Notice of Privacy Practices and Compliance

• Privacy Notice
• Nonpublic Personal Financial Information Policy
• Electronic Communications Disclosure
• Website and Mobile Privacy Policy

En Español

• Privacy Notice – Spanish
• Politica de Información Financiera Personal No Pública

• Authorization to Disclose Information
• Authorization to Disclose Information — Spanish

Annual Notices/Reports—Commercial

• Member
• Provider – New York
• Provider – Vermont
• Vermont Report

Rate Filing—Narrative Summaries

• 2026 New York Individual HMO
• 2026 New York Small Group HMO
• 2026 New York Small Group EPO and PPO
• 2026 New York Large Group HMO
• 2025 New York Individual HMO
• 2025 New York Small Group HMO
• 2025 New York Small Group EPO and PPO
• 2025 New York Large Group HMO

Protocols for Domestic Violence and Endangered Victims

• Protocols for Domestic Violence Victims and Endangered Victims
• Protocolos de Confidencialidad para Víctimas de Violencia Doméstica y Víctimas en Peligro

New York State Out-of-Network (OON) Law (Effective 3/30/15)

• Independent Dispute Resolution Process for Emergency and Surprise Bills—Member
• Independent Dispute Resolution Process for Emergency and Surprise Bills—Health Care Providers
• Out-of-Network Reimbursement Examples

• Annual Health Equity Analysis of Utilization Management Policies and Procedures: 2024 (PDF)

• NY No Surprises Act Disclosure Notice
• VT No Surprises Act Disclosure Notice

New York Individual

• FRNY EP 1&2 2025 COC
• FRNY EP 3&4 2025 COC
• FRNY44 INDV HMO COC 2025 CAT CL
• FRNY44 INDV HMO COC 2025 CHILD ONLY HDHP
• FRNY44 INDV HMO COC 2025 CHILD ONLY
• FRNY44 INDV HMO COC 2025 NSTD AGG-EMB
• FRNY44 INDV HMO COC 2025 NSTD PCP
• FRNY44 INDV HMO COC 2025 NSTD
• FRNY44 INDV HMO COC 2025 STD HDHP
• FRNY44 INDV HMO COC 2025 STD PCP
• FRNY44 INDV HMO COC 2025 STD
• NY44 INDV HMO COC 2025 CAT
• NY44 INDV HMO COC 2025 CHILD ONLY HDHP
• NY44 INDV HMO COC 2025 CHILD ONLY
• NY44 INDV HMO COC 2025 NSTD HDHP
• NY44 INDV HMO COC 2025 NSTD PCP
• NY44 INDV HMO COC 2025 NSTD
• NY44 INDV HMO COC 2025 STD HDHP
• NY44 INDV HMO COC 2025 STD PCP
• NY44 INDV HMO COC 2025 STD

New York Small Group

• NY43 SG EPO COC 2025 AGG-EMB-Q (NoFP)
• NY43 SG EPO COC 2025 AGG-EMB
• NY43 SG EPO COC 2025 PCP-Q (NoFP)
• NY43 SG EPO COC 2025 PCP
• NY43 SG EPO COC 2025-Q (NoFP)
• NY43 SG EPO COC 2025
• NY44 SG HMO COC 2025 AGG-EMB-Q (NoFP)
• NY44 SG HMO COC 2025 AGG-EMB
• NY44 SG HMO COC 2025 HNY-Q (NoFP)
• NY44 SG HMO COC 2025 HNY
• NY44 SG HMO COC 2025 PCP-Q (NoFP)
• NY44 SG HMO COC 2025 PCP
• NY44 SG HMO COC 2025- Q (NoFP)
• NY44 SG HMO COC 2025

