Insurance Consulting Archives - Page 2 of 3

California PPA Rate Filing Moratorium: What Should Insurers Do?

As loss ratios for personal auto continue to climb in California, insurers are experiencing significant pressure to raise their rates. Frequencies have been increasing from the lows hit during the pandemic and severities trends are at levels not seen for decades – both of which are pushing loss costs above levels seen pre-pandemic. At the same time, the California Department of Insurance (“CDI”) has a rate filing moratorium on any increases for personal auto and has not approved any personal auto rate increase for over two years.

Many companies feel their hands are tied and there is nothing that can be done until the moratorium is lifted by the CDI. However, according to our actuarial consulting experts, there are several options available to insurers when it comes to addressing a needed rate change for personal auto in California.

Submitting a rate filing during the rate freeze

There is no debate that the pandemic has had an impact on personal auto. Behind the scenes, the CDI has been evaluating the most recent data available from insurers to determine the impact of the pandemic and how this should be addressed in personal auto rate filings. At this moment, the CDI has given no indication as to when they will complete their review. As a result, most companies are not spending the effort required to prepare and submit a rate increase filing for personal auto in California, which the CDI will just put on hold.

Over the last several years, the average time to approval for a rate filing in California has been steadily increasing and the problem has been made worse by a staffing shortage at the CDI. Prior to COVID-19, it took an average of 150 days to receive approval on rate increase filings for personal auto and homeowners – both of which are heavily regulated lines of business in California. Now, it is taking over 300 days to receive approval on rate filings for homeowners. Part of the reason for the lengthy review is that every rate filing for homeowners needs to be reviewed by upper management including the insurance commissioner. It is not unreasonable to anticipate the same treatment for personal auto. Which means if you submit a rate filing today, it might take a year to receive the approval. Any company that has adopted the “wait and see” approach and is taking no actions on their personal auto program will likely have subpar results in the next year and may be playing catch up for multiple years.

Several of the top 20 carriers have recently filed for rate increases on their California personal auto programs including the following companies: GEICO, Interinsurance Exchange of the Auto Club, Mercury, Progressive, Infinity and Wawanesa. The filings for these companies show strong support for a rate increase. Does this mean the CDI will start approving rate increases for personal auto soon? Nobody really knows the timing on this – the insurance commissioner will likely err on the side of keeping the rates low for consumers. However, eventually the freeze on rate increases will be lifted and the companies that have already filed will be first in line to receive approvals on rate increases. If an insurer anticipates needing a rate increase for personal auto within the next year in California and has not started the rate filing process, it is time to get moving on this.

Filing for a variance

Most insurers have not submitted a rate increase filing because they do not have sufficient data to support an increase using the CDI ratemaking methodology. For companies that do not have credible data in the last 12-months, the CDI requires multiple years of data, which includes the period impacted by the pandemic. Furthermore, the premium and loss trend calculations required by the CDI require at least 12-quarters of data and will also be impacted by the pandemic. As a result, a rate filing for personal auto may need a variance on the loss and premium trend. Filings for variances must make public notice, so it is important to include this in the initial filing or there could be delays in the approval of the filing.

When preparing a rate filing, our actuarial consulting experts recommend that insurers review recent competitor rate filings, which have valuable information, including their request for variances. Several of the large carriers have submitted filings with fully credible data for the last 12 months. For companies that do not have credible data, the trend data in the competitor filings may be helpful – especially given the lag in receiving available industry data. Additionally, the CDI has a COVID-19 questionnaire that is required with every rate filing for the lines of business impacted by the pandemic. The responses to the questionnaire include insight from the filing company on the impact of COVID-19 on their business, which companies may find helpful in preparing their own rate filings. Also, a review of the objections in these filings along with the corresponding responses may assist a company in preparing a filing that more thoroughly addresses all the CDI’s concerns, which will in the end speed up the filing review process.

Waiving or not waiving the deemer

Nowadays, the CDI requests a waiver of the 60-day deemer on virtually all rate filings in order to have more time to review the filing. Insurers have accepted this as part of the rate filing review process and have historically waived the deemer. Companies do have a choice when it comes to waiving the deemer. Most companies believe the filing will be disapproved without the waiver of the deemer, which is not true. If a company decides to not waive the deemer, the CDI’s only option is to issue a notice of hearing or let the filing be deemed approved. Since there is no chance that the CDI will let a rate filing be deemed approved, not waiving the deemer will result in a notice of hearing.

When the deemer has been waived on a filing, the insurer has the option to reactivate the demeer. Wawanesa has chosen to do this with their pending personal auto rate filing, which was submitted December 13, 2021. Since the CDI has a moratorium on rate increases for personal auto and was unable to complete their review of the rate filing before the deemer date, the CDI issued a notice of hearing for the Wawanesa filing on May 3, 2022 stating the following: “the Commissioner is currently still conducting his review of the Application and has not yet sufficient time to determine whether additional information is required or to determine whether the requested rate change is excessive, inadequate, and/or unfairly discriminatory.” The CDI and Wawanesa have subsequently held scheduling conferences and an order has been drafted with the date for the evidentiary hearing.

Many insurers and our actuarial consulting team will be actively following the Wawanesa filing to see how it plays out. The hearing may force the CDI to review the filing and the supporting data within a certain timeframe and determine whether any rate increase is actuarially justified by the company. Other insurers have chosen to waive the deemer on their rate filings and have continued discussions with the CDI with the hopes that the CDI will change its position at some point. Normally, the CDI and insurers want to avoid a hearing and work together to find a solution, which ultimately may have an insurer agreeing to a rate change lower than the filed amount. Depending on the outcome of the Wawanesa hearing, there may be more companies choosing the Wawanesa route and opting for a hearing with the CDI. That said, the CDI may also change its position at some point and start allowing rate increases for personal auto.

