1 Accident and Health Filing Update, Webinar 1 March 1, 2016 Karl Knable Chief Health Actuary.

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Presentation transcript:

1 Accident and Health Filing Update, Webinar 1 March 1, 2016 Karl Knable Chief Health Actuary

Celebrating 200 Years 2

Audience for Today’s Webinar All accident and health carriers with rate and form filings 3

Mark Your Calendars for These Upcoming Webinars! March 8  Audience: major medical, student health plans, and major medical supplement March 15  Audience: ACA-compliant filings both on and off exchange, individual and small group, and dental March 22  Audience: On and off Marketplace plan management, Indiana-specific- individual and small group templates March 29  Audience: On and off Marketplace actuarial topics 4

5 Changes to our website Filing best practices Changes in SERFF Changes to IDOI filing requirements IDOI Webinar Agenda

Navigating IDOI’s Updated Website 6

Finding Compliance Rates and Forms 7 1.Visit our homepage Under IDOI home, click “Compliance Rates and Forms”

Compliance Rates and Forms Page 8 3. Click on the circled links to access Forms, Rates and Reference Documents

Accident and Health Forms Available on the Website 9 ACA major medical checklists Checklists for other than ACA major medical Checklists for Medicare and Long term care

Accident and Health Rating Info Available on the Website Binders Actuarial Memoranda Outlines Experience Workbooks 10

Filing Best Practices Download new checklists, outlines, and workbooks for each new filing  All items you need will be available in SERFF based on your TOI Make sure you add items under the appropriate tab within supporting documents Provide a redline copy when you make changes to the forms. Provide a redline copy of any changes other than rates in the rate manual. 11

Filing Best Practices You may find these requirements under Supporting Documentation:  A checklist (only on submissions including forms)  Actuarial memorandum outline  Required Rate Fields in SERFF  Experience Workbook Submit the completed checklist, workbook, or actuarial memorandum under the appropriate requirement Do not clone your filings PDFs need to be searchable Please call with questions 12

Reference Documents New 2017 EHB documents  New FedVip  New Fed dental  State benefits ACA related  Final letter to issuers  Notice of Benefit & Payment Parameters for 2016  2016 others 13

Understanding SERFF 14

New Types of Insurance New TOI’s and sub TOI’s Student Health Blanket Sickness Pediatric dental Limited wrap-around coverage Others 15

Instructions For SERFF Filings Updated General Instructions Correct filing type  Form  Form/rate  Rate Implementation date  No less than 60 days after submission date  All rate filings need an implementation date 16

Instructions For SERFF Filings General Instructions Market type  Individual  Group Group market size  For ACA. Specify small v. large and do not file together Overall rate impact  Carriers are required to submit  Should match the overall rate percent on the rate/rule schedule Filing description  Use this instead of cover letter  Include prior SERFF tracking number in the first line  If this is a new form, please indicate such 17

Form Schedule Always include final form here and redline changes under Supporting Documents. Include Policy, Certificate, and Applications. Review checklist changes from Supporting Documents PDFs need to be searchable 18

Rate/Rule Schedule Do not put Actuarial Memorandum here, please save in Supporting Documentation Each field needs to be filled out for rate changes Need to complete Overall Percentage of Last Rate Revision if applicable 19

Rate/Rule Schedule For rate changes use the correct description for Rate Change Type, under Rate/Rule Schedule Submit rates with any new filing The written premium should be for the 12 months prior to the requested implementation date. 20

Supporting Documentation Requirements: Checklist Experience Workbook Actuarial Memo Required Rate Fields in SERFF Additional documentation: Statement of Variability Third Party Authorization Readability Certification 21

Supporting Documentation Experience Workbooks (“EW”) For anything that involves a new set of rates please submit a new EW 4 Kinds: Maj Med, LTC, Med Sup, and Basic For new filings, if based on sister company or other company experience, we expect an experience workbook and comparison of rates and benefits Student Health plans will use Major Medical Experience Workbook 22

Supporting Documentation Experience Workbook  Do not create extra columns/rows  No text where it should be a number  Do not create your own Experience Workbook  Contact us if you have questions BEFORE SUBMISSION 23

Supporting Documentation Experience Workbook General Filing Information tab  Rows must be completed because they populate the dates in the experience tabs.  Contact information will be used for correspondence on the filing as well targeted industry s. 24

Supporting Documentation Experience Workbooks  Plan Overview  Rate changes are segregated into  (A)=One Time Rate Changes (no Trend)  (B)=Annualized Premium Trend The Overall % Rate Impact reported on the Rate/Rule Schedule is equal to [(1+(A))*(1+(B))-1]*100% 25

Supporting Documentation  Actuarial Memos  PDF’s must be searchable  Can use provided template or a format of your own choosing  Generally, we like to see comparisons of existing products to the proposed filing; this should be included as an additional exhibit and show differences in benefits  Make sure you comply with existing Actuarial Standards of Practice 26

Supporting Documentation Required Rate Fields in SERFF  If you have a rate change, review our instructions in Required Rate Field in SERFF at _in_SERFF.pdf _in_SERFF.pdf  Significant changes in the Required Rate Field instructions  MAKE SURE YOU READ IF YOU HAVE NOT FILED RECENTLY 27

Medicare Supplement Medicare Supplement Refund Calculation these to: Please indicate Medicare Supplement Refund Calculation in the subject line. 28

Companies and Contact; Filing Correspondence Tabs Companies and Contact  It is possible to put a secondary contact person for form/rate Filing Correspondence  What information is considered public? EVERYTHING  If you need additional time, please submit a note to reviewer 29

IDOI Contact Information Karl Knable, Chief Health Actuary   Stephen Chamblee, Associate Actuary   Bobbi Henn, Policy Analyst   Indiana Compliance Mailbox  30

Any Questions? Don’t forget to register for Webinar 2 -- MHPAEA, Student Health Plans, & Renewal Letters! The intended audience for this March 8 webinar is major medical, major medical supplement, student health, dental, grandfathered, transitional, and ACA-compliant plans with rate and form filings 31