Section R590-148-25 - Reporting Requirements(1)(a) An insurer shall maintain records for each producer detailing the:(i) producer's number of replacement sales as a percent of the agent's total annual sales; and(ii) amount of lapses of long-term care insurance policies sold by the producer as a percent of the producer's total annual sales.(b) An insurer shall report the 10% of its producers with the greatest percentage of lapses and replacements under Subsection (1)(a).(c) An insurer shall report the number of:(i) 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; and(ii) 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 end of the preceding calendar year.(d) The reports required by this subsection shall be reported on the Replacement and Lapse Reporting Form.(e) Reported replacement and lapse rates do not, by themselves, constitute a violation of Utah laws nor do they necessarily imply wrongdoing. The reports are for reviewing producer activities regarding the sale of long-term care insurance.(2)(a) An insurer shall report, for qualified long-term care insurance contracts, the number of claims denied for each class of business, expressed as a percentage of claims denied.(b) The report shall include, at a minimum, the information contained in the Claims Denial Reporting Form Long-Term Care Insurance.(3) An insurer shall maintain a record of each policy or certificate rescission, both state and nationwide, except those the insured voluntarily effectuated, and shall annually report this information on the Rescission Reporting Form.(4)(a) An insurer shall report the total number of applications received from Utah residents, the number of those who declined to provide information on the personal worksheet, the number of applicants who did not meet the suitability standards, and the number of those who chose to confirm after receiving a suitability letter.(b) The report shall be submitted on the Suitability Reporting Form.(5) For purposes of this section: (a) "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 any terms or conditions of the policy have been met;(b) "denied" means that an insurer refused to pay a claim for any reason other than for claims not paid for failure to meet a waiting period or due to a preexisting condition; and(c) "report" means a report filed on a statewide basis.(6) A report required under this section shall be filed with the commissioner annually on or before June 30 and in compliance with Rule R590-220.Utah Admin. Code R590-148-25
Adopted by Utah State Bulletin Number 2024-21, effective 10/22/2024