This is the Final Public Hearing on the adoption of proposed amendments to Rule 69O-157.302,.303,.304, Florida Administrative Code, published on May 30, 2008 in Vol. 34, No. 22, of the Florida Administrative Weekly.; August 12, 2008, 9:00 a.m.; ...

 

DEPARTMENT OF FINANCIAL SERVICES
OIR – Insurance Regulation

RULE NO: RULE TITLE
69O-157.301: Rate Increase Standards
69O-157.302: Facility Only Rates
69O-157.303: Home Health Care Only Rates
69O-157.304: Comprehensive Only Rates

The Financial Services Commission, Office of Insurance Regulation announces a hearing to which all persons are invited.

DATE AND TIME: August 12, 2008, 9:00 a.m.

PLACE: Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, Florida

GENERAL SUBJECT MATTER TO BE CONSIDERED: This is the Final Public Hearing on the adoption of proposed amendments to Rules 69O-157.302, .303, .304, Florida Administrative Code, published on May 30, 2008 in Vol. 34, No. 22, of the Florida Administrative Weekly.

A copy of the agenda may be obtained by contacting: Governor and Cabinet Website at http://www.myflorida.com/myflorida/cabinet/mart.html. The agenda should be available approximately one week before the cabinet meeting.

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Gerry Smith at e-mail [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

For more information, you may contact Gerry Smith at e-mail [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

69O-157.301 Rate Increase Standards.

(1) Rate increase filings for long term care insurance shall be filed in accordance with filing requirements and standards of Rule Chapters 69O-149 and 69O-157, F.A.C.

(2) The term “policies with similar coverage” has the same meaning as “similar policy forms” as defined in subsection 69O-157.103(17), F.A.C.

(3) The footnote following Section 627.9407, F.S., states that Section 11, Ch. 2006-254, L.O.F., provides that “[t]his act shall apply to long-term care insurance policies issued or renewed on or after July 1, 2006. For any long-term care insurance policy issued prior to July 1, 2006, the provisions of [Section 627.94076, F.S.] shall apply to such policy only upon renewal of such policy on or after July 1, 2008, and the policy shall so provide by endorsement to the policy.”

(4) Pursuant to the provisions of Section 627.9407(7)(c), F.S., for insurers that are currently actively marketing and issuing similar coverage, the rates resulting after a rate increase filing shall not exceed the insurer’s new business rate.

(5)(a) Section 627.9407(7)(c), F.S., requires that the office annually determine and publish the currently available new business rates for similar coverage being sold in Florida. The published new business rates represent the maximum annual rate that may be charged after a rate increase for insurers not currently issuing new coverage.

(b) The published rates shall be determined by first identifying those carriers currently issuing policies with similar coverage. For each of the similar coverage categories, the Florida new business earned premium, defined as first year premium in Florida, is determined for the prior calendar year. Those insurers reporting at least the top 80% of that earned premium, cumulatively, starting with the largest, will be used to tabulate the new business rate. The new business rate shall be the weighted average of the insurers’ rates, using the market share, as measured by first year premium in Florida, as the weight.

(c)1. The new business rates are for the standard underwriting class for the insurer. Standard underwriting class is the underwriting class with the most predominant sales, measured by number of policies, regardless of the name given to it by the insurer.

2. The new business rates for other underwriting classes, as well as for more liberal or more restrictive standards for benefit triggers as defined by Section 627.94074, F.S., or area factors, shall bear the same relationship to the standard rate schedules that the insurer has filed and approved. For example, if an insurer’s preferred rate is 85% of its standard rate, the premium limit applicable to the rate increase for business sold as preferred will be 85% of the standard rate schedule.

(d)1. The published new business rates represent the particular benefit configuration listed. If an insurer has policies in force that have benefits different from the benefit used to determine the published rates, including differences in benefit triggers, the insurer may contact the office for the new business rate that reflect the different benefits.

2. The office shall determine the new business rates for the requested benefit configuration in the same manner as it used for determining the published rates. The resulting rates shall be consistent with the published new business rates reflecting benefit differences only.

