SERFF Tracking #: SMPJ State Tracking #: Company Tracking #: 14-IR-WC-9018R
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1 Product Name: Employers Liability WC Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Sompo Japan Insurance Company of America Employers Liability WC District of Columbia 16.0 Workers Compensation Employers Liability WC Rate/Rule Date Submitted: 11/14/2014 SERFF Tr Num: SERFF Status: State Tr Num: State Status: Co Tr Num: Effective Date Requested (New): Effective Date Requested (Renewal): Author(s): Reviewer(s): SMPJ Closed-APPROVED 14-IR-WC-9018R 03/01/ /01/2015 Mary Alado Disposition Date: 12/10/2014 Disposition Status: Effective Date (New): Effective Date (Renewal): APPROVED
2 Product Name: Employers Liability WC General Information Project Name: Employers Liability (Stop Gap) Project Number: 14-IR-WC-9018R Reference Organization: N/A Reference Title: N/A Filing Status Changed: 12/10/2014 State Status Changed: Created By: Mary Alado Corresponding Filing Tracking Number: N/A Status of Filing in Domicile: Not Filed Domicile Status Comments: Reference Number: N/A Advisory Org. Circular: N/A Deemer Date: Submitted By: Mary Alado Filing Description: We are revising our Employers Liability (Stop Gap) Coverage rating rules. Our proposed rates for this coverage are significantly lower than our current rates and are based on competitor s filings. Historically, we have provided only a very incidental amount of this coverage on a countrywide basis and therefore do not have credible experience on which to base our premium charges. As a result, we believe there is no meaningful rate impact for this revision. Please refer to our filing memorandum for additional information. Manual pages SDC-WC-MR-3 and 4 will replace Page 1 showing our revised rating rules for this coverage. The endorsement which provides this coverage, NCCI Endorsement WC C, was filed on our behalf by the appropriate WC Bureau/Advisory Organization and approved by your department. Company and Contact Filing Contact Information Mary Alado, State Filings Analyst II North Community House Rd. Suite 600 Charlotte, NC Filing Company Information Sompo Japan Insurance Company of America 777 Third Avenue 24th Floor New York, NY (212) ext. [Phone] [email protected] [Phone] CoCode: Group Code: 3219 Group Name: FEIN Number: State of Domicile: New York Company Type: State ID Number: Filing Fees Fee Required? Retaliatory? No No
3 Product Name: Employers Liability WC Fee Explanation:
4 Product Name: Employers Liability WC Correspondence Summary Dispositions Status Created By Created On Date Submitted APPROVED Robert Nkojo 12/10/ /10/2014
5 Product Name: Employers Liability WC Disposition Disposition Date: 12/10/2014 Effective Date (New): Effective Date (Renewal): Status: APPROVED Comment: Rate data does NOT apply to filing. Schedule Schedule Item Schedule Item Status Public Access Supporting Document Consulting Authorization Yes Supporting Document Actuarial Certification (P&C) Yes Supporting Document District of Columbia and Countrywide Experience for the Yes Last 5 Years (P&C) Supporting Document District of Columbia and Countrywide Loss Ratio Analysis Yes (P&C) Supporting Document Memorandum Yes Rate Rule Page Yes Rate Rule Page Yes Rate Rule Page Yes
