Requirements and procedures for obtaining certification.

(a) To be certified by CMS, a policy must meet— (1) The NAIC model standards specified in § 403.210; (2) The loss ratio standards specified in § 403.215; and (3) Any State requirements applicable to a policy— (i) Issued in that State; or (ii) Marketed in that State. (b) An insuring organization requesting certification of a policy must submit the following to CMS for review— (1) A copy of the policy form (including all the documents that would constitute the contract of insurance that is proposed to be marketed as a certified policy). (2) A copy of the application form including all attachments. (3) A copy of the uniform certificate issued under a group policy. (4) A copy of the outline of coverage, in the form prescribed by the NAIC model standards. (5) A copy of the Medicare supplement buyers' guide to be provided to all applicants if the buyers' guide is not the CMS/NAIC buyers' guide. (6) A statement of when and how the outline of coverage and the buyers' guide will be delivered and copies of applicable receipt forms. (7) A copy of the notice of replacement and statement as to when and how that notice will be delivered. (8) A list of States in which the policy is authorized for sale. If the policy was approved under a deemer provision in any State, the conditions involved must be specified. (9) A copy of the loss ratio calculations, as specified in § 403.250. (10) Loss ratio supporting data, as specified in § 403.256. (11) A statement of actuarial opinion, as specified in § 403.258. (12) A statement that the insuring organization will notify the policyholders in writing, within the period of time specified in § 403.245(c), if the policy is identified as a certified policy at the time of sale and later loses certification. (13) A signed statement in which the president of the insuring organization, or a designee, attests that— (i) The policy meets the requirements specified in paragraph (a) of this section; and (ii) The information submitted to CMS for review is accurate and complete and does not misrepresent any material fact.