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Important Interested Party COI Acknowledgment

Dear Interested Party:

In 2007, the Academy Board of Directors adopted a policy requiring all who serve as interested parties on any Academy boards, councils, committees, sub-committees, task forces, and work groups, etc. (collectively “Committee”), to acknowledge annually the existing Conflict of Interest (“COI”) policy that applies to all Academy members who do volunteer work for the Academy. The Academy guidelines for interested parties includes a requirement that interested parties also acknowledge annually the existing COI policy: Academy Committee Governance Policy.

Academy members who participate as interested parties on a Committee are required to:

1. disclose actual or potential conflicts of interest if and when they arise (and, as appropriate, recuse themselves from Committee projects giving rise to any such conflict); and
2. refrain from disclosing a Committee’s work product other than in a manner consistent with the COI policy and the Academy’s Guidelines for Making Public Statements.

As an interested party, by acknowledging the COI policy, you will be indicating that you understand that the fundamental purposes of the Academy require it to maintain a high level of professional objectivity and independence from any specific interests of the employers of its members or interested parties. Your current interested party and/or volunteer positions with the Academy are listed at the bottom of this page.

Please review the below acknowledgment and attest to same. Before submitting your acknowledgment, I also encourage you to review and make any necessary updates to your member profile information below to ensure that the Academy has your most current information and to help us compile key metrics about our members' demographics.

Sincerely,
Nancy Behrens, MAAA, FSA
Vice President, Council on Professionalism and Education
American Academy of Actuaries

Conflict of Interest Acknowledgment

I hereby acknowledge the following:

1. I am a member of the American Academy of Actuaries ("Academy") and also serve as an interested party on one or more of the Academy's committees, councils, boards, task forces, or work groups, etc. including service through the Pension Assistance List (PAL) program, (collectively, "Committee").
2. I have read the Conflict of Interest Policy issued by the Academy and acknowledge my obligation to adhere to this policy and, in particular, my duty to carefully consider and address any situation that may arise in my role as an interested party that may call into question my professional objectivity.

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Membership Profile Information*

Please review information that is currently in your membership profile and make updates as needed.

Primary Area of Practice

Select One... Casualty Health Life Pension Risk Mgt and Fin Other

Additional Area of Practice

Select One... Casualty Health Life Pension Risk Mgt and Fin Other

Employment Type

Select One... Bank or Investment Advisor Consulting Actuary Government Insurance Dept Insurance Broker Insurance Dept (State or Prov) Insurance Organization Non-profit Association Organization Serving Insurance Other Other Government Employment Retired Software Developer/Vendor Unaffiliated University or College

Other Employment Type

Specializations Within Area of Practice(s)

Academic/Education Annuities Catastrophe Commercial Lines Disability Income Insurance Distribution Financial Reporting Health Insurance - Commercial Health Insurance – Public Systems Investments Liability Insurance Life Insurance Long Term Care Insurance Marketing Other Post-Employment Benefits Personal Lines Predictive Analytics Private Sector - Pension Product Pricing/Development Property Insurance Provider Systems Public Sector - Pension Public Systems/Social Insurance Regulatory Reinsurance Research Risk Management Specialty Lines Taxation Underwriting Valuation/Reserving Workers Compensation Insurance

Academic Degrees

A.B. B.A. B.A.Sc. B.B.A. B.Com B.Math B.S. B.S.B.A. B.Sc. B.Sc.H. H.B.Sc. J.D. M.A. M.A.S. M.B.A. M.Math M.P.P. M.S. M.Sc. Ph.D.

Gender

Select One... Female Male Non-Binary Prefer Not to Say

Race/Ethnicity

Select One... American Indian Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian Pacific Island White Prefer Not to Say

*Please note that membership profile information changes you make on this webpage will also be updated in the Academy's membership database.

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