Statutory accounting update
Agenda
1)
Substantive revisions adopted
2)
Nonsubstantive revisions adopted
3)
Items currently open for exposure
4)
Updates to risk sharing provisions of
PPACA
5)
Questions
Substantive revisions
adopted
Substantive revisions
Underlying principle for qualifying
transactions:
>
Absolute control equivalent to direct ownershipSSAP No. 40R:
Wholly-Owned Single Property Real Estate in LLC
Substantive revisions (cont.)
Adopted conditions:
>
No other LLC transactions– Except for transactions associated with managing real estate
>
Owns single-real estate supported by appraisal– Multiple structures are contiguously located and managed
>
Solely controls real estate– Controls access, and can sell as promptly as directly owned
SSAP No. 40R:
Substantive revisions (cont.)
Adopted conditions (cont.):
>
Solely possess all risks and rewards– No constraints by LLC
– Clarification of whether a mortgage loan disqualifies is pending
>
Reporting entity is only member of LLC– Does not allow any other members – even if other members of the LLC are affiliates; LLC comprised of affiliates is not allowed
– Restriction also applies to down-stream holding companies
SSAP No. 40R:
Wholly-Owned Single Property Real Estate in LLC
Substantive revisions (cont.)
Adopted conditions (cont.):
>
No apportionment of income or expenses>
Ownership in LLC must be directSSAP No. 40R:
Nonsubstantive
revisions adopted
Nonsubstantive revisions
>
SSAP No. 1– Going concern disclosures – Insurance-linked securities
>
SSAP No. 4– Restricted asset guidelines
>
SSAP No. 11– Disclosure requirements
>
SSAP No. 37 / 40R– Foreclosed mortgage loans
>
SSAP No. 61R– Disclosure to capture information regarding
reinsurance agreements with affiliated captive insurers
Nonsubstantive revisions (cont.)
>
SSAP No. 65 – Disclosure regarding aggregate unsecured high-deductible recoverables>
SSAP No. 69– Cash flow statements (non-cash items)
>
SSAP No. 86– Derivatives reporting
>
SSAP No. 97– SCA permitted or prescribed practices disclosure
– Disclosure of the reported value for SCAs and filing information
Key adopted nonsubstantive SAP revisions
(cont.)
Nonsubstantive revisions (cont.)
SSAP No. 1
Adopts ASU 2014-15 Going Concern Disclosures
>
Requires management evaluation about whether there areconditions or events, that raise substantial doubt about an entity’s ability to continue as a going concern within one year after the date the financial statements are issued
>
If substantial doubt, management shall evaluate whether itsplans to mitigate those concerns and events, when implemented, will alleviate the substantial doubt
Nonsubstantive revisions (cont.)
SSAP No. 1 (cont.)
Adopts ASU 2014-15 Going Concern Disclosures
>
If after considering management’s plans, substantial doubtis alleviated, disclosures about the doubt, plans, etc. are required
>
If after considering management’s plans, substantial doubtis NOT alleviated, entity shall include statement in the financials:
“There is substantial doubt about the entity’s ability to
continue as a going concern within one year after the date that the financial statements are issued.”
Nonsubstantive revisions (cont.)
SSAP Nos. 48, 68, and 97
Nonadmit Investments with Going Concern
>
SSAP No. 48 – Joint Ventures, Partnerships and LLCs>
SSAP No. 97 – Investments in SCA’s– The investment shall be nonadmitted if the audited financial statements include substantial doubt about the entity’s ability to continue as a going concern
– The investment shall be nonadmitted on the basis/contents of the audit opinion as detailed in paragraph 20 of SSAP No. 97. (This guidance is not new - includes qualified, disclaimer, and adverse opinions.)
Nonsubstantive revisions (cont.)
SSAP Nos. 48, 68, and 97 (cont.)
Nonadmit Investments with Going Concern
>
SSAP No. 68 – Joint Ventures, Partnerships, and LLCs– All positive goodwill shall be nonadmitted when the underlying investment in the SCA or partnership, joint venture and limited liability company is nonadmitted
– Includes, but is not limited to:
» Situations in which the investment is nonadmitted as the audited financial statements for the SCA, joint venture, partnership or limited liability company includes substantial doubt on the entity’s ability to continue as a going concern, or on the basis/contents of the audit opinion pursuant to paragraph 20 of SSAP No. 97
Nonsubstantive revisions (cont.)
