Current through Register Vol. 63, No. 9, September 1, 2024
(1) This rule applies to any long-term care
policy issued in this state on or after January 1, 2016.
(2) The following annual submission
requirements apply subsequent to initial rate filings for individual long-term
care insurance policies made under this rule:
(a) An actuarial certification prepared,
dated and signed by the member of the American Academy of Actuaries who
provides the information. The actuarial certification shall provide at least:
(A) A statement of the sufficiency of the
current premium rate schedule and the following:
(i) For the rate schedules currently
marketed:
(I) The premium rate schedule
continues to be 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 increase
anticipated; or
(II) If the above
statement cannot be made, a statement that margins for moderately adverse
experience may no longer be sufficient. In this situation, the insurer shall
provide to the Director within 60 days of the date the actuarial certification
is submitted to the Director, a plan of action, including a time frame, for the
re-establishment of adequate margins for moderately adverse experience so that
the ultimate premium rate schedule would be reasonably expected to be
sustainable over the future life of the form with no future premium increases
anticipated. Failure to submit a plan of action to the Director within 60 days
or to comply with the time frame stated in the plan of action constitutes
grounds for the Director to withdraw or modify its approval of the form for
future sales pursuant to ORS
742.007.
(ii) For the rate schedules that are no
longer marketed:
(I) That the premium rate
schedule continues to be sufficient to cover anticipated costs under best
estimate assumptions; or
(II) That
the premium rate schedule may no longer be sufficient. In this situation, the
insurer shall provide to the Director, within 60 days of the date the actuarial
certification is submitted to the Director, a plan of action, including a time
frame, for the re-establishment of adequate margins for moderately adverse
experience.
(B) A description of the review performed
that led to the statement.
(b) An actuarial memorandum dated and signed
by a member of the American Academy of Actuaries who prepares the information
shall be prepared to support the actuarial certification. The actuarial
memorandum shall provide at least the following information:
(A) A detailed explanation of the data
sources and review performed by the actuary prior to making the statement in
subsection (a) of this section.
(B) A complete description of experience
assumptions and their relationship to the initial pricing assumptions.
(C) A description of the
credibility of the experience data.
(D) An explanation of the analysis and
testing performed in determining the current presence of margins.
(3) The actuarial
certification required under section (2)(a) and (b) of this rule must be based
on calendar year data and submitted annually no later than May 1st of each year
starting in the second year following the year in which the initial rate
schedules are first used. The actuarial memorandum required under section
(2)(a) and (b) of this rule must be submitted at least once every three years
with the certification.
Stat. Auth.: ORS
731.244,
742.023,
743.013,
743.655,
743.656 &
746.240
Stats. Implemented: ORS
731.244,
742.003,
742.005,
742.009,
743.010(3),
743.013(3),
743.650,
743.653,
743.655,
743.656 &
746.240
