il-v50i40-50-ill-adm-code-3801: 50 Ill. Adm. Code 3801 — Small Employer Carrier Actuarial Certification and Documentation Requirements

1) Heading of the Part: Small Employer Carrier Actuarial Certification and Documentation Requirements 2) Code Citation: 50 Ill. Adm. Code 3801 3) Section Number: Proposed Action: 3801.60 Amendment 4) Statutory Authority: Implementing and authorized by Sections 30(b) and 40 of the Small Employer Health Insurance Rating Act [215 ILCS 93/30(b) and 40]. 5) A Complete Description of the Subjects and Issues Involved: This rulemaking is filed pursuant to Section 5-15 of the Illinois Administrative Procedure Act and is only changing the address of the Department's Springfield Office to reflect the fact that the office is moving on September 23, 2026. Section 5-15 of the Illinois Administrative Procedure Act requires agencies to include a statement of how the proposed rule made under this Section satisfies the criteria established by subsections (a) and (b). The Department's address is used by the public to obtain information from the Department and/or make submissions or requests of the Department. These members of the public may include insurance companies, persons licensed by the Department, and Illinois insurance consumers. The address provided in the rules should be accurate, otherwise such persons may go to or send correspondence to the wrong address. The decision to relocate the Springfield office was an internal management decision. The private rights of individuals are not affected by Department rules containing the accurate address, although having the incorrect address in rule will cause unnecessary confusion and delay for people seeking information from and/or making submissions to the Department in person or via mail. It is in the public interest to have the Department's office address published in the Illinois Administrative Code be correct. 6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: Not required for Section 5-15 notices. 7) Will this proposed rulemaking replace an emergency rule currently in effect? Not required for Section 5-15 notices. 8) Does this rulemaking contain an automatic repeal date? Not required for Section 5-15 notices. 9) Does this proposed amendment contain incorporations by reference? Not required for Section 5-15 notices. 10) Are there any other proposed rulemakings pending on this Part? No 11) Statement of Statewide Policy Objectives: Not required for Section 5-15 notices. 12) Time, Place, and Manner in which interested persons may comment on this proposed rulemaking: Persons who wish to comment on this proposed rulemaking may submit written comments no later than 14 days after the publication of this Notice to: Kathryn Williams Department of Insurance 115 S. LaSalle Street, 13 Floor Chicago IL 60603 (312) 814-8212 Kathryn.A.Williams@illinois.gov 13) Initial Regulatory Flexibility Analysis: Not required for Section 5-15 notices. A) Description of the type of small business, not for profit corporations or small municipalities subject to the proposed amendment: None B) Description of the proposed reporting, bookkeeping and other procedures required for compliance with the amendment: None C) Description of the types of professional skills necessary for compliance: None 14) Small Business Economic Impact Analysis: Not required for Section 5-15 notices. 15) Regulatory Agenda on which this rulemaking was summarized: Not required for Section 5-15 notices. 16) Any other information or justification for the proposed rule or amendment that the agency believes would be helpful to the public regarding the proposed rule or amendment. For example, a discussion or analysis of the benefits of the proposed rule or DEPARTMENT OF INSURANCE NOTICE OF PROPOSED AMENDMENT amendment is projected to have on the Illinois public, consumers, investors or other similar groups. Not required for Section 5-15 notices. The full text of the Proposed Amendment begins on the next page: DEPARTMENT OF INSURANCE NOTICE OF PROPOSED AMENDMENT TITLE 50: INSURANCE CHAPTER I: DEPARTMENT OF INSURANCE SUBCHAPTER pp: SMALL EMPLOYER HEALTH INSURANCE RATING ACT PART 3801 SMALL EMPLOYER CARRIER ACTUARIAL CERTIFICATION AND DOCUMENTATION REQUIREMENTS Section 3801.10 Purpose 3801.20 Applicability and Scope 3801.30 Definitions 3801.40 Pre-approval of an Individual Who is Not a Member of the American Academy of Actuaries for the purpose of filing an Actuarial Certification 3801.50 Small Employer Carrier Rating and Underwriting Record Maintenance 3801.60 Actuarial