Court Reinforces the Filed-rate Doctrine in Collins et al v. Metropolitan Life Ins. Co.

On February 3, 2023, the United States District Court for the Eastern District of Missouri granted MetLife’s motion to dismiss for failure to state a claim in Collins et al v. Metropolitan Life Ins. Co. In granting MetLife’s motion to dismiss, the Court reinforced both the filed-rate doctrine and the requirement for plaintiffs to exhaust administrative remedies before turning to the judicial process.

The Plaintiffs in this case, who were citizens of Missouri and Illinois, brought suit against MetLife for recovery of premiums paid for inflation protection under long-term care insurance policies. Plaintiffs had purchased a “5% Automatic Compound Inflation Protection Rider” (Inflation Rider), which contained a clause stating that the insured’s benefit will “automatically increase each year with no corresponding increase in premiums.” Plaintiffs claimed that after purchasing this product, their annual base premiums doubled in amount, and thus alleged that MetLife made fraudulent misrepresentations and concealed material facts about the effect of the inflation Rider on their premiums.

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Faegre Drinker Long-Term Care Summit V Recap

Faegre Drinker held its fifth Long-Term Care Insurance Summit in Chicago this fall. The event kicked off on October 18 with an informal, fun, and engaging social get-together, while the overall format for the interactive meeting was selective, informative, and fast-moving. Carrol Golden, Executive Director of the Specialty Centers at the National Association of Insurance and Financial Advisors (NAIFA), shares a recap of the event.

The first day, Faegre Drinker Partner Steve Serfass shared welcome remarks and introduced Peter Lucas, CEO of Davies, and John Sieb, Business Head and COO – Long Term Care at Prudential and invited them to share their views about the most significant issues and opportunities facing the LTCi community today. Peter urged that while embracing new concepts and insights, the industry should not lose focus on the basics of good policy and claim administration, and he also addressed the importance of creating attractive career paths and opportunities for young and mid-level professionals while mentoring them to become the next generation of leaders. As he discussed the importance of proactive block management, John stressed three strategic pillars: data and analytics, digital TP and claims management.

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Highlights from the LTCi EX Task Force Meeting at NAIC

We want to bring you some highlights from the in-person LTCi EX Task Force meeting we attended August 12 during NAIC’s Summer National Meeting in Portland.  The Commissioners principally discussed the next steps in the rollout of the Multistate Actuarial (MSA) Framework and the results of a survey of financial advisors to help the Task Force understand how policyholders are considering rate increase communications and the accompanying reduced benefit options that the rate increase communications include.

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LTCi Carrier Secures Dismissal of Class Action Case Alleging ERISA Violations Stemming from LTC Insurance Premium Rate Increases

A federal judge has dismissed a putative class action case brought by a plaintiff asserting ERISA violations against The Prudential Company of America (“Prudential”) and Tufts University (“Tufts”), stemming from premium rate increases to an ERISA group long-term care insurance plan sponsored by plaintiff’s employer, Tufts, and issued by Prudential.

On July 12, 2022, United States District Judge Richard Stearns granted Tufts and Prudential’s respective motions to dismiss the action, Parmenter v. Prudential Insurance Company of America, et al., No. 1:22-CV-10079, Dkt. No. 43 (D. Mass. July 12, 2022), which was originally filed on January 20, 2022 in the United States District Court for the District of Massachusetts.

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Possible $2.5 billion CalPERS Settlement Agreement Falls Through

A possible settlement agreement has fallen through in a suit between CalPERS and a group of policyholders over a 2013 proposed 85 percent rate hike. The agreement would have covered approximately 60,000 policyholders.

The suit was filed by California policyholders that elected to pay for inflation protection benefits in their long-term care insurance (LTCi) policies, ranging from policies purchased in the 1990s through 2004. The Plaintiffs alleged that CalPERS proposed rate hike violated their policy agreements. They contended that CalPERS marketing materials promised that the policies’ optional benefit would not increase their premiums, while CalPERS asserted that it had the authority to raise rates to keep plans funded.

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NAIC’s Long-Term Care Insurance Multistate Rate Review (EX) Subgroup Releases New MSA Framework Draft

NAIC’s Long-Term Care Insurance Multistate Rate Review (EX) Subgroup recently released a new draft of its MSA Framework document. Comments are due by December 6.

The NAIC has charged the Long‐Term Care Insurance (EX) Task Force with developing a consistent national approach for reviewing current LTCi rates that results in actuarially appropriate increases being granted by the states in a timely manner and that eliminates cross‐state rate subsidization.

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Liability Insurance Rates and Reduced Capacity Add Pressure to the Cost of Long-Term Care Services

The cost of long-term care services continued to rise during the pandemic, and many care providers expect their clients’ costs to increase significantly in 2021.1  A new Willis Towers Watson Insurance Marketplace Realities 2021 Spring Update (“Spring Update”) concludes that 2021 will continue to squeeze long-term and senior care providers from both sides—with general and professional liability insurance rates predicted to increase by 30% or more, and a persistence of 2020’s overall reduced liability capacities in the market for the long-term care provider sector.

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Organisation for Economic Cooperation and Development Seeks Information Regarding Long-Term Care Needs and Payment Sources

Over the past few years, insurers, consumers and regulators have asked the question: who, and how, will consumers receive and pay for long-term care? The older, retired population will soon substantially outnumber the working population and the number of private insurers providing long-term care continues to dwindle. A report from the American Council of Life Insurers projects 70% of Americans turning age 65 or older will require long-term care. By 2060, the number of Americans turning age 65 or older will double and those turning age 85 or older will triple. As the population continues to age, the average cost of care continues to rise. Thus, the government faces a looming risk of unbearable expenses as more individuals rely on Medicaid for elder care. In light of this statistical reality, governments, insurers and long-term care (LTC) providers are trying to find cost-efficient ways to offer long-term care to consumers in need and, in turn, increase access to care.

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