Nebraska Novation Answers to Frequently Asked Questions

Transcription

1 Nebraska Novation Answers to Frequently Asked Questions *Please note that these answers are appropriate for Nebraska policyholders ONLY. The answers may not be appropriate for policyholders residing in other states. * Novation is a legal term meaning the process of transferring contract rights from one party to another. The Policyholders received a Notice of Transfer in the mail recently. The Notice of Transfer allows the policyholder to accept or reject the novation. The following Frequently Asked Questions were developed to help Policyholders understand the novation process and the effects of accepting or rejecting the novation. 1. Why did Medico and Ability enter into this transaction? Long-Term Care (LTC) policies- Medico Group ceased marketing LTC insurance on 12/31/2004. Reserves necessary to maintain this business, even with reinsurance, were prohibitive for a company the size of Medico. Medico searched for a Company with a strong sense of commitment to LTC insurance and the financial strength necessary to properly administer the business. Medico believes Ability is the right Company and that the transfer will benefit all LTC policyholders. Non-LTC policies- Ability Resources, Inc. purchased Medico Life from Medico. Ability Resources is a company dedicated to the administration of closed blocks of LTC insurance. Because Ability s focus is on LTC insurance, Ability has transferred all non-ltc insurance policies to Medico. Medico has had a long commitment to the senior market. 2. Can the Medico Insurance Company do this? Yes, the Nebraska Department of Insurance approved the transfer of business agreement and the novation. 3. What did the Nebraska Insurance Department use to make their decision? The Nebraska Insurance Department considered: The financial condition of both Companies; The competence, experience and integrity of management of both Companies; The plans or proposals that each assuming party has with respect to the administration of the policies; Whether the transfer is fair and reasonable to the policyholders; and

2 Whether the notice of transfer to be provided by the insurer is fair, adequate and not misleading. 4. What does novate mean to the Policyholder s policy? The assuming Company (this is the company taking over the policy after the transfer) will have direct responsibility to the Policyholder for the payment of all claims, benefits and for all other policy obligations. Policyholders will make all premium payments and claims submissions and direct all questions to the assuming Company. The Policyholder s original Company will no longer have any obligations to them. 5. When will this change take effect? In Nebraska, the novation will be effective July 1, However, the assuming Company has reinsured 100% of the liability for the policies and is currently administering the policies. 6. Will this change Policyholder s premiums? The premiums will not change based on the Policyholder s decision to consent to or reject the novation. Nonetheless, the premiums may change based on periodic rate changes that are not associated with this novation. 7. Can Medico or Ability advise Policyholders what to do? The companies cannot advise Policyholders whether to consent to or reject the transfer - that is a decision Policyholders will need to make. The companies recommend that the Policyholders seek advice from their agents, financial advisors, friends or relatives. 8. Can Policyholders accept/reject the transfer on the phone? No, the assuming companies need to have the Policyholders signature on the Response Form. Please check the appropriate box on the Response Form, sign it and return it in the postage paid envelope that was sent out with the Notice of Transfer. (The policyholder may also fax the signed form.) 9. What does the Policyholder do if they want to accept the transfer? The Policyholder should check the Yes box on the Response Form, sign it and return it in the postage paid envelope that was sent with the Notice of Transfer. 10. If the Policyholder accepts the transfer, how does the Policyholder pay the premium after the transfer? Automatic bank withdrawal-since the bank withdrawal authorization signed by the Policyholder applies to both Companies, the premiums will continue to be withdrawn from the Policyholder s account on the scheduled date. However, the company name that shows up on the Policyholder s bank statement will change to that of the assuming insurer.

3 Direct bill-after the Policyholder consents to the transfer, the Policyholder will receive premium notices from the assuming insurer, and the Policyholder will pay the premium to the assuming insurer at the address given on the premium notice. 11. Will the Policyholder s policy number change? No, the policy number will not change. The Policyholder should continue to use the policy number on the policy for correspondence with the current insurer and/or the assuming insurer. 12. Will the Policyholder receive a new policy? The Policyholder will not receive a new policy. If the Policyholder chooses to consent to the transfer, he or she will receive a Certificate of Assumption, which becomes a part of the policy and should be attached to the policy. 13. Who will process pending claims? The acceptance or rejection of the novation will not impact any pending claims. The assuming Company is already administering the policy, and will continue to do so even if the Policyholder does not accept the novation. Each policyholder of a mutual insurance company has two issues. One is the membership interest, which allows the policyholder to attend the mutual company s annual meeting and to vote for the board of directors. This membership interest does not novate to the assuming company if the policyholder chooses to accept the transfer, and remains in effect for three years. The contract rights do transfer to the assuming company permanently if the policyholder chooses to novate, but the terms and conditions of the policy itself do not change. 14. Why do I have to give up my membership rights through Medico Mutual Insurance Holding Company after three years? Your membership rights in Medico Mutual Insurance Holding Company arose from your insurance policy with Medico. By transferring your insurance policy to Ability, you will no longer have a meaningful interest in Medico Mutual Insurance Holding Company. Nonetheless, you will retain your membership rights for three years (until July 1, 2012 in Nebraska). 15. What are my membership rights? Your membership rights entitle you to attend the Annual Policyholder Meeting and vote to elect the Board of Directors. You also may have additional rights in the event of liquidation or demutalization. 16. If I choose to reject the transfer to Ability, what happens to my membership rights?

