Health Insurance Information For Insurers

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• Filing in New York
• Filing Resources
• General Information
• Health Insurance Premiums - Prior Approval
• Municipal Cooperative Health Benefit Plans
• Updated! Reporting Requirements

Filing in New York

• SERFF Filing Instructions (PDF Format, revised 03/14/2012)
• Readability Certification (requires Acrobat Reader 7.0 or above)
• Standard Transmittal Form for non-SERFF filings
• Child Health Plus Rate Filings (effective August 2006):
  • Instructions (PDF Format)
  • Rate Submission Package (Excel Format)

Filing Resources

• Product Checklists and Outlines (All checklists are in interactive format with links to references.)
• Updated! Regulations - Selected
• Filing Guidances (revised 03/21/2012)
• New! Model Language
• New! Federal Reform Immediate Market Reform
  • PPACA Filings Instructions (PDF Format)
  • PPACA Compliance Checklist (interactive PDF format, revised 08/20/2010)
  • Model Language Rider (WORD Format)
  • Model UR Language (WORD Format)
  • Frequently Asked Questions (PDF Format)
• Prior Approval Rate Filings
  • Updated! Checklist - Section 3231(e)(1) and Section 4308(c) Rate Adjustment Filings (in interactive format)
  • Standard Exhibit 1 - General Information (Excel Format)
  • Standard Exhibit 2 - Summary of Average Claim Trend and Administrative Expenses (Excel Format)
  • Standard Exhibit 3 - Narrative Summary (Excel Format)
  • Standard Exhibit 4 - Summary of Proposed Percentage Rate Changes (Excel Format)
  • Standard Exhibit 5 - Distribution of Contracts Affected by Proposed Rate Adjustments (Excel Format)
  • Standard Exhibit 6 - Summary of Policy Form and Product Changes (Excel Format)
  • Standard Exhibit 7 - Historical Data (Excel Format)
• Updated! Mandated and Make Available Benefits - Commercial, HMO & Article 43 Insurance Contracts
  • Listings:
    • HTML Format
    • PDF Format
  • Required Immunizations
  • Definition of Infertility
• Circular Letters
  • 1975 - 1998
  • 1999 - present
• Health Bureau Filing Compliance Seminars
  • November 6, 2008
  • December 12, 2007
• Insurance Laws - Selected

General Information

• News Releases
• Consumer Information of Note for Insurers
  • 2010 New York Consumer Guide to Health Insurance
  • Consumer Health Information index
  • External Appeals - Information and Application
  • Healthy NY Program
  • Premium Rates for HMO Standard Individual Health Plans by County
• Frequently Asked Questions

Reporting Requirements

• New! Loss Ratio Report Submissions for Experience Year 2011-Community Rated (revised 03/21/2012)
• New! Disability Benefits Law (DBL) Reporting Blank for Calendar Year 2011 (PDF format)
• HIDE (Health Insurance Data Exhibit) Submissions
• Filing instructions for Health Insurance Claims Payable (NY) Quarterly Report: A&H Companies
• Health Bureau Data Calls

Updated 05/03/2012