COPLFR (excl 7-8) Flashcards
What should the opening paragraph state?
Actuary’s Name and Title
Who made the appointment (BOD)
Affirmation of qualifications
Relationship w/ the company (Employee or consultant?)
Date of appointment
statement that the qualification documentation was provided to the board
Appointment of AA
Initial Appointment:
By BOD before 12/31 year opining on (notify dom com within 5 days with )
- Name and title
- manner of appointment
- person meets requirements of a qualified actuary (or was approved by dom com, presented to BOD)
after no further notice is needed unless change!
3 types of “Board of Directors”
can include designated BOD, its equivalent, or an appropriate committee directly reporting to the BOD
Identification Illustrative Language
I, Name of AA [designations], am associated with ABC insurance. I was appointed by the BOD of ABC insurance on xx/xx/xxxx to render this opinion. I meet the def of a QA per the NAIC annual statement instructions - P&C, AO. I have provided my qualification documentation to the BOD directly.
Def of Qualified Actuary
meets basic education, experience, CE reqs of SQS for SAO, NAIC P&C AS as set forth in QS for actuaries issuing SAO in the U.S, promulgated by the AAA and…..
obtained and maintains an AAD
and….
is member of professional act organization that.
-adheres to code of conduct of Academy
-reqs adherence to U.S QS
-ABCD participation while actuaries are practicing in the US
exception to qualified actuary
-evaluated by Academy’s CPC and determined to be a QA for some LOBs and business activities (provides exemption for all QA reqs except for member of org that does the 3 things)
- approved by dom com
What must company do if AA is a QA by the exception?
company must attach, each year, approval letter and reference in the ID paragraph
U.S QS
Basic ed: ACAS/FCAS/EA/MAAA
exp: 3 yrs responsible
U.S specific knowledge: law and practices
subject area knowl:
30 hours relevant CE
- 6 + hours organized activities
- 3 + professionalism
- 1 +bias
- <=3 general business
+
one of…
fellowship (SOA/CAS) AND completed relevant education
min of 1yr responsible exp under review of QA
OR
min 3 years responsible exp under review of QA
U.S SQS
Basic ed: exams from academy/soa/cas on
policy forms & coverages, UW, marketing, ratemaking, insurance accounting, reinsurance OR
obtained signed statement from QA familiar with your background
exp: 3 yrs responsible
CE: 15 hours +, 6+ organized activities
NAIC standards for QA
US SQS
AAD
member of org that does the 3 things
state reqs vary
What should the qualification documentation contain?
-brief bio of actuary
-description of how def of QA is met for that year (CE)
-describe relevant experience to SAO
At what level should the review of the qualification documentation take place?
level within holding company structure that is responsible for overseeing insurance operations
-can be a parent board if a subsidiary (note in meeting minutes the name of the lead entity that reviewed the documentation or by attaching a copy of the parent boards meeting minutes reflecting their review)
Is the qualification documentation sent to the commissioner?
It is considered workpapers and available for inspection upon regulator request or during a financial exam
same confidentiality as the AR
Where can qualification documentation be reviewed if a single AR is used for multiple companies (in intercompany pooling for example)?
may be reviewed at level other than statutory entity defined as “responsible for overseeing insurance operations”
What constitutes an AAD?
designation meeting or exceeding NAIC P&C educational standards for AAs
examples:
FCAS & 6U
ACAS & 6U & 7
FSA (GI track)
exceptions can be made for 6U for example, can override with experience
How should actuaries (subject to US QS) document CE?
maintain timely records as evidence, should be for 6 + years
include
dates
hours
brief desc
whether it applies to a SQS and which one
is it an organized activity?
Procedure for changing an AA
Within five days of the action, the company must advise the relevant domiciliary insurance department in writing of the change.
Within 10 days of the notification, the company must write to the domiciliary Commissioner stating whether in the 24 months preceding the change (any disagreements on important things, list them and state whether they were resolved, nature of resolution(s))
The letter must be accompanied by a response from the former Appointed Actuary addressed to the company “stating whether the Appointed Actuary agrees with the statements contained in the Insurer’s letter and, if not, stating the reasons for which he or she does not agree
What reserve items may be included in the scope?
