Nebraska Administrative Code
Topic - INSURANCE, DEPARTMENT OF
Title 210 - NEBRASKA DEPARTMENT OF INSURANCE
Chapter 46 - LONG-TERM CARE INSURANCE
Section 210-46-020 - Standards for Marketing
Universal Citation: 210 NE Admin Rules and Regs ch 46 ยง 020
Current through September 17, 2024
020.01 Every insurer, health care service plan or other entity marketing long-term care insurance coverage in this state, directly or through its producers, shall:
020.01(A) Establish marketing procedures to
assure that any comparison of policies by its agents or other producers will be
fair and accurate.
020.01(B)
Establish marketing procedures to assure excessive insurance is not sold or
issued.
020.01(C) Display
prominently by type, stamp or other appropriate means, on the first page of the
outline of coverage and policy the following:
"Notice to buyer: This policy may not cover all the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations."
020.01(D)
Inquire and otherwise make every reasonable effort to identify whether a
prospective applicant or enrollee for long-term care insurance already has
sickness and accident or long-term care insurance and the types and amounts of
any such insurance except that in the case of qualified long-term care
insurance contracts, an inquiry into whether a prospective applicant or
enrollee for long-term care insurance has accident and sickness insurance is
not required.
020.01(E) Every
insurer or entity marketing long-term care insurance shall establish auditable
procedures for verifying compliance with this subsection 020.01.
020.01(F) If the state in which the policy or
certificate is to be delivered or issued for delivery has a senior insurance
counseling program approved by the Director, the insurer shall, at
solicitation, provide written notice to the prospective policyholder and
certificateholder that such a program is available and the name, address and
telephone number of the program.
020.01(G) For long term care health insurance
policies and certificates, use the terms "noncancellable" or "level premium"
only when the policy or certificate conforms to section
006.01(C) of this
regulation.
020.02 In addition to the practices prohibited in Neb.Rev.Stat. § 44-1522 through §1544, the following acts and practices are prohibited:
020.02(A) Twisting. Knowingly making any
misleading representation or incomplete or fraudulent comparison of any
insurance policies or insurers for the purpose of inducing, or tending to
induce, any person to lapse, forfeit, surrender, terminate, retain, pledge,
assign, borrow on or convert any insurance policy or to take out a policy of
insurance with another insurer.
020.02(B) High pressure tactics. Employing
any method of marketing having the effect of or tending to induce the purchase
of insurance through force, fright, threat, whether explicit or implied, or
undue pressure to purchase or recommend the purchase of insurance.
020.02(C) Cold lead advertising. Making use
directly or indirectly of any method of marketing which fails to disclose in a
conspicuous manner that a purpose of the method of marketing is solicitation of
insurance and that contact will be made by an insurance agent or insurance
company.
020.02(D)
Misrepresentation. Misrepresenting a material fact in selling or offering to
sell a long-term care insurance policy.
020.03
020.03(A) With respect to the obligations set
forth in this subsection, the primary responsibility of an association, as
referenced in Neb.Rev.Stat.
§
44-4508,
when endorsing or selling long-term care insurance shall be to educate its
members concerning long-term care issues in general so that its members can
make informed decisions. Associations shall provide objective information
regarding long-term care insurance policies or certificates endorsed or sold by
such associations to ensure that members of such associations receive a
balanced and complete explanation of the features in the policies or
certificates that are being endorsed or sold. This paragraph shall not apply to
qualified long-term care insurance contracts.
020.03(B) The insurer shall file with the
insurance department the following material:
020.03(B)(1) The policy and
certificate,
020.03(B)(2) A
corresponding outline of coverage, and
020.03(B)(3) All advertisements requested by
the insurance department.
020.03(C) The association shall disclose in
any long-term care insurance solicitation:
020.03(C)(1) The specific nature and amount
of the compensation arrangements (including all fees, commissions,
administrative fees and other forms of financial support) that the association
receives from endorsement or sale of the policy or certificate to its members;
and
020.03(C)(2) A brief
description of the process under which the policies and the insurer issuing the
policies were selected.
020.03(D) If the association and the insurer
have interlocking directorates or trustee arrangements, the association shall
disclose that fact to its members.
020.03(E) The board of directors of
associations selling or endorsing long-term care insurance policies or
certificates shall review and approve the insurance policies as well as the
compensation arrangements made with the insurer.
020.03(F) The association shall also:
020.03(F)(1) At the time of the association's
decision to endorse, engage the services of a person with expertise in
long-term care insurance not affiliated with the insurer to conduct an
examination of the policies, including its benefits, features, and rates and
update the examination thereafter in the event of material change;
020.03(F)(2) Actively monitor the marketing
efforts of the insurer and its agents; and
020.03(F)(3) Review and approve all marketing
materials or other insurance communications used to promote sales or sent to
members regarding the policies or certificates.
020.03(F)(4) Subsections
020.03(F)(1)
through
020.03(F)
(3) shall not apply to qualified long-term
care insurance contracts.
020.03(G) No group long-term care insurance
policy or certificate may be issued to an association unless the insurer files
with the state insurance department the information required in this
subsection.
020.03(H) The insurer
shall not issue a long-term care policy or certificate to an association or
continue to market such a policy or certificate unless the insurer certifies
annually that the association has complied with the requirements set forth in
this subsection.
020.03(I) Failure
to comply with the filing and certification requirements of this section
constitutes an unfair trade practice in violation of
Neb.Rev.Stat.
§
44-1521
through §
44-1535.
Disclaimer: These regulations may not be the most recent version. Nebraska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.