Certification and Format 3801.ILLUSTRATION A Actuarial Certification 3801.ILLUSTRATION B Statement of the Company Officer AUTHORITY: Implementing and authorized by Sections 30(b) and 40 of the Small Employer Health Insurance Rating Act [215 ILCS 93/30(b) and 40]. SOURCE: Adopted at 24 Ill. Reg. 19162, effective December 19, 2000; transferred from the Department of Insurance to the Department of Financial and Professional Regulation pursuant to Executive Order 2004-6 on July 1, 2004; transferred from the Department of Financial and Professional Regulation to the Department of Insurance pursuant to Executive Order 2009-4 on July 1, 2009; recodified from 50 Ill. Adm. Code 5101 to 50 Ill. Adm. Code 3801 at 40 Ill. Reg. 16164; amended at 50 Ill. Reg. ______, effective ____________. Section 3801.60 Actuarial Certification and Format An actuarial certification filing, an example of which is set forth in Illustration A of this Part, must contain the following information: a) The full legal name of the small employer carrier for which the certification is being submitted; b) The actuary's name, title and company affiliation, if applicable, or the individual's DEPARTMENT OF INSURANCE NOTICE OF PROPOSED AMENDMENT name, title and company affiliation that has been pre-approved pursuant to Section 3801.30 of this Part; c) A statement as to whether the undersigned actuary is a member of the American Academy of Actuaries and meets the Qualification Standards appropriate for this certification. If not a member, the individual must indicate when he or she was pre-approved by the Director pursuant to Section 3801.30 of this Part and include a copy of the approval; d) The period for which the certification is being made; e) If appropriate, a statement indicating on whom the actuary relied for data. The actuary may rely on company personnel for data, but may not rely on another actuarial opinion. The nature and extent of reliance must be disclosed in the statement. The extent of reliance is subject to the Actuarial Standards of Practice No. 23 on Data Quality. A sample statement to be completed by the person on whom the actuary relied is shown in Illustration B of this Part; f) The number of classes contained in the actuarial certification shall be the number in existence as of the end of the certification period. In the case of multiple classes, the certification must contain a list of the classes and a description of the substantial differences that support the establishment of each class. Refer to Section 20(a)(1), (2) and (3) of the Act [215 ILCS 93/20] for information concerning the allowable criteria that support the establishment of each class. This must include the criteria by which groups are assigned to each class; g) The actuarial certification must contain a statement that the small employer carrier's rates either were or were not in compliance with Section 25 of the Act [215 ILCS 93/25]; h) If the actuary determines that the small employer carrier's rates and rating factors in the rating manuals did not comply with statutory requirements under subsection (g) of this Section, the certification must include a detailed description of the instances of noncompliance, steps taken to correct or detailed plans to correct the areas of noncompliance; i) If the actuary determines that the small employer carrier's actual rates did not agree with the rates provided in the rating manual(s), the certification must include a detailed description of the instances of noncompliance, steps taken to DEPARTMENT OF INSURANCE NOTICE OF PROPOSED AMENDMENT correct or detailed plans to correct the areas of noncompliance; j) The annualized premium dollar amount for small employer groups in force at the end of the certification period and the annualized premium dollar amount for groups whose actual premium rates were tested to verify that the rates charged were in accordance with the rating manuals; k) A certification that the actuary completed the work in compliance with Actuarial Standards of Practice 23, Data Quality, and 26, Compliance with Statutory and Regulatory Requirements for the Actuarial Certification of Small Employer Health Benefits (1100 Seventeenth Street, N.W., 7 Floor, Washington, D.C. 20006), and all applicable laws. l) The actuarial certification required by this Part must be submitted to: Illinois Department of Insurance Life Actuarial Section 4800 Wabash Ave.320 West Washington Street Springfield, Illinois 6271162767-0001 (Source: Amended at 50 Ill. Reg. ______, effective ____________)