{"data":{"id":"us/42-cfr-403.232","jurisdiction":"us","citation":"42 CFR 403.232","heading":"Requirements and procedures for obtaining certification.","body":"(a) To be certified by CMS, a policy must meet—\n(1) The NAIC model standards specified in § 403.210;\n(2) The loss ratio standards specified in § 403.215; and\n(3) Any State requirements applicable to a policy—\n(i) Issued in that State; or\n(ii) Marketed in that State.\n(b) An insuring organization requesting certification of a policy must submit the following to CMS for review—\n(1) A copy of the policy form (including all the documents that would constitute the contract of insurance that is proposed to be marketed as a certified policy).\n(2) A copy of the application form including all attachments.\n(3) A copy of the uniform certificate issued under a group policy.\n(4) A copy of the outline of coverage, in the form prescribed by the NAIC model standards.\n(5) A copy of the Medicare supplement buyers' guide to be provided to all applicants if the buyers' guide is not the CMS/NAIC buyers' guide.\n(6) A statement of when and how the outline of coverage and the buyers' guide will be delivered and copies of applicable receipt forms.\n(7) A copy of the notice of replacement and statement as to when and how that notice will be delivered.\n(8) A list of States in which the policy is authorized for sale. If the policy was approved under a deemer provision in any State, the conditions involved must be specified.\n(9) A copy of the loss ratio calculations, as specified in § 403.250.\n(10) Loss ratio supporting data, as specified in § 403.256.\n(11) A statement of actuarial opinion, as specified in § 403.258.\n(12) A statement that the insuring organization will notify the policyholders in writing, within the period of time specified in § 403.245(c), if the policy is identified as a certified policy at the time of sale and later loses certification.\n(13) A signed statement in which the president of the insuring organization, or a designee, attests that—\n(i) The policy meets the requirements specified in paragraph (a) of this section; and\n(ii) The information submitted to CMS for review is accurate and complete and does not misrepresent any material fact.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER A—GENERAL PROVISIONS","PART 403—SPECIAL PROGRAMS AND PROJECTS","Subpart B—Medicare Supplemental Policies"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"139d76cabb687ba58ccef4931d9a8e76b8ef3c88a2c0ce0385d880ac23203756","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-403.231","next":"us/42-cfr-403.235"},"notice":"GroundRules: Original legal text. Not legal advice."}