Discontinuance Notifications to DFS

Unless noted otherwise, the documents available below are in MS Word format.

• Instructions for Individual Insurers for 2025 (PDF)
• Instructions for Group Insurers for 2025 (PDF)

Discontinuance Notice Templates

• Model Notice to Individual Policyholders outside NYSOH
• Model Notice to Individual Policyholders within NYSOH
• Model Notice to Small Group Policyholders
• Model Notice to Small Group Members
• Model Notice to Large Group Policyholders 
• Model Notice to Large Group Members

2025 Renewal/Rate Notifications

• Instructions for 2025 Renewal/Rate Notifications by Insurers
• Model Notice for Individual Policies outside NYSOH
• Model Notice for Individual Policies within NYSOH
• Model Notice for Small Group Policyholders

Attachments to Discontinuance Notices

• Attachment A Ian’s Law Group Policyholder (PDF)
• Attachment A Ian’s Law Member notice (PDF)
• Attachment B Reg 78 notice (PDF)