[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR403.239]



[Page 40]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 403_SPECIAL PROGRAMS AND PROJECTS--Table of Contents

 

                Subpart B_Medicare Supplemental Policies

 

Sec. 403.239  Submittal of material to retain certification.



    (a) CMS certification of a policy that continues to meet the 

standards will remain in effect, if the insuring organization files the 

following material with CMS no later than the date specified in 

paragraph (b) or (c) of this section--

    (1) Any changes in the material, specified in Sec. 403.232(b), that 

was submitted for previous certification.

    (2) The loss ratio supporting data specified in Sec. 403.256(b).

    (3) A signed statement in which the president of the insuring 

organization, or a designee, attests that--

    (i) The policy continues to meet the requirements specified in Sec. 

403.232(a); and

    (ii) The information submitted to CMS for review is accurate and 

complete and does not misrepresent any material fact.

    (b) Except as specified in paragraph (c) of this section, the 

insuring organization must file the material with CMS no later than June 

30 of each year. The first time the insuring organization must file the 

material is no later than June 30 of the calendar year that follows the 

year in which CMS--

    (1) Certifies a new policy; or

    (2) Certifies a policy that lost certification as provided in Sec. 

403.245.

    (c) If the loss ratio calculation period, used to calculate the 

expected loss ratio for the last actuarial certification submitted to 

CMS, ends before the June 30 date of paragraph (b) of this section, the 

insuring organization must file the material with CMS no later then the 

last day of that rate calculation period.