"I, [name], am [title] of [insurance company name] and a member of the American Academy of Actuaries. I was appointed by, or by the authority of, the Board of Directors of said insurer to render this opinion as stated in the letter to the commissioner dated [insert date]. I meet the Academy qualification standards for rendering the opinion and am familiar with the valuation requirements applicable to life and health insurance companies."
"I, [name], a member of the American Academy of Actuaries, am associated with the firm of [name of consulting firm]. I have been appointed by, or by the authority of, the Board of Directors of [name of company] to render this opinion as stated in the letter to the commissioner dated [insert date]. I meet the Academy qualification standards for rendering the opinion and am familiar with the valuation requirements applicable to life and health insurance companies."
"I have examined the actuarial assumptions and actuarial methods used in determining reserves and related actuarial items listed below, as shown in the annual statement of the company, as prepared for filing with state regulatory officials, as of December 31, 20[ ]. Tabulated below are those reserves and related actuarial items which have been subjected to asset adequacy analysis."
Asset Adequacy Tested Amounts-Reserves and Liabilities | |||||
Statement Item | Formula Reserves (1) | Additional Actuarial Reserves (a)(2) | Analysis Method (b) | Other Amount (3) | Total Amount (1)+(2)+(3) (4) |
Exhibit 5 A Life Insurance | |||||
B Annuities | |||||
C Supplementary Contracts Involving Life Contingencies | |||||
D Accidental Death Benefit | |||||
E Disability - Active | |||||
F Disability - Disabled | |||||
G Miscellaneous | |||||
Total (Exhibit 5 Item 1, Page 3) | |||||
Exhibit 6 A Active Life Reserve | |||||
B Claim Reserve | |||||
Total (Exhibit 6 Item 2, Page 3) | |||||
Exhibit 7 Premium and Other Deposit | |||||
Funds (Column 5, Line 14) | |||||
Guaranteed Interest Contracts (Column 2, Line 14) | |||||
Other (Column 6, Line 14) | |||||
Supplemental Contracts and Annuities Certain (Column 3, Line 14) | |||||
Dividend Accumulations or Refunds (Column 4, Line 14) | |||||
Total Exhibit 7 (Column 1, Line 14) | |||||
Exhibit 8, Part 1 1 Life (Page 3, Line 4.1) | |||||
2 Health (Page 3, Line 4.2) | |||||
Total Exhibit 8, Part 1 | |||||
Separate Accounts (Page 3 of the Annual Statement of the Separate Accounts, Lines 1, 2, 3.1, 3.2, 3.3) | |||||
TOTAL RESERVES |
IMR (General Account, Page ___Line ___) | |
(Separate Accounts, Page Line ) | |
AVR (Page ___ Line ___) | (c) |
Net Deferred and Uncollected Premium |
Notes:
"I have relied on [name], [title] for [e.g., "anticipated cash flows from currently owned assets, including variations in cash flows according to economic scenarios" or "certain critical aspects of the analysis performed in conjunction with forming my opinion"], as certified in the attached statement. I have reviewed the information relied upon for reasonableness."
A statement of reliance on other experts should be accompanied by a statement by each of the experts in the form prescribed by §2111. E
"My examination included such review of the actuarial assumptions and actuarial methods and of the underlying basic asset and liability records and such tests of the actuarial calculations as I considered necessary. I also reconciled the underlying basic asset and liability records to [exhibits and schedules listed as applicable] of the company's current annual statement."
"In forming my opinion on [specify types of reserves] I relied upon data prepared by [name and title of company officer certifying in force records or other data] as certified in the attached statements. I evaluated that data for reasonableness and consistency. I also reconciled that data to [exhibits and schedules to be listed as applicable] of the company's current annual statement. In other respects, my examination included review of the actuarial assumptions and actuarial methods used and tests of the calculations I considered necessary."
The section shall be accompanied by a statement by each person relied upon in the form prescribed by Subsection E.
"In my opinion the reserves and related actuarial values concerning the statement items identified above:
The reserves and related items, when considered in light of the assets held by the company with respect to such reserves and related actuarial items including, but not limited to, the investment earnings on the assets, and the considerations anticipated to be received and retained under the policies and contracts, make adequate provision, according to presently accepted actuarial standards of practice, for the anticipated cash flows required by the contractual obligations and related expenses of the company. (At the discretion of the commissioner, this language may be omitted for an opinion filed on behalf of a company doing business only in this state and in no other state.)
The actuarial methods, considerations and analyses used in forming my opinion conform to the appropriate Standards of Practice as promulgated by the Actuarial Standards Board, which standards form the basis of this statement of opinion.
This opinion is updated annually as required by statute. To the best of my knowledge, there have been no material changes from the applicable date of the annual statement to the date of the rendering of this opinion which should be considered in reviewing this opinion.
or
The following material changes which occurred between the date of the statement for which this opinion is applicable and the date of this opinion should be considered in reviewing this opinion: (Describe the change or changes.)
Note: Choose one of the above two paragraphs, whichever is applicable.
The impact of unanticipated events subsequent to the date of this opinion is beyond the scope of this opinion. The analysis of asset adequacy portion of this opinion should be viewed recognizing that the company' future experience may not follow all the assumptions used in the analysis. __________________________________ Signature of Appointed Actuary __________________________________ Address of Appointed Actuary __________________________________ Telephone Number of Appointed Actuary __________________________________ Date" |
(1) Product Type | (2) Death Benefit or Account Value | (3) Reserves Held | (4) Codification Reserves | (5) Codification Standard |
La. Admin. Code tit. 37, § XIII-2111