New York Large Group

• NY43 CERT EPO GF 2025
• NY43 HMOPOS COC 2025 IntRX FP
• NY43 HMOPOS COC 2025 IntRX NoFP
• NY43 HMOPOS COC 2025 NoRX FP
• NY43 HMOPOS COC 2025 NoRX NoFP
• NY43 HMOPOS COC GF 2025
• NY43 LG 7 EPO COC 2025 IntRX AGG HD NoFP
• NY43 LG 7 EPO COC 2025 IntRX AGG HD
• NY43 LG 7 EPO COC 2025 IntRX AGG NoFP
• NY43 LG 7 EPO COC 2025 IntRX AGG
• NY43 LG 7 EPO COC 2025 IntRX AggEmb HD NoFP
• NY43 LG 7 EPO COC 2025 IntRX AggEmb HD
• NY43 LG 7 EPO COC 2025 IntRX AggEmb NoFP
• NY43 LG 7 EPO COC 2025 IntRX AggEmb
• NY43 LG 7 EPO COC 2025 IntRX EMB HD NoFP
• NY43 LG 7 EPO COC 2025 IntRX EMB HD
• NY43 LG 7 EPO COC 2025 IntRX EMB NoFP
• NY43 LG 7 EPO COC 2025 IntRX EMB
• NY43 LG 7 EPO COC 2025 NoRX EMB NoFP
• NY43 LG 7 EPO COC 2025 NoRX EMB
• NY43 PPO COC GF 2025
• NY44 HMO COC GF 2025
• NY44 LG 7 HMO COC 2025 IntRX NoFP
• NY44 LG 7 HMO COC 2025 IntRX
• NY44 LG 7 HMO COC 2025 NoRX NoFP
• NY44 LG 7 HMO COC 2025 NoRX

Vermont Small Group and Individual

• FRVT HMO HDHP NON-STANDARD CTR (2025)
• FRVT HMO HDHP STANDARD CTR (2025)
• FRVT HMO NON-STANDARD CTR (2025)
• FRVT HMO STANDARD CTR (2025)

Vermont Large Group

• VT 5 HMO 2025 COC INTRX HDHP
• VT 5 HMO 2025 COC INTRX
• VT 5 HMO 2025 COC

New York Individual

• FRNY EP 1&2 COC (2024)
• FRNY EP 3&4 COC (2024)
• FRNY44 INDV HMO COC 2024 CAT
• FRNY44 INDV HMO COC 2024 CHILD ONLY
• FRNY44 INDV HMO COC 2024 CHILD ONLY HDHP
• FRNY44 INDV HMO COC 2024 NSTD
• FRNY44 INDV HMO COC 2024 NSTD AGG EMB
• FRNY44 INDV HMO COC 2024 NSTD AGG EMB HDHP
• FRNY44 INDV HMO COC 2024 NSTD HDHP
• FRNY44 INDV HMO COC 2024 NSTD PCP
• FRNY44 INDV HMO COC 2024 STD
• FRNY44 INDV HMO COC 2024 STD HDHP
• FRNY44 INDV HMO COC 2024 STD PCP
• NY44 INDV HMO COC 2024 CAT
• NY44 INDV HMO COC 2024 CHILD ONLY
• NY44 INDV HMO COC 2024 CHILD ONLY HDHP
• NY44 INDV HMO COC 2024 NSTD
• NY44 INDV HMO COC 2024 NSTD AGG EMB
• NY44 INDV HMO COC 2024 NSTD AGG EMB HDHP
• NY44 INDV HMO COC 2024 NSTD HDHP
• NY44 INDV HMO COC 2024 NSTD PCP
• NY44 INDV HMO COC 2024 STD
• NY44 INDV HMO COC 2024 STD HDHP
• NY44 INDV HMO COC 2024 STD PCP

