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Accident and Health

Federal Health Care Reform:
Patient Protection and Affordable Care Act (PPACA)
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 Student Accident and Health Policies;
  • Group Dental and Group Vision Policies;
  • Group Accident and Health Policies that include Group Medicare Supplement and Group Long-Term Care;
  • Blanket Accident and Health;
  • Franchise Accident and Health

HMOs and PPOs:

  • Group HMO policy forms issued by HMOs under the Health Maintenance Organization Act and Group PPO policy forms issued under Section 630 of the Insurance Company Law of 1921

Hospital Plan Corporations and Professional Health Services Plan Corporations:

  • Group Accident and Health Policy Forms;
  • Blanket Accident and Sickness Policy Forms;
  • Blanket Student Accident and Sickness Policy Forms;
  • Group Dental and Group Vision Policy Forms;
  • Franchise Accident and Health Policy Forms as defined in Section 621.4 of the Insurance Company Law of 1921

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.

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