september series - pennsylvania insurance department · 7 outreach division cindy fillman...

Market Analysis ~ September Series

www.insurance.pa.gov

R b t L P tt A ti PA I C i i



Presented by:The Pennsylvania Insurance Department

September 16, 2010

8 a.m. to 3 p.m.Property & Casualty

focus

September 30, 2010

8 a.m. to 3 p.m.Life, Accident & Health

focus

Temple University HarrisburgConference Center

234 Strawberry Square, Harrisburg, PA 17101www.temple.edu/harrisburg



2

Welcoming Comments and Useful Information

Scanning Today's Program

Brief Overview of the Department

Brief Overview of the PA Market

PA Complaint Overview

Program Overview ~ Setting the Stage

Ron Gallagher, Deputy Insurance [email protected]



3

Our Sponsors:

The Insurance Federation of Pennsylvania, Inc.

PA Association of Mutual Insurance Companies



4

Who is in the audience today?

(as of 9/24/10)

28 Carriers

Legislative Staff

House of Representatives Senate Banking Committee

7 Law Firms

1 Trade Groups

Maryland Insurance Administration

PA Insurance Department Presenters, Support Staff and Legal Counsel

Useful Information



5

Scanning Today’s Program:

8:00 Registration

8:30 Setting the StageRon Gallagher, Deputy Commissioner forMarket Regulation

9:00 “Undressing” Market AnalysisJeff Arnold, Market Analysis

10:00 The “411” for Carriers and Consultants Cindy Fillman, Director, Market Analysis and Education

10:30 Morning Break

10:45 Market Actions - A Year in ReviewChris Monahan, Director, Bureau of Market Conduct

11:15 Morning Wrap-up/Questions

11:45 Lunch (on your own)

1:00 Walk in the Regulator‘s ShoesParticipate in a workshop and conduct a market regulation committee session

2:00 Afternoon Wrap-up/Questions

2:30 Roundtable Discussion with Deputy Commissioners



6

In s u r a n c e C o m m is s io n e r

O ff ic e o f G e n e r a l C o u n s e l O f f ic e o f C h ie f C o u n s e l

P o lic y O f f ic e

C o m m u n ic a t io n s O f f ic e

D e p u ty In s u r a n c e C o m m is s io n e r fo r M a rk e t

R e g u la t io n

D e p u ty In s u ra n c e C o m m is s io n e r fo r L iq u id a t io n s ,

R e h a b i l i ta t io n s , a n d S p e c ia l F u n d s

D e p u ty In s u r a n c e C o m m is s io n e r fo r C o rp o ra te

a n d F in a n c ia l R e g u la t io n

D e p u ty In s u ra n c e C o m m is s io n e r fo r C H IP

a n d A d u lt B a s ic In s u r a n c e

D e p u ty In s u r a n c e C o m m is s io n e r fo r In s u r a n c e

P r o d u c t R e g u la t io n a n d A d m in is t r a t io n

D e p u ty In s u ra n c e C o m m is s io n e r fo r M e d ic a l

C a re A v a i la b i l i ty a n d R e d u c t io n o f E r ro r

( M C A R E )

A d m in is t r a t iv e H e a r in g s O f f ic e

B u re a u o f M e d ic a l M a lp ra c t ic e A d m in is t r a t io n

D iv is io n s :

O p e ra t io n s S u p p o r t P o lic y A d m in is tr a t io n

D iv is io n s :P o l ic y a n d P la n n in gQ u a li ty A s s u r a n c e

O p e r a t io n s S u p p o r tM a r k e t in g a n d O u t r e a c h

B u r e a u o f L iq u id a t io n s a n d R e h a b i l i ta t io n s A d m in is t r a t io n

D iv is io n s :A s s e t M a n a g e m e n t

S u p p o r t S e r v ic e s

B u r e a u o f L iq u id a t io n C la im sD iv is io n s :

P r o p e r ty a n d C a s u a ltyL ife , A c c id e n t , a n d H e a lth

B u re a u o f S p e c ia l F u n d sD iv is io n s :

