## Notice of Carrier Intent - Instructions Page 4

**INSTRUCTIONS FOR COMPLETING THE NOTICE OF CARRIER INTENT**

**OPTION 1:**

**Company Name and NAIC Number:**Enter the company name and NAIC code of each company in your group for which you are filing.**Column (1) - Current Deviation:**Enter each company´s current average deviation from the 1/1/97 Relativities.**Column (2) - Rate Change:**Enter a factor of 1.000.**Column (3) - Off-Balance Factor:**Enter a factor of 0.700.**Column (4) - Deviation From 1/1/99 Relativities:**Calculate the deviation from the 1/1/99 relativities as follows: Column (1) / Column (3). If the resulting deviation for a company is greater than 1.000, then that company**must**provide**actuarial support**for its deviation.

**OPTION 2:**

**Company Name and NAIC Number:**Enter the company name and NAIC code of each company in your group for which you are filing.**Column (1) - Current Deviation:**Enter each company´s current average deviation from the 1/1/97 Relativities.**Column (2) - Rate Change:**Enter a factor of 1.000.**Column (3) - Off-Balance Factor:**Enter the company, or group off-balance factor.**Actuarial support for the off-balance factor must be provided.**Actuarial support consists of an exhibit showing the following: (i) the payroll for each classification for which it writes business; (ii) the corresponding 1/1/97 relativity; (iii) the product of (i) and (ii); (iv) the corresponding 1/1/99 relativity; and (v) the product of (i) and (iv). The company´s off-balance factor is the sum over all class codes of (v) divided by the sum over all class codes of (iii).**Column (4) - Deviation From 1/1/99 Relativities:**Calculate the deviation from the 1/1/99 relativities as follows: Column (1) / Column (3). If the resulting deviation for a company is greater than 1.000, then that company**must**provide**actuarial support**for its deviation.

**OPTION 3:**

**Company Name and NAIC Number:**Enter the company name and NAIC code of each company in your group for which you are filing.**Column (1) - Current Deviation:**Enter each company´s current average deviation from the 1/1/97 Relativities.**Column (2) - Rate Change:**Enter the same number shown on Column (3) (see column (3), below). This number should be consistent with the overall rate change found on TDI´s*Filings Made Easy*Exhibit C, column (E), line (3). For example, if**Column (2)**is 0.800, thenExhibit C, col. (E), line 3 should be -20%.**Column (3) - Off-Balance Factor:**Enter either 0.700 or, the company determined off-balanced factor. If column (3) is a number other than 0.700,**actuarial support for the off-balance factor must be provided.**See the instructions for column (3) under option 2 for required support.**Column (4) - Deviation From 1/1/99 Relativities:**Enter the deviation shown in column (1). If the resulting deviation for a company is greater than 1.000, then that company**must**provide**actuarial support**for its deviation.

**OPTION 4:**

**Company Name and NAIC Number:**Enter the company name and NAIC code of each company in your group for which you are filing.**Column (1) - Current Deviation:**Enter each company´s current average deviation from the 1/1/97 Relativities.**Column (2) - Rate Change:**Enter the rate change as a factor (a -10% rate change should be expressed as 0.900). This number should be consistent with the overall rate change found on TDI*Filings Made Easy*Exhibit C, column (E), line (3). For example, if**Column (2)**is 0.900, then Exhibit C, col. (E), line 3 should be -10%.**Column (3) - Off-Balance Factor:**Enter either 0.700 or, the company determined off-balanced factor. If column (3) is a number other than 0.700**actuarial support for the off-balance factor must be provided.**See the instructions for column (3) under option 2 for required support.**Column (4) - Deviation From 1/1/99 Relativities:**Calculate the deviation from the 1/1/99 relativities as follows: [Column (1)*Column (2)]/ Column (3). If the resulting deviation for a company is greater than 1.000, then that company**must**provide**actuarial support**for its deviation.

**OPTION 5:**

**Company Name and NAIC Number:**Enter the company name and NAIC code of each company in your group for which you are filing.**Column (1) - Current Deviation:**Enter each company´s current average deviation from the 1/1/97 Relativities. This should be based on the company´s*most current*distribution of business by class code. Actuarial support for this figure must be provided. See the instructions for column (3) under option 2 for required support.**Column (2) - Rate Change:**Enter the rate change as a factor (a -10% rate change should be expressed as 0.900). This number should be consistent with the overall rate change found on TDI*Filings Made Easy*Exhibit C, column (E), line (3). For example, if**Column (2)**is 0.900, then Exhibit C, col. (E), line 3 should be -10%.**Column (3) - Off-Balance Factor:**Enter a factor of 1.000, or any applicable off-balance factor. Actuarial support for this figure must be provided. See the instructions for column (3) under option 2 for required support.**Column (4) - Deviation From 1/1/99 Relativities:**Enter the average deviation from the 1/1/99 relativities as a weighted average of the deviations from the 1/1/99 relativities for each class code.