FILING GUIDANCE NOTICES

Property and Casualty


2006-A: Compliance with M.G.L. 175, § § 18 and 192 pdf format of    Notice2006ACompanyName.pdf
2006-B Excess/Umbrella Endorsements pdf format of    Notice2006BExcessUmbrella.pdf
2006-D: Lead Poisoning & Residential Property Disclosure Statement pdf format of    Notice2006DLeadDisclosure.pdf
2007-A: Updates to Policy Form Review Checklists pdf format of    2007-A UpdatesToChecklists.pdf
2007-B: Interline Filing Instructions pdf format of    Notice2007BInterlineForm.pdf
2008-A: Addendum to Bulletin 2008-04 pdf format of    2008-04 Addendum To Filing Procedures For...
2008-C: Private Passenger Motor Vehicle Rate Filings pdf format of    2008Priv_Pass_Veh_Rem.pdf
2008-E:Premium Modifications For Motor Vehicle Safety Devices or Features pdf format of    Notice2008E_Prem_Mod.pdf
2008-F:Anti-Theft Systems or Devices Used to Discount Premiums for Certain Motor Vehicles pdf format of    Notice2008F_Anti_Theft.pdf
2008-G:Adoption of Advisory Rates for Automobile Insurance Policies pdf format of    Notice2008G_Advisory_Rates.pdf
2008-H:Private Passenger Motor Vehicle Rate/Rule Filings pdf format of    Notice2008H_Filing_guidance.pdf
2008-I: Warranty Reimbursement Insurance Policies pdf format of    Notice2008I_Filing_guidance.pdf
2009-B Designation of High-Theft Motor Vehicles Effective August 1, 2009 pdf format of    FileGuidNotice2009-B.pdf
2009-D Changes to Regulation 211 CMR 94.00 - Pre-Insurance Inspection of Private Passenger Motor Vehicles pdf format of    Notice2009D_PreInsurance.pdf
2009-H Filing of Interline Forms and Rules pdf format of    InterlineForms.pdf
2009-I Supplemental Filing Document to be Submitted with Private Passenger Motor Vehicle Rate/Rule Filings for Policies Effective on or after April 1, 2010 pdf format of    Supp_Filing_Private _Passenger.pdf
2010-B Rate and Form Filing Requirements for Insuring Low-Speed Private Passenger Motor Vehicles pdf format of    Low_Speed.pdf
2010-C Required Filing Documents to be Submitted with Private Passenger Motor Vehicle Rate/Rule Filings for Policies Effective on or after July 1, 2010 pdf format of    rate_filing.pdf
2010-D Filing Requirements for Private Passenger Motor Vehicle Rate Symbol Assignments Effective 8/1/2010 pdf format of    2010-d.pdf
2010-E High Theft Motor Vehicle List Effective 8/1/2010 pdf format of    2010-e.pdf
2011-A General Liability - Claims Made Options pdf format of    2011_A.pdf
2011-B 2012 High Theft Vehicle List for Private Passenger Auto pdf format of    2011_B.pdf
2012-A 2013 High Theft Vehicle List for Private Passenger Auto pdf format of    pandc2012-a.pdf
2013-A Submitting Commercial Automobile Insurance Rate Filings in Massachusetts pdf format of    pandc2013-a.pdf
2013-B 2014 High Theft Vehicle List for Private Passenger Auto pdf format of    2013-b-pandc.pdf

Life and Annuity


2006-C: Table of Guaranteed Values pdf format of    GuarenteedValues.pdf
2006-E: Guaranteed Minimum Benefits pdf format of    2006-E_GMB.pdf


Accident and Sickness

2009-C: Long-Term Care Insurance Rate Filings pdf format of    AccSick2009C.pdf

Health

2013-L: Data Collection Tool pdf format of    2013-l-data-collection-tool.pdf              Data Collection Tool xlsx format of    2013-l-data-collection-tool.xlsx                                
2013-L: Submission of Additional Rate Filing Material for Rates Intended to Be Effective for Coverage Issued or Renewed in 2014 pdf format of    2013-l.pdf
2013-K: Submission of Material to Illustrate Changes to Rating Factors in Rate Filings for Rates to be Effective in 2014 and 2015 pdf format of    2013-k.pdf
2013-J: Dental Data Collection Tool pdf format of    dental-data-collection-tool.pdf          Dental Data Collection Tool xlsx format of    dental-data-collection-tool.xlsx
2013-J: Standard Worksheet to be Used With Dental Rate Filings Submitted for Dental Plans Proposed to be Offered as Exchange-Certified Stand-Alone Dental Plans pdf format of    2013-j.pdf
2013-I: Reflecting Reinsurance and Risk Adjustment in Small Group Health Insurance Filings for Rates Effective On and After January 1, 2014 FILING GUIDANCE pdf format of    2013-i.pdf
2013-H: Submission of Federally Required Rate Filing Justification pdf format of    2013-h.pdf
2013-G: Submission of Material to Support Calculated Actuarial Values pdf format of    2013-g.pdf
2013-F: Submission of Rate Filing Material on July 1, 2013 pdf format of    2013-f.pdf
2013-E: Submission of Confidential Rate Filing Material to the Division of Insurance pdf format of    2013-e.pdf
2013-D: Services Provided by Physician Assistants pdf format of    2013-d.pdf
2013-C: Telemedicine Services pdf format of    2013-c.pdf
2013-B: Changes to Names of Agencies Responsible for Managed Care Practices pdf format of    2013-b.pdf
2013-A: Submission of Materials Necessary for the Review of Health Benefit Plans pdf format of    2013-a.pdf
2012-G:Reflection of ACA Costs in Small Group Health Insurance Rate Filings pdf format of    2012-g.pdf
2012-E: Rate Filings for New Products and Significant Changes to Existing Products pdf format of    2012-e.pdf
2012-D: Filings for Products that Include Rewards and/or Discounts pdf format of    2012-d.pdf
2012-C: Small Group Health Insurance Rate Filings - Administrative Expenses pdf format of    2012-c.pdf
2012-B Worksheets: PDF pdf format of    data-collection-tool.pdf          Excel Version xls format of    data-collection-tool.xls
2012-B: Standard Worksheet to be Used With Small Group Health Rate Filings Submitted for Rates Proposed to be Effective On and After October 1, 2012 pdf format of    2012-b.pdf   
2012-A: Responses to Group Purchasing Cooperative Request for Proposals pdf format of    2012-A
2011-C: Small Group Health Insurance Rate Filings - Medical Loss Ratio pdf format of    2011-C.pdf
2010-D: SERFF PPACA Uniform Compliance Form pdf format of    serff_uniform_compliance.pdf
2010-A: Filing Rates and Changes to Rating Factors under 211 CMR 43.00 pdf format of    2010-A_Notice.pdf
2009-G: Tiered Benefits Within Closed Network Health Plans pdf format of    Tiered_Benefits.pdf
2009-B:Closed Network Health Plans pdf format of    Closed_Network_Plans.pdf
2009-A:Material Changes Required by 211 CMR 52.00 pdf format of    Filing_Guidance.pdf

