Section 403.232 - Requirements and procedures for obtaining certification(a) To be certified by CMS, a policy must meet-(1) The NAIC model standards specified in § 403.210 ;(2) The loss ratio standards specified in § 403.215 ; and(3) Any State requirements applicable to a policy-(i) Issued in that State; or(ii) Marketed in that State.(b) An insuring organization requesting certification of a policy must submit the following to CMS for review- (1) A copy of the policy form (including all the documents that would constitute the contract of insurance that is proposed to be marketed as a certified policy).(2) A copy of the application form including all attachments.(3) A copy of the uniform certificate issued under a group policy.(4) A copy of the outline of coverage, in the form prescribed by the NAIC model standards.(5) A copy of the Medicare supplement buyers' guide to be provided to all applicants if the buyers' guide is not the CMS/NAIC buyers' guide.(6) A statement of when and how the outline of coverage and the buyers' guide will be delivered and copies of applicable receipt forms.(7) A copy of the notice of replacement and statement as to when and how that notice will be delivered.(8) A list of States in which the policy is authorized for sale. If the policy was approved under a deemer provision in any State, the conditions involved must be specified.(9) A copy of the loss ratio calculations, as specified in § 403.250 .(10) Loss ratio supporting data, as specified in § 403.256 .(11) A statement of actuarial opinion, as specified in § 403.258 .(12) A statement that the insuring organization will notify the policyholders in writing, within the period of time specified in § 403.245(c) , if the policy is identified as a certified policy at the time of sale and later loses certification.(13) A signed statement in which the president of the insuring organization, or a designee, attests that-(i) The policy meets the requirements specified in paragraph (a) of this section; and(ii) The information submitted to CMS for review is accurate and complete and does not misrepresent any material fact.