Form and Rate Filing Instructions

System For Electronic Rates and Forms Filing (SERFF) is the preferred method of form/rate submission.  SERFF is the most efficient way to submit rate and form filings to North Carolina.

Filing Instructions - Life and Health Division

SERFF Submissions

SERFF Submissions

The Life and Health Division accepts all life and health form and rate filing types submitted through SERFF for review and approval prior to use in North Carolina.  Product-specific NCDOI checklists have been provided to assist with form and rate filing submissions. Though use of an NCDOI checklist when preparing a filing for submission is encouraged, filers are not required to submit a completed NCDOI checklist along with a form and rate filing submission. In addition, when creating a SERFF submission to the state of North Carolina using the SERFF system, filers are provided with general information regarding life and health form and rate filing submission requirements for North Carolina. Please also note, the SERFF form and rate filing system also offers a trade secret filing feature.

VISIT SERFF

NC No Paper - Electronic Submissions (Non-SERFF)

NC No Paper - Electronic Submissions (Non-SERFF)

NC No Paper Electronic Submissions (Non-SERFF)

The Life and Health Division will accept form and rate filings submitted through email. All email submissions must include a valid email return address. Omitting a valid email return address will force the Division to reject the entire submission.The Life and Health Division strongly encourages the use of the SERFF system, rather than email, to file forms and rates for review and approval prior to use in the state of North Carolina.

NC No Paper Electronic Submissions - Instructions

Public Record Submissions – Please Follow These Steps:

Convert all paper transmittal documents including forms, actuarial materials, transmittal header, or cover letter to PDF documents.  Attach all components of the filing to an e-mail message and address to LHinbox@ncdoi.gov. The Life and Health Division does not accept multi-company filings under a single cover letter or e-mail submission. Each company must file in its own name.

Complete the body of your E-mail in this order:

  1. List the company name
  2. Identify the product type
  3. State the total number of new forms and total number of pages
  4. Identify filing (New Form; Rate Revision; Provider Agreement; Initial Operations;
    Intermediary; Network Addition; etc)
  5. Code type of insurance - use the most recent version of NAIC Uniform Product Coding Matrix 
  6. List filer's name, email address, and telephone number.
  7. Attach transmittal form
  8. Label and attach  PDF documents to your email:
    1. Transmittal form or cover letter
    2. Forms
    3. Rates and actuarial demonstration
    4. Provider agreement
    5. Credentialing
    6. Utilization review
    7. Grievances
    8. Supplemental documents
    9. Other (Specify)
  9. Resubmissions shall include a red-lined comparison showing any changes made to the form(s) in response to a disapproval communication from NCDOI under T11 NCAC 12.0329(3)(h) . The resubmission must also include a statement certifying the company has made no other changes than those in the red-line document.  The resubmission also must red-line any additional changes not related to the disapproval communication.

The Life and Health Division will create a work unit and attach each submitted document to the work unit. We will send an electronic email to the filer containing the NCDOI tracking number assigned to the submission and identify the assigned reviewer.  All communications will occur through email.

The work unit contains communications (notes to filer; approval or disapproval letters, and responses) and is accessible on-line at Life and Health Filing Search. If your submission exceeds the document size afforded e-mail transmittals, send email to LHinbox@ncdoi.gov for instructions.

To check the status of your filing submission or to read correspondence generated by the assigned reviewer:

Visit Life & Health Filing Search 

Non-Public Record Submissions - Please Follow Trade Secret Steps:

Follow the Public Record Submission steps above. Complete the transmittal reference line and body of your email to state that a portion of the filing is designated TRADE SECRET.  Initial identification of material as TRADE SECRET is a requirement to prevent failure to meet the criteria of N.C.G.S. §132-1.2.

Separate the submitted electronic filing into two distinct parts labeled: Part 1 and Part 2, as defined below. Attach Part 1 and Part 2 to a single transmittal E-mail:

 Part 1: Trade Secret: a complete filing that includes all parts of the submission (all public and trade secret materials): 1The filing letter or transmittal header must state TRADE SECRET SUBMISSION in the Reference and/or Transmittal Header Title.

