BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                   AB 999|
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                                 THIRD READING


          Bill No:  AB 999
          Author:   Yamada (D)
          Amended:  8/23/12 in Senate
          Vote:     21

           
           SENATE INSURANCE COMMITTEE  :  5-3, 6/13/12
          AYES:  Calderon, Corbett, Correa, Lieu, Lowenthal
          NOES:  Gaines, Anderson, Wyland
          NO VOTE RECORDED:  Price
           
          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8
           
          ASSEMBLY FLOOR  :  42-33, 6/1/11 - See last page for vote


           SUBJECT  :    Long-term care insurance

           SOURCE  :     Department of Insurance


           DIGEST  :    This bill revises long-term care (LTC) insurance 
          oversight to enhance consumer information and revise rate 
          calculation requirements.   

           Senate Floor Amendments  of 8/23/12 provide the Insurance 
          Commissioner (Commissioner) with greater flexibility 
          relating to the LTC insurance rate review process for 
          proposed rate increase filings.

           ANALYSIS  :    

          Existing law:
                                                           CONTINUED





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          1. Provides for the regulation of insurers by the 
             Department of Insurance (CDI), including insurers 
             issuing policies of LTC insurance.

          2. Regulates the marketing or solicitation of LTC insurance 
             policies and, in that regard, requires specified 
             disclosures to prospective applicants or enrollees.

          3. Requires the Commissioner to annually prepare a consumer 
             rate guide for LTC insurance and to include specified 
             information.

          4. Requires the premium rate schedules for all individual 
             and group LTC insurance policies issued in this state to 
             be filed with, and receive the prior approval of, the 
             Commissioner before the policy may be offered, sold, 
             issued, or delivered to a resident of this state. 

          5. Requires an insurer of LTC insurance to submit to the 
             Commissioner for approval all proposed premium rate 
             schedule increases and to include specified information 
             with the rate application.  Approval of all premium rate 
             schedule increases is subject to specified criteria.

          This bill:

          1. Requires an insurer of LTC insurance to clearly post on 
             its Internet Web site and provide written notice at the 
             time of solicitation that a specimen individual policy 
             form or group master policy and certificate form for 
             each policy form offered by the insurer is available 
             upon request and to provide that form within 15 calendar 
             days upon request.

          2. Requires the annual consumer rate guide to include a 
             specimen outline of coverage for each product currently 
             marketed by each insurer listed in the rate guide.

          3. Provides that if the premiums in any rate revision 
             filing calculated pursuant to those criteria produce a 
             lifetime expected loss ratio that is less than the 
             highest lifetime expected loss ratio for the policy form 
             in the initial filing or for requested premium rates in 







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             any filing made after January 1, 2013, the insurer would 
             be required to reduce the premiums in that filing such 
             that the current lifetime expected loss ratio is equal 
             to or greater than the highest filed loss ratio, as 
             specified. 

          4. Sets forth criteria for calculating the margin in the 
             determination of a lifetime expected loss ratio.

          5. Prohibits, for those policies, an insurer from 
             justifying a rate increase prior to approval by the 
             Commissioner based upon asset investment yield rate 
             changes, except as specified, and requires all of the 
             experience on all similar LTC policy forms issued by an 
             insurer and its affiliates and retained within the 
             affiliated group to be pooled together and used as the 
             basis for determining whether an increase is reasonable 
             or shall be approved under specified provisions. 

          6. Requires similar LTC policy forms to be classified into 
             benefit classifications of nursing facility and 
             residential care facility only, home care only, or 
             comprehensive LTC benefits.

          7. Allows the Commissioner to approve a rate increase, or a 
             series of increases over a set schedule, without 
             submission of certification under Insurance Code (IC) 
             Section 10236.13(a) by the insurer's actuary only if the 
             Commissioner determines that accepting a lower premium 
             rate schedule increase or increases is in the best 
             interest of California policyholders, the insurer makes 
             certain disclosures as specified, and the premium rate 
             schedule complies with the other requirements of IC 
             Sections 10236.14 (based on the information in the 
             actuarial memorandum).

          8. Provides that the Commissioner must condition the 
             approval of proposed rate increases on the 
             administration of a contingent benefit on lapse, unless 
             that condition threatens the insurer's financial 
             condition as specified.  That is, if the insurer 
             increases the premium above a defined threshold, the 
             insured has the option to convert the coverage to 
             paid-up coverage with a new maximum lifetime benefit 







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             equal to the amount of premiums paid for the coverage.  
             The insured will not lose all coverage, but the lifetime 
             benefit will be reduced proportionally.  If the 
             Commissioner approves an incremental series of 
             increases, the qualification point for the contingent 
             benefit may be delayed because of the schedule.  

