§36-4061. Definitions - Reserves and related actuarial items -
3,042 words·~14 min read·
/ok/title-36-insurance/36-4061·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Appropriate computation and adequacy - Periodic opinion and memorandum of qualified actuary - Requirements - Liability - Actuarial Opinion of Reserves - Confidentiality.
A. Definitions. For the purposes of this section, the following definitions shall apply on or after the operative date of the valuation manual:
1. "Accident and health insurance" means contracts that incorporate morbidity risk and provide protection against economic loss resulting from accident, sickness, or medical conditions and as may be specified in the valuation manual;
2. "Appointed actuary" means a qualified actuary who is appointed in accordance with the valuation manual to prepare the actuarial opinion required in this section;
3. "Company" means an entity which:
a. has written, issued, or reinsured life insurance
contracts, accident and health insurance contracts, or
deposit-type contracts in this state and has at least
one such policy in force or on claim, or
b. has written, issued, or reinsured life insurance
contracts, accident and health insurance contracts, or
deposit-type contracts in any state and is required to
hold a certificate of authority to write life
insurance, accident and health insurance, or deposit-
type contracts in this state;
4. "Deposit-type contract" means contracts that do not incorporate mortality or morbidity risks and as may be specified in the valuation manual;
5. "Life insurance" means contracts that incorporate mortality risk, including annuity and pure endowment contracts, and as may be specified in the valuation manual;
6. "NAIC" means the National Association of Insurance Commissioners;
7. "Principle-based valuation" means a reserve valuation that uses one or more methods or one or more assumptions determined by the insurer and is required to comply with subsection Q of Section 1510 of this title as specified in the valuation manual;
8. "Qualified actuary" means an individual who is qualified to sign the applicable statement of actuarial opinion in accordance with the American Academy of Actuaries qualification standards for actuaries signing such statements and who meets the requirements specified in the valuation manual; and
9. "Valuation manual" means the manual of valuation instructions adopted by the NAIC as specified in Section 1510 of this title or as subsequently amended.
B. Actuarial Opinion Beginning January 1, 1998, and Prior to the Operative Date of the Valuation Manual.
1. Every life insurance company doing business in this state shall annually, and quarterly if required by the Insurance Commissioner, submit the opinion of a qualified actuary as to whether the reserves and related actuarial items held in support of the policies and contracts specified by the Insurance Commissioner by rule are computed appropriately, are based on assumptions which satisfy contractual provisions, are consistent with prior reported accounts and comply with applicable laws of this state. The Commissioner by rule shall define the specifics of this opinion and add any other items deemed to be necessary to its scope.
2. a. Every life insurance company, except as exempted by or
pursuant to rule, shall also annually, and quarterly
if required by the Insurance Commissioner, include in
the opinion required by paragraph 1 of this
subsection, 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 Commissioner by rule, when considered
in light of the assets held by the company 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, make adequate provision for the company's
obligations under the policies and contracts,
including but not limited to the benefits under and
expenses associated with the policies and contracts.
b. The Commissioner may provide by rule for a transition
period for establishing any higher reserves which the
qualified actuary may deem necessary in order to
render the opinion required by this section.
3. Each opinion required by paragraph 2 of this subsection shall be accompanied by a memorandum, in form and substance
acceptable to the Commissioner as specified by rule, prepared to support each actuarial opinion. If the insurance company fails to provide a supporting memorandum at the request of the Commissioner within a period specified by rule, or the Commissioner determines that the supporting memorandum provided by the insurance company fails to meet the standards prescribed by the rules or is otherwise unacceptable to the Commissioner, the Commissioner may engage a qualified actuary at the expense of the company to review the opinion and the basis for the opinion and prepare such supporting memorandum as is required by the Commissioner.
4. Every opinion shall be governed by the following provisions:
a. the opinion shall be submitted with the annual
statement and quarterly statement, if a quarterly
statement is required by the Commissioner, reflecting
the valuation of such reserve liabilities for each
year,
b. the opinion shall apply to all business in force
including individual and group health insurance plans,
in form and substance acceptable to the Commissioner
as specified by rule,
c. the opinion shall be based on standards adopted from
time to time by the Actuarial Standards Board and on
such additional standards as the Commissioner may by
rule prescribe,
d. in the case of an opinion required to be submitted by
a foreign or alien company, the Commissioner may
accept the opinion filed by that company with the
insurance supervisory official of another state if the
Commissioner determines that the opinion reasonably
meets the requirements applicable to a company
domiciled in this state,
e. except in cases of fraud or willful misconduct, the
qualified actuary shall not be liable for damages to
any person, other than the insurance company and the
Commissioner, for any act, error, omission, decision
or conduct with respect to the actuary's opinion, and
f. disciplinary action by the Commissioner against the
company or the qualified actuary shall be defined in
rules by the Commissioner.
