TO: Licensees, Insurers and Interested Parties
FROM: Linda Ruthardt, Commissioner of Insurance
DATE: February 12, 2001
RE: Forms Submitted For Approval, Pursuant to Chapter 175, Section 2B

As part of the Division of Insurance's ("Division") efforts to improve its ability to timely and efficiently review insurance policy and other related forms submitted for approval, the Division has created a series of checklists for a variety of life, annuity, long term care and health products. Each checklist delineates the product requirements and prohibitions of applicable Massachusetts statutes and regulations.

Mandatory Use of Checklists
Effective March 1, 2001, all filings in connection with life, annuity, long term care and health insurance policy form approval must be accompanied by a completed checklist from those currently available on the Division's website ( Such checklists must be completed in full with respect to each entry thereon, indicating where in the company's filing (page and paragraph number) the requirement is satisfied. Additionally, a duly authorized representative of the company must certify, with respect to each such checklist that it is the insurer's good faith belief, based upon reviews both of the applicable checklist and the submitted form, that the form complies with applicable Massachusetts law.

Any submission that is not accompanied by the applicable, completed checklist and such certification of compliance will be rejected as incomplete and returned to the insurer. Checklists for similar use in connection with forms respecting other kinds of insurance, e.g., property and casualty lines subject to prior approval, will be forthcoming in due course.

Funding Agreements

By this Bulletin, the Division also gives notice that it does not review for prior approval forms constituting or relating to funding agreements. The Commissioner has no authority under Massachusetts statutes to do so.