Disclosure and performance standards for long-term care insurance

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  1. (a) The Insurance Commissioner may adopt rules for long-term care insurance that include, but are not limited to, standards for full and fair disclosure addressing:

    1. (1) The manner, content, and required disclosures for the sale of long-term care insurance policies;

    2. (2) Terms of renewability;

    3. (3) Initial and subsequent conditions of eligibility;

    4. (4) Nonduplication of coverage provisions;

    5. (5) Coverage of dependents;

    6. (6) Preexisting conditions;

    7. (7) Termination of insurance;

    8. (8) Continuation or conversion of coverage;

    9. (9) Probationary periods;

    10. (10) Limitations, exceptions, reductions, and elimination periods;

    11. (11) Requirements for replacement;

    12. (12) Recurrent conditions; and

    13. (13) Definitions of terms.

  2. (b) No long-term care insurance policy shall:

    1. (1) Be cancelled, not renewed, or otherwise terminated because of age or the deterioration of the mental or physical health of the insured individual or certificate holder;

    2. (2) Contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other form of coverage within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or

    3. (3) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care within a facility than coverage for lower levels of care.


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