Utah Admin. Code R590-148-22 - Loss Ratio

(1) This section applies to all individual long-term care insurance policies except those covered in Sections R590-148-21 and R590-148-24.

(2) Benefits under an individual policy are considered reasonable in relation to the premium if the expected loss ratio is at least 60%, calculated in a manner that provides for adequate reserving of the long-term care insurance risk.

(3) In evaluating the expected loss ratio, consideration shall be given to each relevant factor, including:

(a) statistical credibility of incurred claims experience and earned premiums;

(b) the period that rates are computed to provide coverage;

(c) experienced and projected trends;

(d) concentration of experience within early policy duration;

(e) expected claim fluctuation;

(f) experience refunds, adjustments, or dividends;

(g) renewability features;

(h) all appropriate expense factors;

(i) interest;

(j) experimental nature of the coverage;

(k) policy reserves;

(l) mix of business by risk classification; and

(m) product features such as long elimination periods, high deductibles, and high maximum limits.

(4) The premium charged to an insured may not increase due to:

(a) the increasing age of the insured at an age beyond 65; or

(b) the duration the insured has been covered under the policy.

(5) Rate filing documents shall contain the information required in Section R590-85-4.

Notes

Utah Admin. Code R590-148-22

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