These loss ratio reports are for use by insurers and HMOs that have submitted rate applications pursuant to section 3231(e)(2)(A) and/or section 4308(g) of the Insurance Law that affect any portion of the direct premiums earned during calendar year 2008.

This Web site also provides specific instructions for filing the New York LOSS RATIO REPORT with the Insurance Department. A copy of the New York LOSS RATIO REPORT Instructions and Reporting Templates are available as indicated below.

The Insurance Department recommends that companies download the forms packet and return the loss ratio reporting templates electronically (e.g., via email or on a compact disc). A company may contact the Insurance Department as indicated below and request a copy of the instructions and templates.

Loss Ratio Report - Specific Filing Information

The Loss Ratio Report Submission INSTRUCTIONS AND FORMS PACKET is a self extracting zipped file; after downloading file, run EXE to obtain the following files. The Instructions are in PDF format and you will need the Adobe Acrobat Reader to view or print this file. The Loss Ratio Report templates are Microsoft Office Excel 2003 files.

FORMS included for Download and/or Print:

• 4308H08 - LOSS RATIO REPORTING TEMPLATE FOR HMO AND POS BUSINESS 2008
• 4308I08 - LOSS RATIO REPORTING TEMPLATE FOR INDEMNITY BUSINESS 2008
• 4308P08 - LOSS RATIO REPORTING TEMPLATE FOR OUT OF NETWORK BENEFITS OF POS POLICIES 2008
• INSTRUCTIONS FOR COMPLETING THE LOSS RATIO REPORT SUBMISSION 2008

To view full instructions for unzipping compressed files, please select this link.

Due Date & Mailing

The Loss Ratio Report is due to the Department by May 1, 2009.

An electronic copy of the Loss Ratio Reports (in Excel format), cover letter, actuarial memorandum, and any other material, may be submitted to the Insurance Department (email Gary Teitel: gteitel@ins.state.ny.us). If the material is submitted by paper, it is recommended that the submission include an electronic version of the Loss Ratio Reports (in Excel format) on a compact disc (unless sent electronically via email), and is to be sent to the address below.

Problems and Questions:

If you need help filling out your forms, contact: Health Bureau, Mr. Gary Teitel (212) 480-7709, mailto: gteitel@ins.state.ny.us or Ms. Elaine Chu (212) 480-5064, mailto: echu@ins.state.ny.us

If you do not have the Adobe Acrobat Reader, you will need to download and install this free Reader in order to view and print PDF files. Please read the software license agreement before downloading the program. Select the 'Adobe' icon to begin the process.