NDAC 45-06-05.1-16
Reserve standards
Cite as N.D. Admin. Code ยง 45-06-05.1-16
1.
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 the benefits shall be
determined in accordance with North Dakota Century Code section 26.1-35-02. Claim
reserves shall also be established in the case when the policy or rider is in claim status.
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:
a.
Definition of insured events;
b.
Covered long-term care facilities;
c.
Existence of home convalescence care coverage;
d.
Definition of facilities;
e.
Existence or absence of barriers to eligibility;
f.
Premium waiver provision;
g.
Renewability;
h.
Ability to raise premiums;
i.
Marketing method;
j.
Underwriting procedures;
k.
Claims adjustment procedures;
l.
Waiting period;
m.
Maximum benefit;
n.
Availability of eligible facilities;
o.
Margins in claim costs;
p.
Optional nature of benefit;
q.
Delay in eligibility for benefit;
r.
Inflation protection provisions; and
s.
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.
2.
When long-term care benefits are provided other than as in subsection 1, reserves shall be
determined in accordance with generally accepted accounting and reserve practices.