19 MAC Pt. 3, R. 8.14
Reserve Standards
Cite as 19 Miss. Admin. Code Pt. 3, R. 8.14
Reserve Standards
A. When long-term care benefits are provided through the acceleration of benefits under
group or individual life policies or riders to such policies, policy reserves for such
benefits shall be determined in accordance with Miss Code Ann. Section 83-7-23
(1972), as Amended. Claim reserves must also be established in the case when such
policy or
rider is in claim status.
B. Reserves for policies and riders subject to this subsection should be based on the
multiple
decrement model utilizing all relevant decrements except for voluntary termination
rates. Single decrement approximations are acceptable if the calculation produces essentially
similar reserves, if the reserve is clearly more conservative, or if the reserve is
immaterial. The calculations may take into account the reduction in life insurance
benefits due to the payment of long-term care benefits. However, in no event shall the
reserves for the long-term care benefit and the life insurance benefit be less than the
reserves for the life insurance benefit assuming no long-term care benefit.
In the development and calculation of reserves for policies and riders subject to this
subsection, due regard shall be given to the applicable policy provisions, marketing
methods, administrative procedures and all other considerations which have an impact
on
projected claim costs, including, but not limited to, the following:
1. Definition of insured events;
2. Covered long-term care facilities;
3. Existence of home convalescence-care coverage;
4. Definition of facilities;
5. Existence or absence of barriers to eligibility;
6. Premium waiver provision;
7. Renewability;
8. Ability to raise premiums;
9. Marketing methods;
10. Underwriting procedures;
11. Claims adjustment procedures;
12. Waiting period;
13. Maximum benefit;
14. Availability of eligible facilities;
15. Margin in claim cost;
16. Optional nature of benefit;
17. Delay in eligibility for benefit;
18. Inflation protection provisions; and
19. Guaranteed insurability option.
Any applicable valuation morbidity table shall be certified as appropriate as a statutory
valuation table by a member of the American Academy of Actuaries.
C. When long-term care benefits are provided other than as in Subsection A above,
reserves shall be determined in accordance with standards adopted by the National
Association of Insurance Commissioners.