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Accident and Health


 
  

 

The following A&H Group Forms have been deregulated and should not be filed with the Department: 

Commercial For-Profit Insurers: 

  • Group Long or Short-Term Disability Policies;
  • Blanket Accident and Health;
 

Hospital Plan Corporations and Professional Health Services Plan Corporations:  

  • Blanket Accident and Sickness Policy Forms
 

Accident and Health Form Submission Checklists:

 
 
Small Group Rating:
 
 Individual Rating:
 

Medicare Supplement: 

 

Long-Term Care: 

 
Disclosure Requirements:
 
 
 *All actuarial worksheets and exhibits with number and/or formulas must be submitted in Excel.
*Actuarial explanatory materials may be submitted in Adobe.