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ACTUARIAL&COMPLIANCE OFFICER

Class Title: ACTUARIAL&COMPLIANCE OFFICER
Bargaining Unit: Use for all Job Titles
Class Code: 075663
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 and experience equivalent to substantial (five or more years of) full-time increasingly responsible professional actuarial, insurance underwriting, insurance claims handling or insurance compliance work; 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; additional pertinent graduate coursework may be substituted for the required experience on a year-for-year basis, to a maximum of two years.

Other Requirements:

Necessary Special Qualifications: A valid vehicle operator’s license may be required for employment in some positions.
Examination Method: Education and Experience,100%, for Preferred Service positions. For Executive Service positions, Minimum Qualifications, Necessary Special Qualifications, and Examination Method are determined by the appointing authority.

Job Overview:

Summary: Under direction, is responsible for professional actuarial work of unusual difficulty and supervisory work of average difficulty in supervising a section of subordinate actuaries in reviewing and analyzing insurance company forms, sales material, rates, and benefits to determine legality, equitability, accuracy, and completeness of coverage; and performs related work as required.
Distinguishing Features: This is the highest class in the Actuarial sub-series. An employee in this class is responsible for supervising a small specialized section of subordinate actuaries within the Department of Commerce and Insurance. Work involves supervising and participating in the use of basic actuarial techniques and mathematical calculations in the analysis and evaluation of insurance rates, rating procedures, rating plans, and schedules or in the analysis of insurance forms, contracts, and sales material. Work includes supervising the review and analysis of requests for rate increases or adjustments and the analysis of 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. Makes decisions on approval, modifications or denial of insurance company or rate service organization requests for rate increases or adjustments.
  2. Makes decisions on approval, modifications or denial of insurance company or rate service organization requests for form’s, rule’s or classification language.
Analyzing Data or Information:
  1. Performs detailed analysis of insurance forms, contracts, and sales material used by insurance companies in Tennessee to determine legality, accuracy, and clarity of information.
  2. Analyzes nationwide and statewide rating statistics to determine the validity of insurance rate change request.
  3. Analyzes pending or existing insurance legislation and developments in the insurance industry and develops and revises legislation to ensure protection of the policy holder.
  4. Analyzes insurance company reports to determine adequacy of rates and rating plans, and soundness of insurance benefits and coverage.
  5. Prepares detailed actuarial studies from insurance company and rate service organization filings.
  6. Analyzes 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.
Evaluating Information to Determine Compliance with Standards:
  1. Determines actuarial information required by statutes, regulations, and bulletins relative to rates is included in filings submitted to the department.
  2. Determines legal compliance of annuity, life, and other insurance policies developing cash value through the use of actuarial formulae.
  3. Ensures that insurance contract actuarial formulae meet the requirements of state laws and regulations.
  4. Determines legal compliance of contract language with statutes, regulations, and bulletins of filings submitted to the department.
  5. Determines information required by statutes, regulations, and bulletins relative to forms/rules is included in filings submitted to the department.
Interpreting the Meaning of Information for Others:
  1. Interprets statutes for insurance companies, consumers, and other interested parties in relation to statutory compliance.
  2. Provides 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. Provides advice to the commissioner, and other governing bodies regarding applicable insurance topics.
  2. Advises insurance company on acceptable practice, procedures and language related to filings and other issues.
  3. Provides advice to upper management regarding insurance topics related to the section mission.
Staffing Organizational Units:
  1. Makes recommendations on employment, retention, promotion, demotion, and other human resources action.
Identifying Objects, Actions, and Events:
  1. Identifies inconsistencies and differences with insurance company filings as compared to industry standard.
Processing Information:
  1. Performs detailed actuarial calculations on allowable insurance rates, values, and benefits.
  2. Compiles information from products submitted by insurance companies.
Documenting/Recording Information:
  1. Prepares highly complex and detailed actuarial analytic records and reports and mathematical and statistical data and routine administrative and supervisory reports.
Developing Objectives and Strategies:
  1. Develops strategies for implementation of new legislation and other state and federal directives.
  2. Develops performance standards for assigned subordinates.
Getting Information:
  1. Researches classifications and NCCI (National Council on Compensation Insurance) rules to support findings, facts, and conclusions of law relative to rate hearings before the commissioner.
  2. Reviews 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.
  3. Researches 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. Researches pending or existing insurance legislation and developments in the insurance industry and develops and revise legislation to ensure protection of the policy holder.
  5. Obtains information from surveys received from companies relative to business activity within the state.
Communicating with Persons Outside Organization:
  1. Develops reports for presentation to the legislature as required by statute or the legislature.
  2. May appear as a witness at legal hearings to defend the position of the insurance division.
  3. Answers inquiries from the general public.
  4. Discusses contract issues with other state insurance departments.
  5. Represents the department at conferences relating to insurance programs, procedures, or theory.
  6. Signs affidavit in lieu of appearance at a court proceeding.
Guiding, Directing, and Motivating Subordinates:
  1. Evaluates subordinate actuarial and clerical staff based on job performance standards.
Resolving Conflicts and Negotiating with Others:
  1. Attempts to resolve problems with insurance rates, benefits provided, and company procedures, contract language, and practices.
  2. Attempts to resolve good faith conflicting opinions among actuaries.
  3. Maintains a respectful and productive work environment within the assigned work unit to minimize disputes and facilitate performance.
Estimating the Quantifiable Characteristics of Products, Events, or Information:
  1. Provides fiscal note estimates as requested from senior management that details net costs or benefits to the state on proposed legislation.
  2. Estimates time and costs associated with consulting actuarial contracts.
Training and Teaching Others:
  1. Trains actuarial and clerical staff on the performance of job duties.

Coaching and Developing Others:

  1. Mentors less experienced actuaries on general insurance knowledge and the performance of work duties.
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.
Thinking Creatively:
  1. Designs spreadsheets used both internally and externally that document information regarding insurance company rate changes and enrollment data.
  2. Creates surveys used to request information from insurance companies.
Communicating with Supervisors, Peers, or Subordinates:
  1. Discusses contract issues with peers and subordinates.
  2. Updates supervisor on problematic filings.
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.
Scheduling Work and Activities:
  1. Assists in the scheduling of meetings and hearings for departmental and interdepartmental responsibilities.
  2. Assists in the scheduling of meetings and hearings for entities responsible for assigned risk plans.
Interacting With Computers:
  1. Accesses electronic filings from electronic filing system used by the insurance industry.
  2. Enters and updates data into database and/or spreadsheet in order to track filings, input survey data and update rate changes.
  3. Utilizes office productivity software in order to maintain correspondence with companies and consumers.
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.
Coordinating the Work and Activities of Others:

  1. Supervises the activities of a small specialized actuarial section within the Department.
  2. Assigns work to professional actuarial and clerical staff.

Monitor Processes, Materials, or Surroundings:

  1. Reviews reports summarizing company operations and activities to determine the adequacy of rates and rating plans and the soundness of insurance benefits and coverage.
  2. Monitors rate trends in the marketplace for the impact on Tennessee residents.
  3. Monitors premiums in the assigned risk plans to evaluate market trends and appropriate pricing levels.
  4. Monitors insurance coverage trends in the marketplace for the impact on Tennessee residents.
  5. Monitors response time associated with insurance company filings in order to address deviations from the standard.
Organizing, Planning, and Prioritizing Work:
  1. Prioritizes filing review in order to meet statutory deadlines.
Operating Vehicles, Mechanized Devices, or Equipment:
  1. May operate a motor vehicle in accomplishing work activities.

Competencies (KSA’s):

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

Tools and Equipment Used:

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

 

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