Utah Admin. Code R590-148-19 - Required Disclosure of Rating Practices to Consumer

(1)

(a) Except as provided in Subsection (1)(b), this section applies to a policy or certificate issued on or after January 1, 2003.

(b) For a certificate issued on or after July 1, 2002, under a group policy that was in force on July 1, 2002, this section shall apply on the first policy anniversary after January 1, 2003.

(2)

(a) Except for a policy for which no applicable premium rate or rate schedule increase can be made, an insurer shall provide the information in Subsection (3) to the applicant at the time of application or enrollment.

(b) If the method of application or enrollment does not allow for delivery at the time of application or enrollment, an insurer shall provide the information in this Subsection (3) to the applicant or enrollee no later than at delivery of the policy or certificate.

(3)

(a) The information to be disclosed under Subsection (2) includes:

(i) a statement that the policy may be subject to rate increases in the future;

(ii) an explanation of potential future premium rate revisions that includes the insured's options in the event of a premium rate revision;

(iii) the premium rate or rate schedule in effect until a request is made for an increase;

(iv) a general explanation for applying a premium rate or rate schedule adjustment that includes:

(A) a description of when a premium rate or rate schedule adjustment will be effective, such as the next policy anniversary date or the next billing date; and

(B) the right to a revised premium rate or rate schedule under Subsection (3)(b), if the premium rate or rate schedule is changed;

(v) information regarding each premium rate increase on the policy form or a similar policy form during the past ten years for this state or any other state that, at a minimum, identifies:

(A) each policy form for which a premium rate has been increased;

(B) each calendar year the policy form was available for purchase; and

(C) the amount, percent, and date of implementation for each increase, expressed as a percentage of the premium rate before the increase, or as a minimum and a maximum percentage, if the rate increase is variable by rating characteristics; and

(vi) additional explanatory information related to the rate increases, as necessary.

(b)

(i) An insurer may exclude from the disclosure a premium rate increase that only applies to a block of business acquired from a nonaffiliated insurer or the policies acquired from a nonaffiliated insurer when the increase occurred before the acquisition.

(ii) If an acquiring insurer files a rate increase on a policy form or a block of policy forms acquired from a nonaffiliated insurer on or before the effective date of this section, or the end of a 24-month period following the acquisition, the acquiring insurer may exclude that rate increase from the disclosure, however, the selling company shall include the disclosure of the rate increase under this subsection.

(iii) If the acquiring insurer files for a subsequent rate increase on the same policy form or block of policy forms acquired from a nonaffiliated insurer, the acquiring insurer shall make each disclosure required by this subsection, including disclosure of an earlier rate increase.

(4)

(a) An applicant shall sign an acknowledgment at the time of application that the insurer made the disclosure required under this subsection, unless the method of application does not allow for signature at that time.

(b) If, due to the method of application, the applicant cannot sign an acknowledgment at the time of application, the applicant shall sign the acknowledgment no later than at delivery of the policy or certificate.

(5) An insurer shall use the Long-Term Care Insurance Personal Worksheet and Worksheet Potential Rate Increase Disclosure Form to comply with this section.

(6) An insurer shall provide notice of an upcoming premium rate schedule increase to each insured, if applicable, at least 45 days before the implementation of a premium rate schedule increase.

Notes

Utah Admin. Code R590-148-19

Adopted by Utah State Bulletin Number 2024-21, effective 10/22/2024