§5071. Scope This chapter applies to long-term care insurance policies or certificates delivered or issued for delivery in this State on or after January 1, 2000, except it does not apply to certificates issued under policies issued in other states to employer groups as described in section 2804 and labor union groups as described in […]
§5072. Definitions As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1999, c. 292, §2 (NEW).] 1. Applicant. “Applicant” means: A. In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; or [PL 1999, c. […]
§5073. Extraterritorial jurisdiction; group long-term care insurance 1. Groups other than employer, union, trustee and association groups. A group long-term care insurance policy may not be offered to a resident of this State under a group policy issued in another state to a group other than an employer group as described in section 2804, a […]
§5074. Disclosure standards for long-term care insurance The following standards apply to disclosures relating to long-term care insurance. [PL 1999, c. 292, §2 (NEW).] 1. Disclosures. The superintendent may adopt rules that include standards for full and fair disclosure setting forth the manner, content and required disclosures for the sale of long-term care insurance […]
§5075-A. Certification by superintendent 1. Filing of form. An insurer, nonprofit hospital or medical service organization or nonprofit health care plan may request, at the time it files a policy or contract for approval for issuance or delivery in the State or at any time thereafter, that the superintendent certify the policy or contract as […]
§5075. Required provisions; prohibitions; loss ratio standards for long-term care insurance 1. Prohibitions. A long-term care insurance policy or certificate may not: A. 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; [PL 1999, c. 292, §2 […]
§5076. Incontestability period 1. Policies or certificates in effect for less than 6 months. For a policy or certificate that has been in effect for less than 6 months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that […]
§5077. Nonforfeiture benefits 1. Offer required. Except as provided in subsection 2, a long-term care insurance policy or certificate 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 that includes a nonforfeiture benefit. The offer of […]
§5078. Rulemaking The superintendent shall adopt rules to promote premium adequacy, to protect a policyholder and a certificate holder in the event of substantial rate increases and to establish minimum standards for marketing practices, insurance producer compensation, insurance producer education, insurance producer testing, penalties and reporting practices for long-term care insurance. Rules adopted pursuant to […]
§5079. Penalties In addition to any other penalties provided by this Title or the laws of this State, an insurer or insurance producer that violates any requirement of this chapter or rule adopted pursuant to this chapter relating to the regulation of long-term care insurance or the marketing of such insurance is subject to a […]
§5080. Applicability This chapter applies to long-term care policies and certificates issued or delivered in this State on or after January 1, 2000. Policies and certificates issued prior to January 1, 2000 and remaining in effect on that date are subject to the requirements of chapter 68. Those policies and any certificates issued pursuant to […]
§5081. Producer training requirements 1. Training required. An individual may not sell, solicit or negotiate long-term care insurance unless: A. The individual is licensed as a life or health insurance producer; [PL 2007, c. 232, §3 (NEW).] B. The individual has completed a one-time training course that is no less than 8 hours […]
§5082. Long-term Care Partnership Program; availability of qualified policies 1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. “Eligible policyholder” means: (1) An individual who holds a qualified individual policy issued before or during the notice period by an insurer that actively […]
§5083. Payment of claims 1. Notice of claim for benefits; response by insured. Notwithstanding any other provision of this Title, upon receipt of a notice of claim for benefits under a policy or certificate of long-term care insurance delivered or issued for delivery in this State, an insurer, whether actively marketing or renewing long-term care […]
§5084. Notice to policyholders of rate increase 1. Notice. An insurer shall notify a policyholder of a long-term care insurance policy issued in accordance with this chapter or chapter 68 of a proposed premium rate increase that affects the policyholder no later than 30 days after the filing by the insurer of the premium rate […]
