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Ny. gov DFS website www. dfs. ny. gov/healthinsurancepremiums If you choose to submit comments to DFS please include the following information The name of your insurer which is Empire HealthChoice HMO Inc. Indicate you have individual coverage. Empireblue. com/ratefiling Notice of approved premium rate After DFS approves the final premium rate you will receive final rate information at least 60 days before your 2015 renewal date. 03592NYMENEBS 06/14 30-day comment period You can contact us...
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How to fill out notice of proposed premium

01
Obtain a copy of the Notice of Proposed Premium form from the insurance company or regulatory agency.
02
Carefully review the instructions provided with the form to understand the required information.
03
Fill out the contact information section, including your name, address, and contact details.
04
Provide the policy details, such as the policy number and effective date.
05
Indicate the type of insurance coverage for which the premium is proposed.
06
Explain the reason for the proposed premium, providing any necessary justifications or explanations.
07
Specify the amount of the proposed premium and the frequency of payment (monthly, quarterly, annually, etc.).
08
In case of any supporting documentation, attach the relevant documents along with the form.
09
Review the completed form for accuracy and completeness before submission.
10
Submit the Notice of Proposed Premium form to the appropriate insurance company or regulatory agency as instructed.

Who needs notice of proposed premium?

01
Individuals who want to propose or suggest a premium amount for their insurance coverage.
02
Policyholders who have experienced changes in their circumstances that may impact the premium.
03
Insured individuals who believe their current premium is not fair or appropriate and want to propose a different amount.
04
Insurance agents or brokers who want to suggest premium adjustments for their clients.
05
Insurance companies or regulatory agencies that require a formal process for proposing premium amounts.
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Notice of proposed premium is a document filed with relevant authorities to notify them of the intended premium rates for insurance policies.
Insurance companies are required to file notice of proposed premium.
Notice of proposed premium can be filled out online on the designated portal of the regulatory authority.
The purpose of notice of proposed premium is to inform the authorities about the upcoming premium rates for insurance policies.
Information such as the proposed premium rates for different insurance policies and any changes from the previous rates must be reported on notice of proposed premium.
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