2025 SERFF Health Filings

• Rating Areas
• State Dental Attestations
• State Medical Attestations
• EHB Plan Index

Filing Requirements

• Compliance Reference for Group Accident and Health Coverages
• Compliance Reference for Individual Accident and Health Coverages

Standardized Credentialing Application

• Online Standardized Credentialing Links
  • Bulletin 2007-2: Online Standardized Credentialing Application effective June 1, 2007

Health Maintenance Organizations

• Explanatory Letter
• Official List
• Application for Certificate of Authority
• Quality of Care Assessment Guidelines
• HMO Estimated Privilege Fee Statement

Pharmacy Benefits Manager

Effective January 1, 2023, all Pharmacy Benefits Managers operating in Kansas are required to be licensed with the Department. See 2022 House Substitute for SB 28.

• Pharmacy Benefit Manager Licensing and Renewal Information and Instructions
• Network Adequacy Report
• Contacts Form
• PBM Licensing Frequently Asked Questions
• PBM Initial Licensing Application Checklist

Third Party Administrators

Note: New TPA applications will be accepted through NIPR.

• New TPA Licensing, Renewal and Annual Report Instructions
• Business Entity Name Change Application
• Annual Report
• Non-Resident Biennial Renewal Attestation
• Hardship Exemption
• Bond of Administrator
• Voluntary Surrender of Kansas TPA Certificate

Utilization Review Organizations

• K.A.R. 40-4-41
• Explanatory Letter
• Application for New Utilization Review Certificate – URO Standard
• Application for New Utilization Review Certificate – URO URAC Accreditation
• Renewal Process – URO Standard: In accordance with K.S.A. 40-22a04, an entity registered as a utilization review organization (URO) in this state must annually submit to the Commissioner of Insurance a $50.00 continuation fee in order for its certificate to remain effective. Failure to pay this fee could result in the revocation of the Utilization Review Organization Certificate by the Commissioner of Insurance.
  • Continuation of Certification Once submitted, a link to pay the $50.00 fee will be presented. The form completion and payment must both be submitted in order for certification to be active.
• Renewal Process – URO URAC Accreditation

Viatical Settlement Companies

• Viatical Settlement Provider License Renewal Form
• Viatical Settlement Provider Annual Statement Form
• Viatical Admission Application
• Viatical Explanatory Letter
• Viatical Instruction Packet

Prepaid Service Plans

• New Application for Dental or Legal Prepaid Service Plan
• Renewal Process for Dental or Legal Prepaid Service Plan
• Prepaid Plans Representatives List – to be submitted by January 1 and July 1 each year
• Qualifying Bond Application

Captive Companies

• Application for Continuance of Kansas Captive Company