SECOND STOP LOSS DATA CALL

# STATE OF NEW MEXICO ## OFFICE OF SUPERINTENDENT OF INSURANCE Superintendent of Insurance John G. Franchini - (505) 827-4299 Deputy Superintendent Robert Doucette - (505) 827-5832 [LOGO] P.O. Box 1689 Santa Fe, NM 87504-1689 1120 Paseo de Peralta Santa Fe, NM 87501 Bulletin 2016-018 August 22, 2016 TO: MEDICAL STOP LOSS COVERAGE PROVIDERS FROM: JOHN G. FRANCHINI, SUPERINTENDENT OF INSURANCE DATE: AUGUST 22, 2016 RE: SECOND STOP LOSS DATA CALL FILED 2016 AUG 22 AM 11 OF INSURANCE OFFICE OF This Bulletin is issued pursuant to Sections 59A-2-8 NMSA 1978 of the New Mexico Insurance Code, 13.1.2 et seq. NMAC. The New Mexico Office of Superintendent of Insurance (OSI) is conducting a second survey to obtain New Mexico-specific data on medical stop loss insurance coverage information. New Mexico's Insurance Code grants the OSI the authority to regulate medical stop loss coverage. Pursuant to this statute and the superintendent's authority to conduct market surveys and inquiries under 59A-4-3 NMSA 1978, the OSI requires insurance carriers selling medical stop loss coverage in New Mexico in 2014 and 2015 to answer the survey questions contained in the spreadsheet "second stop loss survey.xlsx" by Friday, September 30, 2016. The spreadsheet, a printout of which is attached, is available on OSI's website at http://osi.state.nm.us/LifeHealthFiling/index.aspx. Please contact Alan Seeley at alan.seeley@state.nm.us if you have any questions about this Bulletin or the survey. DONE AND ORDERED on this 22nd day of August, 2016. OFFICE OF SUPERINTENDENT OF INSURANCE JOHN G. FRANCHINI ey.xlsx" by Friday, September 30, 2016. The spreadsheet, a printout of which is attached, is available on OSI's website at http://osi.state.nm.us/LifeHealthFiling/index.aspx. Please contact Alan Seeley at alan.seeley@state.nm.us if you have any questions about this Bulletin or the survey. DONE AND ORDERED on this 22nd day of August, 2016. OFFICE OF SUPERINTENDENT OF INSURANCE JOHN G. FRANCHINI | New Mexico Office of Superintendent of Insurance | | --- | | STOP LOSS SURVEY | | Stop loss insurer: | | | Name of company contact for survey: | | | Phone for company contact for survey: | | | Email for company contact for survey: | | | | Add columns for more plans, if needed | | Provide the following information for each New Mexico plan that the company insured where the policy year ended in 2015: | Plan 1 | Plan 2 | Plan 3 | | | Policy effective date | | | | | | Policy expiration date | | | | | | Average number of covered employees | | | | | | Premium for aggregate stop loss coverage | | | | | | Premium for specific stop loss coverage | | | | | | Total premium for policy | | | | | | Aggregate attachment point, in dollars, based on actual policy year exposures | | | | | | Individual attachment point, in dollars | | | | | | Second individual attachment point (if any), in dollars | | | | | | Add rows here for additional individual attachment points, if needed. | | | | | | Are there any other claim-triggering specifications, e.g premium for policy | | | | | | Aggregate attachment point, in dollars, based on actual policy year exposures | | | | | | Individual attachment point, in dollars | | | | | | Second individual attachment point (if any), in dollars | | | | | | Add rows here for additional individual attachment points, if needed. | | | | | | Are there any other claim-triggering specifications, e.g. aggregating-individual, tiered attachment? | | | | | | If you answered "yes," please describe: | | | | Expected dollar amount of claims (per covered employee) to be incurred by plan, that was used in pricing the policy | | | | | | Total dollar amount of claims that stop loss insurer incurred because individual attachment points were breached | | | | | | Total dollar amount of claims that stop loss insurer incurred because aggregate attachment point was breached | | | | | | Total dollar amount of claims that stop loss insurer incurred on the policy | | | | | | The policy provides stop loss coverage for claims by the plan during the policy period: | | | | | | Fill in the blank with one of the following: paid; incurred; reported; other | | | | | | If you entered "other," please describe: | | | Submit completed survey to Alan Seeley at alan.seeley@state.nm.us |