02-031 C.M.R. ch. 940, § 13 - Policies Subject to the ACA Rating Requirements

Current through 2022-14, April 6, 2022

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

02-031 C.M.R. ch. 940, § 13

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