SSAP No. 1
Insurance-Linked Securities
>
Requires disclosure when reporting entities may receivepossible proceeds as the issuer, ceding insurer or counterparty of ILS
>
Narrative disclosure in 2015>
Disclosure will be reviewed and revisited in 2016 for dataNonsubstantive revisions (cont.)
SSAP No. 1 and SSAP No. 4
Restricted Assets Clarifications
>
Adopted revisions to clarify guidance and disclosuresrelated to admitted and restricted assets
>
“Admitted” and “Restricted” are not interchangeableterms.
>
SSAP No. 4 Revisions:– Asset restrictions may be a factor in determining admissibility
– However, determining that a restricted asset is an admitted asset does not eliminate the statutory requirements to document and identify the asset as restricted
Nonsubstantive revisions (cont.)
SSAP No. 1 and SSAP No. 4 (cont.)
Restricted / Admitted Assets
>
All assets pledged as collateral or otherwise restricted(regardless if admitted) shall be reported in the SSAP No. 1 restricted asset disclosures, general interrogatories and in any other schedule or disclosure requesting
information on restricted assets
>
Referral to Capital Adequacy Task Force (Spring 2015):– Requested Task Force to re-evaluate whether a separate
“restricted asset” RBC charge is needed for assets on deposit with states held for the benefit of all policyholders
Nonsubstantive revisions (cont.)
SSAP No. 11
Postemployment Benefits
>
In 2014, SSAP No. 11 was updated:– Disclosures removed
– Driven from identification of adopted GAAP guidance not included in SSAP No. 92 (OPEBs)
– Ultimately resulted in revisions to clearly indicate the previously-adopted GAAP guidance
– Noted that SSAP No. 11 disclosures fit pension/OPEB plans, requested new project to review SSAP No. 11 disclosures
Nonsubstantive revisions (cont.)
SSAP No. 11 (cont.)
Postemployment Benefits
>
In Spring 2015, most SSAP No. 11 disclosureswere deleted
– Remaining disclosure:
Nonsubstantive revisions (cont.)
SSAP No. 37 and SSAP No. 40R
Foreclosed Mortgage Loans
>
Guidance when to derecognize foreclosed mortgageloans and:
– Recognize real estate (property collateralizing loan)
» Lower of FV less costs to sell, or recorded investment
– Recognize other receivable (government guarantee)
» Amount from mortgage loan expected to be recovered » Gov’t receivable is admitted asset even if over 90 days
>
Guidance applied prospectively from adoption date(March 2015)
– Adopts ASU 2014-14 (Government Guaranteed)
Nonsubstantive revisions (cont.)
SSAP No. 61R
Disclosures Related to Reinsurance
Agreements with Affiliated Captive Insurers
>
For reinsurance of variable annuity contracts with anaffiliated captive reinsurer:
– Type of benefits reinsured
– Description of the purpose of the transaction and significant terms of the reinsurance agreement
– Description of risks retroceded
– Whether reporting entity reinsurers variable annuities in a standalone captive
– Amount of reserves held by the captive reinsurer, reserve methodologies utilized
Nonsubstantive revisions (cont.)
SSAP No. 65
Disclosure Regarding High-Deductible
Recoverables
>
Revisions incorporate a disclosure to identify professionalemployer organization’s aggregate unsecured high-deductible recoveries
Nonsubstantive revisions (cont.)
SSAP No. 69
Cash Flow Statement
>
Clarifies inclusion of non-cash items in the cash flowstatement
– For SSAP Purposes:
» Cash = Cash, Cash Equivalents & Short-Term Investments
>
Only items involving cash are in the Cash Flow Statement>
New disclosures for non-cash items. Examples:– Receiving non-cash assets from parent as a capital contribution – Settling reinsurance transactions with non-cash financial assets
>
A/S worksheets require modification to remove non-cashNonsubstantive revisions (cont.)
