(1) An
insurer shall provide the information listed in this subsection for approval
pursuant to Section 627.410, F.S., prior to making a
long-term care insurance form available for sale.
(a) A filing made pursuant to rule Chapter
69O-149, F.A.C., with the actuarial material identified below in lieu of the
actuarial memorandum required by subparagraph
69O-149.003(2)(b)
4., F.A.C.
(b) A copy of the
disclosure documents required in Rule
69O-157.107, F.A.C.;
and
(c) An actuarial certification
consisting of at least the following:
1. A
statement that the initial premium rate schedule is sufficient to cover
anticipated costs under moderately adverse experience and that the premium rate
schedule is reasonably expected to be sustainable over the life of the form
with no future premium increases anticipated;
2. A statement that the policy design and
coverage provided have been reviewed and taken into consideration;
3. A statement that the underwriting and
claims adjudication processes have been reviewed and taken into
consideration;
4. A complete
description of the basis for contract reserves that are anticipated to be held
under the form, to include:
a. Sufficient
detail or sample calculations provided so as to have a complete depiction of
the reserve amounts to be held;
b.
A statement that the assumptions used for reserves contains reasonable margins
for adverse experience;
c. A
statement that the net valuation premium for renewal years does not increase;
and
d. A statement that the
difference between the gross premium and the net valuation premium for renewal
years is sufficient to cover expected renewal expenses; or if such a statement
cannot be made, a complete description of the situations where this does not
occur;
(I) An aggregate distribution of
anticipated issues may be used as long as the underlying gross premiums
maintain a reasonably consistent relationship;
(II) If the gross premiums for certain age
groups appear to be inconsistent with this requirement, upon request of the
Office, a demonstration under subsection
69O-157.108(2),
F.A.C., based on a standard age distribution shall be made;
and
5.
a. A statement that the premium rate schedule
is not less than the premium rate schedule for existing similar policy forms
also available from the insurer except for reasonable differences attributable
to benefits; or
b. A comparison of
the premium schedules and benefits for similar policy forms that are currently
available from the insurer with an explanation of the relative value of the
benefit differences; and
6.
a. The
date and explanation of the reason for the discontinuance of all forms
discontinued within the past 5 years;
b. Whether any currently available form will
be discontinued upon approval of the proposed form; and
c. A summary of the significant differences
between the forms.
