62S.01 DEFINITIONS. Subdivision 1. Application. The definitions in this section apply to this chapter. Subd. 2. Activities of daily living. “Activities of daily living” means eating, toileting, transferring, bathing, dressing, and continence. Subd. 3. Acute condition. “Acute condition” means that the individual is medically unstable and requires frequent monitoring by medical professionals, such as physicians […]
62S.02 QUALIFIED LONG-TERM CARE INSURANCE POLICY. Subdivision 1. Requirements. A qualified long-term care insurance policy may not be offered, issued, delivered, or renewed in this state unless the policy satisfies the requirements of this chapter and the filing provisions of section 62A.02. A qualified long-term care insurance policy must cover qualified long-term care services. Subd. […]
62S.021 LONG-TERM CARE INSURANCE; INITIAL FILING. Subdivision 1. Applicability. This section applies to any long-term care policy issued in this state on or after January 1, 2002, under this chapter or sections 62A.46 to 62A.56. Subd. 2. Required submission to commissioner. An insurer shall provide the following information to the commissioner 30 days prior to […]
62S.03 EXTRATERRITORIAL JURISDICTION. Group long-term care insurance coverage may not be offered to a resident of this state under a group policy issued in another state to a group described in section 62S.01, subdivision 15, clause (4), unless this state or another state having statutory and regulatory long-term care insurance requirements substantially similar to those […]
62S.04 PROHIBITIONS. A long-term care insurance policy may not: (1) 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; (2) contain a provision establishing a new waiting period in the event existing coverage is converted to […]
62S.05 PREEXISTING CONDITION. Subdivision 1. Authorized definition. A long-term care insurance policy or certificate, other than a policy or certificate issued to a group as defined in section 62S.01, subdivision 15, clause (1), may not use a definition of preexisting condition that is more restrictive than the definition in this subdivision. “Preexisting condition” means a […]
62S.06 PRIOR HOSPITALIZATION OR INSTITUTIONALIZATION. Subdivision 1. Prohibited conditions. A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility for any benefits: (1) on a prior hospitalization requirement; (2) provided in an institutional care setting on the receipt of a higher level of institutional […]
62S.07 RIGHT TO RETURN; REFUND. Subdivision 1. Right to return. A long-term care insurance applicant may return the policy or certificate within 30 days of its delivery and is entitled to a refund of the premium if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance […]
62S.08 COVERAGE OUTLINE. Subdivision 1. Delivery. An outline of coverage must be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its purpose. In the case of agent solicitations, an agent must deliver the outline […]
62S.081 REQUIRED DISCLOSURE OF RATING PRACTICES TO CONSUMERS. Subdivision 1. Application. This section applies as follows: (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. (b) For certificates issued on or after July 1, 2001, under a […]
62S.09 CERTIFICATE REQUIREMENTS. Subdivision 1. Content. A certificate issued under a group long-term care insurance policy delivered or issued for delivery in this state must include: (1) a description of the principal benefits and coverage provided in the policy; (2) a statement of the exclusions, reductions, and limitations contained in the policy; and (3) a […]
62S.10 POLICY SUMMARY. Subdivision 1. Delivery. At the time of policy delivery, a policy summary must be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer must deliver the policy summary upon the applicant’s request, but regardless […]
62S.11 MONTHLY REPORT. Subdivision 1. Required report. Any time a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report must be provided to the policyholder. Subd. 2. Contents. The report must include the following information: (1) long-term care benefits paid […]
62S.12 CLAIM DENIAL. If a claim under a qualified long-term care insurance contract is denied, the issuer shall provide a written explanation of the reasons for the denial and make available all information directly related to the denial within 60 days of the date of a written request by the policyholder or certificate holder, or […]
62S.13 INCONTESTABILITY PERIOD. Subdivision 1. Rescission before six months. For 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 an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to acceptance for […]
62S.14 RENEWABILITY. Subdivision 1. Guaranteed renewable. A qualified long-term care insurance policy must be guaranteed renewable. Subd. 2. Terms. The terms “guaranteed renewable” and “noncancelable” may not be used in an individual long-term care insurance policy without further explanatory language that complies with the disclosure requirements of section 62S.20. The term “level premium” may only […]
62S.15 AUTHORIZED LIMITATIONS AND EXCLUSIONS. (a) No policy may be delivered or issued for delivery in this state as long-term care insurance if the policy limits or excludes coverage by type of illness, treatment, medical condition, or accident, except as follows: (1) preexisting conditions or diseases; (2) mental or nervous disorders; except that the exclusion […]
62S.16 EXTENSION OF BENEFITS. Termination of long-term care insurance must be without prejudice to any benefits payable for institutionalization if the institutionalization began while the long-term care insurance was in force and continues without interruption after termination. The extension of benefits beyond the period the long-term care insurance was in force may be limited to […]
62S.17 CONTINUATION OR CONVERSION. Subdivision 1. Requirement. Group long-term care insurance shall provide covered individuals with a basis for continuation or conversion of coverage. Subd. 2. Basis for continuation of coverage. A basis for continuation of coverage policy provision must maintain coverage under the existing group policy when the coverage would otherwise terminate and is […]
62S.18 DISCONTINUANCE AND REPLACEMENT. Subdivision 1. Required coverage. If a group long-term care policy is replaced by another group long-term care policy issued to the same policyholder, the succeeding insurer shall offer coverage to all persons covered under the previous group policy on its date of termination. Coverage provided or offered to individuals by the […]