5. a. Any memorandum in support of the opinion, and any
other material provided by the company to the
Commissioner in connection therewith, shall be kept
confidential by the Commissioner and shall not be made
public and shall not be subject to subpoena, other
than for the purpose of defending an action seeking
damages from any person by reason of any action
required by this section or by rules promulgated
hereunder; provided, however, that the memorandum or
other material may otherwise be released by the
Commissioner as follows:
(1)with the written consent of the company, or
(2)to the American Academy of Actuaries upon request
stating that the memorandum or other material is
required for the purpose of professional
disciplinary proceedings and setting forth
procedures satisfactory to the Commissioner for
preserving the confidentiality of the memorandum
or other material.
b. Once any portion of the confidential memorandum is
cited by the company in its marketing or is cited
before any governmental agency other than a state
insurance department or is released by the company to
the news media, all portions of the confidential
memorandum shall be no longer confidential.
6. 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 rules promulgated by the Insurance Commissioner.
C. Actuarial Opinion of Reserves after the Operative Date of the Valuation Manual.
1. Every company with outstanding life insurance contracts, accident and health insurance contracts or deposit-type contracts in this state and subject to regulation by the commissioner shall annually, and quarterly if required by the Insurance Commissioner, submit the opinion of the appointed actuary as to whether the reserves and related actuarial items held in support of the policies and contracts are computed appropriately, are based on assumptions which satisfy contractual provisions, are consistent with prior reported accounts and comply with applicable laws of this state.
The valuation manual will prescribe the specifics of this opinion including any items deemed to be necessary to its scope.
2. Every life insurance company with outstanding life insurance contracts, accident health insurance contracts or deposit type contracts in this state and subject to regulation by the commissioner, except as exempted in the valuation manual, shall also annually, and quarterly if required by the Insurance Commissioner, include in the opinion required by paragraph 1 of this subsection, an opinion of the same appointed actuary as to whether the reserves and related actuarial items held in support of the policies and contracts specified in the valuation manual, when considered in light of the assets held by the company 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, make
adequate provision for the company's obligations under the policies and contracts, including, but not limited to, the benefits under and expenses associated with the policies and contracts.
3. Each opinion required by paragraph 2 of this subsection shall be accompanied by a memorandum, in form and substance as specified in the valuation manual, and acceptable to the Commissioner, prepared to support each actuarial opinion. If the insurance company fails to provide a supporting memorandum at the request of the Commissioner within a period specified in the valuation manual or is otherwise unacceptable to the Commissioner, the Commissioner may engage a qualified actuary at the expense of the company to review the opinion and the basis for the opinion and prepare such supporting memorandum as is required by the Commissioner.
4. Every opinion shall be governed by the following provisions:
a. the opinion shall be in form and substance as
specified in the valuation manual and acceptable to
the Commissioner,
b. the opinion shall be submitted with the annual
statement and quarterly statement, if a quarterly
statement is required by the Commissioner, reflecting
the valuation of such reserve liabilities for each
year ending on or after the operative date of the
valuation manual,
c. the opinion shall apply to all policies and contracts
subject to paragraph 2 of this subsection, plus other
actuarial liabilities as may be specified in the
valuation manual,
d. the opinion shall be based on standards adopted from
time to time by the Actuarial Standards Board or its
successor, and on such additional standards as may be
prescribed in the valuation manual,
e. in the case of an opinion required to be submitted by
a foreign or alien company, the Commissioner may
accept the opinion filed by that company with the
insurance supervisory official of another state if the
Commissioner determines that the opinion reasonably
meets the requirements applicable to a company
domiciled in this state,
f. except in cases of fraud or willful misconduct, the
appointed actuary shall not be liable for damages to
any person, other than the insurance company and the
Commissioner, for any act, error, omission, decision
or conduct with respect to the appointed actuary's
opinion, and
g. disciplinary action by the Commissioner against the
company or the appointed actuary shall be defined in
rules by the Commissioner.
