Notice of Intent to Terminate Health Insurance
Please be advised that HIP INSURANCE COMPANY OF NEW YORK (“HIPIC”) intends to terminate
group health insurance coverage effective on February 1, 2011.
Your members covered under the HIPIC contract are eligible for the following:
A. Reimbursement under the contract terms for covered services rendered prior to the date
B. An extension of benefits based upon total disability to the extent set forth in the
certificate of insurance.
C. The opportunity to request coverage under HIPIC’s standard direct payment conversion
plans at the application premium rates. The benefits under these direct payment plans
may be different from those under the group coverage.
HIPIC is also required to advise you that you must do the following:
A. Provide a copy of this notice of intent to terminate together with a covering letter to each
of your certificate holders advising them of the intended termination. The notice must be
hand delivered (e.g. in a pay envelope) at the members place of employment or mailed to
the member’s last known address.
B. Post a copy of this Notice of Intent to Terminate Health Insurance and the required
covering letter in a conspicuous location most likely to give notice to all certificate
In accordance with the Insurance Law and the Labor Law, requirements “A” and “B” above will not apply
if you pay your premium on a timely basis or if you have done either of the following:
1. Taken necessary steps whereby the intended termination is rendered null and void; or
2. Contracted with another insurer to replace HIPIC as your health insurance carrier and
provide similar coverage for the same certificate holders and you have filed an affidavit
with the Commissioner of Labor and Superintendent of Insurance to that effect.
Affidavits filed with the Commissioner of Labor must refer to Labor Law Section 217 and be addressed to:
Director of Labor Standards
New York State Department of Labor
Agency Building 12
State Office Building Campus
Albany, New York, 12240
Affidavits filed with the Superintendent of Insurance must refer to Labor Law Section 12 and Part 55 of
Regulation 62 of the New York State Insurance Regulations and be addressed to:
Chief Health Policy Bureau
New York State Insurance Department
One Commerce Plaza
Albany, New York, 12257
Notice Provided By:
HIP INSURANCE COMPANY OF NEW YORK (“HIPIC”)