Insurance Examiner II - Licensing Coordinator and Analyst

Job Description

About the Organization:

The Division of Insurance ("DOI"), an Agency within the Office of Consumer Affairs and Business Regulation, administers the Commonwealth's insurance consumer protection laws through its regulation of the insurance industry. The primary mission of the Division is to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products. The Division also investigates and responds to consumer inquiries and complaints, enforces state insurance laws and regulations, and provides the public with accurate and unbiased insurance information. An important aspect of the Division's work is ensuring that the individuals and business entities conducting the business of insurance in Massachusetts do so in a legal and timely manner.

The Division of Insurance is committed to creating and sustaining a work culture that is welcoming, inclusive, and mutually respectful to all its employees regardless of race, color, age, creed, religion, national origin, ethnicity, sex, gender identity or expression, sexual orientation, genetic information, veteran or disability status. We strive to reflect diversity in all facets and levels of our agency. The Division of Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

The Division of Insurance is committed to ensuring a diverse and inclusive workplace where all employees feel respected, valued, and empowered to maximize their skills and talents to serve our citizens.

About the Role:

The basic purpose of this position is to serve as a licensing coordinator within the Division of Insurance. The work associated with this position shall include, but not be limited to, the coordination of licensing activities relating to entities wishing to serve as Pharmacy Benefit Managers (M.G.L. c. 176Y as enacted by Chapter 342 of the Acts of 2024) within the Commonwealth.

In addition to the coordination of licensing of PBMs, the licensing coordinator assists the Financial Surveillance and Company Licensing Section in collecting data, performing research, analyzing information, and preparing evaluations relative to the financial solvency structure of the insurance industry, insurance companies, and organizations bearing insurance risk doing business in the Commonwealth of Massachusetts and applying to do business in the Commonwealth of Massachusetts - including compliance with Massachusetts laws, regulations and regulatory bulletins, financial licensing standards and compliance with analysis timelines. The licensing coordinator provides administrative support to the Financial Surveillance and Company Licensing Section.

• In accordance with (M.G.L. c. 176Y as enacted by Chapter 342 of the Acts of 2024). The Insurance Examiner II will accept, and review license applications submitted to the Division by PBMs wishing to offer their services within the Commonwealth. The review will include, but not be limited to, evaluating the applications for completeness, accuracy, and reasonableness.
• Assist in the examination and analysis of financial reports and documentation submitted by insurance companies and organizations bearing insurance risk, as well as any other organizations required to make financial filings with the Division of Insurance. Items to be analyzed include, but may not be limited to: (1) company annual financial statements, quarterly financial statements, supporting schedules and exhibits; (2) independent audit reports; (3) actuarial opinions and certifications; (4) holding company filings; (5) management discussion & analysis; (6) NAIC I-Site reports and analysis; (7) financial analysis computations; (8) risk based capital calculation; (9) reinsurance analysis; (10) SEC filings; and (11) external rating agency reports.
• Review and analyze applications submitted to the Division and prepares reports based on findings outlining recommendations concerning the licensing of organizations bearing insurance risk in the Commonwealth, as well as those organizations seeking to amend their authority to transact insurance business in the Commonwealth. These reports should evaluate financial soundness, regulatory compliance and impact on the insurance marketplace.
• Coordinate and record securities on deposit transactions between companies, the Massachusetts Office of State Treasurer and Receiver General, and the Division.
• Participate in the review process of risk bearing provider organizations seeking solvency certificates under MGL Chapter 176T.
• Perform general administrative duties of the Financial Surveillance and Company Licensing section including, but not limited to: (1) processing of direct mail, (2) issuing certificates of compliance, (3) processing documents received both electronically and as hard copy, and (4) processing renewals of insurance companies and other organizations bearing insurance risk.
• Process electronic payments and documents and submit required reports to the Division's Administration Department per Division policies and procedures.
• Assist in creating and maintaining electronic (online/virtual) insurance company folders as well as other analysis and licensing materials and documents.
• Assist with Company Licensing record keeping activities, including but not limited to: (1) maintaining the NAIC's SBS licensing database, (2) processing admissions, amendments, and license renewals of insurance companies and other organizations bearing insurance risk.
• Serve as the secondary or back-up individual responding to public records inquiries.
• Respond professionally to inquiries from the public, insurance companies, law firms, and other state agencies pertaining to company licensing and financial surveillance inquiries.
• Develop and maintain the level of technical expertise required to effectively utilize the many types of data media that are available from a variety of sources. Required skills include, but are not limited to, the use of Microsoft Office and the various subsystems of the NAIC.
• Develop and maintain a working knowledge of the policies, procedures, standards, guidelines, and practices governing the Financial Surveillance and Company Licensing Section.

• Knowledge of the principles and practices of general accounting, including terminology.
• Knowledge of the principles and practices of auditing.
• Ability to analyze and determine the applicability of data, to draw conclusions, and to make appropriate recommendations.
• Ability to read and interpret documents such as financial reports, accounts, and ledgers.
• Ability to understand, apply, and explain the laws, rules, regulations, policies, procedures, etc., governing assigned unit activities.
• Ability to follow oral and written instructions.
• Ability to gather information by examining records and documents, and through questioning individuals.
• Ability to maintain accurate records.
• Ability to effectively and professionally communicate via email and respond in a timely manner to inquiries from the public, insurance companies, law firms, and other state agencies pertaining to company licensing and financial surveillance matters.
• Ability to exercise discretion in handling confidential information.
• Ability to adapt to varying work situations.
• Ability to work both independently and in a team setting.