PPACA and SERFF – What you Need to Know

Over the last several weeks the Speed to Market (EX) Task Force and NAIC SERFF staff has been working to identify a number of items to be implemented for PPACA filings. The overall goal was to very quickly make it as simple as possible for both industry and states to identify, submit, review, and report on PPACA filings.

Below is an overview how the NAIC SERFF staff plans to work with states to implement changes in SERFF so industry may begin submitting PPACA utilizing the new uniform methods:

• A new field is being implemented to identify PPACA filings. Industry will be required to complete information on the General Information Tab of a SERFF filing if a filing has been marked PPACA eligible. The functionality is expected to be released in SERFF Wednesday evening, June 9.  Documentation is currently being developed for both states and industry and will be available in SERFF's Online Help. Release Notes will be available on SERFF's splash page at: https://login.serff.com

IMPORTANT NOTE - the three field values being added to SERFF are:
      Not PPACA-Related
      Non-Grandfathered Immed Mkt Reforms
      Grandfathered Immed Mkt Reforms

• Filing Rules is being modified to add a new column to flag TOI's and Sub-TOI's that are PPACA eligible and NAIC SERFF staff will automatically mark PPACA eligible TOI's and Sub-TOI's for states the day after the release. What this means to industry is if a PPACA eligible TOI and Sub-TOI is selected when creating a filing, the new PPACA options will automatically appear on the General Information Tab of your filing. Other health filings that are not PPACA eligible, for example a dental filing, will not display the options.

• The PPACA Uniform Compliance Summary has been developed to assist both industry and states. The NAIC SERFF staff has made the PPACA Uniform Compliance Summary an interactive PDF and is currently working with states to get the summary implemented in SERFF. This uniform document will assist industry in ensuring they are meeting the immediate market reform requirements and will assist states in expediting the review of PPACA filings.

PPACA Uniform Compliance Summary

**NOTE: The PPACA Uniform Compliance Summary does not apply to HIPPA excepted benefits.

• The NAIC SERFF staff is currently working with states to update General Instructions in SERFF to indicate specific requirements related to PPACA filings. Please review state General Instructions prior to sending a PPACA filing.
  
• Supplemental policies that cover non-medical services, such as dental or vision, or the other HIPAA excepted benefits such as Medigap are not PPACA eligible.

2010 Medicare Supplement Information

Last month, changes were adopted to the 2009 NAIC Uniform Life, Accident & Health, Annuity and Credit Product Coding Matrix by the NAIC’s Speed to Market Task Force. The revised Product Coding Matrix went into effect July 1, 2009, which includes the new TOI’s and Sub-TOI’s for 2010 Medicare Supplement plans.

It is important that industry use the correct TOI’s and Sub-TOI’s when submitting 2010 Medicare Supplement filings. Please review the revised Product Coding Matrix to ensure you are selecting the correct TOI and Sub-TOI. The PCM is located on the NAIC website at: http://www.naic.org/documents/industry_09_pcm_lahac.pdf

Click here for a list of states that are prepared to accept 2010 Medicare Supplement Filings.

Click here for a matrix overview of the Medicare Supplement changes.

Have you heard? There are currently 23 states that have made it official - they want you to SERFF or file electronically!

Click here for a list of states that mandate SERFF

In addition to mandating SERFF, Iowa, Rhode Island, New Hampshire, Minnesota, South Dakota, Massachusetts, West Virginia, Vermont, Georgia, Oklahoma, Nebraska, Maine, and Alabama require that all state filing fees be paid via EFT (Electronic Funds Transfer). Maryland has mandated EFT payments for all SERFF filings, both Life and Health and Property and Casualty.

What does this mean to you? If you are not already SERFF and EFT licensed, you need to get licensed as quickly as possible!

Contact our SERFF Marketing Team to initiate the process: serffmktg@naic.org.

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If you can answer “yes” to these three questions, you should be SERFFing! It's that easy, so what are you waiting for?

To find out more about SERFF can help make your company's filing process more efficient and to schedule a free online demonstration, contact the SERFF Marketing Team at 816-783-8787.