for Rate, Form, Territory, Classification and Rule Filings Submitted via SERFF
Table of Contents
|Section I||General Guidelines|
|Section II||Completing Submission Requirements|
|Section III||Errors in Filing Submission|
|Section IV||Department Contact Information|
|Section V||Other General Instructions, Guidelines, Specifications and Prohibitions|
ALL FILINGS THAT ARE NOT IN CONFORMITY WITH OUR GENERAL INSTRUCTIONS OR FILINGS RULES WILL BE REJECTED.
The Department will accept electronic filings only through the NAIC's System for Electronic Rate and Form Filing (SERFF). The evaluation, review and approval process is completed in this electronic environment. An important component of SERFF is the submission requirements database, which helps eliminate incomplete filings and improves the quality of submission by detailing what insurers must file. Please refer to the SERFF website, www.serff.com, for additional information such as information on licensing, remote hosting and cost/benefit analysis of submitting filings through SERFF.
This document is intended to provide general instructions that must be followed in submitting SERFF filings. It also includes components that must be attached to your filings and some that need not be included.
The company should review the information in the New York SERFF General Instructions, State Filing requirements and any other relevant requirements when submitting a filing through SERFF.
In addition, the Industry Manual for SERFF v5 which is available at http://www.serff.com should be consulted before submitting a filing.
Please complete all fields when using the filing wizard. We need the information in the Filing Wizard and on the General Information tab. This requirement is in lieu of a separate transmittal document and/or a cover letter. Also, please complete all the fields related to new and revised forms, rates and rules on the apppropriate schedule in SERFF. If the data and attachments are not included in the appropriate schedule your filing will be rejected.
New York has implemented the Uniform Property & Casualty Product Coding Matrix; a copy of which can be downloaded in PDF format by selecting this link: http://www.naic.org/documents/industry_pcm_p_c.pdf
Filings received by the Department after close of business (5 p.m. EST) will be considered received the next business day.
1. Acceptable Submission Formats
All attachments must be provided in Adobe Acrobat (PDF) format. Adobe Acrobat submissions of poor quality will be rejected. In order to avoid this potential problem and make use of the full range of Adobe Acrobat publishing tools, files should be converted to PDF format through the use of the Acrobat Distiller in lieu of merely scanning such documents. No information will be modified. If Microsoft Excel attachments are required to support the filing or requested during the review of the filing, exact copies in Adobe Acrobat (PDF) format must also accompany the submission. If the company finds it necessary to submit any Microsoft Word attachments, they must also be accompanied by exact copies in Adobe Acrobat (PDF) format.
The Department uses the SERFF PDF Pipeline to assist in the review process. The PDF Pipeline will not convert individual attachments that are larger than 3 megabytes (mb). The easiest way to determine whether your individual attachments are larger than 3 mb is to use the PDF Pipeline before you submit the filing. Once your filing is complete and ready to submit to the state, click on “PDF Pipeline” and look at the Legend Icon. If you see the red “x” icon, at least one of the attachments associated with that Schedule Item is over 3 mb or is not a PDF document and, therefore, cannot be converted in the PDF Pipeline. From that point, you return to the attachment and reduce the file size or separate it into multiple attachments, then submit your filing to the state.
2. General Information
A cover letter is no longer required. All information previously provided in the cover letter should be included in the Filing Description field under the General Information tab in SERFF. It should clearly explain the intent of the filing, and highlight any substantive changes (such as changes in ratemaking methodology or major coverages provided). If the filing is currently in use in another state, this should also be indicated in the Filing Description. If more details are required, you may attach a supplementary explanatory memorandum on the supporting documentation tab.
If the filing is based on a previous filing which was not approved in New York, the Filing Description should include reference to the previous Department file number or SERFF tracking number. If the filing is currently in use in another state, this should be indicated in the Filing Description.
If compliance with applicable Submission Requirements has been evidenced in a SERFF filing previously approved by the Department and no changes to such portion of the filing and requirement categories are included in the current filing, such Submission Requirement may be by-passed by referencing the Department's "R" file number or SERFF tracking number with the explanation “previously submitted and approved”.
Adoption of RSO or Other Filings:
If new form(s), territories, classification(s), or rule(s) are being filed and there are similar ones currently approved for use by a Rate Service Organization (RSO), the reference organization, reference title, and reference number fields must be completed on the General Information tab and the Filing Description should include the Department's "R" file number or SERFF tracking number and effective date of the approval. If the filing is currently in use in another state, this should be indicated in the Filing Description.