Class plan filings are an option

Although the CDI is not currently approving rate filings for personal auto, insurers are able to file and receive approval of revenue-neutral class plan changes. In a time where the rate level on an overall basis may be below target, insurers should be carefully reviewing their class plan and ensuring the rate adequacy is the same across all class risks. Otherwise, companies may see shifts in the mix business into classes that are less adequately priced resulting in a further deterioration of the overall loss ratio on the program. Additionally, insurers can update their auto physical damage model years and add the latest model year through a class plan filing. When submitting the model year filing, our actuarial consulting experts advise insurers to also include the annual symbol filing in the class plan filing.

Use an expert with years of California experience

Having an expert with years of experience preparing personal auto rate filings in California could improve the time to approval and potentially save a company a substantial amount of money. Whether it is preparing the actual rate filing or performing a review of a rate filing prepared by the company, an expert can provide guidance that will increase the chance of having the most successful filing.

Perr&Knight is a leading provider of actuarial and state filing services to insurers in California. Our actuarial consulting team actively follows the California market and is very familiar with all the filing requirements in the state. We prepare and submit more California filings than any other company. Our actuarial consulting experience includes expert testimony on rating filings and providing guidance to industry associations.

Please contact us for any insurance filings support that is needed with your California insurance products.

Tips for Adding Flexibility to Your Commercial Lines Rating Plan

by Michael Covert

Every company writing commercial insurance products needs flexibility in its filed rates in order to charge the appropriate premium. There are many different types of rating flexibilities in the commercial lines insurance marketplace for admitted state filings, but the terminology is somewhat confusing and is often misunderstood. In this summary, we describe each main type of rating flexibility and provide a clearer definition based on our experience with the various Departments of Insurance (“DOI”s) and lines of business.
With some exceptions, commercial lines rates and rules are subject to the DOI’s state filings and approval requirements, similar to personal lines. Commercial lines premiums must also be calculated in compliance with filed rates and rules.
However, commercial lines policy premiums are generally bigger, coverages are more complex, and limits are higher compared to personal lines. As a result, the level of underwriting required for commercial lines is more than personal lines. In addition, risks insured under commercial lines are more heterogeneous, so is difficult for a rating manual to address the rating characteristics of all possible risks. This heterogeneous nature often leads to the need for customized coverage. Also, larger and more sophisticated commercial risks may utilize risk managers to evaluate and mitigate their exposure to loss. To address all of that, commercial lines products require more flexibility in their rating manuals than personal lines.
Incorporating rating flexibilities into a filed commercial lines rate and rule manual can help an insurance company be more competitive, have more accurate premiums and reduce the need for rate filing revisions year over year—saving time and money.
For states that are fully exempt from filing requirements (meaning rates/rules are not required to be filed), companies have more rate flexibility than in states that require filings. Additionally, large risk filing exemptions (which vary by state and are related to number of employees, premium size, etc.) provide companies with greater rate flexibility in determining the appropriate rate for the risk. Below we have addressed the various ways companies add rate flexibility to programs that are filed with the state DOIs.

Schedule Rating Plans

This classic underwriting tool is a table of debits or credits that are applied to the manual rate to reflect the characteristics of an individual insured that are expected to have a material impact on expected loss.
It allows the underwriter to adjust an insured’s premium up or down to recognize that they may be better or worse than the average risk while remaining compliant with the filed rates and rules. Schedule rating is meant to address characteristics of the risk which are generally not otherwise reflected in the rating manual.
Most DOIs allow Schedule Rating plans, but the requirements regarding maximum overall debits and credits, maximums by risk characteristic and minimum premium eligibility vary by state. It is important to be familiar with each state’s requirements to achieve maximum flexibility while remaining compliant.

Ranges of rates

Many states permit ranges of rates within the base rates and rating factors to allow for additional flexibility in a rating plan. Although allowing this flexibility, some states will require underwriting guidance in the rating manual giving some details on how the factors within the range are selected. Note that ranges of rates are allowed in addition to Schedule Rating plans. In combination, they can provide a significant amount of flexibility.

Refer to Company Rating / (a) rates

Refer to company and (a) rating mean the same thing: they tell a DOI in an admitted filing that a particular risk is difficult to price and the premium calculations will be performed internally (generally by an experienced underwriter) and the actual rate will not be filed.
This is also very similar to (and sometimes used interchangeably with) “Individual risk rating”. While most state DOIs allow individual risk rating, the requirements for state filings vary. First, states have different requirements regarding filing the individual risk rating rule—some don’t require a rule be filed at all, others require a simple rule notifying the DOI of an insurer’s intention to individually rate risks, while some require that the manual include specific formulas and/or procedures that will be used to determine the individual risk premium.
States also differ on the documentation or requirements for state filings when an individual risk rating rule is utilized for individual risk. Some require only that the premium calculation be documented in the underwriting file, while others require that the individual premiums be filed with the DOI. There are also some additional reporting requirements in some states. It is important to be familiar with these requirements to ensure your underwriters use this flexible rating tool compliantly.

