Health coverage filing instructions
Who files and what needs to be filed?
You must file all rates and forms prior to use if you're a disability insurer, Health Care Service Contractor (HCSC), or Health Maintenance Organization (HMO).
May 6, 2016 is the deadline for filing rates, forms and networks with the Office of the Insurance Commissioner for individual market and small group market health plans and for stand-alone dental plans that offer the pediatric essential health benefit for plan year 2017.
Student health plans issued to higher education institutions are individual market health plans and have the same filing deadline of May 6, 2016 for the 2016-17 school year.
System for Electornic Rate and Form Filing (SERFF) binders are also due on May 6, 2016 for individual market and small group market health plans and for stand-alone dental plans that offer the pediatric essential health benefit. SERFF binders are not required for student health plans.
Filings received after May 6, 2016 will be rejected without review.
How do I file?
Use the documents below to assist you in your filing.
- Instructions - Forms - SERFF HD general form filing instructions (PDF, 607KB)
- Instructions - Rates - SERFF HD general rate filing instructions (PDF, 456KB)
- Appendix A - Large group rate and form filing flowchart (PDF, 125KB)
- Instructions - Binder - SERFF HD General Binder Filing Instructions (PDF, 265KB)
- Exhibit A - Templates Required (PDF, 93KB)
- Exhibit B - Washington EHBs on the 2017 Plans Benefits Template (PDF, 261KB)
- Exhibit C - Visual Maps of PBT with Washington EHBs (PDF, 163KB)
- Medicare Supplement Outlines of Coverage (PDF, 120KB)
For HCSCs and HMOs
- NAIC life, accident & health, annuity and credit-coding matrix (PDF, 455KB)
- Groups other than small groups filing summary (Word, 72KB)