New York Small Group

• NY43 SG EPO COC 2024
• NY43 SG EPO COC 2024 AGG EMB
• NY43 SG EPO COC 2024 AGG EMB HDHP
• NY43 SG EPO COC 2024 AGG EMB Q NoFP
• NY43 SG EPO COC 2024 AGG EMB Q NoFP HDHP
• NY43 SG EPO COC 2024 HDHP
• NY43 SG EPO COC 2024 PCP
• NY43 SG EPO COC 2024 PCP Q NoFP
• NY43 SG EPO COC 2024 Q NoFP
• NY43 SG EPO COC 2024 Q NoFP HDHP
• NY44 SG HMO COC 2024
• NY44 SG HMO COC 2024 AGG EMB
• NY44 SG HMO COC 2024 AGG EMB HDHP
• NY44 SG HMO COC 2024 AGG EMB Q NoFP
• NY44 SG HMO COC 2024 AGG EMB Q NoFP HDHP
• NY44 SG HMO COC 2024 HDHP
• NY44 SG HMO COC 2024 HNY
• NY44 SG HMO COC 2024 HNY Q NoFP
• NY44 SG HMO COC 2024 PCP
• NY44 SG HMO COC 2024 PCP Q NoFP
• NY44 SG HMO COC 2024 Q NoFP
• NY44 SG HMO COC 2024 Q NoFP HDHP

New York Large Group

• NY43 CERT EPO GF 2024
• NY43 HMOPOS COC 2024 IntRX FP
• NY43 HMOPOS COC 2024 IntRX NoFP
• NY43 HMOPOS COC 2024 NoRX FP
• NY43 HMOPOS COC 2024 NoRX NoFP
• NY43 HMOPOS COC GF 2024
• NY43 LG 7 EPO COC 2024 IntRX AGG HD NoFP
• NY43 LG 7 EPO COC 2024 IntRX AGG HD
• NY43 LG 7 EPO COC 2024 IntRX AGG NoFP
• NY43 LG 7 EPO COC 2024 IntRX AGG
• NY43 LG 7 EPO COC 2024 IntRX AggEmb HD NoFP
• NY43 LG 7 EPO COC 2024 IntRX AggEmb HD
• NY43 LG 7 EPO COC 2024 IntRX AggEmb NoFP
• NY43 LG 7 EPO COC 2024 IntRX AggEmb
• NY43 LG 7 EPO COC 2024 IntRX EMB HD NoFP
• NY43 LG 7 EPO COC 2024 IntRX EMB HD
• NY43 LG 7 EPO COC 2024 IntRX EMB NoFP
• NY43 LG 7 EPO COC 2024 IntRX EMB
• NY43 LG 7 EPO COC 2024 NoRX EMB NoFP
• NY43 LG 7 EPO COC 2024 NoRX EMB
• NY43 PPO COC GF 2024
• NY44 HMO COC GF 2024
• NY44 LG 7 HMO COC 2024 IntRX NoFP
• NY44 LG 7 HMO COC 2024 IntRX
• NY44 LG 7 HMO COC 2024 NoRX NoFP
• NY44 LG 7 HMO COC 2024 NoRX

Vermont Small Group and Individual

• FRVT HMO HDHP NON-STANDARD CTR (2024)
• FRVT HMO HDHP STANDARD CTR (2024)
• FRVT HMO NON-STANDARD CTR (2024)
• FRVT HMO STANDARD CTR (2024)

Vermont Large Group

• VT 4 HMO 2024 COC INTRX HDHP
• VT 4 HMO 2024 COC INTRX NQHDHP
• VT 4 HMO 2024 COC Intrx
• VT 4 HMO 2024 COC

New York

Individual 

• FRNY EP 1&2 COC (2023)
• FRNY EP 3&4 COC (2023)
• FRNY44 INDV HMO COC 2023 CAT
• FRNY44 INDV HMO COC 2023 CHILD ONLY
• FRNY44 INDV HMO COC 2023 NSTD
• FRNY44 INDV HMO COC 2023 NSTD AGG-EMB
• FRNY44 INDV HMO COC 2023 NSTD PCP
• FRNY44 INDV HMO COC 2023 STD
• FRNY44 INDV HMO COC 2023 STD PCP
• NY44 INDV HMO COC 2023 CAT
• NY44 INDV HMO COC 2023 CHILD ONLY
• NY44 INDV HMO COC 2023 NSTD
• NY44 INDV HMO COC 2023 NSTD AGG-EMB
• NY44 INDV HMO COC 2023 NSTD PCP
• NY44 INDV HMO COC 2023 STD
• NY44 INDV HMO COC 2023 STD PCP