Guide (a) rates

This term is used less often in the industry and is usually described as a rating plan that has very large ranges of rates and is proposed as a rough “guide” for rating. The final charged rate is not permitted to go outside the bounds of the large ranges included in the rating plan.
Generally, the ranges are so large, it is very similar to (a) rating (described above) but gives a significant amount of additional flexibility when a DOI does not allow a certain section or manual to be completely (a) rated and is looking for some premium boundaries.

Tiering

Another method for adding rating reflexibility is tiering, which typically includes three to five tiers with factors below and above one. Criteria such as experience, financial stability and loss prevention are typically used for each tier to differentiate risk.
Where permitted, tiering can be introduced within a single company (intra-company tiering) and/or across multiple companies in a group (inter-company tiering). Intra-company tiering guidelines are required to be filed in most states, but are rarely required to be filed for inter-company tiering. The criteria used in tiering should generally not overlap with the criteria used in the Schedule Rating Plans or rating plans with ranges of rates to prevent double counting.

Consent to Rate

Once an insurance carrier has an approved filing, many DOIs allow consent to rate filings. These generally require a short form signed by the insured showing the premium they will be charged, which will be some amount above (or below, in a handful of states) the premium calculated from the filed and approved rate. In some states, support is also required for the deviation. Filing approval is generally very quick, which may make this the optimal way to achieve a more appropriate rate for the risk.

Do you need guidance on maximizing the rating flexibilities in your commercial lines rating plans? The state filings experts at Perr&Knight are here to help.

Key Things to Know Before Getting Into the Insurance Business

by Mark Nawrath

Authors: Mark Nawrath, PMP, MBA, and Dean Ferdico
Today’s technology advancements have the potential to transform businesses across industries. Aging systems and increased demand for new and innovative products mean insurance is ripe for disruption, but new solutions are not always as easy to implement as they may seem. Insurance is both complex and highly regulated: a double hit for Insurtech or non-insurance companies looking to break into the space. That said, there are endless opportunities for your company to make major waves in the industry…if you take a careful approach.
Based on our decades of insurance consulting along with our experience helping numerous Insurtech startups over the last several years, here’s what you should know as you break into the insurance market.

The insurance industry is highly regulated

Many of today’s Insurtech companies emerge from the finance world, where modern technology has transformed everything from customer service to the nature of banking itself. While U.S. banking must comply with a single federal charter, insurance products are subject to disparate rules in 51 jurisdictions, multiplied by 20 to 30 lines of business that each has its own individual coverages. The number of details required for each product filing can be staggering and small errors have the potential to stall the filing on the path-to-market.
Partnering with a seasoned insurance technology consulting company with state filings experts enables you to achieve a clear roadmap of what to expect, potential pitfalls, and areas to consider before you get too far along in the product development process. Experienced partners will provide you with a clear understanding of the playing field and help you draft a realistic strategy for rolling out your product.

Add insurance executives to your team

State Departments of Insurance (DOIs) look favorably upon companies with proven histories in insurance. They have no time to teach inexperienced technology companies or non-insurance companies the ins and outs of creating a compliant filing. Bringing a seasoned insurance executive onto your team – and partnering with proven insurance consultants – helps sidestep avoidable regulatory pitfalls and adds instant credibility to your organization in the eyes of the regulators. The same also applies when raising capital. Venture capital firms feel more comfortable investing in firms with experienced in-house teams and insurance consulting experts onboard.

Primary insurers are skittish

Around eight years ago, many primary insurance companies started issuing paper to unproven Insurtech companies – a move that ultimately damaged their standing with state DOIs. Since then, primary insurers (as well as reinsurance companies) are more discerning about with whom they will do business. After all, their reputations and licenses are on the line. This is where working with a seasoned insurance technology consulting company with state filings experts pays off. Having insurance consultants on your team to thoroughly review and pressure-test your proof of concept will help you stand out to primary insurers and reinsurance carriers.

Insurance compliance is full of hurdles

Receiving approval from state DOIs and remaining compliant also means your policy, billings, and claims administration systems must all meet regulatory standards. These standards include everything from how your products are priced to how you advertise to consumers to how data must be reported. Some requirement documents are thousands of pages long, a difficult task to manage for teams short on insurance experience.
Whether you are implementing an Insurtech solution or offering ancillary insurance along with your primary service offerings, insurance product development is a tricky process. Even bureau-based products that lean heavily on Insurance Services Office (ISO) or National Council on Compensation Insurance (NCCI) content are extremely complicated to interpret and adopt in a compliant manner. Seasoned insurance consultants like the team at Perr&Knight know this content and the related regulatory requirements inside and out because we work with them daily.
We help new Insurtech and non-insurance companies understand how to consume the content to develop an insurance product, how to structure the content for systems development and testing, and how to implement a compliant operational process from the outset. Building compliant systems and communications from the ground up protect your company from speed to market issues or costly re-work while avoiding potential fines for your carrier partner.

Use professional “matchmakers”

Primary insurance companies and reinsurers have what Insurtech companies and non-insurance companies need: approved licenses from state DOIs and capacity. Insurtech/non-insurance businesses have what primary carriers are looking for: fresh ideas, technologies, and access to new markets. Both must vet one another, a daunting task if neither company can accurately verify the validity of the other party’s credentials.
Experienced insurance consultants like the team at Perr&Knight can provide an insurance-focused perspective to determine whether the partnership will be beneficial for both parties. Evaluations from unbiased insurance professionals can increase your confidence that your prospective partner can deliver.

