S.C. Code Regs. § ch. 69, 69-44, app G
Replacement and Lapse Reporting Form
For the State of __________For the Reporting Year of __________
Company Name: __________Due: June 30 annually
Company Address: __________Company NAIC Number: __________
Contact Person: __________Phone Number: (__________)__________
Instructions
The purpose of this form is to report on a statewide basis information regarding long term care insurance policy replacements and lapses. Specifically, every insurer shall maintain records for each agent on that agent's amount of long term care insurance replacement sales as a percent of the agent's total annual sales and the amount of lapses of long term care insurance policies sold by the agent as a percent of the agent's total annual sales. The tables below should be used to report the ten percent (10%) of the insurer's agents with the greatest percentages of replacements and lapses.
Listing of the 10% of Agents with the Greatest Percentage of Replacements
Agent's Name | Number of Policies Sold By This Agent | Number of Policies Replaced By This Agent | Number of Replacements As % of Number Sold By This Agent |
Listing of the 10% of Agents with the Greatest Percentage of Lapses
Agent's Name | Number of Policies Sold By This Agent | Number of Policies Lapsed By This Agent | Number of Lapses As % of Number Sold By This Agent |
Company Totals
Percentage of Replacement Policies Sold to Total Annual Sales __________%
Percentage of Replacement Policies Sold to Policies In Force (as of the end of the preceding calendar year) __________%
Percentage of Lapsed Policies to Total Annual Sales __________%
Percentage of Lapsed Policies to Policies In Force (as of the end of the preceding calendar year)__________%
S.C. Code Regs. ch. 69, 69-44, app G