Complete all forms in John Doe fashion, with the dollar amounts the insurer proposes to use. If the rates or some of the forms have been previously approved in another filing, the issuer should:
- Show the approval date
- File the rates and actuarial memorandum
- Include the completed forms in support of the current filing
Submit the following:
- Policy
- Group contract and certificate - for group insurance only
- John Doe application
- Outline of Coverage WAC 284-83-145
- Potential Rate Increase Disclosure Form WAC 284-83-190
- Disclosure statement, "Things You Should Know Before You Buy" WAC 284-83-175
- Notice to Applicant Regarding Replacement WAC 284-83-063
- Suitability Letter WAC 284-83-180
- Unintentional Lapse Designation Form (if not included in the application)
- Riders and endorsements, if applicable
- Premium rates
- Actuarial memo signed by qualified actuary
Guidance