R590-268-8. Annual Actuarial Memorandum and Certification

  (1) The insurer shall submit annually on or before April 1 using SERFF:

  (a) stop-loss experience for the previous two years for Utah;

  (b) certification of compliance with requirements of section 31A-43-301; and

  (c) an actuarial memorandum describing the review done in preparation of the certification.

  (2) The insurer's stop-loss experience shall be presented by small employer and experience year and shall include:

  (a) a group identifier that uniquely identifies the group and is consistent from year to year for the same employer group;

  (b) the effective date of coverage for the policy year for the employer group;

  (c) contract type (e.g. 12/24);

  (d) employer size including both covered lives count and employee count as of the beginning of the contract;

  (e) covered lives exposure years and employee exposure years for the experience time period;

  (f) specific attachment point;

  (g) expected claims in the absence of stop-loss insurance;

  (h) expected claims under the specific attachment point;

  (i) aggregate attachment point;

  (j) earned premium; and

  (k) claims paid by the stop-loss insurance broken out by specific losses and aggregate losses.

  (3)(a)(i) The insurer's stop-loss experience shall be submitted in Excel format using the Utah Stop-Loss Experience Report dated July 1, 2019.

  (ii) The Utah Stop-Loss Experience Report dated July 1, 2019, is available on the Department's website at https://insurance.utah.gov.

  (b) Experience shall be aggregated over the entire contract incurral period, rather than aggregated by incurral month.

  (c) The experience report shall only include those stop-loss contracts where the final claim incurral date is contained within the two calendar years previous to the submission date.

  (d) Runout claims that are paid after the submission date shall be updated in the following year's experience submission.