Health insurers, Article 43 corporations, and HMOs must publicly disclose on their websites whether or not they use AI-based algorithms in their utilization review process. This is a blanket transparency obligation — entities must affirmatively state both the use and the lack of use of such algorithms. The disclosure must be posted on the entity's accessible Internet website, making it available to all insureds and enrollees. The superintendent is directed to require compliance through rulemaking.

Health insurers, Article 43 corporations, and HMOs must submit both their AI-based algorithms and their training datasets to the Department of Financial Services for review and certification. The department must establish a certification process verifying that the algorithms and training data minimize the risk of bias across enumerated protected characteristics (race, color, religious creed, ancestry, age, sex, gender, national origin, handicap or disability) and adhere to evidence-based clinical guidelines. This is a dual obligation: the entity must submit materials, and the department must certify them. Submission covers both algorithms currently in use and those planned for future use. Entities should anticipate that ongoing submissions may be required as algorithms and training data evolve.

When a utilization review process initially uses AI-based algorithms, a clinical peer reviewer must personally open and review the individual's clinical records or data and document that review before issuing any adverse determination. This ensures that AI-generated initial assessments do not result in denials without individualized human clinical review. The obligation falls on the clinical peer reviewer personally — they cannot rely solely on the AI algorithm's output when making an adverse determination. The documentation requirement creates an audit trail confirming individualized review occurred.