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CA Department of Insurance

Guidance for Health Legislation

Guidance documents issued by the Department regarding health-related legislation may be accessed by following the links below.

Comments regarding draft guidance may be submitted by e-mail to: guidancecomments@insurance.ca.gov.

Guidance Documents

Number Draft Date Final Date Subject
1163:1 11/24/2010 12/02/2010 SERFF Filing of Rates
2244:1 12/16/2010 01/06/2011 Coverage for children on every policy, OEP, LEP other topics
1163:2 02/03/2011 04/05/2011 Unreasonable rate increases, Filing and Notice, Actuarial Certification, Filing Requirements
Form 02/03/2011 04/05/2011 California Rate Filing Form
Form 04/05/2011 California New Product Rate Filing Form
Form 02/03/2011 04/05/2011 California Plain-Language Rate Filing Description
Spreadsheet 04/05/2011 California Rate Filing Spreadsheet
Spreadsheet 04/05/2011 California Plain-Language Spreadsheet
2244:2 02/07/2011 03/07/2011 Children's coverage - further guidance
2470:1 03/11/2011 Superseded by 2470:2 Notice re: Commissioner's review of cancellation/rescission/non-renewal [superseded by 2470:2]
2244:3 05/09/2011 06/06/2011 Exempted policy types
2470:2 05/26/2011

07/01/2011

Notice and Amendment 11/21/2011

Cancellation, Rescission, Non-Renewal of policies; Review of Complaints
1163:3 08/03/2011 08/25/2011 Annual Aggregate Rate Data Report Filing
form 08/03/2011 08/25/2011 California Annual Aggregate Rate Data Report Form
1163:4 08/03/2011 08/25/2011 Submission of Preliminary Rate Information
1163:5 04/16/2012 withdrawn Large Group Rate Filing
1163:6 06/29/2012 Administrative Costs, Reinsurance, Risk Adjustment, Risk Corridors, Medical Loss Ratio
1163:7 06/29/2012 Individual Coverage Sold Through Associations
AB 1962 Dental MLR 03/04/2015 04/27/2015 Cover Letter
AB 1962 Dental MLR 03/04/2015 04/27/2015 Guidance
AB 1962 Dental MLR 03/04/2015 05/26/2015 Reporting Form
AB 1962 Dental MLR 03/04/2015 04/27/2015 Filing Instructions
AB 1962 Dental MLR 9/29/2016 Guidance for submitting 2015 data
AB 1962 Dental MLR 9/29/2016 Reporting form for submitting 2015 data
AB 1962 Dental MLR 9/29/2016 Filing Instructions for submitting 2015 data
SB 137 Provider Directory Standards 12/30/2016 Uniform Provider Directory Standards
AB72:1 06/09/2017 Implementation Guidance, Dispute Resolution Process: Relevant Reimbursement Data
AB72:1 06/09/2017 Average Contracted Rate Form Instructions
AB72 Form: Individual 06/09/2017 AB72 Average Contracted Rate Form - Individual
AB72 Form: Small 06/09/2017 AB72 Average Contracted Rate Form - Small Group
AB72 Form: Large 06/09/2017 AB72 Average Contracted Rate Form - Large Group
AB72:2 09/12/2017Independent Dispute Resolution Process
AB72:2 Request Form  09/12/2017IDRP Request Form
AB72:2 Request Spreadsheet 09/12/2017IDRP Request Claim Information Spreadsheet 
AB72:2 Response Form 09/12/2017IDRP Response Form 
AB 1962 Dental MLR 09/14/2017Reporting form for 2016 data (use above guidance, Filing Instructions for 2016 data)
AB 1962 Dental MLR 09/14/2017 AB1962 Guidance
AB 1962 Dental MLR 09/14/2017 AB1962 Filing Instructions
SB 546 Large Group Aggregate Rate Data 08/7/2018California Large Group Annual Aggregate Rate Data Report Form: PDF or DOCx (v. 5, 8/7/18) New
SB 546 Large Group Aggregate Rate Data  08/6/2018 CA Large Group Historical Data Spreadsheet (8/6/18) New
SB 546 Large Group Aggregate Rate Data  09/14/2017Additional Information, Large Group Aggregate Rate Filing (8/31/16) 
SB 17 Cost Reporting for Commercial Plans 07/16/2018Prescription Drug Cost Reporting Form Instructions for Commercial Plans (7/16/18) New
SB 17 Cost Reporting for Commercial Plans 07/16/2018Prescription Drug Cost Reporting Form for Commercial Plans (7/16/18) New
SB 17 Cost Reporting for Large Group Plans 7/16/18Large Group Prescription Drug Cost Reporting Form Instructions (7/16/18) New
SB 17 Cost Reporting for Large Group Plans 7/16/18Large Group Prescription Drug Cost Reporting Form (7/16/18) New
SB 17 Cost Reporting Glossary 7/16/18SB 17 Glossary (7/16/18) New
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