Survey of 1992 Accident and Health Experience

[LOGO] DEPARTMENT OF INSURANCE STATE OF NORTH DAKOTA Glenn Pomeroy Commissioner of Insurance # BULLETIN 93-2 TO: All Companies Writing Accident and Health Insurance Coverage FROM: Glenn Pomeroy, Commissioner DATE: June 4, 1993 SUBJECT: Survey of 1992 Accident and Health Experience Enclosed is a request for information form. The North Dakota Legislative Assembly established a new small employer insurance program this session (House Bill No. 1504). One of the requirements under this legislation is to collect data on small employer group policies. This information will be used to establish the assessments necessary to fund the reinsurance pool, as stipulated in the legislation. In addition to the small employer information, the Department requests similar data for other policy categories. This information will be utilized for other public policy projects underway. The data requested pertains to 1992 year-end figures for accident and health insurance for the State of North Dakota only. If your company does not have accident and health business in North Dakota, please return this form marked "NONE". If your company only reinsures accident and health business in North Dakota, please return this form marked "REINSURANCE ONLY". Thank you for your assistance. Please return the data to the North Dakota Insurance Department by June 21, 1993. If questions arise, contact Vance Magnuson at 224-4977. GP/njb Enclosure 600 EAST BOULEVARD • BISMARCK, ND 58505 • (701) 224-2440 Consumer Hotline: 1-800-247-0560 # 1992 ACCIDENT & HEALTH EXPERIENCE FOR NORTH DAKOTA COMPANY CONTACT PERSON NAIC CO. CODE NO. TELEPHONE NO. SECTION 1--SMALL EMPLOYER GROUP COVERAGE ONLY* as of 12/31/92 | | Written Premium | Earned Premium | Claims Paid | Claims Incurred | No. of Groups | No. of Enrollees | | --- | --- | --- | --- | --- | --- | --- | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | . TELEPHONE NO. SECTION 1--SMALL EMPLOYER GROUP COVERAGE ONLY* as of 12/31/92 | | Written Premium | Earned Premium | Claims Paid | Claims Incurred | No. of Groups | No. of Enrollees | | --- | --- | --- | --- | --- | --- | --- | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | * Small employer is defined as "any person actively engaged in business, that on at least fifty percent of its working days during the proceeding calendar quarter, employed at least 3 but no more than 25 eligible employees, the majority of whom were employed within this state. In determining the number of eligible employees, companies that are affiliated companies, or that are eligible to file a combined tax return for purposes of state taxation, must be considered one employer". SECTION 2--OTHER TYPES OF COVERAGE as of 12/31/92 | | Written Premium | Earned Premium | Claims Paid | Claims Incurred | No. of Policies/ Certif. | No. of Insured Lives** | | --- | --- | --- | --- | --- | --- | --- | | ACCIDENT/ACCIDENTAL DEATH/DISABILITY | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | CANCER/SPECIFIED DISEASE | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | 1992 ND EXPERIENCE tion 2 continued Page 2 as of 12/31/92 __ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | CANCER/SPECIFIED DISEASE | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | 1992 ND EXPERIENCE tion 2 continued Page 2 as of 12/31/92 | | Written Premium | Earned Premium | Claims Paid | Claims Incurred | No. of Policies/ Certif. | No. of Insured Lives** | | --- | --- | --- | --- | --- | --- | --- | | CHAMPUS SUPPLEMENT | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | CREDIT ACCIDENT & HEALTH | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | DENTAL | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | DISABILITY INCOME | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | EXCESS OR STOP-LOSS | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | HOSPITAL INDEMNITY | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | 1992 ND EXPERIENCE Section 2 continued Page 3 as of 12/31/92 ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | HOSPITAL INDEMNITY | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | 1992 ND EXPERIENCE Section 2 continued Page 3 as of 12/31/92 | | Written Premium | Earned Premium | Claims Paid | Claims Incurred | No. of Policies/ Certif. | No. of Insured Lives** | | --- | --- | --- | --- | --- | --- | --- | | HOSPITAL/SURGICAL EXPENSE | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | LONG-TERM CARE (INCLUDING HOME HEALTH CARE) | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | MAJOR MEDICAL | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | MEDICARE SUPPLEMENT | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | VISION | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | MISCELLANEOUS ACCIDENT & HEALTH | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | GRAND TOTAL*** | ____ | ____ | ____ | ____ | ____ | ____ | INCLUDE DEPENDENTS WHEN DETERMINING LIVES INSURED | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | MISCELLANEOUS ACCIDENT & HEALTH | | | | | | | | Group | ____ | ____ | ____ | ____ | ____ | ____ | | Individual | ____ | ____ | ____ | ____ | ____ | ____ | | Total | ____ | ____ | ____ | ____ | ____ | ____ | | GRAND TOTAL*** | ____ | ____ | ____ | ____ | ____ | ____ | INCLUDE DEPENDENTS WHEN DETERMINING LIVES INSURED SHOULD EQUAL THE ANNUAL STATEMENT STATE PAGE FIGURES