NY-FIS — Financial Services Law

ARTICLE 1 General Provisions

§ 101 — Short title

Short title. This chapter shall be known and may be cited as

the "financial services law".

§ 101-a — Legislative findings and determinations

Legislative findings and determinations. The legislature

finds and determines that the banking, insurance and financial services

industries constitute a critical sector of New York state's economy.

The legislature also finds and determines that responsive, effective,

innovative, state banking and insurance regulation is necessary to

operate in a global, evolving and competitive market place.

The legislature additionally finds and determines that this

legislation is necessary to modernize and transform the present state

banking department and state insurance department into a new integrated

department of financial services.

§ 102 — Department of financial services

Department of financial services. The legislature hereby

declares that the purpose of this chapter is to consolidate the

departments of insurance and banking, and provide for the enforcement of

the insurance, banking and financial services laws, under the auspices

of a single state agency to be known as the "department of financial

services" and to accomplish goals including the following:

(a) To encourage, promote and assist banking, insurance and other

financial services institutions to effectively and productively locate,

operate, employ, grow, remain, and expand in New York state;

(b) To establish a modern system of regulation, rule making and

adjudication that is responsive to the needs of the banking and

insurance industries and to the needs of the state's consumers and

residents;

banking and insurance laws;

(d) To expand the attractiveness and competitiveness of the state

charter for banking institutions and to promote the conversion of banks

to such status;

(e) To promote and provide for the continued, effective state

regulation of the insurance industry;

(f) To provide for the regulation of new financial services products;

(g) To promote the prudent and continued availability of credit,

insurance and financial products and services at affordable costs to New

York citizens, businesses and consumers;

(h) To promote, advance and spur economic development and job creation

in New York;

(i) To ensure the continued safety and soundness of New York's

banking, insurance and financial services industries, as well as the

prudent conduct of the providers of financial products and services,

through responsible regulation and supervision;

(j) To protect the public interest and the interests of depositors,

creditors, policyholders, underwriters, shareholders and stockholders;

(k) To promote the reduction and elimination of fraud, criminal abuse

and unethical conduct by, and with respect to, banking, insurance and

other financial services institutions and their customers; and

(l) To educate and protect users of banking, insurance, and financial

services products and services through the provision of timely and

understandable information.

§ 103 — Explanation of order of provisions

Explanation of order of provisions. In this financial services

law, the provisions have been divided in descending order of

application, with illustrations, as follows:

Article 1

Section 101

Subsection (a)

Paragraph (1)

Subparagraph (A)

Item (i)

Clause (I)

Subitem (aa)

Subclause (aaa)

§ 104 — Definitions

Definitions. (a) In this chapter, unless the context otherwise

requires:

(1) "Department" shall mean the department of financial services.

(2) "Financial product or service" shall mean: (A) any financial

product or financial service offered or provided by any person regulated

or required to be regulated by the superintendent pursuant to the

banking law or the insurance law or any financial product or service

offered or sold to consumers except financial products or services: (i)

regulated under the exclusive jurisdiction of a federal agency or

authority, (ii) regulated for the purpose of consumer or investor

protection by any other state agency, state department or state public

authority, or (iii) where rules or regulations promulgated by the

superintendent on such financial product or service would be preempted

by federal law; and

(B) "Financial product or service" shall also not include the

following, when offered or provided by a provider of consumer goods or

services: (i) the extension of credit directly to a consumer

exclusively for the purpose of enabling that consumer to purchase such

consumer good or service directly from the seller, (ii) the collection

of debt arising from such credit, or (iii) the sale or conveyance of

such debt that is delinquent or otherwise in default.

(2-a) A "financial product or service regulated for the purpose of

consumer or investor protection": (A) shall include (i) any product or

service for which registration or licensing is required or for which the

offeror or provider is required to be registered or licensed by state

law, (ii) any product or service as to which provisions for consumer or

investor protection are specifically set forth for such product or

service by state statute or regulation and (iii) securities, commodities

and real property subject to the provisions of article twenty-three-a of

the general business law, and (B) shall not include products or services

solely subject to other general laws or regulations for the protection

of consumers or investors.

(3) "Person" shall mean any individual, partnership, corporation,

association or any other entity.

(4) "Regulated person" or "person regulated" shall mean any person (A)

operating under or required to operate under a license, registration,

certificate or authorization under the insurance law or the banking law,

(B) authorized, accredited, chartered or incorporated or possessing or

required to possess other similar status under the insurance law or the

banking law, or (C) regulated by the superintendent pursuant to this

chapter.

(5) "Superintendent" shall mean the superintendent of financial

services of this state.

(b) Whenever the terms "include", "including" or terms of similar

import appear in this chapter, unless the context requires otherwise,

such terms shall not be construed to imply the exclusion of any person,

class or thing not specifically included.

state, or of any other jurisdiction, means such law or statute as

amended to the effective date of this chapter, and unless the context

otherwise requires, as amended thereafter.

ARTICLE 2 Organization of the Department of Financial Services

§ 201 — Declaration of policy

Declaration of policy. (a) It is the intent of the legislature

that the superintendent shall supervise the business of, and the persons

providing, financial products and services, including any persons

subject to the provisions of the insurance law and the banking law.

(b) The superintendent shall take such actions as the superintendent

believes necessary to:

(1) foster the growth of the financial industry in New York and spur

state economic development through judicious regulation and vigilant

supervision;

(2) ensure the continued solvency, safety, soundness and prudent

conduct of the providers of financial products and services;

(3) ensure fair, timely and equitable fulfillment of the financial

obligations of such providers;

(4) protect users of financial products and services from financially

impaired or insolvent providers of such services;

(5) encourage high standards of honesty, transparency, fair business

practices and public responsibility;

(6) eliminate financial fraud, other criminal abuse and unethical

conduct in the industry; and

(7) educate and protect users of financial products and services and

ensure that users are provided with timely and understandable

information to make responsible decisions about financial products and

services.

§ 202 — Superintendent

Superintendent. (a) The head of the department shall be the

superintendent of financial services, who shall be appointed by the

governor, by and with the advice and consent of the senate, and who

shall hold office at the pleasure of the governor. The superintendent

shall possess the rights, powers, and duties in connection with

financial services and protection in this state, expressed or reasonably

implied by this chapter or any other applicable law of this state.

(b) The superintendent may, in the superintendent's discretion,

designate one of the superintendent's deputies to act as superintendent

during the superintendent's absence or inability to act. If the office

of superintendent is vacant, or if the superintendent's absence or

inability to act continues for a period of more than thirty successive

days, the governor may designate a deputy to act as superintendent until

the filling of the vacancy or the return or recovery of the

superintendent.

any other law the superintendent is authorized but not required to take

any action or the superintendent's approval is required as a condition

precedent to the doing of any act, the taking of such action and the

giving of such approval shall be within the superintendent's sound

discretion. In taking any action with respect to any banking

organization, and in approving or disapproving any application made by a

banking organization, the superintendent shall give due consideration to

the policy of the state of New York as set forth in section ten of the

banking law.

