Current through Reg. 50, No. 187; September 24, 2024
(1) Other than policies for which no
applicable premium rate or rate schedule increases can be made, insurers shall
provide all of the information listed in this rule to the applicant at the time
of application or enrollment, unless the method of application does not allow
for delivery at that time. In such case, an insurer shall provide all of the
information listed in this rule to the applicant no later than at the time of
delivery of the policy or certificate.
(a) A
statement that the policy may be subject to rate increases in the
future;
(b) An explanation of
potential future premium rate revisions, and the policyholder's or
certificateholder's option in the event of a premium rate revision;
(c) The premium rate or rate schedules
applicable to the applicant that will be in effect until a request is made for
an increase;
(d) A general
explanation for applying premium rate or rate schedule adjustments that shall
include:
1. A description of when premium rate
or rate schedule adjustments will be effective (e.g., next anniversary date,
next billing date, etc.); and
2.
The right to a revised premium rate or rate schedule as provided in paragraph
69O-157.107(1)(b),
F.A.C., if the premium rate or rate schedule is changed;
(e)
1.
Information regarding each premium rate increase on this policy form or similar
policy forms over the past 10 years for this state or any other state that, at
a minimum, identifies:
a. The policy forms
for which premium rates have been increased;
b. The calendar years when the form was
available for purchase; and
c. The
amount or percentage of each increase. The percentage may be expressed as a
percentage of the premium rate prior to the increase, and may also be expressed
as minimum and maximum percentages if the rate increase is variable by rating
characteristics.
2. The
insurer may, in a fair manner, provide additional explanatory information
related to the rate increases.
3.
An insurer shall have the right to exclude from the disclosure premium rate
increases that apply only to blocks of business acquired from other
nonaffiliated insurers or the long-term care policies acquired from other
nonaffiliated insurers when those increases occurred prior to the
acquisition.
4.
a. If an acquiring insurer files for a rate
increase on a long-term care policy form acquired from nonaffiliated insurers
or a block of policy forms acquired from nonaffiliated insurers on or before
the later of the effective date of this Part II or the end of a 24 month period
following the acquisition of the block or policies, the acquiring insurer may
exclude that rate increase from the disclosure.
b. The nonaffiliated selling insurer shall
include the disclosure of that rate increase in accordance with subparagraph
69O-157.107(1)(e)
1., F.A.C.
5. If the
acquiring insurer in subparagraph
69O-157.107(1)(e)
4., F.A.C., files for a subsequent rate increase, even within the 24 month
period, on the same policy form acquired from nonaffiliated insurers or block
of policy forms acquired from nonaffiliated insurers referenced in subparagraph
69O-157.107(1)(e)
4., F.A.C., the acquiring insurer shall make all disclosures required by
paragraph 69O-157.107(1)(e),
F.A.C., including disclosure of the earlier rate increase referenced in
subparagraph 69O-157.107(1)(e)
4., F.A.C.
(2)
An applicant shall sign an acknowledgement at the time of application, unless
the method of application does not allow for signature at that time, that the
insurer made the disclosure required under paragraphs
69O-157.107(1)(a) and
(e), F.A.C. If due to the method of
application the applicant cannot sign an acknowledgement at the time of
application, the applicant shall sign no later than at the time of delivery of
the policy or certificate.
(3) An
insurer shall use the content and format of Appendices B, "Long Term Care
Personal Worksheet" (10/02), and F, "Potential Rate Increase Disclosure Form
OIR-1554" (10/02), which are incorporated herein by reference, to comply with
the requirements of subsection
69O-157.107(1),
F.A.C. All Appendices adopted and incorporated by reference in this rule
chapter are available from the Division of Life and Health Product Review, 200
East Gaines Street, Tallahassee, Florida 32399-0328.
(4)
(a) An
insurer shall provide notice of an upcoming premium rate schedule increase to
all policyholders or certificateholders, if applicable, at least 45 days prior
to the implementation of the premium rate schedule increase by the
insurer.
(b) The notice shall
include the information required by subsection
69O-157.107(1),
F.A.C., when the rate increase is implemented.
Rulemaking Authority 624.308(1), 627.9407(1), 626.9611 FS.
Law Implemented 624.307(1), 626.9541(1)(a), (b), (k), 627.9402, 627.9407(1),
627.9408 FS.
New 1-13-03, Formerly
4-157.107.
