Health Insurance: New York Governor Executive Order & DFS Emergency Regulation

Date Added: 4.13.2020

Health Insurance: New York Governor Executive Order & DFS Emergency Regulation

A recent Executive Order issued by Governor Cuomo, together with recent amendments to the insurance and banking regulations (the “DFS regulation”) issued by the New York State Department of Financial Services (“Department”), extend grace periods and give you other rights under your individual, small group, or student blanket comprehensive health insurance policy if you can demonstrate financial hardship as a result of the novel coronavirus (“COVID‑19”) pandemic. These grace periods and rights are currently in effect but are temporary, though they may be extended further.  Please check the Department’s website at https://www.dfs.ny.gov/consumers/coronavirus for updates.

 

Insurance Payments – Grace Period

If you can demonstrate financial hardship as a result of the COVID-19 pandemic, your insurer must extend the period for the payment of premiums to the later of the expiration of the applicable contractual grace period and 11:59 p.m. on June 1, 2020 for any individual, small group, or student blanket comprehensive health insurance policy.

The insurer, HMO, and student health plan shall be responsible for the payment of claims during such period and may not retroactively terminate the insurance policy for non-payment of premium during such period.

If you do not make a timely premium payment and can demonstrate financial hardship as a result of the COVID-19 pandemic, your insurer:

  • Shall not impose any late fees relating to the premium payment; or
  • Shall not report you to a credit reporting agency or a debt collection agency regarding such premium payment; and
  • Shall provide information to the policyholder or contract holder regarding alternate policies available from the insurer, HMO, or student health plan and provide contact information for the NY State of Health.

The period set forth in the Executive Order and the DFS regulation applies only to terminations

attributed to a failure by an individual, small group, or student blanket comprehensive health insurance policyholder or contract holder to pay premiums during such period. If an insurer, HMO, or student health plan terminates a policy for any other reason permitted by law, the insurer, HMO, or student health plan shall comply with statutory notice requirements.

 

Catching up on Overdue Insurance Payments

If you are unable to make a timely premium payment due to financial hardship as a result of the COVID-19 pandemic, contact your insurer to discuss and make alternative payment arrangements.

 

How to Demonstrate Financial Hardship

If you are unable to make a timely premium payment due to financial hardship as a result of the COVID-19 pandemic, you may submit to your insurer, HMO, or student health plan, as applicable, a statement that you swear or affirm in writing under penalty of perjury that you are experiencing financial hardship as a result of the COVID-19 pandemic, which the insurer, HMO, or student health plan, as applicable, shall accept as satisfactory proof.  Such statement is not required to be notarized.

 

Questions

If you have any questions regarding your rights under the Order or DFS regulation, please contact your SterlingRisk Account Executive or insurer.

The Order and DFS regulation cover additional requirements that this notice does not discuss. Please review the DFS regulation and Order for full requirements.

The Order is available on the Governor’s website.  Read a copy of the Executive Order.  The emergency amendments can be found on the New York Department of Financial Services Website. Read a copy of the emergency regulation.