N.J. Admin. Code § Tit. 11, ch. 3, subch. 16, APPENDIX, exh. A

Current through Register Vol. 56, No. 21, November 4, 2024

Exhibit A

EXHIBIT A

PRIOR APPROVAL FILINGS

Company/Group:________________________________

Company File No.:_________________________________

Section	Item	Page
#
1)	Filing Requirements	Yes/ No
16.3(d)	Certification of compliance (exact text in regulation)	Yes
	signed by officer	/ No
16.3(e)	All data reported on direct basis exclusive of	Yes
	reinsurance	/ No
16.6(a)1	Cover letter including proposed revision, effective
	date, and company contact information
16.6(a)2	This checklist	Yes
		/ No
16.6(a)3	Appendix Exhibit B	Yes
		/ No
16.6(a)4	Narrative overview	Yes
		/ No
16.6(a)8	Proposed rates (or loss costs) for each territory and
	coverage together with their derivation.
16.6(a)9	Calculation demonstrating compliance with NJSA 17:29A-36	________
16.6(a)10	Data in Microsoft Excel or compatible spreadsheet	Yes
		/ No
16.6(a)11	Proposed manual rate and/or rule pages	Yes/No
16.6(c)	Revised Manual Pages	________
2) Premium, Loss, and LAE Data--All data must be at total limits and/or
basic limits and must be consistent throughout the filing. All data is to be
provided by coverage by accident year for each of the latest three years.
16.8(a)1	NJ direct earned premium (or loss cost) at present	________
	rates with supporting documentation
16.8(a)2	Premium trend exhibits	________
16.8(a)3	NJ direct earned exposures	________
16.8(a)4	NJ direct paid and/or incurred losses	________
16.8(a)5	NJ direct paid and/or incurred D&CC LAE	________
16.8(a)6	NJ direct paid and/or incurred A&O LAE	________
16.8(a)7	Ultimate developed loss and LAE	________
16.8(a)8	NJ direct paid and/or incurred claim counts	________
16.8(a)9	Ultimate developed claim counts	________
16.8(a)10	Loss trend exhibits	________
16.8(a)11	Trended ultimate developed loss and LAE	________
16.8(b)	(Required only if losses are separated into catastrophe
	and non-catastrophe)
	-- Clear description and justification of the standard	________
	used
	-- At least 10 years used to determine catastrophe load	________
	-- Explanation if database used for catastrophe load is	________
	different from that used for rate level change
16.8(c)	(Required only if territorial factors are changing)
	-- Territorial rate indications	________
16.8(d)	(Required only if classification factors are changing)
	-- Differentials and loss ratios by class	________
16.8(e)	(Required only if tier relativities are changing)
	-- Differentials and loss ratios by tier	________
16.8(f)	Credibility exhibits	________
3)	Expense Data	________
16.9(a)1	Selected expense provisions and related information	________
16.9(a)2i	Commission and Brokerage expenses from NJ Page 14	________
16.9(a)2ii	Other acquisition expenses from IEE	________
16.9(a)2iii	General expenses from IEE	________
16.9(a)2iv	Taxes, Licenses, and Fees expenses from NJ Page 14	________
16.9(a)3	Finance and other miscellaneous charges	________
16.9(a)4	Description of affiliated-company transactions	________
16.9(b)	Expense flattening per NJSA 17:29A-37	________
16.9(c)	Expenses Capped by Appendix Exhibit E Calculation (available on DOBI web site)
		Yes
		/ No
16.9(d)	Excluded Expenses (state if none)	________
16.9(e)	Bodily Injury Liability Commissions equalized using
	Appendix Exhibit C	________
16.9(f)	Expense data on direct basis	Yes
		/ No
4)	Profit and contingency provision	Yes
		/ No
16.10(a)	Profit and contingency provision does not result in	________
	rates that are excessive, inadequate, or unfairly
	discriminatory

N.J. Admin. Code Tit. 11, ch. 3, subch. 16, APPENDIX, exh. A

New Rule, R.2003 d.173, effective 5/5/2003
See: 34 N.J.R. 3475(a), 35 N.J.R. 1907(a).
Amended by R.2003 d.499, effective 12/15/2003.
See: 35 N.J.R. 3084(a), 35 N.J.R. 5604(a).
In 5), deleted "PIP losses capped at $ 75,000"; in 6), deleted "PIP losses limited to $ 75,000"; in 11), substituted "ROE formula:
for "Clifford Formula" in 16.10(a)1; rewrote 12).
Repeal an New Rule, R.2005 d.176, effective 6/6/2005.
See: 36 N.J.R. 5640(a), 37 N.J.R. 2026(a)
Repeal and New Rule, R.2014 d.004, effective 1/6/2014.
See: 45 N.J.R. 1886(a), 46 N.J.R. 86(a).

Amended by 54 N.J.R. 67(b), effective 1/3/2022