§ 10-19-101. Short Title

This article shall be known and may be cited as the “Long-term Care Insurance Act”. Source: L. 90: Entire article R&RE, p. 643, § 1, effective July 1.

§ 10-19-102. Legislative Declaration

The general assembly hereby declares that the purpose of this article is to promote the public interest and the availability of long-term care insurance policies, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term […]

§ 10-19-103. Definitions

As used in this article 19, unless the context otherwise requires: “Applicant” means: In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and In the case of a group long-term care insurance policy, the proposed certificate holder. (1.5) Repealed. “Certificate” means any certificate issued under a […]

§ 10-19-104. Scope and Applicability of Article

The requirements of this article shall apply to policies delivered or issued for delivery in this state on or after July 1, 1990. This article is not intended to supersede the obligations of entities subject to this article to comply with the substance of other applicable insurance laws insofar as they do not conflict with […]

§ 10-19-105. Extraterritorial Jurisdiction – Group Long-Term Care Insurance

A group long-term care insurance coverage shall not be offered to a resident of this state under a group policy issued in another state to a group described in section 10-19-103 (4)(d), unless this state or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this state has […]

§ 10-19-106. Rules on Disclosure

The commissioner may adopt rules and regulations that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, […]

§ 10-19-107. Performance Standards

A long-term care insurance policy may not: Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder; or Contain a provision establishing a new waiting period in the event that existing coverage is converted to or replaced […]

§ 10-19-108. Requirements for Preexisting Conditions

A long-term care insurance policy or certificate, other than a policy or certificate thereunder, issued to a group as defined in section 10-19-103 (4)(a), shall not use a definition of “preexisting condition” that is more restrictive than the following: “Preexisting condition” means a condition for which medical advice or treatment was recommended by or received […]

§ 10-19-109. Requirements for Prior Hospitalization or Institutionalization

A long-term care insurance policy shall not be delivered or issued for delivery in this state if such policy: Conditions the eligibility for any benefits on a prior hospitalization requirement; Conditions the eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or Conditions eligibility for […]

§ 10-19-110. Loss Ratio Standards

The commissioner may adopt rules and regulations establishing loss-ratio standards for long-term care insurance policies if a specific reference to long-term care insurance policies is contained in the regulation. Such rules and regulations shall be in accordance with the “State Administrative Procedure Act”, article 4 of title 24, C.R.S. Source: L. 90: Entire article R&RE, […]

§ 10-19-111. Right to Return Policy – Free Look

A long-term care insurance applicant has the right to return the policy or certificate within thirty days after its delivery and to have the premium refunded if, after examination of the policy or certificate, other than a certificate issued pursuant to a policy issued to a group defined in section 10-19-103 (4)(a), the applicant is […]

§ 10-19-112. Outline of Coverage – Certificate

An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means which prominently direct the attention of the recipient to the document and its purpose. The commissioner shall prescribe a standard format, including style, arrangement, and overall appearance, and the content of an […]

§ 10-19-113. Option for Inflation Adjustment – Renewability

No insurer may offer a long-term care insurance policy unless the insurer also offers to the policyholder, in addition to any other inflation protection, the option to purchase a policy that provides for benefit levels to increase with benefit maximums or reasonable durations that are meaningful to account for reasonable anticipated increases in the costs […]

§ 10-19-113.3. Incontestability Period

With respect to a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny a long-term care insurance claim under such a policy upon a showing of misrepresentation that is material to the acceptance for coverage. With respect to […]

§ 10-19-113.4. Nonforfeiture Benefits – Rules

Except as provided in subsection (2) of this section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate including a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in […]

§ 10-19-113.6. Producer Training Requirements

An individual may not sell, solicit, or negotiate long-term care insurance unless the individual is licensed as an insurance producer for accident and health or sickness or life insurance and has completed a one-time training course and ongoing training every twenty-four months. The training must meet the requirements set forth in subsection (2) of this […]

§ 10-19-113.7. Rules

The commissioner shall adopt rules to promote premium adequacy, to protect the policyholder in the event of substantial rate increases, and to establish minimum standards for marketing practices, producer education, producer compensation, producer examination, penalties, and reporting practices for long-term care insurance. In addition, the commissioner may issue regulations to establish minimum standards concerning suitability. […]

§ 10-19-114. Compliance

No policy may be advertised, marketed, or offered as long-term care or nursing home insurance unless it complies with the provisions of this article. Source: L. 90: Entire article R&RE, p. 649, § 1, effective July 1.

§ 10-19-114.5. Penalties

In addition to any other penalties provided by the laws of Colorado, any carrier or any producer who violates any requirement of Colorado law relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a fine of up to three times the amount of any commissions paid […]

§ 10-19-115. Severability

If any provision of this article or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the article and the application of such provision to other persons or circumstances shall not be affected thereby. Source: L. 90: Entire article R&RE, p. 649, § 1, effective […]