Insurance Regulatory Analyst I
About The Position
The mission of the North Carolina Department of Insurance is to promote a stable insurance market through unbiased regulation and to protect the lives and property of every citizen in all 100 counties while fostering superior, user-friendly service, courtesy, and respect. Our agency licenses insurance agents, adjusters, bail bondsmen and more, along with investigating fraud matters involving insurance consumers and any entity or individual regulated by the Department. In an ever-changing environment, it is the vision of the Department of Insurance to maintain the stabilization of the insurance industry in order to provide more products, competitive prices and consumer protection. This position currently qualifies for a hybrid telework option with routine office and up to one remote workday per week. The NC Department of Insurance trusts our employees to be self-motivated and successful in hybrid/remote roles. Telework options are subject to change at the discretion of management. The primary purpose of this position is to review policy form filings and premium rate justifications. Employees in this position must have cross training in the evaluation of individual and group major medical health insurance plus specialty health insurance coverages such as Medicare supplement, dental and vision. This employee is responsible for reviewing for approval or disapproval Medicare Supplement advertising, policy forms and quasi-actuarial approval/disapproval of rate filings. In addition, dental and vision form filings and rate filings are also reviewed. Coordination of form and rate review activities between other Divisions is expected of this position. In connection with the rate review process, the insurer must demonstrate compliance by providing a series of actuarial projections or assumptions. Loss ratio projections must project future experience, i.e. trend and rationale for trend, lapse rates, state and national experience. Sufficient understanding of the elements of premium rate development is required. This position provides solutions and answers to inquiries received by telephone, written, personal and electronic mail communications with insurance companies, Department Staff, State Agencies, insurance agents and the general public. In addition, technical assistance is provided to staff members of the Department’s Consumer Services Division as needed. This technical assistance includes, but is not limited to interpretation of policy form provisions as it applies to claims adjudication. The Consumer Division uses this interpretation definitively and will use this precedent to apply to other consumers with similar questions.
Requirements
- Bachelor's degree in business or economics or a related program from an appropriately accredited institution and three years of experience in policy and rate examinations, underwriting, claims adjusting work, or financial/marketing analysis; or an equivalent combination of education and experience.
- Strong health insurance background is necessary.
- Ability to handle multi tasks simultaneously is important.
Nice To Haves
- Working knowledge of Medicare Supplement insurance is helpful.
Responsibilities
- Review policy form filings and premium rate justifications.
- Evaluate individual and group major medical health insurance plus specialty health insurance coverages such as Medicare supplement, dental and vision.
- Review for approval or disapproval Medicare Supplement advertising, policy forms and quasi-actuarial approval/disapproval of rate filings.
- Review dental and vision form filings and rate filings.
- Coordinate form and rate review activities between other Divisions.
- Provide solutions and answers to inquiries received by telephone, written, personal and electronic mail communications with insurance companies, Department Staff, State Agencies, insurance agents and the general public.
- Provide technical assistance to staff members of the Department’s Consumer Services Division as needed, including interpretation of policy form provisions as it applies to claims adjudication.
Benefits
- 12 Annual paid Holidays
- North Carolina State Health Plan administered by AETNA
- Supplemental Benefits including: Flexible Spending Accounts, Accident Insurance, Cancer & Specified Disease, Critical Illness, Dental and Vision
- NC State Retirement (TSERS)
- WeSave Employee Discounts
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