- Loss and LAE reserves;
- Retroactive reinsurance assumed reserves;
- Unearned premium reserves for P&C long-duration contracts;
- Unearned premium reserves for extended reporting endorsements (>= 1st schedule P interrogatory amt)
- Other reserve items for which the Appointed Actuary is providing an opinion
Language for examining actuarial methods and assumptions
I have examined the actuarial assumptions and methods used in determining the reserves listed in Exhibit A, as shown in the Annual Statement of the Company as prepared for filing with state regulatory officials, as of December 31, 2022.
Examples of “stated basis of representation” for reserve items in scope
-discounted for TVM?; items discounted
-explicit risk margin?
-gross or net of specified recoverables?
-is potential for uncollectible recoverables considered?
-types of LAE included
-is it only for portion of reserves in Exhibit A?
-misc
What must a 0% participant of an intercompany pooling arrangement do?
-speak on risks/uncertainties relevant to the lead entity
-A,B include their data
-attach A,B of lead entity
What must be disclosed for intercompany pooling?
-lead entity, description of the pool
-pooling %s, state of domicile, names of those involved
Do the requirements of intercompany pooling apply to 100% qs agreements?
No, for example dont mention this or attach any other companies SAO exhibits (also goes for AOS)
Review date def
“the date (subsequent to the valuation date) through which material information known to the actuary is included in forming the reserve opinion.
Language for data source
“In forming my opinion on the loss and loss adjustment
expense reserves, I relied upon data prepared by
___________ (officer name and title at the Company). I
evaluated that data for reasonableness and consistency. I
also reconciled that data to Schedule P, Part 1 of the
Company’s current Annual Statement. In other respects, my
examination included such review of the actuarial
assumptions and methods used and such tests of the
calculations as I considered necessary
Can the appointed actuary themselves be “responsible for the data provided” instead of an officer?
Yes, can also be a TPA, however regulators expect this to be an officer
When are “letters of representation” used in SAOs?
For consultant appointed actuaries sometimes which can include:
company-provided comprehensive data
info on events subsequent (to valuation date)
basis of reserves
changes in company methodology
any LDCs?
pools
reinsurance
What should the actuary do if the data is unreasonable or inconsistent to a significant degree? and the problem was not resolved satisfactorily
Do not rely on the data in question: If, in the Appointed Actuary’s judgment, this causes a significant increase in the uncertainty inherent in the Appointed Actuary’s opinion on the reserves, then the situation is typically described in the Statement of Actuarial Opinion and elaborated upon in the Actuarial Report,
or
– Conclude that an actuarial opinion cannot be formed based on the available data
What does the schedule P reconciliation include?
-should be gross and net, if not discuss in AR
-significant data types reconciled to Part 1 (A => R);
paid loss, incurred, paid LAE, sal/sub, claim counts, EP
-reconcile paid for either cumulative, or current CY, same for case reserves
-if differences deemed immaterial, discuss in AR
-aggregate up / down to minimum necessary level
What are some factors that can cause schedule P reconciliation issues?
-may use additional data not in Schedule P (exposure, policy lims)
-not aggregated with the same basis
What should the actuary do if unexplained differences remain between their data and Sched.P?
confirm the persons responsible for the data are aware
recommend company inform its auditors
discuss in SAO and elaborate in AR (explain any material differences)
Illustrative language for Schedule P reconciliation
I also reconciled that data to Schedule P – Part 1 of the Company’s current Annual Statement. The data generally reconciled with one exception: The total amount of Company XXX’s paid loss differs by $21,000. This difference results from rounding and is not material.
Data testing requirements
actuary typically writes a letter to company management (cc the company’s financial statement auditor(s)) identifying any significant data items for testing
auditor has discretion on what to test specifically
not required to write a letter, its just good for documentation reasons
ASOP 21 - responding to / assisting auditors can help
Evaluated methods and assumptions language if they did examine them
I have examined the actuarial assumptions and methods used in determining reserves listed in Exhibit A, as shown in the Annual Statement of the Company as prepared for filing with state regulatory officials, as of December 31, 2022, and reviewed information provided to me through XX/XX/2022 …my examination included such review of the actuarial assumptions and methods used and such tests of the calculations as I considered necessary.
