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Health Insurance Data Exhibit (HIDE) Data Collections Instructions

This Exhibit is a snapshot of individual, small group, and large group Health Insurance* enrollment and premiums on January 1 and July 1 of each year. This Exhibit is required to be submitted no later than 45 days after the date of the report submitted through the DFS Portal.

Portal Applications & Accounts

Guest applications on the DFS Portal do not require login or a portal account. For access to SECURED applications, you must have a Portal account. You will also find a list of all of the DFS Secured and Guest (unsecured) applications available when you log into the DFS Portal:

A.  For Individual and Small Group health Insurance (As defined in Section 360.2 of New York Regulation 145) Issued in New York State**:

  1. One Health Insurance Data Exhibit is required to be completed for each of the following with New York State issued business in-force as of the date being submitted for.  (Association group should be categorized as "small group.")
    1. Each standardized Medicare Supplement policy form A - L, reporting Plans H, I, and J without drugs, separately from Plans H, I, and J with drugs, and Plan F+, separately from Plan F.
    2. Each pre-standardized Medicare Supplement block, where all forms included in the block
      have the same Category Code (See Instruction #4)
    3. Each active (i.e., available to new enrollees) individual non-Medicare Supplement
      health insurance policy form
    4. Each closed (i.e. no longer available to new enrollees) individual non-Medicare Supplement
      health insurance block, where all forms included in the block have the same Category Code (See Instruction #4)
    5. The closed small group non-Medicare Supplement health insurance block, where all forms included in the block have the same Category Code (See Instruction #4)
    6. The active small group non-Medicare Supplement health insurance block where all forms included in the block have the same Category Code (See Instruction #4)
    7. Each Healthy New York policy form (See NOTE 2 below.)

    NOTE 1: Insurers may continue to submit one Health Insurance Data Exhibit for each health insurance policy form, but it is not required except as noted above.  When a Health Insurance Data Exhibit is first submitted for a block, please submit an exhibit for each of the forms included in the block noting in the Interrogatories that this will be the last time that an exhibit for this form will be submitted.

    NOTE 2: Please separate Healthy New York business into Group Healthy New York business and Individual Healthy New York business even if both are written on the same policy form number. That is, two Health Insurance Data Exhibits are required.

  2. The policy form number or block name should be no more than 30 characters long. Once an exhibit has been submitted, its form number will appear in the drop down list. Do not create a new name in the future.
  3. If the Health Insurance Data Exhibit is the first or last exhibit to be submitted for a particular policy form or block, the appropriate date should be included on Line 1 or 3.of the Interrogatories.
  4. Line 4 is for the Category Code as follows:

  5. COVERAGE TYPE

    CATEGORY CODE

    SMALL GROUP NON-MEDICARE SUPPLEMENT SUBJECT TO POOLING

    A

    INDIVIDUAL NON-MEDICARE SUPPLEMENT SUBJECT TO POOLING

    B

    INDIVIDUAL MEDICARE SUPPLEMENT SUBJECT TO POOLING

    C

    GROUP MEDICARE SUPPLEMENT SUBJECT TO POOLING

    D

    GROUP CONVERSIONS

    E

    SUPPLEMENTAL COVERAGE ONLY

    F

    SMALL GROUP NON-MEDICARE SUPPLEMENT NOT SUBJECT TO POOLING

    G

    INDIVIDUAL NON-MEDICARE SUPPLEMENT NOT SUBJECT TO POOLING

    H

    INDIVIDUAL MEDICARE SUPPLEMENT NOT SUBJECT TO POOLING

    I

    GROUP MEDICARE SUPPLEMENT NOT SUBJECT TO POOLING

    J

  6. Line 5 refers to whether or not the insurer still offers this type of coverage to new enrollees. A policy form available to new enrollees is considered "active".
  7. Lines 6A - 6E ask for the number of New York State policyholders/certificate holders/subscribers and the number of covered lives. One direct pay policyholder, one certificate holder, or one subscriber is considered one insured unit. The number of group policyholders on line 6E, column 1, should always be completed for small group insurance. For individual insurance the answer to line 6E, column 1, should be 0.
  8. Round lines 7A – 7C and 8A and 8B to the nearest dollar.
  9. For the purposes of Section 4 age is to be determined as the difference between the current calendar year and the calendar year of birth.

B. For Large Group Health Insurance Issued in New York State**

Once a Health Insurance Data Exhibit has been completed for each individual and small group policy form or block, complete the Summary of NYS Large Groups. * This single exhibit collects enrollment and premium information about large employer group coverage** in New York State. The top of the form is for fully insured large group coverage. The two spaces at the bottom are for less than fully insured groups. Less than fully insured includes but is not limited to situations where this insurer only provides one part of the coverage; e.g., medical or hospital coverage only) or where the insurer provides only administrative services; e.g., ASO arrangements. (Inclusion of data on these less than fully insured groups in the upper part of the form would skew the premium data.)


**For the purposes of this form for all group insurance, New York issued business is considered to be groups situated in New York State.