Get Exhibit G - Loss Costs Reference Information - Texas Department Of ...

Filling out the Exhibit G - Loss Costs Reference Information is essential for ensuring accurate rate submissions to the Texas Department of Insurance. This guide offers clear, step-by-step instructions to help users navigate the form effectively.

Follow the steps to accurately complete the Exhibit G form online.

1. Click ‘Get Form’ button to obtain the form and open it effectively in the editor.
2. Begin by filling out the fields for company information, including the company name, NAIC number, and filing number. Ensure all details are accurate.
3. In the section for 'Loss Costs Being Referenced,' select either 'Loss Costs Provided by an Advisory Organization' or 'Loss Costs Underlying Another Company's Effective Rate Filing.' Provide the necessary references based on your selection.
4. For the 'Loss Cost Modification Factor,' input a value reflecting your company's modification factor, ensuring you provide justification based on your experience.
5. Fill in the 'Expense and Profit Provisions Utilized in this Filing' section. List out all relevant expenses, including commission and brokerage, other acquisition expenses, general expenses, taxes, licenses & fees, and profit. Ensure that the total aligns correctly.
6. Calculate the 'Loss Cost Multiplier' using the formula in line 2 divided by line 3h. This is vital for determining the accurate multiplier for your submission.
7. Input the loss cost multiplier used immediately prior to the effective date of this filing, ensuring alignment with previous submissions.
8. State the rate level change for the coverage/form to which this page applies, indicating any adjustments clearly.
9. Once all the sections are filled accurately, you can save your changes, and options to download, print, or share the completed form will be available for further processing.

Start preparing your submissions by completing the necessary documents online today.