          9. Provides that the insured qualifies for the contingent 
             benefit upon the first increase in an approved series 
             based on the sum of the scheduled increases.

          10.Requires the rate filings to comply with the requirement 
             for the Personal Worksheet related to suitability 
             standards pursuant to IC Section 10234.95 and the 
             Long-term Care Insurance Rate Guide pursuant to IC 
             Section 10234.6.

          11.Provides that if the insurer seeks a lesser increase, 
             the lifetime anticipated loss ratio for a policy form 
             will be calculated using the total filed rate schedule 
             increase or series of increases, even if future 
             increases are not approved.

           Background 
           
           The LTC marketplace  .  LTC insurance is a relatively new, 
          albeit very important, insurance product.  As life 
          expectancies have increased, a growing number of people 
          find the need to have late-in-life LTC services, which can 
          be very expensive.  Thus, an insurance product to help pay 
          for these expenses has developed.  But LTC insurance is 
          different in many ways from most other insurance products.  
          While it is possible that a catastrophic event will result 
          in LTC needs in the early years of a policy, the general 
          expectation is that a policyholder will pay premiums for 
          many years before ever needing to make a claim.  The 
          incentive to pay premiums for many years before needing the 
          insurance is based on the pricing mechanism that rewards 
          those who purchase during their relatively younger, 
          healthier years.  As people age, and begin to have health 
          problems, they either face extremely high premiums or do 
          not qualify at all for this type of insurance.

          The nature of LTC insurance - the expectation that claims 







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          will occur only years in the future - has made predicting 
          what the claim costs will be very difficult.  It is widely 
          accepted that the insurance industry struggled in the early 
          development of LTC policies to analyze the potential for 
          future losses.  In retrospect, many factors can be seen as 
          rendering that process difficult:  increasing life 
          expectancies; life extending technology; faulty assumptions 
          on lapse ratios; and even basic predictions about what 
          nursing home care would cost.  The result was that early 
          LTC buyers who bought policies they could afford faced 
          sharp and repeated premium increases as a clearer 
          understanding of expected loss costs emerged. 

          The industry and regulators in the late 1990s began to 
          address these problems by adopting new rate-making rules.  
          These rules have been termed "rate stabilization."  
          Policies sold pre-2002-03 are termed "pre-stabilization" 
          policies, and policies sold since then are termed 
          "post-stabilization" policies.  According to the author and 
          sponsor, the CDI, the post-stabilization reforms have not 
          worked well, and the same issues that plagued the 
          pre-stabilization market continue to plague the 
          post-stabilization market.  

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  6/26/12)

          Department of Insurance (source)
          Alzheimer's Association, California Council  
          California Nurses Association   
          California Professional Firefighters 
          California School Employees Association, AFL-CIO  
          Consumer Federation of California  


           ASSEMBLY FLOOR  :  42-33, 6/1/11
          AYES:  Alejo, Allen, Ammiano, Atkins, Beall, Block, 
            Blumenfield, Bonilla, Bradford, Brownley, Butler, Campos, 
            Carter, Cedillo, Chesbro, Davis, Dickinson, Eng, Feuer, 
            Fong, Furutani, Gordon, Hall, Hayashi, Roger Hern�ndez, 
            Hueso, Huffman, Lara, Bonnie Lowenthal, Ma, Mendoza, 
            Mitchell, Monning, Portantino, Skinner, Solorio, Swanson, 







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            Torres, Wieckowski, Williams, Yamada, John A. P�rez
          NOES:  Achadjian, Bill Berryhill, Buchanan, Charles 
            Calderon, Conway, Cook, Donnelly, Fletcher, Beth Gaines, 
            Garrick, Gatto, Grove, Hagman, Halderman, Harkey, Hill, 
            Huber, Jeffries, Jones, Knight, Logue, Mansoor, Miller, 
            Morrell, Nestande, Nielsen, Norby, Olsen, Perea, Silva, 
            Smyth, Valadao, Wagner
          NO VOTE RECORDED:  Fuentes, Galgiani, Gorell, Pan, V. 
            Manuel P�rez


          JJA:k  8/24/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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