6 Product Name: Employers Liability WC Rate Information Rate data does NOT apply to filing.
7 Product Name: Employers Liability WC Rate/Rule Schedule Item Schedule Item Previous State No. Status Exhibit Name Rule # or Page # Rate Action Filing Number Attachments 1 Rule Page SDC-WC-MR-3 New SDC-WC-MR-3.pdf 2 Rule Page SDC-WC-MR-4 New SDC-WC-MR-4.pdf 3 Rule Page Page 1 Withdrawn 01-WC-158; Rule Page Withdrawn.pdf
8 DISTRICT OF COLUMBIA (08) WORKERS COMPENSATION AND EMPLOYERS LIABILITY MISCELLANEOUS RULE PAGE Sompo Japan Insurance Company of America The following is added to Part One, Rule 3.A.14 Limits of Liability Employers Liability Coverage Endorsement (Stop Gap Coverage) WC C Employers Liability Coverage Endorsement Rules: - This form is most commonly requested when an insured has operations in a monopolistic workers compensation jurisdiction. Monopolistic workers compensation coverage does not include Employers Liability Coverage. This form can be used to provide Employers Liability Coverage for operations in monopolistic jurisdictions. - For operations in a monopolistic jurisdiction, an employer must purchase Workers Compensation insurance from the appropriate state fund. - This form is appropriate for use in non-monopolistic jurisdictions only in isolated circumstances. These are if 1) all employees are excluded from the workers compensation law or all employees have elected not to be subject the law, and 2) there is no state law or regulation making the use of this form illegal. - This is an optional endorsement that will be attached to NCCI's Workers Compensation and Employers Liability Policy. - Premium charged for this coverage will be non-auditable. Rates: (1) If Known / Ongoing Exposure in a Monopolistic State Basic Limits and Rates: Bodily Injury by Accident $100,000 each accident Bodily Injury by Disease $500,000 policy limit Bodily Injury by Disease $100,000 each employee Rate: per $100 in estimated monopolistic state payroll Rates for Increased Limits: $500,000 / $500,000 / $500, $1,000,000 / $1,000,000 / $1,000, $2,000,000 / $2,000,000 / $2,000, Minimum Premium: $150 Edition SDC-WC-MR-3 Includes copyrighted material of National Council on Compensation Insurance, Inc. with its permission.
9 DISTRICT OF COLUMBIA (08) WORKERS COMPENSATION AND EMPLOYERS LIABILITY MISCELLANEOUS RULE PAGE Sompo Japan Insurance Company of America Employers Liability Coverage Endorsement (Stop Gap Coverage) cont'd (2) If No Known / Incidental Exposure In A Monopolistic State Employers Liability can be provided on an "if any" basis if the insured currently has no exposure in a monopolistic state or jurisdiction. A premium charge of $150 applies. If exposure develops in a monopolistic state or jurisdiction, the rates shown in (1) above apply. (3) If Provided in a Non-Monopolistic State (per Rules above). Use the same rates as shown in (1) above per $100 payroll for the non-monopolistic state for which coverage is needed. Edition SDC-WC-MR-4 Includes copyrighted material of National Council on Compensation Insurance, Inc. with its permission.
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11 Product Name: Employers Liability WC Supporting Document Schedules Bypassed - Item: Bypass Reason: Attachment(s): Item Status: Status Date: Bypassed - Item: Bypass Reason: Attachment(s): Item Status: Status Date: Bypassed - Item: Bypass Reason: Attachment(s): Item Status: Status Date: Bypassed - Item: Bypass Reason: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Consulting Authorization N/A Actuarial Certification (P&C) N/A District of Columbia and Countrywide Experience for the Last 5 Years (P&C) N/A District of Columbia and Countrywide Loss Ratio Analysis (P&C) N/A Memorandum WC Stop Gap Filing Memo.pdf
12 Sompo Japan Nipponkoa America Workers Compensation Employers Liability (Stop Gap) Coverage Rate Memorandum Sompo Japan Insurance Company of America and Sompo Japan Fire & Marine Insurance Company of America (if applicable in your state) is/are submitting this rate filing memorandum in support of the proposed rates for Employers Liability (Stop Gap) coverage. We propose an effective date of March 1, This revised rating rule would be used with endorsement WC C Employers Liability Coverage Endorsement, which was previously filed on our behalf by the appropriate WC Bureau/Advisory Organization or previously adopted by us in your state. This filing is an update to our previous submission for Employers Liability (Stop Gap) coverage in your state. Our previous rates are significantly higher than those available in the current market. This, combined with the rare need to provide this coverage in non-monopolistic states, means we currently provide only a very incidental amount of this coverage on a countrywide basis. The rates proposed represent a significant decrease from our previously approved rates, but with minimal current writings, we believe there is no meaningful rate impact tied to this update. Also, you may notice that our previous rule contained rates by classification; however, for simplicity, we have eliminated the distinction by classification in our revised rules. Since we have a very limited volume of Employers Liability (Stop Gap) coverage on a countrywide basis and no claims, we do not have credible experience that would allow us to develop revised rates for this coverage on its own. As a result, we have based our proposed rates on a review of competitors rates. Proposed rates apply to payroll per $100. We are proposing rates that are in line with the average of the Berkley, Berkshire-Hathaway and Accident Fund rates that have been filed in monopolistic states since These are recapped below along with our proposed rates. Employers Liability (Stop Gap) is a coverage that is typically requested by clients with operations in monopolistic states, but there are a few situations under which stand-alone Employers Liability coverage might be needed in a non-monopolistic state. For these rare situations, we have included a provision in our updated rule. The minimum premium charge would be $150 and simply reflects a reasonable minimum charge to provide this coverage. Competitor Stop Gap Rate Information and Rate Selection Limits of Liability Berkley Berkshire- Hathaway Accident Fund Average Sompo Selected 100/500/ /500/ /1000/ /2000/ Minimum Premium $150 $350 $250 $250 $150
SERFF Tracking Number: AGNY-125606356 State: District of Columbia National Union Fire Insurance Company of. State Tracking Number: Pittsburgh, Pa.
