Life, Accident & Health

Insurance policies offered in South Carolina are to be readable and fair in relation to the coverage offered and must ensure prices charged for such coverage should be calculated in accordance with all state laws.  The Life, Accident, and Health Unit staff review and analyze individual and group policy rates, rules, and forms for these lines of insurance and for health maintenance organizations (HMOs).  Filings made with the LA&H Unit are generally completed within 30 to 90 days, unless additional information is needed.

Statutes & Regulations
Bulletins & Positions
PPACA Resources  (updated 5-11-16)
Filing Resources


The following Instructions and checklists are intended to be used as a tool by the insurer to properly prepare and submit filings to the South Carolina Department of Insurance. Please know that improper and/or incomplete filings will result in a rejection or disapproval of the filing.  

All rate, rule, and/or form filings must be submitted via the State Electronic Rate Form Filing system (SERFF). For more information on SERFF, please call 1-816-783-8787 or email Additional information is also available by visiting

Filings must be submitted by insurer and by line of business.

The South Carolina Department of Insurance will review filings for compliance; however it remains the responsibility of the insurer to adhere to all applicable federal and State of South Carolina insurance laws, regulations and policies.

Statutes and Regulations

South Carolina Code of Laws, Title 38: Insurance
South Carolina Code of Regulations, Chapter 69: Department of Insurance

Key Statutes and Regulations
  • SC Code Section 38-1-20
Accident and Health 
  • Title 38, Chapter 71
  • Regulation 69-17
  • Regulation 69-34
  • Regulation 69-43
Credit Accident and Health 
  • SC Code Section 37-4-203
Credit Life 
  • SC Code Section 37-4-203
Group Life Insurance 
  • Title 38, Chapter 65
  • Regulation 63-12.1
  • Regulation 69-40
Health Maintenance Organizations 
  • Title 38, Chapter 33
  • Regulation 69-22
Insurance Contracts Generally 
  • Title 38, Chapter 63
  • Regulation 63-12.1
  • Regulation 69-30
Long Term Care Insurance 
  • Title 38, Chapter 72
  • Regulation 69-44
Medicare Supplement Insurance 
  • Regulation 69-46

Bulletins and Positions

For a complete listing of bulletins and orders, click here.

Key Bulletins and Orders
  • Bulletin 8-84SCID 1504 Form
  • Bulletin 89-1: Group policies issued outside of this sate which extend coverage to residents of this state 
  • Bulletin 2003-12: Interpretive Bulletin Relating to the Use of Endorsements, Amendments and Riders for all Individuals and Group Policies
  • Bulletin 2003-13: List of "Exempt" Policy Forms, Filing Procedures for "Exempt" and "Prior Approval"
  • Bulletin 2006-08: Service and Administrative Fees
  • Bulletin 2007-11: Service and Administrative Fees
  • Bulletin 2009-02: South Carolina Health Care Financial Recovery and Protection Act (Prompt Pay)
  • Bulletin 2009-22: Retaliatory Fees
  • Bulletin 2011-04: Compliance with the External Review Requirements of the Patient Protection and Affordable Care Act
  • Bulletin 2011-09: Mandatory Use of SERFF for all Insurance Rate, Rule, and Form Filings
  • Bulletin 2012-06: Reduced Agent Compensation for Medicare Supplement Policies Sold
  • Bulletin 2013-11: Service and Policy Fees
  • Bulletin 2014-14: Requirements Applicable to Hospital Indemnity or Other Fixed Indemnity Policies Sold in the Individual Market
  • Bulletin 2015-07: Autism Spectrum Disorder Maximum Benefit for Coverage for Behavioral Therapy
  • Order Number 2015-05: Rates for Credit Accident and Health Insurance Sold in Conjunction with Loans Subject to 1966 S.C. Act No. 988- Approved Rate for 2015 Basic Statistical Plan
  • Order Number 2015-06Rates for Credit Accident and Health Insurance Sold in Conjunction with Consumer Credit Transaction subject to South Carolina Consumer Protection Code (S.C. Code Ann. 37-1-101 et seq.) Other Than Loans Made Under 1966 S.C. Act No. 988 - Approved Rates for 2015 Basic Statistical Plan
  • Bulletin 2015-08: Impact of the PACE Act on the Small Group Market
Position Highlights
  • Enrollment Forms are required for all group policy filings.
  • SCID 1504 Form is required for all individual filings and group rate filings unless specifically exempted.
  • This Department takes exception to wording which indicates that the statements of the applicant are other than representations. Hence the word “certify” must be deleted.
  • The SCDOI requires all notices of discontinuations or market exits to be filed in SERFF (filings should be made under the Form type).  The Department has published guidance for health insurance issuers regarding these submissions as follows: Added 5/5/15

PPACA Resources

2014 Market Reforms

Filing Procedures and Requirements

Filing Requirements and Resources for 2017 Plans (2016 Filing Period) Updated 5-11-16

Filing Requirements and Resources for 2017 Student Health Plans (2016 Filing Period) Updated 5-4-16

Filing Requirements and Resources for 2016 Plans (2015 Filing Period)

Transitional Policy for Non-grandfathered Health Insurance Coverage

Bulletins Important Update - See Bulletin 2016-01 below, published 3-29-16
  • List: Companies Participating in Transitional Relief Pursuant to Bulletin 2013-12
  • Instructions Manual: HHS Rate Review Justification Instructions for Transitional Policies and Student Health Plans (Updated April 1, 2015)

Immediate Market Reforms

Filing Procedures and Requirements
  • Bulletin 2011-03: New Rate Filing Procedures to Comply with 45 CFR Part 154
  • Bulletin 2011-11: Application of New Rate Filing Procedures to Comply with 45 CFR Part 154 to Association-based Coverage

LA&H Filing Resources

Filing Checklists