North Carolina Administrative Code

11 NCAC 11E .0110 REDUCED INSTALLMENT PAYMENTS History Note: Filed as a Temporary Rule Eff. July 22, 1988 For a Period of 180 Days to Expire on January 18, 1989; Statutory Authority G.S. 105-228.5; Eff. January 1, 1989; Transferred & Recodified to 17 NCAC 5E .0101 Eff. January 15…

SECTION .0200 - FIRE AND CASUALTY: GENERAL NATURE 11 NCAC 11E .0201 GENERAL NATURE History Note: Authority G.S. 58-9 Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. April 1, 1993.

11 NCAC 11E .0202 TAX ON RECEIPTS FOR PREMIUMS History Note: Authority G.S. 58-2-40; 118-2; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Amended Eff. April 1, 1993; Transferred & Recodified to 17 NCAC 5E .0102 Eff. January 15, 1998.

11 NCAC 11E .0203 PREMIUM FINANCE CHARGES History Note: Authority G.S. 58-2-40; 105-228.5; Eff. April 1, 1993; Transferred & Recodified to 17 NCAC 5E .0103 Eff. January 15, 1998.

SECTION .0300 - LIFE: GENERAL NATURE 11 NCAC 11E .0301 GENERAL NATURE History Note: Authority G.S. 58-9; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. July 1, 1988.

11 NCAC 11E .0302 DIVIDENDS APPLIED TO PURCHASE ADDITIONAL PAID-UP LIFE History Note: Authority G.S. 105-228.5; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Transferred & Recodified to 17 NCAC 5E .0104 Eff. January 15, 1998.

11 NCAC 11E .0303 PREMIUM TAXES ON ANNUITIES History Note: Authority G.S. 105-228.5; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. January 1, 1995.

11 NCAC 11E .0304 GROSS PREMIUM TAXATION OF GROUP PREMIUMS History Note: Authority G.S. 105-228.5; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Transferred & Recodified to 17 NCAC 5E .0105 Eff. January 15, 1998.

11 NCAC 11E .0305 EMPLOYEE BENEFITS PLANS: LIFE AND ACCIDENT AND HEALTH History Note: Authority G.S. 105-228.5; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Transferred & Recodified to 17 NCAC 5E .0106 Eff. January 15, 1998.

SECTION .0400 - MISCELLANEOUS: GENERAL NATURE 11 NCAC 11E .0401 GENERAL NATURE History Note: Authority G.S. 58-9; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. July 1, 1988.

11 NCAC 11E .0402 EXTENSION OF FILING DATE History Note: Authority G.S. 57-9; 57A-9; 57A-21; 58-21; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. April 1, 1993.

SUBCHAPTER 11F - ACTUARIAL SECTION .0100 - GENERAL PROVISIONS 11 NCAC 11F .0101 GENERAL NATURE History Note: Authority G.S. 58-9; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. July 1, 1988.

11 NCAC 11F .0105 RESERVES FOR ANNUITIES History Note: Authority G.S. 58-9(1); 58-201.1; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. December 1, 1985.

11 NCAC 11F .0106 RESERVES FOR PRESENT VALUE OF FUTURE BENEFITS REQUIRED History Note: Authority G.S. 58-9; Eff. February 1, 1976; Readopted Eff. February 28, 1978; Repealed Eff. April 1, 1993.

SECTION .0200 - HEALTH INSURANCE MINIMUM RESERVE STANDARDS 11 NCAC 11F .0201 DEFINITIONS As used in this section and in the Statement of Actuarial Opinion required by the NAIC Annual Statement Instructions pursuant to G.S. 58-2-165: (1) "Annual claim cost" means the net annual co…

11 NCAC 11F .0202 GENERAL (a) This Section applies to all accident and health insurance coverages under G.S. 58, Articles 50 through 55. (b) When an insurer determines that adequacy of its insurance reserves requires reserves in excess of the minimum standards specified in this S…

11 NCAC 11F .0203 CLAIM RESERVES (a) General: (1) Claim reserves are required for all incurred but unpaid claims on all accident and health insurance contracts. (2) Appropriate claim expense reserves are required with respect to the estimated expense of settlement of all incurred…

11 NCAC 11F .0204 PREMIUM RESERVES (a) General: (1) Unearned premium reserves are required for all contracts with respect to the period of coverage for which premiums, other than premiums paid in advance, have been paid beyond the date of valuation. (2) If premiums due and unpaid…

