Current through Register No. 12, March 21, 2024
(a) Every insurer,
health care service plan or other entity marketing long-term care insurance
coverage in this state, directly or through its producers, shall:
(1) Establish marketing procedures and
producer training requirements to assure that:
a. Any marketing activities, including any
comparison policies, by its producers or other producers will be fair and
accurate; and
b. Excessive
insurance is not sold or issued.
(2) 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 of 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."
(3) Provide
copies of the disclosure forms required in
Ins
3601.08 (Appendices B and F) to the
applicant.
(4) Inquire and
otherwise make every reasonable effort to identify whether a prospective
applicant or enrollee for long-term care insurance already has accident and
sickness 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.
(5) Every insurer or
entity marketing long-term care insurance shall establish auditable procedures
for verifying compliance with this subsection (a).
(6) 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 commissioner, the insurer shall, at
solicitation, provide written notice to the prospective policyholder and
certificateholder that the program is available and the name, address and
telephone number of the program.
(7) For long-term care health insurance
policies and certificates, use the terms "noncancellable" or "level premium"
only when the policy or certificate conforms to
Ins
3601.05(a)(3) of this rule.
(8) Provide an explanation of contingent
benefit upon lapse provided for in
Ins
3601.25(d)(3) and, if applicable, the
additional contingent benefit upon lapse provided to policies with fixed or
limited premium paying periods in
Ins
3601.25(d)(4).
(b) In addition to the practices prohibited
in RSA 417, the following acts and practices are prohibited:
(1) 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.
(2) 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.
(3) 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 producer or insurance company.
(4) Misrepresentation. Misrepresenting a
material fact in selling or offering to sell a long-term care insurance
policy.
(c)
(1) With respect to the obligations set forth
in this subsection, the primary responsibility of an association, as defined in
RSA 415-D:3 IV. (b),
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.
(2) The insurer shall file with the
department the following material:
a. The
policy and certificate;
b. A
corresponding outline of coverage; and
c. All advertisements requested by the
department.
(3) The
association shall disclose in any long-term care insurance solicitation:
a. 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
b. A brief description of the process under
which the policies and the insurer issuing the policies were
selected.
(4) If the
association and the insurer have interlocking directorates or trustee
arrangements, the association shall disclose that fact to its
members.
(5) 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.
(6) The association shall also:
a. 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;
b. Actively monitor the marketing efforts of
the insurer and its producers; and
c. Review and approve all marketing materials
or other insurance communications used to promote sales or sent to members
regarding the policies or certificates.
d. Subparagraphs a. through c. shall not
apply to qualified long-term care insurance contracts.
(7) 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.
(8) 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.
(9) Failure to comply
with the filing and certification requirements of this section constitutes an
unfair trade practice in violation of RSA 417.
#8036, eff 5-1-04; ss by #10154, eff
6-25-12
The amended
version of this section by
New
Hampshire Register Volume 35, Number 10, eff.2/13/2015 is not yet
available.