SERFF Tracking Number: AGNY-125606356 State: District of Columbia Filing Company: National Union Fire Insurance Company of State Tracking Number: Pittsburgh, Pa. Company Tracking Number: AIC-08-EO-05 TOI:
Filing at a Glance. General Information
/ Filing at a Glance Companies: American Zurich Insurance Company, American Guarantee and Liability Insurance Company, Zurich American Insurance Company of Illinois, Zurich American Insurance Company Contractor/
SERFF Tracking #: HNVX-G129898950 State Tracking #: Company Tracking #: DC150350100010
Product Name: *MPL- Miscellaneous Professional Liability Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: The Hanover Insurance Company *MPL- Miscellaneous Professional Liability
TOI: 19.0 Personal Auto Sub-TOI: 19.0001 Private Passenger Auto (PPA)
/ Filing at a Glance Company: National General Insurance Company SERFF Tr Num: GMMX- State: Wisconsin G127107534 TOI: 19.0 Personal Auto SERFF Status: Closed-Filed State Tr Num: Sub-TOI: 19.0001 Private
SERFF Tracking #: SMPJ-130229500 State Tracking #: Company Tracking #: 15-I-GL-9011
SERFF Tracking #: SMPJ-130229500 State Tracking #: Company Tracking #: 15-I-GL-9011 State: District of Columbia Filing Company: Sompo Japan Insurance Company of America TOI/Sub-TOI: 17.0 Other Liability-Occ/Claims
Filing at a Glance. General Information. Company and Contact. Company: 13565 - Arkansas Mutual Insurance Company
SERFF Tracking Number: ARKS-126116216 State: Arkansas Filing Company: 13565 - Arkansas Mutual Insurance Company State Tracking Number: #1426 $25 Company Tracking Number: 2009-01 TOI: 11.2 Med Mal-Claims
SERFF Tracking #: NCCI-127176855 State Tracking #: Company Tracking #: B-1423 (MJ)
SERFF Tracking #: NCCI-127176855 State Tracking #: Company Tracking #: B-1423 (MJ) State: Missouri Filing Company: NCCI TOI/Sub-TOI: 16.0 Workers Compensation/16.0004 Standard WC Product Name: B-1423 Elimination
Filing at a Glance. General Information. Company and Contact
Filing at a Glance Companies: Great American Alliance Insurance Company, Great American Assurance Company, Great American Insurance Company, Great American Insurance Company of New York SERFF Tr Num: GRTA-125667912
Filing at a Glance. General Information. Company and Contact
11.0 - Claims Filing at a Glance Company: 00006 - INSURANCE SERVICES OFFICE, INC. SERFF Tr Num: ARKS-125411752 State: Arkansas 11.0 - Claims SERFF Status: Closed State Tr Num: #104677 $250 11.0000 Med
SERFF Tracking Number: PHAR-125833359 State: District of Columbia Filing Company: Pharmacists Mutual Insurance Company State Tracking Number:
SERFF Tracking Number: PHAR-125833359 State: District of Columbia Filing Company: Pharmacists Mutual Insurance Company State Tracking Number: Company Tracking Number: DC-PHL/CSP-01-09-R TOI: 11.2 Medical
Filing at a Glance. The Guardian Life Insurance Company of America. Product Name: DC 3/5/14 CI Filing
SERFF Tracking #: GARD-129444557 State Tracking #: Company Tracking #: State: District of Columbia Filing Company: The Guardian Life Insurance Company of America TOI/Sub-TOI: H07G Group Health - Specified
Filing at a Glance. General Information
InnKeepers Liability Coverage Endorsement (Bailment Coverage) 64002 (6/08)/ Filing at a Glance Companies: American Home Assurance Company, American International South Insurance Company, AIG Casualty Company,
TOI: 09.0 Inland Marine Sub-TOI: 09.0005 Other Commercial Inland Marine Product Name: Transportation Rate Filing 2007
Project Name/Number: / Filing at a Glance Company: Maxum Casualty Insurance Company SERFF Tr Num: MXCC-125344646 State: Arkansas TOI: 09.0 Inland Marine SERFF Status: Closed State Tr Num: Sub-TOI: 09.0005
TOI: 17.0 Other Liability-Occ/Claims Made Sub-TOI: 17.0001 Commercial General Liability
Care, Custody or Control- Self Storage Items- 97307 (2/08)/ Filing at a Glance Companies: American Home Assurance Company, American International South Insurance Company, AIG Casualty Company, Commerce
