§ 7703 — Scope

New York § 7703

• Jurisdiction: New York
• Law ISC: Insurance
• Art. 77: The Life and Health Insurance Company Guaranty Corporation of New York Act

Text

§ 7703. Scope. (a) (1) This article shall apply to direct life\ninsurance policies, health insurance policies, annuity contracts,\nfunding agreements, and supplemental contracts issued by a life\ninsurance company, health insurance company, or property/casualty\ninsurance company licensed to transact life or health insurance or\nannuities in this state at the time the policy, contract, or funding\nagreement was issued or on the date of entry of a court order of\nliquidation or rehabilitation with respect to such a company that is an\nimpaired or insolvent insurer, as the case may be.\n (2) Except as otherwise provided in this section, this article shall\napply to the policies, contracts, and funding agreements specified in\nparagraph one of this subsection with regard to a person who is:\n (A) an owner or certificate holder under a policy, contract, or\nfunding agreement and in each case who:\n (i) is a resident of this state; or\n (ii) is not a resident of this state, but only under all of the\nfollowing conditions:\n (I) the insurer that issued the policy, contract, or agreement is\ndomiciled in this state;\n (II) the state or states in which the person resides has or have a\nguaranty entity similar to the corporation created by this article; and\n (III) the person is not eligible for coverage by a guaranty entity in\nany other state because the insurer was not licensed or authorized in\nthat state at the time specified in that state's guaranty entity law;\n (B) the beneficiary, assignee, or payee of the person specified in\nsubparagraph (A) of this paragraph, regardless of where the person\nresides; or\n (C) a health care provider that has rendered services to a person\nspecified in subparagraph (A) of this paragraph.\n (3) Except as otherwise provided in this section:\n (A) with regard to a group annuity contract (or portion of any such\ncontract) that does not guarantee annuity benefits with respect to any\nspecific individual identified in the contract, this article shall apply\nto a person who is the owner of such a contract:\n (i) if the contract is issued to or in connection with a specific\nbenefit plan where the plan sponsor has its principal place of business\nin this state; provided, however, that for the purpose of this\nsubparagraph:\n (I) "plan sponsor" shall mean:\n (aa) the employer in the case of a benefit plan established or\nmaintained by a single employer;\n (bb) the employee organization in the case of a benefit plan\nestablished or maintained by an employee organization, provided that\n"employee organization" shall mean any labor union or any organization\nof any kind, or any agency or employee representation committee,\nassociation, group, or plan, in which employees participate and that\nexists for the purpose, in whole or in part, of dealing with employers\nconcerning an employee benefit plan, or other matters incidental to\nemployment relationships, or any employees' beneficiary association\norganized for the purpose in whole or in part, of establishing such a\nplan; or\n (cc) in the case of a benefit plan established or maintained by two or\nmore employers or jointly by one or more employers and one or more\nemployee organizations, the association, committee, joint board of\ntrustees, or other similar group of representatives of the parties who\nestablish or maintain the benefit plan; and\n (II) "principal place of business" shall mean:\n (aa) the state in which the individuals who establish policy for the\ndirection, control, and coordination of the operations of the entity as\na whole primarily exercise that function, except that if more than fifty\npercent of the participants in the benefit plan are employed in a single\nstate, then that state shall be deemed to be the principal place of\nbusiness of the plan sponsor; or\n (bb) with regard to a plan sponsor of a benefit plan described in\nsubitem (cc) of clause (I) of this item, the principal place of\nbusiness, as determined pursuant to subitem (aa) of this clause, of the\nemployer or employee organization that has the largest investment in the\nbenefit plan; or\n (ii) issued to or in connection with a government lottery if the owner\nis a resident; and\n (B) with regard to a structured settlement annuity, this section shall\napply to a person who is a payee under the structured settlement\nannuity, or the beneficiary of a payee if the payee is deceased, if the\npayee (or beneficiary):\n (i) is a resident, regardless of where the owner of the structured\nsettlement annuity resides; or\n (ii) is not a resident, but only under the following conditions:\n (I) (aa) the owner of the structured settlement annuity is a resident;\nor\n (bb) the owner of the structured settlement annuity is not a resident,\nbut the insurer that issued the structured settlement annuity is\ndomiciled in this state and the state in which the owner resides has a\nguaranty entity similar to the corporation created by this article; and\n (II) neither the payee (or beneficiary) nor the owner of the\nstructured settlement annuity is eligible for coverage by a guaranty\nentity of the state in which the payee (or beneficiary) or owner\nresides.\n (b) This article shall not apply to:\n (1) that portion or part of a variable life insurance policy, variable\nannuity contract or variable funding agreement not guaranteed by an\ninsurer;\n (2) that portion or part of any policy, contract or agreement under\nwhich the risk is borne by the holder thereof;\n (3) any policy, contract, or agreement, or part thereof, assumed by\nthe impaired or insolvent insurer under a contract of reinsurance, other\nthan reinsurance for which assumption certificates have been issued;\n (4) any policy, contract, or agreement issued by or through the\nfacilities of the New York Insurance Exchange, Inc., or any similar\nentity, or pursuant to article sixty-three of this chapter;\n (5) any policy, contract, or agreement issued or issued for delivery\noutside the United States, to the extent it covers persons not citizens\nor permanent residents of the United States; and\n (6) any policy, contract, or agreement payable other than in United\nStates dollars.\n (c) This article shall not apply to a person:\n (1) who is a payee, or the beneficiary of a payee if the payee is\ndeceased, of an owner resident if the payee (or beneficiary) is afforded\nany coverage by a guaranty entity of another state; or\n (2) covered under subparagraph (A) of paragraph three of subsection\n(a) of this section if the guaranty entity of another state provides any\ncoverage to the person.\n