WAC 284-16-500: Specific minimum morbidity standards for individual disability contracts

Link to law: http://apps.leg.wa.gov/wac/default.aspx?cite=284-16-500
Published: 2015

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WACs > Title 284 > Chapter 284-16 > Section 284-16-500











284-16-490    

284-16-510







No agency filings affecting this section since 2003







WAC 284-16-500









Specific minimum morbidity standards for individual disability contracts.









(1) Disability income benefits due to accident or sickness.
(a) Contract reserves for:
(i) Contracts issued on or after January 1, 1967, and prior to January 1, 1986: The 1964 Commissioners Disability Table (64 CDT).
(ii) Contracts issued on or after January 1, 1993: The 1985 Commissioners Individual Disability Tables A (85CIDA); or The 1985 Commissioners Individual Disability Tables B (85CIDB).
(iii) Contracts issued during 1986 through December 31, 1992: Optional use of either the 1964 Table or the 1985 Tables.
(iv) Each insurer shall elect, with respect to all individual contracts issued in any one statement year, either it will use Tables A or Tables B as the minimum standard. The insurer may, however, elect to use the other tables with respect to any subsequent statement year.
(b) Claim reserves: The minimum morbidity standard in effect for contract reserves on currently issued contracts, as of the date the claim is incurred.
(2) Hospital benefits, surgical benefits and maternity benefits (scheduled benefits or fixed time period benefits only).
(a) Contract reserves for:
(i) Contracts issued on or after January 1, 1967, and before January 1, 1986: The 1956 Intercompany Hospital-Surgical Tables.
(ii) Contracts issued on or after January 1, 1993: The 1974 Medical Expense Tables, Table A, Transactions of the Society of Actuaries, Volume XXX, pg. 63. Refer to the paper (in the same volume, pg. 9) to which this table is appended, including its discussions, for methods of adjustment for benefits not directly valued in Table A: "Development of the 1974 Medical Expense Benefits," Houghton and Wolf.
(iii) Contracts issued during 1986 through December 31, 1992: Optional use of the 1974 Medical Expense Tables.
(b) Claim reserves: No specific standards. See subsection (5) of this section.
(3) Cancer expense benefits (scheduled benefits or fixed time period benefits only).
(a) Contract reserves for:
(i) Contracts issued on or after January 1, 1993: The 1985 NAIC Cancer Claim Cost Tables.
(ii) Contracts issued during 1986 through December 31, 1992: Optional use of the 1985 NAIC Cancer Claim Cost Tables.
(b) Claim reserves: No specific standard. See subsection (5) of this section.
(4) Accidental death benefits.
(a) Contract reserves for contracts issued on or after January 1, 1967: The 1959 Accidental Death Benefits Table.
(b) Claim reserves: Actual amount incurred.
(5) Other individual contract benefits.
(a) Contract reserves: For all other individual contract benefits, morbidity assumptions are to be determined using tables established for reserve purposes by a qualified actuary and acceptable to the commissioner.
(b) Claim reserves: For all benefits other than disability, claim reserves are to be based on the insurer's experience, if such experience is considered credible, or upon other assumptions designed to place a sound value on the liabilities.
[Statutory Authority: RCW 48.02.060. WSR 92-19-038 (Order R 92-8), § 284-16-500, filed 9/9/92, effective 10/10/92.]