Reporting Requirements

01. Maintenance of Producer Records. Every insurer maintains records for each producer of that producer’s amount of replacement sales as a percent of the producer’s total annual sales and the number of lapses of long-term care insurance policies sold by the producer as a percent of the producer’s total annual sales, in the format of Appendix G. (3-31-22) 02. Producers Experiencing Lapses and Replacements. Every insurer reports annually by June 30 the ten percent (10%) of its producers with the greatest percentages of lapses and replacements as measured by Subsection 019.01. (3-31-22) 03. Purpose of Reports. Reported replacement and lapse rates do not alone constitute a violation of insurance laws or necessarily imply wrongdoing. The reports are for the purpose of reviewing more closely producer activities regarding the sale of long-term care insurance. (3-31-22) 04. Lapsed Policies. Every insurer reports annually by June 30, the number of lapsed policies as a percent of its total annual sales and as a percent of its total number of policies in force as of the end of the preceding calendar year. (7-1-26) 05. Replacement Policies. Every insurer reports annually by June 30 the number of replacement policies sold as a percent of its total annual sales and as a percent of its total number of policies in force as of the preceding calendar year. (3-31-22) 06. Claims Denied. Every insurer reports annually by June 30, for qualified long-term care insurance contracts, the number of claims denied for each class of business, expressed as a percentage of claims denied, other than claims denied for failure to meet the waiting period or because of an applicable preexisting condition, in the format of Appendix E. (3-31-22) IDAHO ADMINISTRATIVE CODE IDAPA 18.04.11 – Long-Term Care Department of Insurance Insurance Minimum Standards Section 020 Page 16 07. Policies and Reports. For purposes of Section 019, “policy” means only long-term care insurance and “report” means on a statewide basis. (3-31-22) a. Policy means only long-term care insurance; (3-31-22) b. Claim means any request for payment of benefits under a policy regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met; (3-31-22) c. Denied means the insurer refused to pay a claim for any reason; and (3-31-22) d. Report means on a statewide basis. (3-31-22) 08. Filing. Reports prescribed under Section 019 are filed with the Director. (3-31-22) 020. (RESERVED)