COVID-19 Procedures: All business with the Commission should be through electronic filing systems, email, or by telephone. For public health safety, in-person visits to SCC offices are suspended. Filings or other deliveries are permitted by drop off at main entrance. On-site staff is minimal and processing of such deliveries may be delayed.
Medicare Supplement Forms
(14 VAC 5-170)
- Medicare Supplement Refund Calculation Forms
- Form for Reporting Medicare Supplement Policies, Appendix B (pdf)
- Disclosure Statements, Appendix C (pdf)
- Notice About Attained Age Rated Medicare Supplement Policies, Appendix D (pdf)