Jobs

ACTUARIAL&COMPLIANCE ANALYST 1

Class Title: ACTUARIAL&COMPLIANCE ANALYST 1
Bargaining Unit: Use for all Job Titles
Class Code: 075661
Education and Experience: Graduation from an accredited college or university with a bachelor’s degree in mathematics, statistics, business, finance, law or other related acceptable field; qualifying full-time professional actuarial, insurance underwriting, insurance claims handling or insurance compliance experience may be substituted for the required education, on a year-for-year basis, to a maximum of four years.

Other Requirements:

Necessary Special Qualifications: None.
Examination Method: Education and Experience,100%, for Preferred Service.

Job Overview:

Summary: Under immediate supervision, is responsible for professional actuarial work of routine difficulty in learning to review and analyze insurance company forms, sales materials, rates, and benefits to determine legality, equitability, accuracy, and completeness of coverage; and performs related work as required.
Distinguishing Features: This is the entry level class in the actuarial sub-series. An employee in this class learns to use basic actuarial techniques and mathematical calculations in the analysis and evaluation of insurance rates, rating procedures, rating plans, and schedules. Work involves learning to prepare comprehensive and detailed actuarial studies in accordance with specific procedures. Work also involves learning to review and analyzing requests for rate increases or adjustments and analyzing insurance company reserves and underwriting procedures. This class differs from that of Actuary 2 in that an incumbent of the latter is responsible for performing actuarial duties at the working level under general supervision.

Work Activities:

