance organizations can be effected. The superintendent shall provide due notice and an opportunity for a hearing to an approved insurer, integrated delivery systems or health maintenance organization prior to implementing this subsection. (r) Notwithstanding any inconsistent provision of law or regulation to the contrary, benefits under the voucher program shall be considered secondary to any other plan of insurance or benefit program under which a person may have coverage. (s) An insurer, integrated delivery system or health maintenance organization may issue contracts approved by the superintendent, providing coverage to voucher recipients, pursuant to the following criteria: (1) the provisions are not misleading or confusing: (2) the provisions are consistent with the needs of the voucher program; (3) the materials describing the contract fully and clearly state the benefits and limitations of such contract; (4) the duration of such contracts and the extent of exposure thereunder by insurers, article forty-three corporations, integrated delivery systems or health maintenance organizations shall be determined by the superintendent; (5) the contract is a reasonable and appropriate approach to expand the availability of health care coverage; (6) the funding for the contract is reasonably related to the benefits provided and sufficient to support the contract; (7) any such contracts must include the preexisting condition provisions permitted by section three thousand two hundred thirty-two and section four thousand three hundred eighteen of this chapter as applicable; and (8) notwithstanding any provisions of this chapter to the contrary, the superintendent may waive, modify or suspend any provisions of this chapter, except as to mandatory benefits, or department regulations as applicable to the insurers, article forty-three corporations, integrated delivery systems or health maintenance organizations which issue coverage pursuant to this section, provided such waiver, modification or suspension is based on the following: (A) any waiver, modification or suspension of provisions of this chapter or department regulations is essential to the operation of the voucher program and to the rational development of programs to provide health care coverage or equivalent coverage mechanisms to the uninsured; and (B) any waiver, modification or suspension of provisions of this chapter or department regulations will not impair the ability of the insurer, article forty-three corporation, integrated delivery system or health maintenance organization to satisfy its existing and anticipated contracts and other obligations, including such standards as the superintendent shall prescribe concerning adequate capital and financial requirements. (t) The contracts issued by insurers, integrated delivery systems or health maintenance organizations and approved by the superintendent providing coverage to voucher recipients must provide for only the following covered services: (1) Outpatient diagnostic X-ray and lab services; (2) Outpatient surgical services including anesthesia; (3) Mammography screening. (4) Cervical cytology screening. (5) Well-child care from birth. (6) Primary and preventive care services. (u) In order to be eligible to purchase coverage under the voucher program, the individual or family shall meet the following criteria: (1) reside or resides in a household having a gross household income at or below two hundred twenty-two percent of the non-farm federal poverty level (as defined and annually revised by the federal office of management and budget). An applicant shall provide the necessary documentation to initially, and annually thereafter, determine eligibility for a voucher. Such documentation shall include the latest annual income tax return. If no such income tax return has been filed or if the household income has changed since the date of the return, such documentation shall also include, but not be limited to: paycheck stubs; written documentation of income from all employers; or other documentation of income (earned or unearned) as determined by the superintendent, provided however, such documentation shall set forth the source of such income; (2) is not eligible for medical assistance under title eleven of article five of the social services law or for medicare pursuant to title eighteen of the federal social security act; (3) does not have equivalent health care coverage as defined by the superintendent. The applicant shall attest to the source and nature of health care coverage available; (4) is a resident of a designated urban, suburban or rural area in New York state. Such residency shall be demonstrated by adequate proof of a New York state street address or if the individual or family has no street address, then by other such proof; (5) has not had equivalent health care coverage within the twelve month period prior to application for a voucher. This limitation shall not apply to persons who became ineligible for medical assistance or whose insurance terminated as a result of loss of employment within such period; (6) the individual or family shall notify the organization administering the voucher program within sixty days, of any changes in income, health care coverage or residency that may make them ineligible for the voucher program; and (7) any individual or family who, with the intent to obtain benefits, willfully misstates income or residence or other health care coverage to establish eligibility or willfully fails to notify an