Washington Administrative Code › Title 284 - Insurance Commissioner, Office of the › Chapter 284-83 - Long-term care insurance rules › Section 284-83-010 - Definitions and standards

Current through Register Vol. 24-14, July 15, 2024
For the purpose of this chapter, the following definitions and
				standards apply, unless the context clearly requires otherwise.
(1) "Certificate" has the meaning set forth
			 in RCW
			  48.83.020(2).
(2) "Exceptional increase" means only those
			 increases filed by the issuer as exceptional for which the commissioner
			 determines the need for the premium rate increase is justified due to changes
			 in laws or regulations applicable to long-term care coverage in this state; or
			 due to increased and unexpected utilization that affects the majority of
			 issuers of similar products. Except as provided in WAC
			 284-83-090, exceptional increases
			 are subject to the same requirements as other premium rate schedule increases.
			 The commissioner may request a review by an independent actuary or a
			 professional actuarial body of the basis for a request that an increase be
			 considered an exceptional increase. The commissioner, in determining that the
			 necessary basis for an exceptional increase exists, must also determine any
			 potential offsets to higher claims costs.
(3) "Incidental," as used in WAC
			 284-83-090, means a value of the
			 long-term care benefits provided that is less than ten percent of the total
			 value of the benefits provided over the life of the policy. These values must
			 be measured as of the date of issue. In simple cases where the base policy and
			 the long-term care benefits have separately identifiable premiums, the premiums
			 can be directly compared. In other cases, annual cost of insurance charges
			 might be available for comparison. Some cases may involve comparison of present
			 value of benefits.
(4) "Group
			 long-term care insurance" has the meaning set forth in
			 RCW
			  48.83.020(6).
(5) "Guaranteed renewable" means that renewal
			 of a long-term care insurance policy cannot be declined by the issuer for any
			 reason except nonpayment of premiums, but the issuer can revise rates on a
			 class basis.
(6) "Insured" means
			 any beneficiary or owner of a long-term care policy regardless of the type of
			 issuer.
(7) "Issuer" has the
			 meaning set forth in
			 RCW
			  48.83.020(4).
(8) "Noncancellable" means that renewal of a
			 long-term care insurance policy cannot be declined and rates cannot be revised
			 by the issuer.
(9) "Policy" has the
			 meaning set forth in
			 RCW
			  48.83.020(7), unless the
			 context clearly indicates otherwise, and includes certificates issued under a
			 group policy.
(10) "Qualified
			 actuary" means a member in good standing of the American Academy of
			 Actuaries.
(11) "Qualified
			 long-term care insurance" has the meaning set forth in
			 RCW
			  48.83.020(8).
(12) "Similar policy forms" means all of the
			 long-term care insurance policies and certificates issued by the issuer in the
			 same long-term care benefit classification as the policy form being considered.
			 Certificates of groups that meet the definition in
			 RCW
			  48.83.020(6)(a) are not
			 considered similar to certificates or policies otherwise issued as long-term
			 care insurance, but are similar to other comparable certificates with the same
			 long-term care benefit classifications. For purposes of determining similar
			 policy forms, long-term care benefit classifications are defined as follows:
			 Institutional long-term care benefits only, noninstitutional long-term care
			 benefits only, or comprehensive long-term care benefits.
Statutory Authority:
				  RCW
				  48.02.060,
				  48.83.070,
				  48.83.110,
				  48.83.120,
				  48.83.130(1), and
				  48.83.140(4)(a).
				  08-24-019 (Matter No. R 2008-09), §
										284-83-010, filed 11/24/08,
				  effective 12/25/08.