BULLETIN
98-01
To: All Alaskan Health Care Insurers
Re: Alaska Small Employer Insurance
Activity Report
Our records indicate that you are licensed to
transact health insurance in Alaska. Pursuant to AS
21.56.075, all insurers licensed to transact
health insurance in Alaska who offer a health
care insurance plan must submit the information
indicated on the attached Alaska Small Employer
Health Insurance Activity Report to the director
by March 15 of each year. The first report
covering calendar year 1997 is due no later than
March 15, 1998.
Among other purposes, this report will be used
to determine your company's share of the Alaska
Small Employer Health Reinsurance Association's
assessment base. It will also be used by the
association to report to the Alaska Legislature
and the Director on the effectiveness of Alaska's
small employer health insurance reforms and to
compare the effectiveness of Alaska's small
employer reforms with other states and regions in
the country.
Please submit the required information on a
copy of the attached activity report and contact
person's information no later than March 15 each
year to:
Director
State of Alaska
Department of Commerce & Economic Development
Division of Insurance
3601 C Street, Suite 1325
Anchorage, Alaska 99503
Date: February 2, 1998
Marianne K. Burke
Director of Insurance |
1997 ALASKA
SMALL EMPLOYER HEALTH INSURANCE
CALENDAR YEAR 1997
ACTIVITY REPORT
IMPORTANT
Return no later than March
15, 1998 to:
Director
State of Alaska
Department of Commerce & Economic Development
Division of Insurance
3601 C Street, Suite 1324
Anchorage, Alaska 99503
1. Administrative:
a. Carrier name:
b. Carrier contact name:
Title:
Phone:
Address
2. Total Accident & Health Insurance
Premium
Total 1997 Accident & Health Insurance
Premium Written in Alaska $ _______________
3. Inforce:
a. Number of policies active as of
12/31/97 _______________
b. Monthly earned premium based on 12/97
billing $ _______________
c. 1997 calendar year earned premium $
_______________
d. Number of insured employees, based on
12/97 billing _______________
e. Number of insured lives (including
dependents) based on 12/97 billing
_______________
4. New Business:
a. Number of policies that became
effective in 1997 _______________
b. Monthly earned premium, based on 12/97
billing for policies that became effective in
1997 $ _______________
c. 1997 Calendar year earned premium for
policies that became effective in 1997 $
_______________
d. Number of insured employees, based on
12/97 billing for policies that became
effective in 1997 _______________
e. Number of insured lives (including
dependents) based on 12/97 billing for
policies that became effective in 1997
_______________
5. Cancellations:
a. Number of policies that canceled
coverage in 1997 _______________
b. Monthly earned premium, based on 1/97
billing for policies that canceled coverage
in 1997 $ _______________
c. 1997 calendar year earned premium for
policies that canceled coverage in 1997
_______________
d. Number of insured employees, based on
1/97 billing for policies that canceled
coverage in 1997 _______________
e. Number of insured lives (including
dependents) based on 1/97 billing of policies
that canceled coverage in 1997
_______________
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