§ 58-55-1 – Short title.
58-55-1. Short title. This Article may be cited as the "Long-Term Care Insurance Act". (1987, c. 331.)
§ 58-55-10 – Purposes.
58-55-10. Purposes. The purposes of this Article are to promote the public interest, to promote 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 care insurance policies, […]
§ 58-55-15 – Scope.
58-55-15. Scope. This Article applies to long-term care insurance policies in this State. This Article does not supersede the obligations of any person subject to its provisions to comply with other applicable laws and rules if those laws and rules do not conflict with this Article. The laws and rules established to govern Medicare supplement […]
§ 58-55-20 – Definitions.
58-55-20. Definitions. As used in this Article: (1) "Applicant" means: a. In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and b. In the case of a group long-term care insurance policy, the proposed certificate holder. (2) "Certificate" means any certificate issued under a group long-term […]
§ 58-55-25 – Limits of group long-term care insurance.
58-55-25. Limits of group long-term care insurance. No group long-term care insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in G.S. 58-55-20(3)d, unless the Commissioner or the insurance regulator of the other state having statutory and regulatory long-term care insurance […]
§ 58-55-30 – Disclosure and performance standards for long-term care insurance.
58-55-30. Disclosure and performance standards for long-term care insurance. (a) The Commissioner 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 policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, […]
§ 58-55-31 – Additional requirements.
58-55-31. Additional requirements. (a) No policy shall be used in this State unless it provides for an offer of nonforfeiture, which shall not be less than an offer of reduced paid-up insurance benefits, extended term insurance benefits, or a shortened benefit period. No policy shall pay a cash surrender value unless the dividends or refunds […]
§ 58-55-35 – Facilities, services, and conditions defined.
58-55-35. Facilities, services, and conditions defined. (a) Whenever long-term care insurance provides coverage for the facilities, services, or physical or mental conditions listed below, unless otherwise defined in the policy and certificate, and approved by the Commissioner, the facilities, services, or conditions have the following definitions: (1) Adult care home. – As defined in G.S. […]
§ 58-55-5 – Dual options.
58-55-5. Dual options. (a) No policy that conditions the eligibility of benefits on prior hospitalization may be delivered or issued for delivery in this State unless the insurer or other entity offering that policy also offers a policy that does not condition eligibility of benefits on such a requirement. (b) Policies that were delivered, issued […]
§ 58-55-50 – Rules for compliance with federal law and regulations.
58-55-50. Rules for compliance with federal law and regulations. The Commissioner may adopt temporary rules necessary to conform long-term care policies and certificates to the requirements of federal law and regulations, including any changes required by Congress or the U.S. Department of Health and Human Services, or any successor agencies. (2001-334, s. 11.2.)
§ 58-55-55 – Definitions.
58-55-55. Definitions. The following definitions apply in this section: (1) Asset. – Resources and income. (2) Department. – The Department of Health and Human Services. (3) Division. – The Division of Health Benefits. (4) Estate recovery. – The placing of a statutory claim on the estate of a deceased Medicaid recipient, as provided by G.S. […]
§ 58-55-60 – Qualified long-term care partnership policy.
58-55-60. Qualified long-term care partnership policy. A qualified long-term care partnership policy is a long-term care insurance policy or a certificate issued under a group long-term care insurance policy that satisfies all of the following requirements: (1) The policy meets the requirements for a qualified long-term care insurance contract, as defined in section 7702B of […]
§ 58-55-65 – Compliance with federal regulations.
58-55-65. Compliance with federal regulations. (a) The Commissioner may adopt rules to conform long-term care policies and certificates to the requirements of federal law and regulations, including any changes required by Congress or the U.S. Department of Health and Human Services, or any successor agencies. (b) The tax-qualified long-term care provisions required of the Health […]
§ 58-55-70 – Disclosure notices.
58-55-70. Disclosure notices. (a) Prior to making a change requested by the policyholder to a qualified long-term care partnership policy that would result in the loss to the policy of qualified policy status, the insurer shall provide to the policyholder a written explanation within 30 calendar days of how this action would affect the insured […]
§ 58-55-75 – Exchange of long-term care policies for long-term care partnership policies.
58-55-75. Exchange of long-term care policies for long-term care partnership policies. An insurer shall offer, on a onetime basis, in writing, to all existing policyholders that were issued a long-term care policy on or after February 8, 2006, the option to exchange their existing long-term care coverage for coverage that is intended to qualify under […]
§ 58-55-80 – Information sharing.
58-55-80. Information sharing. (a) In order to assist in the performance of the Commissioner’s duties under the long-term care partnership program specified in the federal Deficit Reduction Act of 2005, the Commissioner may: (1) Share information, including identifying information, related to the long-term care partnership program with other state and federal agencies, the National Association […]