Welcome to the Ohio Department of Insurance

Skip Navigation

Please Note: You are viewing the non-styled version of Ohio Department of Insurance. Either your browser does not support Cascading Style Sheets (CSS) or it is disabled. We suggest upgrading your browser to the latest version of your favorite Internet browser.

Ohio.gov
Rate Fling Guidance

​The following guidance provides rate filing requirements for major medical and certified SADP plans. This guidance is not exhaustive. Health plan issuers are responsible to review and comply with all applicable state and federal law.

Important Notices

  • The form filing deadlines for (1) student health plans, (2) both on-exchange and off-exchange major medical plans, and (3) both on-exchange and off-exchange certified Stand Alone Dental Plans (SADPs) are provided below.

Deadlines
  • March 28, 2018 - Student Health Plans for the 2018/2019 school year
  • May 21, 2018 -  Certified SADPs NEW!
  • June 15, 2018 - On-Exchange Individual and Small Group Major Medical Plans
  • July 25, 2018 - Off-Exchagne ONLY Individual and Small Group Major Medical Plans NEW

 

Ohio Rate Filing Requirements

  • Ohio ACA Rate Filing Guidance and Checklist
    T
    his checklist is should be used in submitting all ACA compliant On-Exchange and Off-Exchange major medical products and On-Exchange and Off-Exchange Certified Stand Alone Dental Plan (SADP) products.
  • 2019 Part 1 Unified Rate Review Template (URRT) - Not applicable to SADPs
    The URRT is required for all single risk pool plans in the individual and small group medical markets, including single risk pool plans that experience rate increases, rate decreases, or no rate changes, as well as new single risk pool plans. Important! Please attach both an Excel (.xls) and a .pdf version of the completed URRT.
  • 2019 Part III Actuarial Memorandum and Certifications
    Required for single risk pool plans in the individual and small group medical markets, Part III is an Actuarial Memorandum that includes the actuarial reasoning and assumptions, justifications and methodologies that support the entries in the Unified Rate Review Template (URRT). Important! Only an unredacted version of the Part III Actuarial Memorandum and Certifications is required for the Ohio rate filing submission in SERFF.

Final 2019 PY Unified Rate Review instructions and the URRT have been posted by CMS on the CCIIO QHP website at: https://www.qhpcertification.cms.gov/s/Unified%20Rate%20Review

 

Special Notes Re: 2019 PY Stand Alone Dental Plan (SADP) Rate Filing Requirements
  • A rate filing with supporting actuarial documents is required for 2019 plan year recertification of all SADPs unless both of the following conditions are met:
    • There is no change in rates from the approved 2018 PY rates; and
    • Trend was not used in developing the approved 2018 PY rates.
  • Certification by a credentialed Actuary that both conditions are met must be filed in SERFF in lieu of the 2018 PY rates.

 

Guidance and Information

​ 


Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
|
|
|
Mike DeWine, Governor | Jillian Froment, Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | Medicare Hotline: 800-686-1578