3 AAC 28.563 - Reporting requirements
(a) Every insurer shall maintain records for
each agent of that agent's amount of replacement sales as a percent of the
agent's total annual sales and the amount of lapses of long-term care insurance
policies sold by the agent as a percent of the agent's total annual sales.
Reported replacement and lapse rates do not alone constitute a violation of
insurance laws or necessarily imply wrongdoing. The reports are for the purpose
of reviewing more closely agent activities regarding the sale of long-term care
insurance.
(b) Every insurer shall
report annually not later than June 30, the 10 percent of its agents with the
greatest percentages of lapses and replacements as measured by (a) of this
section.
(c) Every insurer shall
report annually not later than June 30, the number of lapsed policies as a
percent of its total annual sales and as a percent of its total number of
policies in force as of the end of the preceding calendar year
(d) Every insurer shall report annually not
later than June 30, the number of replacement policies sold as a percent of its
total annual sales and as a percent of its total number of policies in force as
of the preceding calendar year.
(e)
Every insurer shall report annually not later than June 30, for qualified
long-term care insurance contracts, the number of claims denied for each class
of business, expressed as a percentage of claims denied.
(f) Reports required under this section shall
be filed with the director.
(g) For
purposes of this section;
(1) "policy" means
only long-term care insurance;
(2)
subject to (3) of this subsection, "claim" means a request for payment of
benefits under an in force policy regardless of whether the benefit claimed is
covered under the policy or the terms or conditions of the policy have been
met;
(3) denied" means the insurer
refuses to pay a claim for a reason other than for claims not paid for failure
to meet the waiting period or because of an applicable preexisting condition;
and
(4) "report" means on a
statewide basis.
Notes
Authority:AS 21.06.090
AS 21.53.020
AS 21.53.030
AS 21.53.050
AS 21.53.090
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