PUBLIC PROTECTION
CABINET

Contribute to the Team Eastern Kentucky Flood Relief Fund at TeamEKYFloodReliefFund.ky.gov 

DEPARTMENT OF INSURANCE
Rate / Form Filing

The Health and Life area, as part of the Division of Insurance Product Regulation, accepts all rate and form filings by mail and also through the National Association of Insurance Commissioners' System for Electronic Rate and Form Filings (SERFF) . If you file through SERFF , it is important that you check the General Instructions document in SERFF  for those additional filing requirements. The General Instructions document is subject to change so it should be referred to before creating each SERFF  filing.

The checklists are very important tools to be used for informational purposes only.


Health Form Filing Checklists
Non-Grandfathered Large Group Health Benefit Plan (Major Medical Coverage) Checklist    - 622K
Group and Individual Medicare Supplement Insurance Filing Checklist    - 292K
Group Non-Health Benefit Plan Checklist    - 480K
Group Limited Health Benefit Plan Checklist    - 471K
General Applications Checklist    - 425K
Individual Short-Term Limited Duration Plan Checklist    - 582K
Student Health (Blanket) with EHB Checklist    - 716K
Standardized Options Silver Plan Checklist    - 809K
Standardized Options Silver 94 CSR Plan Checklist    - 811K
Pediatric Dental Essential Health Benefit Checklist    - 467K
Provider Directory Checklist     - 332K
Long-Term Care Filing Checklist     - 87K
Non-Grandfathered Small Group Health Benefit (Major Medical Coverage) Plan Checklist    - 738K
Provider Agreements for Health Benefit Plans Checklist    - 369K
Provider Agreements for Limited Health Benefit Plans Checklist    - 410K
Standardized Options Silver 73 CSR Plan Checklist    - 811K
Blanket Insurance Checklist    - 512K
Date of Filing Checklist    - 411K
Non-Grandfathered Individual & Conversion Health Benefit Plan (Major Medical Coverage) Checklist    - 782K
Group and Individual Medicare Supplement Insurance Filing Checklist - Attachment 1    - 50K
Short-Term Nursing Home Insurance Filing Checklist    - 20K
Grandfathered Individual Health Benefit Plan Checklist    - 600K
Grandfathered Large Group Health Benefit Plan Checklist    - 591K
Grandfathered Small Group Health Benefit Plan Checklist    - 575K
Individual Limited Health Benefit Plan Checklist    - 507K
Individual Non-Health Benefit Plan Checklist    - 503K
Provider Agreements for Limited Health Service Organizations Checklist    - 416K
Standardized Options Bronze Plan Checklist    - 809K
Standardized Options Gold Plan Checklist    - 809K
Standardized Options Silver 87 CSR Plan Checklist    - 811K
Health Rate Filing Documents
Health Form Filing Documents
Life Form Filings
Life Form Filing Checklists
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