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Judicial Watch • New York Life Documents from Oregon

New York Life Documents from Oregon

New York Life Documents from Oregon

Page 1: New York Life Documents from Oregon

Category:FOIA Response

Number of Pages:24

Date Created:November 25, 2013

Date Uploaded to the Library:December 16, 2013

Tags:ACA, SRRHIC, obamacare, Oregon


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SERFF Tracking NYLM-128998137
State Tracking NYLM-128998137
Company Tracking DISCONTINUATION
MEDICAL INSURANCE COV...
State:
Oregon
TOI/Sub-TOI:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Filing Company:
Product Name:
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number: Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Filing Glance
Company:
Product Name:
State:
TOI:
Sub-TOI:
Filing Type:
Date Submitted:
SERFF Num:
SERFF Status:
State Num:
State Status: Num:
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon
Oregon
H16G Group Health Major Medical
H16G.002C Large Group Only Other
Form
04/24/2013
NYLM-128998137
Closed-Filed information
NYLM-128998137
Review completed
DISCONTINUATION MEDICAL INSURANCE COVERAGE OREGON
Implementation
Date Requested:
Author(s):
Reviewer(s):
Disposition Date:
Disposition Status:
Implementation Date:
02/22/2013 Gomes
Rhonda Saunders-Ricks (primary), Rick Barry
06/05/2013
Filed information
06/05/2013
State Filing Description:
Modification and Discontinuance Health Benefit Plans
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking NYLM-128998137
State Tracking NYLM-128998137
Company Tracking DISCONTINUATION
MEDICAL INSURANCE COV...
State:
Oregon
TOI/Sub-TOI:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Filing Company:
Product Name:
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number: Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
General Information
Project Name: Discontinuation Medical Insurance Coverage Oregon
Project Number: Discontinuation Medical Insurance
Coverage Oregon
Requested Filing Mode: Informational
Explanation for Combination/Other:
Submission Type: New Submission
Group Market Type: Association, Trust, Non Employer Group
Filing Status Changed: 06/05/2013
State Status Changed: 06/05/2013
Created By: Gomes
Corresponding Filing Tracking Number:
Status Filing Domicile:
Date Approved Domicile:
Domicile Status Comments:
Market Type: Group
Group Market Size: Large
Overall Rate Impact:
Deemer Date:
Submitted By: Gomes
PPACA: Not PPACA-Related
PPACA Notes: null
Include Exchange Intentions:
Filing Description: requested Rhonda Saunders-Ricks and Rick Barry the Oregon Insurance Division, the enclosed information has been
submitted via SERFF. outlined the withdrawal letter, New York Lifes discontinuance all medical insurance coverage includes group major
medical insurance provided through out-of-state, non-employer based, bona fide associations/trust plans.
The sole group that was actively marketed sold Oregon was the Trustees the American Veterinary Medical Association
Group Health and Life Insurance Trust (AVMA) issued form GMR (group policy G-14884-3 State Num: 0603 OID 248/SERFF Num: NYLM-125961198). 12/31/2012, this case longer being actively marketed sold.
Additionally, there are two individuals who obtained major medical coverage through the American Association
Orthodontists (AAO group policy G14242-1); one individual who obtained coverage through the American College
Surgeons (ACS group policy G-29001-3); and three individuals who obtained coverage under the Trustee the Geocare
Benefits Group Insurance Trust (AAPG group policy 29065-0). Coverage these groups has not been marketed sold
Oregon for several years. AAO (State Num: 0478 OID 559/SERFF Num: NYLM-126798497) and ACS (State Num: 0483 OID 580/SERFF Num: NYLM-126798584) were filed for group approval. The individuals insured
under AAPG presumably obtained coverage another jurisdiction and subsequently moved Oregon.
Finally, the insureds under the remaining policy numbers (G-29058; G-30100; and G-30104) consist group limited
benefits catastrophic insurance which was never sold New York Life. These insureds were the result New York Life
taking over the case when the prior carrier terminated the business.