§ 203 — Deputies; employees

Deputies; employees. (a) The superintendent shall appoint a

deputy for insurance who shall be the head of the insurance division and

a deputy for banking who shall be the head of the banking division. The

superintendent may appoint such other deputies as the superintendent

deems necessary to fulfill the responsibilities of the department. The

superintendent may remove at will any deputy appointed by the

superintendent, except as may be otherwise provided by the civil service

law.

(b) The superintendent may appoint and remove from time to time, in

accordance with law and any applicable rules of the state civil service

commission, such employees, under such titles as the superintendent may

assign, as the superintendent may deem necessary for the efficient

administration of the department. They shall perform such duties as the

superintendent shall assign to them. The compensation of such employees

shall be determined by the superintendent in accordance with law.

hereinafter by this chapter, the banking law, the insurance law or other

laws to take may be taken by a deputy or authorized employee to whom the

duty of taking such action has been delegated or assigned by the

superintendent.

§ 204 — Offices of the department

Offices of the department. Suitable offices for conducting the

business of the department shall be located in the cities of Albany and

New York, and such other cities as the superintendent deems necessary.

Necessary additional office, filing and storage space that cannot be

supplied by the state commissioner of general services may be leased by

the superintendent, and rent or expenses incurred pursuant to any such

lease shall, unless otherwise provided for, be paid on the certificate

of the superintendent and the audit and warrant of the comptroller.

§ 205 — Bureaus

Bureaus. The superintendent shall establish an insurance

division and a banking division. The superintendent may establish such

other bureaus, divisions, and other units within the department as may

be necessary for the administration and operation of the department and

the proper exercise of its powers and the performance of its duties,

under this chapter, and may, from time to time, consolidate or abolish

such divisions, bureaus or other units within the department.

Notwithstanding any inconsistent provision of law, the superintendent

may determine the official functions of each division, bureau, or other

unit within the department. There shall be a head of each bureau,

division or other unit to be appointed by the superintendent, who shall

serve at the pleasure of the superintendent, except as may be otherwise

provided by the civil service law. The heads of bureaus, divisions or

units in the banking and insurance departments who are in office when

this chapter takes effect shall continue in office at the pleasure of

the superintendent, except as may be otherwise provided by the civil

service law.

§ 205-a — Report

Report. The governor shall by June thirtieth, two thousand

eleven, create a working group to examine ways to improve the efficiency

and effectiveness of banking regulation and insurance regulation,

including opportunities to integrate certain regulatory activities

prescribed by the banking law and the insurance law. Such working group

shall consult, in making its examination, with representatives of the

banking, insurance and financial services industries. On or before

January first, two thousand twelve, the superintendent shall issue a

report on the results of this review to the governor, the speaker of the

assembly and the temporary president of the senate.

§ 205-b — State charter advisory board

* § 205-b. State charter advisory board. There shall be within the

department a state charter advisory board to work with the

superintendent in retaining state chartered banking institutions,

encouraging federally chartered institutions to convert to a state

charter and promoting the state banking system. There shall be nine

members of the advisory board who shall be appointed by the

superintendent. The membership shall consist of: (a) one representative

of credit unions, (b) one representative of consumers, (c) one

representative of foreign banks; and (d) representatives of banks which,

to the extent practicable, reflect a range of size and geographical

location, provided, however, that at least one shall represent

institutions of more than three billion dollars in assets; at least two

shall represent institutions of less than five hundred million dollars

in assets. The superintendent shall make rules to govern the method by

which state chartered institutions may nominate persons to the board and

the process for selecting such members, provided that the representative

of consumers shall be selected by the superintendent. The term of each

member of such advisory board shall be three years, or until a successor

is appointed and vacancies shall be filled for the unexpired term only.

The board shall meet at least three times annually pursuant to the call

of the superintendent. Such meetings may be held by means of a

conference telephone or similar communications equipment allowing all

persons participating in the meeting to hear each other at the same

time. The members of the advisory board shall receive no compensation

nor reimbursement for expenses. The advisory board may:

(1) consider and recommend ways to maintain the state charter as a

viable and attractive option, including bringing to the superintendent's

attention issues of concern to state chartered banking institutions;

(2) consider and recommend ways to encourage banking institutions to

offer a diversity of financial products and services throughout the

state;

(3) recommend to the superintendent the establishment of such laws as

may be deemed necessary, and the amendment or repeal thereof;

(4) recommend to the superintendent the promulgation of rules and

regulations not inconsistent with the law, as may be deemed necessary,

and the amendment or repeal thereof; and

(5) report within thirty days after receipt, on any proposed

regulations, amendments thereto, or repeal thereof, prior to final

action thereon by the superintendent.

The advisory board shall have no executive, administrative or

appointive powers or duties.

The superintendent shall make an annual report no later than thirty

days after the end of each year to the temporary president of the senate

and the speaker of the assembly, which shall include a summary of the

topics discussed at state charter advisory board meetings during such

year, and any legislative recommendations related to the topics raised

at such meetings or made by any member of the state charter advisory

board.

* NB Repealed October 3, 2031

§ 206 — Assessments to defray operating expenses of the department

Assessments to defray operating expenses of the department.

(a) For each fiscal year commencing on or after April first, two

thousand twelve, assessments to defray operating expenses, including all

direct and indirect costs, of the department, except expenses incurred

in the liquidation of banking organizations, shall be assessed by the

superintendent in accordance with this subsection. Persons regulated

under the insurance law shall be assessed by the superintendent for the

operating expenses of the department that are solely attributable to

regulating persons under the insurance law, which shall include any

expenses that were permissible to be assessed in fiscal year two

thousand nine-two thousand ten, with the assessments allocated pro rata

upon all domestic insurers and all licensed United States branches of

alien insurers domiciled in this state within the meaning of paragraph

four of subsection (b) of section seven thousand four hundred eight of

the insurance law, in proportion to the gross direct premiums and other

considerations, written or received by them in this state during the

calendar year ending December thirty-first immediately preceding the end

of the fiscal year for which the assessment is made (less return

premiums and considerations thereon) for policies or contracts of

insurance covering property or risks resident or located in this state

the issuance of which policies or contracts requires a license from the

superintendent. Persons regulated under the banking law shall be

assessed by the superintendent for the operating expenses of the

department that are solely attributable to regulating persons under the

banking law in such proportions as the superintendent shall deem just

and reasonable. Persons regulated under this chapter that engage in

"virtual currency business activity," as that term is defined by the

department, shall be assessed by the superintendent for the operating

expenses of the department that are solely attributable to regulating

such persons in such proportions as the superintendent shall deem just

and reasonable. Operating expenses of the department not covered by the

assessments set forth above shall be assessed by the superintendent in

such proportions as the superintendent shall deem just and reasonable

upon all domestic insurers and all licensed United States branches of

alien insurers domiciled in this state within the meaning of paragraph

four of subsection (b) of section seven thousand four hundred eight of

the insurance law, and upon any regulated person under the banking law,

other than mortgage loan originators, and upon persons regulated under

this chapter that engage in virtual currency business activity, except

as otherwise provided by sections one hundred fifty-one and two hundred

twenty-eight of the workers' compensation law and by section sixty of

the volunteer firefighters' benefit law. The provisions of this

subsection shall not be applicable to a bank holding company, as that

term is defined in article three-A of the banking law. Persons regulated

under the banking law will not be assessed for expenses that the

superintendent deems to benefit solely persons regulated under the

insurance law or under this chapter that engage in virtual currency

business activity, and persons regulated under the insurance law will

not be assessed for expenses that the superintendent deems to benefit

solely persons regulated under the banking law or under this chapter

that engage in virtual currency business activity. Persons regulated

under this chapter that engage in virtual currency business activity

will not be assessed for expenses that the superintendent deems to

benefit solely persons regulated under the insurance law or under the

banking law.

