Amending Circular 1/20 of the Single Circular on Insurance and Sureties

DOF: 31/03/2020

Amending Circular 1/20 of the Single Circular on Insurance and Sureties

On the margin, a seal with the National Coat of Arms, which says: United Mexican States.- TREASURY.- Ministry of

Public Finance and Public Credit.- National Insurance and Sureties Commission.

AMENDING CIRCULAR 1/20 OF THE SINGLE CIRCULAR ON INSURANCE AND SURETIES

(Annex 38.1.9-f.)

The National Insurance and Sureties Commission, based on the provisions of articles 366, fraction II, 372, fractions VI and XLII, 373 and 381 of the Law of Insurance and Surety Institutions, and

CONSIDERING

That in terms of what is provided in article 389 of the Law of Insurance and Surety Institutions, Institutions and Mutual Societies must submit to the National Insurance and Sureties Commission, in the form and terms established for this purpose through general provisions, the reports and tests regarding their organization, operations, accounting, investments or assets that are requested for regulatory, supervisory, control, inspection, surveillance, statistical and other functions that, in accordance with said Law or other legal, regulatory and administrative provisions, it is responsible for exercising.

That in accordance with what is established in Provision 26.1.1 of the Single Circular on Insurance and Sureties, Insurance Institutions and Mutual Societies must have statistical databases that serve as support for the supervisory work carried out by the Commission, as well as to support the analysis of the evolution of insurance activity, the preparation of statistical and actuarial bases for the calculation of risk premiums, the carrying out of studies and investigations in the matter and, in general, the development of the insurance sector.

That Provision 38.1.9, fraction V, of the Single Circular on Insurance and Sureties, provides that the Statistical Systems of the Insurance Sector (SESA) for the operation of accidents and diseases, with respect to health insurance referred to in Provision 26.1.4, subsection e), fraction II, of said Circular, must be presented in the form and terms indicated in Annex 38.1.9-f, adhering to the "Manual of the Statistical System of Health Insurance".

That the National Insurance and Sureties Commission has determined that it has a better structured database that allows generating actuarial studies and publishing more reliable and precise statistical information, which contribute to the development and growth of the insurance sector in the health branch.

That in view of the foregoing, it is necessary to restructure the information of the Health Insurance Statistical System into three groups: data related to policy issuance, hospital event claims and expenses related to prevention measures.

For the aforementioned reasons, this Commission has resolved to issue the following modification to the Single Circular on Insurance and Sureties in the terms indicated below:

AMENDING CIRCULAR 1/20 OF THE SINGLE CIRCULAR ON INSURANCE AND SURETIES

(Annex 38.1.9-f.)

SOLE. - Annex 38.1.9-f of the Single Circular on Insurance and Sureties is modified.

TRANSITIONAL

SOLE. - This Amending Circular shall enter into force the day following its publication in the Official Gazette of the Federation.

The foregoing is made known to you, based on articles 366, fraction II, 372, fractions VI and XLII, 373 and 381 of the Law of Insurance and Surety Institutions.

Respectfully,

Mexico City, March 5, 2020. - The President of the National Insurance and Sureties Commission, Ricardo Ernesto Ochoa Rodríguez.- Rubric.

ANNEX 38.1.9-f.

PRESENTATION OF THE REGULATORY REPORT ON STATISTICAL INFORMATION (RR-8), REGARDING THE SESA FOR THE OPERATION OF ACCIDENTS AND DISEASES, WITH RESPECT TO HEALTH INSURANCE

Institutions will deliver the Regulatory Report on Statistical Information (RR-8) with respect to health insurance, through the RR8SAL product, which must be identified according to the following 19-character alphanumeric nomenclature:

a)

In the first 6 positions, the specific product identifier must be placed: RR8SAL.

b)

In the seventh position, the company type key must be placed:

Key

Definition

H

Insurance institutions authorized to operate health insurance.

c)

From the eighth to the eleventh position, the key assigned to the Institution in question must be placed. This key must be preceded by a zero to occupy the four positions.

d)

From the twelfth to the nineteenth position, the report date must be indicated, specifying the year, month and day (yyyymmdd).

