Current through Register Vol. 39, No. 6, September 16, 2024
For those filings made in accordance with
11 NCAC
10 .1102(15), supporting
information shall be presented as follows:
(1) Reference Filing Adoption Form:
(a) Insurer's name.
(b) Contact person for filing.
(c) Title of contact person.
(d) Phone number.
(e) Insurer's FEIN.
(f) Insurer's file number.
(g) Department file number.
(h) NCRB reference filing number.
(i) Effective date.
(j) Insurer's proposed effective date (if
different from NCRB effective date).
(k) Insurer's approximate market share of
North Carolina written premium.
(l)
Whether the multiplier is applicable to this filing only or to subsequent
reference filings.
(m) Statement of
accuracy of information.
(n)
Signature of company official.
(o)
Date signed.
(2) Summary
of Supporting Data Form:
(a) Statement of
whether the filing applies uniformly to all workers' compensation
classes.
(b) Loss costs
modification:
(i) Without modification (factor
equals 1.000).
(ii) With
modification (supporting documentation required).
(c) Loss costs modification factor.
(d) Selected expenses (attach Expense
Provision Exhibit):
(i) Commission and
brokerage.
(ii) Other
acquisition.
(iii) General
expenses.
(iv) Taxes, licenses,
fees, loss based assessments.
(v)
Profit, contingencies, credit for investment income.
(vi) Other.
(vii) Total (i+ii+iii+iv+v+vi).
(e) Development of Expected Loss
and Loss Adjustment Expense (Target Cost) Ratio: Expressed in decimal form:
1.000-(d)(vii).
(f) Overall effect
of expense constant and minimum premiums: Expressed in decimal form, i.e., 1.2%
overall effect would be 0.988.
(g)
Overall effect of size-of-risk discounts plus expense gradation recognition in
retrospective rating: Expressed in decimal form, i.e., 8.6% average discount
would be 0.914.
(h) Provision for
loss based assessments: See NCRB Reference Filing, Exhibit II.
(i) Company formula loss costs multiplier
(b)(ii) x (1.000 - h)/ [(g) - (d)(vii)] x (f).
(j) Company selected loss costs multiplier.
Explain any differences between (i) and (j).
(k) Rate level changes for the coverages to
which this page applies.
(l)
Statement of whether the insurer is amending the minimum premium
formula.
(m) Statement of whether
the insurer is amending the expense constant(s).
(n) Statement of whether the insurer is
changing the premium discount schedules.
(o) If the answer to (l), (m), or (n) is yes,
documentation is required.
(3) Expense Provisions Exhibit: For the
following items, the insurer shall provide the three most recent years, the
average, industry average, and the selected:
(a) Commissions and brokerage.
(b) Other acquisition.
(c) General expenses.
(d) Taxes, licenses, fees, and loss based
assessments.
(e) Profit,
contingencies, and investment income:
(i)
Profit and contingencies.
(ii)
Credit for investment income.
(f) Other.
(g) Total (a+b+c+d+e+f).
The insurer shall indicate if the insurer's actual expense
ratios are North Carolina, countrywide, or other (explain); and if the
insurer's actual expense ratios are a percent of standard premium, percent of
net premium, or other (explain). The insurer shall explain if the selected
provisions differ from the average for reasons other than
rounding.
Authority
G.S.
58-2-40;
58-36-15;
58-36-100;
Eff.
February 1, 1996;
Temporary Amendment Eff. December 1,
1999;
Amended Eff. July 1, 2000;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. January 3,
2017.
