Mass Marketed Life And Health Insurance Filing Abstracts

WEST VIRGINIA INFORMATIONAL LETTER

NO. 43

MASS MARKETED LIFE AND HEALTH INSURANCE FILING ABSTRACTS

July 1987

This letter is intended to provide a standardized format in which basic information in support of

mass marketed life and health insurance filings is presented. The information is required by these

abstracts is requested pursuant to the requirements of 1987 West Virginia Senate Bill No. 487.

Effective immediately, each mass marketed life and health insurance policy forms, rates and

advertising must be supported by the attached abstracts. Each filing, i.e. forms, rates and

advertising, must be a separate and distinct filing with a separate cover letter for each filing.

Filings not accompanied by the appropriate and properly completed filing abstract will be

disapproved without further review.

Fred E. Wright

Insurance Commissioner

WEST VIRGINIA

MASS MARKETED LIFE AND HEALTH INSURANCE

ADVERTISING FILING ABSTRACT

The following are the points of disclosure that apply to the advertising activities associated with

mass marketed life and health insurance. Please provide the following information.

1) Television advertisements must be submitted in the form of a 3/4 inch VHS videocassette

tape and be accompanied by a written script.

2) Radio advertisements must be submitted in the form of an audio cassette tape and be

accompanied by a written script.

3) Printed advertising and sales solicitation material to be sent through the mail must be

submitted in the printed form in which it will be mailed.

4) All other printed advertising and sales solicitation material, including but not limited to

material appearing in newspapers and other periodicals, must be submitted in written

form and be accompanied by an explanation of its intended use.

MASS MARKETED LIFE AND HEALTH INSURANCE

FORM FILING ABSTRACT

The following are data and information requests concerning the policy forms and policy contract

provisions.

d advertising and sales solicitation material, including but not limited to

material appearing in newspapers and other periodicals, must be submitted in written

form and be accompanied by an explanation of its intended use.

MASS MARKETED LIFE AND HEALTH INSURANCE

FORM FILING ABSTRACT

The following are data and information requests concerning the policy forms and policy contract

provisions.

(1) Date filed ___________________________________________________________.

(2) Proposed effective date ________________________________________________.

(3) Policy types effected (i.e.: health or life). Provide a brief statement itemizing

coverage.

(4) Provide a copy of the entire policy and contract provisions.

(5) All forms and policy disclosures should be itemized in accordance with the

format on page 2 of this abstract.

(6) All policies and related forms being submitted for approval shall be submitted in

duplicate. One copy will be retained by the Department, the other copy will be returned

to the insurer with the action taken by this Department. All forms should be duly

numbered. A postage-paid envelope must be submitted with all filings.

(7) If the form is new, not replacing an existing form, a statement to that effect should be

made.

(8) If the form contains provisions, conditions, or concepts, which depart from those

generally accepted by the industry, a statement to this effect should point out the purpose

and use of the form.

(9) Submission letters should state whether or not the form has been approved or

authorized for use by the Insurance Department of the insurers state of domicile.

hat effect should be

made.

(8) If the form contains provisions, conditions, or concepts, which depart from those

generally accepted by the industry, a statement to this effect should point out the purpose

and use of the form.

(9) Submission letters should state whether or not the form has been approved or

authorized for use by the Insurance Department of the insurers state of domicile.

(10) Every policy form and every rider or endorsement to be used which affects the

premium rate scheduled for a policy form, submitted for approval shall be accompanied

by a rate filing.

WEST VIRGINIA REGULATIONS

MASS MARKETED LIFE AND HEALTH INSURANCE

RATE FILING ABSTRACT

INSTRUCTIONS: The following data requests relate to the rates being charged for mass

marketed life and health insurance. All questions must be answered;

if no answer is applicable, enter the reason for such determination. USE A

SEPARATE ABSTRACT FOR EACH POLICY FORM AFFECTED, OR FOR

EACH PROPOSED PREMIUM RATE ADJUSTMENT.