Please see the attached submission Transmittal Form (440-2896), Notice Discontinuation Medical Insurance Coverage
and applicable Exhibits.
Please not hesitate contact you have any other questions.
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking NYLM-128998137
State Tracking NYLM-128998137
Company Tracking DISCONTINUATION
MEDICAL INSURANCE COV...
State:
Oregon
TOI/Sub-TOI:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Filing Company:
Product Name:
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number: Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Company and Contact
Filing Contact Information Gomes, Senior Associate
New York Life Insurance Company Rockwood Road
Sleepy Hollow, 10591
Filing Company Information
New York Life Insurance Company Madison Avenue
New York, 10010
(212) 576-5814 ext. [Phone]
Al_Gomes@newyorklife.com
914-846-3445 [Phone]
914-846-4354 [FAX]
CoCode: 66915
Group Code: 826
Group Name:
FEIN Number: 13-5582869
State Domicile: New York
Company Type:
State Number:
Filing Fees
Fee Required?
Retaliatory?
Fee Explanation:
State Specific
Have you reviewed the General Instructions attached separate pdf the bottom the General Instructions page?: Yes
Did you read the instructions regarding how enter the form number and edition date the Forms Schedule tab?: Yes
Did you realize Oregon does not respond Status Requests thru SERFF?: Yes
Please confirm that you have read the Fraud Bulletin 2010-3 located at:
http://www.cbs.state.or.us/external/ins/bulletins/bulletin2010-03.pdf: Yes
Have you attached under the Supporting Documentation tab any state specific Amendatory Endorsements that will used
bring the submitted forms into compliance with our statutes?: N/A
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
Filing Company:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Correspondence Summary
Dispositions
Status
Filed
information
Approved
Created
Rhonda Saunders-Ricks
Created
06/05/2013
Date Submitted
06/05/2013
Rhonda Saunders-Ricks
06/05/2013
06/05/2013
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
Filing Company:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Disposition
Disposition Date: 06/05/2013
Implementation Date: 06/05/2013
Status: Filed information
HHS Status: Not Reported
State Review:
Comment:
Rate data does NOT apply filing.
Schedule
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Form
Form
Form
Form
Form
Schedule Item
Cover Letter Explanatory Memorandum
Third party filers letter authorization
3894 Certification Compliance
2448 Standards for Group Health Benefit Plans Medical Hospital Surgical
3899 Readability Certification
2896 Benefit Modification Discontinuance Health
Benefit Plans
Highlighted/Redline form version replaced, amended similar forms
2441; 2441A; 2441D Standards for Associations, Trusts, Discretionary Groups
Notice Discontinuation Medical Insurance Coverage
Exhibit
Exhibit
Exhibit
Group Major Medical
Group Major Medical
Group Major Medical
Group Major Medical
Group Limited Benefits Catastrophic Insurance
Schedule Item Status
Reviewed-No Action
Reviewed-No Action
Reviewed-No Action
Reviewed-No Action
Public Access
Yes
Yes
Yes
Yes
Reviewed-No Action
Reviewed-No Action
Yes
Yes
Reviewed-No Action
Yes
Reviewed-No Action
Yes
Reviewed-No Action
Information only
Information only
Information only
Withdrawn/no approval
Withdrawn/no approval
Withdrawn/no approval
Withdrawn/no approval
Withdrawn/no approval
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
Filing Company:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Disposition
Disposition Date: 06/05/2013
Implementation Date: 06/05/2013
Status: Approved
HHS Status: HHS Approved
State Review:
Comment: Effective 12/31/2013
Rate data does NOT apply filing.
