Section 514G.1
514G.1 Repealed by 2008 Acts, ch 1175, §16 .
Section 514G.10 – Long-term care consumer guide.
514G.10 Long-term care consumer guide. Repealed by 2008 Acts, ch 1175, §16 .
Section 514G.101 – Title and purpose.
514G.101 Title and purpose. This chapter may be known and cited as the “Long-term Care Insurance Act”. The purpose of this chapter is to promote the public interest, to promote the availability of long-term care insurance, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to establish standards for […]
Section 514G.102 – Scope.
514G.102 Scope. The requirements of this chapter apply to policies delivered or issued for delivery in this state on or after July 1, 2008. The requirements of this chapter related to independent review of benefit trigger determinations apply to all claims made on or after January 1, 2009. The requirements of this chapter related to […]
Section 514G.103 – Definitions.
514G.103 Definitions. As used in this chapter, unless the context requires otherwise: 1. “Activities of daily living” means at least bathing, continence, dressing, eating, toileting, and transferring. 2. “Applicant” means either of the following: a. In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits. b. In […]
Section 514G.104 – Extraterritorial jurisdiction — group long-term care insurance.
514G.104 Extraterritorial jurisdiction — group long-term care insurance. Group long-term care insurance coverage shall not be offered to a resident of this state under a group policy issued in another state unless either this state or another state with statutory and regulatory requirements for long-term care insurance that are substantially similar to those adopted in […]
Section 514G.105 – Disclosure and performance standards for long-term care insurance.
514G.105 Disclosure and performance standards for long-term care insurance. 1. Prohibited policy practices. A long-term care insurance policy shall not: a. Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or deterioration of the mental or physical health of the insured individual or certificate holder. b. Contain a provision establishing a new […]
Section 514G.106 – Incontestability period.
514G.106 Incontestability period. 1. An insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim if the policy or certificate has been in force for less than six months upon a showing of misrepresentation that is material to the insurer’s acceptance for coverage. 2. An insurer […]
Section 514G.107 – Nonforfeiture benefits.
514G.107 Nonforfeiture benefits. 1. Except as otherwise provided in subsection 2, a long-term care insurance policy or certificate shall 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. A nonforfeiture benefit may […]
Section 514G.108 – Prompt payment of claims — requirements.
514G.108 Prompt payment of claims — requirements. 1. An insurer providing long-term care insurance under this chapter and subject to state insurance regulation shall either accept and pay or deny a clean claim. For the purposes of this section, “clean claim” means a properly completed paper or electronic request for payment that contains all necessary […]
Section 514G.109 – Benefit trigger determinations — notice — appeals.
514G.109 Benefit trigger determinations — notice — appeals. 1. Notice. When a long-term care insurer determines that the benefit trigger in an insured’s long-term care insurance policy has not been met, the insurer shall provide a clear, written notice to the insured of all of the following: a. The reason that the insurer determined that […]
Section 514G.110 – Independent review of benefit trigger determinations.
514G.110 Independent review of benefit trigger determinations. 1. Request. An insured may file a written request for independent review of a benefit trigger determination with the commissioner after the internal appeal process has been exhausted. The request shall be filed within sixty days after the insured receives written notice of the insurer’s internal appeal decision. […]
Section 514G.111 – Authority to promulgate rules.
514G.111 Authority to promulgate rules. The commissioner may adopt rules pursuant to chapter 17A related to long-term care insurance and to the administration and enforcement of this chapter, including but not limited to the following: 1. Promoting adequate premiums and protecting policyholders in the event of substantial rate increases. 2. Establishing minimum standards for producer […]
Section 514G.112 – Severability.
514G.112 Severability. If any provision of this chapter or the application of this chapter to any person or circumstance is for any reason held to be invalid, the remainder of the chapter and the application of the provision to other persons or circumstances shall not be affected. 2008 Acts, ch 1175, §13
Section 514G.113 – Penalties.
514G.113 Penalties. In addition to any other penalties provided by the laws of this state, any insurer or any producer found to have violated a provision of this chapter or any other requirement of this state relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a […]
Section 514G.2
514G.2 Repealed by 2008 Acts, ch 1175, §16 .
Section 514G.3
514G.3 Repealed by 2008 Acts, ch 1175, §16 .
Section 514G.4
514G.4 Repealed by 2008 Acts, ch 1175, §16 .
Section 514G.5
514G.5 Repealed by 2008 Acts, ch 1175, §16 .
Section 514G.6
514G.6 Repealed by 2008 Acts, ch 1175, §16 .