TDI Commissioner's Bulletin B-0034-99
Call for Second Quarter Experience 1999; Call for Second Quarter Experience 1999 Workers Compensation Deductible Plans
June 30, 1999
COMMISSIONER’S BULLETIN NO. B-0034-99
TO
ALL
INSURANCE
COMPANIES,
CORPORATIONS,
EXCHANGES,
MUTUALS,
RECIPROCALS, ASSOCIATIONS, LLOYDS, OR OTHER INSURERS LICENSED TO WRITE
PRIVATE PASSENGER NON FLEET AUTOMOBILE, HOMEOWNERS MULTI PERIL,
WORKERS' COMPENSATION, COMMERCIAL FIRE & ALLIED, COMMERCIAL MULTI PERIL,
GENERAL LIABILITY, BOILER & MACHINERY, COMMERCIAL CRIME, COMMERCIAL
GLASS, MEDICAL PROFESSIONAL LIABILITY OR MISCELLANEOUS PROFESSIONAL
LIABILITY IN THE STATE OF TEXAS
RE:
CALL FOR SECOND QUARTER EXPERIENCE - 1999
CALL FOR SECOND QUARTER EXPERIENCE - 1999 - WORKERS’
COMPENSATION DEDUCTIBLE PLANS
The attached mandatory calls are being issued pursuant to Article 1.24 of the Texas Insurance
Code. This information is the basis for a report required under Article 5.13-2, Section 5(e) of the
Texas Insurance Code, for submission to the Governor and certain members of the Texas
Legislature. These calls are designed to provide the Texas Department of Insurance with
immediate access to market condition information.
These calls must be completed and returned in accordance with the instructions by not later than
August 15, 1999. Underlying data, individual source documents and other information
utilized in the development of your call response must be maintained in your records for a
minimum of three years after August 15, 1999.
Failure to comply with the requirements of this call within the time limits specified may constitute a
violation or violations of the Texas Insurance Code and may subject the insurer to the penalties
provided by law.
Please make copies of this package and submit separate forms for each company in your
group that is licensed for one or more lines of business covered in these data calls. The
forms for the Quarterly Call for Experience also can be accessed and downloaded via the
Internet at www.tdi.state.tx.us.
Questions concerning this call should be directed to Vicky Knox at the Texas Department of
Insurance at (512) 475-1879.
_______________________
Clare Pramuk
Director, Data Services
Technical Analysis
Attachments
CALL FOR SECOND QUARTER EXPERIENCE - 1999
Due August 15, 1999
Instructions:
1. This call must be completed on an individual carrier basis. Make copies and submit
separate forms for each company in your group that is licensed to write one or more lines of
business covered in this data call. Group reporting is not allowed. Enter Carrier Name and
Carrier NAIC Number on the report form along with the name and telephone number of the
carrier contact person.
2. Reported experience should be valued as of 06/30/99.
3. If a company has no experience to report, "NONE" should be stamped on the form and the
affidavit should be completed.
4. Direct Policies Written (column (1)) are defined as Texas new and renewal policies issued
by the carrier acting as the primary carrier. An adjustment for cancellations should be made
only if the policy is issued and canceled in the same quarter. There should be no
adjustment for policies assumed or ceded. Reported policies should be adjusted to an
annual basis (a twelve month policy should be reported as 1.0 policy; a six month policy
should be reported as 0.5 policies.)
Use the accounting date, rather than the policy effective date, to determine the calendar
quarter in which a policy is to be reported.
For Private Passenger Automobile policies that include both liability and physical damage
coverage, report a policy for each.
For Workers' Compensation, use an annual premium to determine the premium size
category in which the policy is to be reported (a six month policy with a premium of $4,000
should be reported as 0.5 policies in the $5,000 - $100,000 category.) Report small
premium policy plan risks as voluntary risks.
For General Liability policies that include both products and premises operations coverage,
report a policy for each.
Commercial Multiple Peril experience should include Fire & Allied and Casualty coverage.
Miscellaneous
Professional
Liability
should
exclude
accountants,
architects,
beauticians/barbers, lawyers, medical laboratory personnel, psychologists, real estate
agents, surveyors, and x-ray lab personnel.
5. Total Premiums on Direct Policies Written This Period (column (2)) are defined as total
policy premiums on the policies reported in column (1). Do not include premiums from any
transaction on a policy issued prior to 04/01/99 or after 06/30/99. Report total policy
premium (estimate if necessary) even if initial premium collected was a deposit or first
installment premium. On multi-state policies, report only the Texas portion. Amounts
reported in this column are not expected to balance to Texas Statutory Page 14 of the
annual statement.