Schedule
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Supporting Document
Form
Form
Form
Form
Form
Schedule Item
Cover Letter Explanatory Memorandum
Third party filers letter authorization
3894 Certification Compliance
2448 Standards for Group Health Benefit Plans Medical Hospital Surgical
3899 Readability Certification
2896 Benefit Modification Discontinuance Health
Benefit Plans
Highlighted/Redline form version replaced, amended similar forms
2441; 2441A; 2441D Standards for Associations, Trusts, Discretionary Groups
Notice Discontinuation Medical Insurance Coverage
Exhibit
Exhibit
Exhibit
Group Major Medical
Group Major Medical
Group Major Medical
Group Major Medical
Group Limited Benefits Catastrophic Insurance
Schedule Item Status
Reviewed-No Action
Reviewed-No Action
Reviewed-No Action
Reviewed-No Action
Public Access
Yes
Yes
Yes
Yes
Reviewed-No Action
Reviewed-No Action
Yes
Yes
Reviewed-No Action
Yes
Reviewed-No Action
Yes
Reviewed-No Action
Information only
Information only
Information only
Withdrawn/no approval
Withdrawn/no approval
Withdrawn/no approval
Withdrawn/no approval
Withdrawn/no approval
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
Filing Company:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Form Schedule
Lead Form Number:
Item
No.
Schedule Item
Status
Withdrawn/no
approval
06/05/2013
Withdrawn/no
approval
06/05/2013
Withdrawn/no
approval
06/05/2013
Withdrawn/no
approval
06/05/2013
Withdrawn/no
approval
06/05/2013
Form
Name
Group Major Medical
Form
Number
GMRFACE/G14884-3
Group Major Medical
GMRFACE/G14242-1
Group Major Medical
GMRFACE/G29001-3
Group Major Medical
GMRFACE/G29065-0
Group Limited Benefits GMRCatastrophic Insurance FACE/G29058; G30100; G30104
Form Type Legend:
Advertising
ADV
Certificate
CER
DDP
MTX
OTH
PJK
POLA
Form
Type
CER
Form
Action
Other
Action Specific
Data
Withdrawal
CER
Other
Withdrawal
CER
Other
Withdrawal
CER
Other
Withdrawal
CER
Other
Withdrawal
AEF
CERA
Data/Declaration Pages
Matrix
Other
Policy Jacket
Policy/Contract/Fraternal Certificate: Amendment,
Insert Page, Endorsement Rider
FND
NOC
OUT
POL
SCH
Readability
Score
Application/Enrollment Form
Certificate Amendment, Insert Page, Endorsement
Rider
Funding Agreement (Annuity, Individual and Group)
Notice Coverage
Outline Coverage
Policy/Contract/Fraternal Certificate
Schedule Pages
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
Attachments
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
Filing Company:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Supporting Document Schedules
Bypassed Item:
Bypass Reason:
Attachment(s):
Item Status:
Status Date:
Cover Letter Explanatory Memorandum
Please see the Filing Description the General Information Tab for details related this filing.
Bypassed Item:
Bypass Reason:
Attachment(s):
Item Status:
Status Date:
Third party filers letter authorization
N/A this filing being submitted the insurer.
Satisfied Item:
Comments:
Attachment(s):
Item Status:
Status Date:
3894 Certification Compliance
Please see attached Certificate Compliance.
(OR) Certificate Compliance.pdf
Reviewed-No Action
06/05/2013
Bypassed Item:
Bypass Reason:
Attachment(s):
Item Status:
Status Date:
2448 Standards for Group Health Benefit Plans Medical Hospital Surgical
N/A this notice withdrawal filing does not contain any forms.
Bypassed Item:
Bypass Reason:
Attachment(s):
Item Status:
Status Date:
3899 Readability Certification
N/A this notice withdrawal filing does not contain any forms.
Satisfied Item:
Comments:
Attachment(s):
Item Status:
2896 Benefit Modification Discontinuance Health Benefit Plans
Please see attached transmittal form.
