§ 3229. Minimum benefit standards for certain long term care plans.
(a) The minimum standards for an insurance plan, which may qualify under
the partnership for long term care program pursuant to section three
hundred sixty-seven-f of the social services law, shall be established
by regulations of the superintendent, in consultation with the
commissioner of health and the director of the state office for the
aging, as approved by the director of the budget, which shall require at
a minimum (1) a residential health care facility benefit in an amount to
be determined by the regulations of the superintendent; (2) a home care
benefit with personal care, nursing care, adult day health care and
respite care services, which shall provide total benefits in an amount
determined by regulations of the superintendent; (3) a duration of
benefits not less than twelve months; and (4) arrangements through the
insurance plan for managed care including preauthorized assessment and
referral programs, utilization controls and use of approved providers.

(b) In establishing minimum benefit standards for insurance plans
pursuant to this section, the superintendent shall seek to ensure the
cost effectiveness of the partnership for long term care program
established pursuant to section three hundred sixty-seven-f of the
social services law, and may establish minimum permissible payments
under such insurance plans. The superintendent shall not approve an
insurance plan which includes an exclusion for pre-existing conditions
that exceeds six months, or which does not comply with paragraph six of
subsection (b) of section one thousand one hundred seventeen of this
chapter.