(1) Actuarial
opinion prior to the operative date of the valuation manual. Before the operative
date of the valuation manual, as that term is defined in section 10-7-301.5 (7):
(a) Every life insurance company doing business in this state shall annually
submit the opinion of a qualified actuary as to whether the reserves and related
actuarial items held in support of the policies and contracts are computed
appropriately, are based on assumptions that satisfy contractual provisions, are
consistent with prior reported amounts, and comply with applicable laws of this
state. The commissioner by rule shall define the specifics of the opinion required by
this subsection (1) and add any other items deemed to be necessary to its scope.
(b) The opinion must apply to all business in force including individual and
group health insurance plans, in form and substance acceptable to the
commissioner as specified by rule.
(c) The opinion shall be based on standards adopted from time to time by the
Actuarial Standards Board or its successor, and on such additional standards as the
commissioner may by rule prescribe.
(d) In the case of an opinion required to be submitted by a foreign or alien
company, the commissioner may accept the opinion filed by that company with the
insurance supervisory official of another state if the commissioner determines that
the opinion reasonably meets the requirements applicable to a company domiciled
in this state.
(e) Except in cases of fraud or willful misconduct, the qualified actuary is not
liable for damages to any person other than the insurance company and the
commissioner for any act, error, omission, decision, or conduct with respect to the
actuary's opinion.
(f) Any memorandum in support of the opinion, and any other material
provided by the company to the commissioner in connection with the opinion, shall
be kept confidential by the commissioner and shall not be made public and is not
subject to subpoena, other than for the purpose of defending an action seeking
damages from any person by reason of any action required by this subsection (1) or
by rules promulgated pursuant to this subsection (1); except that the memorandum
or other material may otherwise be released by the commissioner with the written
consent of the company or, upon request stating that the memorandum or other
material is required for the purpose of professional disciplinary proceedings, to the
American Academy of Actuaries. The commissioner shall require that any request
of this nature from the American Academy of Actuaries set forth procedures
satisfactory to the commissioner for preserving the confidentiality of the
memorandum or other material. Once any portion of a confidential memorandum
prepared for purposes of this subsection (1) is cited by an insurer in its marketing or
is cited before any governmental agency other than a state insurance regulatory
authority or is released by the insurer to any news media, the confidentiality of the
portions of any confidential memorandum are deemed waived.
(g) Every life insurance company, except as exempted by or pursuant to rule,
shall also annually include in the opinion required by this subsection (1) an opinion
of the same qualified actuary as to whether the reserves and related actuarial items
held in support of the policies and contracts specified by the commissioner by rule,
when considered in light of the assets held by the company with respect to the
reserves and related actuarial items, including the investment earnings on the
assets and the considerations anticipated to be received and retained under the
policies and contracts, make adequate provision for the company's obligations
under the policies and contracts including the benefits under and expenses
associated with the policies and contracts. The commissioner may provide by rule
for a transition period for establishing any higher reserves that the qualified
actuary may deem necessary in order to render the opinion required by this
subsection (1).
(h) Each opinion required by paragraph (g) of this subsection (1) is subject to
the following requirements:
(I) A memorandum, in form and substance acceptable to the commissioner as
specified by rule, shall be prepared to support each actuarial opinion for each year
on or after December 31, 1992.
(II) If the insurance company fails to provide a supporting memorandum at
the request of the commissioner within a period specified by rule, or the
commissioner determines that the supporting memorandum provided by the
insurance company fails to meet the standards prescribed by rule or is otherwise
unacceptable to the commissioner, the commissioner may engage a qualified
actuary at the expense of the company to review the opinion and the basis for the
opinion and prepare any supporting memorandum required by the commissioner.
