SERFF Tracking #: IADC-131924001 State Tracking #: 19-1760 Company Tracking #: PETFIRST FORM AND RATE FILING CA State: California Filing Company: Independence American Insurance Company TOI/Sub-TOI: 09.0 Inland Marine/09.0004 Pet Insurance Plans Product Name: PetFirst Form and Rate Filing Project Name/Number: / Filing at a Glance Company: Independence American Insurance Company Product Name: PetFirst Form and Rate Filing State: California TOI: 09.0 Inland Marine Sub-TOI: 09.0004 Pet Insurance Plans Filing Type: New Program Date Submitted: 05/02/2019 SERFF Tr Num: IADC-131924001 SERFF Status: Closed-Approved State Tr Num: 19-1760 State Status: Approved Co Tr Num: PETFIRST FORM AND RATE FILING CA Effective Date 06/01/2019 Requested (New): Effective Date Requested (Renewal): Author(s): Christopher Devine Reviewer(s): Gerald Hill (primary), David Li Disposition Date: 09/03/2019 Disposition Status: Approved Effective Date (New): Effective Date (Renewal): This filing was provided as part of The California Insurance ADVISOR Subscribe @ www.martincompanyus.com or call 800-896-8000 PDF Pipeline for SERFF Tracking Number IADC-131924001 Generated 09/10/2019 07:03 PM SERFF Tracking #: IADC-131924001 State Tracking #: 19-1760 Company Tracking #: PETFIRST FORM AND RATE FILING CA State: California Filing Company: Independence American Insurance Company TOI/Sub-TOI: 09.0 Inland Marine/09.0004 Pet Insurance Plans Product Name: PetFirst Form and Rate Filing Project Name/Number: / General Information Project Name: Status of Filing in Domicile: Project Number: Domicile Status Comments: Reference Organization: Reference Number: Reference Title: Advisory Org. Circular: Filing Status Changed: 09/03/2019 State Status Changed: 09/03/2019 Deemer Date: 07/23/2019 Created By: Christopher Devine Submitted By: Christopher Devine Corresponding Filing Tracking Number: Filing Description: This is a new filing to present forms and rates for the Independence American Insurance Company's line of pet health insurance as administered and sold by PetFirst. Company and Contact Filing Contact Information Christopher Devine, Compliance Analyst [email protected] 5450 E. High Street 602-861-6096 [Phone] Phoenix, AL 85054 Filing Company Information Independence American Insurance CoCode: 26581 State of Domicile: Delaware Company Group Code: 450 Company Type: Life and 485 Madison Avenue Group Name: Health New York, NY 10022 FEIN Number: 74-1746542 State ID Number: (212) 355-4141 ext. [Phone] Filing Fees Fee Required? No Retaliatory? No Fee Explanation: State Specific Variance Requested? (Yes/No): Yes PDF Pipeline for SERFF Tracking Number IADC-131924001 Generated 09/10/2019 07:03 PM SERFF Tracking #: IADC-131924001 State Tracking #: 19-1760 Company Tracking #: PETFIRST FORM AND RATE FILING CA State: California Filing Company: Independence American Insurance Company TOI/Sub-TOI: 09.0 Inland Marine/09.0004 Pet Insurance Plans Product Name: PetFirst Form and Rate Filing Project Name/Number: / Correspondence Summary Dispositions Status Created By Created On Date Submitted Approved Gerald Hill 09/03/2019 09/03/2019 Objection Letters and Response Letters Objection Letters Response Letters Status Created By Created On Date Submitted Responded By Created On Date Submitted Pending Gerald Hill 08/29/2019 08/29/2019 Christopher Devine 08/29/2019 08/29/2019 company response Pending Gerald Hill 08/29/2019 08/29/2019 Christopher Devine 08/29/2019 08/29/2019 company response Pending Gerald Hill 08/28/2019 08/28/2019 Christopher Devine 08/28/2019 08/28/2019 company response Pending Gerald Hill 08/16/2019 08/16/2019 Christopher Devine 08/16/2019 08/16/2019 company response Pending Gerald Hill 08/13/2019 08/13/2019 Christopher Devine 08/13/2019 08/13/2019 company response Pending Gerald Hill 08/01/2019 08/01/2019 Christopher Devine 08/09/2019 08/09/2019 company response Respond Gerald Hill 07/31/2019 07/31/2019 Christopher Devine 08/01/2019 08/01/2019 immediately Pending Gerald Hill 07/24/2019 07/24/2019 Christopher Devine 07/31/2019 07/31/2019 company response Respond Gerald Hill 07/01/2019 07/01/2019 Christopher Devine 07/01/2019 07/01/2019 immediately Pending Gerald Hill 06/27/2019 06/27/2019 Christopher Devine 07/11/2019 07/11/2019 company response PDF Pipeline for SERFF Tracking Number IADC-131924001 Generated 09/10/2019 07:03 PM SERFF Tracking #: IADC-131924001 State Tracking #: 19-1760 Company Tracking #: PETFIRST FORM AND RATE FILING CA State: California Filing Company: Independence American Insurance Company TOI/Sub-TOI: 09.0 Inland Marine/09.0004 Pet Insurance Plans Product Name: PetFirst Form and Rate Filing Project Name/Number: / Objection Letters and Response Letters Objection Letters Response Letters Status Created By Created On Date Submitted Responded