6. Total Direct Premiums Written This Period (column (3)) and Total Direct Losses Paid This
Period (column (4)) should be completed using the same methods/rules used in completing
the Texas Statutory Page 14 of the annual statement. This includes any premium
transaction that occurred during the quarter (i.e., cancellations, endorsements, retro
adjustments, etc.) and any direct losses paid during the quarter regardless of when the
policy was written or when the accident occurred.
7. Additional calls will be issued as experience for subsequent calendar quarters becomes
available. Such calls will be due approximately 45 days after the end of the quarter.
8. The affidavit on the reverse side of the report form must be signed by the highest ranking
company official with management and control authority over the development of the
reported information. The affidavit must be notarized and the original must be submitted.
9. If a TDI acknowledgment of receipt is desired, include a stamped, self addressed envelope
and an additional copy of the call report which will be date stamped and returned.
Mail the completed call form and affidavit to:
Texas Department of Insurance
Attn: Vicky Knox (MC105-5D)
P. O. Box 149096
Austin, Texas 78714-9096
Express mail may be sent to:
Texas Department of Insurance
Attn: Vicky Knox (MC105-5D)
333 Guadalupe
Austin, Texas 78701
Questions concerning this call should be directed to Vicky Knox
Texas Department of Insurance - phone (512)475-1879, fax (512)463-6122
TEXAS CALL FOR SECOND QUARTER EXPERIENCE - 1999
Due August 15, 1999
Carrier Name
Carrier NAIC Number
Contact Person
Telephone Number
(1)
Number of
Direct
Policies
Written This
Period
(2)
Total
Premiums on
Direct
Policies
Written This
Period
(3)
Total
Direct
Premiums
Written This
Period
(4)
Total Direct
Losses Paid
This Period
(Deducting
Salvage)
For the Period 04/01/99 – 06/30/99
1. Private Passenger Non Fleet Automobile
a. Voluntary Liability & No Fault
b. Assigned Risk Liability & No Fault
c.
Physical Damage
2. Homeowners Multiple Peril
3. Workers' Compensation
a. Voluntary Policies with
Annual Written Premium of
Less Than $5,000
XXX
XXX
b. Voluntary Polices with
Annual Written Premium of
$5,000 - $100,000
XXX
XXX
c.
Voluntary Policies with
Annual Written Premium of
More Than $100,000
XXX
XXX
d. Total Voluntary
e. Total Assigned Risk
XXX
XXX
4. Commercial Fire & Allied
5. Commercial Multiple Peril
6. General Liability
a. Product Liability
b. Other General Liability
7. Boiler and Machinery
8. Commercial Crime
9. Commercial Glass
10. Miscellaneous Professional Liability *
11. Medical Professional Liability
* Excluding accountants, architects, beauticians/barbers, lawyers, medical laboratory personnel,
psychologists, real estate agents, surveyors, and x-ray lab personnel.
A F F I D A V I T
THE STATE OF
COUNTY OF
I, , the (position)
of the
being duly sworn, deposes and says that all of the information of the named Company
contained herein, together with any necessary related exhibits, schedules and explanations
contained, annexed or referred to are a full and true statement in accordance with the
instructions provided according to the best of my information, knowledge and belief.
Signature
SUBSCRIBED AND SWORN TO BEFORE ME this the ___ day of ________________, 19___.
Notary Public
(Printed Name of Notary)
My Commission Expires:
Call For Second Quarter Experience - 1999
Workers' Compensation Deductible Plans
Due August 15, 1999
Instructions:
1. This call must be completed on an individual carrier basis along with the Call For Second
Quarter Experience. Make copies and submit separate forms for each company in your
group that is licensed to write Workers' Compensation. Group reporting is not allowed.
Enter Carrier Name and Carrier NAIC Number on the report form along with the name and
telephone number of the carrier contact person.
2. Reported experience should be valued as of 06/30/99.
3. If a company has no experience to report, "NONE" should be stamped on the form and the
affidavit should be completed.
4. Complete each deductible plan as applicable for the voluntary portion of the Workers'
Compensation market only.
Direct policies written (column (1)) are defined as Texas new and renewal policies issued by
the carrier acting as the primary carrier. An adjustment for cancellations should be made
only if the policy is issued and canceled in the same quarter. There should be no
adjustment for policies assumed or ceded. Reported policies should be adjusted to an
annual basis (a twelve month policy should be reported as 1.0 policy; a six month policy
should be reported as 0.5 policies.)
Use the accounting date, rather than the effective date, to determine the calendar
quarter in which a policy is to be reported.
Use an annual premium prior to deductible credit (column (2)) to determine the premium
size category in which the policy is to be reported (a six month policy with a premium of
$4,000 should be reported as 0.5 policies in the $5,000 - $9,999 category for the appropriate
plan.)
5. Estimated Annual Premiums on Direct Policies Written This Period Prior To Deductible
Credit (column (2)) are defined as total policy premiums on the policies reported in column
(1) before any credit is given for the purchase of deductible plan. Do not include
premiums from any transaction on a policy issued prior to 04/01/99 or after 06/30/99.
