Illinois Administrative Code › Title 50 - INSURANCE › Part 3801 - SMALL EMPLOYER CARRIER ACTUARIAL CERTIFICATION AND DOCUMENTATION REQUIREMENTS › Section 3801.60 - Actuarial Certification and Format

Current through Register Vol. 48, No. 28, July 12, 2024
An actuarial certification filing, an example of which is set
				forth in Illustration A of this Part, must contain the following
				information:
a) The full legal name of
			 the small employer carrier for which the certification is being
			 submitted;
b) The actuary's name,
			 title and company affiliation, if applicable, or the individual's name, title
			 and company affiliation that has been pre-approved pursuant to Section
			 5101.30
			 of this Part;
c) A statement as to
			 whether the undersigned actuary is a member of the American Academy of
			 Actuaries and meets the Qualification Standards appropriate for this
			 certification. If not a member, the individual must indicate when he or she was
			 pre-approved by the Director pursuant to Section
			 5101.30
			 of this Part and include a copy of the approval;
d) The period for which the certification is
			 being made;
e) If appropriate, a
			 statement indicating on whom the actuary relied for data. The actuary may rely
			 on company personnel for data, but may not rely on another actuarial opinion.
			 The nature and extent of reliance must be disclosed in the statement. The
			 extent of reliance is subject to the Actuarial Standards of Practice No. 23 on
			 Data Quality. A sample statement to be completed by the person on whom the
			 actuary relied is shown in Illustration B of this Part;
f) The number of classes contained in the
			 actuarial certification shall be the number in existence as of the end of the
			 certification period. In the case of multiple classes, the certification must
			 contain a list of the classes and a description of the substantial differences
			 that support the establishment of each class. Refer to Section 20(a)(1), (2)
			 and (3) of the Act [
			 215 ILCS
			 93/20 ] for information concerning the allowable
			 criteria that support the establishment of each class. This must include the
			 criteria by which groups are assigned to each class;
g) The actuarial certification must contain a
			 statement that the small employer carrier's rates either were or were not in
			 compliance with Section 25 of the Act [
			 215 ILCS 93/25
			 ];
h) If the actuary determines
			 that the small employer carrier's rates and rating factors in the rating
			 manuals did not comply with statutory requirements under subsection (g) of this
			 Section, the certification must include a detailed description of the instances
			 of noncompliance, steps taken to correct or detailed plans to correct the areas
			 of noncompliance;
i) If the actuary
			 determines that the small employer carrier's actual rates did not agree with
			 the rates provided in the rating manual(s), the certification must include a
			 detailed description of the instances of noncompliance, steps taken to correct
			 or detailed plans to correct the areas of noncompliance;
j) The annualized premium dollar amount for
			 small employer groups in force at the end of the certification period and the
			 annualized premium dollar amount for groups whose actual premium rates were
			 tested to verify that the rates charged were in accordance with the rating
			 manuals;
k) A certification that
			 the actuary completed the work in compliance with Actuarial Standards of
			 Practice 23, Data Quality, and 26, Compliance with Statutory and Regulatory
			 Requirements for the Actuarial Certification of Small Employer Health Benefits
			 (1100 Seventeenth Street, N.W., 7th Floor, Washington, D.C. 20006), and all
			 applicable laws.
l) The actuarial
			 certification required by this Part must be submitted to:
Illinois Department of Insurance
Life Actuarial Section
320 West Washington Street
Springfield, Illinois 62767-0001