Florida Administrative Code
69 - DEPARTMENT OF FINANCIAL SERVICES
69O - OIR - Insurance Regulation
Chapter 69O-157 - LONG-TERM CARE INSURANCE
Section 69O-157.009 - Minimum Coverage
Current through Reg. 50, No. 187; September 24, 2024
(1) All long-term care policies shall provide coverage for at least 24 consecutive months for each covered person for care in a nursing home.
(2) All long-term care policies shall provide coverage for at least one type of lower level of care in addition to coverage for care in a nursing home.
(3) No long-term care policy may provide significantly more coverage for care in a nursing home than coverage for lower levels of care. In furtherance of this requirement, benefits for all lower levels of care, in the aggregate, shall provide a level of benefits equivalent to 50 percent of the benefits provided for nursing home coverage. For the purposes of applying this 50 percent equivalency requirement, if a long-term care policy provides nursing home coverage for an unlimited duration, the nursing home benefit shall be considered to be payable for ten years. A long-term care policy may use an overall lifetime benefit maximum which may be exhausted by any combination of benefits.
(4) For the purposes of this rule, "lower level(s) of care" means the following:
Rulemaking Authority 624.308(1), 627.9407(1) FS. Law Implemented 624.307(1), 627.9407(1), (3) FS.
New 5-17-89, Formerly 4-81.009, 4-157.009.
