(1) This section
shall apply as follows:
(a) Except as
provided in paragraph (b), this section applies to any long-term care policy or
certificate issued in this state on or after April 1, 2008.
(b) For certificates issued on or after the
effective date of this amended regulation under a group long-term care
insurance policy as defined in O.C.G.A. Section
33-42-4, which policy was in force
at the time this amended regulation became effective, the provisions of this
section shall apply on the policy anniversary following April 1,
2009.
(2) Other than
policies for which no applicable premium rate or rate schedule increases can be
made, insurers shall provide all of the information listed in this subsection
to the applicant at the time of application or enrollment, unless the method of
application does not allow for delivery at that time. In such a case, an
insurer shall provide all of the information listed in this section to the
applicant no later than at the time of delivery of the policy or certificate:
(a) A statement that the policy may be
subject to rate increases in the future;
(b) An explanation of potential future
premium rate revisions, and the policyholder's or certificateholder's option in
the event of a premium rate revision;
(c) The premium rate or rate schedules
applicable to the applicant that will be in effect until a request is made for
an increase;
(d) A general
explanation for applying premium rate or rate schedule adjustments that shall
include:
(i) A description of when premium
rate or rate schedule adjustments will be effective (e.g., next anniversary
date, next billing date, etc.); and
(ii) The right to a revised premium rate or
rate schedule as provided in paragraph (c) if the premium rate or rate schedule
is changed;
(e)
(i) Information regarding each premium rate
increase on this policy form or similar policy forms over the past 10 years for
this state or any other state that, at a minimum, identifies:
(A) The policy forms for which premium rates
have been increased;
(B) The
calendar years when the form was available for purchase; and
(C) The amount or percent of each increase.
The percentage may be expressed as a percentage of the premium rate prior to
the increase, and may also be expressed as minimum and maximum percentages if
the rate increase is variable by rating characteristics.
(ii) The insurer may, in a fair manner,
provide additional explanatory information related to the rate
increases.
(iii) An insurer shall
have the right to exclude from the disclosure premium rate increases that only
apply to blocks of business acquired from other nonaffiliated insurers or the
long-term care policies acquired from other nonaffiliated insurers when those
increases occurred prior to the acquisition.
(iv) If an acquiring insurer files for a rate
increase on a long-term care policy form acquired from nonaffiliated insurers
or a block of policy forms acquired from nonaffiliated insurers on or before
the later of the effective date of this section or the end of a
twenty-four-month period following the acquisition of the block or policies,
the acquiring insurer may exclude that rate increase from the disclosure.
However, the nonaffiliated selling company shall include the disclosure of that
rate increase in accordance with subparagraph (i) of this paragraph.
(v) If the acquiring insurer in subparagraph
(iv) above files for a subsequent rate increase, even within the
twenty-four-month period, on the same policy form acquired from nonaffiliated
insurers or block of policy forms acquired from nonaffiliated insurers
referenced in subparagraph (iv), the acquiring insurer shall make all
disclosures required by paragraph (e), including disclosure of the earlier rate
increase referenced in subparagraph (iv).
(3) An applicant shall sign an
acknowledgement at the time of application, unless the method of application
does not allow for signature at that time, that the insurer made the disclosure
required under paragraphs (2)(a) and (2)(e). If due to the method of
application the applicant cannot sign an acknowledgement at the time of
application, the applicant shall signno later than at the time of delivery of
the policy or certificate.
(4) An
insurer shall use the forms in Appendices B and F to comply with the
requirements of subsections (2) and (3) of this section.
(5) An insurer shall provide notice of an
upcoming premium rate schedule increase to all policyholders or
certificateholders, if applicable, at least 45 days prior to the implementation
of the premium rate schedule increase by the insurer. The notice shall include
the information required by subsection (2) when the rate increase is
implemented.
O.C.G.A. Secs.
33-2-9,
33-42-6,
33-42-7,
49-4-164,
49-4-165.