Form 440-2896_AssociationTrust.pdf
Reviewed-No Action
Reviewed-No Action
06/05/2013
Reviewed-No Action
06/05/2013
Reviewed-No Action
06/05/2013
Reviewed-No Action
06/05/2013
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
Filing Company:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Status Date:
06/05/2013
Bypassed Item:
Bypass Reason:
Attachment(s):
Item Status:
Status Date:
Highlighted/Redline form version replaced, amended similar forms
N/A this notice withdrawal filing does not contain any forms.
Bypassed Item:
2441; 2441A; 2441D Standards for Associations, Trusts, Discretionary Groups
N/A this filing for withdrawal from the medical insurance market, not endeavor issue coverage association,
trust discretionary group.
Bypass Reason:
Reviewed-No Action
06/05/2013
Attachment(s):
Item Status:
Status Date:
Reviewed-No Action
06/05/2013
Satisfied Item:
Comments:
Attachment(s):
Item Status:
Status Date:
Notice Discontinuation Medical Insurance Coverage
Please see attached notice.
Oregon.pdf
Reviewed-No Action
06/05/2013
Satisfied Item:
Comments:
Attachment(s):
Item Status:
Status Date:
Exhibit
Please see attached Exhibit.
(OR) Letter Policyholders-Exhibit A_2-14-2013.pdf
Information only
06/05/2013
Satisfied Item:
Comments:
Attachment(s):
Item Status:
Status Date:
Exhibit
Please see attached Exhibit.
(OR) Letter Plan Sponsors-Exhibit B_2-14-2013.pdf
Information only
06/05/2013
Satisfied Item:
Comments:
Attachment(s):
Item Status:
Exhibit
Please see attached Exhibit.
(OR) Letter Insureds-Exhibit C_2-15-2013.pdf
Information only
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
SERFF Tracking
NYLM-128998137
State Tracking
NYLM-128998137
Company Tracking
State:
Oregon
TOI/Sub-TOI:
H16G Group Health Major Medical/H16G.002C Large Group Only Other
Product Name:
Discontinuation Medical Insurance Coverage Oregon
Project Name/Number:
Discontinuation Medical Insurance Coverage Oregon/Discontinuation Medical Insurance Coverage Oregon
Status Date:
Filing Company:
DISCONTINUATION MEDICAL
INSURANCE COV...
New York Life Insurance Company
06/05/2013
PDF Pipeline for SERFF Tracking Number NYLM-128998137 Generated 11/25/2013 05:28
Department Consumer Business Services
Oregon Insurance Division
350 Winter St.,
Salem, Oregon 97301-3883
Phone: (503) 947-7983
TRANSMITTAL AND REQUIREMENTS FOR
MODIFICATION AND DISCONTINUANCE HEALTH BENEFIT PLANS defined ORS 743.730(19)(a)
Date:4/22/2013
NAIC No:66915
Insurer name:New York Life Insurance Company
Department Action:
 Approved;
Limitations_______________
________________________
Filing entity name (if not insurer): not the insurer, letter authorization must included the filing.
 Processed Information
Contact person name:Al Gomes
 Withdrawn
Title:Senior Associate
 Disapproved;
Mailing address:1 Rockwood Road, Sleepy Hollow, 10591
Reason: _________________
_______________________
Action Date: _______________
Toll-free/collect phone no.:212-576-7000
Email address:Al_Gomes@newyorklife.com
Effective date:
Effective Date: _____________ different from action date
Analyst: ___________________
State Filing No.:_____________
This filing submitted for:
MODIFICATION OAR 836-053-0001 (complete Section III, and IV)
DISCONTINUANCE ORS 743.737; 743.754; 743.766 (complete Section II, III, and IV)
Patient Protection Affordability Care Act (PPACA)
Plan(s) are:
Non-Grandfathered
Grandfathered grandfathered the plans are:
Losing Grandfathered status
Maintaining Grandfathered status
The following checklist standards help carriers make complete filing compliance with
relevant statutes and rules. some cases, the statements contained this form are summaries and may necessary refer the entire statute rule. The filer signature the certification form confirmation that diligent consideration has been given each item. the case modification,
replacement rates and forms must submitted with this transmittal document.
