211 CMR 41.09 - Content and Timing of Policy Form Filings

Current through Register 1466, April 1, 2022

(1) Carriers shall submit to the Division three copies of the policy, certificate of coverage or evidence of coverage for each of its Closed Guaranteed Issue Health Plans and Closed Plans with the associated Rate Filing for each plan submitted pursuant to 211 CMR 41.06. As part of the policy form filing for each Closed Guaranteed Issue Health Plan, Carriers shall submit the applicable application or enrollment form, replacement form and outline of coverage or disclosure statement.

(2) Policy forms for all Closed Guaranteed Issue Health Plans and Closed Plans must comply with all applicable provisions in M.G.L. c. 176M and 211 CMR 41.00 and any other applicable Massachusetts statutes and regulations, including 211 CMR 42.00, 43.00, 51.00 and 52.00, which are not inconsistent with M.G.L. c. 176M and 211 CMR 41.00, as well as any applicable federal statutes and regulations. Policy forms for Closed Guaranteed Issue Health Plans and Closed Plans must include all benefits required under the Carrier's licensing statutes.

(3) Policy forms for Standard Benefits Plans must contain all benefits required to be included in the Standard Benefits Plans approved by the Commissioner pursuant to M.G.L. c. 176M, § 2(c). Policy forms for Closed Guaranteed Issue Health Plans with Enhanced Benefits Plans must contain the benefits of the comparable Standard Benefits Plans and must identify each additional benefit or lower cost-sharing requirement that the Carrier proposes to include in the plans.

(4) Policy forms for Alternative Benefits Plans must contain coverage for the same services and supplies as the Standard Benefits Plans, except for the prescription drug benefit, but may include higher cost-sharing requirements than the Standard Benefits Plans. All filings of Alternative Benefits Plans must identify each benefit that is lower than or each cost-sharing requirement that is higher than what is being offered in the Carrier's Standard Benefits Plan or Enhanced Benefits Plan.

(5) Carriers shall comply with all form filing fee requirements.

Notes

211 CMR 41.09