The future is full of opportunity

Technology and consumer product development move with lightning speed. Insurance, on the other hand, is extremely sluggish. The merging of these complementary industries opens a plethora of opportunities for proactive companies, but success is never guaranteed. Re-framing your expectations, working with experts, and adopting a calculated approach to your new insurance offerings are the most effective ways to improve your position. Start exploring “what you know you don’t know” with seasoned insurance experts before you get too far down the road.

Considering launching a new insurance product? Talk to the team at Perr&Knight first.

The Time Is Now: The American Rescue Plan’s Impact on Supplemental Health Insurance

by Perr&Knight

If your company hasn’t reviewed your supplemental health products lately, now is the time to refresh your portfolio. The Biden-Harris administration’s American Rescue Plan reduces healthcare costs and expands access to coverage for millions of Americans. The subsidies are technically temporary (in place for 2021-2022), but we anticipate these popular provisions may ultimately remain in place for the foreseeable future, regardless of administration.
The plan provides fresh assurance to individuals buying their or their family’s health insurance through a marketplace that they will receive a premium-reducing tax credit. As more buyers enter the health market, the need for supplemental products will expand. Marketplace-insured Americans may still be facing moderate to significant out-of-pocket costs that supplemental health insurance plans can help alleviate.

Start laying the groundwork

As the supplemental health product marketplace has expanded over the last decade, these products have faced increasing regulatory pushback. Meeting this evolving regulatory challenge requires doing your homework ahead of time. Conducting comprehensive competitive analyses, market surveys, and evaluating existing competitor pricing puts you in a stronger position to release Gap medical and other supplemental health products that match state department of insurance (DOI) requirements directly out of the gate.

Accelerate time-to-market by partnering with experts

There are no shortcuts when it comes to insurance product development, but working with experienced actuaries, product development experts, and state filing experts can help you make up for lost time. Their access to historical filings, knowledge of region-specific requirements, and particulars of each state’s DOI protect you from costly, time-consuming mistakes that are likely to delay approval. Additional support means shifting from a reactive to a proactive position.
At Perr&Knight, we have experience developing limited medical/hospital indemnity plans, gap medical coverage products, and critical illness products that are more relevant – and necessary – to today’s marketplace than ever. We can help you gauge the interest to see if augmenting your portfolio with these products is worth the investment.

Changes are likely here to stay

It’s tempting to “play it safe” and hold off on investing in insurance product development because you believe the ARP’s health insurance provisions will be undone in the event of an administration change. But if the past is any indicator, even politically fraught plans like the Affordable Care Act (ACA) have withstood a barrage of threats, remaining popular with the American people.
As the saying goes, the best defense is a good offense. Failure to begin in earnest means your company is already behind other carriers who have either recently refreshed their portfolios with updated gap medical or other supplemental health products, or those who have started the insurance product development process. The time to get started is now.
Read more: New Trends in Accident & Health Insurance.

Ready to reevaluate the role of supplemental health coverage in your portfolio? Our actuarial and state filings experts are here to help.

Supplemental A&H Group vs Blanket Filings: An Overview

by Perr&Knight

At Perr&Knight, our insurance consultants help many clients develop group and individual supplemental health products. We are often approached by insurance companies with confusion about what group policyholder types to use and where a client should use group vs. blanket. When an employer policyholder is not appropriate, insurance companies look to other group types such as associations, trusts, or discretionary groups.

UNDERSTANDING GROUP POLICYHOLDER TYPES

Many clients want to rely on the outdated practice that, by using association or trust filings, a situs state approval means automatic approvals in other states and rating can be more flexible. While that was once the case, it no longer holds true. As associations became more popular, regulators noted that many of the associations lacked a common purpose and thought that the associations were used primarily to circumvent form and rate requirements.
Associations, trusts and discretionary groups often have to be approved by state regulators before a policy can be issued or, in some circumstances, before policy solicitation. Single case filings for these groups are required more often. Approvals for discretionary groups are particularly difficult to gain when the policyholder/insured relationship is not clear.

GROUP VERSUS BLANKET POLICIES

Another area of confusion is how a blanket policy is different from a group policy. On the surface they appear similar; there is a master policyholder and groups of individuals are covered. However, blanket coverage is usually offered to institutions (e.g. schools or camps) that provide excess or secondary accident/medical coverage to individuals participating in activities under their purview. While a few states require blanket coverage to have underlying certificates (like group), the people covered under these policies are often not aware that they have coverage under a blanket program.

HOW TO CHOOSE BETWEEN GROUP AND BLANKET POLICIES

Depending on the needs of the insurance company, policyholder and the individuals to be insured, insurance companies can utilize either a group or blanket policyholder format. Many jurisdiction handle non-employer groups and blanket programs differently. Some states will provide greater latitude to blanket products than group products simply due to the types of groups that may be insured.
Selecting a group type can be confusing so let our insurance consultants guide you. Our accident & health product development consulting team has ample experience in helping companies find success with non-employer groups.

Contact Perr&Knight today to schedule a consultation.

A&H Insurance Advertising: Rules & Compliance Overview

by Susan Cornett

Advertisements are an integral part of any A&H insurance marketing plan. Insurance companies must find ways to get and keep the attention of a prospective insured. Given that the average American sees more than 4,000 advertisements each day, insurance companies look for creative ways to attract prospective insureds. However, it’s not as simple as writing a clever ad. Insurance companies are subject to various levels of regulation and process requirements.

What is an advertisement?

