California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 8 - CALIFORNIA PARTNERSHIP FOR LONG-TERM CARE › Article 4 - PREMIUM PROVISIONS › Section 58066 - Provisions Governing Premiums When Benefits Increase or Decrease

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The extra
					 premiums for the optional rider(s) that add a Shortened Benefit Period
					 Non-Forfeiture Benefit described in Section
					 58059 (
l
) and/or
					 that increase the amounts of the covered benefits of the Policy or Certificate
					 as provided in Section
					 58061(a)(1)(2) and
					 (3) shall be in the same form as the original
					 Policy--either remain level for the life of the Policy or increase annually at
					 no more than five percent (5%). The extra premiums for the optional rider(s)
					 may be based on the attained age of the Policy or Certificate holder at the
					 time the rider is elected. Premiums for the optional riders shall be filed and
					 approved by the Department of Insurance at the time rates are filed initially.
					 For the optional riders allowed in Section
					 58061(a)(1) and
					 (2), the premiums for each additional $10
					 unit of a covered benefit shall be the rate that corresponds to the current
					 attained age of the Policy or Certificate holder as such rates were filed
					 initially and approved by the Department of Insurance. For the optional riders
					 allowed in Section
					 58061(a)(3), the
					 premium for the increase in the lifetime maximum benefit shall be the
					 difference in premiums between the new lifetime maximum benefit elected and the
					 lifetime maximum benefit of the current Policy or Certificate, based on the
					 rates filed initially and approved by the Department of Insurance and the
					 current attained age of the Policy or Certificate holder. The premium for the
					 underlying coverage of the original Policy or Certificate shall not be changed
					 by the addition of one or more riders and shall continue to be based on the age
					 of the Policy or Certificate holder on the date when the original Policy or
					 Certificate was issued or delivered.
(b) When an Issuer replaces a non-Partnership
					 or a Partnership Policy or Certificate it has previously issued with either a
					 new non-Partnership or Partnership Policy or Certificate, the Issuer shall
					 recognize past insured status by granting a premium credit that meets the
					 requirements of Insurance Code 10234.87, and satisfies the following
					 conditions:
(1) a credit equal to or not less
					 than five percent (5%) of the premium for the original policy or certificate
					 for each full year the original policy or certificate was in force shall be
					 given toward all subsequent premium payments for the replacement policy or
					 certificate. However, the cumulative credit allowed need not exceed fifty
					 percent (50%).
(2) no credit need
					 be provided if a claim has been filed under the original policy or certificate.
					 The cumulative credits allowed need not reduce the premium for the replacement
					 policy to less than the premium for the original policy or certificate. No
					 credit need be provided if there is no difference between the premium for the
					 replacement policy or certificate and the premium for the current policy or
					 certificate.