(b) For each fiscal year commencing on or after April first, two

thousand twelve, a partial payment shall be made by each entity subject

to this section in a sum equal to twenty-five per centum, or such other

per centum or per centums as the superintendent may prescribe, of the

annual expenses assessed upon it for the fiscal year as estimated by the

superintendent. Such payment shall be made on March tenth of the

preceding fiscal year and on June tenth, September tenth and December

tenth of each year, or at such other dates as the superintendent may

prescribe. The balance of assessments for the fiscal year shall be paid

upon determination of the actual amount due in accordance with the

provisions of this section. Any overpayment of annual assessment

resulting from complying with the requirements of this subsection shall

be applied against the next estimated quarterly assessment, if less than

or equal to such amount, with any excess refunded to the assessed. As an

alternative, if the estimated annual assessment for the fiscal year is

equal to or less than the annual minimum assessment set by the

superintendent, the superintendent may require full payment to be made

on or before September thirtieth or such other date of the fiscal year

as the superintendent may determine.

services performed on account of, any bank holding company, as that term

is defined in the banking law, or any regulated person under the banking

law, shall be assessed provided, however, that the superintendent, in

the superintendent's sole discretion, may determine, with respect to

expenses incurred in the making of any specific examination or

investigation, or the performing of any special services, that any such

expense shall be assessed against and paid by the bank holding company

or any other regulated person under the banking law for which they were

incurred or performed.

(d) The expenses incurred in making an examination of any affiliate of

a banking organization pursuant to the banking law, and the expenses

incurred in making an examination, pursuant to the banking law, of a

non-banking subsidiary of a corporation or any other entity that is an

affiliate of a banking organization, shall be assessed against and paid

by such banking organization if the affiliate cannot be assessed

pursuant to the provisions of the banking law.

(d-1) The expenses of every examination of the affairs of any person

regulated pursuant to this chapter that engages in virtual currency

business activity shall be borne and paid by the regulated person so

examined, but the superintendent, with the approval of the comptroller,

may in the superintendent's discretion for good cause shown remit such

charges.

(e) The superintendent may, in the superintendent's sole discretion,

upon notice, suspend the license, registration, certificate or authority

(for purposes of this section, a license) granted to any person pursuant

to this chapter, the banking law or insurance law, upon the failure of

such person to make any payment required by this section within thirty

days after the due date. If the superintendent has suspended any such

license, such license may be reinstated if the superintendent determines

that such person has made any such payments within ninety days after the

date of such notice of suspension. Otherwise, unless the superintendent,

in the superintendent's sole discretion, has extended such suspension,

the license of such person shall be deemed to be automatically

terminated by operation of law at the close of business on such

ninetieth day.

(f) (1) The expenses of every examination of the affairs of any

regulated person subject to the insurance law, including an appraisal of

such regulated person's real property or of any real property on which

such regulated person holds a mortgage, made pursuant to the authority

conferred by any provision of this chapter, the insurance law or the

banking law, shall be borne and paid by the regulated person so

examined, but the superintendent, with the approval of the comptroller,

may in the superintendent's discretion for good cause shown remit such

charges.

(2) (A) For any such examination by the superintendent or a deputy

superintendent personally, the charge made shall be only for necessary

traveling expenses and other actual expenses. In all other cases, the

expenses of examination shall also include reimbursement for the

compensation paid for the services of persons employed by the

superintendent or by the superintendent's authority to make such

examination or appraisal.

(B) Notwithstanding any provisions of this section to the contrary, in

case of an examination or appraisal of a domestic insurer made within

this state, the traveling and living expense of the person or persons

making the examination shall be considered a cost of operation, as

referred to in section three hundred thirty-two of the insurance law and

not an expense of examination.

(3) All charges, including necessary traveling and other actual

expenses, except as hereinabove provided, as audited by the comptroller

and paid on the comptroller's warrant in the usual manner by the

comptroller to the person or persons making the examination or

appraisal, shall be presented to the insurer, or other person whose duty

it is to pay the same, in the form of a copy of the itemized bill

therefor as certified and approved by the superintendent or by any

deputy superintendent or authorized employee of the department. Upon

receiving such certified copy the insurer or other person whose duty it

is to pay such charges shall pay the amount thereof to the

superintendent, to be paid by the superintendent into the state

treasury.

§ 207 — Annual report of the superintendent

Annual report of the superintendent. (a) The superintendent

shall submit a report annually to the governor and to the legislature on

or before the fifteenth day of June. The report shall contain the

following items, with respect to the preceding calendar year:

(1) a general review of the insurance business, banking business, and

financial product or service business utilizing the most current

information available;

(2) a consolidated statement of condition showing the combined assets

and liabilities of all banking organizations comprising each of the

following classes: (A) banks and trust companies; and (B) private

bankers. Each such consolidated statement shall combine the information

contained in the last periodical reports of condition received from such

banking organizations as of a date during the year for which such report

of the superintendent is rendered;

(3) a consolidated statement of condition showing the combined assets

and liabilities of all banking organizations comprising each of the

following classes: (A) savings banks; (B) safe deposit companies; (C)

savings and loan associations; (D) credit unions; and (E) investment

companies. Each such consolidated statement shall combine the

information contained in the last periodical reports of condition made

to the superintendent as of a date during the year for which the report

of the superintendent is rendered, except that with respect to those

classes making reports to the superintendent as of the first day of the

following year, such consolidated statements shall combine the

information contained in such reports;

(4) a consolidated statement of condition showing the combined assets

and liabilities of all licensed lenders. Each such consolidated

statement shall combine the information contained in the reports to be

made on or before the first day of April of the year following the year

for which the report of the superintendent is rendered;

(5) a statement of condition of each banking organization required by

the banking law to make periodical reports of condition to the

superintendent. Such statement shall include the information contained

in the last periodical report of condition made to the superintendent as

of a date during the year for which such report of the superintendent is

rendered, except that in the case of banking organizations making

reports to the superintendent as of the first day of the following year,

each such statement shall include the information contained in such

reports. Notwithstanding any other provision of this subsection, in lieu

of making a statement of the condition of each covered banking

organization, the superintendent may make such information available by

any other means that provides for direct public access or availability

to such required reports of condition;