  • A request to designate trade secret status for specified parts of the submission, including statements explaining and confirming:
  1. Why the information meets the definition of a trade secret, as defined in NCGS § 132-1.2?
  2. How the release of the information would cause harm?
  3. Confirmation that NCDOI will not be held responsible for any unintentional release of the trade secret materials.
  4. Agreement to pay all fees required to defend NCDOI regarding the confidential handling of trade secret materials.
  • Each page of the trade secret filing must be labeled or stamped TRADE SECRET.

Part 2 Public Copy: a filing that includes the following parts of the submission:  

  1. A cover letter stating the reason part of the filing meets the definition of a trade secret as defined in NCGS § 132-1.2. and also confirms agreement to pay all fees required to defend North Carolina Department of Insurance regarding the confidential handling of trade secret materials.
  2. All components of the submission that are NOT designated trade secret, with all pages labeled or stamped PUBLIC.
  3. Any premium rate calculations designated TRADE SECRET shall include an actuarial certification confirming that the trade secret rate formula is based on sound actuarial practices.
  4. If provider payment methodologies are designated TRADE SECRET, instead of data placement in the public copy, the filer must provide a clear statement designating the material as TRADE SECRET.

The Life and Health Division only accepts trade secret materials properly prepared and submitted for review. Please review the Trade Secret filing instructions before making a submission containing confidential material.

 

Trade Secret Instructions

Trade Secret Instructions

Instructions for Filing Items Designated “Trade Secret”

All records, reports, forms or rates filed with the Life and Health Division are open to the public, regardless of filing status or method of receipt, as required by North Carolina General Statute (NCGS) § 132-1. The Life and Health Division can grant an exception to the public record law, but only if the document in question meets the definition of a trade secret under NCGS § 132-1.2.

North Carolina Department of Insurance will not accept responsibility for the unintentional release of any trade secret information. Only materials meeting the trade secret definition and are submitted and labeled as Part 1 and Part 2 as described below, will be accepted.

Please prepare a submission containing trade secret information in this format:

Part 1 Trade Secret: a complete filing that includes all parts of the submission (all public and trade secret materials):

  • The filing letter or transmittal header must state TRADE SECRET SUBMISSION in the Reference and/or Transmittal Header Title.
  • A request to designate trade secret status for specified parts of the submission, including statements explaining and confirming:
  1. Why the information meets the definition of a trade secret, as defined in NCGS § 132-1.2.?
  2. How the release of the information would cause harm?
  3. Confirmation that NCDOI will not be held responsible for any unintentional release of the trade secret materials.
  4. Agreement to pay all fees required to defend NCDOI regarding the confidential handling of trade secret materials.
  • Label or stamp each page with TRADE SECRET.

Part 2 Public Copy: a filing that includes the following parts of the submission:  

  1. A cover letter stating the reason part of the filing meets the definition of a trade secret as defined in NCGS § 132-1.2. and also confirms agreement to pay all fees required to defend NCDOI regarding the confidential handling of trade secret materials.
  2. All components of the submission that are NOT designated trade secret, with all pages labeled or stamped PUBLIC.
  3. Any premium rate calculations designated TRADE SECRET shall include an actuarial certification confirming that the trade secret rate formula is based on sound actuarial practices.
  4. If provider payment methodologies are designated TRADE SECRET, instead of data placement in the public copy, the filer must provide a clear statement designating the material TRADE SECRET.

The Life and Health Division will only accept trade secret materials properly prepared and submitted for review.

 

Reminders - Approvals - Market Conduct Examinations

Reminders - Approvals - Market Conduct Examinations

Life & Health Division ceased its practice of sending a printed-paper approval letter for approved filings and also discontinued the practice of affixing a stamp of approval on policy forms. Retention of L&H approval letters, as evidence of form approval, is required for your records. During a scheduled market conduct examination,  your company may be requested to produce a copy of the L&H approval letter as evidence of form approval.

If you have a question about this approval procedure, send a written inquiry to L&Hinbox@ncdoi.gov