62S.181 ELECTRONIC ENROLLMENT FOR GROUP POLICIES. Subdivision 1. Employers or labor unions. In the case of a group defined in section 62S.01, subdivision 15, clause (1), any requirement that a signature of an insured be obtained by an agent or insurer is satisfied if: (1) the consent is obtained by telephonic or electronic enrollment by […]
62S.19 UNINTENTIONAL LAPSE. Subdivision 1. Notice before lapse or termination. No individual long-term care policy or certificate shall be issued until the insurer has received from the applicant either a written designation of at least one person, in addition to the applicant, who is to receive notice of lapse or termination of the policy or […]
62S.20 REQUIRED DISCLOSURE PROVISIONS. Subdivision 1. Renewability. (a) Individual long-term care insurance policies must contain a renewability provision that is appropriately captioned, appears on the first page of the policy, and clearly states that the coverage is guaranteed renewable or noncancelable. This subdivision does not apply to policies which are part of or combined with […]
62S.21 PROHIBITION AGAINST POSTCLAIMS UNDERWRITING. Subdivision 1. Health condition. All applications for long-term care insurance policies or certificates, except those which are guaranteed issue must contain clear and unambiguous questions designed to ascertain the health condition of the applicant. Subd. 2. Medication information required. If an application for long-term care insurance contains a question which […]
62S.22 MINIMUM STANDARDS FOR HOME HEALTH AND COMMUNITY CARE BENEFITS. Subdivision 1. Prohibited limitations. A long-term care insurance policy or certificate shall not, if it provides benefits for home health care or community care services, limit or exclude benefits by: (1) requiring that the insured would need care in a skilled nursing facility if home […]
62S.23 REQUIREMENT TO OFFER INFLATION PROTECTION. Subdivision 1. Inflation protection feature. (a) 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 […]
62S.24 REQUIREMENTS FOR APPLICATION FORMS AND REPLACEMENT COVERAGE. Subdivision 1. Required questions. An application form must include the following questions designed to elicit information as to whether, as of the date of the application, the applicant has another long-term care insurance policy or certificate in force or whether a long-term care policy or certificate is […]
62S.25 REPORTING REQUIREMENTS. Subdivision 1. Insurer records. Each 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. Subd. […]
62S.251 RESERVE STANDARDS. Subdivision 1. Benefits provided through acceleration of benefits under life policies. When long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders to these policies, policy reserves for the benefits must be determined in accordance with section 61A.25. Claim reserves must also be established […]
62S.26 LOSS RATIO. Subdivision 1. Minimum loss ratio. The minimum loss ratio must be at least 60 percent, calculated in a manner which provides for adequate reserving of the long-term care insurance risk. In evaluating the expected loss ratio, the commissioner shall give consideration to all relevant factors, including: (1) statistical credibility of incurred claims […]
62S.265 PREMIUM RATE SCHEDULE INCREASES. Subdivision 1. Applicability. (a) Except as provided in paragraph (b), this section applies to any long-term care policy or certificate issued in this state on or after January 1, 2002, under this chapter or sections 62A.46 to 62A.56. (b) For certificates issued on or after July 1, 2001, under a […]
62S.266 NONFORFEITURE BENEFIT REQUIREMENT. Subdivision 1. Applicability. This section does not apply to life insurance policies or riders containing accelerated long-term care benefits. Subd. 2. Requirement. (a) An insurer must offer each prospective policyholder a nonforfeiture benefit in compliance with the following requirements: (1) a policy or certificate offered with nonforfeiture benefits must have coverage […]
62S.267 STANDARDS FOR BENEFIT TRIGGERS. Subdivision 1. Benefit payment determinations. A long-term care insurance policy must condition the payment of benefits on a determination of the insured’s ability to perform activities of daily living and on cognitive impairment. Eligibility for the payment of benefits must not be more restrictive than requiring either a deficiency in […]
62S.268 ADDITIONAL STANDARDS FOR BENEFIT TRIGGERS FOR QUALIFIED LONG-TERM CARE INSURANCE CONTRACTS. Subdivision 1. Definitions. For purposes of this section, the following terms have the meanings given them: (a) “Qualified long-term care services” means services that meet the requirements of section 7702(c)(1) of the Internal Revenue Code of 1986, as amended, as follows: necessary diagnostic, […]
62S.27 FILING REQUIREMENT. Before an insurer or similar organization offers group long-term care insurance to a resident of this state under section 62S.03, it must file with the commissioner evidence that the group policy or certificate has been approved by a state having statutory or regulatory long-term care insurance requirements substantially similar to those adopted […]
62S.28 FILING REQUIREMENTS FOR ADVERTISING. Subdivision 1. Advertisement copy. An insurer or other entity providing long-term care insurance or benefits in this state shall provide a copy of any long-term care insurance advertisement intended for use in this state whether through written, radio, or television medium to the commissioner for review or approval by the […]
62S.29 STANDARDS FOR MARKETING. Subdivision 1. Requirements. An insurer or other entity marketing long-term care insurance coverage in this state, directly or through its producers, shall: (1) establish marketing procedures and agent training requirements to assure that any marketing activities, including any comparison of policies by its agents or other producers, are fair and accurate; […]
62S.291 AVAILABILITY OF NEW SERVICES OR PROVIDERS. Subdivision 1. Requirement. An insurer shall notify policyholders of the availability of a new long-term policy series that provides coverage for new long-term care services or providers material in nature and not previously available through the insurer to the general public. The notice must be provided within 12 […]
62S.292 RIGHT TO REDUCE COVERAGE AND LOWER PREMIUMS. Subdivision 1. Required policy or certificate provision. Every long-term care insurance policy and certificate shall include a provision that allows the policyholder or certificate holder to reduce coverage and lower the policy or certificate premium in at least one of the following ways: (1) reducing the maximum […]
62S.30 SUITABILITY. Subdivision 1. Standards. Every insurer or other entity marketing long-term care insurance shall: (1) develop and use suitability standards to determine whether the purchase or replacement of long-term care insurance is appropriate for the needs of the applicant; (2) train its agents in the use of its suitability standards; and (3) maintain a […]
