NY A05438

Requires out-of-state entities offering health care cost sharing plans or arrangements to New York residents (such as health care sharing ministries) to submit annual reports to the Superintendent of Insurance, with initial reports due October 1, 2025, and annually by March 1 thereafter

Mandates detailed reporting on participant numbers (individual, household, and employer groups), provider contracts, total fees collected, reimbursement requests submitted and paid, denial rates, and five-year administrative versus medical spending ratios

Requires disclosure of all covered benefits, excluded procedures, drugs, conditions, pre-existing condition policies, waiting periods, and eligibility rules such as age limits or marriage requirements

Imposes a $5,000 daily fine for entities that fail to correct deficiencies in their submissions within 30 days of notification, with additional penalties including cease-and-desist orders at the superintendent's discretion

Directs the superintendent to publish an annual summary report by April 1 along with consumer guidance on filing complaints