(1) An insurer filing a health benefit plan filing shall comply with:
- (a) Title 31A, Chapter 30, Individual, Small Employer, and Group Health Insurance Act;
- (b) Title 31A, Chapter 45, Managed Care Organizations;
- (c) Rule R590-167; and
- (d) Rule R590-277.
(2) Form Filing.
- (a) A non-2014 PPACA compliant health benefit plan form filing shall include the SERFF tracking number for the form's applicable rate manual filing.
- (b) A grandfathered or transitional plan shall be filed separate from a 2014 PPACA compliant health benefit plan.
(3) Rate Manual Filing for a Non-2014 PPACA Compliant Health Benefit Plan.
- (a) A rate manual filing that does not request a change in rating methodology is a file before use filing.
- (b) A change in a rating methodology filing is a file for approval filing.
(c) A new or revised rate manual shall:
- (i) include an actuarial certification signed by a qualified actuary; and
- (ii) be filed 30 days before use.
- (d) The company rate information on the rate/rule schedule tab shall be compliant.
(4) Rate Filing for a 2014 PPACA Compliant Health Benefit Plan.
- (a) A rate filing shall be filed according to the department's annual bulletin to insurers.
- (b) Quarterly changes to a rate filing shall be filed according to Bulletin 2015-3.
KEY: health insurance filings
Date of Last Change: July 21, 2023
Notice of Continuation: February 7, 2024
Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-2-201.1; 31A-2-202; 31A-22-605; 31A-22-620; 31A-30-106