760 IAC 2-12-1 - Reserves for policies, certificates, and riders
Authority: IC 27-8-12-7
Affected: IC 27-8-12
Sec. 1.
(a) When
long term care benefits are provided through the acceleration of benefits under
group or individual life policies or riders to such policies or certificates,
policy reserves for such benefits shall be determined in accordance with IC
27-1-12 - 10(2)(h) [IC
27-1-12-10 was repealed by
P.L.
276-2013 ,
SECTION
5 , effective July 1, 2013.]. Claim
reserves must also be established in the case when such policy, certificate, or
rider is in claim status. Reserves for policies, certificates, and riders
subject to this section should be based on the multiple decrement model
utilizing all relevant decrements except for voluntary termination rates.
Single decrement approximations are acceptable if the calculation produces
essentially similar reserves, if the reserve is clearly more conservative, or
if the reserve is immaterial. The calculations may take into account the
reduction in life insurance benefits due to the payment of long term care
benefits. However, in no event shall the reserves for the long term care
benefit and the life insurance benefit be less than the reserves for the life
insurance benefit assuming no long term care benefit.
(b) In the development and calculation of
reserves for policies, certificates, and riders subject to this section, due
regard shall be given to the applicable policy, certificate, or rider
provisions, marketing methods, administrative procedures, and all other
considerations which have an impact on projected claim costs, including, but
not limited to, the following:
(1) Definition
of insured events.
(2) Covered long
term care facilities.
(3) Existence
of home convalescence care coverage.
(4) Definition of facilities.
(5) Existence or absence of barriers to
eligibility.
(6) Premium waiver
provision.
(7)
Renewability.
(8) Ability to raise
premiums.
(9) Marketing
method.
(10) Underwriting
procedures.
(11) Claims adjustment
procedures.
(12) Waiting
period.
(13) Maximum
benefit.
(14) Availability of
eligible facilities.
(15) Margins
in claim costs.
(16) Optional
nature of benefit.
(17) Delay in
eligibility for benefit.
(18)
Inflation protection provisions.
(19) Guaranteed insurability
option.
(c) Any
applicable valuation morbidity table shall be certified as appropriate as a
statutory valuation table by a member of the American Academy of
Actuaries.
(d) When long term care
benefits are provided other than as in subsections (a) and (b), reserves shall
be determined using a table established for reserve purposes by a qualified
actuary and acceptable to the commissioner.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.