440-2896 (rev. 3/13/INS)
MODIFICATION OAR 836-053-0001 modification change changes that alter the actuarial valuation the health benefit
plan less than 10% the aggregate the policyholder.
Modifications can only implemented the time renewal. notice explaining all changes must sent all policyholders least days prior
their renewal date. OAR 836-053-0001(3) Please select the type(s) health plan involved
Small employer group health benefit plan
Large group health benefit plan
Individual health benefit plan
Portability health benefit plan Please select the type modification that applies:
Eliminating adding benefits services payable health benefit plan
Increasing decreasing benefits payable services under plan, including decrease increase that occurs result change formulas, methodologies schedules
that serve the basis for making benefit determinations.
Increasing decreasing deductibles, copayments other amounts paid
enrollee.
Establishing new conditions requirements such preauthorization requirements
obtain services benefits under the plan eliminating such conditions requirements. ORS 742.003(4) Prior issuing notices: Include copy the notice that will sent policyholders renewal advising them the modification(s) their plan. the case group plan, carrier plans notify subscribers, include copy the
notice that advises them the modification(s) their plan renewal. For Individual plan modifications, include copy the notice that will sent
policyholders.
Continue Section III.
440-2896 (3/13/INS)
II.
DISCONTINUANCE ORS 743.737; 743.754; 743.766 Please select the type health plan involved:
Small group health benefit plan
Large group health benefit plan
Individual health benefit plan
Portability health benefit plan carrier discontinuing all the group products this state, separate Portability
discontinuance filing must submitted. there are other group products and result,
Portability plans cannot continued, carriers may offer enrollees their Individual plans with health status underwriting well the option obtain coverage through the Oregon
Medical Insurance Pool (OMIP). Does the carrier have other group products this state? yes,
small
large
Yes
both large and small group
Corresponding portability plan(s) discontinuation filing included under separate cover. Portability discontinuation filing not included this filing under separate cover,
please explain why:
Withdrawing altogether from the medical care market. Does the carrier have individual products this state?
Yes
a.) yes, will the carrier offer the portability members the individual plan
without medical underwriting
with medical underwriting
The carrier discontinuing offering renewing, offering and renewing all health
benefit plans specified area(s) within Oregon. Which counties are affected?
All.
The carrier discontinuing offering renewing, offering and renewing health benefit
plan Oregon.
The carrier discontinuing offering renewing, offering and renewing health benefit
plan specified area(s) within Oregon. Which counties are affected?(closed block) ORS 742.003(4) Prior issuing notices:
 Provide copy the notice DCBS for review prior issuing the notices the
policyholders. The notices must provide detailed information regarding the
policyholder options.
440-2896 (3/13/INS)
III.
REQUIRED SUPPORTING DOCUMENTATION
List all plans being discontinued modified and provide the number policyholders each
plan involved. (Attach additional page needed)
Plan and Form Number Grandfathered
Name Insured Lives
Yes/No
GMR-FACE/G-14884-3
Both
AVMA
302
GMR-FACE/G-14242-1
Both
AAO
GMR-FACE/G-29001-3
Both
ACS
GMR-FACE/G-29065-0
Both
AAPG
N/A
GMR-FACE/G-29058; G-30100; G-30104
IV. Items required filing, whether modification discontinuance: actuarial demonstration describing the changes benefits and/or rates.
Include chart showing claim cost percentages premium for all the added
discontinued benefits and/or services and the sum the changes. Note: the idea here prove modification (less than 10%) discontinuance (more than 10%). The same
service can have different dollar values depending other provisions such
deductibles. need the overall effect, best stated percentage including the
percentage for each item the list that represents the items portion the total premium. this information not included the filing, please provide written explanation.
