"I, [name], am [title] of [insurance company name] and a member of the American Academy of Actuaries. I was appointed by, or by the authority of, the Board of Directors of said insurer to render this opinion as stated in the letter to the Commissioner dated [insert date]. I meet the Academy qualification standards for rendering the opinion and am familiar with the valuation requirements applicable to life and health insurance companies."
"I, [name], a member of the American Academy of Actuaries, am associated with the firm of [name of consulting firm]. I have been appointed by, or by the authority of, the Board of Directors of [name of company] to render this opinion as stated in the letter to the Commissioner dated [insert date]. I meet the Academy qualification standards for rendering the opinion and am familiar with the valuation requirements applicable to life and health insurance companies."
"I have examined the actuarial assumptions and actuarial methods used in determining reserves and related actuarial items listed below, as shown in the annual statement of the company, as prepared for filing with state regulatory officials, as of December 31, 20[ ]. Tabulated below are those reserves and related actuarial items which have been subjected to asset adequacy analysis.
Asset Adequacy Tested Amounts - Reserves and Liabilities | |||||
Statement Item | Formula Reserves (1) | Additional Actuarial Reserves (a)(2) | Analysis Method (b) | Other Amount (3) | Total Amount (1)+(2)+(3) (4) |
Exhibit 5 A Life Insurance | |||||
B Annuities | |||||
C Supplementary Contracts Involving Life Contingencies | |||||
D Accidental Death Benefit | |||||
E Disability - Active | |||||
F Disability - Disabled | |||||
G Miscellaneous | |||||
Total (Exhibit 5 Item 1, Page 3) | |||||
Exhibit 6 A Active Life Reserve | |||||
B Claim Reserve | |||||
Total (Exhibit 6 Item 2, Page 3) | |||||
Exhibit 7 Premiums and Other Deposit Funds (Column 5, Line 14) | |||||
Guaranteed Interest Contracts (Column 2, Line 14) | |||||
Other (Column 6, Line 14) | |||||
Supplemental Contracts (Column 3, Line 14) | |||||
Dividend Accumulations or Refunds (Column 4, Line 14) | |||||
Total Exhibit 7 (Column 1, Line 14) | |||||
Exhibit 8 Part 1 1 Life (Page 3, Line 4.1) | |||||
2 Health (Page 3, Line 4.2) | |||||
Total Exhibit 8, Page 1 | |||||
Separate Accounts (Page 3 of the Annual Statement of the Separate Accounts, Lines 1, 2, 3.1, 3.2, 3.3) | |||||
TOTAL RESERVES |
IMR (General Account, Page __ Line __) | |
(Separate Accounts, Page ___ Line ___) | |
AVR (Page __ Line __) | (c) |
Net Deferred and Uncollected Premium |
Notes:
"I have relied on [name], [title] for [e.g., "anticipated cash flows from currently owned assets, including variations in cash flows according to economic scenarios" or "certain critical aspects of the analysis performed in conjunction with forming my opinion"] as certified in the attached statement. I have reviewed the information relied upon for reasonableness."
"My examination included such review of the actuarial assumptions and actuarial methods and of the underlying basic asset and liability records and such tests of the actuarial calculations as I considered necessary. I also reconciled the underlying basic asset and liability records to [exhibits and schedules listed as applicable] of the company's current annual statement."
"In forming my opinion on [specify types of reserves] I relied upon data prepared by [name and title of company officer certifying in-force records or other data] as certified in the attached statements. I evaluated that data for reasonableness and consistency. I also reconciled that data to [exhibits and schedules to be listed as applicable] of the company's current annual statement. In other respects, my examination included review of the actuarial assumptions and actuarial methods used and tests of the calculations I considered necessary."
"In my opinion the reserves and related actuarial values concerning the statement items identified above:
Or
Note: Choose one of the above two paragraphs, whichever is applicable.
______________________________
Signature of Appointed Actuary
______________________________
Address of Appointed Actuary
______________________________
Telephone Number of Appointed Actuary
______________________________
Date"
(1) Product Type | (2) Death Benefit or Account Value | (3) Reserves Held | (4) Codification Reserves | (5) Codification Standard |
Ala. Admin. Code r. 482-1-112-.06
Author: Commissioner of Insurance
Statutory Authority:Code of Ala. 1975, §§ 27-2-17 and 27-36A-1 to 27-36A-20.