3. Insurers needing a different benefit configuration should make such request of the office in advance of a rate filing so as to give the office time to determine such rates and provide them to the insurer.

4. If the office is unable to determine the rates by a tabulation of the insurers currently selling similar coverage, the office shall use its best actuarial judgment in determining the new business rates using the information available from the insurers in the 80% market share. Alternatively in such cases, If the Office is unable to determine the new business rates based on the above procedures, at the option of the insurer, the insurer may, at its option, submit the results of a model used to price new long term care products by an actuarial consulting firm currently pricing long term care for other clients, who is independent of the insurer, acceptable to the office, and contracted by the insurer. The assumptions used shall be available to the office for review and approval. The model will be used to develop the new business pricing for the insurer’s policy benefit configuration, the new business pricing for the published benefit configuration, and to develop a factor which is the ratio of the insurer’s policy benefits to the published benefits. It is noted that the provisions of Section 627.9407(7)(c), F.S., provide that the differences shall be benefit differences only; all other provisions of the two policies being modeled shall be identical. Such factor, representing benefit differences only, shall be used to adjust the published new business rates. Independent, as used in this section, shall mean that the actuarial consulting firm or the actuary to be involved in the project has no relationship currently or for the last three years with the insurers for pricing, valuation, or other reviews.

(e) If the application of this rule results in different increases being applied to different plans within the filing, the requirements of subparagraph 69O-149.003(1)(a)4., F.A.C. shall apply.

(f) The published rates apply to sales in Hillsborough County. For all other counties, the rate from the published table should be adjusted by the insurer’s current area factor applicable in that county relative to the insurer’s area factor in Hillsborough County.

(f)(g) The premium for all additional benefits provided in the policy or by rider to the policy shall be the same proportion of the base rates after any rate change as they were before such change.

Specific Authority 627.9408(1) FS. Law Implemented 627.9407(7) FS. History–New 11-1-07.

 

69O-157.302 Facility Only Rates.

(1) The footnote following Section 627.9407, F.S., states that Section 11, Ch. 2006-254, L.O.F., provides that “[t]his act shall apply to long-term care insurance policies issued or renewed on or after July 1, 2006. For any long-term care insurance policy issued prior to July 1, 2006, the provisions of [Section 627.94076, F.S.] shall apply to such policy only upon renewal of such policy on or after July 1, 2008, and the policy shall so provide by endorsement to the policy.”

(2) The following maximum new business rates are effective for 2006 rate increase filings and for 20087 and later rate filings until new rates are published: These annual rates are appropriate for:

(a) Tax qualified policies;

(b) A benefit of $100/day;

(c) An elimination period of 90 days.

(d) Policies offering Restoration of Benefits, and

(e) Sales in Hillsborough County. For all other counties, the rate from this table should be adjusted by the insurer’s current area factor applicable in that county relative to the insurer’s area factor in Hillsborough County

(f) Insurers who did not use area factors in the closed blocks for which a rate change is being requested may calculate the new business rate as a weighted average of the Hillsborough and the South Florida area factors, where the weights used are in-force premium by county. For the purposes of this calculation, the South Florida area factors are those that apply in Broward, Duval and Palm Beach county. The South Florida area factor is equal to 1.00.

(3)(a) Facility Only Rates:

