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054.00.13-4. Definitions.

AR ADC 054.00.13-4Arkansas Administrative Code

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 13. Long Term Care Insurance
Ark. Admin. Code 054.00.13-4
054.00.13-4. Definitions.
Currentness
For the purpose of this rule, the terms “long-term care insurance,” “qualified long-term care insurance,” “group long-term care insurance,” “Commissioner,” “applicant,” “policy” and “certificate” shall have the meanings set forth in Ark. Code Ann. § 23-97-304. In addition, the following definitions apply.
A. (1) “Exceptional increase” means only those increases filed by an insurer as exceptional for which the Commissioner determines the need for the premium rate increase is justified:
(a) Due to changes in laws or rules applicable to long-term care coverage in this state; or
(b) Due to increased and unexpected utilization that affects the majority of insurers of similar products.
(2) Except as provided in Section 20 of this Rule, exceptional increases are subject to the same requirements as other premium rate schedule increases.
(3) The Commissioner may request a review by an independent actuary or a professional actuarial body of the basis for a request that an increase be considered an exceptional increase.
(4) The Commissioner, in determining that the necessary basis for an exceptional increase exists, shall also determine any potential offsets to higher claims costs.
B. “Incidental,” as used in Section 20(J) of this Rule, means that the value of the long-term care benefits provided is less than ten percent (10%) of the total value of the benefits provided over the life of the policy. These values shall be measured as of the date of issue.
C. “Insurer or Issuer” means any entity authorized to issue long-term care insurance pursuant to Ark. Code Ann. § 23-97-304(7)(C).
D. “Partnership policies or Partnership program” means those long-term care insurance policies that meet the requirements of the Federal Long-Term Care Partnership Program as authorized under the Deficit Reduction Act of 2005, Section 6021.
E. “Qualified actuary” means a member in good standing of the American Academy of Actuaries.
F. “Similar policy forms” means all of the long-term care insurance policies and certificates issued by an insurer in the same long-term care benefit classification as the policy form being considered. Certificates of groups that meet the definition in Ark. Code Ann. § 23-97-304(6) are not considered similar to certificates or policies otherwise issued as long-term care insurance, but are similar to other comparable certificates with the same long-term care benefit classifications. For purposes of determining similar policy forms, long-term care benefit classifications are defined as follows: institutional long-term care benefits only, non-institutional long-term care benefits only, or comprehensive long-term care benefits.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.13-4, AR ADC 054.00.13-4
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