An advertisement is any material that is published, printed, scripted, or displayed to a consumer. This includes, but is not limited to, postcards, electronic communications, billboards, radio or TV ads, and websites. It can also include sales talks and presentations for use by agents, brokers, producers, and solicitors.
Advertisement includes advertising material sent with a policy when the policy is delivered and material used in the solicitation of renewals and reinstatements. It also extends to the use of all media for communications to the general public, to the use of all media for communications to specific members of the general public, and to the use of all media for communications by agents, brokers, producers and solicitors. The definition of advertisement casts a wide net.

What rules apply?

Insurance advertisements are subject to federal, state, and in some cases, local statutes, regulations, and ordinances. At the federal level, insurance companies must review HIPAA marketing regulations and the CAN-SPAM Act.
The HIPAA regulation defines marketing materials as a communication about a product or service that encourages recipients of the communication to purchase or use the product or service. Applicability of the act depends on the recipient and the service or product in the communication.
CAN-SPAM sets the rules for commercial email, establishes requirements for commercial messages, and provides penalties for violations.
In addition to the federal requirements, most states have adopted some version of the NAIC’s Advertisements of Accident and Sickness Insurance Model Regulation. This regulation defines advertisements and sets forth requirements for content, control, and filing requirements. Most states require insurance companies to file Medicare Supplement and long-term care ads, but some states require that all advertisements be filed. At the local level, city and county ordinances control signage, such as those seen in traffic medians or attached to light poles.

Who controls advertisements?

Insurance companies have a duty to maintain control of their advertisements, whether those ads are created by a home office employee, a broker, or an independent agent. Insurance companies must have procedures in place to establish and maintain a system of control over the content, form, and method of dissemination of all of its advertisements.
According to our insurance support services experts, best practices include a formal advertising approval process, tracking, and record retention. States rely on insurance companies to self-monitor their advertising procedures and require a signed certification of compliance each year with the annual statement filing.
While A&H advertising requirements can be overwhelming, it’s also important to note that most states have adopted the same basic requirements with respect to content. It’s usually not necessary to create 51 versions of an ad, although there are almost always state variations.

Next steps

Whether the advertising campaign is one jurisdiction or fifty-one jurisdictions, insurance companies must understand requirements for content, filing, and distribution. Contact the insurance consultants at Perr&Knight to learn how we can provide insurance support services for advertising review and the development of processes and procedures to manage advertising.

Digital Transformation: Old Wine in New Bottles?

by Rob Berg

So much of what we find new and exciting requires what we too often write off as outmoded.
Today’s insurance technology initiatives are increasingly motivated by our latest term of art, digital transformation. We love to throw those words around as if they represent some magical incantation that, when invoked, will produce brilliant solutions that lift us to otherwise unattainable competitive positions, as masterworks of art that evoke feelings of awe eons after their original creation.
Of course, we’ve been “digitally transforming” for decades. Setting aside the nineteenth-century innovations of Charles Babbage for a moment, modern “digital” computing is easily traced at least as far back as 1945 with the introduction of ENIAC, “the first programmable, general-purpose electronic digital computer”.[1] The intervening years have seen a remarkable explosion of computing power. Famously, the Apollo Guidance Computer (AGC) used to put men on the moon in 1969, with its 2 MHz CPU speed, had roughly the same computing power as a twenty-five year-old Nintendo Entertainment System (1.8 MHz). An old iPhone 4 (2010), with its 800 MHz CPU speed, outgunned the $32 million Cray 2 supercomputer (1985) by a factor of three (244 MHz).[2] And today’s iPhone 12 (2.99 GHz) and Sony PlayStation 5 (3.5 GHz) make those computing milestones seem quaint.
The growth in computing power, and therefore the number of practical applications that can be handled by affordable computers, has been astonishing. Indeed, it has made the aspirations of computer scientists who only dreamed about artificial intelligence and virtual reality just a few decades ago – dreams because they would require rooms full of very expensive hardware – available to the masses in tiny packages for very modest sums.
So it follows that today when we hear about insurers wishing to undertake digital transformation initiatives, we understand that their desire is to leverage today’s massive computing power to gain a competitive advantage. Otherwise, we’re simply talking about modernization, which was all the rage way, way back in 2015. Today’s initiatives have the far more ambitious goal of producing novel solutions, in the sense that competitors haven’t yet discovered – let alone adopted – them, and so they’re in a very real sense disruptive.
But disruption comes out of tolerance for mistakes. Disruption comes from having the wherewithal to experiment and fail repeatedly. Disruption comes from having the courage to engage in radically candid conversations laced with dissent and debate. So disruption can only happen if the company culture permits it to happen – an idea antithetical to an insurance company’s traditional mission, which is to avoid undue risk.
This frosty bit of insight begs an entirely different approach to insurance company operations that goes well beyond technology. Famously linear thinkers, insurance professionals have historically worked to place a price x on some risk y in anticipation of a positive return z. We press this button and that happens. Of course, this approach has turned out to be of dubious value, evidenced by the prevalence of combined ratios that exceed the century mark. Instead, a confluence of factors in a variety of dimensions conspire to destroy our bottom lines, if not our innocence: Geopolitics. The environment. Social movements. Generational sensibilities. Competitive moves. Regulatory constraints. Human psychology. Solar flares?! And yes, the rapid pace of technological change. After all, how popular was cyber insurance – arguably influenced by each of those factors – in 1950?
Woke (forgive me, but the term seems to work in this context, too) insurers have accepted this. And so their efforts are directed toward aggregating not just traditional datasets that populate rating algorithms or underwriting rules, but those many ancillary bits of information that influence risk selection and loss potential in a far more informed (read: non-linear) way. They utilize Big Data. They leverage artificial intelligence. They employ dedicated predictive analytics units. They automate routine operational processes. They invest in new technology. And they adopt change management programs to support those initiatives. That’s a long list of expensive undertakings for a smaller insurer. But that’s the world in which they have to compete.
Middle-tier regionals with relatively modest means must contend with tiny upstarts with tens of millions in capital investment unburdened by years of legacy operations on one end, and multi-billion dollar behemoths spinning off autonomous innovation centers on the other, for their share of the hundreds of billions of premium dollars blown skyward by the shattering of preconceived notions.
And so we arrive at the intersection of culture and technology, of art and science, of hard skills and soft skills. In an industry famously fixated on risk avoidance and profit margins, this juncture becomes an especially challenging moment in time. Indeed, a quick review of recent literature on disruption in the insurance industry makes scant mention of the behavioral changes that must accompany any radical innovation, both within an organization among its constituents and outside among its customers and suppliers.
The impact on many well-established insurers? InsureTech startups are eating their lunch. That is, unless those veteran organizations were prescient (and well-capitalized) enough to develop their own skunkworks, separate and apart from their core organizations in order to permit the risk-tolerant cultures found in their more nimble adversaries. That’s fine if you’re a major player, one of the billion-dollar insurers who can afford separately funded venture arms, or an agile start-up with fifty million smackers to burn. But what of the middle tier, those thousands of regional insurers vying for market share in the face of old threats (mainstays) and new (InsureTechs)?
The obvious answer is they need to think a little differently. With no discretionary trove of millions to casually deploy, the focus must be on manifesting beneficial change. And beneficial change begins with vision, culture, and leadership – not bits and bytes. Old wine in new bottles, you might say.
I’m not suggesting plastering office walls with poster-sized admonitions to “embrace change,” nor am I suggesting that beneficial change is a thing that happens if you hire the right consultants. I am suggesting, however, that with all of the marvels of technology available in the twenty-first century, it’s still people who matter most. It’s still paying attention to what motivates – inspires – every individual responsible for the welfare of the organizations in which they toil that separates leaders from laggards. And most importantly, it’s regularly respecting and acknowledging their contributions to ensure they stay focused and motivated, long after the paint is dry on that beautifully executed automation project.
Of course, standard “tactical” practices for operational improvements and technology deployments involving proven toolsets for workflow analysis, business process design, and technical project management are essential for a successful digital transformation initiative. But no amount of funding will replace the unbridled enthusiasm of a group of colleagues setting out to effect change for the better. It’s that enthusiasm and commitment that drive organizations to prosperity; it is rarely prosperity – and never technology – that drives individuals to become enthused if they’re not adequately engaged and committed to the work they do.

