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Froogle 1.1.1.7
Froogled By:
Elias Makere, FSA, MAAA
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ASOP 3 | §3.11 | ADDITIONAL CONSIDERATIONS AFFECTING CCRC OR AT HOME PROGRAM FINANCES

The actuary should determine the scope of the organization’s commitments to current and prospective contractual residents or members and the nature of its fee structure. The actuary may obtain this information from the applicable residency agreements or membership agreements and any other reasonable source of information about the organization. When interpreting these documents, the actuary should determine the following:
a. the admission and underwriting criteria and how they are applied;

b. the terms of the residency agreement or membership agreement and any limitations on the period for which commitments are made;

c. any known, significant limitations on the organization’s ability to change future periodic fees;

d. any refund guarantees;

e. any limitation on the services provided and any collectability risk for services limited under the contract or requiring additional payment;

f. any contract provisions for prepaid health care or for additional charges if a contractual resident or member receives health care;

g. any affiliation with another entity and the extent to which any such entity would assume responsibility for the organization’s obligations; and

h. any other matter that, in the actuary’s professional judgment, is expected to have a material effect on the organization’s current or future financial statements.
ASOP 3 | Commentary Section 3.11 | COMMENT ON SECTION 3.11
Section 3.11, Additional Considerations Affecting CCRC or At Home Program Finances
CommentResponse
One commentator suggested adding more objective guidance to the actuary when analyzing residency contracts and membership agreements.The reviewers disagree and made no change in response to this comment. The reviewers note that section 3.11 provides an objective list of contractual items for the actuary to consider.
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