By Created On Date Submitted Pending Jesse Rivera 05/09/2019 05/09/2019 Christopher Devine 05/15/2019 05/15/2019 company response Amendments Schedule Schedule Item Name Created By Created On Date Submitted Form Pet Insurance Policy Christopher Devine 08/30/2019 08/30/2019 Supporting California Table Christopher Devine 05/02/2019 05/02/2019 Document Filing Notes Subject Note Type Created By Created On Date Submitted RE: Extension Note To Filer Gerald Hill 08/08/2019 08/08/2019 Extension Request Note To Reviewer Christopher Devine 08/08/2019 08/08/2019 Contact Information Note To Reviewer Christopher Devine 08/06/2019 08/06/2019 Contact Information Note To Filer Gerald Hill 08/06/2019 08/06/2019 RE: Phone Number Note To Filer Gerald Hill 07/15/2019 07/15/2019 Phone Number Note To Reviewer Christopher Devine 07/11/2019 07/11/2019 PDF Pipeline for SERFF Tracking Number IADC-131924001 Generated 09/10/2019 07:03 PM SERFF Tracking #: IADC-131924001 State Tracking #: 19-1760 Company Tracking #: PETFIRST FORM AND RATE FILING CA State: California Filing Company: Independence American Insurance Company TOI/Sub-TOI: 09.0 Inland Marine/09.0004 Pet Insurance Plans Product Name: PetFirst Form and Rate Filing Project Name/Number: / Disposition Disposition Date: 09/03/2019 Effective Date (New): Effective Date (Renewal): Status: Approved Comment: Only the proposals specifically indicated in the application set forth above, as it may have been amended, are approved. Nothing in this letter shall constitute approval of any other application, whether incorporated by reference, or filed prior or subsequent to the application set forth above. The Company shall begin issuing policies pursuant to this approval within 90 days of the date of this approval, provided that the insurer is licensed in California to transact the line of insurance for which the approval is given. The Company may implement this approval earlier if it is able to do so. Regardless of the implementation date, the Company shall implement this approval with the same effective date for both new and renewal business and shall offer this product to all eligible applicants as of the implementation date. This approval shall continue to have full force and effect until such time as a subsequent change for the referenced lines or programs may be approved or ordered by the Insurance Commissioner. If any portion of the application or related documentation conflicts with California law, that portion is specifically not approved. This approval does not constitute an approval of underwriting guidelines nor the specific language, coverages, terms, covenants and conditions contained in any forms, or of the forms themselves. Policy forms and underwriting guidelines included in this filing were reviewed only insofar as they relate to rates contained in this filing or currently on file with the California Department of Insurance. Any subsequent changes to underwriting guidelines or coverages, terms, covenants and conditions contained in any forms must be submitted with supporting documentation when those changes result in any rating impact. The Commissioner may at any time take any action allowed by law if he determines that any underwriting guidelines, forms or procedures for application of rates, or any other portions of the application conflict with any applicable laws or regulations. Rate data does NOT apply to filing. Schedule Schedule Item Schedule Item Status Public Access Supporting Document (revised) New Prior Approval Rate Application Yes Supporting Document New Prior Approval Rate Application Yes Supporting Document New Prior Approval Rate Application Yes Supporting Document New Prior Approval Rate Application Yes Supporting Document New Prior Approval Rate Application Yes Supporting Document Letter of Authorization Yes Supporting Document Underwriting Guidelines Yes Supporting Document (revised) CA Required Exhibits Yes Supporting Document CA Required Exhibits Yes PDF Pipeline for SERFF Tracking Number IADC-131924001 Generated 09/10/2019 07:03 PM SERFF Tracking #: IADC-131924001 State Tracking #: 19-1760 Company Tracking #: PETFIRST FORM AND RATE FILING CA State: California Filing Company: Independence American Insurance Company TOI/Sub-TOI: 09.0 Inland Marine/09.0004 Pet Insurance Plans Product Name: PetFirst Form and Rate Filing Project Name/Number: / Schedule Schedule Item Schedule Item Status Public Access Supporting Document Actuarial Justification Yes Supporting Document California Table Yes Supporting Document Objection Response 20190515 Yes Supporting Document Deemer Waiver 070119 Yes Supporting Document Objection Response 20190711 and Additional Exhibits Yes 20190710 Supporting Document Pet Table Yes Supporting Document (revised) Additional Exhibits - 20190809