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Network Adequacy and Out-of-Network Guidance

Guidance, filing instructions, and materials for implementation of the out-of-network law, Part H of Chapter 60 of the Laws of 2014.

General Health Insurance Filing Instructions

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.

Health Insurance Checklists and Model Language

(comprehensive medical, accident, long term care, disability, specified disease & PFL)

Health Insurance Guidance

New York State of Health (NYSOH) Coverage

Model Notices

Dental Filings

Child Health Plus Filings


Student Health Insurance Filings

Medicare Supplement Rate Adjustment Filings – Instructions/Checklist & Exhibits

Unless noted otherwise, the following documents are in Excel Macro-Enabled Worksheet format.

Rate Adjustment Filings - Instructions, Exhibits and Checklists

2019 Prior Approval NYSOH and Outside NYSOH

Unless noted otherwise, the following documents are in Excel Macro-Enabled Worksheet format.

Prior Approval Checklist and Exhibits

Unless noted otherwise, the following documents are in Excel format.

Utilization Review (UR) Agent Report Application, Instructions and Forms

The following documents are in PDF format.

Reporting Requirements

Health Insurance Laws, Regulations, Circular Letters, Mandated & Make Available Benefits

Updated 05/02/2018

Department of Financial Services

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