Contact Perr&Knight to support your digital transformation initiative with experienced project managers, business analysts, and process improvement experts well-versed in the ‘people part’ of transformation, who can assist with the requirements management, process redesign, and change management capabilities that are essential for any such project.

[1] Swaine, M. ENIAC. (n.d.). Britannica. Retrieved January 25, 2021 from https://www.britannica.com/technology/ENIAC
[2] Routley, N. (2017, November 4). Visualizing the trillion-fold increase in computing power. Visual Capitalist. https://www.visualcapitalist.com/visualizing-trillion-fold-increase-computing-power/.

Large Risk Rating Options for Workers’ Compensation: What You Should Know

by Cyndi Cooper

The market for workers’ compensation insurance has undergone a shift as large employers with more bargaining power recognize they can achieve a better financial position by obtaining coverage that more closely aligns the total cost with their unique risk factors. State Departments of Insurance (DOI) have approved a number of sophisticated loss-sensitive options for workers’ compensation insurance, further prompting insurance companies to develop programs like these in order to remain competitive.
Below we have provided an overview of large risk rating workers’ compensation products and how Perr&Knight can help you develop competitive plans with the best chance of approval.

Large Deductible Plans

Large deductible workers’ compensation plans provide the same coverage as guaranteed or fixed cost plans, but with higher deductibles, possibly leading to reduced costs for insureds. Deductibles for these plans generally start at $25,000 to $100,000 per occurrence and are ideal for large employers seeking to self-insure a portion of their workers’ compensation losses.
Given the insurer is typically required to pay claims as they occur and seek reimbursement from the policyholder for claims below the deductible amount, insurers will often require the insured to provide collateral to secure the claims in this layer. Some jurisdictions may require insurance carriers to hold collateral, and insurers often need to analyze each risk individually to determine the amount of collateral to collect. This is an instance where turning to experienced actuarial consultants is invaluable. Our expert teams can assist in determining how much collateral to hold, either by performing actuarial loss projections based on historical loss runs prior to the onset of the policy or performing a collateral evaluation over time to ascertain how losses and collateral needs have developed for a particular policyholder.
Our actuarial consultants can help you develop your large deductible program, provide guidance on the various premium threshold requirements and permissible deductible levels by jurisdiction, as well as meet other state-specific requirements when filing large deductible workers’ compensation programs.

