Current through Register Vol. 56, No. 18, September 16, 2024
(a) This section
applies to any long-term care policy or certificate issued on or after December
19, 2005.
(b) Other than policies
for which no applicable premium rate or rate schedule increases can be made,
carriers 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, a carrier
shall provide all of the information listed below to the applicant no later
than at the time of delivery of the policy or certificate.
1. A statement that the policy or certificate
may be subject to rate increases in the future, including the circumstances
that might lead to a rate increase. The description of circumstances shall
include those factors that pose significant risk of rate increases to
policyholders or certificate holders;
2. An explanation of potential premium rate
revisions, and the policyholder's or certificate holder's option(s) in the
event of a premium rate revision, including a description of any contingent
benefits or other benefits upon lapse;
3. The premium rate or rate schedule
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:
i. A description of when premium
rate or rate schedule adjustments will be effective (for example, next
anniversary date, next billing date, etc.); and
ii. A statement that a copy of the revised
premium rate or rate schedule as provided in (b)3 above, will be provided if
the premium rate or rate schedule is changed; and
5. Information regarding each premium rate
increase on this policy or certificate form or similar policy or certificate
forms over the past 10 years for this State and any other state.
i. Such information will identify:
(1) The form numbers and marketing names of
the policy and certificate forms for which premium rates have been
increased;
(2) The calendar years
when the form was available for purchase; and
(3) The amount and percentage 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
carrier may, in a fair manner, provide additional explanatory information
related to the rate increases.
iii.
A carrier shall have the right to exclude from the disclosure information to be
provided premium rate increases that only apply to blocks of business acquired
from other nonaffiliated carriers or the long-term care policies acquired from
other nonaffiliated carriers when those increases occurred prior to the
acquisition.
iv. If an acquiring
carrier files for a rate increase on a long-term care policy form acquired from
nonaffiliated carriers or a block of policy forms acquired from nonaffiliated
carriers on or before the later of December 19, 2005 or the end of a 24-month
period following the acquisition of the block or policies, the acquiring
carrier may exclude that rate increase from the disclosure information.
However, the nonaffiliated selling carrier shall include that rate increase in
its disclosure information in accordance with (b)5i above.
v. If the acquiring carrier in (b)5iv above
files for a subsequent rate increase, even within the 24-month period, on the
same policy form or block of policy forms acquired from nonaffiliated carriers
referenced in (b)5iv above, the acquiring carrier shall make all disclosures
required by this paragraph, including disclosure of the earlier rate increase
referenced in (b)5iv above.
(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 carrier made the disclosure
required under (b)1 and 5 above. If, due to the method of application, the
applicant cannot sign an acknowledgement at the time of application, the
applicant shall sign such an acknowledgement no later than at the time of
delivery of the policy or certificate.
(d) A carrier shall use the forms in
subchapter Appendices B and F, incorporated herein by reference, to comply with
the requirements of (b) and (c) above.
(e) A carrier shall provide notice of an
upcoming premium rate schedule increase to all policyholders and
certificateholders, if applicable, at least 45 days prior to the implementation
of the premium rate schedule increase by the carrier. The notice shall include
the information required by (b) above when the rate increase is
implemented.
(f) In the case of a
policy providing long-term care benefits in combination with other benefits, a
description of how premiums paid for the policy are allocated between long-term
care and other benefits shall be disclosed in the policy and
certificate.
