24-A §952-A. Actuarial opinion of reserves - Maine Statutes

Title 24-A: MAINE INSURANCE CODE

Chapter 11: ASSETS AND LIABILITIES

Subchapter 3: LIFE INSURANCE RESERVES

§952-A. Actuarial opinion of reserves

1. General. A life insurer doing business in this State shall annually submit the opinion of a qualified actuary as to whether the reserves and related actuarial items of that life insurer held in support of the policies and contracts specified by the superintendent by rule 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 superintendent by rule shall define the specifics of this opinion and add any other items considered necessary to its scope.

[ 1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF) .]

2. Actuarial analysis of reserves and assets supporting those reserves. A life insurer, except as exempted by or pursuant to rule, shall include in the opinion required by 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 superintendent by rule, when considered in light of the assets held by the insurer with respect to the 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, adequately provide for the insurer's obligations under the policies and contracts, including, but not limited to, the benefits under and expenses associated with the policies and contracts.

The superintendent may provide by rule for a transition period for establishing any higher reserves that the qualified actuary may consider necessary in the opinion required by this subsection.

[ 1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF) .]

3. Requirement for opinion under subsection 2. An opinion required by subsection 2 is governed by the following provisions.

A. A memorandum, in form and substance acceptable to the superintendent as specified by rule, must be prepared to support the actuarial opinion. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

B. If the insurer fails to provide a supporting memorandum at the request of the superintendent within a period specified by rule or the superintendent determines that the supporting memorandum provided by the insurer fails to meet the standards prescribed by the rules or is otherwise unacceptable to the superintendent, the superintendent may engage a qualified actuary at the expense of the insurer to review the opinion and the basis for the opinion and prepare a supporting memorandum as required by the superintendent. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

[ 1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF) .]

4. Requirement for all opinions. An opinion required pursuant to subsection 1 or 2 is governed by the following provisions.

A. The opinion must be submitted with the annual statement reflecting the valuation of reserve liabilities for each year ending on or after December 31, 1995. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

B. The opinion must apply to all business in force, including individual and group health insurance plans, in a form and substance acceptable to the superintendent as specified by rule. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

C. The opinion must be based on standards adopted by the actuarial standards board and on those additional standards as the superintendent by rule prescribes. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

D. In the case of an opinion required to be submitted by a foreign or alien insurer, the superintendent may accept the opinion filed by that insurer with the insurance supervisory official of another state if the superintendent determines that the opinion reasonably meets the requirements applicable to an insurer domiciled in this State. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

E. For the purposes of this section, "qualified actuary" means a member in good standing of the American Academy of Actuaries who meets the requirements set forth in the rules of the American Academy of Actuaries. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

F. Except in cases of fraud or willful misconduct, a qualified actuary is not liable for damages to any person, other than the insurer and the superintendent, for any act, error, omission, decision or conduct with respect to the qualified actuary's opinion. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

G. Disciplinary action by the superintendent against the insurer or the qualified actuary must be defined in rules established by the superintendent. [1993, c. 634, Pt. B, §1 (NEW); 1993, c. 634, Pt. B, §4 (AFF).]

H. Except as provided in paragraphs K, L and M, any memorandum in support of the opinion and any other documents, materials or other information provided by the insurer to the superintendent in connection with the memorandum must be kept confidential by the superintendent and are not public records within the meaning of the freedom of access laws and are not subject to subpoena or discovery, nor admissible in evidence in any private civil action. The superintendent is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the superintendent's official duties. [2001, c. 89, §1 (RPR).]

I. Neither the superintendent nor any person who received documents, materials or other information while acting under the authority of the superintendent is permitted or required to testify in any private civil action concerning any confidential documents, materials or information pursuant to paragraph H. [2001, c. 89, §2 (NEW).]

J. Disclosure to the superintendent under this section or as a result of sharing of documents, materials or other information pursuant to section 216 does not constitute a waiver of any applicable privileges or claim of confidentiality in the documents, materials or other information. [2001, c. 89, §2 (NEW).]

K. A memorandum in support of the opinion, and any other documents, materials or other information provided by the life insurer to the superintendent in connection with the memorandum, may be subject to subpoena for the purpose of defending an action seeking damages from the actuary submitting the memorandum by reason of an action pursuant to this section or by rule adopted pursuant to this section. [2001, c. 89, §2 (NEW).]

L. The memorandum or other documents, materials or other information may otherwise be released by the superintendent with the written consent of the life insurer or upon a written request by the American Academy of Actuaries stating that the memorandum or other documents, materials or other information is required for the purpose of professional disciplinary proceedings and setting forth procedures satisfactory to the superintendent for preserving the confidentiality of the memorandum or other documents, materials or other information. [2001, c. 89, §2 (NEW).]

M. Once any portion of a memorandum is cited by the life insurer in its marketing or is cited by the life insurer before a governmental agency other than a state insurance agency or is released by the life insurer to the news media, all portions of the memorandum become public records. [2001, c. 89, §2 (NEW).]

[ 2001, c. 89, §§1, 2 (AMD) .]

5. Applicability to health carriers. A health carrier not otherwise subject to this section or section 993 shall file an actuarial opinion in accordance with the applicable National Association of Insurance Commissioners annual statement instructions. For purposes of this section, “health carrier” means an insurer, health maintenance organization, nonprofit corporation subject to Title 24 or fraternal benefit society that provides health insurance or comparable health benefits. This section and rules adopted pursuant to this section apply to health carriers to the extent that they specifically refer to health carriers or impose requirements that are consistent with and no more stringent than the annual statement instructions.

[ 2009, c. 511, Pt. B, §1 (NEW) .]

SECTION HISTORY

1993, c. 634, §B1 (NEW). 1993, c. 634, §B4 (AFF). 2001, c. 89, §§1,2 (AMD). 2009, c. 511, Pt. B, §1 (AMD).