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
- Reporting Requirements
Filing in New York
- SERFF Filing Instructions (PDF, revised 09/04/2012) 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.
- 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)
- Rate Submission Package (Excel)
Filing Resources
- Model Language (for all individual and small group comprehensive health insurance products sold both inside and outside the NY Health Benefits Exchange)
- New! Standard Exchange Benefit Design Chart (PDF, revised 5/6/13)
- Product Filing Guidance (for individual and small group comprehensive health insurance products sold both inside and outside the NY Health Benefits Exchange) (PDF)
- Dental Filing Guidance (PDF)
- Submission Deadlines for Exchange and Off-Exchange Filings (PDF)
- QHP Binder Filing Instructions in SERFF (for submission of binders for individual and small group products inside and outside the New York Health Benefit Exchange)
- Product Checklists and Outlines (All checklists are in interactive PDF format with links to references.)
- New! 2014 Exchange & Off Exchange Rate Checklists and Exhibits:
- Checklist for Individual Exchange Plans and Off-Exchange Plans (PDF)
- Checklist for SHOP Exchange Plans and Small Group Off-Exchange Plans (PDF)
- Checklist for Stand-Alone Dental Plans (PDF)
- Exhibit 1 - General Information (Excel)
- Exhibit 7 - Historical Data (Excel)
- Exhibit 8 - Index Rate/Plan Design Level Adjustment Worksheet (Excel)
- Exhibit 9 - Summary of Claim Trend, Administrative Expenses and Profit Margin (Excel)
- Regulations - Selected
- Filing Guidances (revised 08/27/2012)
- Group Health Insurance Class Discontinuance Notices (PDF, 09/19/2012)
- Federal Reform Immediate Market Reform:
- PPACA Filings Instructions (PDF)
- PPACA Compliance Checklist (interactive PDF Format, revised 08/20/2010)
- Model Language Rider (WORD)
- Model UR Language (WORD)
- Frequently Asked Questions (PDF)
- Updated! Prior Approval Rate Filings:
- Checklist - Section 3231(e)(1) and Section 4308(c) Rate Adjustment Filings (interactive PDF Format)
- Standard Exhibit 1 - General Information
- Standard Exhibit 2 - Summary of Average Claim Trend and Administrative Expenses
- Standard Exhibit 3 - Narrative Summary
- Standard Exhibit 4 - Summary of Proposed Percentage Rate Changes:
- Standard Exhibit 5 - Distribution of Contracts Affected by Proposed Rate Adjustments:
- Standard Exhibit 6 - Summary of Policy Form and Product Changes
- Standard Exhibit 7 - Historical Data
Unless otherwise noted, the following documents are in Excel format.
- Mandated and Make Available Benefits - Commercial, HMO & Article 43 Insurance Contracts:
- Circular Letters
- Health Bureau Filing Compliance Seminars
- Insurance Laws - Selected
General Information
- News Releases
- Consumer Information of Note for Insurers
- Frequently Asked Questions
Reporting Requirements
- Loss Ratio Report Submissions for Experience Year 2012-Community Rated (revised 04/04/2013)
- Disability Benefits Law (DBL) Reporting Blank for Calendar Year 2012 (PDF, March 2013)
- HIDE (Health Insurance Data Exhibit) Submissions
- Filing instructions for Health Insurance Claims Payable (NY) Quarterly Report: A&H Companies
- Health Bureau Data Calls
Updated 05/07/2013
