Section 284-83-040 - Initial rate filing requirementsThe issuer must provide the following information to the commissioner no fewer than thirty days prior to making a long-term care insurance form available for sale in this state:
(1) A copy of each disclosure document required in WAC 284-83-035; and(2) An actuarial certification consisting of at least the following: (a) 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;(b) A statement that the policy design and coverage provided have been reviewed and taken into consideration;(c) A statement that the underwriting and claims adjudication processes have been reviewed and taken into consideration;(d) A complete description of the basis for policy reserves that are anticipated to be held under the form, including: (i) Sufficient detail or sample calculations provided so as to have a complete depiction of the reserve amounts to be held;(ii) A statement that the assumptions used for reserves contain reasonable margins for adverse experience;(iii) A statement that the net valuation premium for renewal years does not increase (except for attained-age rating, where permitted); and(iv) 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; (A) An aggregate distribution of anticipated issues may be used as long as the underlying gross premiums maintain a reasonably consistent relationship;(B) If the gross premiums for certain age groups appear to be inconsistent with this requirement, the commissioner may request a demonstration based on a standard age distribution; and(e)(i) A statement that the premium rate schedule is not less than the premium rate schedule for existing similar policy forms also available from the issuer except for reasonable differences attributable to benefits; or(ii) A comparison of the premium schedules for similar policy forms that are currently available from the issuer with an explanation of the differences.(3)(a) The commissioner may request an actuarial demonstration that benefits are reasonable in relation to premiums. The actuarial demonstration must include: (i) Premium and claim experience on similar policy forms, adjusted for any premium or benefit differences;(ii) Relevant and credible data from other studies; or(iii) Both (a)(i) and (ii) of this subsection.(b) In the event the commissioner asks for additional information, the period in subsection (2) of this section does not include the period during which the issuer is preparing the requested information.Wash. Admin. Code § 284-83-040
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), § 284-83-040, filed 11/24/08, effective 12/25/08.