SSAP No. 86
Derivative Reporting
>
Guidance to agree derivatives on Schedule DB to the BS– Derivatives reported on Schedule DB reported gross
– Derivatives reported on BS reported net (if right to offset)
>
Schedule DB-D-1 shows derivatives by counterparty– Book adjusted carrying amount > 0 (derivative assets) – Book adjusted carrying amount < 0 (derivative liabilities)
>
New cross-check to agree to balance sheet!Nonsubstantive revisions (cont.)
SSAP No. 86 (cont.)
Benchmark Interest Rate
>
Incorporates GAAP definition for “benchmark interestrate”
– Widely recognized and quoted rate in active market
– Broadly indicative of interest rate for high-credit quality obligors – In theory, a risk-free rate (e.g., no risk of default)
– In US only the Treasury Rate, London interbank offered Rate (LIBOR), and Fed Funds Effective Rate are benchmark rates
>
Eliminates prior requirement to use the same benchmarkrate as the rate being hedged for similar hedges
Nonsubstantive revisions (cont.)
SSAP No. 97
SCA Permitted or Prescribed Practices
>
Incorporates a new disclosure for reporting entities thathave insurance SCAs for which audited statutory equity of the insurance SCA included permitted or prescribed practices
>
Disclosure from the SCA to be included in the reportingentity
Nonsubstantive revisions (cont.)
SSAP No. 97 (cont.)
Filing Information
>
All SCA investments (except 8.b.i. entities) shall includedisclosure of the SCA balance sheet value (admitted and non-admitted) as well as information received from the NAIC in response to the SCA filing (e.g., date and type of filing, NAIC valuation amount, whether resubmission of filing is required).
>
Disclosure includes the aggregate total of all SCAs withItems currently open
for exposure
Key substantive items open for exposure
Exposed items – substantive
>
Investment Classification Project (Ref #2013-36)>
SSAP No. 41Exposed items – substantive (cont.)
Investment Classification Project
>
Directed staff to continue working with issuers, vendorsand industry in addressing questions on the proposed measurement method for SVO bond-designated ETFs
Exposed items – substantive (cont.)
SSAP No. 41
Surplus Notes
>
Inclusion of impairment guidance>
Expansion of amortized cost to include NAIC 2 surplusnotes
>
Removal of guidance duplicated in the P&P ManualKey nonsubstantive items open for exposure
Exposed items – nonsubstantive
>
SSAP No. 1– Quarterly disclosure of restricted assets (Ref #2015-19)
– Improve guidance and reporting of permitted and prescribed practices (Ref #2015-52)
>
SSAP No. 3– Refiling of amended financial statements for corrections of errors (Ref #2015-46)
>
SSAP No. 55Key nonsubstantive items open for exposure
(cont.)
Exposed items – nonsubstantive
(cont.)
>
SSAP No. 97– Ownership of an ETF or mutual fund clarification (Ref #2015-49) – Accounting of non-insurance SCAs (Ref #2015-08)
Exposed items – nonsubstantive
(cont.)
SSAP No. 1
Quarterly Disclosure of Restricted Assets
>
Quarterly disclosure of restricted assets if significantlydifferent from the prior year-end financial statements
Guidance and Reporting of Permitted and
Prescribed Practices
>
Proposes to improve guidance and reporting of permittedand prescribed practices
Exposed items – nonsubstantive
(cont.)
SSAP No. 3
Error Corrections
>
Clarifies that amended financial statements shall be filedfor material accounting errors unless otherwise direct by the domiciliary regulator, and for reporting discrepancies identified within a submitted annual financial statement
Exposed items – nonsubstantive
(cont.)
SSAP No. 55
Reporting of Subrogation Expenses
>
Clarifies that fees incurred for salvage and subrogationrecoveries shall be reported gross, regardless of whether the fees are paid to third parties or processed internally
>
IPs commented that this proposal was inconsistent withcurrent SAP
>
Re-exposed to solicit more comments on the issues priorto developing a revised recommendation
Exposed items – nonsubstantive
(cont.)
SSAP No. 97
Ownership of an ETF or Mutual Fund
>
Clarifies that ownership or mutual fund does notrepresent ownership in an underlying entity within the scope of SSAP No. 97, unless ownership of the ETF actually results in “control” of an underlying company.
Exposed items – nonsubstantive
(cont.)
SSAP No. 97 (cont.)