If the company wants to use an RSO’s loss costs or rating plans, you must complete the rate filing sequence checklist. For rating plans, a copy of the rating plan must also be submitted and attached to the Rate/Rule Schedule. For adoption of loss costs, the rate/rule page(s) containing the proposed Loss Costs Multiplier(s) must be attached to the Rate/Rule Schedule.
If new form(s), territories, classification(s), or rule(s) are being filed and there are similar ones currently approved for use by another insurer, the Filing Description field on the General Information tab should include reference to the Department's file number or SERFF tracking number and effective date of the approval, or copies of the approved items should be included. If the filing is currently in use in another state, this should also be indicated in the Filing Description.
Requests for Confidentiality / Proprietary Material:
- The Department does not permit the company to designate the whole filing as confidential except as permitted by the Insurance Law, for example, credit scoring models.
- SERFF allows the company to designate parts of the filing confidential (Please review Industry SERFF Manual for instructions on marking the filing). If you are requesting confidentiality under the Freedom of Information Law for a part of your filing, you must identify the specific document(s): form name and number, rating supporting documentation, etc., for which confidentiality is being requested, in the Filing Description field on the General Information tab. The Filing Description field must also include the reasons why the information should be exempted from disclosure. The reasons provided must meet the standards contained in Section 87(2) of the N.Y. Public Officers Law. This law exempts from disclosure records that contain trade secrets or would cause competitive injury, if disclosed. The company must explain why the document(s) are trade secrets or if released, would cause competitive injury. The Department may reject your request for confidentiality if the reasons are not specified or are inadequate.
- If you are requesting confidentiality for documents and/or amendments sent after the original submission of the filing, you must identify the exact document(s): form name and number, rating supporting documentation, etc., for which confidentiality is being requested in a Note to the Reviewer including the reasons why the information should be excepted from disclosure.
- The request for confidentiality must be clearly stated and designated as described above and must be made by the entity submitting the filing. A request for confidentiality made by a third party other than the submitting party is not deemed to be a statutory request.
- Note that the process of making a determination regarding whether that portion of the filing meets the standards contained in Section 87(2)(d) of the N.Y. Public Officers Law may be done at anytime.
- Pursuant to Section 2806(b) of the New York Insurance Law, any filing relating to credit information is not subject to disclosure under Article 6 or Article 6A of the Public Officers Law.
3. Form Schedule
The SERFF form schedule must be completed for all form filings.
Each form must be listed individually on the form schedule. All form schedule fields must be completed: form name, form number, edition date, form type and attachments. The form must be included in the “Attachment” column on the relevant lines on the schedule. If a single attachment on the schedule contains more than one form, the filing will be rejected.
A sample of a completed Form Schedule is shown below:
Form Count: 2
|Schedule Item Status|
Action Specific Data
|10-30-2006||Name of Endorsement||12345||12 06||Endorsement/|
|10-30-2006||Name of Endorsement||6789||12 06||Endorsement/|
|Replaced||Previous Filing #||R20000000||40||67.pdf|
|Replaced Form #||678. 06 05|
4. Rate/Rule Schedule
The rate data fields on the rate/rule schedule must also be completed for all rate and rating rule filings (This includes adoption of rate service organization loss cost, rating plans, rating rules, symbols, deductibles, classifications, individual risk submissions, territories and other rate/rating rule filing.) with the exception of non-rating rule filings.
The company must select “yes” for the question “Add Rate Data” to display the rate data fields. Below is a screen print of the question.
Complete all fields for each company included in the filing.
- Overall percentage of last rate revision: This is the statewide average of the last percentage change implemented in the state.
- Effective Date of last rate revision: This is the implementation date of the last overall percentage rate impact.
- Filing Method of Last Filing (Prior Approval, File & Use, etc): This is the review method for which the last filing was submitted. See State Specific Requirements.
- Overall % Rate Impact - This is the statewide average percentage change to the current rates for the coverages included for each company.
- Written premium change for this program - This is the statewide change in written premium based on the proposed overall percentage rate impact for each company.
- # of policyholders affected for this program - This is the number of policyholders affected by the overall percentage rate impact for each company.
- Written premium for this program - This is the statewide written premium for each company.
