NYDFS Emergency Regulation for Individual, Small Group, and Student Health Policyholders

Dear Policyholder,

A recent Executive Order issued by Governor Cuomo, together with recent amendments to the insurance and banking regulations (the “regulations”) issued by the New York State Department of Financial Services (“Department”), extend grace periods and give you other rights under certain health insurance policies if you are an individual, small group or student blanket comprehensive health insurance policyholder or contract holder and can demonstrate financial hardship as a result of the novel coronavirus (“COVID‑19”) pandemic (“affected policyholder”).  Note that any policyholder or contract holder of a child health insurance plan where the policyholder or contract holder pays the entire premium shall also be deemed and affected policyholder.

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.

A copy of the Executive Order and regulations can be found at https://www.governor.ny.gov/news/no-20213-continuing-temporary-suspension-and-modification-laws-relating-disaster-emergency and https://www.dfs.ny.gov/system/files/documents/2020/04/re62_a59_text.pdf, respectively.

Insurance Payments – Grace Period and Moratorium on Retroactive Termination

If you can demonstrate financial hardship as a result of the COVID-19 pandemic, your insurer must extend to later of the applicable contractual grace period or June 1, 2020, for the payment of premiums and fees under your individual, small group or student blanket comprehensive health insurance policy.  If you do not make a timely premium payment and can demonstrate financial hardship as a result of the COVID-19 pandemic, your insurer may not retroactively terminate your policy for non-payment of premium during that period, impose any late fees relating to the premium payment or report you to a credit reporting agency or a debt collection agency regarding such premium payment.

How to Demonstrate Financial Hardship

If you, as an affected policyholder, 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 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 shall accept as satisfactory proof.  Such statement is not required to be notarized.

Questions

If you have any questions regarding your rights under the Executive Order or regulations, please contact your insurer or broker.