ASOP Flashcards
ASOP list
ASOP 5 - incurred claims, health and disability
ASOP 7 - insurer cash flows (testing)
ASOP 11 - financial statement treatment of reinsurance
ASOP 18 - LTC
ASOP 21 - responding to auditors
ASOP 22 - statement of opinion, asset adequacy testing
ASOP 23 - data quality
ASOP 26 - compliance requirements for certification of small ER health benefit plans
ASOP 28 - Actuarial Statement of Opinion, health liabilities and assets
ASOP 41 - actuarial communications
ASOP 42 - actuarial liabilities and assets other than incurred claims, health and disability
ASOP 45 - use of health status based risk adjustment
ASOP 8 - preparing health regulatory filings
ASOP 26 - certifications of small employer health benefit plans
ASOPs (list and describe) relevant to health/ACA filings
ASOP 8 - regulatory filings for health plan benefits
-applies to actuaries when performing services with respect to preparing or reviewing health filings required by and made to state insurance departments, state health departments, the federal government (including for ACA), and other regulatory bodies.
ASOP 26 - compliance with requirements for certification of small ER health benefit plans
-applies to actuaries when performing services with respect actuarial certifications of compliance prescribed by regulatory requirements that a carrier’s rating methods and other actuarial practices applicable to small ER health benefit plans comply with statutory and regulatory rating constraints
ASOP 8 - projections for new health benefit plan considerations
Use of business plans to project future results
-request and review, if available, relevant business plans for the health plan benefit that is the subject of the filing
-consider the information along with any other information relevant to the business plan in setting the assumptions and methodologies used in the filing
-not required to use assumptions identical to those in the business plan in developing the rate filing
Use of past experience to project future results
-determine whether past claims experience can be used to project future results
-determine extent to which past experience trends are relevant to assumed future trends
-make adjustments to reflect any known or expected changes that are likely to have a material effect on expected future results
-ASOP 23 for data selection
–consider applicability and credibility of data which may differ for total claims in a period, claims for a particular service category, and experience trends
–if data inadequate or inappropriate for use, identify additional sources that are appropriate
New plans or benefits
-consider available data relevant to new plans or benefits
-in absence of sufficient data, use data from similar benefits or plans of coverage that are reasonably consistent with new plans or benefits
ASOP 8 - list
Purpose of filing
Rating calculations
Use of business plans to project future results
Use of past experience to project future results
Recognition of plan provisions
Rating factors
New plans or benefits
Projection of future capital and surplus
Regulatory Benchmark
Reasonableness of assumptions
Reliance on data or other information supplied by others
Documentation
ASOP 28 guidance on liabilities net of ceded reinsurance
-consider the collectability of ceded reinsurance in evaluating net liabilities
–solicit information from management regarding collectability problems, significant disputes with reinsurers, and practices regarding provisions for uncollectable reinsurance
-actuary’s consideration of collectability does not imply an opinion on the financial condition of any reinsurer
Academy qualifications required for issuing SAO
basic education
experience
continuing education
Actuary must document continuing education activities and attest to satisfying standards annually
ASOP 23 - considerations regarding quality of data used
Use data that is appropriate to the work being performed
Data should be reviewed for general reasonableness and consistency; does not need to be an audit
Disclose reliance on others who reviewed the data
For claim reserves, review and documentation should address the reconciliation of paid claims against the general ledger. Proper reserve estimates should include some attempt to account for al paid claims related to a line of business