Making Decisions and Solving Problems:
  1. Learns to make decisions on approval, modifications or denial of insurance company or rate service organization requests for form’s, rule’s or classification language.
  2. Learns to make decisions on approval, modifications or denial of insurance company or rate service organization requests for rate increases or adjustments.
Resolving Conflicts and Negotiating with Others:
  1. Learns to attempt to resolve problems with insurance rates, benefits provided, and company procedures, contract language, and practices.
Analyzing Data or Information:
  1. Learns to perform a detailed analysis of insurance forms, contracts, and sales material used by insurance companies in Tennessee to determine legality, accuracy, and clarity of information.
  2. Learns to analyze nationwide and statewide rating statistics to determine the validity of insurance rate change request.
  3. Learns to analyze pending or existing insurance legislation and developments in the insurance industry and develops and revises legislation to ensure protection of the policy holder.
  4. Learns to analyze pertinent pending or existing legislation or developments in the insurance industry to determine the effects on the regulation of insurance rates, forms, sales material, and benefits.
  5. Learns to analyze insurance company reports to determine adequacy of rates and rating plans, and soundness of insurance benefits and coverage.
  6. Learns to prepare detailed actuarial studies from insurance company and rate service organization filings.
Evaluating Information to Determine Compliance with Standards:
  1. Learns to determine legal compliance of contract language with statutes, regulations, and bulletins of filings submitted to the department.
  2. Learns to determine actuarial information required by statutes, regulations, and bulletins relative to rates is included in filings submitted to the department.
  3. Learns to ensure that insurance contract actuarial formulae meet the requirements of state laws and regulations.
  4. Learns to determine information required by statutes, regulations, and bulletins relative to forms/rules is included in filings submitted to the department.
  5. Learns to determine legal compliance of annuity, life, and other insurance policies developing cash value through the use of actuarial formulae.
Interpreting the Meaning of Information for Others:
  1. Learns to interpret statutes for insurance companies, consumers, and other interested parties in relation to statutory compliance.
  2. Learns to provide interpretation of insurance policy language for consumers.
  3. Assists in the development of bill analysis for new legislation.
Provide Consultation and Advice to Others:
  1. Learns to advise insurance companies on acceptable practice, procedures and language related to filings and other issues.
  2. May provide advice to upper management regarding insurance topics related to the section mission.
Processing Information:
  1. Learns to perform detailed actuarial calculations on allowable insurance rates, values, and benefits.
  2. Learns to compile information from products submitted by insurance companies.
Identifying Objects, Actions, and Events:
  1. Learns to identify inconsistencies and differences with insurance company filings as compared to industry standard.
Communicating with Persons Outside Organization:
  1. Learns to develop reports for presentation to the legislature as required by statute or the legislature.
  2. Learns to answer inquiries from the general public.
  3. Learns to discuss contract issues with other state insurance departments.
  4. Represents the department at conferences relating to insurance programs, procedures, or theory.
  5. Signs affidavit in lieu of appearance at a court proceeding.
  6. May appear as a witness at legal hearings to defend the position of the insurance division.
Getting Information:
  1. Learns to review rate, rule, and form filings that companies or rate service organizations propose to use within the state of Tennessee for compliance with Tennessee statutes, regulations and bulletins.
  2. Learns to research pending or existing insurance legislation and developments in the insurance industry and develops and revise legislation to ensure protection of the policy holder.
  3. Learns to research pertinent pending or existing legislation or developments in the insurance industry to determine the effects on the regulation of insurance rates, forms, sales material, and benefits.
  4. Obtains information from surveys received from companies relative to business activity within the state.
Establishing and Maintaining Interpersonal Relationships:
  1. Establishes and maintains a variety of personal contacts with departmental associates, upper management, insurance company representatives, attorneys, accountants, lobbyist, legislators and the general public to explain, interpret, and enforce actuarial and insurance rating laws, rules and regulations and policies and procedures.
Developing Objectives and Strategies:
  1. Assists actuarial officer in the development of strategies for implementation of new legislation and other state and federal directives.
Documenting/Recording Information:
  1. Learns to prepare and maintain a variety of routine to complex records and reports including statistical data, actuarial and mathematical analytic reports and accompanying written narratives.
Interacting With Computers:
  1. Learns to access electronic filings from electronic filing system used by the insurance industry.
  2. Learns to utilize office productivity software in order to maintain correspondence with companies and consumers.
  3. Learns to enter and update data into database and/or spreadsheet in order to track filings, input survey data and update rate changes.
Organizing, Planning, and Prioritizing Work:
  1. Learns to prioritize filing review in order to meet statutory deadlines.
Communicating with Supervisors, Peers, or Subordinates:
  1. Updates supervisor on problematic filings.
  2. Discusses contract issues with peers and subordinates.
Performing Administrative Activities:
  1. Responds to emails, phone calls, and other correspondence as required.
  2. Enters personal time and leave/overtime requests into the appropriate database as required.
  3. Matches correspondence to open files submitted by insurance companies for review. 
Thinking Creatively:
  1. Learns to design spreadsheets used both internally and externally that document information regarding insurance company rate changes and enrollment data.
  2. Learns to create surveys used to request information from insurance companies.
Updating and Using Relevant Knowledge:
  1. Remains up-to-date on new federal and state legislation that affects the insurance industry.
  2. May attend industry meetings as necessary or required.
Monitor Processes, Materials, or Surroundings:
  1. Learns to review reports summarizing company operations and activities to determine the adequacy of rates and rating plans and the soundness of insurance benefits and coverage.
  2. Learns to monitor rate trends in the marketplace for the impact on Tennessee residents.
  3. Learns to monitor insurance coverage trends in the marketplace for the impact on Tennessee residents.
  4. Learns to monitor response time associated with insurance company filings in order to address deviations from the standard.

Competencies (KSA’s):

Competencies:
  1. Decision Quality
  2. Functional/Technical Competency
  3. Written Communication
  4. Technical Learning
  5. Timely Decision Making
  6. Action Oriented
  7. Perseverance
  8. Priority Setting
  9. Patience
  10. Negotiating
Knowledge:
  1. Knowledge of Basic Computer Applications
  2. Basic Knowledge of Insurance Terminology and Concepts
  3. Knowledge of Statistics
  4. Knowledge of Customer and Personal Service
  5. Basic Knowledge of Law and Government
  6. Knowledge of Algebra
Skills:
  1. Reading Comprehension
  2. Critical Thinking
  3. Writing Skills
  4. Active Learning
  5. Active Listening
Abilities:
  1. Oral Expression
  2. Written Expression
  3. Inductive Reasoning Ability
  4. Written Comprehension
  5. Oral Comprehension
  6. Memorization Ability

Tools and Equipment Used:

  1. Copier
  2. Scanner
  3. Fax Machine
  4. Telephone
  5. Computer
  6. Printer

Back to top button