Health Care Claims Reports

Current Calendar Year | 2022

Insurance Law section 345 requires insurers and HMOs (issuers) to submit reports to the Superintendent quarterly and annually on health care claims payment performance for comprehensive health insurance coverage.  The reports provide information on claims received, claims paid, and claims denied and their dollar values, by major category of health care provider.  The reports are due to the Superintendent 45 days after the end of the reporting period.

DFS posts the reports on the DFS website as submitted by the issuers.  The reports have not been reviewed by DFS for accuracy.

NOTE: The reports available on this page are in Excel format.

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Company NameNAIC #2023-Q1-Reports2023-Q2-Reports2023-Q3-Reports2023-Q4-Reports2023-Annual-Reports
4 Ever Life Insurance Company80985Q1Q2Q3  
Aetna Health Insurance Company of New York84450Q1Q2Q3  
Aetna Life Insurance Company60054Q1Q2Q3  
Capital District Physicians' Health Plan, Inc. (CDPHP)95491Q1Q2Q3  
CDPHP Universal Benefits, Inc.47027Q1Q2Q3  
Cigna Health and Life Insurance Company67369Q1Q2Q3  
Connecticut General Life Insurance Company (Cigna)62308Q1Q2Q3  
Delaware American Life Insurance62634N/AN/AQ3  
EmblemHealth Insurance Company60094Q1Q2Q3  
Emblem Health Plan, Inc.55239Q1Q2Q3  
Empire Healthchoice Assurance, Inc.55093Q1Q2Q3  
Empire Healthchoice HMO, Inc.95433Q1Q2Q3  
Excellus Health Plan, Inc.55107

Q1 - Group

Q1 - Individual

Q2 - Group

Q2 - Individual

Q3 - Group

Q3 - Individual

  
Health Insurance Plan of Greater New York (HIP)55247Q1Q2Q3  
Healthfirst Insurance Company, Inc.16031Q1Q2Q3  
Healthfirst PHSP, Inc.15071Q1Q2Q3  
HealthPlus HP, LLC16574Q1Q2Q3  
Highmark Western and Northeastern New York, Inc. (formerly HealthNow New York, Inc.)55204Q1Q2Q3  
Independent Health Association, Inc.95308Q1Q2Q3  
Independent Health Benefits Corporation47034Q1Q2Q3  
MetroPlus Health Plan95546Q1Q2Q3  
Molina Healthcare of New York, Inc.15799Q1Q2Q3  
MVP Health Plan, Inc.95521Q1Q2Q3  
MVP Health Services Corporation47062Q1Q2Q3  
Nippon Life Insurance Company of America81264Q1Q2Q3  
NYQHC dba Fidelis Care16352Q1Q2Q3  
Oscar Insurance Corporation15281Q1Q2Q3  
Oxford Health Insurance, Inc.78026Q1Q2Q3  
UnitedHealthcare Insurance Company of New York60093Q1Q2Q3  
UnitedHealthcare of New York, Inc.95085Q1Q2Q3  
Wellfleet New York Insurance Company
(formerly Atlanta International Insurance Company)
20931Q1Q2Q3