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Indiana Department of Insurance

IDOI > Company Compliance > Accident & Health  > Product Filing Information/Instructions  > INDIVIDUAL and GROUP FILING INSTRUCTIONS for OTHER PRODUCTS/BLANKET INDIVIDUAL and GROUP FILING INSTRUCTIONS for OTHER PRODUCTS/BLANKET

(INCLUDING ASSOCIATIONS and/or TRUSTS)

The following is a list of Other Products:

  • Accident Only
  • Credit
  • Dental
  • Disability Income
  • Employer Coverage for Medicare Eligible
  • Indemnity Only
  • Major Medical
  • Other
  • Short Term Medical
  • Specified Disease
  • Student
  • Supplemental Plan
  • Travel
  • Vision

 

All filings must be submitted via SERFF and include the following information for form and/or rate filings:

Form Filing Instructions

  1. Complete the appropriate checklist for the filing submitted.
    1. 10 Individual Checklist
    2. 20 Small Group Checklist
    3. 21 Large Group Checklist
    4. 20(C) Out of State Association/Trust Products Checklist
    5. 29 Other Products/Blanket Checklist
  2. Include applicable filing requirements.
    1. 4.1 Individual New Rate/Form
    2. 4.2 Small Group New Rate/Form
    3. 4.3 Credit New Rate/Form
    4. 9.0 Large Group New Rate/Form
      1. Requirement applies to new rates and/or forms filed.
        (Provide data for sections II and III, as applicable, if the form filing affects rates or benefit structure.)
    5. Provide the SERFF Tracking Number(s) for prior and/or current rate filings related to the form filing within the last 18 months. Include data under the General Information tab in the Filing Description field.
    6. Please complete the PPACA Uniform Compliance Summary checklist as applicable.
  3. Add the form number to the lower left-hand corner of the first page of the policy to relevant documents, such as riders and amendments.
    1. Documents must be in final print form.
    2. Form numbers cannot be variable.

Rate Filing Instructions

  1. Complete the appropriate checklist for the filing submitted.
    (Some sections may not be relevant to rate filings.)
    1. 10 Individual Checklist
    2. 20 Small Group Checklist
    3. 21 Large Group Checklist
    4. 20(C) Out of State Association/Trust Products Checklist
    5. 29 Other Products/Blanket Checklist
  2. Include applicable filing requirements.
    1. 4.1 Individual New Rate/Form
    2. 4.2 Small Group New Rate/Form
    3. 4.3 Credit New Rate/Form
    4. 9.0 Large Group New Rate/Form
      1. Requirement applies to new rates and/or forms filed.
    5. 4.3(A) Credit Rate Adjustment 
    6. 7.0 Individual Rate Adjustment 
    7. 8.0 Small Group Rate Adjustment 
    8. 9.1 Large Group Rate Adjustment 
      1. Requirement applies to rate adjustments for existing rates as an increase, decrease or rate neutral.
  3. Include related policy form numbers.
  4. Complete Other Products/Blanket Experience Workbook.
    1. Applicable to rate adjustments for existing rates.
    2. Include as an attachment under the Supporting Documentation tab in SERFF with the file name “Experience Workbook.”

*Product filings fees for rates and policy forms must be submitted via Electronic Funds Transfer (EFT) at the time of filing submission. View General Instructions in SERFF for additional details.