Overview
DFS remains committed to closing the health equity gap and reducing health disparities. To help identify disparities that exist in the quality and utilization of care experienced by underrepresented populations and inform data-driven public policymaking, DFS adopted regulation 11 NYCRR § 52.52 in April 2025.
The regulation requires health insurers to request voluntarily disclosed information regarding an applicant’s, insured’s, and an insured’s covered dependent’s race, ethnicity, preferred language, sexual orientation, and gender identity or expression. The data collected may not be used in a manner that is unfairly or unlawfully discriminatory and may not be used by an insurer in underwriting or rating decisions. Only aggregated, anonymized data will be used by insurers and the DFS to study potential health equity issues in health insurance and to improve access to health care services.
A Sample Form Template: Questionnaire to Support Health Equity has been developed by DFS to collect demographic data through the regulation. Insurers may use this form to comply with the requirements of the regulation.
This initiative builds upon DFS’s efforts to advance health equity in the state of New York and increase access and affordability to critical services, including through strengthening the Governor’s initiative to eliminate cost-sharing for insulin, regulations to increase access to mental health and substance use disorder services, and regulations to increase access to prescription drugs.
FAQs for Consumers
Your health insurer is required to request information from you about your race, ethnicity, preferred language, sexual orientation, and gender identity or expression. This is called demographic information. However, responses are voluntary, and you are not required to reply. Your health insurer is asking for this information to help you get health care services and to promote health equity.
Why is my health insurer asking for my demographic information?
Your health insurer and the Department will be able to use this data to identify groups or communities that may not be using their health insurance benefits and direct resources where they are most needed.
For example, we may find that certain communities are not using primary care because their networks don’t have providers who speak their language. This data will allow us to understand and improve how health insurance serves all New Yorkers.
Must I provide my demographic information to my health insurer?
No, you are not required to provide this information to your health insurer. All responses are voluntary.
How will my health insurer use my information?
Your health insurer is allowed to use your information:
- To communicate with you using your preferred language.
- To give you information that could be beneficial to you.
- To identify individuals or communities that may not be using the benefits they pay for and find ways to increase the use of benefits that help to eliminate health disparities and promote health equity.
Will my insurer send information to the New York State Department of Financial Services?
The Department can request that insurers share the data to ensure that New Yorkers are receiving the health care they pay for and deserve.
Will providing my demographic information affect my health insurance coverage or premium rates?
No, your health insurer is not allowed to use your answers to make decisions about your health insurance coverage or premium rates.
Will my demographic information be protected?
Yes, your information must be kept confidential.
Can my health insurer use my demographic information (or if I do not provide it) to discriminate against me?
No, your health insurer is not allowed to discriminate against you. Additionally, insurers are not permitted to use this information to make decisions on whether to sell you an insurance policy or what to charge you for a policy.
FAQs for Insurers
Which insurers must comply with the regulation?
The regulation applies to insurers licensed to write accident and health insurance in New York State, corporations organized pursuant to Insurance Law Article 43, HMOs certified pursuant to Public Health Law Article 44, and student health plans certified pursuant to Insurance Law § 1124 in relation to comprehensive health insurance policies.
The regulation does not apply to self-funded plans, municipal cooperative health benefit plans, or government-sponsored health plans, such as Medicaid managed care plans, Child Health Plus, or the Essential Health Plan.
When does the regulation take effect?
The regulation is effective July 31, 2025. Insurers must begin collecting demographic information on and after that date.
What demographic information must insurers request from insureds under the regulation?
Insurers must request information regarding an insured’s race, ethnicity, preferred language, sexual orientation, and gender identity or expression.
The Department has provided a Sample Form Template: Questionnaire to Support Health Equity that lists the demographic information that insurers must request.
The template questionnaire corresponds to questions and response fields already required to be used by many insurers by state and federal agencies. Consistent data collection will ensure that insurers develop effective data sources across commercial and public plans.
How should insurers collect this demographic information?