- Maximum % Change & Minimum % Change
- If all the policyholders get increases, then the maximum change is the largest increase and the minimum change is the smallest increase.
- If all the policyholders get decreases, then the maximum change is the smallest decrease and the minimum change is the largest decrease.
- If some of the policyholders get increases and others get decreases, then the maximum change is the largest increase and the minimum change is the largest decrease.
- Overall percentage rate impact for this filing: This is the statewide average percentage change to the accepted rates for the coverages included in the filing. This field only needs to be completed for group filings.
- Effect of Rate Filing—Written Premium Change for this program: This is the statewide change in written premium based on the proposed overall percentage rate impact. This field only needs to be completed for group filings.
- Effect of Rate Filing—Number of policyholders affected: This is the number of policyholders affected by the overall percentage rate impact. This field only needs to be completed for group filings.
If there are multiple companies on a filing, the Overall Rate Information (Premium and Policyholders) will automatically calculate for the user.
For rate, rating rule or adoption of rate service organization filing that results in no rate impact or a zero rate impact for the company and for filings for new programs, the company should select “yes” to for Add Rate Data and indicate “0” for all the rate data fields which require rate change information.
The SERFF rate/rule schedule must be completed for all rate and rule filings (This also includes loss cost, rating plans, symbols, deductibles, classifications, deductibles, individual risk submissions, symbols or territories.).
Each rate/rule page must be listed individually on the Rate/Rule Schedule. The rate pages, and/or rule pages must be included in the “Attachment” column on the relevant lines on the schedule. If a single attachment on the schedule contains more than one rate/rule page the filing will be rejected. However, if the company is submitting an entire rating manual for our review, the rating manual may be included as one attachment in the Rate/Rule Schedule. The rate/rule pages for an adoption of a rate service organization does not have to be listed and attached to the Rate/Rule Schedule except for adoption of rating plans and loss costs. For rating plans, a copy of the rating plan must also be submitted and attached to the Rate/Rule Schedule. For adoption of loss costs, the rate/rule page(s) containing the proposed Loss Costs Multiplier(s) must be attached to the Rate/Rule Schedule.
Credit scoring model filings - The Department recommends that the company submit credit scoring model filings and any revisions as a stand alone file. Credit scoring model filings and any revisions must be included in the Rate/Rule Schedule. Filings to adopt credit scoring models from a third party without any modifications do not have to be listed on the Rate/Rule Schedule. Per the instructions in Section II, the company should mark the entire filing as confidential. Article 28 of the Insurance law, Regulation 182 (Limitations Upon and Requirements for the Use of Credit Information for Personal Lines Insurance) and Circular Letter No. 2 (2005) provide additional requirements regarding the submission of credit scoring model filings and any revisions.
5. Supporting Documentation
All other documentation should be attached under the supporting documentation tab. Such documentation may include side-by-side comparisons, actuarial support, and checklists.
If a new form(s) or endorsement(s) modifies existing policy provision(s) currently in effect, be sure to include an explanatory memorandum with a discussion of the policy provision(s) which will be affected as well as a copy of the current policy provision(s). In addition, a side-by-side comparison of the new form(s) and existing policy provision(s) should be provided. If the filing is a non-rating revision to existing form(s), territories, classification(s) or rule(s):
- Except for simple, non-substantive changes, a side-by-side comparison of the form(s) or rule(s) being proposed and those currently in use in New York, with all changes clearly marked and explained in the Filing Description and/or explanatory memorandum must be included.
- Revisions to classifications and territories must include a comparison between those currently on file (in New York) and those proposed.
Review Standards Checklists
To assist you in preparing filings, the Department has developed review standards checklists and compliance questionnaires which can be found within the filing rules and submission requirements for the relevant types of insurance. Note – the “types of insurance” are based upon annual statement lines of business. The attachment of the appropriate Review Standards Checklist is mandatory for all filings submitted through SERFF pursuant to Supplement No. 5 to Circular Letter No. 11 (1998). These checklists and compliance questionnaires are intended to provide guidance in regard to many of New York's minimum requirements. The review standards checklists list the categories of review standards that a filing will be expected to evidence. The review standards checklists, including Column 4 - “Location of Standard in Filing”, must be fully completed for new programs and major revisions to existing programs to facilitate review of the filing. If the submission is limited to minor revisions to previously approved programs, endorsements, etc. that do not include changes to regulatory requirements, insert a brief explanation on the first page of the checklist indicating the reason(s) the review standards are not applicable. Please be advised that compliance with the review standards checklists or compliance questionnaires alone does not guarantee approval of any filing. If you have questions regarding completion of the checklists or compliance questionnaires please contact the Department representative shown in Section IV below.
