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



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



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



(2)  An actuarial certification consisting of at least
the following:



(A)  A statement that the initial premium rate
schedule is sufficient to cover anticipated costs under moderately adverse
experience and that the premium rate schedule is reasonably expected to be
sustainable over the life of the form with no future premium increases
anticipated;



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



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



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



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



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



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



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



(E)  With respect to premium rate schedules:



(i)  A statement that the premium rate schedule
is not less than the premium rate schedule for existing similar policy forms
also available from the insurer except for reasonable differences attributable
to benefits; or



(ii)  A comparison of the premium schedules for
similar policy forms that are currently available from the insurer with an
explanation of the differences.



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