§ 10233.2. — 10233.2. (Amended by Stats. 1999, Ch. 947, Sec. 8.)

Long-term care insurance may not:
(a)
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.
(b)
Contain a provision establishing a new waiting period in the event existing coverage is converted to, or replaced by, a new or other form within the same insurer, except with respect to an increase in benefits
voluntarily selected by the insured individual or group policyholder.
(c)
Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care.
(d)
Provide for payment of benefits based on a standard described as “usual and customary,” “reasonable and customary,” or words of similar import.
(e)
Terminate a policy, certificate, or rider, or contain a provision that allows the premium for an in-force policy, certificate, or rider, to be increased due to the divorce of a policyholder or certificate holder.
(f)
Include an additional benefit for a service with a known market value other than the statutorily required home- and community-based service benefits in Section
10232.9, the assisted living benefit in Section 10232.92, or a nursing facility benefit, unless the additional benefit provides for the payment of at least five times the daily benefit and the dollar value of the additional benefit is disclosed in the schedule page of the policy.

Legislative History

Amended by Stats. 1999, Ch. 947, Sec. 8. Effective January 1, 2000.