Non-insurance SCAs
>
Issue #1 – Transfer of nonadmitted assets into anon-insurance SCA
– Incorporation of referenced to paragraph 16d of SSAP No. 25 directly into SSAP No. 97
>
Issue #2 – Permitted or prescribed practices of insuranceSCA
– Current exposure provides optionality as it relates to reporting
entities making adjustments for SCAs with permitted or prescribed practices
– Disclosure of permitted or prescribed practices in insurance SCAs
Exposed items – nonsubstantive
(cont.)
SSAP No. 97 (cont.)
Non-insurance SCAs (cont.)
>
Issue #3 – Valuation of non-insurance SCAs engaging ininsurance activities and foreign insurance entities
– Include guidance to clarify that non-insurance SCAs meeting the revenue and activity test shall reflect limited statutory revisions and complete a review of the adjustments detailed in paragraph 9 of SSAP No. 97
Exposed items – nonsubstantive
(cont.)
Quarterly Investment Schedules
>
NAIC proposed to require additional quarterly investmentreporting (almost a “light Schedule D”) to include:
– CUSIP – Par value
– Book/adjusted carrying value – Fair value
>
Re-exposed based upon opposition from IPsUpdates to risk
sharing provisions
of PPACA
What’s documented within
SSAP No. 107
42SSAP
No. 107
December 12, 2014Accounting treatment for risk corridor (Assets and Liability)
II
Accounting treatment for reinsurance (3 Products, 3 Assessments, Distributions)
I
Accounting treatment for risk
adjustments (Assets and Liability)
III
Financial Statement disclosure of risk sharing provision estimates.
Three risk sharing provisions of
PPACA
Section 1341 Section 1343PPACA
Section 1342Reinsurance
44
Program Administration
Operated within each state, either by the State or HHS.
Effective for years 2014 through 2016.
Assessments
Payment based on an annual national per-capita rate.
Used to provide reinsurance coverage and cover administrative costs.
Purpose
Compensate issuers who enroll high-risk individuals. Considered an Involuntary Pool.
Distributions
Made to issuers with medical costs of enrollees above a determined attachment point.
Risk corridor
Program Administration
Federal program operated by HHS. Effective for years 2014 through 2016.
Assessments
Liability of issuer when allowable costs are less than 97% of target amount.
Purpose
Protect against inaccurate rate setting through risk sharing of allowable costs between issuers and HHS.
Distributions
Receivable from HHS when allowable costs are greater than 103% of target amounts.
Risk adjustment
46
Program Administration
Established in each individual state. Permanent program effective in 2014
Assessments
Liability of issuer with average actuarial risk of members below the overall market.
Purpose
Protect against the risk of adverse selection. Transfers funds from issuers with lower risk members to plans with greater amounts of high risk members.
Distributions
Receivable of issuer with average actuarial risk of members in excess of the overall market.
Transitional reinsurance
Product groups subject to reinsurance:
> Subject Individual Insured Products – subject to ACA market reform
> Other Insured Health Products – not subject to ACA market reform (ex. individual grandfathered products)
> Self-Insured Health Products
Product Groups
Three assessments, one distribution:
> Assessments for Reinsurance
> Administrative Cost Assessments
> US Treasury Assessments
> Reinsurance Distributions
What’s Paid
Expense
Ceded Premium Ceded Premium
Ceded Premium
Claim Benefit Recovery Ceded Premium
Expense
Subject individual insured products
48 Payments Assessments for Reinsurance Administrative Cost Assessments U.S. Treasury Assessments Reinsurance Distributions Reasoning
Satisfy risk transfer and timely reimbursement
requirements
Traditional Reinsurance considers Admin.
Expenses
Taxes, Licenses and Fees Category
Reduction to the reported benefits paid
Add’l Guidance
SSAP No. 61R
SSAP No. 35R
SSAP No. 61R Par. 27
Other insured health products
Assessments
> Issuers not considered as “Participating”
> All Assessments reported as Expense.
Distributions
Self insured health products
Assessments
> Responsibility of the self-insured plan.
> Treated as Pass-through by the reporting entity.
Distributions
> Issuers not considered as “Participating”
> Not eligible for distribution.
Risk corridor and risk adjustment
Admissible based on criteria documented within SSAP No. 107.
ASSET
Meets the definition of a liability as outlined in SSAP No. 5R.
