Section R590-148-22 - Loss Ratio(1) This section applies to all individual long-term care insurance policies except those covered in Sections R590-148-21 and R590-148-24.(2) Benefits under an individual policy are considered reasonable in relation to the premium if the expected loss ratio is at least 60%, calculated in a manner that provides for adequate reserving of the long-term care insurance risk.(3) In evaluating the expected loss ratio, consideration shall be given to each relevant factor, including: (a) statistical credibility of incurred claims experience and earned premiums;(b) the period that rates are computed to provide coverage;(c) experienced and projected trends;(d) concentration of experience within early policy duration;(e) expected claim fluctuation;(f) experience refunds, adjustments, or dividends;(g) renewability features;(h) all appropriate expense factors;(j) experimental nature of the coverage;(l) mix of business by risk classification; and(m) product features such as long elimination periods, high deductibles, and high maximum limits.(4) The premium charged to an insured may not increase due to: (a) the increasing age of the insured at an age beyond 65; or(b) the duration the insured has been covered under the policy.(5) Rate filing documents shall contain the information required in Section R590-85-4.Utah Admin. Code R590-148-22
Adopted by Utah State Bulletin Number 2024-21, effective 10/22/2024