Current through Register No. 12, March 21, 2024
(a)
This section shall apply as follows:
(1)
Except as provided in (2) below, this section applies to any long-term care
policy or certificate issued in this state on or after the effective date of
this rule; and
(2) For certificates
issued on or after the effective date of this amended rule under a group
long-term care insurance policy as defined in
RSA 415-D:3 IV.(a),
which policy was in force at the time this amended rule became effective, the
provisions of this section shall apply on the policy anniversary following 12
months after the effective date of this amended rule.
(b) 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:
(1) A statement that the policy may be
subject to rate increases in the future;
(2) An explanation of potential future
premium rate revisions, and the policyholder's or certificateholder's option in
the event of a premium rate revision;
(3) The premium rate or rate schedules
applicable to the applicant that will be in effect until a request is made for
an increase;
(4) A general
explanation for applying premium rate or rate schedule adjustments that shall
include:
a.A description of when premium rate
or rate schedule adjustments will be effective (e.g., next anniversary date,
next billing date, etc.); and
b.The
right to a revised premium rate or rate schedule as provided in paragraph (3)
if the premium rate or rate schedule is changed; and
(5)
a.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:
1.The policy forms for which premium rates
have been increased;
2.The calendar
years when the form was available for purchase; and
3.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.
b.The insurer may, in a fair manner, provide
additional explanatory information related to the rate increases;
c.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;
d.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 24 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 a. of this paragraph; and
e.If the acquiring insurer in subparagraph d.
above files for a subsequent rate increase, even within the 24 month period, on
the same policy form acquired from nonaffiliated insurers or block of policy
forms acquired from nonaffiliated insurers referenced in subparagraph d., the
acquiring insurer shall make all disclosures required by paragraph (5),
including disclosure of the earlier rate increases referenced in subparagraph
d.
(c) 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 subsections (b)(1) and (5). If due
to the method of application the applicant cannot sign an acknowledgement at
the time of application, the applicant shall sign no later than at the time of
delivery of the policy or certificate.
(d) An insurer shall use the forms in
Appendices B and F to comply with the requirements of (b) and (c) of this
section.
(e) 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:
(1) Include the information
required by subsection (b) when the rate increase is implemented;
(2) Include available benefit reduction and
other rate increase mitigation options; and
(3) Address the guaranteed renewable nature
of the policy so that the insured shall understand that the premium rates may
increase again in the future.
#8036, eff 5-1-04; ss by #10154, eff
6-25-12