An applicable set of review standards checklists and the related compliance questionnaires should be completed for each coverage part included in the filing. For example, if a filing contains forms for Commercial General Liability coverage (written on an occurrence basis with defense outside limits) and Directors and Officers and Employment Practices Liability coverage parts (written on a claims-made basis with defense within limits), the insurer must complete and submit the following forms, review standards checklists, and compliance questionnaires:
- One Master List of Review Standards Checklists and Compliance Questionnaires;
- One Policy Form Compliance Certification;
- Two Commercial Liability Review Standards Checklists (one for Commercial General Liability form and one for Employment Practices Liability Coverage Part);
- One Directors and Officers Review Standards Checklist (for the Directors and Officers form);
- Three Commercial Liability Insurance Form Filing Compliance Questionnaires (for the Commercial General Liability form, Directors and Officers form, and Employment Practices Liability Coverage Part );
- Two Claims-Made Policies Form Filing Compliance Questionnaires (one for Directors and Officers Coverage Part and one for Employment Practices Liability Coverage Part);
- Two Defense-Within-Limits Form Filing Compliance Questionnaires (one for Directors and Officers Coverage Part and one for Employment Practices Liability Coverage Part);
- One or more Commercial Lines Cancellation & Nonrenewal Form Filing Compliance Questionnaires (one compliance Questionnaire for each form that contains separate cancellation and nonrenewal provisions); and
- One or more Supplementary Form Information (if
Please note that we are constantly revising/updating existing forms, review standard checklists, and compliance questionnaires and adding new forms, review standard checklists, and compliance questionnaires. Please check to make sure you are using the current version in SERFF.
Rate Filing Sequence Checklist
The rate filing sequence checklist must be completed for any filing containing rates, rules, classifications, territories, or rating plans. The Fourth Supplement to Circular Letter No. 11 (1998) amends the procedures for the filing of policy rules and rates by prescribing required exhibits. Insurers will continue to be responsible for developing their own exhibits, with the exception of the following preformatted exhibits: STM-1 (Master List of Compliance Checklists), and STM-2 (Rate and/or Rating Plan Compliance Certification). These exhibits must be labeled according to the sequence numbering system of this checklist. Use of this checklist is mandatory for all filings of rates, rating rules, classifications, territories and rating plans. If you have questions or comments regarding the completion of the checklist, please contact Mr. Anthony Yoder, Supervising Actuary, Property Bureau, at the Department’s New York City address, or by telephone at (212) 480-5500 or by email to Mr. Anthony Yoder .
6. States Specific
The STATES-SPECIFIC FIELDS must be completed for all filings. Please enter the appropriate code within the fields. In the event a field is not applicable, enter 0 into that field. Please refer to the following:
Speed-To-Market Field: enter code "98" for "Speed-To-Market" filings;
Terrorism Exclusion Field: enter code "46-01" for filings which includes forms, rates or rules for the Terrorism Exclusion;
Mold (Fungi, Bacteria, Virus) Exclusion Field: enter code "46-02" for filings which includes forms, rates or rules for the Mold Exclusion;
Rate/Rule Schedule Tab: the “Add Rate Data” button must be changed to “yes” for all rating rules and rate filings in order for the appropriate fields to be completed. Please enter “Yes” for filings with the rate data fields completed and “No” for all other filings.
7. Free Trade Zone Class 3 Risks
Chapter 490, which took effect on November 15, 2011, amended Insurance Law § 6303 by adding a new (a)(3), which sets forth a new special risk insurance exemption (“class 3”) from rate and form filing or approval requirements until June 30, 2013 for certain types of policies issued to large commercial insureds that employ or retain a special risk manager to assist in the negotiation and purchase of the policies. Pursuant to the Third Amendment to Regulation 86 Section 16.4 (c)(1), insurers are required to electronically submit via SERFF all FTZ Class 3 submissions unless they have filed and received approval for a hardship exemption from the electronic filing requirement in which case the paper filing requirements should be followed. Insurers are required to make three separate submissions for each FTZ Class 3 policy issued as follows:
The Department’s e-mail address used to receive the certificate of insurance was previously impeded by the affects of Storm Sandy. This impediment has been removed as of February 13, 2013 and filers should continue to use PRPFTZClass3Submissions@dfs.ny.gov.
a. Certificate of Insurance to be filed within one business day of binding the coverage.