Provide description the data (source and time period) used develop the value for
the benefits and/or services. list the changes the modification including side-by-side comparison showing the
previous benefit structure compared the new benefit structure. side-by-side comparison showing the new plan that will closest the discontinued.
Language changes that constitute benefit service change must included the
side-by-side comparison.
Provide statement why the changes are needed. (*See Filing Description and
enclosed Withdrawal letter)
Carriers are subject 5-year ban from the Oregon market product line they elect
discontinue.
Small Employer ORS 743.736(12)
Individual ORS 743.769(6)
440-2896 (3/13/INS)
Large Group ORS 743.752(2)
440-2896 (3/13/INS)
The Company You Keep 
New York Life Insurance Company Rockwood Road
Sleepy Hollow, 10591
Raghu Rangachar
Vice President Actuary
Bus: 914-846-3376
Fax: 914-846-4469
rrangach@nyl.com
February 15, 2013
Commissioner Insurance
Mr. Louis Savage
Oregon Insurance Department
Insurance Division
350 Winter Street NE, Room 440
Salem, 97301-3883
Re:
Discontinuation Medical Insurance Coverage
Dear Mr. Savage:
Please accept this notice, pursuant U.S.C. 300gg-2, that New York Life Insurance
Company New York Life intends discontinue offering all medical care insurance coverage Oregon and all other States and D.C. effective January 2014.
This decision, which will impact 330 individuals, came after careful consideration,
including weighing the impact the new requirements imposed carriers the Patient
Protection and Affordable Care Act PPACA Based upon PPACA and confirmed through
our discussions with CMS has become clear that beginning January 2014, New York Life
would required offer medical care insurance all individuals and employers. New York
Life currently only underwrites group association coverage the medical care market, primarily non-employer based bona fide association coverage. New York Life does not have the ability terms resources, time, personnel, and systems, nor the administrative capability become individual health carrier. New York Life had exited the individual health market many years
ago and our strategic initiatives not include re-entry into the individual medical care market.
This decision not limited Oregon New York Life exiting the medical insurance
market all fifty states and the District Columbia.
With regard Oregon, New York Life discontinuation all group association medical
insurance coverage will affect the following medical care coverages and policy forms:
Medical Care Coverages:
Major Medical Insurance Catastrophe Medical Insurance (Policy Form GMR al.)
New York Life has made efforts ensure smooth transition for the individuals
impacted this decision. Most importantly, all individuals will have medical care coverage
through December 31, 2013 prevent any gaps coverage. New York Life intends
notify each group policyholder, plan sponsor, and plan participant covered under these policies
that their coverage will non-renewed effective January 2014 and that that date, they
will have the option obtaining replacement coverage from the following sources:
The State Federal health insurance exchange which anticipated become
operational October 2014.
Individuals will provided the names and contact information for the three
major carriers the medical care market Oregon.
New York Life will prepared respond inquiries from individuals impacted
this decision. The company will have staff ready respond questions from plan sponsors
and plan participants. have included our notification letter. New York Life further
anticipates that will mail the statutory 180-day notice each group policyholder, plan
sponsor and plan participant covered under New York Life current medical insurance
coverage June 2013. Drafts the notice letters proposed sent group
policyholders, plan sponsors and plan participants are attached hereto Exhibits and
respectively.
Please advised that this notice does not apply the coverages outlined below:
The Excepted benefits outlined The Code Federal Regulations Title -Subtitle Part 146 Section 146.145 (c) (2) benefits excepted all
circumstances; (c) (3) Limited excepted benefits; (c) (4) Noncoordinated benefits,
and (c) (5) Supplemental benefits; including but not limited the following
coverages:
Dental
Vision
Accident
Critical Illness Specified Disease illness
Cancer
Long Term Care
Disability Income
Long-Term
Short-Term
Hospital Indemnity other fixed indemnity insurance
Please not hesitate contact Gomes New York Life (914) 846-3445
email Al_Gomes@newyorklife.com you have any questions regarding the anticipated
actions described this letter.
