MI | The Michigan Department of Insurance and Financial Services has issued Bulletin 2024-15-INS.
DIFS will continue to perform Plan Management functions for Plan Year 2025 (PY25). Plan Management functions are part of DIFS’ regulatory role for products offered on- and off-Marketplace. Issuers will work directly with DIFS to submit all Stand-Alone Dental Plan (SADP) application data in accordance with federal and state guidelines. SERFF will be used by issuers to transmit information to DIFS, and DIFS will use SERFF to transmit information to the Centers for Medicare & Medicaid Services (CMS).
Issuers will again be required by CMS to be registered for the CCIIO Plan Management Community. This platform will be utilized to issue all notices, including corrections and notification notices.
Pursuant to the PY25 Notice of Benefit and Payment Parameters, CMS requires SADP issuers, as a condition of Marketplace certification, to use an enrollee’s age at the time of policy issuance or renewal as the sole method to calculate an enrollee’s age for rating and eligibility purposes. This requirement is applicable whether the SADP is sold on- or off-Marketplace.
The Notice of Benefit and Payment Parameters also requires SADP issuers, as a condition of Marketplace certification, to submit guaranteed rates. This requirement is applicable whether the SADP is sold on-or off-Marketplace.