New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 14 - MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP HEALTH INSURANCE CONTRACTS
Section 13.10.14.16 - CONTRACT RESERVES
Universal Citation: 13 NM Admin Code 13.10.14.16
Current through Register Vol. 35, No. 18, September 24, 2024
The contract reserve is in addition to claim reserves and premium reserves.
A. Contract reserves required. Contract reserves are required, unless otherwise specified in Subsection B of 13.10.14.16 NMAC, for:
(1) all individual and group contracts with
which level premiums are used; or
(2) all individual and group contracts with
respect to which, due to the gross premium pricing structure at issue, the
value of the future benefits at any time exceeds the value of any appropriate
future valuation net premiums at that time. The values specified in this
Paragraph (2) of Subsection A of 13.10.14.16 NMAC shall be determined on the
basis specified in 13.10.14.17 NMAC.
B. Contracts not requiring a contract reserve:
(1) contracts which cannot be
continued after one year from issue; or
(2) contracts already in force on the
effective date of these standards for which no contract reserve was required
under the immediately preceding standards.
C. Consistent method required. The methods and procedures for contract reserves should be consistent with those for claim reserves for any contract, or else appropriate adjustment must be made when necessary to assure provision for the aggregate liability. The definition of the date of incurral must be the same in both determinations.
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