Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-16 - LONG TERM CARE INSURANCE
Rule 120-2-16-.10 - Intial Filing Requirements
Universal Citation: GA Rules and Regs r 120-2-16-.10
Current through Rules and Regulations filed through March 20, 2024
(1) This section applies to any long-term care policy issued in this state on or after April 1, 2008.
(2) An insurer shall provide the information listed in this subsection to the Commissioner 30 days prior to making a long-term care insurance form available for sale.
(a) A copy of the disclosure documents
required in Section
120-2-16-.09; and
(b) An actuarial certification consisting of
at least the following:
(i) 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;
(ii)
A statement that the policy design and coverage provided have been reviewed and
taken into consideration;
(iii) A
statement that the underwriting and claims adjudication processes have been
reviewed and taken into consideration;
(iv) 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 contain reasonable margins for adverse
experience;
(C) A statement that
the net valuation premium for renewal years does not increase (except for
attained-age rating where permitted); 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, the Commissioner may
request a demonstration under subsection (3) based on a standard age
distribution; and
(v)
(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 for
similar policy forms that are currently available from the insurer with an
explanation of the differences.
(3)
(a) The
Commissioner may request an actuarial demonstration that benefits are
reasonable in relation to premiums. The actuarial demonstration shall include
either premium and claim experience on similar policy forms, adjusted for any
premium or benefit differences, relevant and credible data from other studies,
or both.
(b) In the event the
Commissioner asks for additional information under this provision, the period
in subsection (2) does not include the period during which the insurer is
preparing the requested information.
O.C.G.A. Secs. 33-2-9, 33-42-6, 33-42-7, 49-4-164, 49-4-165.
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