Workers Compensation

2012-F: Submission of Deviation and Schedule Credit Plan Filings to be Effective on or After September 1, 2012 pdf format of    2012-f-workers-comp.pdf
2009-J:Repatriation Policy Guidance pdf format of    2009J Rep_ Policy_ Guidance.pdf


CHECKLISTS

Base Checklists (Revised October 2013):


Applications for Life Insurance, Accident and Sickness Insurance, and Annuities pdf format of    AppLifeAndSick.pdf
Individual Accident and Sickness Insurance pdf format of    IndivAccidentAndSick.pdf
Individual and Group Annuities pdf format of    IndivGroupAnnuities.pdf
Individual and Group Life Insurance pdf format of    IndivGroupLife.pdf
Legal Service Plans pdf format of    LegalServPlan.pdf
Life Settlement pdf format of    life-settlement-checklist.pdf
Property and Casualty Insurance pdf format of    PropAndCas.pdf

Supplemental Checklists (Revised January 2013):


Accelerated Benefit and Early Annuity Withdrawal Provisions pdf format of    AccelBenProv.pdf
Credit Insurance pdf format of    CredLifeDisInvUnempProd.pdf
Equity-Indexed Benefit Provisions pdf format of    EqIndBenProv.pdf
Guaranteed Minimum Benefit Provisions pdf format of    GuarMinBenProv.pdf
Long-Term Care Insurance pdf format of    LongTermCareProd.pdf
No-Lapse Guarantee Provisions pdf format of    NoLapseGuarProv.pdf
Overloan Protection Provisions pdf format of    OverProtProv.pdf
Specified Disease Products pdf format of    SpecDisProd.pdf
Variable Life Insurance  pdf format of    VarLifeAnnProd.pdf

Additional Checklists for Property and Casualty Products:

Lead Poisoning & Residential Property Disclosure StatementPDF Version pdf format of    leadpoisoning.pdf
Deviations for Group Marketing Plans for Automobile and Homeowners InsurancePDF Version pdf format of    GroupMarketingChecklists.pdf
Group Marketing Checklist Word Version doc format of    group-marketing-checklist-2
Application Spreadsheet For Group Marketing Plan Excel Version xls format of    Application Spreadsheet Instructions  file size 1MB
Workers' Compensation FormsPDF Version pdf format of    Module_4_Form.pdf  Word Version doc format of    Module_4_Form.doc    Legal Service Plans pdf format of    LegalServPlan.pdf
Workers' Compensation RatesPDF Version pdf format of    Module_4_Rate.pdf   
Motor Vehicle FormsPDF Version pdf format of    Module_8_Form.pdf  Word Version doc format of    Module_8_Form.doc
Motor Vehicle RatesPDF Version pdf format of    Module_8_Rate.pdf  Word Version doc format of    Module_8_Rate.doc
Motor Vehicle Insurance Installment Plan ChecklistPDF Version pdf format of    MV_Installment.pdf  Word Version doc format of    MV_Installment.doc
Home Insurance Installment Payment Plan ChecklistPDF Version pdf format of    Home_Installment.pdf  Word Version doc format of    Home_Installment.doc
Pre-insurance private passenger motor vehicle inspection plansPDF Version pdf format of    PreInspectionPlanChecklist.pdf  Word Version doc format of    PreInspectionPlanChecklist.doc

Checklists for Managed Care:


Health Maintenance Organizations pdf format of    HMO.pdf  file size 1MB
Insured Preferred Provider Plans pdf format of    InsPrefProv.pdf
Insurance Companies pdf format of    InsCompanies.pdf  file size 1MB
Provider Contracts pdf format of    ProviderContracts.pdf
Initial Accreditation pdf format of    InitialAccred.pdf
Renewal Accreditation pdf format of    RenewalAccred.pdf
Medicare Supplement Plan pdf format of    MedSuppPlan.pdf
Group Stand-Alone Dental and Vision pdf format of    StandAloneDV.pdf
Individual Stand-Alone Dental and Vision pdf format of    IndStandAloneDV.pdf

Purchasing Groups and Risk Retention Groups


Annual Application for Registration as a Purchasing Group pdf format of    APPLICATION.PDF
Application to Register a Risk Retention Group pdf format of    Risk Retention Group Registration