Insurers should use a questionnaire that requests that insureds voluntarily provide the demographic information. The Department has provided a Sample Form Template: Questionnaire to Support Health Equity that insurers may use to collect the demographic information to comply with the regulation.
May insurers send the questionnaire to insureds electronically?
Yes, insurers may send the questionnaire to insureds electronically if the insured or covered dependent has consented to receiving the questionnaire electronically.
Must insureds answer the demographic questions?
No, responses are voluntary. Insureds are not required to respond to the demographic questions.
How will insureds know that they do not have to provide their demographic information?
When insurers request demographic information, they must disclose, in writing, that insureds may refuse to provide any requested demographic information. The template questionnaire contains model language that will help make this point clear to insureds.
What must insurers disclose to insureds when they request demographic information?
Insurers must disclose that:
- Insureds may refuse to provide any requested demographic information;
- The insurer is prohibited from using the demographic information (or the insured’s refusal to provide the information) for underwriting determinations, including eligibility determinations, or rating purposes;
- The insurer may not use the demographic information in a manner that would constitute unfair or unlawful discrimination under state law;
- The insurer will keep any demographic information that is provided confidential consistent with state and federal law and regulations; and
- The insurer is requesting demographic information to support efforts to promote health equity, and the insured may receive information from the insurer in connection with the insurer’s health equity programs or services.
When must insurers collect the demographic information?
Insurers must request the demographic information after an insured has completed an application for a comprehensive health insurance policy.
For insureds who are already covered under a policy, for whom the insurer does not have such information when the regulation becomes effective, the issuer must request the demographic information at the first policy renewal that is at least 90 days after the effective date of the regulation.
Must an insurer follow-up if an insured does not respond to the request for demographic information?
No, the regulation does not require an insurer to follow-up if an insured does not respond, but an insurer may choose to do so.
How often should insurers ask about potential changes to demographic information for insureds covered under a health insurance policy?
The regulation requires insurers to ask insureds for this information after completing an application for a comprehensive health insurance policy (or one time upon the first policy renewal after the regulation becomes effective if the insurer does not have the information); however, the regulation does not preclude insurers from asking for this information more frequently.
How may insurers use the demographic information?
The regulation permits insurers to use the demographic information to communicate with insureds using preferred language and to support insurers’ efforts to eliminate health disparities and to promote health equity.
May insurers use an insured’s response or refusal to respond to a demographic question as a basis for any underwriting determination, including eligibility determinations or rating purpose?
No, insurers may not use an insured’s response or refusal to respond to any demographic question as a basis for any underwriting determination, including eligibility determinations or rating purpose.
May insurers use the demographic information collected to solicit an insured to purchase or use any service or product?
No, insurers may not use the demographic information collected to solicit an insured. However, insurers may use the preferred language of an insured to communicate with that insured, and insurers may use the demographic information to support efforts to eliminate health disparities and to promote health equity.
Does the regulation require insurers to obtain questionnaire responses from a certain number or percentage of insureds?
No, the regulation does not require insurers to obtain questionnaire responses from a certain number or percentage of insureds.
Does the regulation specify how insurers must maintain the demographic information collected pursuant to the regulation?
Yes, the regulation requires insurers to keep the demographic information confidential consistent with federal and state laws and regulations.
Additionally, the regulation requires insurers to maintain a record of the demographic information collected in accordance with 11 NYCRR 243, which sets forth insurer record retention requirements.
Must insurers request and collect demographic information as required by the regulation if the New York State of Health (NYSOH) already collects the same information?
Yes, insurers must request the demographic information required by the regulation even if NYSOH already collects the information.
How does the regulation protect against discrimination?
The regulation expressly prohibits insurers from using the demographic information in a manner that would constitute unfair or unlawful discrimination under state law. It further prohibits insurers from using the responses (or lack thereof) for underwriting determinations, including eligibility determinations, and rating purposes. Insurers must file annual attestations with the Department that attest to the foregoing.