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
 2014-A High Theft Vehicle List for Private Passenger Auto Effective August 1, 2014  pdf format of 2014-a.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
 
Workers' Compensation Rate Deviation AbstractPDF Version pdf format of workers-compensation-rate-deviation-abstract.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
 Insured Preferred Provider Plans pdf format of InsPrefProv.pdf
 Insurance Companies pdf format of InsCompanies.pdf
 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