NAIC Product Checklists
SERFF Instructions
Variability Guidance Document
Accident and Sickness
- Accident and Sickness Applications
- Embedded Dental
- Essential Health Benefits
- Explanation of Benefits
- Group Accident Only and Indemnity Insurance
- Group Association Short-Term Limited-Duration Major Medical, PPO, Hospital-Medical-Surgical
- Group Disability Income
- Group Family Leave Insurance
- Group Long-Term Care Insurance
- Group Long-Term Care Rider
- Group Medicare Supplement Insurance
- Group Medicare Supplement Applications
- Group Specified Disease and Cancer Only
- Group Stand-Alone Dental
- Group and Individual Stand-Alone Vision and/or Hearing Policy
- Individual Accident Only Insurance
- Individual Disability Income
- Individual Hospital Confinement Indemnity
- Individual Income Replacement
- Individual Long-Term Care Insurance
- Individual Long-Term Care Insurance Rider
- Individual Major Medical, PPO, Hospital-Medical Surgical
- Individual Medicare Select Insurance
- Individual Medicare Supplement Applications
- Individual Medicare Supplement Insurance
- Individual Short-Term Limited-Duration Major Medical, PPO, Hospital-Medical-Surgical
- Individual Specified Disease Insurance
- Individual Stand-Alone Dental
- Large Group Major Medical, PPO, Hospital-Medical Surgical
- Long-Term Care Applications
- Long-Term Care New Rate Filing Checklist
- Long-Term Care Rate Revision Checklist
- Mental Health and Substance Use Disorder Benefits Parity
- Health Rate Review Checklist
- Virginia ACA Rate Filing Template
- Virginia ACA Rate Filing Template Instructions
- Template for data supporting rate revisions Form 130A (Not used for ACA plans)
- Trend analysis detail Form 130B (Not used for ACA plans)
- Health Insurance Rate Request Summary Part 1
- Unified Rate Review Template
- Part III Actuarial Memorandum
- Reinsurance Care Management Protocol Assessment
- Virginia Medigap Premium Finder - Premium Table Submission Instructions
- Virginia Medicare Supplement Premium Data Table 1
- Virginia Medicare Supplement Premium Data Table 2
- Individual - Virginia Dental Rate Template
- Small Group - Virginia Dental Rate Template
- Small Group Major Medical, PPO, Hospital-Medical-Surgical
- Stop Loss/Excess Loss
- Student Health Small Group Major Medical, PPO, Hospital-Medical-Surgical
- Virginia Plan Schedule Comparison (Exchange-certified stand-alone dental only)
Annuity
- Equity Index Products
- Fraternals
- Group Annuity
- Group Variable Annuity
- Individual Annuity
- Individual Variable Annuity
- Life/Annuity Applications
- Market Value Adjustment Products
- Preneed Funeral Products
Assumption Certificates
Credit Insurance
- Credit Accident and Sickness Insurance
- Credit Life Insurance
- Credit Life/Accident and Sickness Application/Disclosures
Dental or Optometric Services Plans
- Individual and Group Dental Services Plan
- Rate Review Checklist
- Individual - Virginia Dental Rate Template
- Small Group - Virginia Dental Rate Template
- Template for data supporting rate revisions Form 130A
- Virginia Plan Schedule Comparison (Exchange-certificate stand-alone dental only)
Dental Plan Organizations
- Individual Stand-Alone Dental Plan Organizations
- Group Stand-Alone Dental Plan Organizations
- Rate Review Checklist
- Individual - Virginia Dental Rate Template
- Small Group - Virginia Dental Rate Template
- Template for data supporting rate revisions Form 130A
- Virginia Plan Schedule Comparison (Exchange-certificate stand-alone dental only)
Foreign Language Forms
Health Maintenance Organizations (HMOs)
- Embedded Dental
- Group Association Short-Term Limited-Duration HMO
- HMO Large Group
- Individual and Group HMO Stand-Alone Dental Plan
- Individual and Small Group HMO
- Individual Short-Term Limited-Duration HMO
- Long-Term Care New Filing Checklist
- Long-Term Care Rate Revision Checklist
- Mental Health and Substance Use Disorder Benefits Parity
- Rate Review Checklist
- Virginia ACA Rate Filing Template
- Virginia ACA Rate Filing Template Instructions
- Template for data supporting rate revisions Form 130A (Not used for ACA plans)
- Trend analysis detail Form 130B (Not used for ACA plans)
- Health Insurance Rate Request Summary Part 1
- Unified Rate Review Template
- Part III Actuarial Memorandum
- Reinsurance Care Management Protocol Assessment
- Individual - Virginia Dental Rate Template
- Small Group - Virginia Dental Rate Template
- Student Health HMO
- Virginia Plan Schedule Comparison (Exchange-certified stand-alone dental only)
Health Services Plans
- Embedded Dental
- Group Association Short-Term Limited-Duration Health Services Plans
- Individual and Group Health Services Plans Stand-Alone Dental
- Individual and Small Group Health Services Plans
- Individual Short-Term Limited-Duration Health Services Plans
- Large Group Health Services Plans
- Long-Term Care New Filing Checklist
- Long-Term Care Rate Revision Checklist
- Mental Health and Substance Use Disorder Benefits Parity
- Rate Review Checklist
- Virginia ACA Rate Filing Template
- Virginia ACA Rate Filing Template Instructions
- Template for data supporting rate revisions Form 130A (Not used for ACA plans)
- Trend analysis detail Form 130B (Not used for ACA plans)
- Health Insurance Rate Request Summary Part 1
- Unified Rate Review Template
- Part III Actuarial Memorandum
- Reinsurance Care Management Protocol Assessment
- Individual - Virginia Dental Rate Template
- Small Group - Virginia Dental Rate Template
- Student Health Health Group Plans
- Virginia Plan Schedule Comparison (Exchange-certified stand-alone dental only)
Legal Services Plans
Life Insurance
- Accelerated Death Benefits
- Equity Index Products
- Fraternals
- Group Flexible Premium Adjustable Life
- Group Life
- Group Variable Life
- Individual Flexible Premium Adjustable Life
- Individual Life
- Individual Variable Life
- Market Value Adjustment Products
- Preneed Funeral Products
- Variable Life Application