4 If you reject the transfer of your policy, you will retain your membership rights. 17. As an Ability policyholder (formerly Medico Life), if I accept the transfer to Medico Insurance Company, will I be granted membership rights through Medico Mutual Insurance Holding Company? No, a policyholder that is novating to Medico Insurance Company will not be granted membership rights. 18. If I accept the transfer to Ability, will I have membership rights through Ability? No. Ability Insurance Company is not a mutual company. 19. What do Policyholders do if they do not want to transfer to the other Company? Policyholders will need to check the No box on the Response Form, sign it and return it in the postage paid envelope that was sent with the Notice of Transfer. However, even if the Policyholder rejects the transfer, the policy will be administered by the other Company, including premium billing and payment of claims, due to the agreement between the two Companies. 20. What if the Policyholder does not want the assuming insurer to administer the policy? For LTC policyholders: Ability Insurance Company is dedicated to the administration of closed blocks of LTC insurance. Ability will be able to administer LTC policies more effectively than Medico. For non-ltc policyholders: Medico has had a long commitment to the senior market. Medico would administer non-ltc policies more effectively than would Ability. 21. What if the Policyholder does nothing? After thirty days from the date of the Notice of Transfer (after June 7, 2009 in Nebraska), and when the Policyholder pays their premium to the assuming Company, the policy will novate (transfer) to that Company. (Note: the policyholder will not receive a second notice. 22. What if the Policyholder is not sure what to do? The Policyholder can still pay their premium to the assuming Company and reserve the right to reject the transfer. The Policyholder must call to reserve this right. The Policyholder will then receive a Second Notice of Transfer in 12 months (in Nebraska). The Policyholder will then have an additional two months to accept or reject the transfer (in Nebraska). If the assuming company does not receive a completed and signed Response

5 Form from the Policyholder within those two months, the policy will novate to the assuming (new) Company. 23. What happens if the Policyholder pays their premium (to the assuming Company), but does not reserve the right to reject the transfer? The policy will novate (transfer) to the assuming Company. 24. A Policyholder has a LTC policy through Medico and a non-ltc policy through Medico Life, they received Notices that propose transferring the policies in opposite directions. Why? Long-Term Care policies- Medico Group ceased marketing LTC insurance on 12/31/2004. Reserves necessary to maintain this business, even with reinsurance, were prohibitive for a Company of our size. Medico searched for a Company with a strong sense of commitment to LTC insurance and the financial strength necessary to properly administer the business. Medico believes Ability is the right Company and that the transfer will benefit all LTC policyholders. Non-LTC policies- Ability Resources, Inc. purchased Medico Life from Medico. Ability is a company dedicated to the administration of closed blocks of LTC insurance. Because their focus is on LTC insurance, Ability has transferred all non-ltc insurance policies to Medico. Medico has had a long commitment to the senior market. 25. What is the advantage of accepting the transfer? Long-Term Care Policyholders The policyholder would be transferring to a company that is solely focused on long-term care products. Non-Long-Term Care Policyholders The policyholder would be transferring his/her policy from a company that is solely focused on long-term Care products to a company that focuses on other H&A and life products (including Medicare supplement, etc.). 26. When will the Policyholders receive/how do the Policyholders get the financial information on Ability Insurance Company? The annual statement balance sheet for Medico Life Insurance Company for the last two years was included in your mailing. Medico Life Insurance Company changed its name to Ability Insurance Company effective February 10, 2009, which was after the annual statement was filed.

6 27. When will the Policyholders receive/how do the Policyholders get the A.M. Best Rating for Ability Insurance Company? The Insurance Ratings form that was sent in your packet includes the A.M. Best Rating for Medico Life Insurance Company for the last five years. Medico Life Insurance Company changed its name to Ability Insurance Company effective February 10, 2009, which was after the A.M. Best Rating was assigned.