HEARING - U.S. Senate Special Committee on Aging
HEARING - U.S. Senate Special Committee on Aging HEARING - U.S. Senate Special Committee on Aging
159 section S. Limits of Srow Long Term Care ZIturmice 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 E(4M, unless this state or another *tete having statutory and regulatory Long Term Care Insurance requirements substantially similar to those adopted in this atete has made a determination that such requirements have bean et. Section 6. Disclosure and Performance Standards tor Long-Temr Care Inmurance A. The Commissioner may adopt regulations 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 end subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, pre-existing conditions, termination of insurance, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. Cements: This subsection permits the adoption of regulations establishing disclosure standards, renewability and eligibility terms and condition6, and other performance requirements for long-term care insurance. Regulations under this subsection should recognize the developing and unique nature of long-term care insurance and the distinction between group and individual long-term care Insurance policies. B. No long-term care insurance policy may: (1) Be cancelled, 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; or,
160 (2) Contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other torm within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder. C. Pre-existing Condition (1) No long-term care insurance policy or certificate shall use a definition of "pre-existing condition" which is more restrictive then the following: Pre-existing condition means the existence of symptoms which would cause an ordinarily prudent person to seek diagnosis. care or treatment, or a condition for which. medical advice or treatment was recommended by, or received trom a provider of health care services, within the limitation periods specified in (a) and (b) below: (a) 6 months preceding the effective date of coverage of an insured person who is 65 years of age or older on the etfective date of coverage; or (b3 24 months preceding the effective date of coverage of an insured pereon who is under age 65 on the effective date of coverage. -9-
- Page 111 and 112: 108 explore all alternatives to lon
- Page 113 and 114: 110 adds to the complexity of Medic
- Page 115 and 116: 112 - 10- Consider first the propos
- Page 117 and 118: 114 - 12- insurance premiums and me
- Page 119 and 120: Consunmer Unon Pubtishcr of Consume
- Page 121 and 122: FOR RELEASE AT 9:00 P.M. H2ST) TUES
- Page 123 and 124: 120 Itema I CENTER FOR MEDICARE ALw
- Page 125 and 126: Page 3 122 aide services, however,
- Page 127 and 128: Page 5 state treasuries." 124 Judge
- Page 129 and 130: 126 462 6485 New Developments 10,05
- Page 131 and 132: 128 462 6-85 New Developments 10,05
- Page 133 and 134: 130 462 6-85 New Developments 10,05
- Page 135 and 136: 132 10,930 New Developments tI.PZ ;
- Page 137 and 138: 10,932 134 New Davelopments 492 346
- Page 139 and 140: 136 10,934 New Developments It! ;6
- Page 141 and 142: 10,936 138 New Developmenlt I. Thc
- Page 143 and 144: 140 10,938 New Development. 492 S-8
- Page 145 and 146: 10,940 142 New Developments i92 586
- Page 147 and 148: ATroR EYS -HARLES C. -ULiIN JUDITH
- Page 149 and 150: 146 reformed its decision-making pr
- Page 151 and 152: 148 : 14 2i57 New Developments 13,1
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- Page 155 and 156: 152 All Of these figures are based
- Page 157 and 158: 154 The requirements of this Act sh
- Page 159 and 160: 156 Drefting Note: Where the word "
- Page 161: 158 (b) The issuance of the group p
- Page 165 and 166: 162 and competitive reasons. It is
- Page 167 and 168: 164 -13- E. Affordability of Long T
- Page 169 and 170: NAIC LTC ADVISORY COMMITEE EXPOSURE
- Page 171 and 172: Setinzn IS. Poicyx D~efinitieno aid
- Page 173 and 174: 170 3. The term "noncancellable' ma
- Page 175 and 176: 172 extension of benefits beyond th
- Page 177 and 178: artinM B Requirmnts for Rplnmacwt 1
- Page 179 and 180: 176 The above "Notice to Applicant"
- Page 181 and 182: (pinnal Rasting &mdsninn 178 Benefi
- Page 183 and 184: APPEMI!X B 180 OCWARISCN OF lVLCY i
- Page 185 and 186: COMPAIeSON OF LOtG TEIM CoAt PfLtCI
- Page 187 and 188: COMPABI:SZN OF LC#C TE" CAiE -OLICI
- Page 189 and 190: COWaPAISON Of LOSt TERM CARE POLICI
- Page 191 and 192: cowRiiSOi or touTE reM CasE nOuczcS
- Page 193 and 194: COGPARISON OF LONG TERM CARE POLICI
- Page 195 and 196: SOME BASIC THINGS YOU SHOULD KNOW M
- Page 197 and 198: Private health insurance is availab
- Page 199 and 200: WHAT MEDICARE PART B PAYS 196 MEDIC
- Page 201 and 202: EXPENSES NOT COVERED BY MEDICARE Me
159<br />
secti<strong>on</strong> S. Limits of Srow L<strong>on</strong>g Term Care ZIturmice<br />
No Group L<strong>on</strong>g Term Care Insurance Coverage may be offered to a resident<br />
of this state under a group policy issued in another state to a group<br />
described in E(4M, unless this state or another *tete having statutory<br />
and regulatory L<strong>on</strong>g Term Care Insurance requirements substantially<br />
similar to those adopted in this atete has made a determinati<strong>on</strong> that<br />
such requirements have bean et.<br />
Secti<strong>on</strong> 6. Disclosure and Performance Standards tor L<strong>on</strong>g-Temr Care<br />
Inmurance<br />
A. The Commissi<strong>on</strong>er may adopt regulati<strong>on</strong>s that include standards for full<br />
and fair disclosure setting forth the manner, c<strong>on</strong>tent, and required<br />
disclosures for the sale of l<strong>on</strong>g-term care insurance policies, terms of<br />
renewability, initial end subsequent c<strong>on</strong>diti<strong>on</strong>s of eligibility,<br />
n<strong>on</strong>duplicati<strong>on</strong> of coverage provisi<strong>on</strong>s, coverage of dependents,<br />
pre-existing c<strong>on</strong>diti<strong>on</strong>s, terminati<strong>on</strong> of insurance, probati<strong>on</strong>ary<br />
periods, limitati<strong>on</strong>s, excepti<strong>on</strong>s, reducti<strong>on</strong>s, eliminati<strong>on</strong> periods,<br />
requirements for replacement, recurrent c<strong>on</strong>diti<strong>on</strong>s, and definiti<strong>on</strong>s of<br />
terms.<br />
Cements: This subsecti<strong>on</strong> permits the adopti<strong>on</strong> of regulati<strong>on</strong>s establishing<br />
disclosure standards, renewability and eligibility terms and c<strong>on</strong>diti<strong>on</strong>6,<br />
and other performance requirements for l<strong>on</strong>g-term care insurance.<br />
Regulati<strong>on</strong>s under this subsecti<strong>on</strong> should recognize the developing and<br />
unique nature of l<strong>on</strong>g-term care insurance and the distincti<strong>on</strong> between group<br />
and individual l<strong>on</strong>g-term care Insurance policies.<br />
B. No l<strong>on</strong>g-term care insurance policy may:<br />
(1) Be cancelled, n<strong>on</strong>renewed, or otherwise terminated <strong>on</strong> the<br />
grounds of the age or the deteriorati<strong>on</strong> of the mental or<br />
physical health of the insured individual or certificate<br />
holder; or,