Bureau of Insurance
OTHER PFR AGENCIES
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Life Health
All Rate and Form Filings submitted to the Bureau of Insurance for
review must be accompanied by the completed appropriate transmittal
Document as well as the completed appropriate rate/form review checklist.
The checklist must be completed by the company submitting the filing
and must reference, for each item on the checklist, the location of
each specific item in the filing. The transmittal Document takes the
place of the cover letter requirement. Blank transmittal documents are
attached here for your use.
MAINE BUREAU OF INSURANCE
REVIEW REQUIREMENTS CHECKLIST FOR LIFE, ACCIDENT & HEALTH, ANNUITY
AND CREDIT
GENERAL REQUIREMENTS FOR ALL FILINGS
| LINE OF BUSINESS: |
LINES OF INSURANCE: |
CODES: |
| _________________ |
[ ]_________________ |
_____________ |
| _________________ |
[ ]_________________ |
_____________ |
| _________________ |
[ ]_________________ |
_____________ |
Checklist Not Applicable [ ] WHY___________________________________________________
| REVIEW REQUIREMENTS |
REFERENCE |
DESCRIPTION OF REVIEW
STANDARDS REQUIREMENTS |
LOCATION OF
STANDARD IN FILING |
SUBMISSION PACKAGE
REQUIREMENTS |
|
Filing must contain a cover letter, transmittal document, and
2 copies of the entire filing. |
|
GROUNDS FOR DISAPPROVAL
(FORM FILINGS ONLY) |
|
This section of Maine Insurance law describes the grounds for
disapproval of a filing. |
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| VARIABILITY OF LANGUAGE |
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Companies are advised that filing of forms with variable bracketed information to the Maine Bureau of Insurance must include all the possible language that might be placed within the brackets. The use of too many variables will result in filing disapproval as Bureau staff may not be able to determine whether the filing is compliant with Maine laws and regulations. |
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| REPRESENTATIONS IN APPLICATIONS |
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All statements and descriptions in any application for insurance
or for an annuity contract, by or in behalf of the insured or annuitant,
are deemed to be representations and not warranties. |
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ADVERTISING
Long Term Care Policies |
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Every insurer, health care service plan or other entity providing long-term care insurance in this state shall file with the superintendent for prior approval a copy of any long-term care insurance advertisement intended for use in this state, whether through written, radio, television, internet or other medium. If the advertisement has not been affirmatively approved or disapproved within 30 days after filing, it will be deemed approved.
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ADVERTISING
Medicare Supplement Policies |
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All Medicare supplement advertisements must be filed for approval
at least 30 days prior to the date the advertisement will be used
in this State. Additionally, all advertising materials shall specifically
disclose the availability of Medicare supplemental products to those
persons eligible for Medicare because of disability. |
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ASSOCIATION/
TRUSTS/
DISCRETIONARY GROUPS
(Group only) |
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All Association, Trust, and other Discretionary groups must file
the appropriate Constitution and Bylaws; Trust Agreement and Joinder/Participation
Agreements; and/or Articles of Incorporation |
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| READABILITY |
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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 as funding vehicles. |
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OTHER:
Filing Fee |
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$20.00 for Rate filings, rating rules filings, insurance policy,
forms, riders, endorsements and certificates |
|
Click here
for the General Requirements for Life, Accident and Health, Annuity
and Credit filings in WORD format.