Example:

In the case of the Insurance Institution with company key 0701, for health insurance with a report date of December 31, 2019, the product name must be constructed as follows:

Position

Extension

Character

R

R

S

A

L

H

.ZIP

.PGP

The information contained in the RR8SAL product will be integrated from 3 files in .TXT format, which will contain the following information:

1)

DGE: General Data. - General data and issuance information for health insurance will be reported.

2)

SEH: Hospital Event Claims. - Information on claims with hospital care for health insurance will be reported.

3)

SNH: Non-Hospital Event Claims. - Information on claims for consultation care for health insurance will be reported.

The indicated files will be identified with a 22-character alphanumeric nomenclature, as follows:

a)

The first six positions will be reserved for the product identifier: RR8SAL.

b)

From the seventh to the ninth positions, the key corresponding to the file identifier must be placed, as appropriate:

DGE

General Data

SEH

Hospital Event Claims

SNH

Non-Hospital Event Claims

c)

In the tenth position, the company type key must be placed:

Key

Definition

H

Insurance institutions authorized to operate health insurance.

d)

From the eleventh to the fourteenth position, the key assigned to the company must be placed; this key must be preceded by zeros until it occupies four positions.

e)

From the fifteenth to the twenty-second position, the report date must be indicated, specifying the year, month and day (yyyymmdd).

Example:

For the general data, hospital event claims and non-hospital event claims files for health insurance for the Insurance Institution with key 0701, relating to December 31, 2019, the following identifiers will correspond:

Position

Extension

Character

R

R

S

A

L

D

G

E

H

.TXT

Position

Extension

Character

R

R

S

A

L

S

E

H

H

.TXT

and

Position

Extension

Character

R

R

S

A

L

S

N

H

H

.TXT

The information reported in the file must be carried out in accordance with the "Manual of the Statistical System of Health Insurance", which is referred to in fraction V of Provision 38.1.9, which will be made known through the Commission's Website.

Entities Obligated to deliver files with statistical information:

File for health insurance

H

Additionally, in the case that Institutions wish to send written document(s) with the clarifications referred to in Annex 38.1.9-a, to complement the delivery of the Regulatory Report on Statistical Information (RR-8) with respect to health insurance, they may do so through the RR8SALESC product, which must comply with what is established in Annex 38.1.9-a and be identified according to the following 22-character alphanumeric nomenclature:

a)

In the first 9 positions, the specific product identifier must be placed:

RR8SALESC.

b)

In the tenth position, the company type key must be placed:

Key

Definition

H

Insurance institutions authorized to operate health insurance.

c)

From the eleventh to the fourteenth position, the key assigned to the Institution in question must be placed. This key must be preceded by a zero to occupy the four positions.

d)

From the fifteenth to the twenty-second position, the report date must be indicated, specifying the year, month and day (yyyymmdd).

Example:

In the case of the Insurance Institution with company key 0701, for the written document with clarifications for health insurance with a report date of December 31, 2019, the product name must be constructed as follows:

Position

Extension

Character

R

R

S

A

L

E

S

C

H

.ZIP

.PGP

The information contained in the RR8SALESC product will be integrated from files in PDF format where

the clarifications they consider convenient will be exposed, in accordance with what is stipulated in the

Annex

38.1.9-a.

The indicated files will be identified with a 24-character alphanumeric nomenclature, as follows:

a)

The first nine positions will be reserved for the product identifier: RR8SALESC.

b)

From the tenth to the eleventh positions, the consecutive number of the written document being sent must be placed, starting at 01, related to clarifications for the delivery of statistical information for health insurance for the specified exercise, filled to two positions (in case the written document is 1 to 9, complete with a zero before).

c)

In the twelfth position, the company type key must be placed:

Key

Definition

H

Insurance institutions authorized to operate health insurance.

d)

From the thirteenth to the sixteenth position, the key assigned to the company must be placed; this key must be preceded by a zero to occupy four positions.

e)

From the seventeenth to the twenty-fourth position, the report date must be indicated, specifying the year, month and day (yyyymmdd).

Example:

For the files of the first two clarifying written documents of the statistical information for health insurance for the Insurance Institution with key 0701, relating to December 31, 2019, the following identifiers will correspond:

Position

Extension

Character

R

R

S

A

L

E

S

C

H

.PDF

and

Position

Extension

Character

R

R

S

A

L

E

S

C

H

.PDF

Entities that can deliver files with clarifying written documents:

Clarifying written document(s) for health insurance

H

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