11 NCAC 11F .0205 CONTRACT RESERVES (a) General: (1) Contract reserves are required, unless otherwise specified in this Rule for: (A) All individual and group contracts with which level premiums are used; or (B) All individual and group contracts with respect to which, due to the…

11 NCAC 11F .0206 REINSURANCE Increases to, or credits against reserves carried, arising because of reinsurance assumed or reinsurance ceded, must be determined in a manner consistent with the minimum reserve standards set out in 11 NCAC 11F .0200 and with all applicable provisio…

11 NCAC 11F .0207 SPECIFIC STANDARDS FOR MORBIDITY, INTEREST AND MORTALITY (a) Minimum standard morbidity tables for valuation of specified individual contract accident and health insurance benefits are as follows: (1) Disability Income Benefits Due to Accident or Sickness. (A) C…

11 NCAC 11F .0208 RESERVES FOR WAIVER OF PREMIUM (a) Tabular reserves using the 1964 CDT, 1985 CIDA or 1985 CIDB tables, i.e. disability valuation tables based on exposures that include contracts on premium waiver as in-force contracts, shall value reserves on the following basis…

SECTION .0300 - ACTUARIAL OPINION AND MEMORANDUM 11 NCAC 11F .0301 APPLICABILITY AND SCOPE (a) This Section applies to all life insurance companies and fraternal benefit societies doing business in this State and to all life insurance companies and fraternal benefit societies tha…

11 NCAC 11F .0302 DEFINITIONS (a) "Annual statement" means that statement required to be filed each year under G.S. 58-2-165. (b) "Appointed actuary" means any individual who is appointed or retained in accordance with Rule .0303(c) of this Section to provide the actuarial opinio…

11 NCAC 11F .0303 GENERAL REQUIREMENTS (a) Submission of Opinion: (1) There shall be included on or attached to page 1 of the annual statement for each year beginning with calendar year 2004, the statement of an appointed actuary, entitled "Statement of Actuarial Opinion," settin…

11 NCAC 11F .0306 OPINION BASED ON ASSET ADEQUACY ANALYSIS (a) The opinion submitted in accordance with this Rule shall consist of: (1) A paragraph identifying the appointed actuary and his or her qualifications as prescribed by Subparagraph (b)(1) of this Rule; (2) A scope parag…

11 NCAC 11F .0307 ACTUARIAL MEMORANDUM WITH ASSET ADEQUACY ANALYSIS (a) General: (1) In accordance with G.S. 58-58-50(i) and (j), the appointed actuary shall prepare a memorandum to the company describing the analysis done in support of his or her opinion regarding the reserves u…

11 NCAC 11F .0308 ADDITIONAL CONSIDERATIONS FOR ANALYSIS History Note: Authority G.S. 58-2-40; 58-58-50(i); 58-58-50(j); Eff. December 1, 1994; Repealed Eff. August 1, 2004.

section .0400 – commissioner's reserve valuation method 11 NCAC 11F .0401 APPLICABILITY (a) This Section does not apply to: (1) Any individual life insurance policy issued on or after January 1, 2000, if the policy is issued in accordance with and as a result of the exercise of a…

11 NCAC 11F .0402 DEFINITIONS As used in this Section: (1) "Basic reserves" means reserves calculated in accordance with G.S. 58-58-50(d). (2) "Contract segmentation method" means the method of dividing the period from issue to mandatory expiration of a policy into successive seg…

11 NCAC 11F .0403 BASIC AND PREMIUM DEFICIENCY RESERVES (a) At the election of the company for any one or more specified plans of life insurance, the minimum mortality standard for basic reserves may be calculated using the 1980 CSO valuation tables with select mortality factors …

11 NCAC 11F .0404 CALCULATION OF 11 NCAC 11f .0401(b) (a) Basic reserves shall be calculated as the greater of the segmented reserves and the unitary reserves. Both the segmented reserves and the unitary reserves for any policy shall use the same valuation mortality table and sel…

11 NCAC 11F .0405 CALCULATION OF 11 NCAC 11F .0401(c) (a) General (1) Policies with a secondary guarantee include: (A) A policy with a guarantee that the policy will remain in force at the original schedule of benefits, subject only to the payment of specified premiums; (B) A pol…

11 NCAC 11F .0406 LIMITED USE OF ANTICIPATED WITHDRAWAL RATES (a) This Rule applies to universal life insurance policies and certificates issued after December 31, 2006, and before January 1, 2014, that contain a secondary guarantee that the death benefits will remain in effect a…

11 NCAC 11F .0505 MODEL RULE FOR RECOGNIZING A NEW ANNUITY MORTALITY TABLE FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES (a) The North Carolina Department of Insurance incorporates by reference, including subsequent amendments and editions, the National Association of …

