Connecticut Administrative Code
Title 38a - Insurance Department
528a - Group Short-Term Care Insurance
Section 38a-528a-14 - Replacement
Current through March 14, 2024
(a) Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant has another group or individual short-term care or long-term care policy or certificate in force or whether a group short-term care certificate is intended to replace any other group or individual accident and sickness policy or certificate, group or individual short-term care or long-term care policy or certificate presently in force. A supplementary application or other form to be signed by the applicant and producer, except where the coverage is sold without a producer, containing such questions may be used.
(b) Agents shall list any other health insurance policies they have sold to the applicant.
(c) Solicitations Other than Direct Response. Upon determining that a sale will involve replacement, an insurer, other than an insurer using direct response solicitation methods, or its agent shall furnish the applicant, prior to issuance or delivery of the group short-term care certificate, a notice regarding replacement of group or individual accident and sickness coverage or certificates or group or individual short-term care or long-term care coverage. One copy of such notice shall be retained by the applicant and an additional copy signed by the applicant shall be retained by the insurer. The required notice shall be provided in the following manner:
NOTICE TO APPLICANT REGARDING REPLACEMENT OF ACCIDENT AND SICKNESS, SHORT-TERM CARE OR LONG-TERM CARE INSURANCE
(Insurer's name and address)
SAVE THIS NOTICE!
IT MAY BE IMPORTANT TO YOU IN THE FUTURE.
According to (your application) (information you have furnished), you intend to lapse or otherwise terminate existing accident and sickness, short-term care or long-term care insurance and replace it with a group short-term care insurance policy evidenced by a certificate delivered herewith and issued by (insurer name) Insurance Company Your new certificate provides thirty (30) days within which you may decide, without cost, whether you desire to keep the certificate. For your own information and protection you should be aware of and seriously consider certain factors that may affect the insurance protection available to you under the new certificate or subscriber agreement.
You should review this new coverage carefully, comparing it with all group or individual accident and sickness policies or certificates and group or individual short-term care or long-term care insurance coverage you now have, and terminate your present coverage only if, after due consideration, you find that purchase of this group short-term care certificate is a wise decision.
STATEMENT TO APPLICANT BY AGENT (PRODUCER OR OTHER REPRESENTATIVE)
(Use additional sheets, as necessary.)
I have reviewed your current medical or health insurance coverage. I believe the replacement of insurance involved in this transaction materially improves your position. My conclusion has taken into account the following considerations that I call to your attention:
(Signature of Agent, Producer or Other Representative)
(Typed Name and Address of Agent, Producer or Other Representative)
The above "Notice to Applicant" was delivered to me on:
(Date)______________
(Applicant's Signature) ___________
(d) Direct Response Solicitations. Insurers using direct response solicitation methods shall deliver a notice regarding replacement of accident and sickness, short-term care or long-term care coverage to the applicant upon issuance of the certificate. The required notice shall be provided in the following manner:
NOTICE TO APPLICANT REGARDING REPLACEMENT OF ACCIDENT AND SICKNESS, SHORT-TERM CARE OR LONG-TERM CARE INSURANCE
(Insurer's name and address)
SAVE THIS NOTICE!
IT MAY BE IMPORTANT TO YOU IN THE FUTURE.
According to (your application) (information you have furnished), you intend to lapse or otherwise terminate existing accident and sickness, short-term care or long-term care insurance and replace it with the group short-term care insurance evidenced by a certificate delivered herewith issued by (insurer name) Insurance Company Your new certificate provides thirty (30) days within which you may decide, without cost, whether you desire to keep the certificate. For your own information and protection, you should be aware of and seriously consider certain factors that may affect the insurance protection available to you under the new policy or certificate.
You should review this new coverage carefully, comparing it with all individual or group accident and sickness coverage and any individual or group short-term care or long-term care insurance coverage you now have, and terminate your present coverage only if, after due consideration, you find that purchase of this short-term care coverage is a wise decision.
(Insurer Name)____________________________________________