42 CFR § 403.258 - Statement of actuarial opinion.

---
identifier: "/us/cfr/t42/s403.258"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 403.258 - Statement of actuarial opinion."
title_number: 42
title_name: "Public Health"
section_number: "403.258"
section_name: "Statement of actuarial opinion."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "A"
subchapter_name: "GENERAL PROVISIONS"
part_number: "403"
part_name: "SPECIAL PROGRAMS AND PROJECTS"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302 and 1395hh."
cfr_part: "403"
---


# 403.258 Statement of actuarial opinion.

(a) For purposes of certification requests submitted under § 403.232(b) and subsequent review as specified in § 403.239(a), *statement of actuarial opinion* means a signed declaration in which a qualified actuary states that the assumptions used in calculating the expected loss ratio are appropriate and reasonable, taking into account actual policy experience, if any, and reasonable expectations.

(b) *Qualified actuary* means—

(1) A member in good standing of the American Academy of Actuaries; or

(2) A person who has otherwise demonstrated his or her actuarial competence to the satisfaction of the Commissioner or Superintendent of Insurance of the domiciliary State of the insuring organization.