(6) a statement of all banking organizations, foreign banking

corporations and licensed lenders authorized or licensed by the

superintendent to do business during the year for which the report is

rendered, with their names and locations and the dates on which their

certificates were approved by the superintendent, and such other

information as the superintendent deems appropriate;

(7) a statement of the banking organizations, foreign banking

corporations whose business has been closed either voluntarily or

involuntarily during the year for which the report is rendered, with the

amount of their resources and of their deposits and other liabilities as

last reported by them;

(8) a statement of any unclaimed amounts held by the superintendent

pursuant to the requirements of the banking law as trustee for the

creditors, depositors, stockholders or shareholders of each banking

organization the business and affairs of which shall have been finally

liquidated; the amount of interest received during the preceding fiscal

year upon all such unclaimed amounts held by the superintendent; and the

amount of abandoned funds paid over by the superintendent to the state

comptroller pursuant to the requirements of the banking law;

(9) a table showing the number and kinds of authorized insurers

according to classes of business, and their total assets, liabilities,

premiums written, and insurance in force, as shown by the annual

statements filed with the superintendent by such insurers;

(10) lists of: (A) insurers organized, admitted, merged, withdrawn, or

placed in liquidation, conservation, or rehabilitation, (B) domestic

insurers that have amended their charters or have increased or decreased

their capital stock, together with a statement of the extent thereof;

and (C) domestic insurers that have changed their corporate names;

(11) a list of department reports filed on examination of authorized

insurers;

(12) a statement of the expenses of administering the

property/casualty insurance security fund and the public motor vehicle

liability security fund pursuant to article seventy-six of the insurance

law;

(13) tables relative to insurer liquidation, conservation or

rehabilitation proceedings by the department for prior years, including

the preceding calendar year;

(14) any amendments to the banking law, the insurance law, and this

chapter, and any amendments to regulations promulgated thereunder,

during the year for which such report is rendered; a summary of

insurance circular letters and banking interpretations issued during the

year for which such report is rendered; and such other matters relating

to the banking organizations, corporations, partnerships, insurers,

insurance producers, or other entities or persons licensed, authorized

to do business, certified, or registered under the banking law, the

insurance law, or this chapter, including public statements,

recommendations and decisions of the superintendent, occurring during

the year for which such report is rendered, which, in the judgment of

the superintendent, may be of historical or regulatory significance;

(15) legislative recommendations that the superintendent deems

necessary or desirable; and

(16) a summary of the department's receipts and expenses during the

preceding fiscal year, including any expenses of liquidation paid out of

amounts appropriated by the legislature, the amounts appropriated by the

legislature for the expenses of the department during such year, and the

amount, if any, for which the treasury of the state shall not have been

reimbursed at the date of such report.

(b) The superintendent may, in addition to the above requirements,

include in such report any other matter or data concerning insurance,

banking, financial products or services or the superintendent's duties

under the insurance law, the banking law, or this chapter, which in the

superintendent's judgment, is of general interest or import.

ARTICLE 3 Administrative and Procedural Provisions

§ 301 — Powers of the superintendent

Powers of the superintendent. (a) The superintendent shall have

such powers as are conferred upon the superintendent by this chapter,

the banking law, the insurance law or any other law of this state.

(b) The superintendent shall have the power to conduct investigations,

research, studies and analyses of matters affecting the interests of

consumers of financial products and services, including tracking and

monitoring complaints.

financial products and services, including:

(1) taking such actions as the superintendent deems necessary to

educate and protect users of financial products and services;

(2) receiving complaints of consumers of financial products and

services, and where appropriate (A) providing assistance to consumers;

(B) mediating the resolution of such complaints with providers of

financial products and services; or (C) referring such complaints to the

appropriate federal, state or local agency authorized by law for

appropriate action on such complaints;

(3) studying the operation of laws and advising and making

recommendations to the governor on matters affecting consumers of and

investors in financial products and services and promoting and

encouraging the protection of the legitimate interests of users of such

financial products and services;

(4) cooperating with, assisting and, when appropriate, referring

matters to the attorney general in the carrying out of the attorney

general's legal enforcement responsibilities for the protection of

consumers of and investors in financial products and services;

(5) initiating and encouraging consumer financial education programs,

and disseminating materials to educate users of financial products and

services;

(6) providing technical assistance to local governments and

not-for-profits in the development of consumer protection measures with

respect to financial products and services; and

(7) continuing and expanding the detection, investigation and

prevention of insurance fraud.

§ 302 — Regulations by superintendent

Regulations by superintendent. (a) The superintendent shall

have the power to prescribe and from time to time withdraw or amend, in

writing, rules and regulations and issue orders and guidance involving

financial products and services, not inconsistent with the provisions of

this chapter, the banking law, the insurance law and any other law in

which the superintendent is given authority:

(1) effectuating any power given to the superintendent under the

provisions of this chapter, the insurance law, the banking law, or any

other law to prescribe forms or make regulations;

(2) interpreting the provisions of this chapter, the insurance law,

the banking law, or any other applicable law; and

(3) governing the procedures to be followed in the practice of the

department.

(b) The superintendent may promulgate a list of financial products and

services excluded from regulation by the superintendent, provided that

such exclusion shall not limit in any way the ability of the

superintendent to take any actions with respect to fraud provided for in

this chapter, the insurance law, the banking law or any other applicable

law.

§ 303 — Orders of superintendent; when writing required

Orders of superintendent; when writing required. Whenever by

any provision of this chapter, the insurance law, the banking law or any

other applicable law the superintendent is authorized to grant any

approval, authorization or permission or to make any other order or

determination affecting any person subject to the provisions of this

chapter, the insurance law, the banking law or any other law, such order

or determination shall not be effective unless made in writing and

signed by the superintendent or by the superintendent's authority.

§ 304 — Notice; how given

Notice; how given. (a) (1) Except when other notice is required

by law, whenever the provisions of this chapter, the insurance law, the

banking law or any other applicable law require the superintendent to

give notice to any person of any authorized action or proposed action,

it shall be sufficient to give such notice in writing either by

delivering it to such person or by depositing the same in the United

States mail, postage prepaid, registered or certified, and addressed to

the last known place of business of such person or if no such address is

known to the superintendent, then to the residence address of such

person.

(2) Such notice shall refer to the provisions of this chapter, the

insurance law, the banking law or any other applicable law pursuant to

which the authorized action was taken or is proposed to be taken and the

grounds therefor, but failure to make such reference shall not render

the notice ineffective if the person to whom it is addressed is thereby

or otherwise reasonably apprised of such grounds.

(3) If the person being notified is entitled to a hearing by the

provisions of this chapter, the banking law, the insurance law or any

other law, the notice of proposed action may specify that such proposed

action may be considered, or when authorized, taken on a date specified

in the notice unless such person shall notify the superintendent in

writing that a hearing is demanded; in such case the superintendent

shall give such person a further notice of the time and place of such

hearing in the manner stated in this paragraph, and to the address

specified by such person if provided.

