§ 24-A §5075 — Required provisions; prohibitions; loss ratio standards for long-term care insurance

1.
Prohibitions.
A long-term care insurance policy or certificate may not:
2.
Preexisting condition.
A long-term care insurance policy or certificate must provide coverage for preexisting conditions in accordance with the following.
3.
Prior hospitalization or institutionalization.
A long-term care insurance policy or certificate that contains provisions regarding prior hospitalization or institutionalization must comply with the following requirements.
4.
Free-look provision.
Applicants for long-term care insurance have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. A long-term care insurance policy or certificate must have a notice prominently printed on the first page or attached to the policy or certificate stating in substance that the applicant has the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason.
5.
Benefit payment status report on long-term care benefits.
Any time a long-term care benefit that is funded through a life insurance policy or certificate by the acceleration of the death benefit is in benefit payment status, a monthly report must be provided to the policyholder or certificate holder. The report must include:
6.
Loss ratios.
The superintendent may adopt rules establishing loss ratio standards for long-term care insurance policies if a specific reference to long-term care insurance policies or certificates is contained in the rules. Any loss ratio standards for employer groups as described in section 2804 and labor union groups as described in section 2805 apply to the group policy and not to certificates. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A.
7.
Marketing as long-term care or nursing home insurance.
This chapter applies to any policy, certificate or rider advertised, marketed or offered as long-term care or nursing home insurance.

Legislative History

PL 1999, c. 292, §2 (NEW).