Retrospective Rating Programs

Retrospective (also called “retro”) rating plans determine the final workers’ compensation premium by evaluating actual losses incurred during the policy period. Employers pay a certain premium upfront, but at set intervals after the policy expires, insurance companies evaluate actual losses versus what was originally expected. This can result in a premium refund to the insured if losses are better than expected and additional premium due if losses are worse than expected. These sophisticated plans can be helpful in controlling the final cost of an organization’s workers’ compensation program.
Because of their complexity, it is imperative to set retro programs up correctly from the outset. Perr&Knight’s actuarial consultants can assist in determining proper rating factors (expected loss ratios, the types of excess factors to file, other rating elements to file in various states, etc.), as well as determining if the state DOI will allow exceptions to bureau filed plans.

Large-Risk Alternative Rating Option (LRARO)

A provision commonly contained in retrospective rating plans, LRARO can be layered on top of other programs, enabling employers with a yearly estimated workers’ compensation premium exceeding a certain threshold to negotiate premiums with their insurance provider. With this rule on file, insurers can negotiate the rating factors and premium components involved in determining the final premium for their workers’ compensation coverage.
This option is permitted in most states, but filing requirements vary by jurisdiction. For example, some states have premium eligibility requirements which must be met before the insurance company may use this rating option.
We have deep experience in developing loss sensitive rating programs and filing LRARO rules to achieve exceptional rating flexibility. Our actuarial consultants understand important jurisdictional filing differences and can help you file this provision correctly.

Partner with Actuarial Experts

Sophisticated large risk rating programs add more complexity to an already complicated process. Our actuarial teams are profoundly experienced in the full scope of loss sensitive programs and can help with designing large risk workers’ compensation products including developing rating plans, defining rules, helping with endorsements, and ultimately managing state filings.
For insurance companies already offering loss sensitive workers’ compensation products, we can conduct reviews to determine if it is possible to enhance your product offerings, or conduct detailed competitive evaluations to make sure your program is in line with the market.

Thinking of making changes to your workers’ compensation products? Our expert actuarial consultants can help.

You Better Watch Out, You Better Not Cry, State Filing Requirement Changes Are Already Here!

by Jessica Witvoet

Authors: Neresa Torres, Jessica Witvoet, API, AIS, AINS, AIT, and Diane Karis,AINS, CPCU
At Perr&Knight, we submit thousands of product filings (rate, rule and form) a year to the various state Departments of Insurance (“DOIs”) – and 2020 has been no exception. In fact, in addition to our normal annual volume of insurance product filings, COVID-19 has increased the number of state filings for pandemic-related submissions.
Throughout the course of this year, we have noticed a few trends in how states’ DOIs are reviewing product filings. Since we handle a high volume of submissions across all jurisdictions and all lines of business, we are able to quickly identify variations from previous years.
Here’s what we have discovered.

States are getting pickier about the rules

Though states have always clearly articulated their filing guidelines, in preceding years DOIs were more likely to excuse minor deviations and process those filings anyway. DOIs in the past may have been inclined to give some leeway. This year, however, many states are opting to exercise their right to issue an objection or reject a filing outright if every detail is not spot on. Small errors that may have been “no big deal” in the past are now grounds for review or disapproval.
For example, Idaho is now closely scrutinizing the status of the filing in the domicile state. In the past, a “pending” entry or concurrent submission of domicile state was acceptable. Now, it is required that the program being filed is approved by the domiciliary state prior to submitting the filing in Idaho. Unless there is a reasonable explanation as to why, the filing will be rejected or subject to a 7-day turnaround for correction. If the information is not included at all, the filing is often disapproved without any opportunity for correction. Kansas has become more finicky, too, requiring each rule filing to have an accompanying form, or an objection will be issued. Other states have implemented guidance tools and checklists to ensure compliance with changing rules and requirements. For example, Massachusetts has created a four-part instruction guide to cover what is required for a filing to be considered acceptable.
The point is: don’t rely on DOIs being as forgiving as they have been in previous years. Make sure all your filing details are correct and complete.

Objections, rejections, and time-to-approval are increasing

Insurers are not the only ones experiencing administrative delays due to the pandemic. Many state DOIs shifted to remote working scenarios as well, and this has impacted their ability to issue speedy approvals. In California, for example, commercial, homeowners’, and other personal policies are taking longer to receive approval than in years past. The number of “pending” approvals has also increased.
Closer scrutiny by state DOIs is resulting in a higher number of rejections for minor issues. On the bright side, turnaround times for re-submitting are also faster. In many instances, we have seen DOIs allow re-submission within 7 to 10 days.
If your filing is rejected, correct the problem immediately and resubmit right away. Sophisticated software solutions like Perr&Knight’s StateFilings.com can help your teams keep a closer eye on filing status.

Other events impacting 2020

In addition to the disruptions caused by the pandemic, social unrest, and an election year, insurers are facing other challenges, such as recertification of the Terrorism Risk Insurance Act (TRIA), which requires all companies to update their language. Travel insurance products are also changing quickly as travel restrictions are lifted and added on a rolling basis worldwide.
This year’s regulatory requirements compel insurers to take a closer look at forms to make sure each meets the DOI’s current standards, which may have been updated recently.

Keeping track of the trends

2020 has been a year of surprise rejections for some insurance companies. It makes sense: companies only submitting a few filings per year – or who haven’t updated their product in recent years – lack the macro perspective to spot trends in DOI behavior.
When a rejection is received, it is important to determine as quickly as possible if the rejection is a unique occurrence or due to a change in a procedural requirement by the DOI. When submitting new filings, comparing against historical filings is no longer enough. Instead, it will be important to keep close track of current trends, as well as to look deeper into the DOI’s reasoning. This insight will help you avoid costly, time-consuming errors moving forward.
Internally, the Perr&Knight state filings department takes note of every rejection/objection we encounter and evaluates it to discover if it is part of a larger directional shift for that DOI, or simply a one-off. When we have questions about a particular DOI action, we contact the reviewer immediately and obtain a more thorough explanation. Because we handle such a high volume of nationwide filings, we remain in regular communication with every state DOI. These strong relationships enable us to obtain clarification on department actions that guide future filings on behalf of our clients.

