# Supplement No. 1 to Insurance CL No. 4 (2022): Health Insurance Coverage for the Prevention of Colorectal Cancer > New York · Agency guidance · In force URL: https://www.frixlaw.com/law-library/statutes/NY_CL_CL2023_CL2022_04_S01 ## Section - **Citation:** Supplement No. 1 to Insurance CL No. 4 (2022) - **Heading:** Health Insurance Coverage for the Prevention of Colorectal Cancer - **Jurisdiction:** New York - **Kind:** Agency guidance - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** New York DFS Insurance Circular Letters / Health Insurance Coverage for the Prevention of Colorectal Cancer ## Text Supplement No. 1 to Insurance Circular Letter No. 4 (2022) July 18, 2023 TO: All Insurers Authorized to Write Accident and Health Insurance in New York State, Article 43 Corporations, Health Maintenance Organizations, Student Health Plans Certified Pursuant to Insurance Law § 1124, Municipal Cooperative Health Benefit Plans, and Prepaid Health Services Plans RE: Health Insurance Coverage for the Prevention of Colorectal Cancer STATUTORY AND REGULATORY REFERENCES: N.Y. Insurance Law §§ 339, 3216, 3221, and 4303; 11 NYCRR Part 52 (Insurance Regulation 62) I. Purpose The purpose of this circular letter is to provide guidance to insurers authorized to write accident and health insurance in this state, article 43 corporations, health maintenance organizations (“HMOs”), student health plans certified pursuant to Insurance Law § 1124, municipal cooperative health benefit plans, and prepaid health services plans (collectively, “issuers”) regarding Chapter 739 of the Laws of 2022 and Chapter 78 of the Laws of 2023 (collectively, the “Chapters”), which enacted additional coverage requirements for preventive colorectal cancer screenings under large group comprehensive health insurance policies and contracts and notification requirements under certain comprehensive health insurance policies and contracts. This circular letter supplements Insurance Circular Letter No. 4 (2022) issued on March 30, 2022. This circular letter does not apply to Child Health Plus, Essential Plan, and Medicaid managed care coverage. II. Coverage Insurance Law §§ 3216(i)(17)(E), 3221(l)(8)(E) and (F), and 4303(j)(3) require issuers that deliver or issue for delivery an insurance policy or contract in New York providing hospital, surgical, or medical care coverage, except for a grandfathered health plan, 1 to provide coverage for preventive care and screenings at no cost-sharing when obtained from an in-network provider verage. II. Coverage Insurance Law §§ 3216(i)(17)(E), 3221(l)(8)(E) and (F), and 4303(j)(3) require issuers that deliver or issue for delivery an insurance policy or contract in New York providing hospital, surgical, or medical care coverage, except for a grandfathered health plan, 1 to provide coverage for preventive care and screenings at no cost-sharing when obtained from an in-network provider. This coverage requirement includes evidence-based care and screenings with an “A” or “B” rating in the current recommendations of the United States Preventive Services Task Force (“USPSTF”). The USPSTF recommendations include preventive screenings for colorectal cancer in adults beginning at the age of 45 and also extend to follow-up colonoscopies after an abnormal or positive non-invasive stool-based screening test or direct visualization screening test as recommended by the USPSTF and clarified in federal guidance issued on January 10, 2022 by the U.S. Department of Labor entitled “FAQS ABOUT AFFORDABLE CARE ACT IMPLEMENTATION PART 51, FAMILIES FIRST CORONAVIRUS RESPONSE ACT AND CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT IMPLEMENTATION.” 11 NYCRR 52.76(a)(2) provides that a policy shall cover preventive care and screenings described in Insurance Law §§ 3216(i)(17)(E), 3221(l)(8)(E) and (F), and 4303(j)(3) upon any policy issuance or renewal that occurs six months or more after the date the recommendation or guideline described in Insurance Law §§ 3216(i)(17)(E), 3221(l)(8)(E) and (F), and 4303(j)(3) is issued. The Chapters amended Insurance Law § 3221(l)(11-b) and added Insurance Law § 4303(uu) to require issuers that deliver or issue for delivery a large group comprehensive health insurance policy or contract in New York, including grandfathered health plans, to provide coverage for colorectal cancer preventive screenings in accordance with the American Cancer Society Guidelines for colorectal cancer screening of average risk individuals at no cost-sharing when obtained from an in-network provider issuers that deliver or issue for delivery a large group comprehensive health insurance policy or contract in New York, including grandfathered health plans, to provide coverage for colorectal cancer preventive screenings in accordance with the American Cancer Society Guidelines for colorectal cancer screening of average risk individuals at no cost-sharing when obtained from an in-network provider. These coverage requirements include all additional colorectal cancer examinations and laboratory tests recommended in accordance with the American Cancer Society Guidelines for colorectal cancer screening of average risk individuals, including an initial colonoscopy or other medical test or procedure for colorectal cancer screening and a follow-up colonoscopy performed as a result of a positive result on a non-colonoscopy preventive screening test. Issuers must cover such colorectal cancer screenings, examinations, and laboratory tests recommended in accordance with the American Cancer Society Guidelines upon any policy or contract issuance or renewal that occurs six months or more after the date the guidelines are issued or updated. These requirements imposed by the Chapters apply to large group comprehensive health insurance policies and contracts issued or renewed on or after December 23, 2022. Therefore, non-grandfathered large group comprehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with