Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69O - OIR - Insurance Regulation › Chapter 69O-157 - LONG-TERM CARE INSURANCE › Section 69O-157.108 - Initial Filing Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) An
				insurer shall provide the information listed in this subsection for approval
				pursuant to Section 627.410, F.S., prior to making a
				long-term care insurance form available for sale.
(a) A filing made pursuant to rule Chapter
				69O-149, F.A.C., with the actuarial material identified below in lieu of the
				actuarial memorandum required by subparagraph
				69O-149.003(2)(b)
				4., F.A.C.
(b) A copy of the
				disclosure documents required in Rule
				69O-157.107, F.A.C.;
				and
(c) An actuarial certification
				consisting of at least the following:
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;
2. A statement that the policy design and
				coverage provided have been reviewed and taken into consideration;
3. A statement that the underwriting and
				claims adjudication processes have been reviewed and taken into
				consideration;
4. A complete
				description of the basis for contract reserves that are anticipated to be held
				under the form, to include:
a. Sufficient
				detail or sample calculations provided so as to have a complete depiction of
				the reserve amounts to be held;
b.
				A statement that the assumptions used for reserves contains reasonable margins
				for adverse experience;
c. A
				statement that the net valuation premium for renewal years does not increase;
				and
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;
(I) An aggregate distribution of
				anticipated issues may be used as long as the underlying gross premiums
				maintain a reasonably consistent relationship;
(II) If the gross premiums for certain age
				groups appear to be inconsistent with this requirement, upon request of the
				Office, a demonstration under subsection
				69O-157.108(2),
				F.A.C., based on a standard age distribution shall be made;
				and
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
b. A comparison of
				the premium schedules and benefits for similar policy forms that are currently
				available from the insurer with an explanation of the relative value of the
				benefit differences; and
6.
a. The
				date and explanation of the reason for the discontinuance of all forms
				discontinued within the past 5 years;
b. Whether any currently available form will
				be discontinued upon approval of the proposed form; and
c. A summary of the significant differences
				between the forms.