Medicare supplement

Filing requirements

1. NAIC TransmittalForm, instructions, and Product Code matrices for completing transmittal forms
2. Instructions for the Filing Description on the Transmittal (cover letter)
3. Certificate of Compliance: Word | PDF
4. Product standards for Plans issued prior to June 2010: Word | PDF Product standards Plans sold on or after June 1, 2010 and Plans Sold on or after January 1, 2020: Word | PDF
5. Readability Certification
6. Appendix A with Actuarial Memorandum: Word | PDF

Annual Medicare Supplement Refund Calculation Report

Insurers that offer Medicare Supplement policies are required under OAR 836-052-0145(2)(a) to submit a Medicare Supplement Refund Calculation Report by May 31 each year. The reports are to be submitted via SERFF under:

• TOI: Annual Required Reports
• Sub-TOI: Medicare Supplement Refund Calculation
• Filing Type: Annual Reports
  
• Reports should be separated by type.
  • Individual and group must be separate.
  • Pre-Standard plans are separate from all others.
  • For 1990 and 2010 plans, separate by plan, but pool each 1990 plan with its corresponding 2010 plan:
    • Plan A
    • Plan B
    • Plan C
    • But pool F high deductible with regular F plan.
    • Also pool J high deductible with regular J plan.

Please direct questions to dcbs.ratesforms@dcbs.oregon.gov.