Form and Rate Filing Fees

Department of Business Regulation

Insurance Division

1511 Pontiac Avenue

Cranston, RI 02920

Insurance Bulletin Number 2002-13

Form and Rate Filing Fees

Pursuant to R.I. Gen. Laws § 42-14-18 a filing fee of forty dollar ($40) will be

charged for each policy or certificate form included in a single package. For all

forms revising a previously approved form or rate (including riders, endorsements,

applications, and alternative paragraphs) a twenty five dollar ($25) filing fee will be

charged for each policy to which the filer requests the filing apply. Fees are due on a

per company basis even if the same form(s) are being filed for multiple companies.

Filings fees are not required for withdrawals of filings (without replacements), or for nonadoption of advisory/ rating organizations filings. All other filings require a filing fee.

The fee must be submitted by electronic funds transfer with each SERFF filing.

Since October 1, 2007 Rhode Island has only accepted form and rate filings electronically

through SERFF (Insurance Bulletin 2007-3.) There is no fee to withdraw forms that a

company no longer intends to use in Rhode Island.

HOW TO FIGURE YOUR FEE

When a master contract and certificates are filed in one

package, count each policy and each certificate and multiply by

forty dollars ($40) and then multiply by the number of companies

to which the filing applies, if applicable. (Do not count riders,

endorsements, application, rates or alternative paragraphs.)

When riders, endorsements, applications, alternative

paragraphs or rates are filed singly or in a package without

policy or certificate forms, count the number of policies to which

the forms will be attached, in which the paragraphs will be used, or

with which the rates will be used and multiply by twenty five

dollars ($25) and then multiply by the number of companies to

which the filing applies, if applicable

ements, applications, alternative

paragraphs or rates are filed singly or in a package without

policy or certificate forms, count the number of policies to which

the forms will be attached, in which the paragraphs will be used, or

with which the rates will be used and multiply by twenty five

dollars ($25) and then multiply by the number of companies to

which the filing applies, if applicable. (Do not count the forms,

paragraphs and/or rates, themselves)

If the retaliatory fee for your company’s domicile is more, pay

the retaliatory fee.

THE SERFF FILING MUST LIST ALL POLICY FORMS WITH WHICH ANY RIDERS,

ENDORSEMENTS, APPLICATION, ALTERNATIVE PARAGRAPHS OR RATES WILL BE

USED. REFERENCE TO “ALL POLICY FORMS APPROVED IN RHODE ISLAND” IS

NOT ACCEPTABLE.

Joseph Torti III

Associate Director and Superintendent of Insurance

September 10, 2009