Pursuant to Section 6303(a)(3)(B) of the Insurance Law the company is required to file with the Superintendent a certificate of insurance evidencing the existence and terms of every such policy within one business day of binding the insurance coverage by sending an email with the certificate of insurance attached to the Department of Financial Services at the following e-mail address, PRPFTZClass3Submissions@dfs.ny.gov. The e-mail caption should say FTZ Class 3 Certificate of Insurance. The body of the e-mail must contain the name of the insurance company, the NAIC number, the named insured, the inception date of the policy and the policy number if known.
b. Certificate of Insurance and the Supplemental Checklist and Certification Form to be filed within 30 days of the inception date of the policy.
Pursuant to Section 16.4(b)(2) of Regulation 86 the company is required to file the supplemental checklist and certification form along with a copy of the certificate of insurance previously filed pursuant to Section 6303(a)(3)(B) of the Insurance Law via SERFF within 30 days of the inception date of the policy.
For the SERFF submission information is to be provided on the general information tab and form tab.
On the general information tab enter all the relevant information and select the Filing Type: “FTZ Class 3 Certificate of Insurance” . The Filing Description field must include the following language: “The company is submitting the FTZ Class 3 Certificate of Insurance and FTZ Class 3 Supplemental Checklist and Certification Form for policies issued to a FTZ Class 3 risk. The certificate of insurance for this risk was also e-mailed to the Department of Financial Services on (insert date here).”
On the form schedule list the following two items individually:
- FTZ Class 3 Certificate of Insurance.
- FTZ Class 3 Supplemental Checklist and Certification Form.
The forms must be included in the “Attachment” column on the relevant lines of the schedule.
The Supplemental Checklist and Certification Form is available in PDF and WORD format to download
- Supplemental Checklist and Certification Form: PDF
- Supplemental Checklist and Certification Form: Word
c. Submissions of Policy Form(s) that has (have) not been previously filed with the Department
Pursuant to Section 6303(a)(3)(C) of the Insurance Law the company is required to file for information only any form that has not been previously filed with the Superintendent within three business days after the first delivery of a policy using such form, but no later than 60 calendar days after the inception date of such policy. It should be noted that any policy form that an insurer previously filed with the Superintendent and that the Superintendent disapproved or rejected or that the insurer withdrew will not be considered to have been previously filed with the Superintendent.
For the SERFF submission information is to be provided on the general information tab and the form tab.
On the general information tab enter all the relevant information including referencing the SERFF and Department file number for the corresponding FTZ Class 3 Certificate of Insurance which was previously filed with the Department and select the Filing Type: “FTZ Class 3 Form”. The Filing Description field must include the following language: "The company is submitting for informational purposes the form(s) for policies issued to a FTZ Class 3 risk which has (have) not been previously filed with the Superintendent. This policy form submission relates to SERFF/Department File Number (Insert Number here) for the FTZ Class 3 Certificate of Insurance submission previously filed with the Department for this policy."
On the form schedule, for each form submitted complete the fields for the form name, form number, form type. The form(s) must be included in the “Attachment” column on the relevant lines of the schedule.
8) SPEED-TO-MARKET Filing
To make "SPEED-TO-MARKET" filings, please follow the procedures described in Supplement No. 3 to Circular Letter No. 11 (1998) and the instructions contained in the Master List of Review Standards Checklists and Compliance Questionnaires. SERFF filings, as noted above, must be submitted with the appropriately completed review standards checklists and compliance questionnaires. Additional requirements for a SERFF filing to be considered as being submitted on a Speed to Market basis are: the completion by an officer of the appropriate compliance certification forms (the link is located in the Review Standards Checklists), the completion of the Master List of the Review Standards Checklists and Compliance Questionnaires, the Filing Description on the General Information tab in SERFF must clearly state that the filing is being submitted on a "Speed to Market" basis, and the filer must enter code “98” - “Speed to Market” filings in the State Specific field.
NOTE: The optional "Speed to Market" filing procedures do not apply to rate filings for the following lines of business: (i) Personal Automobile; (ii) Public Automobile; and (iii) Workers Compensation; and (iv) Physicians' & Surgeons' Medical Malpractice Liability.
