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284-55-205  <<  284-55-210 >>   End of Chapter

WAC 284-55-210

No agency filings affecting this section since 2003

Form of medicare supplement loss ratio experience.

The following form of medicare supplement loss ratio experience shall be used by all insurers:
MEDICARE SUPPLEMENT LOSS RATIO EXPERIENCE
(SUMMARIZED BY POLICY YEAR)
Experience reported for January 1 to December 31 of 19         
 
To be filed on or before June 30
of the
 
Address (City, State, and Zip Code)
 
NAIC Group Code
 
NAIC Company Code
 
CIC Code
 
National Experience
Form No.
No. of
Contracts
in Force
Policy
Duration
Incurred
Losses
Earned
Premiums
Loss Ratio
Unearned
Premium
Reserve
Policy
Reserves
Claim
Reserves
 
 
 
 
 
 
 
 
 
Washington Experience
 
 
 
 
 
 
 
 
 
Form No.
No. of
Contracts
in Force
Policy
Duration
Incurred
Losses
Earned
Premiums
Loss Ratio
Unearned
Premium
Reserve
Policy
Reserves
Claim
Reserves
 
 
 
 
 
 
 
 
 
I hereby certify that I have supervised the preparation of this experience exhibit, that it is complete and accurate to the best of my knowledge, and it is in compliance with RCW 48-66-150, and WAC 284-55-115, and WAC 284-55-150.
 
 
 
Signature of Officer
Date
 
 
 
 
 
 
Name and Title of Officer
Prepared by
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Phone Number
 
 
[Statutory Authority: RCW 48.02.060 (3)(a) and 48.66.050. WSR 89-11-096 (Order R 89-7), § 284-55-210, filed 5/24/89.]