Asset admissibility – risk corridor
Criteria for risk corridor asset admission:
52
Assumptions used for these retrospective premium adjustments must be consistent with similar assets and liabilities with impact on underwriting results. Related expenses must be reported in the same period as the effect on premium.
Estimate Assumptions
Effects of premiums (additions or reductions) are recognized over the entire period. Methods used for estimates must be reasonable and consistent each period. Being conservative, experience to
date, and sufficient data must be used, as well as consideration of the impact of other
risk-sharing programs.
Receivables are not reported as non-admitted based solely on aging greater than 90 days. Receivables are considered admitted assets until impairment or payment denial is received from the governmental entity.
Collectability shall be evaluated each reporting period. (SSAP No. 5R)
Aging Impairment Collectability Effects on Premiums
Asset admissibility – risk adjustment
Criteria for risk adjustment asset admission:
Estimates are based on experience to date and the method used must be applied consistently between reporting periods. The SSAP notes issuer be aware of significant uncertainty,
conservative, and have sufficient data. Estimate
Assumptions
Estimates are determined for the expired portion of the policy period as an immediate adjustment to premiums.
Receivables are not reported as non-admitted based solely on aging greater than 90 days. Receivables are considered admitted assets until impairment or payment denial is received from the governmental entity.
Collectability shall be evaluated each reporting period. (SSAP No. 5R)
Aging Impairment Collectability Effects on Premiums
SSAP No. 107: Disclosure
Includes assets, liabilities, and revenue elements and whether policies were
written.
Beginning Year End 2014
Example of disclosure
within SSAP No. 107, Par. 57
2015 developments
June 17, 2015 CMS letter:
>
CMS increases coinsurance rate increased from 80% to100% for reinsurance program
>
Refer to CMS memo at:https://www.cms.gov/CCIIO/Programs- and-Initiatives/Premium-Stabilization-Programs/The-Transitional- Reinsurance-Program/Downloads/RI-Payments-National-Proration-Memo-With-Numbers-6-17-15.pdf
2015 developments (cont’d)
June 30, 2015 CMS report:
>
CMS issues summary report on reinsurance and riskadjustment programs
– $7.9 billion reinsurance payments made to 437 issuers
“Our preliminary analysis of the transitional reinsurance program for the 2014 benefit year shows that the reinsurance program is working as intended – by providing protection to issuers
2015 developments (cont’d)
June 30, 2015 CMS report (cont.):
>
CMS issues summary report on reinsurance and riskadjustment programs
– Various observations related to risk adjustment program
“Our preliminary analysis of the risk adjustment transfers for the 2014 benefit year shows that the risk adjustment methodology is working as intended – by compensating issuers that
enrolled higher risk individuals and protecting against adverse selection within a market within a state.”
– Refer to CMS report at:
https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium- Stabilization-Programs/Downloads/RI-RA-Report-Draft-6-30-15.pdf
2015 developments (cont’d)
June 30, 2015 CMS report (cont.):
Table 1: Reinsurance Summary DataSUMMARY DATA ELEMENT TOTALS
Number of Issuers with Enrollment in Reinsurance-Eligible Individual Market Plans, Nationwide
484 Number of Issuers Receiving Reinsurance Payments,
Nationwide5
437 Dollar Value of 2014 Benefit Year Reinsurance Payment
Requests
Approximately $7.9 billion Total 2014 Benefit Year Reinsurance Contributions
Collected to Date
Approximately $8.7 billion Estimated 2014 Benefit Year Reinsurance Contributions to
be Collected by or before November 15, 2015 for Use in Subsequent Years
Approximately $1 billion Uniform Payment Parameters for 2014 $45,000 attachment point,
$250,000 reinsurance cap and 100 percent coinsurance rate
2015 developments (cont’d)
June 30, 2015 CMS report (cont.):
60 Table 2: HHS Risk Adjustment Program Summary Data7
HHS RISK ADJUSTMENT TRANSFER CATEGORY NUMBER OF ISSUERS WITH
RISK ADJUSTMENT
COVERED PLANS IN HHS RISK ADJUSTMENT
Total Number of Issuers Participating in HHS Risk Adjustment Transfers
758 Number of Issuers with Individual
Non- Catastrophic Plans
468
Number of Issuers with Individual Catastrophic Plans
291
Number of Issuers with Small Group Plans 628 Number of Issuers in a Merged Market
(Individual and Small Group)
2015 developments (cont’d)
July 16, 2015 CMS letter to DOI:
“Although CMS will use all appropriate debt collection processes available to the federal government to enforce the collection of risk adjustment charges, in rare circumstances it is possible that an issuer may be unable to make full payment for its risk adjustment charges due to insolvency. To the extent CMS is not able to fully collect 2014 risk adjustment charges in a risk pool in a market in a state, 2014 risk adjustment payments for that risk pool will be adjusted on a pro rata basis to reflect the under collection.