Issue Age3-Yr. Benefit5-Yr. BenefitUnlimited Benefit

PeriodPeriodPeriod

30$284.03$350.92$459.40

31$287.49$356.69$468.20

32$291.06$362.46$477.10

33$294.63$368.43$486.30

34$298.31$374.41$495.60

35$301.98$380.48$505.10

36$305.97$386.97$514.70

37$310.07$393.46$524.50

38$314.16$400.05$534.50

39$318.36$406.75$544.70

40$322.67$413.65$555.00

41$326.97$420.55$565.60

42$331.28$427.66$576.40

43$335.69$434.87$587.40

44$340.20$442.18$598.60

45$344.72$449.60$610.00

46$350.81$458.76$623.20

47$357.00$468.14$636.70

48$363.30$477.71$650.50

49$369.71$487.50$664.60

50$376.22$497.49$679.00

51$382.83$507.69$693.80

52$389.55$518.09$708.80

53$396.38$528.70$724.20

54$403.41$539.51$739.90

55$410.55$550.54$755.90

56$440.48$588.75$809.80

57$472.61$629.64$867.50

58$507.05$673.31$929.30

59$543.90$720.07$995.50

60$583.59$770.03$1,066.40

61$626.12$823.49$1,142.40

62$671.79$880.65$1,223.80

63$733.74$962.95$1,339.80

64$801.47$1,052.97$1,466.80

65$865.58$1,126.68$1,569.48

66$934.83$1,216.81$1,679.34

67$1,009.62$1,314.16$1,796.89

68$1,090.38$1,419.29$1,930.23

69$1,211.81$1,547.81$2,150.64

70$1,340.75$1,729.87$2,396.25

71$1,540.77$1,933.44$2,669.85

72$1,735.55$2,160.93$2,974.77

73$1,924.97$2,433.75$3,335.67

74$2,109.14$2,740.95$3,740.31

75$2,346.15$3,087.00$4,194.18

76$2,642.60$3,476.81$4,702.95

77$2,976.56$3,915.74$5,273.55

78$3,282.46$4,316.20$5,783.13

79$3,619.73$4,757.64$6,342.03

80$3,991.68$5,244.13$6,954.93

81$4,401.81$5,867.91$7,804.10

82$4,854.18$6,530.20$8,685.00

83$5,343.31$7,198.98$9,574.40

84$5,881.77$7,874.25$10,472.40

85$6,474.57$8,556.00$11,379.10

86$7,127.00$9,704.97$12,907.30

87$7,845.30$10,842.09$14,419.60

88$8,524.85$11,967.26$15,916.00

89$9,263.27$13,080.28$17,396.40

Issue Age3-Yr. Benefit5-Yr. BenefitUnlimited Benefit

PeriodPeriodPeriod

35$247.43$302.74$378.50

45$363.53$446.70$555.75

55$522.32$646.08$810.43

65$1,126.33$1,406.97$1,750.61

75$3,073.57$3,879.00$4,769.07

(b) The insurers used to tabulate the above rates are:

InsurerWeighing Percentage

Bankers Life & Casualty Company90.3%

Metropolitan Life Insurance25.5%

Company

Penn Treaty Network America74.5% 9.7%

Insurance Company

Specific Authority 627.9408(1) FS. Law Implemented 627.9407(7) FS. History–New 11-1-07.

 

69O-157.303 Home Health Care Only Rates.

(1) The footnote following Section 627.9407, F.S., states that Section 11, Ch. 2006-254, F.S., provides that “[t]his act shall apply to long-term care insurance policies issued or renewed on or after July 1, 2006. For any long-term care insurance policy issued prior to July 1, 2006, the provisions of [Section 627.94076, F.S.] shall apply to such policy only upon renewal of such policy on or after July 1, 2008, and the policy shall so provide by endorsement to the policy.”

(2) The following maximum new business rates are effective for 2006 rate increase filings and for 20087 and later rate filings until new rates are published. These annual rates are appropriate for:

(a) Tax qualified policies;

(b) A benefit of $100/day;

(c) An elimination period of 90 days;

(d) Policies offering Restoration of Benefits, and

(e) Sales in Hillsborough County. For all other counties, the rate from this table should be adjusted by the insurer’s current area factor applicable in that county relative to the insurer’s area factor in Hillsborough County

(f) Insurers who did not use area factors in the closed blocks for which a rate change is being requested may calculate the new business rate as a weighted average of the Hillsborough and the South Florida area factors, where the weights used are in-force premium by county. For the purposes of this calculation, the South Florida area factors are those that apply in Broward, Duval and Palm Beach county. The South Florida area factor is equal to 1.30.

