New York Insurance License

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

$100 for full licensing period (applications submitted during odd-numbered years); $50 for half licensing period (applications submitted during even-numbered years).

Ensure all application materials are clipped or stapled together. DFS may reject application materials as "submitted separately" if pages are not fastened.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

$1,000

Adjuster (Independent or Public) (IA or PA)

File by mail.

$100

January 1 of odd-numbered years.

Ensure all application materials are clipped or stapled together. DFS may reject application materials as "submitted separately" if pages are not fastened.

$1,000

http://www.dfs.ny.gov/insurance/faxappi.htm

Varies by insurance type. Baseline of $100

http://www.dfs.ny.gov/insurance/faxappi.htm

Varies by insurance type. Baseline of $100

Biennially

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

By June 30 of odd-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

By October 31 of even-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

By March 31 of odd-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

By June 30 of odd-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

By June 30 of odd-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

$80 per sub-licensee if New York is your home state. If not, see the fee schedule retaliatory fee details.

By October 31 of even-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

By December 31 of even-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

By August 31 of even-numbered years.

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

TPA Registration Application 

Email licensing@wcb.ny.gov

$0

NYCRR Section 302-1.2

• Proof of workers' compensations and disability coverage forms (C-105.2 and DB-120.1)
• Third Party Administrator (TPA) Surety Bond form (OC-407)
• List of Corporate Officers
• List of clients represented by the TPA
• Certificate from NYS DOS

TPA Registration Application (Renewal)

Email licensing@wcb.ny.gov

$0

Triennially by date of issuance. 

• Proof of workers' compensations and disability coverage forms (C-105.2 and DB-120.1)
• Third Party Administrator (TPA) Surety Bond form (OC-407)
• List of Corporate Officers
• List of clients represented by the TPA
• Certificate from NYS DOS

Mail or online. Email licensing.applications@dfs.ny.gov to obtain a paper application and instructions.

1. Submit a request for name approval to licensing@dfs.ny.gov. Include the applicant’s name, the entity name, a mailing address and the type of license for which you are applying. A response will be sent in 4-6 weeks.
2. Entites using a trade name must register the name and submit a filing receipt with the license application.
3. Apply for a license through the online portal.

Online

By June 30 of odd-numbered years.

UR Agent Report Application and Attestation Form

$0

• Set of UR policies and procedures, including UR plan, demonstrating Agent’s ability to carry out the relevant requirements of Insurance Law
• Certificate of Incorporation in New York State or other documentation that the Agent has been approved by the Secretary of State to do business in New York State
• Corporate organization chart demonstrating the position of the Agent, subsidiaries, and any parent organizations in the corporate structure (an internal organization chart is not required)
• List of all insurers and/or municipal cooperative health benefit plans for which the Agent is performing utilization review in New York State and/or anticipated contract date
• URAC Certificate (if applicable)
• Template notice letters
• External Appeal Standard Description and Application

UR Agent Report Application and Attestation Form (Renewal)

$0

Biennially by the registration anniversary date.