Section 3801.60  Actuarial Certification and Format

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 3801.30 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 3801.30 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., 7^th 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