Free Written Example of a Corporate Training Plan by pju20777

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									                         NEW YORK STATE INSURANCE DEPARTMENT
                                      INSTRUCTIONS
                             FOR COMPLETION OF SPECIAL REPORT
                                DISASTER RESPONSE PLAN QUESTIONNAIRE
                                            (EXCEL VERSION)



1. The "DisRespQ.xls" file you will be working with contains cells (highlighted in yellow) for
   entering your responses to complete this Special Report.


2. You should immediately back-up the "DisRespQ.xls" file to your drive before inputting
   any data.


3. Please rename the "DisRespQ.xls" file, by saving it with the five-digit NAIC number
   of the reporting insurer. For example, if your NAIC number is 12345, you should save the
   file as "12345.xls." Make as many separate files as necessary, to report on all the entities
   in your reporting group.

   If all of the responses are identical for each company within your group, you may respond
   on a group basis. If you do respond on a group basis please save your file using the prefix "G"
   and your four digit NAIC group number. For example, if your NAIC group number is 0013,
   you should save the file as "G0013.xls".


4. After naming and saving the file(s), open one spreadsheet file, and before entering any other data,
   complete the General Information section of the report, on the "Questionnaire" tab. In the highlighted
   yellow cells enter your company's name, NAIC and group number, etc. You should enter information
   only in the cells highlighted in yellow, all other cells in the file are protected, and no entries should be
   made into them.

   Note: If you are completing the report on a group basis:
         a) Use your group name instead of company name,
         b) Enter all of the NAIC numbers, for each company the report covers, where the
             NAIC number is requested.


5. DO NOT CHANGE THE POSITION OR CONTENT OF ANY CELLS IN THIS FILE.


6. In the next section - "Data Required"

   In this section you should begin by entering your responses to the questions.
   Please note: where you are requested to answer a question yes or no,
   you should indicate your response by placing a numeral "1" (without the quotation marks)
   in the appropriate box(es).
   The questions in this disaster plan questionnaire have been divided into six subsections,
   please be sure to provide answers to all of the questions in each section.


7. The final section of the file contains the AFFIRMATION. The name of the duly authorized
   Responsible Corporate Officer and the date should be entered in the appropriate yellow
   highlighted spaces provided.

   If you have completed the General Information Section [see step (4), above] your company
   name, NAIC code number, and NAIC group number should appear in the appropriate cells.

   Next, the affirmation should be printed, following the instructions in step (9) below.
   Then, the printed affirmation must be signed by the Responsible Corporate Officer and
   submitted to the Department via US Mail.

   Unless the questionnaire is being completed on a group basis a separate affirmation must
   be submitted for each reporting company.


8. The table below contains the range names which will allow you to print the various parts of your
   submission, for your records. Use the appropriate range name to select the desired print items,
   then print as you normally would (using the File, Print Area, Set Print Area commands and the
   "File", "Print" commands).

            To Print - on the "Questionnaire" tab                       Hit
      Section I Insurer/Contact Information                         F5 (GoTo)
      Section II Data Required                                      F5 (GoTo)
      Section III Affirmation                                       F5 (GoTo)


9. When saving the file(s) you will be returning to the Department, please
   be certain you have followed the naming procedure described in step (3) above.


10. You are encouraged to submit your data by e-mail, the file(s) should be sent to:

          DRP@ins.state.ny.us


11. If you do submit your data by e-mail the printed affirmations discussed in step (7) above
    must be submitted separately by US Mail.

          New York State Department of Insurance
         Disaster Preparedness & Response Bureau
                     DRP Unit, 5th Floor
                      25 Beaver Street
                    New York, NY 10004
12. If you intend to mail your entire response to the Department, please save your file(s) to CD
    or diskette. Label your diskette in the following manner:

      DISASTER RESPONSE PLAN QUESTIONNAIRE
      Company Name
      Company NAIC Number
      Group Number


13. If you experience technical difficulties in using the "DisRespQ.xls" file, please contact
    Mr. Vincent Mazzarella, Associate Insurance Examiner by phone at (212) 480-5339,
    or by e-mail at vmazzare@ins.state.ny.us
T
E
                Select Range
                    Info
                    Data
                   Affirm




d be sent to:




ed in step (7) above
save your file(s) to CD




, please contact
212) 480-5339,
                                           SPECIAL REPORT TO THE SUPERINTENDENT OF INSURANCE
                                                 NEW YORK STATE INSURANCE DEPARTMENT
                                                 DISASTER RESPONSE PLAN QUESTIONNAIRE




A. General Information

                  INSURER                                                                          CONTACT PERSON
                      Name                                                                                Title
                    Address                                                                         Salutation
                        City                                                                      Last Name
                       State                                                                  First Name, MI
                   ZIP Code                                                                           Address
               NAIC Code #                                                                                City
                   Group #                                                                               State
                                                                                                     ZIP Code
                                                                                                Telephone #
             Date of Report                                                                     Fax Number
                                                                                             E-mail Address



B. Data Required

     Section I - Personnel and Emergency Preparedness Plan

1)   Does your company have a disaster response plan, that meets the general criteria                           Yes   No
     shown in section D(1)(a) of Circular Letter No. 6 (2007)?

     Place a numeral "1" (without the quotation marks) in all of the appropriate box(es).


2)   Please provide the following information on your Disaster Liaisons
       (Disaster Liaisons are company personnel who in a disaster are available to relay
        information between the Department and the company):
     [Note the duties for a Disaster Liaison are delineated in section E(1) of Circular Letter No. 6 (2007).]

