Process for Submitting Consumer Disclosure Information for Health Benefit Plans in the Individual and Small Employer Group Markets

For non-grandfathered health benefit plans with rate change requests, the MIA will require the following documentation: • Unified Rate Review Template • Preliminary Justification Part II • Rate Filing Documentation Part III • Consumer Friendly Summary On March 28, 2013, the Center for Consumer Information & Insurance Oversight will be finalizing the Uniform Rate Review Template. Until such time, the MIA will make the draft template available on the MIA website. Carriers must use the draft template for nongrandfathered plan filings until the finalized template is available. After March 28, 2013, Preliminary Justification Part I will no longer be available through HIOS. The MIA will post the Preliminary Justification Part I to the MIA website so that it can still be downloaded and submitted for grandfathered plans. Carriers should submit rate filings via SERFF after the required consumer disclosure documentation has been attested in HIOS. Once the forms have been attested in HIOS, then the carriers can submit the SERFF filing to the MIA along with the Consumer Friendly Summary. The consumer disclosure documentation must match exactly what is posted to HIOS. Carriers must submit Preliminary Justification Part I and the Unified Rate Review Template to the MIA in both PDF and Excel format through SERFF. The Rate Filing Documentation Part III should contain information that justifies the data collected in the Unified Rate Review Template and is a subset of the information required by the MIA in the full Actuarial Memorandum. For more detail on what should be included in the Rate Filing Documentation Part III please refer to 45 CFR 154.215(f). Please note that the MIA has updated the Consumer Friendly Summary. Carriers can download the new version from the MIA website for use with all filings. The changes reflect the fact that carriers must provide the incremental premium rate change, not the year-over-year premium rate change. Additionally, carriers must submit information about the three most recent incremental premium rate changes approved for the product along with the month and year those changes were made. A copy of the updated Consumer Friendly Summary can be found below. Questions concerning this bulletin may be directed to Megan Mason, Special Assistant to the Commissioner for Health Care Reform at megan.mason@maryland.gov. _ _ Karen Stakem Hornig Deputy Commissioner Signature on original Revision 3/21/2013 Consumer Friendly Summary Issuer Marketing Name: NAIC Company Code: Market Segment: Small Group Individual SERFF Tracking Number: has requested approval of a premium rate change for the following product in Maryland: and . If the premium rate change is approved as requested: 1. The average premium rate change for this product in Maryland would be . * The rate changes discussed in this document are all incremental, which means an increase or decrease to the rate which was previously approved. These changes are typically filed on either an annual, semiannual, or quarterly basis. Note that the proposed change is an average incremental premium rate change for all covered groups or individuals. Your premium may be higher or lower than this average. In addition to the rate change, your premium may change because of factors such as age, family structure, and geographic area. 2. The proposed effective date of the premium rate change is . *Your premium rate change may vary based on the anniversary date of your policy and other factors. 3. This premium rate change may affect people. 4. The primary factors driving this proposed change in premium rates are: 5. The most recent three premium rate changes for this product: Month & Year Requested Approved Note to consumers: Boxes with "+" indicate expanded responses. To view the entire response, click on the shaded box and scroll. SERFF Filing Company SERFF Tracking Number SERFF Filing Company SERFF Rate/Rule Schedule Affected Form Number HIOS Product ID(s)