3 Alaska Admin. Code § 28.563

Current through September 25, 2024
Section 3 AAC 28.563 - Reporting requirements
(a) Every insurer shall maintain records for each agent of that agent's amount of replacement sales as a percent of the agent's total annual sales and the amount of lapses of long-term care insurance policies sold by the agent as a percent of the agent's total annual sales. 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 agent activities regarding the sale of long-term care insurance.
(b) Every insurer shall report annually not later than June 30, the 10 percent of its agents with the greatest percentages of lapses and replacements as measured by (a) of this section.
(c) Every insurer shall report annually not later than 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
(d) Every insurer shall report annually not later than 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.
(e) Every insurer shall report annually not later than 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.
(f) Reports required under this section shall be filed with the director.
(g) For purposes of this section;
(1) "policy" means only long-term care insurance;
(2) subject to (3) of this subsection, "claim" means a request for payment of benefits under an in force policy regardless of whether the benefit claimed is covered under the policy or the terms or conditions of the policy have been met;
(3) denied" means the insurer refuses to pay a claim for a reason other than for claims not paid for failure to meet the waiting period or because of an applicable preexisting condition; and
(4) "report" means on a statewide basis.

3 AAC 28.563

Eff. 3/27/2022, Register 241, April 2022

Authority:AS 21.06.090

AS 21.53.020

AS 21.53.030

AS 21.53.050

AS 21.53.090