D. Confidentiality.
1. For purposes of this subsection "confidential information" means:
a. a memorandum in support of an opinion submitted under
this section and any other documents, materials and
other information, including, but not limited to, all
working papers, and copies thereof, created, produced
or obtained by or disclosed to the commissioner or any
other person in connection with such memorandum,
b. all documents, materials and other information,
including, but not limited to, all working papers, and
copies thereof, created, produced or obtained by or
disclosed to the commissioner or any other person in
the course of an examination made under paragraph 6 of
subsection P of Section 1510 of this title; provided,
however, that if an examination report or other
material prepared in connection with an examination
made under Sections 309.1 through 309.7 of this title
is not held as private and confidential information
under Sections 309.1 through 309.7 of this title, an
examination report or other material prepared in
connection with an examination made under paragraph 6
of subsection P of Section 1510 of this title shall
not be "Confidential Information" to the same extent
as if such examination report or other material had
been prepared under Sections 309.1 through 309.7 of
this title,
c. any reports, documents, materials and other
information developed by a company in support of, or
in connection with, an annual certification by the
company under subparagraph
(b)of paragraph 2 of
subsection Q of Section 1510 of this title evaluating
the effectiveness of the company's internal controls
with respect to a principle-based valuation and any
other documents, materials and other information,
including, but not limited to, all working papers, and
copies thereof, created, produced or obtained by or
disclosed to the commissioner or any other person in
connection with such reports, documents, materials and
other information,
d. any principle-based valuation report developed under
subparagraph
(c)of paragraph 2 of subsection Q of
Section 1510 of this title and any other documents,
materials and other information, including, but not
limited to, all working papers, and copies thereof,
created, produced or obtained by or disclosed to the
commissioner or any other person in connection with
such report, and
e. any documents, materials, data and other information
submitted by a company under subsection R of Section
1510 of this title, collectively, "experience data",
and any other documents, materials, data and other
information, including, but not limited to, all
working papers, and copies thereof, created or
produced in connection with such experience data, in
each case that include any potentially company-
identifying or personally identifiable information,
that is provided to or obtained by the commissioner,
together with any "experience data", the "experience
materials", and any other documents, materials, data
and other information, including, but not limited to,
all working papers, and copies thereof, created,
produced or obtained by or disclosed to the
commissioner or any other person in connection with
such experience materials.
2. Privilege for, and Confidentiality of, Confidential Information.
a. except as provided in this subsection, a company's
Confidential Information is confidential by law and
privileged, and shall not be subject to Oklahoma Open
Records Act, shall not be subject to subpoena and
shall not be subject to discovery or admissible in
evidence in any private civil action; provided,
however, that the commissioner is authorized to use
the Confidential Information in the furtherance of any
regulatory or legal action brought against the company
as a part of the commissioner's official duties,
b. neither the commissioner nor any person who received
Confidential Information while acting under the
authority of the commissioner shall be permitted or
required to testify in any private civil action
concerning any Confidential Information,
c. in order to assist in the performance of the
commissioner's duties, the commissioner may share
Confidential Information:
(1)with other state, federal and international
regulatory agencies and with the NAIC and its
affiliates and subsidiaries,
(2)in the case of Confidential Information specified
in subparagraphs
(a)and
(d)of paragraph 1 of
this subsection, with the Actuarial Board for
Counseling and Discipline or its successor upon
request stating that the Confidential Information
is required for the purpose of professional
disciplinary proceedings and with state, federal
and international law enforcement officials, and
(3)in the case of
(1)and (2), provided that such
recipient agrees, and has the legal authority to
agree, to maintain the confidentiality and
privileged status of such documents, materials,
data and other information in the same manner and
to the same extent as required for the
commissioner.
d. the commissioner may receive documents, materials,
data and other information, including otherwise
confidential and privileged documents, materials, data
or information, from the NAIC and its affiliates and
subsidiaries, from regulatory or law enforcement
officials of other foreign or domestic jurisdictions
and from the Actuarial Board for Counseling and
Discipline or its successor and shall maintain as
confidential or privileged any document, material,
data or other information received with notice or the
understanding that it is confidential or privileged
under the laws of the jurisdiction that is the source
of the document, material or other information,
e. the commissioner may enter into agreements governing
sharing and use of information consistent with
paragraph 2 of this subsection,
f. no waiver of any applicable privilege or claim of
confidentiality in the Confidential Information shall
occur as a result of disclosure to the commissioner
under this section or as a result of sharing as
authorized in subparagraph
(c)of paragraph 2 of this
subsection,
g. a privilege established under the law of any state or
jurisdiction that is substantially similar to the
privilege established under paragraph 2 of this
subsection shall be available and enforced in any
proceeding in, and in any court of, this state,
h. in this subsection "regulatory agency", "law
enforcement agency" and the "NAIC" include, but are
not limited to, their employees, agents, consultants
and contractors.
3. Notwithstanding paragraph 2 of this subsection, any Confidential Information specified in subparagraphs a and d of paragraph 1 of this subsection:
a.
may be subject to subpoena for the purpose of
defending an action seeking damages from the appointed
actuary submitting the related memorandum in support
of an opinion submitted under this section or
principle-based valuation report developed under
subparagraph c of paragraph 2 of subsection Q of
Section 1510 of this title by reason of an action
required by Section 1510 of this title or by rules
promulgated hereunder,
b. may otherwise be released by the commissioner with the
written consent of the company, and
c. once any portion of a memorandum in support of an
opinion submitted under this section or a principle-
based valuation report developed under subparagraph c
of paragraph 2 of subsection Q of Section 1510 of this
title is cited by the company in its marketing or is
publicly volunteered to or before a governmental
agency other than a state insurance department or is
released by the company to the news media, all
portions of such memorandum or report shall no longer
be confidential. Added by Laws 1997, c. 273, § 4, eff. July 1, 1997. Amended by Laws 2001, c. 363, § 20, eff. July 1, 2001; Laws 2014, c. 50, § 2, eff. Nov. 1, 2014.