Work with an experienced partner

Staying compliant today presents more of a challenge than it has in years past. Because the landscape is shifting quickly (as quickly as the insurance industry can shift), insurers are at higher risk of receiving rejections – especially those who submit a relatively low number of filings per year.
This is where working with an external insurance filings support partner can deliver a dramatic difference. Experienced state filings teams manage filings day-in and day-out. Their level of intimate knowledge of each transmittal requirement, variations between states, and regulatory expectations for each line of business can mean the difference between a smooth approvals process or being sent back to square one.
As 2020 draws to a close, the winds of change continue to shift. We expect more deviations from the status quo in the coming year. We’ll keep our clients posted on what we discover and how they can stay ahead of the game.

Questions about how to improve the efficiency of your rate filings? Our state filings experts can help.

Insurers Need to Plan for the Future of Workers’ Compensation Data Reporting

by Chris Curry

The world of workers’ compensation statistical data reporting is constantly evolving. Rating bureaus are continually updating regulatory requirements and increasing the number of reportable data elements. The past few years have seen multiple rating bureaus roll out brand new data collection and reporting tools, introduce a new Indemnity data call, and increase the number of relational validations between Unit Statistical data and Financial Call data. The need for developing and maintaining adaptable reporting solutions has never been more important than it is today.

Expansion of Reporting and Testing Requirements

A substantial effort has been made by state independent rating bureaus to establish their own internal Policy and Unit Statistical Reporting applications. Historically, paper submissions were an option for Proof of Coverage Reporting. This is no longer the case. Electronic submission uploads or manual data entry are now required by all bureaus. For smaller insurers, manual data entry may be an option, but due to the amount of human intervention, is subject to a sizeable degree of error. Automated electronic data submissions are key to reducing costs associated with error resolution and manual entry.
For a carrier to be approved for electronic reporting by a rating bureau for all required reports, a thorough testing process is required. For WCPOLS, this involves comparing converted text files in bureau formats to hard copy policies to validate the accuracy and completeness of the data reported. DCI, Medical Data Calls, and Indemnity Data Calls all require stringent data validation checks and reconciliation to Unit Statistical Reports. State independent bureaus are increasing the complexity of their required test cases to account for multiple complex policy scenarios. This can be seen most recently with California’s Star systems and Pennsylvania’s expansion of testing requirements. The accuracy of data capture is essential for insurers to avoid fines and remediation.
On top of increased testing requirements, we are seeing the rating bureaus expand data requirements. The National Council on Compensation Insurance (“NCCI”) and several state independent bureaus implemented the new Indemnity Data Call on 9/30/2020 to collect detailed claims data on indemnity losses. Financial data call relational data validations are expanding on an annual basis and comparisons to other reporting requirements such as Unit Statistical are becoming more prevalent. Data sources need to not only pass initial data validations but must also meet actuarial reasonability standards with increased accuracy. This is especially true for regulator-level premium calculations related to financial calls.

The Importance of Automated Error Correction

Reporting of workers’ compensation statistical data allows very little, if any, room for error. As data elements continue to expand and edit packages become more robust, data scrubbing and error correction will become more time consuming. Companies will be required to spend more money on resources to either improve data capture or invest more in additional resources and people to resolve data quality errors. Alternatively, working with an experienced reporting vendors’ data validation packages will make the reporting process more streamlined, allowing companies to identify data quality errors and make corrections in groups, rather than searching out errors one at a time. Implementation of automated bulk updates will result in a significant number of hours saved on an annual basis.

Single Source Solutions

Over the last few years, rating bureaus have expanded their systems to allow for direct reporting and error correction to be completed through internal web-based applications. In addition, NCCI has expanded their system to allow for the reporting of multiple state independent bureaus. This has improved the overall reporting process by reducing the number of websites utilized for data reporting, but there is still room for improvement. While the Compensation Data Exchange allows for the loading and reporting for both Policy and Unit Statistical data for all states, the application still does not capture all edits for all bureaus. In the future, insurance companies will be looking for a single platform where data for all bureaus can be loaded, validated, and corrected. Carriers will seek a more simplistic solution – one that limits their employee’s effort and number of clicks required to search multiple websites to ensure they comply with Policy and Unit Statistical reporting requirements.

Summary

As reporting requirements expand and data validations become more robust, staying current on reporting changes is a must in the digitization of data compliance. Being prepared for changes in statistical data reporting is the only true way to avoid countless hours of additional work staying compliant. Perr&Knight continuously works on anticipating trends in data reporting and regulatory compliance. Additionally, Perr&Knight continues to develop new data collection, data validation and error correction applications. Utilizing Perr&Knight will expedite data reporting processes, improve error resolution procedures and offer rapid data comparisons, allowing our clients to focus more of their time on profitability rather than compliance issues.

Stop worrying about missed deadlines and steep fines. Save time, save money and eliminate the hassle of accurate, on-time statistical reporting. Use Perr&Knight’s cutting-edge Statistical Reporting Solution to keep control of all of your statistical reporting needs.