Virginia Administrative Code
Title 14 - INSURANCE
Agency 5 - STATE CORPORATION COMMISSION, BUREAU OF INSURANCE
Chapter 200 - RULES GOVERNING LONG-TERM CARE INSURENCE
Form - FORMS (14VAC5-200)

Universal Citation: 14 VA Admin Code
Current through Register Vol. 41, No. 3, September 23, 2024

Rescission Reporting Form, Form A (eff. 2/2002)

Long-Term Care Insurance Personal Worksheet, Form B (rev. 4/2015)

Things You Should Know Before You Buy Long-Term Care Insurance, Form C (rev. 9/2007)

Long-Term Care Insurance Suitability Letter, Form D (rev. 2/2002)

Claims Denial Reporting Form, Form E (rev. 4/2015)

Potential Rate Increase Disclosure Form, Form F (rev. 12/2015)

Replacement and Lapse Reporting Form, Form G (eff. 9/2007)

Partnership Program Notice, Form 200-A (eff. 9/2007)

Partnership Disclosure Notice, Form 200-B (eff. 9/2007)

Long-Term Care Partnership Certification Form, Form 200-C (rev. 4/2015)

Statutory Authority: §§ 12.1-13, 38.2-223, and 38.2-5202 of the Code of Virginia.

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