West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-32 - Long-Term Care Insurance
Section 114-32-8 - Initial Filing Requirements
Universal Citation: 114 WV Code of State Rules 114-32-8
Current through Register Vol. XLI, No. 52, December 27, 2024
8.1. This section applies to any long-term care policy issued in this state on or after six (6) months after the effective date of this rule, amended in 2009.
8.2. An insurer shall provide the information listed in this subsection to the Commissioner sixty (60) days prior to making a long-term care insurance form available for sale.
8.2.a. A copy of the disclosure documents required
in section 7 of this rule; and
8.2.b. An
actuarial certification consisting of at least the following:
8.2.b.1. A statement that the initial premium rate
schedule is 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 increases
anticipated;
8.2.b.2. A statement that
the policy design and coverage provided have been reviewed and taken into
consideration;
8.2.b.3. A statement that
the underwriting and claims adjudication processes have been reviewed and taken into
consideration;
8.2.b.4. A complete
description of the basis for contract reserves that are anticipated to be held under
the form, to include:
8.2.b.4.A. Sufficient detail
or sample calculations provided so as to have a complete depiction of the reserve
amounts to be held;
8.2.b.4.B. A
statement that the assumptions used for reserves contain reasonable margins for
adverse experience;
8.2.b.4.C. A
statement that the net valuation premium for renewal years does not increase (except
for attained-age rating where permitted); and
8.2.b.4.D. A statement that the difference between
the gross premium and the net valuation premium for renewal years is sufficient to
cover expected renewal expenses; or if such a statement cannot be made, a complete
description of the situations where this does not occur;
8.2.b.4.D.1. An aggregate distribution of
anticipated issues may be used as long as the underlying gross premiums maintain a
reasonably consistent relationship;
8.2.b.4.D.2. If the gross premiums for certain age
groups appear to be inconsistent with this requirement, the Commissioner may request
a demonstration under subsection 8.3 of this section based on a standard age
distribution; and
8.2.b.5.
8.2.b.5.A. A statement that the premium rate
schedule is not less than the premium rate schedule for existing similar policy
forms also available from the insurer except for reasonable differences attributable
to benefits; or
8.2.b.5.B. A comparison
of the premium schedules for similar policy forms that are currently available from
the insurer with an explanation of the differences.
8.3.
8.3.a. The Commissioner may request an actuarial
demonstration that benefits are reasonable in relation to premiums. The actuarial
demonstration shall include either premium and claim experience on similar policy
forms, adjusted for any premium or benefit differences, relevant and credible data
from other studies, or both.
8.3.b. In
the event the Commissioner asks for additional information under this provision, the
period in subsection 8.2 of this section does not include the period during which
the insurer is preparing the requested information.
Disclaimer: These regulations may not be the most recent version. West Virginia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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