(b) Whenever the provisions of this chapter, the insurance law, the

banking law, or any other law require the superintendent to give to any

person a hearing on any proposed action, it shall be sufficient

compliance with such requirement if the superintendent gives to such

person:

(1) notice of the time and the place at which an opportunity for

hearing will be afforded, and

(2) an opportunity for hearing, if the person appears at the time and

place specified in the notice or any adjourned date.

time to time without other notice than the announcement thereof at such

hearing.

(d) Whenever any person is entitled to a hearing by the provisions of

this chapter, the insurance law, the banking law, or any other law

before any proposed action is taken, the notice of such proposed action

may, if the superintendent deems it expedient, be in the form of a

notice to show cause stating that such proposed action may be taken

unless such person shows cause at a hearing to be held at a time and

place specified in such notice, why such proposed action should not be

taken.

(e) The statement of any regular salaried employee of the department

of financial services, subscribed and affirmed by such employee as true

under the penalties of perjury, stating facts which show that any notice

referred to in this section has been delivered or mailed as hereinbefore

provided, shall be presumptive evidence that such notice has been duly

delivered or mailed, as the case may be.

§ 304-a — Actions of the department subject to the state administrative procedure act

Actions of the department subject to the state administrative

procedure act. Unless otherwise specifically exempted in this chapter,

all rule making and adjudicatory proceedings shall be made in accordance

and consistent with the provisions of the state administrative procedure

act.

§ 305 — Hearings; conduct; findings and report

Hearings; conduct; findings and report. (a) Unless otherwise

provided in this chapter, the banking law, the insurance law or any

other law, any hearing pursuant to any such law may be held before the

superintendent, any deputy superintendent, or any designated salaried

employee of the department authorized by the superintendent for such

purpose. Any adjudicatory proceeding, including any hearings to assess

civil penalties under section four hundred eight or four hundred eight-a

of this chapter, held pursuant to the provisions of this chapter, the

insurance law or the banking law shall be noticed, conducted and

administered in compliance with the state administrative procedure act.

(b) The person conducting such hearing shall have power to administer

oaths, examine and cross-examine witnesses and receive documentary

evidence, and shall report such person's findings, orally or in writing,

to the superintendent with or without recommendation. Such report, if

adopted by the superintendent may be the basis of any determination made

by the superintendent. One hundred twenty days after the effective date

of a determination of liability for a civil penalty pursuant to section

four hundred eight or four hundred eight-a of this chapter or four

hundred three, one thousand one hundred two, two thousand one hundred

two, two thousand one hundred seventeen, two thousand one hundred

thirty-three or seven thousand eight hundred sixteen of the insurance

law, such determination of liability for a civil penalty may be entered

as a judgment and enforced, without court proceedings, in the same

manner as the enforcement of a money judgment in civil actions in any

court of competent jurisdiction or any other place provided for the

entry of civil judgment within this state.

shall be open to the public unless the superintendent or the person

authorized by the superintendent to conduct such hearing, shall

determine that a private hearing would be in the public interest, in

which case the hearing shall be private. Hearings under the banking law

shall be as provided for in the banking law.

(d) Every person affected shall be allowed to be present during the

giving of all the testimony, and shall be allowed a reasonable

opportunity to inspect all adverse documentary proof, to examine and

cross-examine witnesses, and to present proof in support of the person's

interest.

(e) Nothing herein contained shall require the observance at any such

hearing of formal rules of pleading or evidence.

§ 306 — Attendance of witnesses; production of documents and records

Attendance of witnesses; production of documents and records.

(a) The superintendent or the person authorized by the superintendent to

conduct a hearing or investigation shall have power to subpoena

witnesses, compel the attendance of witnesses, administer oaths, examine

any person under oath, and to compel any person to subscribe to his or

her testimony after it has been correctly reduced to writing, and in

connection therewith to require the production of any books, papers,

records, correspondence or other documents which the superintendent

deems relevant to the inquiry. A subpoena issued under this section

shall be regulated by the civil practice law and rules.

(b) No person subject to the provisions of this chapter, the insurance

law or the banking law whose conduct, condition or practices are being

investigated, and no officer, director or employee of any such person,

shall be entitled to witness or mileage fees.

civil practice law and rules, any person who, without just cause fails

or refuses to attend and testify or to answer any lawful inquiry or to

produce any books, papers or records in obedience to a subpoena issued

by the superintendent shall be guilty of a misdemeanor.

(d) Every regulated person under this chapter, the insurance law or

the banking law who is given a notice of hearing pursuant to this

chapter shall upon the service of a notice to produce books and records,

when attached to the notice of hearing or mailed subsequently thereto in

the same manner as the notice of hearing, pursuant to such notice,

produce at the hearing the books, records and documents enumerated

therein.

§ 308 — Judicial review of orders, regulations and decisions of superintendent

Judicial review of orders, regulations and decisions of

superintendent. (a) Notwithstanding the specific enumerations of the

right to judicial review in this chapter, the insurance law or the

banking law, any order, regulation or decision of the superintendent is

declared to be subject to judicial review in a proceeding under article

seventy-eight of the civil practice law and rules, provided that nothing

in this section or article seventy-eight of the civil practice law and

rules shall affect the time period provided in the banking law or the

insurance law for commencing such proceeding.

(b) Except as provided in section two thousand one hundred twenty-four

of the insurance law, the commencement of such proceeding shall not

affect the enforcement or validity of the superintendent's order,

regulation or decision under review unless the court shall determine,

after a preliminary hearing of which the superintendent is notified at

least forty-eight hours in advance, that a stay of enforcement pending

the proceeding or until further direction of the court will not unduly

injure the interests of the people of the state, in which case a stay of

execution may be granted.

§ 309 — Injunction to restrain violation of this chapter

Injunction to restrain violation of this chapter. (a) In

addition to such other remedies as are provided under this chapter, the

superintendent may maintain and prosecute an action against any person

subject to this chapter, the insurance law or the banking law, or the

person's officers, directors, trustees or agents, for the purpose of

obtaining an injunction restraining such person or persons from doing

any acts in violation of the provisions of this chapter, the insurance

law or the banking law.

(b) In such action if the court finds that a defendant is threatening

or is likely to do any act in violation of this chapter, the insurance

law or the banking law and that such violation will cause irreparable

injury to the interests of the people of this state, the court may grant

an injunction restraining such violation. The court may on motion and

affidavits grant a preliminary injunction and interlocutory injunction,

upon such terms as may be just; but the superintendent shall not be

required to give security before the issuance of any such injunction.

§ 310 — Certificates as evidence; affirmation of documents and testimony

Certificates as evidence; affirmation of documents and

testimony. (a) Every certificate, assignment, conveyance or other paper

executed by the superintendent or one of the superintendent's deputies

pursuant to law and sealed with the official seal of the department

shall be received as evidence in any judicial or other proceeding and

may be recorded in the proper recording offices.

