Attachment A "Lapse/Replacement Report Form" - Oklahoma

What Is Attachment A?

This is a legal form that was released by the Oklahoma Insurance Department - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the Oklahoma Insurance Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Attachment A by clicking the link below or browse more documents and templates provided by the Oklahoma Insurance Department.

ADVERTISEMENT
ADVERTISEMENT

Download Attachment A "Lapse/Replacement Report Form" - Oklahoma

854 times
Rate (4.7 / 5) 60 votes
Reset Form
Attachment A
Lapse/Replacement Report
Company Name: ____________________________________ Due: June 30 annually
Company Address: ______________________________________________________
______________________________________________________________________
Company NAIC Number: _________________________________________________
Oklahoma Company Number: ___________
Contact Person: _____________________ Phone Number: _____________________
Instructions
a) Every insurer shall maintain records for each agent of that agent’s amount of 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.
(b) Each insurer shall report annually by June 30 the ten percent (10%) of its agents with the greatest
percentages of lapses and replacements as measured by (a) of this section.
(c) Reported replacement and lapse rates do not alone constitute a violation of insurance laws or
necessarily imply wrongdoing. The reports are for the purpose of reviewing more closely agent activities
regarding the sale of long-term care insurance.
(d) Every insurer shall report annually by June 30 the number of lapsed policies as a percent of its total
annual sales and as a percent of its total number of policies in force as of the end of the preceding
calendar year.
(e) Every insurer shall report annually by June 30 the number of replacement policies sold as a percent of
its total annual sales and as a percent of its total number of policies in force as of the preceding calendar
year.
Listing of the 10% of agents with the Greatest Percentage of Replacements
Agent’s Name
Number of Policies
Number of Policies
Number of
Sold by this Agent
Replaced by this
Replacements as %
Agent
of Number Sold By
this Agent
Listing of the 10% of agents with the Greatest Percentage of Lapses
Agent’s Name
Number of Policies
Number of Policies
Number of Lapses
Sold by this Agent
Lapsed by this
as % of Number
Agent
Sold By this Agent
Ref: See 365:10-5-45.1. Reporting Requirements
Reset Form
Attachment A
Lapse/Replacement Report
Company Name: ____________________________________ Due: June 30 annually
Company Address: ______________________________________________________
______________________________________________________________________
Company NAIC Number: _________________________________________________
Oklahoma Company Number: ___________
Contact Person: _____________________ Phone Number: _____________________
Instructions
a) Every insurer shall maintain records for each agent of that agent’s amount of 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.
(b) Each insurer shall report annually by June 30 the ten percent (10%) of its agents with the greatest
percentages of lapses and replacements as measured by (a) of this section.
(c) Reported replacement and lapse rates do not alone constitute a violation of insurance laws or
necessarily imply wrongdoing. The reports are for the purpose of reviewing more closely agent activities
regarding the sale of long-term care insurance.
(d) Every insurer shall report annually by June 30 the number of lapsed policies as a percent of its total
annual sales and as a percent of its total number of policies in force as of the end of the preceding
calendar year.
(e) Every insurer shall report annually by June 30 the number of replacement policies sold as a percent of
its total annual sales and as a percent of its total number of policies in force as of the preceding calendar
year.
Listing of the 10% of agents with the Greatest Percentage of Replacements
Agent’s Name
Number of Policies
Number of Policies
Number of
Sold by this Agent
Replaced by this
Replacements as %
Agent
of Number Sold By
this Agent
Listing of the 10% of agents with the Greatest Percentage of Lapses
Agent’s Name
Number of Policies
Number of Policies
Number of Lapses
Sold by this Agent
Lapsed by this
as % of Number
Agent
Sold By this Agent
Ref: See 365:10-5-45.1. Reporting Requirements