Maine Bureau of Insurance Form Filing Requirements Checklist INDIVIDUAL MAJOR MEDICAL PLANS (H16I) (NON-GRANDFATHERED) Inside and Outside the Marketplace For Plans Issued On or After January 1, 2019 (Revised 9/27/2018) Carriers must confirm compliance and IDENTIFY the LOCATION (Page number, Section, Paragraph, etc.) of the standard in the form in the last column. N/A: Check this box if a contract does not have to meet this requirement carriers must EXPLAIN WHY in the last column. State Description of Requirement State Benefit/Provision State N/A CONFIRM COMPLIANCE and/or Law/ Rule AND IDENTIFY LOCATION and/or ACA Requirement and/or OF STANDARD IN FILING ACA Description of Requirement Federal Law MUST EXPLAIN IF REQUIREMENT IS INAPPLICABLE General Submission Requirements Electronic (SERFF) All filings must be filed electronically, using the NAIC System for ☐ Submission Electronic Rate and Form Filing (SERFF). See . Requirements FILING FEES $20.00 for Rate filings, rating rules filings, insurance policy, forms, ☐ riders, endorsements and certificates. See General Instructions page in SERFF for additional information on filing fee structure. Filing fees must be submitted by EFT in SERFF at the time of submission of the filing. All filings require a filing fee unless specifically excluded per 24-A M.R.S.A. §4222(1), and/or are a required annual report. Grounds for disapproval Seven categories of the grounds for disapproving a filing. ☐ Readability Minimum of 50. Riders, endorsements, applications all must be ☐ scored. They may be scored either individually or in conjunction with the policy/certificate to which they will be attached. Exceptions: Federally mandated forms/language, Groups > 1000, Group Annuities
Maine Bureau of Insurance Form Filing Requirements Checklist INDIVIDUAL MAJOR MEDICAL PLANS (H16I) (NON-GRANDFATHERED) Inside and Outside the Marketplace For Plans Issued On or After January 1, 2019 (Revised 9/27/2018) Carriers must confirm compliance and IDENTIFY the LOCATION (Page number, Section, Paragraph, etc.) of the standard in the form in the last column. N/A: Check this box if a contract does not have to meet this requirement carriers must EXPLAIN WHY in the last column. State Benefit/Provision and/or ACA Requirement State Law/ Rule and/or Federal Law State Description of Requirement and/or ACA Description of Requirement N/A CONFIRM COMPLIANCE AND IDENTIFY LOCATION OF STANDARD IN FILING MUST EXPLAIN IF REQUIREMENT IS INAPPLICABLE General Submission Requirements Electronic (SERFF) Submission Requirements All filings must be filed electronically, using the NAIC System for Electronic Rate and Form Filing (SERFF). See . ☐ FILING FEES $20.00 for Rate filings, rating rules filings, insurance policy, forms, riders, endorsements and certificates. See General Instructions page in SERFF for additional information on filing fee structure. Filing fees must be submitted by EFT in SERFF at the time of submission of the filing. All filings require a filing fee unless specifically excluded per 24-A M.R.S.A. §4222(1), and/or are a required annual report. ☐ Grounds for disapproval Seven categories of the grounds for disapproving a filing. ☐ Readability Minimum of 50. Riders, endorsements, applications all must be scored. They may be scored either individually or in conjunction with the policy/certificate to which they will be attached. Exceptions: Federally mandated forms/language, Groups > 1000, Group Annuities ☐
individual_major_medical_plans-non-grandfathered.docx