NY HIMP-1 2009 free printable template
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New York State Workers' Compensation Board Health Insurers' Match Program Part I Health Insurer's/Health Benefit Plan's Request for Reimbursement WEB Case Number Claimant's Social Security No. Date
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How to fill out NY HIMP-1
01
Obtain the NY HIMP-1 form from the appropriate state department website or office.
02
Fill in the header section with your personal information including name and address.
03
Complete the sections regarding the program details, including any required project information.
04
Provide the necessary financial information as requested on the form.
05
Review the form thoroughly for any missing information or errors.
06
Sign and date the form before submission.
07
Submit the completed form to the designated office or online platform as instructed.
Who needs NY HIMP-1?
01
Individuals or organizations applying for a specific program or funding in New York that requires the HIMP-1 form.
02
Anyone needing to report project details and facilitate compliance with state regulations.
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What is NY HIMP-1?
NY HIMP-1 is a form used by the New York State Department of Health to report health insurance metrics, primarily related to the Healthy Initiatives and Monitoring Program.
Who is required to file NY HIMP-1?
Health insurers and managed care organizations operating in New York State are required to file NY HIMP-1.
How to fill out NY HIMP-1?
To fill out NY HIMP-1, organizations must provide detailed information about their health insurance offerings, coverage metrics, and compliance with health regulations as specified in the form instructions.
What is the purpose of NY HIMP-1?
The purpose of NY HIMP-1 is to collect data to enhance the oversight of health insurance practices and ensure compliance with state health regulations, ultimately improving health outcomes for residents.
What information must be reported on NY HIMP-1?
Information that must be reported on NY HIMP-1 includes data on enrollment figures, claims processing statistics, and information on quality of care measures among insured populations.
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