A u to C A T F u n dW o r k e rs C o m p e n s a t io n S e c u r i ty

F u n dU n d e rg r o u n d S to ra g e T a n k

In d e m n if ic a t io n F u n d

B u r e a u o f C o n s u m e r S e r v ic e s

R e g io n a l O f f ic e s :H a r r is b u r g

P h i la d e lp h ia

B u r e a u o f M a rk e t C o n d u c tD iv is io n s :

L i fe a n d H e a lth M a r k e t C o n d u c t

P ro p e r ty a n d C a s u a lty M a rk e t C o n d u c t

B u r e a u o f L ic e n s in g a n d E n fo r c e m e n t

D iv is io n s :L ic e n s in g S e r v ic e s

In fo r m a t io n S e rv ic e sL ic e n s in g C o m p lia n c e

F ie ld In v e s t ig a t io n sF r a u d

B u r e a u O f F in a n c ia l E x a m in a t io n s

B u re a u o f C o m p a n y L ic e n s in g a n d F in a n c ia l A n a ly s is

D iv is io n s :F in a n c ia l A n a ly s is

C o m p a n y L ic e n s in g

B u re a u o f A d m in is t r a t io nD iv is io n s :

H u m a n R e s o u r c e s a n d E q u a l E m p lo y m e n t O p p o r tu n ity

B u d g e tO f f ic e M a n a g e m e n t

B u r e a u o f P r o p e r ty a n d C a s u a lty In s u r a n c e

D iv is io n s :A c tu a r ia l R e v ie w

P o lic y R e v ie w

B u re a u o f L i fe In s u r a n c eD iv is io n s :

A c tu a r ia l R e v ie wP o lic y R e v ie w

B u r e a u o f A c c id e n t a n d H e a lth In s u r a n c eD iv is io n s :

A c tu a r ia l D iv is io nP o l ic y R e v ie w

O ff ic e o f th e B u d g e tC o m p tr o l le r ’s O f f ic e

B u r e a u o f M C A R E C la im s A d m in is t r a t io n

D iv is io n s :C la im s A d m in is t r a t io n

S u p p o r tP h ila d e lp h ia R e g io n a l

O f f ic eE a s te r n R e g io nC e n t r a l R e g io n

W e s te r n R e g io n

IN S U R A N C E D E P A R T M E N T

L e g is la t iv e O f f ic e

B u r e a u o f M a rk e t A n a ly s is a n d E d u c a t io n

M a r k e t S u r v e i l la n c e D iv is io n



7

Outreach DivisionCindy Fillman

[email protected]

Market Analysis Division

Vacant, Supervisor

Deputy Insurance CommissionerRon Gallagher

[email protected]

Bureau of Consumer Services Carolyn Morris, [email protected]

783-9862

Bureau of Licensing and Enforcement

Jack Yanosky, [email protected]

705-0020

Harrisburg Regional Office

Roger [email protected]

705-4395

Philadelphia Regional Office

Leslie [email protected]

215-560-2630

L & H Market ConductYonise Paige

[email protected]

P & C Market ConductChet Derk

[email protected]

Licensing DivisionAdriane Force

[email protected]

Compliance DivisionJim Krebs

[email protected]

Program AnalystChristine Diep

[email protected]

Field InvestigationsDivision

Robert [email protected]

772-3598

Bureau of Market Analysis and Education

Cindy Fillman, [email protected]

783-2011

Fraud DivisionDeborah Lee

[email protected]

Bureau of Market Conduct

Christopher Monahan, [email protected]

787-9100

Executive Secretary Lori Magaro

[email protected]

Complaint Intake UnitBrenda John

[email protected]

Information Services Division

Ann Barnett [email protected]

783-2186

Office of Market Regulation

Sharon FraserBureau Support

[email protected]



8

Overview of the PA Market:

$81 billion in Annual Premium 5th Largest Market in US 12th Largest Market in World

288 Domestic carriers

1,869 licensed carriers

181,327 licensed producers 72,301 residents 109,026 non-resident

$41 million to GF annually (approx)

$18.5 million budget annually (approx)

220 positions (approx on regulatory only)



9

Overview of the PA Market ~ State Budget:

