(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 such benefits shall be
determined in accordance with 33-2-523, MCA. Claim reserves must
also be established in the case when such policy or rider is in claim status.
(2) 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.
(3) 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 of 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.
(4) Any applicable valuation morbidity table shall be�certified
as appropriate as a statutory valuation table by a member
of the American academy of actuaries.
(5) When long-term care benefits are provided other than as in
(1) above, reserves shall be determined as acceptable to the
commissioner of insurance.
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