(b) Any charter, or any certificate or other instrument supplemental

to or amendatory of the charter, of any regulated person filed in the

office of the superintendent and containing statements of fact required

or permitted by law to be contained therein, shall be received in all

courts, public offices and official bodies as prima facie evidence of

such facts and of the execution of such instrument.

any certificate by any officer in such jurisdiction or a copy of any

instruments certified or exemplified by any such officer, may be

received as prima facie evidence of the incorporation, existence or

capacity of any corporation incorporated in such jurisdiction, or

claiming so to be, such certificate when exemplified, or such copy of

such instrument when exemplified shall be received in all courts, public

offices and official bodies of this state, as prima facie evidence with

the same force as in such jurisdiction. Such certificate or certified

copy of such instrument shall be so received, without being exemplified,

if it is certified by the secretary of state, or official performing the

equivalent function as to corporate records of such jurisdiction.

(d) Notwithstanding any provision of this chapter, the insurance law

or the banking law requiring an oath as to the proof of a document or

the truth of testimony, the affiant may, if the affiant's religious

beliefs cause the affiant to object to giving an oath, affirm the

document or the affiant's testimony.

§ 311 — Financial literacy education

Financial literacy education. (a) Any youth participating in

the summer youth employment program, as defined in subdivision (c) of

this section, shall be provided with financial literacy education.

(b) The financial literacy education shall be developed and provided

in accordance with the standards and best practices of currently

operating summer youth employment programs or other similar models used

by local government in coordination with nonprofit organizations and/or

financial institutions for any summer youth employment programs that do

not already have a workshop as of the effective date of this

subdivision.

program" shall mean any such program funded through the office of

temporary and disability assistance.

ARTICLE 4 Financial Frauds Prevention

§ 402 — Legislative declaration

Legislative declaration. The legislature hereby finds and

declares that financial frauds take many forms across multiple

industries. The legislature further finds that financial fraud is

detrimental to the social and economic well-being of the citizens of

this state. In order to more thoroughly uncover, investigate and

eliminate the myriad financial frauds that may be perpetrated in, and

may involve the people of, New York state, the legislature finds that it

is appropriate that the responsibilities of the insurance frauds bureau

and the criminal investigations bureau that were administered by the

department of insurance and the department of banking, respectively,

prior to the enactment of this article, be consolidated into a new

financial frauds and consumer protection unit under the supervision of

the superintendent.

§ 403 — Financial frauds and consumer protection unit

Financial frauds and consumer protection unit. (a) The

superintendent shall establish a financial frauds and consumer

protection unit in the department of financial services.

(b) The financial frauds and consumer protection unit shall be a

qualified agency, as defined in section eight hundred thirty-five of the

executive law, to enforce the provisions of this article and article

four of the insurance law and article II-B of the banking law.

the unit as peace officers as defined in section 2.10 of the criminal

procedure law. Any such designations made by the superintendent of

insurance or the superintendent of banks, as they relate to peace

officers within the insurance frauds bureau and the criminal

investigations bureau, made prior to the effective date of this chapter,

shall be deemed continued and will remain effective subject to the

discretion of the superintendent.

(d) The superintendent is authorized to establish within the financial

frauds and consumer protection unit one or more units designated for the

purpose of investigating and preventing fraud and other criminal

activity in certain specified areas of the banking, finance and

insurance industries, as authorized by this chapter.

§ 404 — Powers of the financial frauds and consumer protection unit

Powers of the financial frauds and consumer protection unit.

(a) The superintendent has authority under this article, the banking

law, the insurance law and other applicable laws to investigate

activities that may constitute violations subject to section four

hundred eight or four hundred eight-a of this article or violations of

the insurance law or banking law and to develop evidence thereon.

(b) If the financial frauds and consumer protection unit has a

reasonable suspicion that a person or entity has engaged, or is

engaging, in fraud or misconduct with respect to the banking law, the

insurance law, the provisions of this chapter or other laws pursuant to

which the superintendent has investigatory or enforcement powers, then

the superintendent, in the enforcement of relevant statutes and

regulations, may undertake an investigation thereon, provided, however,

that the scope of authority set forth in this section shall not be

deemed to otherwise limit or impair the ability of the superintendent to

assist any other entity in an investigation involving a violation of

law, and provided further that the responsibility and power to

investigate any specific frauds or misconduct enumerated in this

chapter, the banking law, the insurance law and other laws pursuant to

which the superintendent has investigatory or enforcement powers shall

be included under the jurisdiction of the financial frauds and consumer

protection unit.

the financial frauds and consumer protection unit the specific powers or

responsibilities of the consumer protection division of the department

of state.

§ 405 — Immunity

Immunity. In the absence of fraud or bad faith, no person

subject to the provisions of this chapter, the banking law or the

insurance law shall be subject to civil liability, and no civil cause of

action of any nature shall arise against such person for any: (a)

information relating to suspected violations of the banking law or the

insurance law furnished to law enforcement officials, their agents and

employees; (b) information relating to suspected violations of the

banking law or the insurance law furnished to other persons subject to

the provisions of this chapter; (c) information furnished in reports to

the financial frauds and consumer protection unit, its agents or

employees or any state agency investigating fraud or misconduct relating

to financial fraud, its agents or employees; and (d) information

relating to insurance fraud as defined in section 176.05 of the penal

law furnished to the National Insurance Crime Bureau. For the purposes

of this section the National Insurance Crime Bureau is a nonprofit

dedicated to the prosecution of insurance fraud and vehicle crime. The

superintendent or any employee of the financial frauds and consumer

protection unit, in the absence of fraud or bad faith, shall not be

subject to civil liability and no civil cause of action of any nature

shall arise against the superintendent or any such employee by virtue of

the publication of any report or bulletin related to the official

activities of the financial frauds and consumer protection unit. Nothing

herein is intended to abrogate or modify in any way any common law

privilege or immunity heretofore enjoyed by any person.

§ 406 — Other law enforcement authority, powers and duties not affected or impaired

Other law enforcement authority, powers and duties not affected

or impaired. This article shall not:

(a) Preempt the authority or relieve the duty of other law enforcement

agencies to investigate and prosecute suspected violations of law;

(b) Prevent or prohibit a person from voluntarily disclosing any

information concerning violations of this article, the banking law or

the insurance law to any law enforcement agency; or

insurance law or other laws to the superintendent or the department to

investigate possible violations of law and take appropriate action.

§ 408 — Civil penalty

Civil penalty. (a) In addition to any civil or criminal

liability provided by law, the superintendent may, after notice and

hearing, levy a civil penalty:

(1) not to exceed five thousand dollars per offense, for:

(A) any intentional fraud or intentional misrepresentation of a

material fact with respect to a financial product or service or

involving any person offering to provide or providing financial products

or services; or

(B) any violation of state or federal fair debt collection practices

or federal or state fair lending laws; and

(2) not to exceed one thousand dollars for any other violation of this

chapter or the regulations issued thereunder, provided that there shall

be no civil penalty under this section for violations of article five of

this chapter or the regulations issued thereunder; and

(3) provided, however, that:

(A) penalties for regulated persons under the banking law shall be as

provided for in the banking law and penalties for regulated persons

under the insurance law shall be as provided for in the insurance law;

and

(B) the superintendent shall not impose or collect any penalty under

this section in addition to any penalty or fine for the same act or

omission that is imposed under the insurance law or banking law; and

interpretation of the term "fraud" as it is used in any other provision

of the consolidated or unconsolidated law.

