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All rate filings for Accident & Health must be submitted via SERFF and include:
Additionally, all fields in SERFF are expected to be completed. Guidance on the most important fields can be found in Required Rate Fields in SERFF, which can also be found on the Supporting Documentation tab in SERFF.
For full details of Filing requirements, see the Indiana General Instructions in SERFF.
All ACA compliant Major Medical and Dental plans must be submitted annually in a Binder through Plan Management in SERFF. If there are changes to rates or forms, then a Rate or Form/Rate filing would also need to be submitted in SERFF. Note that all Plan Management templates and other documents that are submitted to HIOS must be identical to the same templates and documents in SERFF. Thus, updated templates and documents must be submitted to both HIOS and SERFF concurrently.
For full details of Plan Management requirements, see the Indiana Plan Management General Instructions. This can also be found in SERFF.
Product filings fees for rates and policy forms must be submitted via Electronic Funds Transfer (EFT) at the time of filing submission. There are no filing fees for Binder submissions. View General Instructions on the Filing Rules tab in SERFF for additional details.
Required for all filings (new and renewal) when morbidity is based on past experience of the same or similar plans sold under the same parent company.
Transitional Major Medical includes Non-Grandfathered plans issued between March 23, 2010 and December 31, 2013. Any change in rates needs to be submitted using a Rate Review Justification (RRJ) sheet. Please read the instructions in the link below. These filings will be done using a rate only type in SERFF. They will need an actuarial memorandum, experience workbook and the RRJ. For rate increases greater than 10%, a concurrent filing in HIOS is needed.
Both the instructions and RRJ Template itself can be found either by doing a search for “RRJ” at CMS.gov, or (as of 4/9/2015) as the first two links show at http://www.cms.gov/site-search/search-results.html?q=RRJ.
Questions related to submitting Accident/Health Rate Filings should be directed to: