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Life Illustrations - Initial Identification

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​Last Updated: September 18, 1997

Life Illustrations - Initial Identification

(From Bulletin of September 15, 1997, Section Ins 2.17, Wis. Adm. Code--Life Illustrations, September 15, 1997)

​Section Ins 2.17, Wis. Adm. Code, effective January 1, 1998, requires that all insurers subject to the rule advise the Office of the Commissioner of Insurance (OCI) of the name of the company’s illustration actuary [refer to s. Ins 2.17 (10) (a), Wis. Adm. Code] and provide OCI with a list of all policy forms which will be used in Wisconsin after December 31, 1997. The insurer must indicate whether each form will be used with an illustration [refer to s. Ins 2.17 (4) (a), Wis. Adm. Code]. Additionally, the company’s illustration actuary must certify, on an annual basis, that the disciplined current scales used in the company’s illustrations conform with the Actuarial Standard of Practice for Compliance with the NAIC Model Regulation on Life Insurance Illustrations promulgated by the Actuarial Standards Board, and that the illustrated scales used in the insurer’s authorized illustrations meet the requirements of s. Ins 2.17, Wis. Adm. Code [refer to s. Ins 2.17 (10) (b) and (d), Wis. Adm. Code]. Further, an officer of the insurance company (other than the illustration actuary) must certify, annually, that the company’s illustration formats meet the requirements of s. Ins 2.17, Wis. Adm. Code, and that the scales used in the insurer’s authorized illustrations are those scales certified by the illustration actuary. The company officer must also certify that it has provided its agents with information about the expense allocation method used by the company in its illustrations [refer to s. Ins 2.17 (10) (f), Wis. Adm. Code].

Instructions: Print this page. Please complete sections 1 - 6 and return the completed form to OCI no later than December 31, 1997. Completed forms may be sent to the attention of Florence DeLuca, Office of the Commissioner of Insurance, P.O. Box 7873, Madison, WI 53707-7873. Questions regarding this form may be directed to Carla Strauch at (608) 264-6235.

  1. Name and address of company:
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
  2. Name, title, and phone number of the person completing this form:
    ___________________________________________________________
    ___________________________________________________________
    ___________________________________________________________
  3. Name of company's illustration actuary (please list all illustration actuaries):
    Name Title Phone
       
       
       
       
  4. Please attach copies of the following:
    • Certification from the company's illustration actuary [refer to s. Ins 2.17 (10) (b) and (d), Wis. Adm. Code].
    • Certification from an officer of the company [refer to s. Ins 2.17 (10) (f), Wis. Adm. Code].
  5. Please indicate the date by which an officer of the company and the illustration actuary will provide OCI with certifications, each year:
    ___________________________________________________________
  6. Please list the form number of each policy and certificate that will be marketed in Wisconsin on January 1, 1998 (applications and other supplemental policy forms need not be listed), indicate the date the form was approved in Wisconsin, and indicate whether or not the form will be marketed with an illustration. You are welcome to use your own format or attach a computer printout showing the information requested below.
    Policy Number Date form approved in WI Will form be used
    with an illustration?
      Yes _____   No _____
      Yes _____   No _____
      Yes _____   No _____
      Yes _____   No _____
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