SECTION .0600 – RECOGNITION OF THE 2001 CSO MORTALITY TABLE FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NONFORFEITURE BENEFITS 11 NCAC 11F .0601 DEFINITIONS As used in this Section: (1) "2001 CSO Mortality Table" means that mortality table, consisting of separate rates…

11 NCAC 11F .0602 2001 CSO MORTALITY TABLE AS MINIMUM STANDARD (a) At the election of the company for any one or more specified plans of insurance and subject to the conditions stated in this Section, the 2001 CSO Mortality Table may be used as the minimum standard for policies i…

11 NCAC 11F .0603 CONDITIONS (a) For each plan of insurance with separate rates for smokers and nonsmokers an insurer shall use one of the following: (1) Composite mortality tables to determine minimum reserve liabilities and minimum cash surrender values and amounts of paid-up n…

11 NCAC 11F .0604 APPLICABILITY OF THE 2001 CSO MORTALITY TABLE TO 11 NCAC 11F .0400 (a) For policies for which the 2001 CSO Mortality Table is the minimum standard for valuation and nonforfeiture purposes, 11F .0400 shall be applied in the following manner: (1) To comply with 11…

11 NCAC 11F .0605 GENDER-BLENDED TABLES (a) For any ordinary life insurance policy delivered or issued for delivery in this state on or after January 1, 2005 that utilizes the same premium rates and charges for male and female lives or is issued in circumstances where applicable …

11 NCAC 11F .0606 MINIMUM STANDARDS FOR PRENEED LIFE INSURANCE (a) For preneed life insurance, the minimum mortality standard for determining reserve liabilities and nonforfeiture values for policies issued after December 31, 2008, shall be the Commissioners' 1980 Standard Ordina…

SECTION .0700 – DETERMINING MINIMUM RESERVE LIABILITIES FOR CREDIT LIFE INSURANCE 11 NCAC 11F .0701 DETERMINING RESERVE LIABILITIES FOR CREDIT LIFE INSURANCE MODEL REGULATION (a) The North Carolina Department of Insurance incorporates by reference, including subsequent amendments…

SECTION .0800 - preferred class structure mortality table 11 NCAC 11F .0801 MODEL REGULATION PERMITTING THE RECOGNITION OF PREFERRED MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES (a) The North Carolina Department of Insurance incorporates by reference, inclu…

SUBCHAPTER 11H - CONTINUING CARE FACILITIES 11 NCAC 11H .0101 DEFINITIONS (a) As used in this Section, unless the context clearly indicates otherwise: (1) "Break-even" means confirmation of sufficient executed resident's agreements to assure the facility's financial stability and…

11 NCAC 11H .0102 LICENSE - STEPS An applicant shall apply for licensure in accordance with the following steps: (1) For new or development stage facilities: (a) The applicant shall initially submit the following items to the Commissioner for review: (i) The applicant's name, add…

11 NCAC 11H .0103 REVOCATION OF LICENSE The revocation process, as provided by G.S. 58-64-10, shall also apply to the Start-Up Certificate, the Preliminary Certificate, and the Restricted or Conditional License. History Note: Authority G.S. 58-2-40; 58-64-10; 58-64-65; Eff. April…

11 NCAC 11H .0104 SALE OR TRANSFER OF OWNERSHIP The sale or transfer process, as provided by G.S. 58-64-15, shall also apply to the Start-Up Certificate, the Preliminary Certificate, and the Restricted or Conditional License. History Note: Authority G.S. 58-2-40; 58-64-15; 58-64-…

11 NCAC 11H .0105 STANDARDIZED DISCLOSURE STATEMENT FORMAT As per G.S. 58-64-20(d), the Commissioner may prescribe a standardized format for the Disclosure Statement. The format shall be maintained by the Commissioner, and may be updated as necessary. History Note: Authority G.S.…

11 NCAC 11H .0106 HEALTH AND FINANCIAL CONDITIONS FOR ACCEPTANCE The health and financial conditions for acceptance as a resident shall appear within the Disclosure Statement, as provided by G.S. 58-64-20(a)(8). The Disclosure Statement shall also include any conditions related t…

11 NCAC 11H .0107 FINANCIAL STATEMENTS AND COMPILED FIVE YEAR FORECASTS Certified financial statements, as required by G.S. 58-64-20(a)(10), and compiled five year forecasts, as required by G.S. 58-64-20(a)(12), shall be of the provider's corporation or other legal entity that ow…