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Instructions/Checklist & Exhibits

Unless noted otherwise, documents are in MS Excel (.xlsx) format.

  • Instructions/Checklist for Filing Medicare Supplement Rate Adjustments (PDF)
  • Exhibit 1 - General Information
  • Exhibit 4 - Summary of Requested Rate Changes
  • Exhibit 6 - History of Rate Adjustments
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  • Exhibit 8 - Historical Experience Since Inception - New York
  • Exhibit 9 - Historical Experience Since Inception - Nationwide
  • Exhibit 11 - Calculation of Proposed Rates

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If you are unable to find the answer to your insurance question here, check our FAQs. If you have a question or need assistance, call (800) 342-3736 (M-F, 8:30 AM to 4:30 PM). Local calls can be made to (212) 480-6400 or (518) 474-6600.

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