Sincerely,
Raghu Rangachar
Exhibit
[New York Life Letterhead]
DATE[Formal policyholder]
[Address]
Re:
Dear
Non-Renewal Health Insurance Coverage accordance with applicable state and federal law, are writing notify you that
New York Life Insurance Company New York Life intends discontinue offering
health insurance coverage the type provided the plan for which you are group
policyholder and non-renew your group policy effective January 2014. New York Life
exiting the group association medical care insurance market all states and notifying all
group policyholders, plan sponsors, and participants under our group association medical care
insurance policies that their group policies will non-renewed January 2014.
Additionally, New York Life making similar notification filings with the state insurance
regulators all fifty states and the District Columbia.
New York Life understands that January 2014, your insureds will have the option seeking appropriate replacement coverage for your New York Life group policy that being
non-renewed participating the state insurance exchange the Federal insurance
exchange (or both). New York Life conjunction with their Third Party Administrators
staffing telephone hotline with trained personnel capable responding questions your
insureds may have with regard seeking replacement coverage for your group policy.
2014 OPEN ENROLLMENT WILL BEGIN OCTOBER 2013 AND END
MARCH 31, 2014. YOU PURCHASE POLICY THROUGH OREGON HEALTH
INSURANCE EXCHANGE, COVER OREGON, YOU MAY ELIGIBLE FOR
SUBSIDY AND/OR TAX CREDITS BASED YOUR INCOME. CONTACT COVER
OREGON 1-855-COVEROR (1-855- 268-3767) YOUR INSURANCE AGENT
FOR MORE INFORMATION.
The decision exit the medical care marketplace was not easy one but the evolving
market conditions the health insurance industry under Health Care Reform laws and
regulations which are named Patient Protection and Affordable Care (PPACA prevent
from continuing offer competitive medical insurance for association plans such yours.
Please not hesitate contact you have any questions regarding the actions described
this letter.
Very truly yours,
Exhibit
[New York Life Letterhead]
DATE
[Plan Sponsor]
[Address]
Re:
Dear
Non-Renewal Health Insurance Coverage previously discussed, accordance with applicable state and federal law, are
writing notify you that New York Life Insurance Company New York Life
intends discontinue offering health insurance coverage the type provided the plan for
which you are sponsor and non-renew your group policy effective January 2014. New
York Life exiting the group association medical care insurance market all states and
notifying all group policyholders, plan sponsors, and participants under our group association
medical care insurance policies that their group policies will non-renewed January
2014. Additionally, New York Life making similar notification filings with the state insurance
regulators all fifty states and the District Columbia.
New York Life understands that January 2014, your insureds will have the option seeking appropriate replacement coverage for your New York Life group policy that being
non-renewed participating the state insurance exchange the Federal insurance
exchange (or both). New York Life will work closely with you and your TPA provide
much detailed information your insureds that they can make informed decision about
replacement coverage. This will include the staffing telephone hotline with trained personnel
capable responding questions insureds may have with regard seeking replacement
coverage for your group policy. will provide several communication pieces your insureds keep them informed and remind them that they need purchase other coverage effective
January 2014. Special attention will given insureds ages and over who may need
enroll Medicare Part and/or who may wish consider Medicare Supplemental policy Medicare Advantage program.
2014 OPEN ENROLLMENT WILL BEGIN OCTOBER 2013 AND END
MARCH 31, 2014. YOU PURCHASE POLICY THROUGH OREGON HEALTH
INSURANCE EXCHANGE, COVER OREGON, YOU MAY ELIGIBLE FOR
SUBSIDY AND/OR TAX CREDITS BASED YOUR INCOME. CONTACT COVER
OREGON 1-855-COVEROR (1-855- 268-3767) YOUR INSURANCE AGENT
FOR MORE INFORMATION.