1. Date Filed:________________________ Proposed Effective Date: _____________

2. Company Name:_______________________________________________________

3. Policy/Contract Type(s) Affected: _________________________________________

________________________________________________________________________

4. Number of West Virginia policyholders (exposure units) affected by this proposed premium rate

adjustment:

Single Insureds: _________________ Family Insureds: ____________________

5. Average Current and Proposed Premium Rate Levels -- Indicate the mode for each:

CURRENT RATE: Single Insured: $ _________ Family Insured: _______

PROPOSED RATE: Single Insured: $ _________ Family Insured: _______

6. List all rate level changes for the last five years for the policy/contract type(s) affected by this

proposed premium rate adjustment:

WEST VIRGINIA: EFFECTIVE DATES

PERCENTAGE ADJUSTMENTS

COUNTRYWIDE:

Form ASA-R-87 (Pg.1)

e the mode for each:

CURRENT RATE: Single Insured: $ _________ Family Insured: _______

PROPOSED RATE: Single Insured: $ _________ Family Insured: _______

6. List all rate level changes for the last five years for the policy/contract type(s) affected by this

proposed premium rate adjustment:

WEST VIRGINIA: EFFECTIVE DATES

PERCENTAGE ADJUSTMENTS

COUNTRYWIDE:

Form ASA-R-87 (Pg.1)

MASS MARKETTED LIFE AND HEALTH INSURANCE

RATE FILING ABSTRACT

7. Underwriting Loss Experience -- List on a year-by-year basis for the past three years,

and aggregately for the lifetime of the policy/contract(s) affected:

WEST VIRGINIA (ONLY)

Earned

Incurred

Loss

Premiums Losses Ratios

3rdPrior Year: 19__ :

________

________

________

2nd Prior Year: 19__ :

________

________

________

1st Prior Year: 19__ :

________

________

________

Lifetime -- Aggregately:

________

________

________

COUNTRYWIDE

Earned

Incurred

Loss

Premiums

Losses

Ratios

3rd Prior Year: 19:__

________

________

________

2nd Prior Year: 19:__

________

________

________

1st Prior Year: 19:__

________

________

________

Lifetime-Aggregately:

________

________

________

8. Permissible Loss Ratio of the policy/contract(s) affected: ____________

Has the Permissible Loss Ratio been adjusted since the inception of the policy/contract(s)

affected by this proposed adjustment? If "yes," give details and dates:

9. Estimated Premium Effect of this proposed premium rate adjustment:

Coverage

Annual Written

Proposed

Additional

Form

Premium Adjustment Annual Premium

_______

_____________

_________

_____________

10

Permissible Loss Ratio been adjusted since the inception of the policy/contract(s)

affected by this proposed adjustment? If "yes," give details and dates:

9. Estimated Premium Effect of this proposed premium rate adjustment:

Coverage

Annual Written

Proposed

Additional

Form

Premium Adjustment Annual Premium

_______

_____________

_________

_____________

10. If the proposed premium rate adjustment is approved as submitted, what is the range of

percentage changes in current premium rate levels that will be felt by the policyholders?

"If the proposed adjustment is approved, the current premium levels may be

changed as little as %, or as great as %, with an overall of %."

Form ASA-R-87 (Pg.2)

MASS MARKETED LIFE AND HEALTH INSURANCE

RATE FILING ABSTRACT

11. The amount of Annual Written Premium entered in Question 9 of this Rate Filing Abstract

accounts for what proportion of the total annual written premium on a countrywide basis for this

particular policy/contract? Please be specific in both total dollars and percentage proportions in

West Virginia:

_____________________________________________________________________________

12. Has this proposed premium rate filing been submitted to any other state insurance departments?

If "yes," give specific information as to which states, when filed, each states proportionate share

of the total annual written premium for this particular policy/contract, the status of said filing in

each state, and any other pertinent information which may be helpful in our review. Please

attach additional sheets if more space is needed.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

13. Provide calculations, along with supporting data, formula, and any other statistics which have

been used to quantify the proposed rates

if more space is needed.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

13. Provide calculations, along with supporting data, formula, and any other statistics which have

been used to quantify the proposed rates.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

14. Provide calculations or support for the determination of an average life of a policy. (for health

policies)

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

15. Provide the dollar amount of reserves that existed and are applicable to this policy for each of

the last five years. (for health policies)

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Form ASA-R-87- (Pg.3)

MASS MARKETED LIFE AND HEALTH INSURANCE

RATE FILING ABSTRACT

16. Provide a copy of the proposed contract, inclusive of the rate breakdown that is requested

____________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Form ASA-R-87- (Pg.3)

MASS MARKETED LIFE AND HEALTH INSURANCE

RATE FILING ABSTRACT

16. Provide a copy of the proposed contract, inclusive of the rate breakdown that is requested.

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

CERTIFICATION: I hereby certify that the information contained in this Rate Filing Abstract is

true and correct to the best of my knowledge and belief, and that a true and

complete copy of this entire filing has been submitted to the West Virginia

Health Care Cost Review Authority as stated herein.

(Signed) ________________________

(Title) ________________________

Form ASA-R-87 (Pg. 4)