Life/Health Group Form Filing Fees
| Submissions | Fees/Requirements |
|---|---|
| Submissions for Review | $100.00 |
| ( Policy, Endorsements, Amendments, Riders & Applications ) | |
| Submissions Exempt from Review | $ 50.00 |
| Substitutions | No Fee |
| Resubmissions (Disapproved) | $ 50.00 |
| Withdrawn forms | $50.00 |
| Corrections sent for pending approval | No Fee |
| Rate filings filed separately from the policy and subject to review/approval | $100.00 |
| Matrix filings | $ 50.00 for each form number filed with a Maximum fee of $500.00 |
| Limited refiling | $ 50.00 |
| Submissions | Fees/Requirements |
|---|---|
| Submissions For Review | $100.00 |
| ( Policy, Endorsements, Amendments, Riders & Applications ) | |
| Forms Submitted For: | $100.00 |
|
|
| Submissions Exempt From Review | $ 50.00 |
| ( Policy, Endorsements, Amendments, Riders & Applications ) | |
| Forms Submitted For: | $ 50.00 |
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| Discretionary Form Filings | |
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| Multiple Employer/Association Trust (MET/MAT) Submissions | |
| (Trust sitused in TX) | |
| Charge for each face page, regardless of coverage | $100.00 |
| Multiple Employer/Association Trust (MET/MAT) Submissions | |
| (Trust sitused Out-of-State) | $100.00 |
| Submissions For Alternate Face Pages For: | |
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| Submissions | Fees/Requirements |
|---|---|
| Medicare Rate Filings | $100.00 |
| Long Term Care Rate Filings | $100.00 |
| Credit Forms & Rate Filings | $100.00 |
| All Other Rate Filings (Individual A&H, Disability, etc.) | $ 50.00 |
| Outline Of Coverage: | |
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| PPO Disclosure Notice: | |
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Last updated: 02/18/2010
