New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 14 - MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP HEALTH INSURANCE CONTRACTS
Section 13.10.14.10 - MINIMUM STANDARDS FOR CLAIM RESERVES FOR DISABILITY INCOME
Universal Citation: 13 NM Admin Code 13.10.14.10
Current through Register Vol. 35, No. 6, March 26, 2024
A. Interest. The maximum interest rate for claim reserves is specified in 13.10.14.24 NMAC.
B. Morbidity. Minimum standards with respect to morbidity are those specified in 13.10.14.22 and 13.10.14.23 NMAC, except that, at the option of the insurer:
(1) For claims with a duration
from date of disablement of less than two years, reserves may be based on the
insurer's experience, if such experience is considered credible, or upon other
assumptions designed to place a sound value on the liabilities.
(2) For group disability income claims with a
duration from date of disablement of more than two years but less than five
years, reserves may, with the approval of the superintendent, be based on the
insurer's experience for which the insurer maintains underwriting and claim
administration control. The request for such approval of a plan of modification
to the reserve basis must include:
(a) an
analysis of the credibility of the experience;
(b) a description of how all of the insurer's
experience is proposed to be used in setting reserves;
(c) a description and qualification of the
margins to be included;
(d) a
summary of the financial impact that the proposed plan of modification would
have had on the insurer's last filed annual statement;
(e) a copy of the approval of the proposed
plan of modification by the superintendent of the state of domicile;
and
(f) any other information
deemed necessary by the superintendent.
C. Duration of Disablement. For contracts with an elimination period, the duration of disablement should be measured as dating from the time that benefits would have begun to accrue had there been no elimination period.
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