Filing at a Glance. General Information
Filing at a Glance Company: Freedom Life Insurance Company of America FLICA Individual SERFF Tr Num: USHG-125738978 State: ArkansasLH First Occurrence Heart Attack/Cancer TOI: H07I Individual Health -
TOI: L07I Individual Life - Whole SERFF Status: Closed State Tr Num: Sub-TOI: L07I.121 Graded Premium - Single Co Tr Num: 11778
/11778 Filing at a Glance Company: CSI Life Insurance Company Graded Death Benefit Whole SERFF Tr Num: CSIN-125750219 State: Wisconsin Life Insurance TOI: L07I Individual Life - Whole SERFF Status: Closed
SERFF Tracking #: ICCI-129123690 State Tracking #: Company Tracking #: B-BTP ACC-13-P-R
Product Name: Pan-Am Blanket Group Accident Policy B-BTP-ACC-13-P Filing at a Glance Company: Pan-American Life Insurance Company Product Name: Pan-Am Blanket Group Accident Policy B-BTP-ACC-13-P State:
SERFF Tracking #: USAA-130216478 State Tracking #: Company Tracking #: PA1520097
State: Pennsylvania First Filing Company: Garrison Property and Casualty Insurance Company,... Filing at a Glance Companies: State: TOI: Sub-TOI: Filing Type: Garrison Property and Casualty Insurance Company
TOI: 17.2 Other Liability-Occ Only Sub-TOI: 17.2001 Commercial General Liability
/ Filing at a Glance Company: Great American Spirit Insurance Company SERFF Tr Num: GRTA-125596599 State: Wisconsin TOI: 17.2 Other Liability-Occ Only SERFF Status: Closed State Tr Num: Sub-TOI: 17.2001
SERFF Tracking #: FHLA-129477086 State Tracking #: Company Tracking #: DCL6RATES
SERFF Tracking #: FHLA-129477086 State Tracking #: Company Tracking #: DCL6RATES State: District of Columbia Filing Company: Family Heritage Life Insurance Company of America TOI/Sub-TOI: Product Name:
AR-MEDAMERICA DENIED CLAIMS, LAPSE/REPLACEMENT AND SUITABILITY REPORTS
TOI: LTC6 Long Term Care - Other Sub-TOI: LTC6. Long Term Care - Other AR-MedAmerica Denied Claims, Lapse/Replacement AR- MedAmerica Denied Claims, Lapse/Replacement /AR- MedAmerica Denied Claims, Lapse/Replacement
SERFF Tracking Number: CNAC-125272315 State: Arkansas First Filing Company: Continental Casualty Company,... State Tracking Number: AR-PC-07-025885
SERFF Tracking Number: CNAC-125272315 State: Arkansas First Filing Company: Continental Casualty Company,... State Tracking Number: AR-PC-07-025885 Company Tracking Number: 07-F2181-UMB TOI: 17.0 Other
State: District of Columbia First Filing Company: GEICO Advantage Insurance Company,... 19.0 Personal Auto/19.0001 Private Passenger Auto (PPA)
SERFF Tracking #: GECC-130245464 State Tracking #: Company Tracking #: 2015-381 State: District of Columbia First Filing Company: GEICO Advantage Insurance Company,... TOI/Sub-TOI: 19.0 Personal Auto/19.0001
TOI: 04.0 Homeowners Sub-TOI: 04.0000 Homeowners Sub-TOI Combinations Revised Rule 521 Water Sewer Backup for HCIC
Project Name/Number: Homeowners Multi Peril/ Filing at a Glance Company: Hartford Casualty Insurance Company Revised Rule 521 Water Sewer SERFF Tr Num: HART-125929339 State: Arkansas Backup for HCIC TOI:
SERFF Tracking Number: LMUG-125263431 State: Arkansas First Filing Company: Liberty Insurance Corporation,... State Tracking Number: AR-PC-07-025842
LC Tobacco Exclusion - LC 21 54 08 07/ Filing at a Glance Companies: Liberty Insurance Corporation, Liberty Mutual Fire Insurance Company, LM Insurance Corporation, Liberty Mutual Insurance Company, The
Project Number: SVF PX Date Approved in Domicile: 02/09/2010
Project Name/Number: / Filing at a Glance Company: Transamerica Financial Life Insurance Company SERFF Tr Num: AEGN-127173488 State: Arkansas TOI: A03G Group Annuities - Deferred Variable SERFF Status:
STATE OF NEVADA. December 12, 2011. Industrial Insurance NCCI Revisions to Statistical Plan for Workers Compensation and Employers Liability Insurance
BRIAN SANDOVAL Governor STATE OF NEVADA TERRY JOHNSON Director SCOTT J. KIPPER Commissioner DEPARTMENT OF BUSINESS AND INDUSTRY DIVISION OF INSURANCE 1818 East College Pkwy., Suite 103 Carson City, Nevada
