50 Ill. Adm. Code 2012.97
Annual Rate Certification Requirements
Section 2012.97 Annual Rate Certification Requirements
a) This
Section applies to any long-term care policy issued in this State on or after July
1, 2018.
b) The
annual rate certifications required by subsection (c) and the memorandum
required by subsection (d), shall be filed in accordance with the filing
requirements in Section 2012.95.
c) An
annual actuarial certification prepared, dated and signed by a member of the
American Academy of Actuaries who provides the information shall be included
and shall provide at least the following information:
1) A
statement of the sufficiency of the current premium rate schedule including:
A) For the
rate schedules currently marketed,
i) The
premium rate schedule continues to be 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; or
ii) If
the above statement cannot be made, a statement that margins for moderately
adverse experience may no longer be sufficient. In this situation, the insurer
shall provide to the Director, within 60 days of the date the actuarial
certification is submitted to the Director, a plan of action, including a time
frame, for the re-establishment of adequate margins for moderately adverse
experience so that the ultimate premium rate schedule would be reasonably
expected to be sustainable over the future life of the form with no future
premium increases anticipated. Failure to submit a plan of action to the
Director within 60 days or to comply with the time frame stated in the plan of
action constitutes grounds for the Director to withdraw or modify its approval
of the form for future sales pursuant to Section 143 of the Illinois Insurance
Code.
B) For the
rate schedules that are no longer marketed,
i) That
the premium rate schedule continues to be sufficient to cover anticipated costs
under best estimate assumptions; or
ii) That
the premium rate schedule may no longer be sufficient. In this situation, the
insurer shall provide to the Director, within 60 days of the date the actuarial
certification is submitted to the Director, a plan of action, including a time
frame, for the re-establishment of adequate margins for moderately adverse
experience.
2) A
description of the review performed that led to the statement.
d) An
actuarial memorandum dated and signed by a member of the American Academy of
Actuaries who prepares the information shall be prepared to support the
actuarial certification and provide at least the following information:
1) A
detailed explanation of the data sources and review performed by the actuary
prior to making the statement in subsection (c)(1).
2) A
complete description of experience assumptions and their relationship to the
initial pricing assumptions.
3) A
description of the credibility of the experience data.
4) An
explanation of the analysis and testing performed in determining the current
presence of margins.