State 2010 RankNew York $556,976,000 1California $240,051,000 2Florida $114,423,066 3Texas $102,547,440 4Ohio $94,830,371 5Kentucky $40,532,900 6West Virginia $40,473,933 7North Carolina $29,863,635 8Louisiana $29,387,018 9New Jersey $29,198,000 10Michigan $29,020,800 11Maryland $27,361,093 12Virginia $26,256,198 13Delaware $25,087,000 14Connecticut $24,828,742 15Washington $23,182,000 16Illinois $22,619,000 17Pennsylvania $21,807,000 18Alabama $20,404,588 19Arizona $19,439,700 20

States in Descending Order of 2010 Budget



10

States in Descending Order of 2008 Premium VolumeState 2008 Rank

California $220,922,831,947 1New York $150,859,397,709 2Florida $105,328,277,735 3Texas $99,037,673,043 4Pennsylvania $81,078,728,038 5Illinois $59,598,002,201 6New Jersey $59,467,162,770 7Ohio $55,366,587,161 8Michigan $50,998,104,902 9Massachusetts $43,551,960,738 10




11

Note: The 2009

market share information came from

the NAIC as of May 4,

2010.


Groups which account for 95.05% of the Total A & H Direct Premium in PA

2009

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

Health Care Groups

Com

plai

nt In

dex

0

5

10

15

20

25

30

35

Mar

ket S

hare

(per

cent

age)

Complaint Index 0.81 0.03 0.31 0.32 0.53 0.16 0.49 0.71 0.14 0.01

Market Share 5.61 3.07 30.81 28.35 4.86 3.1 6.01 2.37 8.47 2.4

AetnaUnited Health Highmark

Independence Blue

Cross

Coventry Corp Geisinger

Capital Blue Cross

Hospital Serv Assn of NEPA

UPMC Health

Systems

Health Partners of Philadelphi



12

Overview of the PA Market:Groups which account for 50.46% of the Total

Life Direct Premium in PA2009

0.00

0.20

0.40

0.60

0.80

1.00

1.20

Life Groups

Com

plai

nt In

dex

0

1

2

3

4

5

6

7

8

9

Mar

ket S

hare

(per

cent

age)

Complaint Index 0.05 0.28 0.63 0.56 0.11 1.00 0.19 0.04 0.10 0.38

Market Share 3.44 5.12 8.35 7.01 3.52 3.57 4.61 5.48 5.49 3.87

State Farm Lincoln Natl Metropolitan Prudential of Amer

Mass Mut Life Ins

Aegon US Holding Grp

New York Life

Northwestern Mut

John Hancock

Axa Ins

Note: The 2009 market share information came from the NAIC as of May 4, 2010.



13

Total Assistance(Complaints, Phone calls, Hotline, Internet Requests, Walk-ins)

26,16027,656 27,803

22,17625,628

21,893

27,432

23,969

95,694

107,023

0

15,000

30,000

45,000

2008

2009

2010

2008

2009

2010

2008

2009

2010

2008

2009

2010

1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr.Quarter

No.

of C

ompl

aint

s

0

20,000

40,000

60,000

80,000

100,000

120,000

2008 2009 2010

Year

Cum

ulat

ive

Tota

l

PA Complaint Overview:



14

Assistance: Internet Requests

845905825740780 1021

832 866 806

1,021 3,661

0

5001000

15002000

2500

30003500

4000

2008

2009

2010

2008

2009

2010

2008

2009

2010

2008

2009

2010


No.

of C

ompl

aint

s

500

1,000

1,500

2,000

2,500

3,000

3,500

4,0002008 2009 2010

Year

Cum

ulat

ive

Tota

l




15

Assistance: Phone Calls

19,40520,080

18,570.0

15,622

18,61915,090

20,64417,519

19,465

67,636

79,908

0

10,000

20,000

30,000

40,000

50,000

2008

2009

2010

2008

2009

2010

2008

2009

2010

2008

2009

2010


No.

of C

ompl

aint

s

0

20,000

40,000

60,000

80,000

2008 2009 2010Year

Cum

ulat

ive

Tota

l




16

Total Assistance: Hotline

1,690 2,1581,800 1,952

2,393

1,614 1,719 1,722 1,653

6,789

7,735

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

2008

2009

2010

2008

2009

2010

2008

2009

2010

2008

2009

2010


No.

of C

ompl

aint

s

0

2,000

4,000

6,000

8,000

10,0002008 2009 2010

Year

Cum

ulat

ive

Tota

l




17

Assistance: Walk-ins

153 170 128175 180

101

171 168 187

703 629

0

100

200

300

400

500

2008

2009

2010

2008

2009

2010

2008

2009

2010

2008

2009

2010


No.

of C

ompl

aint

s

0

500

2008 2009 2010

Year

Cum

ulat

ive

Tota

l




18

Total Complaints Received

4,1255,500

4,573 4,327 4,025 4,259 4,349 3,782 3,584

17,43216,765

0

5,000

10,000

15,000

20,000

25,000

2008

2009

2010

2008

2009

2010

2008

2009

2010

2008

2009

2010

1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr.