(1.1) Definition. For purposes of subsection (1) of this section, qualified
actuary means a person who:
(a) Is a member in good standing of the American Academy of Actuaries, or is
experienced, skilled, and competent to perform actuarial duties, and meets the
requirements set forth by rule of the commissioner;
(b) Is qualified to sign statements of actuarial opinion for life and health
insurance company annual statements in accordance with the American Academy
of Actuaries qualification standards for actuaries signing such statements;
(c) Is familiar with the valuation requirements applicable to life and health
insurance companies;
(d) Has not been found by the commissioner, upon appropriate notice and
hearing, or, if so found, has been reinstated as a qualified actuary, to have:
(I) Violated any provision of, or any obligation imposed by, the insurance law
or other law in the course of his or her dealings as a qualified actuary;
(II) Been found guilty of fraudulent or dishonest practices;
(III) Demonstrated incompetency, lack of cooperation, or untrustworthiness
to act as a qualified actuary;
(IV) Submitted to the commissioner, during the past five years, an actuarial
opinion or memorandum that the commissioner rejected because it did not meet the
provisions of this part 1 and part 7 of this article including standards set by the
Actuarial Standards Board or its successor; or
(V) Resigned or been removed as an actuary within the past five years as a
result of acts or omissions indicated in any adverse report on examination or as a
result of failure to adhere to generally acceptable actuarial standards; and
(e) Has not failed to notify the commissioner of any action taken by any
commissioner of any other state similar to that under paragraph (d) of subsection (1)
of this section.
(2) Actuarial opinion of reserves after the operative date of the valuation
manual. On and after the operative date of the valuation manual, as that term is
defined in section 10-7-301.5 (7):
(a) Every company with outstanding life insurance contracts, accident and
health insurance contracts, or deposit-type contracts in this state and subject to
regulation by the commissioner shall annually submit the opinion of the appointed
actuary as to whether the reserves and related actuarial items held in support of
the policies and contracts are computed appropriately, are based on assumptions
that satisfy contractual provisions, are consistent with prior reported amounts, and
comply with applicable laws of this state. The valuation manual will prescribe the
specifics of this opinion, including any item the commissioner deems to be
necessary to its scope.
(b) Every opinion required by this subsection (2) is governed by the following
provisions:
(I) The opinion must be in form and substance as specified in the valuation
manual and acceptable to the commissioner.
(II) The opinion must be submitted with the annual statement reflecting the
valuation of reserve liabilities for each year ending on or after the operative date of
the valuation manual.
(III) The opinion must apply to all policies and contracts subject to this
paragraph (b), plus other actuarial liabilities as may be specified in the valuation
manual.
(IV) The opinion must be based on standards adopted from time to time by
the Actuarial Standards Board or its successor, and on such additional standards as
may be prescribed in the valuation manual.
(V) In the case of an opinion required to be submitted by a foreign or alien
company, the commissioner may accept the opinion filed by that company with the
insurance supervisory official of another state if the commissioner determines that
the opinion reasonably meets the requirements applicable to a company domiciled
in this state.
(VI) Except in cases of fraud or willful misconduct, the appointed actuary is
not liable for damages to any person, other than the insurance company and the
commissioner, for any act, error, omission, decision, or conduct with respect to the
appointed actuary's opinion.
(VII) Disciplinary actions capable of being taken by the commissioner against
the company or the appointed actuary must be defined in rules promulgated by the
commissioner.
(c) Every company with outstanding life insurance contracts, accident and
health insurance contracts, or deposit-type contracts in this state and subject to
regulation by the commissioner, except as exempted in the valuation manual, shall
also annually include in the opinion required by this subsection (2) an opinion of the
same appointed actuary as to whether the reserves and related actuarial items held
in support of the policies and contracts specified in the valuation manual, when
considered in light of the assets held by the company with respect to the reserves
and related actuarial items, including the investment earnings on the assets and the
considerations anticipated to be received and retained under the policies and
contracts, make adequate provision for the company's obligations under its policies
and contracts, including the benefits under and expenses associated with the
policies and contracts.
(d) Each opinion required by paragraph (c) of this subsection (2) is governed
by the following provisions:
(I) A memorandum, in form and substance as specified in the valuation
manual and acceptable to the commissioner, must be prepared to support each
actuarial opinion.
(II) If the insurance company fails to provide a supporting memorandum at
the request of the commissioner within a period specified in the valuation manual,
or the commissioner determines that the supporting memorandum provided by the
insurance company fails to meet the standards prescribed by the valuation manual
or is otherwise unacceptable to the commissioner, the commissioner may engage a
qualified actuary at the expense of the company to review the opinion and the basis
for the opinion and prepare the supporting memorandum required by the
commissioner.