Evaluated methods and assumptions language if they did NOT examine them and performed independent tests
I have examined the reserves listed in Exhibit A, as shown in the Annual Statement of the Company as prepared for filing with state regulatory officials, as of December 31, 2022, and reviewed information provided to me through XX/XX/2022…my examination included the use of such actuarial assumptions and methods and such tests of the calculations as I considered necessary
What does “meets the insurance laws of state X” mean?
generally interpreted as statutory accounting requirements.
Thus, to comply with insurance laws, reserves ordinarily represent management’s best estimate.
Language for when actuary reviewed methods and assumptions used in setting the recorded reserves (OPINION)
Are computed in accordance with accepted actuarial standards.
Language for when actuary performed an independent analysis of recorded reserves (OPINION)
Are consistent with reserves computed in accordance with
accepted actuarial standards.
Reasonable provision language
Make a reasonable provision for all unpaid loss and loss
adjustment expense obligations of the Company under the terms
of its contracts and agreements.
reasonable net, redundant / deficient gross language
Make a reasonable provision for all net unpaid loss and loss
adjustment expense obligations of the Company under the
terms of its contracts and agreements, but a deficient [or
redundant] provision on a gross of reinsurance basis. The
provision for all gross unpaid losses and loss adjustment
expenses is $X less than [or greater than] the minimum [or
maximum] amount I consider necessary to be within the range
of reasonable estimates.
What should a qualified opinion include?
items to which qualifications relate
amounts qualified
reasons for qualification
an opinion on the remaining reserves
2 examples where an opinion is not qualified even if the actuary doesnt review a segment
-that segment is not material to total reserves
-actuary reviews anothers analysis on material reserves and determines that it produces reasonable result (no independent analysis)
- should disclose whether they reviewed and the extent of the
review
Qualified reserves language (beginning statement)
In my opinion, with the qualification that it does not include the
[identify the item(s) to which the qualification(s) relate(s)], the
amounts carried in Exhibit A on account of the items identified:
Qualified reserves language (ending statement)
The Company’s management has informed me that the reserves
listed in Exhibit A include $X (x.x%) on a net of reinsurance basis,
and $Y (y.y%) on a direct and assumed basis, for [item(s) to which
the qualification(s) relate(s)]. I did not include in my review an
evaluation of the reserves related to [item(s) to which the
qualification(s) relate(s)] because there was not sufficient
information available for me to assess the reasonableness of those
reserves. Thus, this is a qualified statement of actuarial opinion.
What should an actuary consider when theres a lack of relevant data?
- Whether there exists adequate data to evaluate the reserves;
- If industry data or another company’s data were used, whether there is reason to believe that these data are likely to be reasonably similar to the data patterns of the company for which the Appointed
Actuary is rendering an SAO; - Whether to provide disclosures concerning the data used
- Whether to provide disclosures concerning the resulting variability and uncertainty.
No opinion language
The ABC Insurance Co. commenced operations in 20XX. Therefore, the Company has only been in business for Y years and, as a result, does not, in my opinion, have sufficient historical experience upon which to
base a reliable actuarial estimate of the loss and loss adjustment
expense reserves as of Dec. 31, 20XX. I am not aware of appropriate
external data upon which to base an estimate.
What are some items seen in Item 6 of Exhibit A (other reserves in scope)
-accrual for DDR in claims-made policies if recorded as a loss reserve instead of UEPR
-WC discount
-retroactive ceded reserves
-contingent liabilities
P&C long-duration contracts definition
contracts which are not….
mortgage guaranty, financial guaranty, or surety
that are both > 13 months and can’t be cancelled nor subject to any premium increases (during contract term)
subject to the 3 tests outlined in SSAP 65
mainly extended warranty contracts
If an actuary makes use of a persons analysis not within their control for a material portion, what should they do?
if actuary: note name, affiliation and credentials
if non-actuary: note name, affiliation, and type of analysis
IN OPINION PARAGRAPH and only if reasonable to do so
also disclose if a review was performed, the extent of the review (of their analysis)
What should the AA consider in determining whether or not to use anothers analysis?
a. The amount of the reserves covered by another’s analyses or opinions in comparison to the total reserves subject to the actuary’s opinion;
b. The nature of the exposures and coverage;
c. The way in which reasonably likely variations in estimates covered by another’s analyses or opinions may affect the actuary’s opinion on the total reserves subject to the actuary’s opinion
d. The credentials of the individual(s) that prepared the analyses or opinions.
