A. When long-term
care benefits are provided through the acceleration of benefits under group or
individual life policies or riders to such policies, policy reserves for such
benefits shall be determined in accordance with Miss Code Ann. Section
83-7-23(1972),
as Amended. Claim reserves must also be established in the case when such
policy or rider is in claim status.
B. Reserves for policies and riders subject
to this subsection 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.
In the development and calculation of reserves for policies
and riders subject to this subsection, due regard shall be given to the
applicable policy 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 methods;
10. Underwriting procedures;
11. Claims adjustment procedures;
12. Waiting period;
13. Maximum benefit;
14. Availability of eligible
facilities;
15. Margin in claim
cost;
16. Optional nature of
benefit;
17. Delay in eligibility
for benefit;
18. Inflation
protection provisions; and
19.
Guaranteed insurability option.
Any applicable valuation morbidity table shall be certified
as appropriate as a statutory valuation table by a member of the American
Academy of Actuaries.
C. When long-term care benefits are provided
other than as in Subsection A above, reserves shall be determined in accordance
with standards adopted by the National Association of Insurance
Commissioners.