9. Documents Requiring Signatures of Authorized Officers
Required Signature of Authorized Officer
A Speed-To-Market Filing requires the signature of an authorized officer of the company on the 'Speed-To-Market' certification form(s). The Explanatory Memorandum for a filing does not require an officer's signature.
Submission by an Officer or other Company Representative:
Creation of Electronic Signature:
If an officer or another person transmits the 'Speed-To-Market' filing via SERFF, the 'Speed-To-Market' certification form(s) signed by an officer must be attached as part of the filing. Please note that when submitting a 'signed' electronic document, the Department is only able to accept the signature if it is electronically scanned from a wet signature and attached to the form or rate filing which is sent to the Department.
Scanned or Pictured Signatures:
If a wet signature has been scanned into a document, the portion of the document containing such signature should be placed into a separate attachment, i.e. separate from those components created using the Adobe Acrobat Distiller.
Responsibilities of the Officer and the Insurers
The Department will hold the officer whose electronic signature is affixed to the 'Speed To Market' certifications responsible for the representations made therein, to the same extent that the person would be held responsible were his or her wet signature affixed to a paper certification. In addition, the insurer, on whose behalf the electronic SERFF filing is being made, will be held responsible by the Department for, and be bound by, the electronic signatures of those officers to whom it has given authority to sign the electronic certifications as to the representations contained therein. Insurers are expected, in light of their responsibilities in this regard, to implement internal controls and procedures for the utilization of electronic signatures in this context to protect against unauthorized use and, to maintain a record of those officers who have been given authority to sign these certifications electronically for the insurer.
The Department has noted that some companies are not utilizing the SERFF design features as instructed in the SERFF Industry Manual. Some errors that have been noted since SERFF v5 was implemented are:
- The Form Schedule, Rate Data, or Rate/Rule Schedule have not been completed.
- For adoption or delayed adoption of RSO filings, the reference organization, reference title, and reference number fields are not completed on the General Information tab. These fields are required to be completed with the applicable RSO information.
- Companies have been using Note to Reviewer to attach filing submissions. Filing submissions should never be attached to a Note to Reviewer.
- Forms, rates and/or rules are being attached under the Supporting Documentation tab. Forms, rates and/or rules are required to be listed and attached to the applicable Forms and/or Rates/Rules Schedule.]
- Companies have been submitting filings that will result in a rate effect without properly completing the Rate Data portion of the Rate/Rule Schedule tab. On the Rate/Rule Schedule Tab, the "Add Rate Data" currently defaults to "No", the company must select "Yes" to display the rate data fields and properly complete them.
If you have questions regarding SERFF, Speed-To-Market procedures, completion of the review standards checklists or compliance questionnaires, please contact a Department representative for the following areas:
|Line of Business||Name of Representative||E-mail address||Phone Number|
|Automobile||Holford Marshall||Mr. Holford Marshall||(212) 480-5596|
Siu Ping Wong
|Mr. Bruce Ascher
Mr. Siu Ping Wong
|Property||Lavi Mathai||Mr. Lavi Mathai||(212) 480-5501|
|Actuarial||Anthony Yoder||Mr. Anthony Yoder||(212) 480-5500|
SECTION V. OTHER GENERAL INSTRUCTIONS, GUIDELINES, SPECIFICATIONS AND PROHIBITIONS
1) Plans of Operation Required Pursuant to Regulation 79 (11 NYCRR 67)
Regulation 79 requires insurers to make a submission describing its plan of operation for establishing and adequately maintaining a vehicle inspection system (Regulation 79 plan). The Department will not accept submissions of Regulation 79 plan via SERFF as the plan is not considered a rate/rule/form filing. If you wish to submit the Regulation 79 plan electronically please do so via e-mail to Richard Nebb at Richard.email@example.com or Debra Parris at Debra.Parris@dfs.ny.gov. If you wish to submit the Regulation 79 plan in hard copy format, please mail the plan to :
New York State Department of Financial Services
Preparation & Analysis Unit
25 Beaver Street, 2nd floor
New York, NY 10004-2319
2. Individual Risk Submission:
Insurers are required to submit individual risk rate filings for those "a" rated risks that are subject to prior approval. Pursuant to Circular Letter No. 4 (1996) , insurers are not required to submit rate filings for policies covering individually rated commercial umbrella and other "a" rated risks that are not subject to prior approval. In lieu of individual risk rate filings, insurers are required to retain in the individual policy file the supporting information that would otherwise be provided in a properly completed form 129-C (contained in Circular Letter No. 19 (1992)). Such information must be available for inspection by the Department for a period of five years from the date the policy is issued.
