Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-157 - LONG-TERM CARE INSURANCE › Section 69O-157.113 - Premium Rate Schedule Increases

Current through Reg. 50, No. 138; July 16, 2024
(1) An
				insurer shall file with the Office for approval any premium rate schedule
				increase, including an exceptional increase, pursuant to Section
				627.410, F.S. The filing shall
				include:
(a) A filing made pursuant to rule
				Chapter 69O-149, F.A.C., with the actuarial information identified below in
				lieu of the actuarial memorandum required by subparagraph
				69O-149.003(2)(b)
				4., F.A.C.
(b) Information required
				by Rule 69O-157.107, F.A.C.;
(c) Certification by a qualified actuary
				that:
1. No further premium rate schedule
				increases are anticipated. If the requested premium rate schedule increase is
				implemented and the underlying assumptions are realized;
2. The premium rate filing is in compliance
				with the provisions of Rule
				69O-157.113,
				F.A.C.;
(d) An actuarial
				memorandum justifying the rate schedule change request that includes:
1. Lifetime projections of earned premiums
				and incurred claims based on both the current rate schedule and the filed
				premium rate schedule increase; and the method and assumptions used in
				determining the projected values, including a summary and the reason for any
				assumptions that deviate from those used for pricing other forms currently
				available for sale;
a. Pursuant to Section
				627.410(6)(e)3., F.S., and as is provided in rule Chapter 69O-149, F.A.C., the
				experience of all similar policy forms as defined in subsection
				69O-157.103(17),
				F.A.C., shall be combined for all rating purposes. However, forms providing
				only non-institutional benefits may utilize different experience pools based
				upon similar benefits consistent with rule Chapter 69O-149, F.A.C.
b. The projections shall include the
				development of the lifetime loss ratio, including calendar year values for the
				complete history of the experience of the business and projections of the
				remaining future lifetime of the business, unless the rate increase is an
				exceptional increase;
c. The
				projections shall demonstrate compliance with subsection
				69O-157.113(2),
				F.A.C., if the form is subject to Part II of these rules, or compliance with
				rule Chapter 69O-149, F.A.C., if the form is subject to Part I of these rules;
				and
d. For exceptional increases,
(I) The projected experience shall be limited
				to the increases in claims payments attributable to the approved reasons for
				the exceptional increase; and
(II)
				In the event the Office determines as provided in paragraph
				69O-157.103(4)(d),
				F.A.C., that offsets may exist, the insurer shall use appropriate net projected
				experience;
2.
				Disclosure of how reserves have been incorporated in this rate increase
				whenever the rate increase will trigger contingent benefit upon
				lapse;
3. Disclosure of the
				analysis performed to determine why a rate adjustment is necessary, which
				pricing assumptions were not realized and why, and what other actions taken by
				the insurer have been relied on by the actuary;
4. A statement that policy design,
				underwriting and claims adjudication practices have been taken into
				consideration; and
5. In the event
				that it is necessary to maintain consistent premium rates for new certificates
				and certificates issued under a group long-term care insurance policy as
				defined in Section 627.9405(1)(a),
				F.S., receiving a rate increase, the insurer will need to file composite rates
				reflecting projections of new certificates;
(e) A statement that renewal premium rate
				schedules are not greater than new business premium rate schedules except for
				differences attributable to benefits; and
(f) Sufficient information for review and
				approval of the premium rate schedule increase by the
				Office.