Filing at a Glance. Sagicor Life Insurance Company Baltimore Life/Sagicor Assumption District of Columbia L01.000 Life - Assumption Agreement
Filing at a Glance Company: State: TOI: Sub-TOI: Filing Type: Sagicor Life Insurance Company District of Columbia L01 Life - Assumption Agreement L01.000 Life - Assumption Agreement Date Submitted: 11/12/2014
Closed Sub-TOI: L08.000 Life - Other Co Tr Num: AR0911952 State Status: Approved-Closed
Comparison (Replacement) Questionnaire/ Filing at a Glance Company: USAA Life Insurance Company Comparison (Replacement) SERFF Tr Num: UNSA-126298161 State: Arkansas Questionnaire (life) TOI: L08 Life
SERFF Tracking #: ZURC-128805817 State Tracking #: Company Tracking #: CW OL 35534
Product Name: Primary Health Care Liability Policy Endorsements Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Zurich American Insurance Company Primary Health Care Liability
SERFF Tracking #: MRTN-130013987 State Tracking #: Company Tracking #: CL DC008230200009
Product Name: Cover Pro Miscellaneous Professional Liability Short Renewal Application Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Philadelphia Indemnity Insurance Company
SERFF Tracking #: MEAM-128778084 State Tracking #: Company Tracking #: DC FC ACTUARIAL ADDENDUM_DISCOUNTS
SERFF Tracking #: MEAM-128778084 State Tracking #: Company Tracking #: DC FC ACTUARIAL ADDENDUM_DISCOUNTS State: District of Columbia Filing Company: MedAmerica Insurance Company TOI/Sub-TOI: LTC06 Long
The requested effective date is 7/03/08. However, AAIC prefers an earlier effective date coincident with the date of your
Filing at a Glance Company: American Alternative Insurance Corp Pet Health Policies, SERFF Tr Num: FRCS-125722242 State: Arkansas Supplemental Forms and Rating TOI: 09.0 Inland Marine SERFF Status: Closed
Status of Filing in Domicile: Not Filed
Filing at a Glance Company: MetLife Insurance Company of Connecticut SERFF Tr Num: METD-125969626 State: ArkansasLH TOI: A03I Individual Annuities - Deferred SERFF Status: Closed State Tr Num: 41346 Variable
Company Tracking Number: 00-T1 TOI: L04I Individual Life - Term Sub-TOI: L04I.003 Single Life - Single Premium
Project Name/Number: /00-T1 Filing at a Glance Company: SERFF Tr Num: GARD-126615290 State: Arkansas TOI: L04I Individual Life - Term SERFF Status: Closed-Filed- State Tr Num: 45745 Closed Sub-TOI: L04I.003
TOI: 35.0 Interline Filings Sub-TOI: 35.0002 Commercial Interline Filings
SERFF Tracking Number: WAUS-125566396 State: Arkansas First Filing Company: Employers Insurance Company of Wausau,... State Tracking Number: EFT $50 Company Tracking Number: MSF-CW-004-08 TOI: 35.0 Interline
SERFF Tracking #: NCCI-129233158 State Tracking #: 112 Company Tracking #: U-1399 (LW)
SERFF Tracking #: NCCI-129233158 State Tracking #: 112 Company Tracking #: U-1399 (LW) State: Missouri Filing Company: NCCI TOI/Sub-TOI: 16.0 Workers Compensation/16.0004 Standard WC Product Name: U-1399
Filing at a Glance. General Information
SERFF Tracking Number: ZURC-126193280 State: Wisconsin First Filing Company: American Zurich Insurance Company,... State Tracking Number: Company Tracking Number: CW-GL-28564 TOI: 17.1 Other Liability-Occ
SERFF Tracking #: MASS-130482511 State Tracking #: Company Tracking #: 2015 ANNUAL LTC REPORTS
SERFF Tracking #: MASS-130482511 State Tracking #: Company Tracking #: 2015 ANNUAL LTC REPORTS State: District of Columbia Filing Company: Massachusetts Mutual Life Insurance Company TOI/Sub-TOI: LTC06
SERFF Tracking #: CUNA-128703657 State Tracking #: Company Tracking #: 2009-SPWL MEMO
Filing at a Glance Company: State: TOI: Sub-TOI: Filing Type: CMFG Life Insurance Company Arkansas L07I Individual Life - Whole L07I.111 Single Premium - Single Life Form Date Submitted: 10/09/2012 SERFF
This advertising material is new and does not replace any advertisements filed by Genworth Life Insurance Company.
