Section 26-A2605. REQUIRED DISCLOSURE OF RATING PRACTICES TO CONSUMERS

 

2605.1Except as provided in subsection 2605.2, this section applies to any long term care policy or certificate issued in the District of Columbia on or after six (6) months after adoption of the amended regulation.

 

2605.2For certificates issued on or after the effective date of this amended regulation under a group long-term care insurance policy as defined in D.C. Official Code § 31-4601(4), which policy was in force at the time this amended regulation became effective, the provisions of this section shall apply on the policy anniversary following twelve (12) months after adoption of the amended regulation.

 

2605.3Other than policies for which no applicable premium rate or rate schedule increase can be made, insurers shall provide all of the following information in this subsection to the applicant at the time of application or enrollment, unless the method of application does not allow for delivery at this time, in which case, an insurer shall provide all of the following information in this section to the applicant no later than at the time of delivery of the policy or certificate:

 

(a)A statement that the policy may be subject to rate increases in the future;

 

(b)An explanation of potential future premium rate revisions, and the policyholder's or certificateholder's option in the event of a premium rate revision;

 

(c)The premium rate or rate schedules applicable to the applicant that will be in effect until a request is made for an increase;

 

(d)A general explanation for applying premium rate or rate schedule adjustments that shall include the following:

 

(1)A description of when premium rate or rate schedule adjustments will be effective (e.g. next anniversary date or next billing date); and

 

(2)The right to a revised premium rate or rate schedule as provided in paragraph (b) if the premium rate or rate schedule is changed;

 

(e)Information regarding each premium rate increase on this policy form or similar policy forms over the past ten (10) years for the District of Columbia or any other jurisdiction that, at a minimum which identifies the following:

 

(1)The policy forms for which premium rates have been increased;

 

(2)The calendar years when the form was available for purchase; and

 

(3)The amount or percent of each increase, expressed as a percentage of the premium rate prior to the increase, or expressed as minimum and maximum percentages if the rate increase is variable by rating characteristics;

 

(f)The insurer may provide in a fair manner, additional explanatory information related to the rate increase.

 

2605.4An insurer shall have the right to exclude from the disclosure premium rate increases that only apply to blocks of business acquired from other nonaffiliated insurers or the long-term care policies acquired from other nonaffiliated insurers when those increases occurred prior to the acquisition.

 

2605.5If an acquiring insurer files for a rate increase on a long term care policy form acquired from nonaffiliated insurers or a block of policy forms acquired from nonaffiliated insurers on or before the later of the effective date of this section or the end of a twenty-four (24) month period following the acquisition of the block of policies, the acquiring insurer may exclude that rate increase from the disclosure, However, the nonaffiliated selling company shall include the disclosure of that rate increase in accordance with subparagraph (e) of section 2605.3.

 

2605.6If the acquiring insurer in subsection 2605.2(e)(4) above files for a subsequent rate increase, even within the twenty-four (24) month period, on the same policy form acquired from nonaffiliated insurers or block of policy forms acquired from nonaffiliated insurers referenced in subsection 2605.2(e)(4), the acquiring insurer shall make all disclosures required by Section or subsection 2605.2 (e), including disclosure of the earlier rate increase referenced in subsection 2605.2(e).

 

2605.7An applicant shall sign an acknowledgement at the time of application, unless the method of application does not allow for signature at that time, that the insurer made the disclosure required under subsections 2605.2 (a) and 2605.2 (e). If due to the method of application the applicant cannot sign an acknowledgement at the time of application, the applicant shall sign no later than at the time of delivery of the policy or certificate.

 

2605.8An insurer shall use the forms in Appendices B and F to comply with the requirements of subsections 2605.1 and 2605.2 of this section.

 

2605.9An insurer shall provide notice of an upcoming premium rate schedule increase to all policyholders or certificateholders, if applicable, at least forty-five (45) prior to the implementation of the premium rate schedule increase by the insurer. The notice shall include the information required by subsection 2605 when the rate increase is implemented.

 

source

Final Rulemaking published at 52 DCR 10902 (December 16, 2005).