Tex.
Ins. Code Section 1651.053
Loss Ratio Standards
(a)
A long-term care benefit plan must provide a benefit plan holder with benefits that are reasonable in relation to the rates charged.(b)
The commissioner shall adopt reasonable rules to establish minimum standards for loss ratios of long-term care benefit plans on the basis of:(1)
incurred claims experience;(2)
earned premiums;(3)
the period for which rates are computed to provide coverage;(4)
experienced and projected trends;(5)
concentration of experience within early benefit plan duration;(6)
expected claim fluctuations;(7)
experience refunds;(8)
adjustments;(9)
dividends;(10)
renewability features;(11)
all relevant expense factors;(12)
interest;(13)
reserves;(14)
mix of business by risk classification; and(15)
product features otherwise affecting claims experience.(c)
Annually, each entity providing a long-term care benefit plan in this state shall:(1)
file its rates, rating schedule, and supporting documentation to demonstrate compliance with the applicable loss ratio standards of this state; and(2)
comply with any other filing requirement adopted by the commissioner relating to loss ratios.(d)
Rules adopted under this section shall be no less favorable to the holders of long-term care benefit plans than any model laws, rules, and regulations adopted in connection with minimum standards for benefits for long-term care benefit plans.
Source:
Section 1651.053 — Loss Ratio Standards, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1651.htm#1651.053 (accessed Jun. 5, 2024).