both the USPSTF and American Cancer Society Guidelines, and grandfathered large group comprehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with the American Cancer Society Guidelines. III ehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with both the USPSTF and American Cancer Society Guidelines, and grandfathered large group comprehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with the American Cancer Society Guidelines. III. Notification Chapter 78 of the Laws of 2023 added a new Insurance Law § 339, which requires insurers authorized to write accident and health insurance in this state, article 43 corporations, and HMOs to notify, at least annually, insureds covered under individual, small group, and large group comprehensive health insurance policies or contracts of the colorectal cancer screenings that are covered under such policies or contracts. Insurance Law § 339 also requires these insurers to notify insureds covered under large group comprehensive health insurance policies or contracts at least annually of the most recently published American Cancer Society Guidelines for colorectal cancer screenings that are covered under such policies or contracts. The notification must be sent by United States postal mail unless the insured consents to an alternative method of notification, including electronic notification. The notice may be included with other disclosures that the insurer provides to insureds. The policy or contract itself may not be used to satisfy the notification requirement. The notification requirements apply to policies and contracts issued or renewed on or after December 23, 2022. IV mail unless the insured consents to an alternative method of notification, including electronic notification. The notice may be included with other disclosures that the insurer provides to insureds. The policy or contract itself may not be used to satisfy the notification requirement. The notification requirements apply to policies and contracts issued or renewed on or after December 23, 2022. IV. Conclusion Non-grandfathered large group comprehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with both the USPSTF and American Cancer Society Guidelines, and grandfathered large group comprehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with the American Cancer Society Guidelines. Note that non-grandfathered individual and small group comprehensive health insurance policies and contracts must provide coverage of colorectal cancer preventive screenings in accordance with the USPSTF recommendations. Insurers authorized to write accident and health insurance in this state, article 43 corporations, and HMOs must also comply with the applicable annual notification requirements imposed by Insurance Law § 339. Please direct any questions regarding this circular letter by email to [email protected] . Very truly yours, Lisette Johnson Chief, Health Bureau 1 A “grandfathered health plan” means coverage provided by an issuer in which an individual was enrolled on March 23, 2010, for as long as the coverage maintains grandfathered status in accordance with 42 U.S.C § 18011(e). Ins. Law §§ 3216(i)(17)(F), 3221(l)(8)(G), and 4303(j)(4). ## Nearby sections - [*13 Point-of-Service Products](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1999_13.md) - [5   Revised Excess Line Broker Premium Tax Statements.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1967_05_REV.md) - [5 Amendment Reports and data specifications.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1982_05_AMD.md) - [7 (Addendum) Non-Medical Life Insurance Limits - Insurance Law Section 40-e; Regulation No. 75 (11 NYCRR 217).](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1979_07_ADD.md) - [14 Amendment Placement of group casualty & group property insurance policies with unauthorized insurers](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1981_14_AMD.md) - [NY Insurance Circular Letter (1929-03-01) Maximum amount or percent of premiums to be contributed by employees under group life policies.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1929_0301_NN.md) - [NY Insurance Circular Letter (1933-02-21) Earliest permissible advance announcement of dividends to policyholders.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1933_0221_NN.md) - [NY Insurance Circular Letter (1939-07-01) Rules for submission of forms.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1939_0701_NN.md) - [NY Insurance Circular Letter (1943-12-21) Reserves for deferred maternity benefits under group hospitalization and surgical policies.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1943_NN_12_21.md) - [NY Insurance Circular Letter (1944-01-06) Reserves for deferred maternity benefits under individual hospitalization contracts (See also CL (11/6/58) on this listing).](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1944_NN_01_06.md) - [NY Insurance Circular Letter (1948-11-01) Group and blanket accident and health premium rates higher in New York on voluntary insurance than in states with compulsory disability benefit laws, justification necessary for some cases.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1948_NN_11_01.md) - [NY Insurance Circular Letter (1948-11-19) Eligibility of corporation directors of group life and accident and health insurance.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1948_NN_11_19.md) - [NY Insurance Circular Letter (1949-06-14) Limitations of benefits in event of death in first two policy years unfair.](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1949_NN_06_14.md) - [NY Insurance Circular Letter (1950-02-27) Filing of advisory policy forms under the Disability Benefits Law. (See (also CL (6/4/52) on this listing).](https://www.frixlaw.com/law-library/statutes/NY_CL_CL1950_NN_02_27.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/NY_CL_CL2023_CL2022_04_S01. Check the current official text before relying on it. Not legal advice.