Current through Register Vol. 39, No. 6, September 16, 2024
(a) This
Rule shall apply as follows:
(1) To any
long-term care policy or certificate issued in this state on or after February
1, 2003, except as provided in Paragraph (a)(2) of this Rule.
(2) For certificates issued on or after
August 1, 2002 under a group long-term care insurance policy as defined in
G.S.
58-55-20(3), which policy
was in force at the time this Rule became effective, the provisions of this
Rule shall apply on the policy anniversary following July 1, 2003.
(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 Paragraph 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 required disclosure to the applicant no later than at the time of delivery
of the policy or certificate. Required disclosure is as follows:
(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 certificate-holder'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 on either the next
anniversary date or the next billing date; and
(B) The right to a revised premium rate or
rate schedule as provided if the premium rate or rate schedule is
changed;
(5) Information
regarding history of rate increases:
(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:
(i) The policy forms
for which premium rates have been increased;
(ii) The calendar years when the form was
available for purchase; and
(iii)
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) An
insurer shall have the right to exclude from the disclosure premium rate
increases that apply only to blocks of business acquired from other
non-affiliated insurers or the long-term care policies acquired from other
non-affiliated insurers when those increases occurred prior to the
acquisition;
(C) 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 non-affiliated
insurers on or before August 1, 2002 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
this Rule; and
(D) If the acquiring
insurer referenced in Paragraph (b)(5)(C) of this Rule 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 Paragraph (b)(5)(C) of this Rule, the
acquiring insurer must make all disclosures required by this Rule, including
disclosure of the earlier rate increase.
(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 this Rule. 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 NAIC Long-Term Care Insurance Model Regulation forms identified as
Appendices B and F to comply with the requirements of Paragraphs (b) and (c) of
this Rule.
(e) An insurer shall
provide notice of an upcoming premium rate schedule increase to all
policyholders or certificate-holders, 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 under this Rule when the rate
increase is implemented.
Authority
G.S.
58-2-40(1);
58-55-30(a);
58-63-15(9);
Eff. August 1, 2002;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. May 1, 2018.