Report total policy premium even if initial premium collected was a deposit or first installment
premium. On multi-state policies, report only the Texas portion.
6. Estimated Annual Premiums on Direct Policies Written This Period After Deductible Credit
(column (3)) are defined as total policy premiums on the policies reported in column (1) after
a credit is given for the purchase of deductible plan. Do not include premiums from any
transaction on a policy issued prior to 04/01/99 or after 06/30/99. Report total policy
premium even if initial premium collected was a deposit or first installment premium. On
multi-state policies, report only the Texas portion.
7. For policies that are not eligible for or did not purchase a deductible plan, section 5, No
Deductible Plan, should be completed. The annual premium for policies reported in column
(1) should be entered in column (3).
8. Question 6a., column (1) of this report should be equal to question 3d., column (1) of the
Call For Second Quarter Experience.
9. Question 6a., column (3) of this report should be equal to question 3d., column (2) of the
Call For Second Quarter Experience.
10. Additional calls will be issued as experience for subsequent calendar quarters becomes
available. Such calls will be due Approximately 45 days after the end of the quarter.
11. If a TDI acknowledgment of receipt is desired, include a stamped, self addressed envelope
and an additional copy of the call report which will be date stamped and returned.
Mail the completed call form and affidavit to:
Texas Department of Insurance
Attn: Vicky Knox (MC105-5D)
P. O. Box 149096
Austin, Texas 78714-9096
Express mail may be sent to:
Texas Department of Insurance
Attn: Vicky Knox (MC105-5D)
333 Guadalupe
Austin, Texas 78701
Questions concerning this call should be directed to Vicky Knox
Texas Department of Insurance - phone (512)475-1879, fax (512)463-6122
Call For Second Quarter Experience - 1999
Workers' Compensation Deductible Plans
Due August 15, 1999
______________________________________
Carrier Name
_____________________________________
NAIC Number
_____________________________________
Contact Person
_____________________________________
Telephone Number
(1)
Number of Direct
Policies Written This
Period
(2)
Estimated Annual
Premium on Direct
Policies Written This
Period Prior To
Deductible Credit
(3)
Estimated Annual
Premium on Direct
Policies Written This
Period After
Deductible Credit
For the Period 04/01/99 – 06/30/99
1. Per Accident Deductible Plan
a. Premium of $5,000 - $9,999...................
b. Premium of $10,000 - $24,999...............
c. Premium of $25,000 - $49,999...............
d. Premium of $50,000 - $74,999...............
e. Premium of $75,000 - $100,000.............
f. Total 'Per Accident' Plan.....................
2. Aggregate Deductible Plan
a. Premium of $5,000 - $9,999...................
b. Premium of $10,000 - $24,999...............
c. Premium of $25,000 - $49,999...............
d. Premium of $50,000 - $74,999...............
e. Premium of $75,000 - $100,000.............
f. Total 'Aggregate' Plan.........................
3. Per Accident/Aggregate
Combination Deductible Plan
a. Premium of $5,000 - $9,999...................
b. Premium of $10,000 - $24,999...............
c. Premium of $25,000 - $49,999...............
d. Premium of $50,000 - $74,999...............
e. Premium of $75,000 - $100,000.............
f. Total 'Combination' Plan.....................
4. Negotiated Deductible Plan
a. Premium Up To $100,000.....................
b. Premium of $100,001 - $150,000...........
c. Premium of $150,001 - $250,000............
d. Premium of $250,001 - $350,000...........
e. Premium of $350,001 - $500,000...........
f. Premium of $500,001 - $750,000...........
g. Premium of $750,001 - $1,000,000........
h. Premium of $1,000,001 - $2,500,000......
i. Premium of $2,500,001 - $5,000,000......
j. Premium of $5,000,001 and above.........
k. Total 'Negotiated' Plan........................
Continued on back
(1)
Number of Direct
Policies Written This
Period
(2)
Estimated Annual
Premium on Direct
Policies Written This
Period Prior To
Deductible Credit
(3)
Estimated Annual
Premium on Direct
Policies Written This
Period After
Deductible Credit
5. No Deductible Plan
a. Premium Less Than $5,000...................
xxx
b. Premium of $5,000 - $9,999...................
xxx
c. Premium of $10,000 - $24,999...............
xxx
d. Premium of $25,000 - $49,999...............
xxx
e. Premium of $50,000 - $74,999...............
xxx
f. Premium of $75,000 - $100,000.............
xxx
g. Premium Greater Than $100,000...........
xxx
h. Total 'No Deductible' Plan..................
xxx
6. TOTAL
a. Sum of 1f, 2f, 3f, 4k and 5h...................