Virginia Administrative Code
Title 14 - INSURANCE
Agency 5 - STATE CORPORATION COMMISSION, BUREAU OF INSURANCE
Chapter 200 - RULES GOVERNING LONG-TERM CARE INSURENCE
Section 14VAC5-200-170 - Standards for marketing
Universal Citation: 4 VA Admin Code 5-200-170
Current through Register Vol. 41, No. 3, September 23, 2024
A. Every insurer, marketing long-term care insurance coverage in this Commonwealth directly or through its agents, shall:
1.
Establish marketing procedures to assure that any comparison of policies by its
agents will be fair and accurate.
2. Establish marketing procedures to assure
excessive insurance is not sold or issued.
3. 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."
4. Provide
copies of the disclosure forms (Forms B and F) to the applicant.
5. 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.
6. Every insurer, marketing long-term care
insurance shall establish auditable procedures for verifying compliance with
this subsection.
7. At
solicitation, provide written notice to the prospective policyholder and
certificateholder that the Virginia Insurance Counseling and Assistance Program
is available at: Virginia Department for the Aging, 1610 Forest Avenue, Suite
100, Richmond, Virginia 23229, Aging Services Hotline 1-800-552-3402.
8. For long-term care health insurance
policies and certificates, use the terms "noncancellable" or "level premium"
only when the policy or certificate conforms with
14VAC5-200-60.
9. Provide an explanation of contingent
benefit upon lapse provided for in
14VAC5-200-185 D 3 and, if
applicable, the additional contingent benefit upon lapse provided to policies
with fixed or limited premium paying periods in
14VAC5-200-185 D 4.
B. In addition to the practices prohibited in Chapter 5 (§ 38.2-500 et seq.) of Title 38.2 of the Code of Virginia, the following acts and practices are prohibited:
1. Twisting. 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 agent or insurance company.
C.
1.
Associations that provide long-term care insurance policies or certificates
endorsed or sold by the association shall disclose in any long-term care
insurance solicitation:
a. The specific
nature and amount of the compensation arrangements (including 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.
2. If the association and the insurer have
interlocking directorates or trustee arrangements, the association shall
disclose that fact to its members.
3. 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.
4. A group long-term care insurance policy or
certificate may not be issued to an association unless the insurer obtains the
information contained in this subsection. The insurer may be required to
provide such information to the commission upon request or certify that the
association has complied with the requirements set forth in this
subsection.
Statutory Authority
§§ 12.1-13 and 38.2-223 of the Code of Virginia.
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