(3)(a) Home Health Care Only Rates:

Issue Age3-Yr. Benefit5-Yr. BenefitUnlimited Benefit

PeriodPeriodPeriod

30$269.87$312.28$349.95

31$269.87$312.28$349.95

32$269.87$312.28$349.95

33$269.87$312.28$349.95

34$269.87$312.28$349.95

35$289.72$338.50$387.94

36$289.72$338.50$387.94

37$289.72$338.50$387.94

38$289.72$338.50$387.94

39$289.72$338.50$387.94

40$322.79$378.01$432.23

41$322.79$378.01$432.23

42$322.79$378.01$432.23

43$322.79$378.01$432.23

44$322.79$378.01$432.23

45$369.28$443.74$508.03

46$369.28$443.74$508.03

47$369.28$443.74$508.03

48$369.28$443.74$508.03

49$369.28$443.74$508.03

50$419.54$503.66$578.79

51$432.77$523.33$597.70

52$452.62$536.43$623.00

53$465.85$562.65$648.29

54$485.87$582.50$673.50

55$529.97$636.44$726.61

56$556.75$663.03$768.52

57$590.32$699.83$810.60

58$630.64$749.93$865.74

59$670.96$796.74$921.05

60$708.00$853.39$976.28

61$754.93$903.67$1,034.35

62$802.05$956.95$1,095.97

63$865.99$1,040.67$1,184.05

64$933.27$1,124.47$1,281.90

65$1,010.63$1,214.83$1,376.28

66$1,087.98$1,301.72$1,476.97

67$1,165.25$1,398.64$1,583.96

68$1,262.76$1,515.59$1,707.65

69$1,366.99$1,642.56$1,844.12

70$1,477.73$1,772.81$1,986.80

71$1,595.09$1,912.89$2,135.79

72$1,712.46$2,056.24$2,297.47

73$1,840.71$2,204.01$2,445.41

74$1,968.78$2,355.32$2,599.83

75$2,106.93$2,516.29$2,763.85

76$2,248.33$2,680.72$2,930.87

77$2,389.72$2,848.23$3,104.12

78$2,571.75$3,056.67$3,308.54

79$2,753.77$3,268.58$3,519.36

80$2,949.12$3,483.48$3,726.71

81$3,151.09$3,715.14$3,950.13

82$3,359.66$3,949.80$4,179.86

83$3,571.71$4,188.29$4,410.21

84$3,793.92$4,433.35$4,656.64

85$4,025.90$4,688.13$4,899.59

86$4,267.96$4,952.94$5,158.79

87$4,513.17$5,224.30$5,420.66

88$4,885.73$5,633.61$5,792.96

89$5,261.44$6,049.38$6,171.47

 

Issue Age3-Yr. Benefit5-Yr. BenefitUnlimited Benefit

PeriodPeriodPeriod

35$166.18$203.65$242.26

45$245.38$306.44$366.65

55$369.58$455.50$548.26

65$691.78$836.06$989.23

75$1,318.83$1,520.52$1,702.93

(b) The insurers used to tabulate the above rates are:

InsurerWeighing Percentage

Bankers Life & Casualty Company79.2% 97.2%

Colonial American Life Insurance20.8% 2.3%

Company

Penn Treaty Network America0.5%

Insurance Company

Specific Authority 627.9408(1) FS. Law Implemented 627.9407(7) FS. History–New 11-1-07.

 

69O-157.304 Comprehensive Only Rates.

(1) The footnote following Section 627.9407, F.S., states that Section 11, Ch. 2006-254, L.O.F., provides that “[t]his act shall apply to long-term care insurance policies issued or renewed on or after July 1, 2006. For any long-term care insurance policy issued prior to July 1, 2006, the provisions of [Section 627.94076, F.S.] shall apply to such policy only upon renewal of such policy on or after July 1, 2008, and the policy shall so provide by endorsement to the policy.”

(2) The following maximum new business rates are effective for 2006 rate increase filings and for 20087 and later rate filings until new rates are published. These annual rates are appropriate for:

(a) Tax qualified policies;

(b) A benefit of $100/day;

(c) An elimination period of 90 days;

(d) Policies offering Restoration of Benefits, and

(e) Sales in Hillsborough County. For all other counties, the rate from this table should be adjusted by the insurer’s current area factor applicable in that county relative to the insurer’s area factor in Hillsborough County.