SERFF Tracking Number: GEFA-125987509 State: Wisconsin Filing Company: Genworth Life Insurance Company State Tracking Number: Company Tracking Number: TOI: LTC03I Individual Long Term Care Sub-TOI: LTC03I.001
Employers Liability Coverage Endorsement WC 00 03 03 B Federal Employers Liability Act Coverage WC 01 01 04
TO: FROM: Pennsylvania Classification & Rating Committee Betty Ann Campbell Director Rating Rules & Policy Reporting DATE: December 8, 2004 RE: Employers Liability Coverage Endorsement WC 00 03 03 B Federal
SERFF Tracking #: SHPW-128659165 State Tracking #: Company Tracking #: INS-00071 (08/11) ADWORDS 1, 6, 7, 8, 9,...
SERFF Tracking #: SHPW-128659165 State Tracking #: Company Tracking #: INS-00071 (08/11) ADWORDS 1, 6, 7, 8, Filing at a Glance Company: Security Health Plan of Wisconsin, Inc. State: TOI: Sub-TOI: Filing
SERFF. Increase SERFF. Company Rate Information. Written Premium. # of Policy. Minimum % Company. Change Name: Holders Affected.
SERFF Tracking #: AEGC-128803974 State Tracking #: Company Tracking #: 1362 State: District of Columbia Filing Company: Monumental Life Insurance Company TOI/Sub-TOI: MS05I Individual Medicare Supplement
Michigan Review Pending
SERFF Tracking Number: MULF-127027120 State: Michigan Filing Company: John Hancock Life Insurance Company (USA) State Tracking Number: Company Tracking Number: 2010 INFORCE RATE INCREASE - JH CCII07 TOI:
SERFF Status: Closed-Filed- State Tr Num: 43499 9/14/09 A156314 AR PRU
Project Name/Number: / Filing at a Glance Company: Pruco Life Insurance Company Group Filing 9/14/09 A156314 AR PRU TOI: A03I Individual Annuities - Deferred Variable Sub-TOI: A03I.002 Flexible Premium
July 12, 2012. Circular Letter No. 12-1616
Minnesota Workers Compensation Insurers Association, Inc. 7701 France Avenue South Suite 450 Minneapolis, MN 55435-3200 July 12, 2012 ALL ASSOCIATION MEMBERS Circular Letter No. 12-1616 RE: NCCI Item B-1425
A02I.003 Single Premium Variable Preparing To Never Need Long-term Care Seminar/I-22163
SERFF Tracking Number: AULD-126526295 State: Arkansas Filing Company: State Life Insurance Company State Tracking Number: 45159 Company Tracking Number: TOI: A02I Individual Annuities- Deferred Non- Sub-TOI:
TOI: 17.1 Other Liability - Claims Made Only Sub-TOI: 17.1019 Professional Errors & Omissions Liability
SERFF Tracking Number: CATL-125892402 State: Arkansas Filing Company: Catlin Insurance Company, Inc. State Tracking Number: EFT $100 Company Tracking Number: 08-OL-PL003-CW-AR-R TOI: 17.1 Other Liability
A02.1I.002 Flexible Premium Variable and Variable
SERFF Tracking Number: ELAS-128324515 State: Arkansas Filing Company: AXA Equitable Life Insurance Company State Tracking Number: Company Tracking Number: 2012GMDB-BO-I TOI: A02.1I Individual Annuities-
