- A&H Uniform Product Coding Matrix 10/26/2010
- A&H SERFF Filing Types 4/9/2012
- MIB Language Change Filings 4/12/12
Deregulated Accident & Health Group Forms
The following Accident & Health Group Forms have been deregulated and should not be filed with the Pennsylvania Insurance Department.
Commercial For-Profit Insurers:
- Group Long or Short-Term Disability Policies
- Blanket Accident and Health
Hospital Plan Corporations and Professional Health Services Plan Corporations:
- Blanket Accident and Sickness Policy Forms
Accident & Health Form Submission Checklists
- Advertising (new 5/19)
- Advertising Compliance Certification (updated 1/2020)
- Individual Accident Only
- Individual Basic Hospital Expense Coverage
- Individual Basic Medical-Surgical Expense Coverage
- Individual Disability Income Protection Coverage
- Individual and Group Comprehensive Major Medical Insurance (3/20)
- Individual and Group Dental or Vision Coverage (3/20)
- Individual and Group Medical Insurance (other than Major Medical) (3/20)
- Individual Preferred Provider Organization (PPO) Coverage
- Individual Specified Disease or Specified Accident Coverage
- Individual Supplemental Insurance Coverage
Small Group Rating
Individual Rating
Medicare Supplement
- 2010 Medicare Supplement (updated 3/27/19)
Long-Term Care
Disclosure Requirements
- Disclosure requirements for health insurance
- Notice regarding replacement disclosure requirement
- Multiple medicare supplement policy-certificate in force reporting
- Plan G Specimen Notice of Change sold on or after January 1, 2020
- Disclosure Requirements for Accident and Sickness Policies or Certificates: Guide to Health Insurance for People with Medicare
- Outline of coverage for Medicare Supplement Insurance Plans sold on or after January 1, 2020
*All actuarial worksheets and exhibits with number and/or formulas must be submitted in Excel.
*Actuarial explanatory materials may be submitted in Adobe.