(f) Insurers who did not use area factors in the closed blocks for which a rate change is being requested may calculate the new business rate as a weighted average of the Hillsborough and the South Florida area factors, where the weights used are in-force premium by county. For the purposes of this calculation, the South Florida area factors are those that apply in Broward, Duval and Palm Beach county. The South Florida area factor is equal to 1.00.

(3)(a) Comprehensive Only Rates:

Issue Age3-Yr. Benefit5-Yr. BenefitUnlimited Benefit

PeriodPeriodPeriod

30$357.66$452.19$592.98

31$359.27$454.73$596.13

32$360.91$457.15$599.55

33$362.81$467.83$610.09

34$372.25$470.36$613.92

35$392.37$485.24$646.03

36$394.19$495.83$656.91

37$396.24$498.95$660.88

38$398.57$501.94$664.98

39$408.46$505.21$669.38

40$422.18$538.84$704.43

41$426.52$542.98$711.03

42$430.28$547.83$717.94

43$434.51$552.75$733.25

44$445.46$558.21$740.15

45$457.15$588.24$767.35

46$469.07$593.07$782.73

47$474.02$599.22$790.99

48$479.33$605.50$799.51

49$492.01$611.69$822.72

50$502.21$631.63$839.32

51$518.00$648.72$859.73

52$533.51$674.20$887.15

53$550.58$693.44$918.49

54$568.09$721.86$949.96

55$588.25$733.65$980.98

56$626.56$787.13$1,040.83

57$661.34$841.03$1,109.08

58$705.13$905.55$1,179.64

59$741.88$954.58$1,260.83

60$795.99$1,022.36$1,336.52

61$852.97$1,093.08$1,431.38

62$919.59$1,166.20$1,537.41

63$991.75$1,254.51$1,661.23

64$1,059.64$1,337.42$1,777.18

65$1,130.19$1,414.66$1,895.31

66$1,239.89$1,554.84$2,083.84

67$1,369.00$1,719.56$2,290.03

68$1,512.16$1,894.92$2,524.36

69$1,651.51$2,086.98$2,776.71

70$1,802.07$2,295.68$3,049.92

71$2,041.92$2,572.02$3,414.19

72$2,293.64$2,876.35$3,811.27

73$2,557.01$3,196.06$4,229.60

74$2,833.53$3,547.08$4,682.75

75$3,132.41$3,931.85$5,162.40

76$3,519.05$4,396.08$5,779.67

77$3,925.72$4,914.88$6,453.45

78$4,344.97$5,450.22$7,131.36

79$4,779.15$5,988.95$7,829.68

80$5,206.95$7,201.34$9,704.96

81$5,695.37$7,855.63$10,582.32

82$6,200.20$8,560.10$11,522.41

83$6,772.84$9,335.36$12,551.65

84$7,380.07$10,190.80$13,680.13

85$8,971.35$11,276.50$15,228.74

86$10,532.62$13,010.62$17,716.18

87$11,566.04$14,303.82$19,459.57

88$12,659.68$15,643.72$21,277.97

89$13,799.95$17,046.75$23,185.77

Issue Age3-Yr. Benefit5-Yr. BenefitUnlimited Benefit

PeriodPeriodPeriod

35$332.88$414.10$574.47

45$474.36$592.44$822.62

55$666.65$824.77$1,151.34

65$1,313.19$1,640.75$2,259.55

75$3,288.22$4,210.08$5,603.51

(b) The insurers used to tabulate the above rates are:

InsurerWeighing Percentage

Allianz Life Insurance Company of3.3%

North America

Bankers Life & Casualty Insurance4.1% 52.7%

Company

Blue Cross Blue Shield of Florida8.1% 5.1%

Genworth Life Insurance Company23.3% 11.5%

Great American Life Insurance9.8%

Company

John Hancock Life Insurance25.5% 14.2%

Company

Metropolitan Life Insurance20.5% 6.7%

Company

New York Life Insurance Company3.0%

Northwestern Long Term Care3.6%

Insurance Company

Provident Life & Accident Insurance3.1%

Company

Unum Life Insurance Company of5.5%

America

Specific Authority 627.9408(1) FS. Law Implemented 627.9407(7) FS. History–New 11-1-07.