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Mandated Benefits Reporting

Mandated Benefits Report Form MB-1 for 2013 Reporting Year, Due On or Before May 1, 2014:

IF TOTAL ANNUAL WRITTEN PREMIUMS REPORTED TO VIRGINIA FOR ALL ACCIDENT AND SICKNESS LINES IS LESS THAN $500,000, OR THE COMPANY IS LICENSED TO ISSUE ONLY CREDIT ACCIDENT AND SICKNESS INSURANCE, THE COMPANY IS EXEMPT FROM FILING REQUIREMENTS, AND SHOULD NOT PROCEED.

Virginia Administrative Code 14VAC5-190-10 et. seq., sets forth rules governing the reporting of cost and utilization data related to mandated benefits and mandated providers. The annual mandated benefits report (Form MB-1) is required of all insurers, health services plans, and Health Maintenance Organizations (HMOs) licensed to write accident and sickness insurance that reported at least $500,000 in total annual written premiums for all accident and sickness lines (excluding credit only accident and sickness) in the company’s Annual Statement to Virginia.

A company may be required to file a complete report or an abbreviated report. The complete report is to be filed when the total annual written premiums for all accident and sickness lines (excluding credit accident and sickness), and total premiums on applicable policies and contracts are both at least $500,000. The total premiums on applicable policies and contracts should represent premiums for all accident and sickness lines (excluding credit accident and sickness) that are subject to mandated benefits and mandated providers requirements. The abbreviated report is to be filed when the total annual written premiums for all accident and sickness lines (excluding credit accident and sickness) is at least $500,000 and the total premiums on applicable policies and contracts is less than $500,000.

Instructions
CPT and ICD-9-CM Codes
Form MB-1: Complete on-line forms or download blank forms