# COMAR Title 31 — Maryland Insurance Administration

## Subtitle 10 — Health Insurance — General

### Chapter 06 — Standards for Medicare Supplement Policies

#### Regulation .19 Report Form for Calculation of Loss Ratios.

*COMAR 31.10.06.19*

The following forms are to be used for reporting loss ratios and calculating refunds for credits required under Regulation .11B of this chapter:

A. Medicare Supplement Refund Calculation Form.

Signature

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Name-Please Type

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Title-Please Type

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Date

B. Reporting Form for Benchmark Ratio for Group Policies.

C. Reporting Form for Benchmark Ratio for Individual Policies.