§ 26-38-108 — Third party notice and reinstatement

(a) Each insurer offering long-term care insurance shall,
as a protection against unintentional lapse, comply with the
following:
(i) No individual long-term care policy or
certificate shall be issued until the insurer has received from
the applicant either a written designation of at least one (1)
person, in addition to the applicant, who is to receive notice
of lapse or termination of the policy or certificate for
nonpayment of premium, or a written waiver dated and signed by
the applicant electing not to designate additional persons to
receive notice. The applicant has the right to designate at
least one (1) person who is to receive the notice of
termination, in addition to the insured. A designation shall
not constitute acceptance of any liability by the third party
for services provided to the insured. The form used for the
written designation shall provide space clearly designated for
listing at least one (1) person. The designation shall include
each person's full name and home address. In the case of an
applicant who elects not to designate an additional person, the
waiver shall state: "Protection against unintended lapse." "I
understand that I have the right to designate at least one (1)
person other than myself to receive notice of lapse or
termination of this long-term care insurance policy for
nonpayment of premium. I understand that notice will not be
given until thirty (30) days after a premium is due and unpaid.
I elect not to designate any person to receive such notice."
The insurer shall notify the insured of the right to change the
written designation, no less than once every two (2) years;
(ii) When the policyholder or certificate holder pays
premium for a long-term care insurance policy or certificate
through a payroll or pension deduction plan, the requirements
contained in paragraph (a)(i) of this section need not be met
until sixty (60) days after the policyholder or certificate
holder is no longer enrolled in the payment plan. The
application or enrollment form for such policies or certificates
shall clearly indicate the payment plan selected by the
applicant;
(iii) No long-term care policy or certificate shall
lapse or be terminated for nonpayment of premium unless the
insurer, at least thirty (30) days before the effective date of
the lapse or termination, has given notice to the insured and to
those persons designated pursuant to paragraph (a)(i) of this
section, at the address provided by the insured, to receive
notice of lapse or termination. Notice shall be given by first
class United States mail, postage prepaid. Notice shall not be
given until thirty (30) days after a premium is due and unpaid.
Notice shall be deemed to have been given as of five (5) days
after the date of mailing.
(b) In addition to the requirements in subsection (a) of
this section, a long-term care insurance policy or certificate
shall include a provision which provides for reinstatement of
coverage, in the event of lapse if the insurer is provided proof
of cognitive impairment or the loss of functional capacity.
This option shall be available to the insured if requested
within five (5) months after termination and shall allow for the
collection of past due premium, where appropriate. The standard
of proof of cognitive impairment or loss of functional capacity
shall not be more stringent than the benefit eligibility
criteria on cognitive impairment or the loss of functional
capacity, if any, contained in the policy or certificate.