Illustrative language for another actuarys work (in opinion paragraph)
The Company participates in the [name of underwriting pool] (“the
Pool”). In forming my opinion, I made use of the analysis and opinion
issued by [Name of Actuary], MAAA, FCAS, Chief Actuary for the Pool,
regarding reserves held by the Company for the Pool.
ASOP 36 required disclosures (in addition to Exhibit B disclosures)
- The intended user(s) of the SAO
- The intended purpose of the SAO
- The stated basis of reserve presentation
- Whether any material assumption or method was prescribed by applicable law
- Whether the Appointed Actuary disclaims responsibility for any material assumption or
method selected by another party
What should the relevant comments risk factors not include?
general, broad statements about risks and uncertainties due to economic changes, judicial decisions, regulatory actions, political or social forces, not required to be exhaustive either
examples of company-specific risk factors (required to disclose, even if no RMAD)
COVID
A&E
mass torts
cyber liability
cats
high excess layers
supply chain disruption
soft/hard market impacts
change in adequacy of case reserves
rapid growth / new products
lack of data
examples of combinations of risk factors that may influence RMAD
➢ Rapid growth during a soft market in a line of business in which the company has limited
historical experience
➢ Risk of adverse medical inflation on a large book of excess workers’ compensation business
➢ Risk of increased sustained unemployment, along with reductions in home prices on a mortgage
insurance book of business
➢ Significant shifts upward in policy limits and attachment points sold, along with a reduction in
reinsurance protection purchased
Risk factor illustrative language (inherently uncertain…)
Actuarial estimates of property and casualty loss and loss adjustment
expense reserves are inherently uncertain because they are dependent
on future contingent events. Also, these reserve estimates are generally
derived from analyses of historical data, and future events or conditions
may differ from the past. The actual amount necessary to settle the
unpaid claims may therefore be significantly different from the reserve
amounts listed in Exhibit A.
What key components should the paragraph on material adverse deviation include?
description of major factors underlying risks / uncertainties
the materiality standard and its basis
statement on whether RMAD exists
choices for a materiality standard
- Percentage of surplus
- Percentage of reserves
- The amount of adverse deviation that would cause surplus
to fall below minimum capital requirements - The amount of adverse deviation that would cause Risk Based Capital (RBC) to fall to the next action level
- Multiples of net retained risk
- Reinsurance considerations, such as levels of ceded
reserves compared to surplus or concerns about solvency
or collectability of reinsurance - The upper limit of a company’s reinsurance protection on
reserve development, if any
What should a 0% pool participant list for items 5,6 in Exhibit A?
$0 and N/A
Brightline Indicator Test
contained in NAIC financial analysis handbook
if actuary doesnt address MAD yet 0.1 x Net loss reserves > TAC - CAL
pursue comments from the actuary on RMAD
Should the materiality standard in Exhibit B pertain to net or gross reserves?
net reserves
if actuary reaches a diff opinion on net /gross, include a relevant comments paragraph on this
Materiality standard language
My Materiality Standard for purposes of addressing the risk of material adverse deviation of the Company’s reserves for unpaid losses and loss adjustment expenses has been established as xx% of the Company’s net loss and LAE reserves, or $X million.
How should SAOs be prepared in reference to anticipated sal / sub?
on the same basis with regard to anticipated salvage and subrogation
as the disclosed basis for the carried loss reserves.
Sal / sub relevant comment language
The Company’s reserves listed in Exhibit A are established net of
anticipated salvage and subrogation. Anticipated salvage and
subrogation disclosed in item 8 of Exhibit B is X% of the Company’s
policyholders surplus.
Do tabular reserves include medical reserves?
No, just indemnity
How would discounting cause a reconciling difference between schedule P and Exhibit A, Item 4 (Gross LAE)?
Schedule P, Part 1 is gross of non-tabular discounts, if D&A reserves include these discounts, they can’t be reconciled
disclose in AOS
What should the actuary do (per ASOP 36), if the SAO relies on material present values?
disclose present values used in forming the opinion
interest rate(s) used by the actuary
amount of monetary discount
4 considerations for an actuary for voluntary / involuntary pools
- Are pool reserves material?
- Does the Company book what the pool reports with no independent analysis, perform independent actuarial analysis and in some instances adjust the pool’s reported reserves, make use of the pool Appointed Actuary’s SAO, or some combination of the above?