(b) Civil penalties received by the superintendent pursuant to this

section shall be applied on an annual basis as follows: funds shall be

applied first to reduce the assessments charged on persons regulated

under the insurance law and the banking law pursuant to section two

hundred six of this chapter up to the full amount paid by persons

regulated under the insurance law and banking law for the operating

expenses of the financial frauds and consumer protection unit not

attributable to regulation under the insurance or banking law for the

fiscal year in which such penalties are received, such amount shall be

applied to any assessment in the following year, and any remaining funds

shall be paid to the general fund. The superintendent shall have

discretion to determine how operating expenses which are not solely

attributable to regulating persons under either the insurance law or the

banking law shall be allocated.

§ 408-a — Unlicensed activities prohibited

Unlicensed activities prohibited. (a) For the purposes of

this section, a "prohibited unlicensed act" shall mean:

(1) engaging in an activity in this state for which a license,

certification, registration, authorization, charter, accreditation or

incorporation is required by this chapter or the banking law, or the

regulations promulgated thereunder, without such license, certification,

registration, authorization, charter, accreditation or incorporation or

an exemption from such requirement; or

(2) any act or omission by a person who is required by this chapter or

the banking law, or the regulations promulgated thereunder, to be

licensed, certified, registered, authorized, chartered, accredited or

incorporated and is not so licensed, certified, registered, authorized,

chartered, accredited or incorporated, or exempted from such

requirement, if such act or omission would constitute a violation of

this chapter or the banking law, or the regulations promulgated

thereunder, subject to monetary penalty if such person were so licensed,

certified, registered, authorized, chartered, accredited or

incorporated.

(b) In addition to any civil or criminal liability provided by law,

the superintendent may, after notice and a hearing, levy a civil penalty

for any prohibited unlicensed act as follows:

(1) The penalty for a prohibited unlicensed act that relates to the

requirements of the banking law or the regulations promulgated

thereunder shall be the same as the penalty provided in section

forty-four of the banking law for any violation of the banking law.

(2) The penalty for a prohibited unlicensed act that relates to the

requirements of this chapter or the regulations promulgated thereunder

shall be the same as the penalty provided for in section four hundred

eight of this article for violations of this chapter or the regulations

promulgated thereunder. However, the superintendent shall not impose or

collect any penalty for a prohibited unlicensed act pursuant to this

paragraph if the superintendent imposes or collects any penalty pursuant

to paragraph one of this subsection or paragraphs two or three of

subsection (a) of section four hundred eight of this article for the

same act or omission.

(3) If a prohibited unlicensed act results in consumer harm, the

penalty shall be not more than double the penalty amount applicable to

such violation set forth in paragraphs one and two of this subsection.

section shall be applied in the same manner as civil penalties received

by the superintendent pursuant to section four hundred eight of this

chapter.

(d) In addition to any other penalty or sanction imposed upon a person

by law for a prohibited unlicensed act, after notice and a hearing, the

superintendent may issue an order directing such person to pay

restitution for such unlicensed act.

§ 409 — Reports

Reports. (a) Whenever the superintendent is satisfied that a

violation subject to section four hundred eight or four hundred eight-a

of this article or fraud or other criminal activity under the insurance

law or banking law has been committed or attempted, the superintendent

shall report any such violation of law, as the superintendent deems

appropriate, to the appropriate licensing agency, the district attorney

of the county in which such acts were committed, to the attorney

general, and where appropriate, to the person who submitted the report

of fraudulent activity, as provided by the provisions of this article.

Within one hundred twenty days of receipt of the superintendent's

report, the attorney general or the district attorney concerned shall

inform the superintendent as to the status of the reported violations.

(b) No later than March fifteenth of each year, beginning in two

thousand twelve, the superintendent shall furnish to the governor, the

speaker of the assembly and the temporary president of the senate a

report describing the activities of the financial frauds and consumer

protection unit. Such report shall describe (1) the unit's efforts with

respect to (A) frauds against entities regulated under the banking and

insurance laws; and (B) frauds against consumers; (2) the unit's

activities to address consumer complaints; and (3) any recommendations

of the superintendent with respect to changes of law that are desirable

to address gaps in protection. The report may address such other matters

relating to the activities of the financial frauds and consumer

protection unit as the superintendent believes will be useful to the

governor or the legislature.

two thousand twelve, the superintendent shall submit to the governor,

the state comptroller, the attorney general, the temporary president of

the senate, the speaker of the assembly, the chairpersons of the senate

finance and health committees, and the assembly ways and means and

health committees, a report summarizing the department's activities to

investigate and combat health insurance fraud including information

regarding referrals received, investigations initiated, investigations

completed, and any other material necessary or desirable to evaluate the

department's efforts.

ARTICLE 5 Restrictions On Officers and Employees of the Department

§ 501 — Restrictions on officers and employees of the department; penalty

Restrictions on officers and employees of the department;

penalty. (a) No officer or employee of the department shall obtain a

loan or extension of credit from any regulated person or be interested

in any such regulated person as a director, partner, owner, officer,

attorney, agent, trustee or employee, or own or deal in, either directly

or indirectly, the stocks or obligations of any such regulated person. A

violation of the provisions of this section by any officer or employee

shall constitute sufficient grounds for his or her removal by the

superintendent.

(b) Nothing in this section shall be construed to prohibit any officer

or employee from obtaining financing from a regulated person upon his or

her primary or secondary residence, provided that the premises securing

such loan are occupied by such employee, and further provided that such

loan is reported to the department, which shall keep a record thereof.

The term "residence," for the purposes of this section, shall mean a

single family or two family residence, condominium apartment or

cooperative apartment, occupied in whole or in part, by the officer or

employee. The term "cooperative apartment" means a residence where

ownership is evidenced by certificates of stock or other evidence of an

ownership interest in, and a proprietary lease from, a corporation or

partnership formed for the purpose of the cooperative ownership of real

estate.

or employee from: (1) obtaining a loan secured by an assignment of his

or her deposit in a banking organization, or an assignment or pledge of

his or her shares in a savings and loan association or credit union; (2)

accepting financing of an automobile, truck or other personal property

from a banking organization or a sales finance company; (3) entering

into a premium finance agreement with a premium finance agency; or (4)

owning shares of an investment company (mutual fund) that may

incidentally invest in the securities of any regulated person, provided

that the purpose of the investment portfolio of such investment company

may not be to invest primarily or exclusively in the securities of

banking or insurance entities. For purposes of this section, investment

companies include open-end and closed-end investment companies and unit

investment trusts as those terms are defined in an Act of Congress

entitled "The Investment Company Act of 1940," as amended.

