Guide to the Regulation of Continuing Care Retirement Communities in Virginia. This Guide should be used for educational purposes only.

CCRC Consumer Guide

Before a long-term care insurance (LTCI) company may increase their rates on policies issued in Virginia, the company must file the request for the increase with the Bureau of Insurance (BOI) for review.  The BOI may approve or disapprove the request or approve a rate that is lower than the requested increase.  The BOI must consider the following for each request:

• Has the insurance company justified the rate increase?
• Does the rate increase comply with state laws and regulations?
• How will the rate increase impact policyholders?

All approved and pending LTCI rate increase requests may be found on the BOI’s website here: https://www.scc.virginia.gov/boi/SERFFInquiry/LtcFilings.aspx  (Ctrl + click)

Your LTCI company must send you a notice to let you know when they submit a rate increase request to the BOI. 

You may submit comments on proposed LTCI rate increases via email or mail to the BOI. Please include with the comment your name, name of the insurer, and SERFF tracking number (which is provided in your insurance company’s notice of rate increase). 

• Email address: LTCRateComment@scc.virginia.gov

• Mailing address: Virginia State Corporation Commission
  Bureau of Insurance
  P.O. Box 1157
  Richmond, VA 23218
  Attn: Life & Health Rate

Please note: If you have concerns regarding an approved LTCI rate increase, you may submit a complaint to the BOI. Information on filing a complaint can be found our website at File a Complaint.

Consumer FAQs

How does a rate increase impact my premium?

People often use “rate” and “premium” interchangeably, but there is a difference between the two.  The “rate” is reviewed and approved by the BOI.  A “rate” is the cost for one unit of insurance that is used to calculate the actual “premium” paid by the insured. The insurance company calculates each policyholder’s “premium” based on the approved rate plus other factors, such as benefit selections, payment mode, etc.  

Does the insurance company have to notify me of a rate increase on my LTCI policy?

Based on a new law enacted by Virginia’s General Assembly effective July 1, 2024, if your LTCI company files a request with the BOI to increase rates, they must provide you with a notice that they’ve done so.  The notice must include the reason(s) for which your insurance company is requesting the rate increase, along with the amount of the rate increase requested.  Your insurance company must also provide you with a notice 90 days before the effective date of an approved rate increase that explains why you will incur a rate increase. You will also receive a notice from your insurance company if the BOI denies the rate increase request.

I have been notified that my LTCI company wants to raise my premium.  Can they do that?

Most LTCI policies are guaranteed renewable which means that your insurance company cannot decline a renewal of your policy for any reason other than non-payment of premium.  However, your policy should disclose that your insurance company can increase your premium.   

Why are insurers requesting rate increases on LTCI policies?

Insurance companies monitor in-force policies to ensure they can pay claims in the future. Several key reasons that a LTC insurer may request a rate increase could include:     

• A greater number of insureds than anticipated have kept their policies in force.
• Claim costs and claim durations have been significantly higher than expected.
• Interest earned on premiums has been less than anticipated.

What does the BOI consider when reviewing LTCI rate increase requests?

The BOI is responsible for ensuring that the LTCI benefits are reasonable in relation to the premium charged while also ensuring that the insurance company receives sufficient premiums to pay claims and remain solvent.  The BOI’s analysis of LTCI rate increase requests includes the following: 

• Regulatory and actuarial requirements as set forth in Chapter 200 of the VA Administrative Code.
• The expected loss ratio based on the rate increase requested to ensure it will not exceed the original approved loss ratio.
• That the insurance company is sharing in the higher-than-expected claim costs rather than passing all claim costs on to policyholders through the rate increase.
• Period of time since the last LTCI rate increase.
• Percentage of rate increase remaining to be earned.
• Average age of the policyholders in the block of policies.
• The options made available to the policyholder to offset or mitigate the rate increase. 

How can I determine the status of a LTCI rate increase request (pending or approved)?

All approved and pending LTCI rate increase requests may be found on the BOI’s website here: https://www.scc.virginia.gov/boi/SERFFInquiry/LtcFilings.aspx

Please be aware that the BOI’s review of an LTCI company’s rate increase request may take months before a final disposition is made. 

What can I do about a premium increase on my LTCI policy?

There are several things a policyholder may consider doing both before and after an increase is approved.

• Upon notification that your insurance company is seeking a rate increase, you may contact them for more information about the requested rate increase on your policy and any options that may be available to you.
• You may provide comments directly to the BOI regarding a pending LTCI rate increase by sending an email to LTCRateComment@scc.virginia.gov or by mail at the address above. 
• Upon notification from your insurance company that a rate increase has been approved and your premium will be increasing, your company will also offer options for your consideration that may reduce, or in some situations, eliminate the increase.  Some companies may also offer a return-of-premium option.  You are encouraged to speak with the company or your financial advisor to make sure you are aware of and understand all your options.
• If you have concerns regarding an approved LTCI rate increase, you may submit a complaint to the BOI. Information on filing a complaint can be found our website at File a Complaint.

 

Policyholder Notification of Proposed Premium Rate Increase Guidance Document

Review Requirements Checklist INDIVIDUAL LONG-TERM CARE INSURANCE (LTCI) (FORMS)

Long-Term Care Policyholder Communications Checklist

CBCC- Registration and Disclosure Filing Guidelines

LifeSpire (VBH) - The Glebe CCRC Disclosure Statement

• At least 13 paid holidays each year
  • New Year's Day, Martin Luther King, Jr. Day, George Washington's Birthday, Memorial Day, Juneteenth, Independence Day, Labor Day, Columbus Day, Election Day, Veteran's Day, Thanksgiving (2 days), & Christmas Day.
• 12 days (minimum) of vacation
  • Annual Leave Accrual Information
• 2 days of volunteer service leave
  • Annually, employees may be granted up to 16 hours of paid leave to provide volunteer services throughout the year for eligible non-profit organizations.
• 8 days sick leave
• 4 days family and personal leave
• Hybrid work schedule for eligible positions (generally 3 days of telework and 2 days in office per week)
• Flex Time/Alternative Work Schedules

Virginia Sickness and Disability Program

The Virginia Sickness and Disability Program (VSDP) provides you with income continuation if you become unable to perform your normal job duties because of an illness or injury. Eligible employees receive sick leave, family and personal leave, and short and long-term disability benefits. The program provides up to ten days of sick leave and up to five days of family and personal leave per year, based on the employee's length of service (with no carry-over from year to year) and up to 125 workdays of short-term disability coverage. The number of days of income continuation depends on the employee's length of state service at the time of disability.

Family and Medical Leave Act

Eligible employees are provided with up to 12 weeks of unpaid leave due to the birth of a child, or for adoption or foster care of a child, or to provide care for a family member (child, spouse, or parent) with a serious health condition, or because the employee's own serious health condition makes him or her unable to do his or her job. Employees are able to use their paid-time-off to receive pay during these periods.

Parental Leave

Eligible employees may receive up to eight (8) weeks (320 hours) of paid parental leave to be used within six (6) months of the birth of an infant(s) or adoptive, foster, or custodial placement for a child(ren) under the age of eighteen (18). Employees may request continuous or intermittent parental leave. Parental leave is designated as FMLA leave and runs concurrent with the FMLA leave period.

Review Requirements Checklist GROUP LONG-TERM CARE INSURANCE (GLTCI) (FORMS)