RULE 23

PROPERTY, CASUALTY, SURETY AND

MARINE RATE AND FORM FILINGS

TABLE OF CONTENTS

APPENDICES

Section 1. Purpose

Section 2. Authority

Section 3. Applicability and Scope

Section 4. Effective Date

Section 5. Definitions

A. Form Filing.

B. Insurance Holding Company Group.

C. Expenses.

D. Rate.

E. Supplementary Rate Information.

F. Supporting Information.

G. Prospective Loss Costs.

H. Participating Insurer.

Section 6. Rate Service Organizations

A. Advisory Organizations ‑ Permitted Activity.

B. Advisory Organizations ‑ Prohibited Activity.

Section 7. Procedures for Rate and Supplementary Rate Information Filings

A. For All Lines Other Than Workers' Compensation and Employers' Liability.

B. Procedures for Rate and Supplementary Rate Information Filings for Workers' Compensation and Employers' Liability Insurance.

Section 8. PROCEDURES FOR FORM FILINGS ‑ All Lines.

A. Property & Casualty Transmittal Header.

B. Supporting Information Required to Supplement a Filing.

C. Filing Deadlines.

Section 9. SELF CERTIFICATION (“STMSCP” Program)

A. Certification of Compliance

B. The Property & Casualty Transmittal Document

C. The Product Requirements Locator

D. Verifying the Reliability of Certified Filings

E. Penalties

Section 10. FORMS

A. Forms. The following forms are prescribed by the Commissioner and are attached as exhibits to this Rule. All forms are available upon request to the Department or via the Department’s web site at http://www.insurance.arkansas.gov.

FORM UT Property & Casualty Uniform transmittal header

FORM RF‑1 Rate filing abstract.

FORM A‑1 Private passenger automobile abstract

FORM H‑1 Homeowners abstract

FORM RF‑2 Reference filing adoption form

FORM RF‑WC Workers' compensation reference filing adoption form

FORM F‑1 Form filing abstract

FORM APCS Automobile survey (as updated)

FORM HPCS Homeowners survey (as updated)

FORM HONOT Homeowners rate notice

FORM PPANOT Private passenger automobile rate notice

FORM PROMAL Professional malpractice rate increase notice to insured

FORM PRONOT Professional malpractice rate increase newspaper notice

B. Use. The forms required by this Rule may be prescribed forms which, from time to time, may be published or amended issued by the commissioner.

Section 11. SEVERABILITY

FORM UT Property & Casualty Transmittal Document (Revised 1/1/06)

3.

Group Name

FEIN #

5.

Company Tracking Number

Contact Info of Filer(s) or Corporate Officer(s) [include toll-free number]

Filing information (see General Instructions for descriptions of these fields)

9.

Type of Insurance (TOI)

10.

Sub-Type of Insurance (Sub-TOI)

Filing Type

Property & Casualty Transmittal Document

20.

This filing transmittal is part of Company Tracking #

21.

Filing Description [This area should be similar to the body of a cover letter and is free-form text]

22.

Filing Fees (Filer must provide check # and fee amount if applicable)

[If a state requires you to show how you calculated your filing fees, place that calculation below]

FORM FILING SCHEDULE

1.

This filing transmittal is part of Company Tracking #

2.

This filing corresponds to rate/rule filing number

Form Name /Description/Synopsis

1.

This filing transmittal is part of Company Tracking #

2.

This filing corresponds to form filing number

3.

Overall percentage rate impact for this filing

Rate Change by Company

Percentage Change for this program

Exhibit Name/Description

/Synopsis

FORM F-1 Additional Forms

16. Form Filing Attachment

FORM RF-1 Rate Filing Abstract NAIC LOSS COST DATA ENTRY DOCUMENT

1.

This filing transmittal is part of Company Tracking #

2.

Company Name

Company NAIC Number

Product Coding Matrix Line of Business (i.e., Type of Insurance)

Product Coding Matrix Line of Insurance (i.e., Sub-type of Insurance)

A. Total Production Expense

This filing transmittal is part of Company Tracking #

This filing corresponds to form filing number

FORM RF-WC NAIC LOSS COST FILING DOCUMENT¾FOR WORKERS’ COMPENSATION

This filing transmittal is part of Company Tracking #

This filing corresponds to form filing number

FORM A-1 PRIVATE PASSENGER AUTOMOBILE ABSTRACT

FORM H-1 HOMEOWNERS ABSTRACT

NOTICE OF RATE INCREASE

(Private Passenger Auto)

NOTICE OF RATE INCREASE

(Homeowners)

NOTICE OF RATE INCREASE

NOTICE OF RATE INCREASE

(Professional Liability)

Private Passenger Auto Premium Comparison Survey Form

Homeowners Premium Comparison Survey Form

Malpractice Premium Comparison Survey Form

ARKANSAS CERTIFICATE OF COMPLIANCE

Company Tracking Number ►