Instructions for Completing the Small Group Health Plan Standards Checklist
In an effort to provide better service and faster review of small group health
policy filings, the Idaho Department of Insurance has prepared the following
checklist and filing instructions. Idaho is a “file and use” state. This means
that it is the company’s responsibility to review all statutes, regulations and
bulletins, which may be pertinent to its filings prior to submission of a
filing. A company representative must sign the Idaho Submission Documentation
Form, which certifies the filing is in compliance with all Idaho laws and
administrative rules. Forms that are submitted that do not meet Idaho’s legal
requirements will be disapproved and returned to the company, which results in
significant delays in the filing process.
To assist companies in determining that a filing meets the requirements of
Idaho’s laws and rules, the Department has created a checklist of specific
legal requirements applicable to small group health products that have been a
recurring source of returned filings. Beginning March 1, 2005, the company
representative certifying the filing will be expected to initial each item in
the checklist below to certify that he or she has reviewed the filing for
compliance with the listed requirement. If a listed requirement is not
applicable to the filing, the representative should designate by inserting
“N/A” instead of an initial. After March 1, 2005, a filing will be
considered incomplete without the submission of the initialed checklist.
- Please note, there are no filing fees in Idaho.
- Idaho Code Section 41-1812
requires the filing of all policy forms for small group health insurance.
- Each filing must include:
(1) A cover letter describing the filing and explaining the purpose of the filing.
(2) A detailed forms list, including the name of the form, the form number and
the form number of the form the filing replaces, if applicable.
(3) The ID-FF Certification form, signed by a
company representative. Filings will be returned disapproved if the signed
certification form is not included in the filing along with the initialed Small
Group Health Plan Checklist.
(4) Either a duplicate set of the forms or a copy of the cover letter to be
returned to the company notifying it of the status of the filing.
Once you have reviewed the appropriate department checklist, you can download
from the Department’s website the required ID-FF Certification form that must
be submitted with all filings.
The Small Group Checklist applies to small group policies providing disability
coverage. Idaho Code §41-503 defines “disability insurance” as:
(a) Insurance of human beings against bodily injury, disablement, or death by
accident or accidental means, or the expense thereof, or against disablement or
expense resulting from sickness, and every insurance appertaining thereto.
Disability insurance does not include worker's compensation coverages; and
(b) A managed care plan for which a certificate of authority is required
pursuant to chapter 39, title 41, Idaho Code.
Small Group Health Plans are subject to the provisions of Chapter 22 and Chapter
47, Idaho Code and IDAPA 18.01.69 and IDAPA 18.01.70 also apply. Small group
managed care plans are also subject to Title 41, Chapter 39, Idaho Code. The
Idaho Code and the Department’s Administrative Rules (IDAPA) can be accessed
through this website under “Laws/Rules/Bulletins.”
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