§431:10H-226.5  Initial filingrequirements.  (a)  This section applies to any long-term care policyissued in this State after December 31, 2007.

(b)  An insurer shall provide the informationlisted in this subsection to the commissioner thirty days prior to making along-term care insurance form available for sale as follows:

(1)  A copy of the disclosure documents required insection 431:10H-217.5; and

(2)  An actuarial certification consisting of at leastthe following:

(A)  A statement that the initial premium rateschedule is sufficient to cover anticipated costs under moderately adverseexperience and that the premium rate schedule is reasonably expected to besustainable over the life of the form with no future premium increasesanticipated;

(B)  A statement that the policy design andcoverage provided have been reviewed and taken into consideration;

(C)  A statement that the underwriting andclaims adjudication processes have been reviewed and taken into consideration;

(D)  A complete description of the basis forcontract reserves that are anticipated to be held under the form, to include:

(i)  Sufficient detail or sample calculationsprovided so as to have a complete depiction of the reserve amounts to be held;

(ii)  A statement that the assumptions used forreserves contain reasonable margins for adverse experience;

(iii)  A statement that the net valuation premiumfor renewal years does not increase (except for attained-age rating wherepermitted); and

(iv)  A statement that the difference between thegross premium and the net valuation premium for renewal years is sufficient tocover expected renewal expenses; or if that statement cannot be made, acomplete description of the situations where this does not occur; provided thatan aggregate distribution of anticipated issues may be used as long as theunderlying gross premiums maintain a reasonably consistent relationship;provided further that if the gross premiums for certain age groups areinconsistent with this requirement, the commissioner may request ademonstration under subsection (c) based on a standard age distribution; and

(E)  With respect to premium rate schedules:

(i)  A statement that the premium rate scheduleis not less than the premium rate schedule for existing similar policy formsalso available from the insurer except for reasonable differences attributableto benefits; or

(ii)  A comparison of the premium schedules forsimilar policy forms that are currently available from the insurer with anexplanation of the differences.

(c)  The commissioner may request an actuarialdemonstration that benefits are reasonable in relation to premiums.  Theactuarial demonstration shall include either premium and claim experience onsimilar policy forms, adjusted for any premium or benefit differences, orrelevant and credible data from other studies, or both.  If the commissionerasks for additional information under this subsection, the period in subsection(b) does not include the period during which the insurer is preparing therequested information. [L 2007, c 233, pt of §4; am L 2009, c 49, §2]