Incumbents in this class are responsible for analyzing and interpreting the terms of insurance products including forms, rates, rules and advertisements to determine compliance with Delaware law, Department of Insurance regulations, bulletins and insurance industry practice; and providing dispositions. Products reviewed by this class include all new, revised or discontinued insurance products for insurance companies offering health, limited benefits plans, discount medication programs, life, private, and commercial insurance policies to Delawareans.
Nature and Scope
Work is performed with general supervision from a technical superior. An incumbent reviews all insurance products including forms, rates, rules and advertisements to determine compliance with Delaware law, Department of Insurance regulations, bulletins and other insurance industry practice; and assess impact on the applicant or policyholder. For each product, class incumbents collect, analyze and evaluate data from a variety of sources; may research similar products in other states for consistency and comparison; and makes recommendations to approve, change, or remove an insurance product based on findings. An incumbent provides technical assistance to insurers in developing forms which comply with Department guidelines. Incumbents review rate and rule filings to determine accuracy, whether rates are reasonable, adequate and non-discriminatory. In the event of non-compliance, the incumbent will recommend modifications to the insurance company to achieve compliance and follows-up to ensure actions are completed through a secondary review. A significant aspect of this work involves protecting the insurance consumer against such practices as unlawful discrimination, premium rates which are unreasonable for benefits provided and ambiguous misleading clauses. In addition, the incumbent prepares informational documents and oral presentations for dissemination to special interest groups and/or the public at large. Work involves frequent contact with representatives of insurance companies, writing to businesses in Delaware, as well as members of the National Association of Insurance Commissioners.
Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.
Interprets and researches federal and state laws, rules, regulations, standards, policies and procedures relevant to insurance products including forms, rates, rules and
advertisements to determine compliance and the impact on the applicant or policy holder.
Provides technical assistance to insurers in developing forms which comply with Delaware guidelines.
Reviews insurance rates to determine whether rates are reasonable, adequate and non-discriminatory; researches actuarial findings and other artifacts; and establishes a cost/benefits analysis of the product offered.
Uses computer programs to assist in rate analysis and verification in connection with requested rate changes.
Meets with insurance representatives to discuss results of findings, causes and impact of any problems, and means of addressing problems; follows up to ensure actions are completed through secondary reviews.
Reviews withdrawal of insurance products in Delaware to ensure removal does not cause any customer issues or result in non-compliance.
Ensures accuracy of information printed, TV broadcast, or delivered via public speech to ensure advertisements accurately describe the products they are advertising.
Reviews premium and loss experience to determine if they are adequately justified on the basis of a statistical analysis of previous submitted policy experience.
Provides testimony at hearings for rating and underwriting pertaining to product review findings, explains recommendations and answers questions.
Communicates critical information both written and oral relating to filings to Supervisor and Commissioner.
Attends meetings, participates in divisional management work groups, task forces, and conducts conference calls with internal staff, insurance agency representatives, state/federal government, other rate insurance departments, industry representatives and the National Association of Insurance Commissioners; for the purpose of resolving issues, discussing current laws, rules and regulations, answering questions, and making recommendations on insurance product reviews.
Knowledge, Skills and Abilities
The intent of the listed knowledge, skills and abilities is to give a general indication of the core requirements for all positions in the class series; therefore, the KSA’s listed are not exhaustive or necessarily inclusive of the requirements of every position in the class.
Knowledge of Delaware insurance laws, rules, and regulations.
Knowledge of insurance theory, principles and practices pertaining to health, limited benefits plans, discount medication programs, life, private, and commercial insurance policies.
Knowledge of Department goals and objectives.
Knowledge of graphic arts.
Skill in analyzing, interpreting, and communicating complex laws and insurance forms and practices.
Skill in ensuring insurance products, forms, rates, rules and advertisements are accurate, reasonable and non-discriminatory.
Skill in the collection, analysis, evaluation and presentation of data from a variety of sources.
Skill in using computer programs to assist in rate analysis and verification.
Skill in analyzing rate deviations and making recommendations on solutions.
Skill in written and oral communications.
Ability to identify and analyze problems/needs/issues, assess their impact and make sound recommendations.
JOB REQUIREMENTS for Insurance Forms and Information Analyst
Applicants must have education, training and/or experience demonstrating competence in each of the following areas:
One year experience in analyzing and evaluating insurance products, forms, rates, rules, and advertisements to identify irregularities for ensuring consumer protection.
One year experience in determining compliance with insurance laws, rules, regulations, standards, policies and procedures.
Six months experience in narrative report writing.
Six months experience in using standard computer software programs for word processing, spreadsheets or databases.