New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 6 - MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP HEALTH INSURANCE CONTRACTS
Section 11:4-6.15 - Specific standards for morbidity for valuation of specified group contract health insurance benefits
Universal Citation: NJ Admin Code 11:4-6.15
Current through Register Vol. 56, No. 6, March 18, 2024
(a) Minimum morbidity standards for valuation of specified group contract health insurance benefits are as follows:
1. For disability
income benefits due to accident or sickness use:
i. When calculating contract reserves:
(1) For contracts issued prior to January 1,
2001: The same basis, if any, as that employed by the insurer as of January 1,
2001;
(2) For contracts issued on
or after January 1, 2001: The 1987 Commissioners Group Disability Income Table
(87CGDT), (incorporated herein by reference).
ii. When calculating claim reserves use:
(1) For claims incurred on or after January
1, 2001: The 1987 Commissioners Group Disability Income Table
(87CGDT);
(2) For claims incurred
prior to January 1, 2001: Use of the 87CGDT is optional.
2. For other group contract
benefits:
i. When calculating contract
reserves: For all other group contract benefits, morbidity assumptions are to
be determined as provided in the reserve standards.
ii. When calculating claim reserves: For all
benefits other than disability, claim reserves are to be determined as provided
in the standards.
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