3. The following is a summary of subjects that either must or must not be contained in your filings, and the required treatment of these subjects in New York. While these may not be "filing or submission requirements", the failure to address them in accordance with the instructions below will result in the rejection of your filing.
NOTE: The following is not an exhaustive subject list. There may be other areas of concern that you may need to address upon completion of this Department’s review of the filing.
Examples of Prohibited Coverages:
Punitive Damages and
Corporal Punishment Coverages are not permitted in NY.
The absolute pollution exclusion is not permitted for personal lines policies.
Pursuant to Section 3426 (g)(2) of the New York Insurance Law, loss information must be provided by the insurer, at the insured's request, covering a period of years specified by the Superintendent by regulation or the period of time coverage has been provided by the insurer, whichever is less. Note: Since the Superintendent has not specified a period of time by Regulation, the company must provide the insured with loss information covering the period of time the insured has been with the insurer.
Computer Simulation Models:
Pursuant to Circular Letter No. 7 (1998), the inclusion of computer simulation modeling results in the ratemaking process is not permitted.
Workers' Compensation Drug Free Workplace Premium Credit:
The guidelines listed below must be followed when submitting a filing to the Department requesting a drug-free workplace credit. Note that requirements for an insured to qualify as a "drug-free workplace" are shown in item 9 below.
- In general, the maximum amount allowed for a drug-free rate credit is 5%. A request for a credit greater than 5% will be reviewed carefully by our actuaries and must contain specific statistical or judgmental support.
- Any approved rate modification will be effective for only four years. After four years, the actual experience will be reflected in the experience rating modification.
- The drug-free rate credit can only be applied to non-retrospectively rated policies.
- The discount should be applied on a multiplicative basis, after the experience modification and before premium discounts and expense constants.
- The insurer must verify from the employer the existence of a drug-free environment and explain in its filing how such verification will occur.
- The filing should include a copy of the format of the certification of a drug-free workplace that will be sent to all employers. The completed certification by the employer must be filed with the company for each year the modification is permitted under the program. If it is subsequently determined that the insured misrepresented its compliance with the drug-free workplace rules, the insured’s policy will be subject to an additional premium equal to the amount of credit previously granted.
- Policy language should include the cancellation and non-renewal guidelines in the New York Workers’ Compensation and Employers Liability Manual.
- The insurer must report annually to the New York Compensation Insurance Rating Board the total amount of the drug-free workplace rate modification for all policies, the standard earned premium and the net earned premium.
- The following
constitute the minimum requirements the Department considers essential in for
an insured to qualify as a drug-free workplace environment. These requirements
should be included in the filing made to the Department as part of the insurer’s
definition of a drug-free workplace.
- Employers should give all employees a written policy statement notifying them of details of the program, including the consequences of testing positive for controlled substances.
- An employer that requires an employee or job applicant to submit to a drug test must document the reasonable suspicions that warrant the testing and must provide a copy of the document to the employee upon request.
- All employees working in safety sensitive positions, as legally allowed by the State, are subject to random urinalysis drug testing. An employee that is involved in an on- the- job accident that requires outside medical attention should submit to a drug test within a reasonable period of time.
- In addition, the employer must ensure the integrity of the testing
system as follows:
- Specimens must be collected and documented in a manner that safeguards the privacy of the individual and in a manner that prevents substitution or contamination of the specimens.
- A licensed and approved laboratory must conduct each initial and confirmation test (excluding the taking or collection of a specimen to be tested). If the drug test result is positive, an employee or job applicant may request that a portion of the specimen be re-tested at another certified laboratory.
- The employee or job applicant must be informed of the test results and may submit information to the designated Medical Review Officer (MRO) explaining or contesting the test results.
- Insurers, employers, laboratories, employee assistance programs, drug and alcohol rehabilitation programs and their agents must keep all information concerning drug test results confidential.
"Other Insurance" Provisions:
In the event that other valid and collectible insurance is applicable to a claim covered under the company's policy, the company may state that its policy will either contribute with or be excess over such other insurance in order to avoid duplication of payment on claims. However, the company may not exclude coverage under its policy in the event the insured has other valid and collectible insurance.