Small Group

• NY43 SG EPO COC 2023
• NY43 SG EPO COC 2023 AGG-EMB
• NY43 SG EPO COC 2023 AGG-EMB-Q (NoFP)
• NY43 SG EPO COC 2023 PCP
• NY43 SG EPO COC 2023 PCP-Q (NoFP)
• NY43 SG EPO COC 2023-Q (NoFP)
• NY44 SG HMO COC 2023
• NY44 SG HMO COC 2023 AGG-EMB
• NY44 SG HMO COC 2023 AGG-EMB-Q No FP
• NY44 SG HMO COC 2023 HNY
• NY44 SG HMO COC 2023 HNY-Q (NoFP)
• NY44 SG HMO COC 2023 PCP
• NY44 SG HMO COC 2023 PCP-Q (NoFP)
• NY44 SG HMO COC 2023- Q (NoFP)

Large Group

• NY43 EPO COC GF 2023
• NY43 PPO COC GF 2023
• NY43 HMOPOS COC GF 2023
• NY43 LG 7 EPO COC 2023 IntRX AGG
• NY43 LG 7 EPO COC 2023 IntRX AggEmb
• NY43 LG 7 EPO COC 2023 IntRX EMB
• NY43 LG 7 EPO COC 2023 NoRX EMB
• NY43 HMOPOS COC 2023 IntRX FP
• NY43 HMOPOS COC 2023 NoRX FP
• NY44 HMO COC GF 2023
• NY44 LG 7 HMO COC 2023 IntRX
• NY44 LG 7 HMO COC 2023 NoRX

Vermont

Small Group & Individual

• FRVT HMO HDHP NON-STANDARD CTR (2023)
• FRVT HMO HDHP STANDARD CTR (2023)
• FRVT HMO NON-STANDARD CTR (2023)
• FRVT HMO STANDARD CTR (2023)

Large Group

• VT 3 HMO 2023 COC
• VT 3 HMO 2023 COC INTRX HDHP
• VT 3 HMO 2023 COC INTRX NQHDHP

Dental

Individual

• Individual Adult Dental COC 2023
• Individual Family Dental COC 2023
• Individual Pediatric Dental COC 2023

Small Group

• Small Group Adult Dental COC 2023
• Small Group Family Dental COC 2023
• Small Group Pediatric Dental COC 2023

New York

Individual

• FRNY44 INDV HMO COC 2022 CAT
• FRNY44 INDV HMO COC 2022 CHILD ONLY
• FRNY44 INDV HMO COC 2022 NSTD
• FRNY44 INDV HMO COC 2022 NSTD AGG-EMB
• FRNY44 INDV HMO COC 2022 NSTD PCP
• FRNY44 INDV HMO COC 2022 STD
• FRNY44 INDV HMO COC 2022 STD PCP
• NY44 INDV HMO COC 2022 CAT
• NY44 INDV HMO COC 2022 CHILD ONLY
• NY44 INDV HMO COC 2022 NSTD
• NY44 INDV HMO COC 2022 NSTD AGG-EMB
• NY44 INDV HMO COC 2022 NSTD PCP
• NY44 INDV HMO COC 2022 STD
• NY44 INDV HMO COC 2022 STD PCP
• 2022 EP Subscriber Contract 1&2
• 2022 EP Subscriber Contract 3&4

