Text Search




The Filter option allows you to narrow your search results to a specific Title, Article, or Chapter . Here is a tip for using the filter option.
  • Use a colon (:) as the last character of your filter to refine searches. For example the filter "10:01" returns the article, chapters, and sections in 10:01.

Quick Find



Enter a Rule Number and click Get Rule to load the Rule. You can enter any Article, Chapter, or Section number. Examples(01:15, 01:15:01, 01:15:01:01, etc.). Use the Get All button to load and entire article or chapter.

Download in Microsoft Word Format Printer Friendly

 

 

 

 

 

 

 

 

 

 

 

 

DEPARTMENT OF LABOR AND REGULATION

 

DIVISION OF INSURANCE

 

 

 

 

REPLACEMENT AND LAPSE REPORTING FORM

 

 

Chapter 20:06:21

 

APPENDIX J

 

SEE: ยง 20:06:21:52

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

          Source: 28 SDR 157, effective May 19, 2002.


 

Long-Term Care Insurance

Replacement and Lapse Reporting Form

 

For the State of _____________________                           For the Reporting Year of __________

 

Company Name:      __________________________             Due:   June 30 annually

Company Address:  __________________________             Company NAIC Number: _________

Contact Person:        __________________________             Phone Number:  (____)___________

 

Instructions

 

The purpose of this form is to report on a statewide basis information regarding long-term care insurance policy replacements and lapses. Specifically, every insurer shall maintain records for each agent on that agent's amount of long-term care insurance replacement sales as a percent of the agent's total annual sales and the amount of lapses of long-term care insurance policies sold by the agent as a percent of the agent's total annual sales. The tables below should be used to report the ten percent (10%) of the insurer's agents with the greatest percentage of replacements and lapses.

 

Listing of the 10% of Agents with the Greatest Percentage of Replacements

 

Agent's Name

Number of Policies Sold

By This Agent

Number of Policies

Replaced by This Agent

Number of Replacements As % of Number Sold By This Agent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Listing of the 10% of Agents with the Greatest Percentage of Lapses

 

Agent's Name

Number of Policies Sold

By This Agent

Number of Policies

Lapsed By This Agent

Number of Lapses As % of Number Sold By This Agent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company Totals

 

Percentage of Replacement Policies Sold to Total Annual Sales _____%

Percentage of Replacement Policies Sold to Policies in Force (as of the end of the preceding calendar year) _____%

 

Percentage of Lapsed Policies to Total Annual Sales _____%

Percentage of Lapsed Policies to Policies In Force (as of the end of the preceding calendar year) _____%

 

 


Back to 20:06:21 | 20:06:21:0J RSS