PPACA and SERFF – What You Need to Know

In order for industry Health filers to correctly report Patient Protection and Affordable Care Act (PPACA) related filings to the states, SERFF has implemented three field values which can be found on the General Information Tab of a PPACA-eligible SERFF filing. The three field values are:

Not PPACA-Related
Non-Grandfathered Immed Mkt Reforms
Grandfathered Immed Mkt Reforms

SERFF requires that at least one of these field values be selected in order to submit a PPACA-eligible filing.

Only the Sub-TOI’s listed on this document will flag a filing as PPACA-eligible, thus activating the new field values. Other health filings that are not PPACA eligible, for example a dental filing, will not display the options.

PPACA-eligible filings will include a new Submission Requirement - the PPACA Uniform Compliance Summary. This uniform document will assist industry in ensuring they are meeting the immediate market reform requirements and will assist states in expediting the review of PPACA filings. **NOTE: The PPACA Uniform Compliance Summary does not apply to HIPAA excepted benefits.

In addition to the new field values found on the General Information tab, PPACA-related rated filings must include Company Rate Information including a mandatory ‘Company Rate Change’ field on the Rate/Rule Schedule tab.

For more information about the PPACA requirements, please review the ‘PPACA-Related Rate Filings’ On Demand Tutorial located inside of Online Help.

SERFFing States

Have you heard? There are currently 30 states that have made it official - they want you to SERFF or file electronically!

Beginning July 1, 2013, Puerto Rico will require all filings go through SERFF.

In October 2012, Arizona mandated Life and Health filings.

Click here for a list of states that mandate SERFF

In addition to mandating SERFF, Alabama, Arkansas, Delaware, Georgia, Guam, Iowa, Maine, Massachusetts, Minnesota, Nebraska, New Hampshire, Nevada, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Vermont, and West Virginia require that all state filing fees be paid via EFT (Electronic Funds Transfer). Maryland has mandated EFT payments for all SERFF filings, both Life and Health and Property and Casualty.

What does this mean to you? If you are not already SERFF and EFT licensed, you need to get licensed as quickly as possible!