                  Primary Disaster Liaison

                                              Name >
                                 Telephone number >
                                 Cell phone number >
                                       Pager number >
                                     E-mail address >

                  Secondary Disaster Liaison

                                              Name >
                                 Telephone number >
                                 Cell phone number >
                                       Pager number >
                                     E-mail address >
3)   Please provide the following information for the individuals in your company who are
     the Catastrophe Leaders (catastrophe leaders are company personnel who have control
     of the company’s disaster operations) to oversee disaster response in the State of New York.

                Primary Catastrophe Leader
                                           Name >
                             Telephone number >
                             Cell phone number >
                                 E-mail address >
                                  Other (specify) >

                Secondary Catastrophe Leader
                                          Name >
                            Telephone number >
                            Cell phone number >
                                E-mail address >
                                 Other (specify) >



4)   Please provide the following information for the individuals in your company who are
     the communication team leaders.

                Primary Communications Leader
                                         Name >
                           Telephone number >
                           Cell phone number >
                               E-mail address >
                                Other (specify) >

                Secondary Communications Leader
                                          Name >
                            Telephone number >
                            Cell phone number >
                                E-mail address >
                                 Other (specify) >




     Section II - Training

                [Place a numeral "1" (without the quotation marks) in all of the appropriate box(es).]

1)   Does your company conduct ongoing training for claims personnel to prepare                          Yes   No
     them for their responsibilities in the event of a catastrophe?

            a) If yes, does your company have “back-up” facilities,                                      Yes   No
               available for use in an emergency?

            b) If yes, does this training include cross training for                                     Yes   No
               proper staffing in an emergency?
2)   Does your company offer education to brokers and agents to prepare them                              Yes   No
     for their responsibilities in the event of a catastrophe?


3)   Does your company provide instructions to its brokers and agents on how                              Yes   No
     to handle customers in the event of a disaster?


4)   Once a catastrophe occurs in New York, does your company have in place                               Yes   No
     a policy for training claims processors on any new procedures and how to
     handle any coverage issues that arise?


5)   Does your company have alternate and/or non-computerized procedures                                  Yes   No
     for processing claims in an emergency?




     Section III - Incident Response Teams

                 [Place a numeral "1" (without the quotation marks) in all of the appropriate box(es).]

1)   Does your company have a national, regional or local dedicated                                       Yes   No
     incident response team or organization?


2)   If you do not have a dedicated national, regional or local incident response                         Yes   No
      team, does your company have a back-up claims processing service or
     customer service center?




     Section IV - Claims

                 [Place a numeral "1" (without the quotation marks) in all of the appropriate box(es).]

1)   Does your company have a local or toll free number for consumers                                     Yes   No
     to report claims on an as needed basis?


2)   How does your company convey its claims telephone number to policyholders?

                                 Member ID cards>
                            Radio/TV advertising >
                                 Telephone calls >
                         Written communications >
                                 Internet website >
                                  Brokers/Agents >
                                           Other >                             Specify >
     Section V - External Communications

                [Place a numeral "1" (without the quotation marks) in all of the appropriate box(es).]

A. Members/Subscribers

1)   Will members be advised of procedural changes occurring due to a disaster?                          Yes   No



2)   If yes, how would such changes be communicated to members/subscribers?

                            Radio/TV advertising >
                                 Telephone calls >
                         Written communications >
                                 Internet website >
                                  Brokers/Agents >
                                           Other >                            Specify >


B. Providers

1)   Will providers be advised of procedural changes occurring due to a disaster?                        Yes   No



2)   If yes, how would such changes be communicated to providers?

                            Radio/TV advertising >
                                 Telephone calls >
                         Written communications >
                                 Internet website >
                                  Brokers/Agents >
                                           Other >                            Specify >
C. Brokers/Agents

1)   Will brokers/agents be advised of procedural changes occurring due to a disaster?                 Yes   No



2)   If yes, how would such changes be communicated to brokers/agents?

                            Radio/TV advertising >
                                 Telephone calls >
                         Written communications >
                                 Internet website >
                                  Brokers/Agents >
                                           Other >                             Specify >




     Section VI - Emergency Response

1)   Does your emergency response plan include having your medical director                            Yes   No
     available to advise on changes to coverage issues?

2)   If yes, are your claims processing system and customer service center                             Yes   No
     capable of promptly implementing any changes put into effect
     by the medical director?




     Section VII - Additional Comments, Questions or Concerns

1)   If you have additional information you would like to provide to supplement any of your answers,
     please do so in a Microsoft Word Document attached to your e-mail submission. If you do
     attach such a document to your submission, please indicate you have done so by placing a
     numeral "1" (without the quotation marks) in the box to the right.

2)   If you wish to be contacted by a representative of the New York State Insurance Department,
     please place a numeral "1" (without the quotation marks) in the box to the right.

3)   If you would like additional information about the New York State Insurance Disaster Coalition
     please place a numeral "1" (without the quotation marks) in the box to the right.

4)   If your company is not already active and would like to become active in the disaster coalition
     please place a numeral "1" (without the quotation marks) in the box to the right.
C. Affirmation


                   SPECIAL REPORT TO THE SUPERINTENDENT OF INSURANCE
                           NEW YORK STATE INSURANCE DEPARTMENT
                           DISASTER RESPONSE PLAN AFFIRMATION

     GROUP# 0                                                                        NAIC# 0



I,                                    , the duly authorized Responsible Corporate Officer of the
  0                                                         do hereby affirm, under penalty of perjury,
that the information included in the electronic submission provided to the Insurance Department,
including all attached exhibits, schedules, and other supporting information is true
to the best of my knowledge and belief.




        Date:
                                          Signature of Responsible Corporate Officer

								
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