Get A Pdf Of This Form Is Available. - California Department Of Insurance

This guide provides clear instructions for filling out the California New Product Rate Filing Form for individual and small group health insurance. By following these steps, you can efficiently submit your form online, ensuring that you meet all necessary requirements.

Follow the steps to complete your form online:

1. Press the ‘Get Form’ button to access the document and open it in your chosen editor.
2. Input your company’s name in the designated field.
3. Enter the number of policy forms covered by the filing in the appropriate section.
4. List all policy form numbers and their associated product names in the spreadsheet that corresponds to Question 7.
5. Select the product types included in your filing from the given options: HMO, PPO, EPO, POS, FFS, or describe any other.
6. Indicate the segment type by choosing either Small Group or Individual, ensuring not to combine filings.
7. Decide the plan/insurer type as either for-profit or not-for-profit and check the respective box.
8. Prepare a separate spreadsheet detailing the annual rates for each product as per the guidelines.
9. Choose the review category that best fits your submission from the options provided.
10. If necessary, include any comments in the designated comments section.
11. After completing the form, use the options to save changes, download, print, or share the form as required.

Complete your document online to ensure timely submission and compliance.