- If there is a lag in the booking of pool losses, does the company accrue for this or not? Are premiums treated similarly? Are these items material?
- How does the company’s ceded reinsurance program treat business that comes in from these pools?
Does the SAO include A&E policies specifically written to cover that exposure?
No
for example, doesn’t cover ‘asbestos abatement policies’
and ‘claims-made pollution policies’
Why are traditional actuarial methods (such as squaring triangles) not applied to A&E liabilities?
they often attach multiple AY/PYs
new claim filings continue to arise for several decades after the policies were issued
What are the three possibilities regarding A&E exposure for a company?
- The company has not provided any coverage that could reasonably be expected to produce
material levels of asbestos and/or environmental liability claims activity. - The company has provided coverage that can reasonably be expected to produce material levels
of asbestos and/or environmental liability claims activity that may rise to the level of a RMAD or
combined with other risks significantly contribute to the determination of a RMAD. - The company has provided coverage that can reasonably be expected to produce material levels
of asbestos and/or environmental claims activity, but it is believed unlikely to rise to the level of a
RMAD alone or in combination with other risks of the company.
When may a company have no A&E exposure?
they have never written commercial liability (primary, excess, or assumed)
When may a company have A&E exposure without RMAD?
-already reserved up to policy limits on such policies
-sufficient retroactive reinsurance in place
-mostly personal lines company but wrote a tiny amount of commercial liability
What in particular may the actuary choose to comment on in regard to A&E liabilities?
any material exposure?
$ reserves
variability and uncertainty
whether liabilities are handled by dedicated claims / legal unit
difficulties in providing an actuarial estimate of ultimate
Are the DDR amounts in Exhibit B, 12 the same as Sched. P Interrogatory 1?
No, SAO includes all, S.P only includes those pertaining to medical professional liability (usually the same though)
What needs to be disclosed for A&H LDCs in Exhibit B?
net loss and lae reserves, UEPRs
A&H LDC def
contract whose term is > 13m and contract reserves are required covering A&H exposure
Is the actuary asked to opine on the reasonableness of A&H reserves?
No, the Appointed Actuary is not asked to opine on the reasonableness of the reserves associated
with A&H Long Duration Contracts except to the extent that the reserves are included within the
amounts reported on Exhibit A of the Actuarial Opinion.
What three aspects of reinsurance should the actuary address in the relevant comments?
retroactive, financial, and uncollectible
What should the actuary do to gain knowledge to opine on reinsurance collectability?
solicit info from management on collectability issues
review reinsurer ratings
review Schedule F (overdue reinsurance.. etc)
Notes to financial statements (Reinsurance Note # 23)
RBC R3 credit rating calculation (Schedule F) => reinsurer by credit rating
How should you account for the effect of assumed retroactive reinsurance in your materiality standard?
base it off surplus
Should an actuary evaluate risk transfer to determine if reinsurance contracts should have received deposit accounting?
no, but they should review the company’s procedures for testing risk transfer
especially contracts with “risk limiting features” like with sliding scale commissions
When is the actuary required to include an explanatory paragraph for IRIS ratios 11 - 13?
when 1+ is unusual
if not, a simple sentence is suggested
What does not constitute a change in methods and assumptions for the relevant comments disclosure?
-new methods and assumptions for new reserve segments
-periodic updating of data, factors, or weights
4 possible disclosure types for changes in methods and assumptions
(1) => material change due to distortions affecting old method (paid to reported)
(2) => changes made but unknown materiality
(3) => can’t quantify impact of changes from prior AA
(4) => unable to review the prior AAs work
What aspects of the SAO can COVID-19 impact?
review date
use of anothers work
RMAD / MAD
Reinsurance
company-specific risk factors
risks and uncertainties
changes in methods and assumptions
When may a $0 entry in Exhibit B, 10 be unusual?
for auto / wc carriers because of the common residual markets plans
When should the SAO be considered in error?
if it would not have been issued or materially altered had the correct data or info been used
not in error if changes based on events subsequent or because actual didnt equal expected results
What is the procedure for when an SAO has been issued in error (before 12/31 of the filing year)?