The decision exit the medical care marketplace was not easy one but the evolving
market conditions the health insurance industry under Health Care Reform laws and
regulations which are named Patient Protection and Affordable Care (PPACA prevent
from continuing offer competitive medical insurance for association plans such yours. will providing greater detail well draft our first communication insureds
shortly. Until then, please not hesitate contact you have any questions regarding the
actions described this letter.
Very truly yours,
[Address]
Re:
Non-Renewal Association Medical Care Insurance Coverage
Dear accordance with applicable state and federal law, are writing inform you that New York
Life Insurance Company New York Life exiting the association medical care
insurance market all states January 2014. This means that the medical care insurance
coverage you and any your insured dependents currently have under Group Policy Number
[__________] issued [_____________] will terminate midnight 12/31/2013. The
decision exit this market was not easy one. The determination was made based the
evolving market conditions and regulatory requirements stemming from the Patient Protection
and Affordable Care Act PPACA
{This decision impacts your medical care coverage only. Any life, disability, hospital indemnity other non-medical coverage you may have through will remain unaffected this
decision.} understand the significance this change and have taken steps assist you the
process replacing your coverage. Under the terms PPACA, effective 1/1/2014 individuals
will able purchase medical care insurance without regard their health status and without
any preexisting conditions impairment limitations. Depending upon your state residence
you may purchase coverage either through your state insurance exchange the federal
insurance exchange (or both) effective after 1/1/2014. Please www.ABCD.com for
information who you can contact about these exchanges, and for information about the major
health care insurers your state. You can also call XXX XXX-XXXX for this information.
urge you contact the provider your choice soon possible review the options
available you. addition you should www.healthcare.gov for additional information
the insurance plans that will available you and how the insurance exchanges will work.
2014 OPEN ENROLLMENT WILL BEGIN OCTOBER 2013 AND END
MARCH 31, 2014. YOU PURCHASE POLICY THROUGH OREGON HEALTH
INSURANCE EXCHANGE, COVER OREGON, YOU MAY ELIGIBLE FOR
SUBSIDY AND/OR TAX CREDITS BASED YOUR INCOME. CONTACT COVER
OREGON 1-855-COVEROR (1-855- 268-3767) YOUR INSURANCE AGENT
FOR MORE INFORMATION. addition exploring the coverage options that may available you through exchange alternate carrier, insureds who are, who will become, Medicare-eligible before
1/1/2014 should contact 1-800-MEDICARE for information about Medicare, Medicare
Supplemental coverage, Medicare Advantage type programs, and Medicare Part The
Medicare website provides that the open enrollment period for Medicare Advantage type
programs and Medicare October 15, 2013 December 2013. states that individuals
who didnt sign for Medicare Part and/or Part when they were first eligible, can sign
during the General Enrollment Period between January March each year. Coverage will
start July and individuals may have pay higher premium for late enrollment. Insureds age and over will receiving notice early October indicating whether their current
prescription drug coverage credible for Medicare Part purposes. also urge you log onto www.Medicare.gov for detailed information about options that are
available you, and you can get personalized health insurance counseling cost you from
your local State Health Insurance Assistance Program (SHIP). Please note that failure enroll timely basis for Medicare Parts and may result penalties that could take the
form permanently increasing the cost you for these coverages.
Please assured that any life, disability income, hospital indemnity other non-medical
coverage you have through {XXX} will not affected this change. Further, your current
medical care insurance will continue throughout 2013, provided the applicable premium paid timely manner. are committed providing you with the information and resources you may need find
replacement coverage timely basis avoid gaps coverage for you your family. will sending you regular communications over the coming months with reminders and
information assist you finding new medical plan that meets your needs. Meanwhile,
please not hesitate contact {YYY}, your plan administrator, {XXX-XXX-XXXX} with
any questions concerns.
Sincerely,