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Get A Pdf Of This Form Is Available. - California Department Of Insurance

Filing of Individual and Small Group Health Insurance New Product Rates, Version 2 (do not use this form for filings of rates for existing products) The rate filing submission for new product rates should include: 1) This form 2) A spreadsheet with rate information responsive to Questions 10 & 15, below. 1) Company Name: 2) Number of policy forms covered by the filing: 3) Policy form numbers covered by the filing: List all of the policy form numbers covered by.

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