ADDITIONAL ACCIDENT & HEALTH FORM FILING
REQUIREMENTS
| Word/HTML |
Group Accident Only - (H02G) |
| Word/HTML |
Individual Accident Only - (H02I) |
| Word/HTML |
Group Accidental Death & Dismemberment - (H03G) |
| Word/HTML |
Individual Accidental Death & Dismemberment - (H03I) |
| Word/HTML |
Blanket Accident and Sickness - (H04) |
| Word/HTML |
Blanket Accident Only - (H04) |
| Word/HTML |
Group Specified Disease - (H07G) |
| Word/HTML |
Individual Specified Disease - (H07I) |
| Word/HTML |
Group Dental - (H10G) |
| Word/HTML |
Individual Dental - (H10I) |
| Word/HTML |
Group Disability Income - (H11G) |
| Word/HTML |
Individual Disability Income - (H11I) |
| Word/HTML |
Excess/Stop Loss - (H12) |
| Word/HTML |
Group Hospital Confinement Indemnity - (H14G) |
| Word/HTML |
Individual Hospital Confinement Indemnity - (H14I) |
| Word/HTML |
Group Major Medical - (H16G) |
| Word/HTML |
Individual Major Medical - (H16I) |
| Word/HTML |
Group HMO/POS - (HOrg02G) |
| Word/HTML |
Individual HMO/POS - (HOrg02I) |
| Word |
Group & Individual Long Term Care/Partnership - (LTC03G and LTC03I) |
| Word/HTML |
Group Medicare Supplement - (MS05G) |
| Word/HTML |
Individual Medicare Supplement - (MS05I) |
| Word/HTML |
Group Vision Plans - (H20G) |
| Word/HTML |
Individual Vision Plans - (H20I) |
| Word/HTML |
Group Basic Hospital Expense - (H21 Other) |
| Word/HTML |
Individual Basic Hospital Expense - (H21 Other) |
| Word/HTML |
Group Basic Hospital/Medical-Surgical Expense - (H21 Other) |
| Word/HTML |
Individual Basic Hospital/Medical-Surgical Expense - (H21 Other) |
| Word/HTML |
Group Basic Medical Expense - (H21 Other) |
| Word/HTML |
Individual Basic Medical Expense - (H21 Other) |
| Word/HTML |
Group Basic Medical-Surgical Expense - (H21 Other) |
| Word/HTML |
Individual Basic Medical-Surgical Expense - (H21 Other) |
| Word/HTML |
Group Supplemental Health Coverage Policies - (H21 Other) |
| Word/HTML |
Individual Supplemental Health Coverage Policies - (H21 Other) |
| Word/HTML |
Out-of-State Groups, Associations/Trusts/
Labor Union Group/Debtor Groups/Other Groups - (H21 Other) |
| Word/HTML |
MEWAs - (H21 Other) |
| Word/HTML |
APPLICATIONS |
ADDITIONAL RATE FILING REQUIREMENTS
| Word/HTML |
Credit - (CR02G & CR04G ) |
| Word/HTML |
Group Health Policies, other than Small Group Health Plans- (H02G, H03G, H04,
H07G, H08G, H09G, H10G, H11G, H12, H13G, H14G, H15G.002, H16G.002A, H16G.002B, H16G.002C,
H16G.004, H17G, H18G, H19G, H20G, HOrg02G.003B) |
| Word/HTML |
Individual Health Plans - (H15I, H16I.005A, H16I.005B, H16I.005C,
HOrg02I.005B, HOrg02I.005C) |
| Word/HTML |
Individual Health Policies, other than Medicare Supplement, Long Term
Care, and Individual Health Plans - (H02I, H03I, H07I, H08I, H09I, H10I, H11I, H13I, H14I,
H16I.004, H17I, H19I, H20I) |
| Word/HTML |
Long Term Care/Nursing Home Care - (LTC03G, LTC03I) - subject to Rule 420 (policies issued prior to 10-01-04) |
| Word/HTML |
Long Term Care - (LTC03G, LTC03I) - Initial Rate Filing for policies subject to Rule 425 (policies issued on and after 10-01-04) |
| Word/HTML |
Long Term Care - (LTC03G, LTC03I) - Rate Revision Filing for policies subject to Rule 425 (policies issued on and after 10-01-04) |
| Word/HTML |
Medicare Supplement - (MS05G, MS05I) |
| Word/HTML |
Small Group Health Plans- (H15G.003, H16G.003A, H16G.003D,H16G.003G,
HOrg02G.004E) |
ADDITIONAL LIFE, ANNUITY & CREDIT FORM FILING REQUIREMENTS
| Word/HTML |
Annuities - (A02G, A02I, A02.1G, A02.1I, A05G A05I, A06.1G, A06.1I,
A10) |
| Word/HTML |
Variable Annuities - (A03G A03I, A06G, A06I, A07G.002, A07I.002,
A10) |
| Word/HTML |
Group Life - (L02G, L03G, L04G, L05G, L07G, L08) |
| Word/HTML |
Individual Life - (L02I, L03I, L04I, L05I, L07I, L08) |
| Word/HTML |
Variable Life - (L06G, L06I, L08) |
| Word/HTML |
Illustrations - (L08) |
| Word/HTML |
Group Credit Life and/or Disability - (CR04G and/or CR02G) |
| Word/HTML |
Individual Credit Life and/or Disability - (CR04I and/or CR02I) |
| Word/HTML |
APPLICATIONS (Group & Individual) |
Last Updated:
February 4, 2010
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