New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter XIII - Life Care Communities
Part 350 - Continuing Care Retirement Communities
Section 350.10 - Fee schedule submission
Universal Citation: 11 NY Comp Codes Rules and Regs ยง 350.10
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Fee schedules submitted pursuant to an approved rating methodology.
(1) The fee schedule shall be submitted to
the superintendent at least 45 days prior to the scheduled effective date of
the fee schedule and shall include the following:
(i) a certification by an officer of the
continuing care retirement community, or of the management company for the
community, that the submission has been prepared pursuant to an approved rating
methodology; and
(ii) supporting
exhibits showing how the rating methodology was applied and how the rating
methodology calculations produced the fees in the schedule submitted.
(2) Provided that the submission
is in accordance with the approved rating methodology, the submission shall be
deemed approved unless the superintendent notifies the continuing care
retirement community of deficiencies in the submission within 30 days of
receipt of the submission. If the community does not correct all deficiencies
within 30 days from the date of the deficiency letter, the fee submission shall
be deemed disapproved.
(3) A rating
methodology shall not be used by a continuing care retirement community until
it has been approved by the superintendent.
(4) A rating methodology that is submitted to
the superintendent for approval shall include all of the following items:
(i) the specific source data to be used in
the calculations;
(ii) the
step-by-step calculations that shall be followed. The calculation steps shall
be coordinated with any plan that an operator submits to the superintendent
pursuant to section
350.8 of this Part;
(iii) the minimum and maximum fee schedule
changes resulting from the rating methodology;
(iv) the timing of when the rating
methodology will be applied to determine an updated fee schedule;
(v) a discussion of the appropriateness of
the proposed methodology, how the calculation steps are impacted by the level
of earned surplus, and how the proposed methodology will maintain the community
in satisfactory actuarial balance or achieve satisfactory actuarial balance (if
the community is not currently in satisfactory actuarial balance);
and
(vi) an illustrative numerical
example showing the application of the methodology and how it produces the
resulting revised fee schedule.
(5) A continuing care retirement community
that does not have an approved rating methodology may develop and submit a
rating methodology to the superintendent for approval.
(6) An already approved rating methodology
may be revised by submitting a revised rating methodology to the superintendent
for approval.
(7) A previously
approved rating methodology may be withdrawn by submitting a written notice of
withdrawal to the superintendent, and the rating methodology shall not be used
beginning with the effective date of the withdrawal notice.
(8) A continuing care retirement community
that has an approved rating methodology shall either use the approved rating
methodology to determine an updated fee schedule according to the timing
provision incorporated into the rating methodology and submit a fee schedule
pursuant to subdivision (a) of this section, or shall submit a fee schedule
pursuant to subdivision (b) of this section.
(9) Submission of a rating methodology to the
superintendent for approval is optional. A continuing care retirement community
that does not have an approved rating methodology shall submit all fee schedule
changes pursuant to subdivision (b) of this section.
(b) Fee schedules submitted outside of an approved rating methodology.
(1) The fee
schedule shall be submitted to the superintendent at least 75 days prior to the
proposed effective date of the fee schedule.
(2) Sufficient documentation shall be
included with the submission to justify the need for the fee change and the
magnitude of the proposed fee change.
(3) The fee schedule shall not be implemented
until it has been approved by the superintendent.
(c) Each fee schedule submission shall include the following information:
(1) for
each continuing care retirement contract type and continuing care at home
contract type an exhibit showing the current fee, the revised fee, and the
percentage change in the fee. Entrance fees and monthly care fees shall be
shown separately. Entrance fees shall be shown separately for the residential
component and the health care component, if applicable. Per diem health care
fees shall also be shown separately, if applicable;
(2) for each continuing care retirement
contract type and each continuing care at home contract type an exhibit showing
the overall weighted average current entrance fee and overall weighted average
revised entrance fee, separately for first persons and second persons, or
single occupancies and joint occupancies, and the percentage change in each of
the overall weighted average entrance fees;
(3) for each continuing care retirement
contract type an exhibit showing the overall weighted average current monthly
care fee and overall weighted average revised monthly care fee, separately for
first persons and second persons, or single occupancies and joint occupancies,
and the percentage change in each of the overall weighted average monthly care
fees;
(4) the effective date of the
current fees and the proposed effective date of the revised fees shall be
clearly indicated; and
(5) the
material indicated in subdivision (a) or (b) of this section, as
appropriate.
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