02- 031 C.M.R. ch. 940, § 13 - Policies Subject to the ACA Rating Requirements
A. This section applies to individual and
small group health plans that were issued or renewed on or after January 1,
2014, other than grandfathered plans and transitional coverage.
B. In addition to the requirements of other
sections of this Rule, rate filings for policies subject to the ACA rating
requirements are subject the following requirements:
1. All such filings must include the ACA Rate
Filing Justification, Part I, the unified rate review template. This template
is a form that summarizes the data used to determine rate increases for the
entire single risk pool.
2. If
required by Section
12, such filings must include the ACA
Rate Filing Justification, Part II, the description justifying the rate
increase.
3. All such filings must
include the ACA Rate Filing Justification, Part III, the actuarial memorandum
and must comply with applicable federal guidance. Part III includes rate filing
documentation that states and CMS uses to understand the actuarial assumptions,
justifications and methodologies used to comply with the market rating rules
and to complete the Part I template.
Notes
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