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.

Service Contract Provider Registration Application Form

Mail or online

$500

The names of all corporations, partnerships, limited liability companies and trade names must receive prior approval from the Department of Financial Services for use in New York. Name changes for entities must also receive prior approval. The name must first be submitted to the Department for consideration, and either approval or disapproval will be forwarded in writing, along with the appropriate application and instructions

Service Contract Provider Registration Application Form

Mail or online

$500

Biennially by February 28 of odd-numbered years

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.