(d) Nothing in this section shall be construed to prevent any officer

or employee from becoming a policyholder of any insurer or from taking

out a loan under the officer's or employee's insurance policy, or

prevent or impair the ability of the superintendent to act as a

liquidator, rehabilitator, or conservator pursuant to article

seventy-four of the insurance law or article thirteen of the banking

law.

(e) The superintendent may promulgate policies and procedures for

exempting particular employees, or classes of employees, from investment

restrictions in subsection (a) of this section as to regulated persons

with which such employee or class of employees has no authority or

involvement.

(f) This section shall not apply to investments held in a blind trust

approved by the superintendent or the superintendent's designee.

ARTICLE 6 Emergency Medical Services and Surprise Bills

§ 601 — Dispute resolution process established

Dispute resolution process established. The superintendent

shall establish a dispute resolution process by which a dispute for a

bill for emergency services or a surprise bill may be resolved. The

superintendent shall have the power to grant and revoke certifications

of independent dispute resolution entities to conduct the dispute

resolution process. The superintendent shall promulgate regulations

establishing standards for the dispute resolution process, including a

process for certifying and selecting independent dispute resolution

entities. An independent dispute resolution entity shall use licensed

physicians in active practice in the same or similar specialty as the

physician providing the service that is subject to the dispute

resolution process of this article for disputes that involve physician

services. To the extent practicable, the physician shall be licensed in

this state. Disputes shall be submitted to an independent dispute

resolution entity within three years of the date the health care plan

made the original payment on the claim that is the subject of the

dispute.

§ 602 — Applicability

Applicability. This article shall not apply to health care

services, including emergency services, where physician fees are subject

to schedules or other monetary limitations under any other law,

including the workers' compensation law and article fifty-one of the

insurance law, and shall not preempt any such law. This article also

shall not apply to health care services, including emergency services,

subject to medical assistance program coverage provided pursuant to

section three hundred sixty-four-j of the social services law.

§ 603 — Definitions

Definitions. For the purposes of this article:

(a) "Emergency condition" means a medical or behavioral condition that

manifests itself by acute symptoms of sufficient severity, including

severe pain, such that a prudent layperson, possessing an average

knowledge of medicine and health, could reasonably expect the absence of

immediate medical attention to result in : (1) placing the health of the

person afflicted with such condition in serious jeopardy, or in the case

of a behavioral condition placing the health of such person or others in

serious jeopardy; (2) serious impairment to such person's bodily

functions; (3) serious dysfunction of any bodily organ or part of such

person; (4) serious disfigurement of such person; or (5) a condition

described in clause (i), (ii) or (iii) of section 1867(e)(1)(A) of the

social security act 42 U.S.C. § 1395dd.

(b) "Emergency services" means, with respect to an emergency

condition: (1) a medical screening examination as required under

section 1867 of the social security act, 42 U.S.C. § 1395dd, which is

within the capability of the emergency department of a hospital,

including ancillary services routinely available to the emergency

department to evaluate such emergency medical condition; and (2) within

the capabilities of the staff and facilities available at the hospital,

such further medical examination and treatment as are required under

section 1867 of the social security act, 42 U.S.C. § 1395dd, to

stabilize the patient.

* (c) "Health care plan" means an insurer licensed to write accident

and health insurance pursuant to article thirty-two of the insurance

law; a corporation organized pursuant to article forty-three of the

insurance law; a municipal cooperative health benefit plan certified

pursuant to article forty-seven of the insurance law; a health

maintenance organization certified pursuant to article forty-four of the

public health law; or a student health plan established or maintained

pursuant to section one thousand one hundred twenty-four of the

insurance law.

* NB Effective until August 26, 2026

* (c) "Health care plan" means an insurer licensed to write accident

and health insurance pursuant to article thirty-two of the insurance

law; a corporation organized pursuant to article forty-three of the

insurance law; a municipal cooperative health benefit plan certified

pursuant to article forty-seven of the insurance law; a health

maintenance organization certified pursuant to article forty-four of the

public health law; a student health plan established or maintained

pursuant to section one thousand one hundred twenty-four of the

insurance law; or a health benefit plan operated pursuant to article

eleven of the civil service law.

* NB Effective August 26, 2026 until August 26, 2031

* (c) "Health care plan" means an insurer licensed to write accident

and health insurance pursuant to article thirty-two of the insurance

law; a corporation organized pursuant to article forty-three of the

insurance law; a municipal cooperative health benefit plan certified

pursuant to article forty-seven of the insurance law; a health

maintenance organization certified pursuant to article forty-four of the

public health law; or a student health plan established or maintained

pursuant to section one thousand one hundred twenty-four of the

insurance law.

* NB Effective August 26, 2031

(d) "Insured" means a patient covered under a health care plan's

policy or contract.

(e) "Non-participating" means not having a contract with a health care

plan to provide health care services to an insured.

(f) "Participating" means having a contract with a health care plan to

provide health care services to an insured.

(g) "Patient" means a person who receives health care services,

including emergency services, in this state.

(h) "Surprise bill" means a bill for health care services, other than

emergency services, with respect to:

(1) an insured for services rendered by a non-participating provider

at a participating hospital or ambulatory surgical center, where a

participating provider is unavailable or a non-participating provider

renders services without the insured's knowledge, or unforeseen medical

services arise at the time the health care services are rendered;

provided, however, that a surprise bill shall not mean a bill received

for health care services when a participating provider is available and

the insured has elected to obtain services from a non-participating

provider;

(2) an insured for services rendered by a non-participating provider,

where the services were referred by a participating physician to a

non-participating provider without explicit written consent of the

insured acknowledging that the participating physician is referring the

insured to a non-participating provider and that the referral may result

in costs not covered by the health care plan; or

(3) a patient who is not an insured for services rendered by a

physician at a hospital or ambulatory surgical center, where the patient

has not timely received all of the disclosures required pursuant to

section twenty-four of the public health law.

(i) "Usual and customary cost" means the eightieth percentile of all

charges for the particular health care service performed by a provider

in the same or similar specialty and provided in the same geographical

area as reported in a benchmarking database maintained by a nonprofit

organization specified by the superintendent. The nonprofit organization

shall not be affiliated with an insurer, a corporation subject to

article forty-three of the insurance law, a municipal cooperative health

benefit plan certified pursuant to article forty-seven of the insurance

law, or a health maintenance organization certified pursuant to article

forty-four of the public health law.

* (j) "Allowed benchmark" means the fiftieth percentile of all allowed

amounts for the particular health care service performed by a

participating provider in the same or similar specialty and provided in

the same geographical area as reported in a benchmarking database

maintained by a nonprofit organization specified by the superintendent.

The nonprofit organization shall not be affiliated with an insurer, a

corporation subject to article forty-three of the insurance law, a

municipal cooperative health benefit plan certified pursuant to article

forty-seven of the insurance law, or a health maintenance organization

certified pursuant to article forty-four of the public health law.

* NB Effective August 26, 2026

* (k) "Maximum fee" means the eightieth percentile of all allowed