Ill. Admin. Code tit. 50, § 3801.60 - Actuarial Certification and Format
An
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
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