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 58067 - Provisions Governing Rate Increases

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Participating Issuers in the California
					 Partnership for Long-Term Care shall conduct annual actuarial reviews to
					 determine how well current premiums are covering anticipated expenditures for
					 Partnership Policies and Certificates. The result of these reviews shall be
					 made available to the Department of Insurance in a manner and format prescribed
					 by the Department.
(b) Increases in
					 the premiums for all Policies or Certificates and all optional riders can only
					 be made on a class basis after approval by the Department of Insurance. The
					 Department of Insurance shall not approve any premium increases greater than a
					 cumulative total of forty percent (40%) over any three-year period; the total
					 amount of any approved rate increase must be spread equally over each of the
					 three years. This restriction may be waived by the Commissioner of the
					 Department of Insurance in the event the Issuer demonstrates to the
					 Commissioner's satisfaction that major unforeseen changes in the long-term care
					 environment threaten the solvency of the plan or the company. Examples of such
					 changes include a significant change by the courts in the interpretation of
					 benefit or benefit eligibility language, or major medical breakthroughs which
					 notably change underlying morbidity patterns.
(c) If a premium increase is approved by the
					 Department of Insurance, the Issuer shall include in the premium increase
					 notice to the Policy or Certificate holder, or by separate notice to the
					 Certificate holder, a statement advising them of the options to lower their
					 premiums by reducing coverage as provided in Section
					 58061(c).
(d) Self-funded Issuers not subject to
					 compliance with the California Insurance Code are exempt from the requirement
					 of Subsection (a), above, that the annual actuarial reviews be submitted to and
					 conducted in a manner prescribed by the Department of Insurance and the
					 requirement of Subsection (b), above, pertaining to the Department of
					 Insurance's approval of all premium increases for Partnership Policies or
					 Certificates and for all optional riders to Partnership Policies or
					 Certificates.
1. New
						section filed 8-30-93 as an emergency; operative 8-30-93 (Register 93, No. 36).
						Submitted for printing only pursuant to section
						22009,
						Welfare and Institutions Code.
2. Certificate of Compliance as to
						8-30-93 order, including amendment of subsection (c) and new subsection (d)
						transmitted to OAL 12-30-93 and filed 1-28-94 (Register 94, No.
						4).
3. Amendment of subsections (a) and (d) filed 10-1-98 as an
						emergency; operative 10-1-98. Submitted to OAL for printing only pursuant to
						Welfare and Institutions Code section
						22009(d)
						(Register 98, No. 41). A Certificate of Compliance must be transmitted to OAL
						by 1-29-99 or emergency language will be repealed by operation of law on the
						following day.
4. Certificate of Compliance as to 10-1-98 order
						transmitted to OAL 1-28-99 and filed 3-15-99 (Register 99, No.
						12).
Note: Authority cited: Section
						  22009(a),
						  Welfare and Institutions Code. Reference: Section
						  22005,
						  Welfare and Institutions Code.