Quarter

No.

of C

ompl

aint

s

0

5,000

10,000

15,000

20,000

25,0002008 2009 2010

Year

Cum

ulat

ive

Tota

l




19

Accident and Health Complaints

1,017

1,358 1,2871,4341,310

2,629

1,532 1,400 1,4411,671

1,311 1,262

5,285

6,698

5,669

0

1,000

2,000

3,000

2007

2008

2009

2007

2008

2009

2007

2008

2009

2007

2008

2009


No.

of C

ompl

aint

s

0

1,000

2,000

3,000

4,000

5,000

6,000

7,0002007 2008 2009

Year

Cum

ulat

ive

Tota

l



20

Accident and Health: Complaints Category2009

666

72 46

245

532

59

373

298

211

483477

648

763

75

226

495

0

200

400

600

800

1000C

laim

s H

andl

ing

Mar

ketin

g an

d S

ales

Pol

icyh

olde

r Ser

vice

s

Und

erw

ritin

g

Cla

ims

Han

dlin

g

Mar

ketin

g an

d S

ales

Pol

icyh

olde

r Ser

vice

s

Und

erw

ritin

g

Cla

ims

Han

dlin

g

Mar

ketin

g an

d S

ales

Pol

icyh

olde

r Ser

vice

s

Und

erw

ritin

g

Cla

ims

Han

dlin

g

Mar

ketin

g an

d S

ales

Pol

icyh

olde

r Ser

vice

s

Und

erw

ritin

g

1st Quarter 2nd Quarter 3rd Quarter 4th Quarter

No.

of C

ompl

aint

s

`



21

Life Complaints

423391503 449 475

266

452519

456382

594544

1,740

1,9461,768

0

500

1000

1500

2007

2008

2009

2007

2008

2009

2007

2008

2009

2007

2008

2009


No.

of C

ompl

aint

s

0

600

1,200

1,800

2,4002007 2008 2009

Year

Cum

ulat

ive

Tota

l



22

Life Complaints: Total Complaints by Category2009

361

4129

154

42

269

455774757039

11480

38

280

0

100

200

300

400

Cla

ims

Han

dlin

g

Mar

ketin

g an

dS

ales

Pol

icyh

olde

rSe

rvic

es

Und

erw

ritin

g

Cla

ims

Han

dlin

g

Mar

ketin

g an

dS

ales

Pol

icyh

olde

rSe

rvic

es

Und

erw

ritin

g

Cla

ims

Han

dlin

g

Mar

ketin

g an

dS

ales

Pol

icyh

olde

rSe

rvic

es

Und

erw

ritin

g

Cla

ims

Han

dlin

g

Mar

ketin

g an

dS

ales

Pol

icyh

olde

rSe

rvic

es

Und

erw

ritin

g

1st Quarter 2nd Quarter 3rd Quarter 4th Quarter

No.

of C

ompl

aint

s



23

Market Regulation Committee:

Deputy for Market

Regulation

Director, Consumer Services

Deputy for Product

Regulation

Bureau Director for

Product Type

Deputy for Financial

RegulationMarket

Analysis Staff

Director, Market

Analysis &

Education

Market Analysis

Chief

Director, Market Actions

Product Area,Division Chief,

Market Actions

Background

• Multidisciplinary Analysis

• Decides on course of action regarding continuum

• Reviews Level 1 Analysis, Complaint Analysis, Product Filings, Financial Health

• Meets 6-9 times annually



24

2008 Market ActionsTotal Projects = 94

Continuums: Interrogations, Phone Calls,

Meetings14%

Market Conduct Exams

31%

Studies/Education Reviews

55%

Market Conduct Examinations:



25



Oversight Compliance

Reviews3%


58%


17%


Meetings22%



26

“Undressing” Market Analysis ~ Overview of baseline, market conduct annual statement

(MCAS), Level 1 data

Jeffrey Arnold, Market Analysis [email protected]



27

Baseline Analysis

Market Conduct Annual Statement

Level 1 Review

“Undressing” Market Analysis Overview:



28

Uses data as a benchmark from which deviations and comparisons are measured

Systematic process whereby basic parameters are used to evaluate the entire marketplace

Used to identify companies that may require a more detailed and thorough analysis

Baseline Analysis:Baseline Analysis:



29

Private Passenger Auto

Homeowners

Individual Life

Individual Annuity

Group Life

Group Annuity

Accident & Health

Group Accident & Health

Credit

Medicare Supplement

Long Term Care




30

Market Analysis Prioritization Tool (MAPT)

Select companies with over $100,000 in direct premiums written

Select specific information from the report to conduct baseline analysis




31

Measures a company’s performance, in terms of complaints, against another company’s in the same market

Measures changes in a company’s complaint performance over the analysis period

Complaint ratios are based on a company’s specific information and provides a ratio of confirmed complaints per $1,000 of premium

Complaint ratios are needed for each company to calculate the complaint index

Measures a company’s performance relative to other companies in the same market

The average complaint index is always 1.0 for a market for analysis purposes

Consumer Complaint Data:



32

Find companies with significant fluctuations in premium volume

Companies should be identified with dramatic growth (33% or more)

Companies should be identified with dramatic decline (10% or more)

Premium Volume:



33

Compare changes in losses and changes in reserves

Identify companies with a spike in reserves without a corresponding increase in losses paid

Losses and reserves should be moving in the same direction at a similar rate

Reserves:



34

Identify companies with loss ratios that are significantly higher or lower than other companies in the same market

Identify unusual trends or year to year variations

Private passenger auto and homeowners

Loss Ratios:



35

Determine if companies have had a significant change in defense costs from year to year

Determine whether defense costs are moving in correlation to direct losses and premium volume

Defense costs should be rising relative to increases in premium volume and losses

Defense Costs:



36

Insurance Regulatory Information System (IRIS)

Tool designed to assist insurance departments in monitoring the industry’s financial condition

Identify potential financial difficulties

There is a separate series of IRIS ratios for P&C and L&H companies

IRIS ratios are a preliminary screening tool

IRIS ratios outside the pre-established norm do not necessarily indicate an adverse financial condition

The IRIS ratio merely provides a signal to follow-up to determine the cause of the changes in the company measured by the ratio or ratios in question

IRIS Ratios:



37

P & C

Gross Premium to Surplus

Net Premium to Surplus

Change in Net Writings

Liabilities to Liquid Assets

L&H

Net Change in Capital and Surplus

Gross Change in Capital and Surplus

Change in Premium

Change in Product Mix



38

The Market Conduct Annual Statement (MCAS) is a uniform method for states to collect key data regarding:

• Individual Life cash and non-cash value products

• Group Life cash and non-cash value products

• Individual fixed and variable annuities

• Private Passenger Auto and Homeowners

Market Conduct Annual Statement (MCAS):

(health insurers do not provide MCAS data)



39

Regulated entities may download instructions and a data collection program from the NAIC

Allows state regulators to compare and contrast entity-specific results with the remainder of the industry regarding such issues as:

Replacements

Nonforfeitures

Complaints

Life Insurance Face Values

Cancellations

Claims taking longer than 60 days to finalize

Market Conduct Annual Statement:




40

Call Letter is sent by the NAIC with instructions on how to load data

Company sends data to Insurance Department to be loaded into Database

Certificate of Compliance

Data Integrity checks are performed to ensure data is correct (20% variance in premium)





41

Statewide averages are viewed

Company data is viewed to determine if there are company ratios that exceed the statewide averages

Company report cards are developed and sent to companies

Company outliers are identified

Outliers are analyzed and compared with companies identified as possible outliers through baseline analysis

Identify companies that may need to have a Level 1 Review conducted





42

MCAS does not pertain to Accident and Health Insurance



43

The Division of Market Analysis uses the Level 1 review as a tool to learn more about a company’s:

Operations

Financial Ratios

Special Activities (SAD)

