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Network Adequacy and Out-of-Network Guidance

Guidance, filing instructions, and materials for implementation of the out-of-network law, Part H of Chapter 60 of the Laws of 2014.

General Health Insurance Filing Instructions

All insurers are encouraged to set their SERFF configuration to accept state generated messages from New York to receive notification of changes that affect filings.

Health Insurance Checklists and Model Language

(comprehensive medical, accident, long term care, disability & specified disease)

Health Insurance Guidance

New York State of Health (NYSOH) Coverage

Model Notices

Dental Filings

Child Health Plus Filings

Student Health Insurance Filings

Medicare Supplement Rate Adjustment Filings – Instructions/Checklist & Exhibits

Rate Adjustment Filings - Instructions, Exhibits and Checklists

2017 Prior Approval NYSOH & Outside NYSOH

Unless noted otherwise, the following documents are in Excel format.

2016 Prior Approval NYSOH & Outside NYSOH

2014 NYSOH & Outside the NYSOH Checklists and Exhibits

Prior Approval Checklist and Exhibits

Utilization Review (UR) Agent Report Application, Instructions and Forms

Reporting Requirements

Health Insurance Laws, Regulations, Circular Letters, Mandated & Make Available Benefits

Updated 03/27/2017


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