Small Group

• NY43 SG EPO COC 2022
• NY43 SG EPO COC 2022-Q (NoFP)
• NY43 SG EPO COC 2022 AGG-EMB
• NY43 SG EPO COC 2022 AGG-EMB-Q (NoFP)
• NY43 SG EPO COC 2022 PCP
• NY43 SG EPO COC 2022 PCP-Q (NoFP)
• NY44 SG HMO COC 2022 HNY
• NY44 SG HMO COC 2022 HNY-Q (NoFP)
• NY44 SG HMO COC 2022
• NY44 SG HMO COC 2022-Q (NoFP)
• NY44 SG HMO COC 2022 AGG-EMB
• NY44 SG HMO COC 2022 AGG-EMB-Q No FP
• NY44 SG HMO COC 2022 PCP
• NY44 SG HMO COC 2022 PCP-Q (NoFP)

Large Group

• NY43 PPO COC GF 2022
• NY43 PPO COC GF NoFP 2022
• NY43 HDHP EPO COC GF 2022
• NY43 EPO COC GF 2022
• NY43 LG 7 EPO COC 2022 T1RX EMB
• NY43 LG 7 EPO COC 2022 T1RX EMB NoFP
• NY43 LG 7 EPO COC 2022 T1RX AggEmb
• NY43 LG 7 EPO COC 2022 T1RX AggEmb NoFP
• NY43 LG 7 EPO COC 2022 IntRX AGG
• NY43 LG 7 EPO COC 2022 IntRX AGG NoFP
• NY43 LG 7 EPO COC 2022 IntRX AggEmb
• NY43 LG 7 EPO COC 2022 IntRX AggEmb NoFP
• NY43 LG 7 EPO COC 2022 IntRX EMB
• NY43 LG 7 EPO COC 2022 IntRX EMB NoFP
• NY43 LG 7 EPO COC 2022 NoRX AGG<
• NY43 LG 7 EPO COC 2022 NoRX AGG NoFP
• NY43 LG 7 EPO COC 2022 NoRX EMB
• NY43 LG 7 EPO COC 2022 NoRX EMB NoFP
• NY43 HMOPOS COC 2022 IntRX FP
• NY43 HMOPOS COC 2022 IntRX NoFP
• NY43 HMOPOS COC 2022 NoRX FP
• NY43 HMOPOS COC 2022 NoRX NoFP
• NY43 HMOPOS COC GF 2022
• NY44 HMO COC GF 2022
• NY44 LG 7 HMO COC 2022 IntRX
• NY44 LG 7 HMO COC 2022 IntRX NoFP
• NY44 LG 7 HMO COC 2022 NoRX
• NY44 LG 7 HMO COC 2022 NoRX NoFP

Vermont

Small Group and Individual

• FRVT HMO STANDARD CTR (2022) (PDF)
• FRVT HMO NON-STANDARD CTR (2022) (PDF)
• FRVT HMO HDHP STANDARD CTR (2022) (PDF)
• FRVT HMO HDHP NON-STANDARD CTR (2022) (PDF)

Large Group

• VT 3 HMO 2022 COC (PDF)
• VT 3 HMO 2022 COC INTRX HDHP (PDF)
• VT 3 HMO 2022 COC INTRX NQHDHP (PDF)

Individual

• Individual Adult NY PPO DD 003 A (PDF)
• Individual Family NY PPO DD 002 F (PDF)
• Individual Pediatric NY PPO DD 001 P (PDF)

Small Group

• Small Group Adult NY PPO SD 003 A (PDF)
• Small Group Family NY PPO SD 002 F (PDF)
• Small Group Pediatric NY PPO SD 001 P (PDF)

New York

• NY43 VISION CTR INDIVIDUAL 2022 (PDF)
• NY43 VISION COC GROUP 2022 SMALL (PDF)
• NY43 VISION COC GROUP 2022 LARGE (PDF)

Vermont

• VT44 VISION CTR INDIVIDUAL 2022 (PDF)
• VT44 VISION COC GROUP 2022 SMALL (PDF)
• VT44 VISION COC GROUP 2022 LARGE (PDF)

• Commercial Member Rights and Responsibilities (PDF)
  
• Medicaid Member Rights and Responsibilities (PDF)
  
• Medicare Member Rights and Responsibilities (PDF)