Regulatory Actions

Examinations

Level 1 Review:



44

Market Initiative Tracking System (MITS)

Premiums

Market Share

Resisted or Unpaid Claims

Complaints


Conclusion

Level 1 Review:



45

Significant changes in officers, directors or trustees over last 3 years

Changes in company’s organization, management or operations

Mergers or consolidations

Revocation of Certificates of Authority, licenses or registration

Change in state of domicile

Operations:



46

Review RBC ratios for the last 5 year period

Has the company’s RBC ratio triggered any action level events or has the RBC ratio significantly declined during the period

Defense costs should be rising relative to increases in premium volume and losses

Financial Ratios:



47

Company Action

Regulatory Action

Authorized Control Level

Mandatory Control Level

Level 1 Review:



48

Entries in the NAIC’s Special Activities Database (SAD) of substantive concern over past 5 years

Market Activities

Legal Actions

Special Activities:



49

Substantive regulatory actions

Reasons for actions

Patterns

High dollar penalties

Regulatory Actions:



50

Review Exam Tracking System (ETS) summary

More than 3 exams in past 12 months

Substantive concerns

Patterns

Exam triggers

Examinations:



51

Review company’s direct premium reported on a national and state basis

Has premium increased or decreased by 33% in any single year during last 5 years

Is company keeping up with growth (claims staff)

Why is there a decrease in premiums (solvency)

Premiums:



52

Significant Changes in market share for state under review over last five years

Specific line of business

U.S. Market Share:



53

For the lines of business under review in all jurisdictions, are loss and expense ratios unusually high or low as compared to industryaverages?

In the state and lines of business under review, are loss and expense ratios unusually high or low as compared to industry averages?

Loss and Expense Ratios:



54

Review Premium written

Direct defense and cost containment expenses paid

Direct Losses Incurred

Industry averages over last 5 years

Resisted or Unpaid Claims:



55

Significant changes in confirmed Complaint Index current year plus four years

Significant changes in complete Complaint Index current year plus four years

Review 5 year complaint report

Complaints:



56

Does a state participate?

Applicable to line of business under review?

Identified as outlier?

What Schedules is company considered an outlier? (PPA, HO, ILCVP, ILNCVP, GL, IFA, IVA)

Statewide average comparisons (Ratios of concern) (MCAS)




57

What is recommended for the next step upon completion of the Level 1 review?

Direct contact with the company

Investigation is scheduled

Examination is scheduled

Enforcement Action may be scheduled

Conclusion:

Contact the Collaborative Action Designee (CAD) of other states with similar concerns

Proceed with another option on the continuum of regulatory responses (develop letter to company, phone call, conference call, or meet with company)

No further analysis is necessary

Level 2 is scheduled



58

An internal report that shows confirmed complaints and/or enforcement referrals for a specified window of time for a company

COGNOS Reports:



59

Reports are developed from a combination of findings from:

Baseline Analysis


Level 1 Review

COGNOS Report

Reporting:



60

Findings are presented to the Market Regulation Committee

Deputies and Directors of the various program areas of the Insurance Department

Action to be taken

Market Conduct Exam

Monitor through future analysis

Continuum through a meeting

Continuum through letter or phone call

Other

Reporting:



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The “411” for Carriers and Consultants

Cindy Fillman, Director, Bureau of Market Analysis and [email protected]

&

Christopher Monahan, Director, Bureau of Market [email protected]



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Educational Reviews

Studies

Questionnaires

Informing your Regulator:



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• Act 62-Autism Mandate

• Initial letter-expectations

• Reports

• Many interventions

• Follow up reports-to inform legislative report

Educational Review-A Case Study:



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Initial letter-expectations

Reassurance

Full disclosure

Purely educational

What PA did right

Studies-climate Change:



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Initial letter-expectations

Questionnaires-not mandatory but detailed. Usually in the insurers interest to share information.