-AA notifies BOD or audit committee in 5 days with summary of findings and amended SAO
-within 10 days company forwards this to dom com and notifies AA
-if actuary doesnt receive noti, then within 15 days actuary tells dom com new SAO has been finalized
What should the actuary do if when the SAO has been issued in error, can’t determine what changes to make (insurer doesn’t provide support)?
after 10 days have passed proceed with notification to the domiciliary commissioner
What must an insurer do to file for exemption?
submit a letter of intent to the domiciliary commissioner no later than Dec 1 of the CY
they can deny the request prior to dec 31
What is the exemption for small companies?
less than 1M GWP and 1m Gross loss + lae reserves
can submit an affidavit under oath of the insurer
What is the exemption for financial hardship?
If the cost of the SAO > min(1% x surplus, 3% x GWP)
GWP is projected from latest quarterly statement (since done before year-end)
surplus is same as latest quarterly statement
Do the SSAP 65 LDC UEPR tests include investment income and anticipated recoveries?
Only deductible recoveries if they’re properly secured
investment income related to unexpired portion only
they are capped @ companys portfolio or 5 yr treasury bonds
duration is equal to (incurred date - current time)
no limits on sal / sub
Can you perform a reserve analysis for an entire intercompany pool and have that be sufficient for all members?
Yes
When should the SAO of a pool be forwarded by the pool admin to all the members?
By 1/31 or as otherwise agreed upon
If reinsurance treaties that should be financial reinsurance but are not accounted for with deposit accounting what is the consequence?
SAO will UNDERSTATE the risk associated with company’s balance sheet
How does SAP treat prepaid LAE to a TPA / other entities?
can’t reduce LAE reserves => SAP is conservative
What are the 3 fundamental requirements for BODs and audit committees to meet their fiduciary responsibliites for loss reserves?
1) Appointing an actuary who is appropriately qualified to opine on the company’s loss reserves;
2) Understanding the basis for management’s best estimate of loss reserves in relation to the Appointed Actuary’s estimate of unpaid claims;
3) Understanding the drivers of risk and uncertainty in the reserves from the perspective of the Appointed Actuary.
What are the three main types of actuaries and their roles in setting loss reserves?
internal - periodic analyses of reserves to assist management, can present to BODs and ACs
audit firm - external firms can assign actuaries to audit engagement teams, evaluate reasonableness of reserves as a whole (develop range of reasonable)
consulting - can replace internal actuary role
What are some major considerations for those in an oversight function of loss reserves (BOD, AC)?
- Unavoidable use of judgment—input from multiple disciplines
- How actuarial estimates are considered
- Extensive public (and non-public) disclosure
- Variability and uncertainty in the loss reserves
- Quality of data and the impact on loss reserve uncertainty
- Context of the reserves
- Impact and collectability of ceded reinsurance
- Governance (control) structure around the company’s loss reserving process
Questions BOD / AC might have on how actuarial estimates are considered
- Does management’s process typically result in differences between the actuary’s estimates and the recorded amounts, and, if so, why?
- How do management’s estimates compare to a range of estimates that may be developed by the actuary? How has management’s position within the actuarial range changed over time and why?
- Has due diligence been performed to identify the potential impact, if any, on the loss reserve estimates of any significant recent changes in the company’s operations (e.g., claims, underwriting, reinsurance)?
- Has the impact of changes in the market or economic activity been properly factored into the analysis with consideration specific to line of business?
What are the internal controls for loss reserves?
segregation of duties (avoid conflicts of interest bw pricing & reserving)
internal audit
actuarial peer review
reserving committees
actuary reports to BOD / management on loss reserve opinion
What are the external controls for loss reserves?
external audit
attestations => required by NAIC for larger insurers on control structure, public companies via Sarbanes-Oxley
financial exams by regulators
replacement of AA
qualification documentation
Signs of undue management influence on loss reserves
- The actuary is not provided with comprehensive information on potentially emerging problem areas (e.g., newer coverages with adverse experience).
- Information is provided late to the actuary, leaving inadequate time to properly incorporate into their analysis.
- The actuary is denied access to certain individuals at the company who may respond to specific questions or provide corroboration of other information obtained.
- Management makes clear to the actuary that his/her continued employment is contingent upon agreement with management’s viewpoint on reserve estimates.
- The opining actuary is replaced, and the new actuary immediately agrees with management’s position.
