Alaska Small Employer Insurance Activity Report

BULLETIN 98-01 To: All Alaskan Health Care Insurers Re: Alaska Small Employer Insurance Activity Report Our records indicate that you are licensed to transact health insurance in Alaska. Pursuant to AS 21.56.075, all insurers licensed to transact health insurance in Alaska who offer a health care insurance plan must submit the information indicated on the attached Alaska Small Employer Health Insurance Activity Report to the director by March 15 of each year. The first report covering calendar year 1997 is due no later than March 15, 1998. Among other purposes, this report will be used to determine your company's share of the Alaska Small Employer Health Reinsurance Association's assessment base. It will also be used by the association to report to the Alaska Legislature and the Director on the effectiveness of Alaska's small employer health insurance reforms and to compare the effectiveness of Alaska's small employer reforms with other states and regions in the country. Please submit the required information on a copy of the attached activity report and contact person's information no later than March 15 each year to: Director State of Alaska Department of Commerce & Economic Development Division of Insurance 3601 C Street, Suite 1325 Anchorage, Alaska 99503 Date: February 2, 1998 Marianne K. Burke Director of Insurance 1997 ALASKA SMALL EMPLOYER HEALTH INSURANCE CALENDAR YEAR 1997 ACTIVITY REPORT IMPORTANT Return no later than March 15, 1998 to: Director State of Alaska Department of Commerce & Economic Development Division of Insurance 3601 C Street, Suite 1324 Anchorage, Alaska 99503 1. Administrative: a. Carrier name: b. Carrier contact name: Title: Phone: Address 2. Total Accident & Health Insurance Premium Total 1997 Accident & Health Insurance Premium Written in Alaska $ _______________ 3. Inforce: a. Number of policies active as of 12/31/97 _______________ b. Monthly earned premium based on 12/97 billing $ _______________ c. 1997 calendar year earned premium $ _______________ d. Number of insured employees, based on 12/97 billing _______________ e. Number of insured lives (including dependents) based on 12/97 billing _______________ 4. New Business: a. Number of policies that became effective in 1997 _______________ b. Monthly earned premium, based on 12/97 billing for policies that became effective in 1997 $ _______________ c. 1997 Calendar year earned premium for policies that became effective in 1997 $ _______________ d. Number of insured employees, based on 12/97 billing for policies that became effective in 1997 _______________ e. Number of insured lives (including dependents) based on 12/97 billing for policies that became effective in 1997 _______________ 5. Cancellations: a. Number of policies that canceled coverage in 1997 _______________ b. Monthly earned premium, based on 1/97 billing for policies that canceled coverage in 1997 $ _______________ c. 1997 calendar year earned premium for policies that canceled coverage in 1997 _______________ d. Number of insured employees, based on 1/97 billing for policies that canceled coverage in 1997 _______________ e. Number of insured lives (including dependents) based on 1/97 billing of policies that canceled coverage in 1997 _______________