Informs policy and potentially legislation

Questionnaires-Healthcare Reform:



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Healthcare Reform

Grant Applications High Risk Pool Exchange Consumer Assistance Program

Other Policy Issues

Climate Change Autism Title Insurance

Division of Education:



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Market Actions ~ A Year in Review

Christopher Monahan, Director, Bureau of Market [email protected]



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Nine lines of insurance and 1,283 insurance companies were analyzed through baseline analysis from 2008 data. Baseline analysis included review of:

Baseline Analysis:

266 individual life and annuities insurers

119 group life and annuities insurers

62 Medicare supplement insurers

37 credit insurers

214 private passenger automobile insurers

166 homeowners insurers

56 long-term care insurers

174 individual accident and health insurers

189 group accident and health insurers



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Baseline analysis scoring includes the use of:

Division of Market Analysis Scoring Model

NAIC Market Analysis Prioritization Tool (MAPT)

MCAS Scoring Model

All three scoring models or tools are used to create aggregate scores for all companies in baseline analysis process

Scores are used as primary tool to select outliers

Baseline Analysis:



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132 outliers from baseline analysis also underwent level 1 analysis in 2008. This is up from last year when 125 companies underwent Level 1 analysis for 2007 data. The number of companies undergoing Level 1 analysis for each line of insurance looks like this:

28 for long-term care and/or Medicare supplement insurance

52 companies for private passenger automobile and/or homeowners lines

29 companies for individual and/or group life and annuities lines

20 for individual accident & health and/or group accident & health

3 companies for the credit insurance

NAIC mandates require PA to conduct a minimum of 40 level 1 reviews each data year and so, PA well exceeded its minimum requirement

Level 1 Analysis:



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From the 132 companies undergoing Level 1 analysis, a total of 68 of them rose to the level of being presented during 6 different MRC meetings over the past nine months.




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The following summarizes the dispositions of the 68 companies presented to MRC based on 2008 data findings:

• 26 companies monitored through future market analysis projects

• 14 companies had meeting scheduled with the Department to gain more information and understanding about issues of concern

• 13 companies were contacted through interrogatories or phone calls to gain more information and understanding about issues of concern

• 6 companies needed us to follow-up with regulators from other states to better understand actions and initiatives involving the companies

• 6 companies had target market conduct examinations called

• 2 companies had suspended market conduct examinations re-opened

• 1 company had a comprehensive market conduct examination called




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During 2009, 48 market conduct examinations were closed resulting in:

$1,063,112 in penalties

$1,119,350 in restitution to PA consumers

The number of market conduct examinations called by the Department has been decliningover the past three years




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3 Year Overview of Exams


2007 2008 2009P & C 43 24 14L & H 22 5 12

Oversights and Multi-State Exams Open 2 0 5

Total Exams Opened 67 29 31P & C 20 31 29L & H 21 18 16

Oversights and Multi-State Exams Closed 3 3 3

Total Exams Closed 44 52 48

Exams Opened

Exams Closed



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Meetings14%


31%


55%



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Oversight Compliance

Reviews3%


58%


17%


Meetings22%



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Morning Wrap-up ~ Questions



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Lunch



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Walk in the Regulator’sShoes



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Deputy for Market

Regulation

Director, Consumer Services

Deputy for Product

Regulation

Bureau Director for

Product Type

Deputy for Financial

RegulationMarket

Analysis Staff

Director, Market

Analysis &

Education

Market Analysis

Chief

Director, Market Actions

Product Area,Division Chief,

Market Actions

Background

• Multidisciplinary Analysis

• Decides on course of action regarding continuum

• Reviews Level 1 Analysis, Complaint Analysis, Product Filings, Financial Health

• Meets 6-9 times annually



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Afternoon Wrap-up ~ Questions



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Roundtable Discussion with Deputy Commissioners



Robert L. Pratter, Acting Pa Insurance Commissioner, [email protected]

Ron Gallagher, Deputy Insurance Commissioner, Office of Market Regulation [email protected]

Randy Rohrbaugh, Deputy Insurance Commissioner,Office of Insurance Product Regulation and Administration [email protected]

Steve Johnson, Deputy Insurance Commissioner,Office of Corporate and Financial Regulation [email protected]

Cindy Fillman, Director, Bureau of Market Analysis and Education, [email protected]

Carolyn Morris, Director, Bureau of Consumer Services, [email protected]

Jack Yanosky, Director, Bureau of Licensing and Enforcement, [email protected]

Christopher Monahan, Director, Bureau of Market Conduct [email protected]

september series - pennsylvania insurance department · 7 outreach division cindy fillman...

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