If CMS calculates such an adjustment prior to the deadline for 2014 risk corridors and Medical Loss Ratio (MLR)
reporting (July 31, 2015), CMS will provide affected
issuers (that is, issuers in that risk pool who will receive risk adjustment payments) with instructions to reflect the adjusted payment amount in their 2014 benefit year
2015 developments (cont’d)
July 16, 2015 CMS letter to DOI (cont.):
“…For any difference between risk adjustment payments as stated in the June 30 report and risk adjustment payments actually received for which CMS does not provide an adjustment for 2014 risk adjustment payments prior to the July 31, 2015 deadline for 2014 risk corridors and MLR reports, including for example an adjustment due to a successful appeal by an issuer in the risk pool, affected issuers will reflect that
difference in their 2015 benefit year risk corridors and MLR submission (which occurs in July 2016).”
2015 developments (cont’d)
August 7, 2015 CMS letter:
>
CMS postpones publishing of preliminary estimates ofrisk corridors program
“While conducting quality assurance of the risk corridors data, we have identified a significant number of discrepancies in the data, which makes it necessary to conduct additional data validation. “
>
Refer to CMS memo at: https://www.cms.gov/CCIIO/Resources/Regulations-2015 developments (cont’d)
October 1, 2015 CMS letter:
>
Based on data available at time of letter, issuers will pay$362 million in risk corridors charges and have submitted for $2.87 billion in payments for 2014
“At this time, assuming full collections of risk corridors charges, this will result in a proration rate of 12.6 percent.”
>
Refer to CMS memo at:https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/Downloads/RiskCorridorsPaymentProrationRatefor2014.pdf
2015 developments (cont’d)
SAPWG/EAIWG risk corridor concerns
Impairment
>
Will 2015 and 2016 program collections be sufficient tofund shortfall of 2014 program results?
Nonadmittance
>
Even though it may be reasonable to expect 2015 and2016 program collections to cover some portion of 2014 benefit year shortfall, is it appropriate to admit anything above the 12.6%?
2015 developments (cont’d)
SAPWG/EAIWG risk corridor concerns
(cont.)
Timing of impairment or nonadmittance
>
With indications of program shortfalls going back as faras 2014, should impairment be reflected in September 30 financials?
2015 and 2016 program receivables
>
Should future program year receivables continue to beaccrued given significance of 2014 shortfall?
2015 developments (cont’d)
INT 15-01
>
Issued November 5, 2015Impairment
>
Amounts in excess of the proration amount of 12.6%must be evaluated for impairment by management each reporting period
2015 developments (cont’d)
INT 15-01 (cont.)
Nonadmittance
>
2014 amounts in excess of the 12.6% proration amountwhich have not been written off for impairment, and have a reasonable expectation of delayed recover shall be
nonadmitted
>
Amounts in excess of the proration amount which arenonadmitted shall remain nonadmitted until additional proration amounts are confirmed by HHS or other
information of a sufficient nature supports that collectibility is probably and reasonable
2015 developments (cont’d)
INT 15-01 (cont.)
Timing
>
Type I subsequent event reflected in September 302015 developments (cont’d)
INT 15-01 (cont.)
2015 and 2016 program receivables
>
Any receivables accrued for 2015 and 2016 shall benonadmitted until 1) the prior benefit year is paid in full
and 2) additional proration amounts are confirmed by HHS or other information of a sufficient nature supports that
collectibility is probable and reasonable
>
Conservatism shall be applied when estimating amountsbased on sufficient information
>
Estimates shall not assume the availability of federal fundsunless such federal funds are appropriated by Congress
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