Filing Instructions For The 2015 Mlr Reporting Year - Centers For Medicare & Medicaid Services (Cms) Page 25
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57• Other additional expenses not included in another category such as rent, legal fees and
expenses, medical examination expenses, inspection reports, professional consulting
fees, travel, advertising, postage, utilities, etc.
• Services provided by affiliates under management agreements
• Rating agencies and other similar organizations
Exclude: Any elements already reported on Lines 5.1, 5.2, 5.3, 5.4, and 5.5
Line 5.7 – Total community benefit expenditures (informational only; include amounts reported in Lines
3.2c and 5.6)
Line 5.8 – Total ICD-10 expenses (informational only; include amounts reported in Lines 4.6 and 5.6)
Include all implementation and maintenance expenses associated with ICD-10.
Section/Line 6 – Income from fees on uninsured plans
Section 7 – Other indicators or information
Line 7.1 – Number of policies/certificates
In the individual market, this is the number of individual policies, not counting dependents, in
force as of the last day of the reporting year.
In the group markets, this is the number of certificates issued to individuals covered under a
group policy in force as of the last day of the reporting year (e.g. number of employees, NOT
counting dependents). It is NOT the number of group policyholders (e.g. employers).
Reasonable approximations are allowed when exact information is not available to the issuer
for group business.
Line 7.2 – Number of covered lives
This is the total number of lives insured, including dependents, under individual policies and
under group certificates as of the last day of the reporting year. Reasonable approximations are
allowed when exact information is not available to the issuer.
Line 7.3 – Number of groups
Applicable to the group markets only. This is the total number of employer groups insured as
of the last day of the reporting year. This is NOT the number of certificates, employees,
covered lives, or life-years.
Line 7.4 – Member months
The total number of lives, including dependents, insured on a pre-specified day of each month
of the reporting period. Reasonable approximations are allowed when exact information is not
available to the issuer.
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