Your State Government's Oversight of Health Insurance in New York
The New York state-level Government is involved in preparing and managing health insurance regulations applicable to the state. In fulfilling this obligation, the State Government usually works to balance consumer protections with an economic environment that supports strong financial and economic growth. With regards to health care insurance, the State Government services three separate constituent groups: resident consumers, insurance providers, and independent licensed brokers.
The Government's main control tool for promoting a beneficial health insurance market is based on the licensing and management of health insurance companies and independent brokers. For managing insurance companies, the Government develops basic standards for health insurance products and requires periodic financial statement audits, to assure that tax requirements are being complied with. For health insurance brokers, the State Government sets professional licensing requirements, takes care of broker license testing and issuance of licenses, establishes and administers continuing education criteria, and is responsible to collect license fees for brokers. The State level Government is in charge of looking out for and investigating insurance fraud schemes, particularly as it relates to consumers or when it threatens the state business environment.
For state insurance consumers, the State Government makes available health insurance guidelines for consumers to help residents succeed in finding their best insurance choices. The Government will also help consumers file health insurance appeals with their insurance company when a dispute occurs relating to the policy coverage or terms. And, the State-level Government has the duty of administering Federal Medicare regulations for state implementation where Federally funded insurance is available to lower income individuals and families, uninsured children, qualified seniors, or self-employed persons.