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Texas Department of Insurance Company Name: Property/Casualty Rate Filing Exhibit Company NAIC Number:

Company Filing Number: Line:

Exhibit A – Rate Filing Checklist (Page 1 of 2)

All rate filings (except short track and those for insurers that qualify for reduced filing requirements under 28 TAC Chapter 5, Subchapter M, Division 9)

Transmittal information

Rates and supplementary rating information

Filing memorandum

Rate filing checklist (Exhibit A)

Rate change information (Exhibit C)

SERFF rate data (Exhibit B, if not filing in SERFF)

Loss cost information for reference filings (Exhibit G)

Actuarial memorandum

Actuarial support

Rate indications (overall, coverage, class, form, or peril)

Relativity analysis

Other actuarial support

Policyholder impact information (for owner-occupied homeowners and personal automobile)

Average rate change by county (Exhibit County, for owner-occupied homeowners)

Historical premium and loss information (Exhibit D)

Historical projected expense information, with disallowed expenses (Exhibit E, all lines except workers’ compensation and mortgage guaranty)

Historical projected expense information (Exhibit F, for mortgage guaranty and workers’ compensation)

Profit provision information (Exhibit L)

Certification (Exhibit MG, for mortgage guaranty)

Workers’ Compensation Information (Exhibit WC)

Short track rate filings Transmittal information

Rates and supplementary rating information

Filing memorandum

Rate filing checklist (Exhibit A)

Rate change information (Exhibit C)

SERFF rate data (Exhibit B, if not filing in SERFF)

Texas Department of Insurance | www.tdi.texas.gov 1/2

http:www.tdi.texas.gov

Texas Department of Insurance Property/Casualty Rate Filing Exhibit

Exhibit A – Rate Filing Checklist (Page 2 of 2)

Division 9 rate filings Transmittal information

Certification (EC-1, residential property)

Certification (EC-2, personal automobile)

Rates and supplementary rating information

Filing memorandum

Rate filing checklist (Exhibit A)

Rate change information (Exhibit C)

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Company Name: Company NAIC Number: Company Filing Number: Line:

SERFF rate data (Exhibit B, if not filing in SERFF)

Policyholder impact information (for owner-occupied homeowners and personal automobile)

Average rate change by county (Exhibit County, for owner-occupied homeowners)

Division 10 additional requirements for certain county mutual insurers Additional information for certain county mutual insurers (Exhibit CM)

Texas Department of Insurance | www.tdi.texas.gov 2/2

http:www.tdi.texas.gov

Print: Company Name: Company NAIC Number: Company Filing Number: Line: All Rate Filings: OffAll Transmittal Form: OffAll Rates and supplementary: OffAll Filing Memorandum: OffAll Rates filing checklist: OffAll Rate change info: OffAll SERFF rate data: OffLoss cost info: OffActuarial memo: OffActuarial support: OffRate indications: OffRelativity analysis: OffOther actuarial support: OffPolicyholder impact: OffAll Average rate change: OffHistorical premium: OffHistorical projected: OffHistorical projected expense: OffProfit provision information: OffShort track rate rilings: OffShort track Transmittal information: OffShort track Rates and supplementary rating: OffShort track Filing memorandum: OffShort track Rate filing checklist: OffShort track Rate and change info: OffShort track SERFF rate data: OffDivision 9 Transmittal information: OffDivision 9 Certification: OffDivision 9 Certification EC-2: OffDivision 9 Rates and supplementary: OffDivision 9 Filing memo: OffDivision 9 Rate filing checklist: OffDivision 9 rate change: OffDivision 9 SERFF rate data: OffDivision 9 Policyholder impact owner-occupied: OffCertification: OffWorkers' Comp: OffDivision 9 Rate Filings: OffDivision 10 Addl Req: OffDivision 9 Average rate change by county: OffDivision 10 additional info county mutuals: Off