Get Item #43b Rate Filing - California Department Of Insurance

The ITEM #43B RATE FILING form is essential for those seeking to transact workers' compensation insurance in California. This guide will provide you with a clear and structured approach to effectively complete the form online, ensuring your submission meets all necessary requirements.

Follow the steps to accurately complete your rate filing form.

1. Click 'Get Form' button to access the ITEM #43B RATE FILING form and open it in your preferred editing tool.
2. In the General Filing Information section, enter the Insurer NAIC company number, the full name and address of the insurer, and the NAIC group number. Additionally, provide the name and title of the person responsible for filing along with their telephone and fax numbers. Finally, indicate the proposed effective date for the filing.
3. Specify whether the filing applies to new and renewal policies only, or to new, renewal, and in-force policies as of the effective date by checking the appropriate box.
4. In the Proposed overall rate level change section, state the percentage change that you are proposing. Also, provide the direct written premium for the most recent calendar year, including total amounts for California workers' compensation and aggregate amounts across all lines and states.
5. Indicate if the insurer elects to apply pure premium rate modifier(s) by checking the appropriate options. If applicable, include any modifiers and deviations you are specifying in your attachments.
6. In the Pure Premium Rate Filings section, select the appropriate options and provide the required information regarding pure premiums, deviations, and any non-reference filings, along with justifications if necessary.
7. Detail the projected expenses as a ratio to the standard premium at the proposed company rates. Complete all subfields for commissions, acquisition expenses, general expenses, taxes, and profit & contingencies.
8. For the Rating Plans and Supplementary Rate Information section, check all that apply and specify the source for each rating plan submitted.
9. Complete the Classification System section by indicating whether the DRO classification system is adopted with or without modifications and ensure supporting documentation is attached as required.
10. The form must be signed by a responsible officer of the insurer. Include their name, title, date signed, and ensure that an actuary's opinion is attached to your filing.
11. Once all sections are completed, review your form for accuracy, then save your changes. You can then choose to download, print, or share the completed form as needed.

Begin your online filing process today by following these steps to ensure your submission is accurate and complete.