Current through Register Vol. 24-06, March 15, 2024
(1)
(a)
Except as provided in (b) of this subsection, this section applies to any
long-term care policy or certificate issued for delivery in this state on or
after January 1, 2009.
(b)
Certificates issued on or after January 1, 2009, under a group long-term care
insurance policy as defined in
RCW
48.83.020(6)(a), that were
in force prior to January 1, 2009, the provisions of this section apply on the
policy anniversary first following January 1, 2009.
(2) Except for policies for which no
applicable premium rate or rate schedule increases can be made, the issuer must
provide all of the information listed in this subsection to the applicant at
the time of application or enrollment. If the method of application does not
allow for delivery at that time, the issuer must provide all of the information
listed in this section to the applicant no later than at the time of delivery
of the policy or certificate. For example, a method of delivery that does not
allow for all listed information to be provided at time of application or
enrollment is an application by mail.
(a) A
statement that the policy may be subject to rate increases in the
future;
(b) 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;
(c) The premium rate or rate schedules
applicable to the applicant that will be in effect until a request is made for
an increase;
(d) A general
explanation for applying premium rate or rate schedule including:
(i) A description of when premium rate or
rate schedule adjustments will be effective (for example, next anniversary date
or next billing date); and
(ii) The
right to a revised premium rate or rate schedule as provided for in (c) of this
subsection if the premium rate or rate schedule is changed;
(e)
(i) Information regarding each premium rate
increase on this policy form or similar policy forms over the past ten years
for this state or any other state that, at a minimum, identifies:
(A) The policy forms for which premium rates
have been increased;
(B) The
calendar years when the form was available for purchase; and
(C) 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.
(ii) The issuer, in a fair manner, may
provide additional explanatory information related to the rate
increases.
(iii) The issuer may
exclude from the disclosure, premium rate increases that only apply to blocks
of business acquired from other nonaffiliated issuers or the long-term care
policies acquired from other nonaffiliated issuers when those increases
occurred prior to the acquisition.
(iv) If the acquiring issuer files for a rate
increase on a long-term care policy form acquired from a nonaffiliated issuer
or a block of policy forms acquired from a nonaffiliated issuer on or before
the later of January 1, 2009, or the end of a twenty-four-month period
following the acquisition of the block or policies, the acquiring issuer may
exclude that rate increase from the disclosure; however, the nonaffiliated
selling issuer must include the disclosure of that rate increase in accordance
with (e)(i) of this subsection.
(v)
If the acquiring issuer in (e)(iv) of this subsection files for a subsequent
rate increase at any time (including during the twenty-four-month period
following the acquisition of the block or policies) on the same policy form
acquired from a nonaffiliated issuer or block of policy forms acquired from a
nonaffiliated issuer referenced in (e)(iv) of this subsection, the acquiring
issuer must make all disclosures required by (e) of this subsection, including
disclosure of the earlier rate increase.
(vi) If the policy is for employer-group
coverage, the disclosures in this subsection need to be made only to the
employer if the employer is paying the entire premium and no contributions or
coverage elections are made by individual employees.
(3) The applicant must sign an
acknowledgement at the time of application, unless the method of application
does not allow for signature at that time, that the issuer made the disclosure
required under subsection (2)(a) and (e) of this section. If due to the method
of application the applicant cannot sign an acknowledgement at the time of
application, the applicant must sign no later than at the time of delivery of
the policy or certificate.
(4) The
forms provided in WAC
284-83-170 and
284-83-190 must be used by the
issuer to comply with the requirements of subsections (2) and (3) of this
section.
(5) The issuer must
provide notice of an upcoming premium rate schedule increase to all
policyholders or certificate holders, as applicable, at least forty-five days
prior to the implementation of any premium rate schedule increase by the
issuer. The notice must include the information required by subsection (2) of
this section when the rate increase is implemented.
Statutory Authority:
RCW
48.02.060,
48.83.070,
48.83.110,
48.83.120,
48.83.130(1), and
48.83.140(4)(a).
08-24-019 (Matter No. R 2008-09), §
284-83-035, filed 11/24/08,
effective 12/25/08.