(1) No
issuer may offer a long-term insurance policy or certificate unless the
issuer also offers to the policyholder, in addition to any other inflation
protection, the option to purchase a policy or certificate that provides for
benefit levels to increase with benefit maximums or reasonable durations which
are meaningful to account for reasonably anticipated increases in the costs of
long-term care services covered by the policy or certificate. Issuers
must offer to each policyholder, at the time of purchase, the option to
purchase a policy or certificate with an inflation protection feature no less
favorable than one of the following:
(a) increases benefit levels annually in a manner so that the increases are
compounded annually at a rate not less than 5%;
(b) guarantees the insured individual the right to periodically increase benefit
levels without providing evidence of insurability or health status so long as
the option for the previous period has not been declined. The amount of the
additional benefit shall be no less than the difference between the existing
policy benefit and that benefit compounded annually at a rate of at least 5%
for the period beginning with the purchase of the existing benefit and
extending until the year in which the offer is made; or
(c) covers a specified percentage of actual or reasonable charges and does not
include a maximum specified indemnity amount or limit.
(2) Where the policy or certificate is issued to a group, the required offer in (1) above shall be made to the group policyholder; except, if the policy or
certificate is issued to a group defined in 33-22-1107(5) (d) , MCA,
other than to a continuing care retirement community, the offering shall be
made to each proposed certificateholder.
(3) The
offer in (1) above shall not be required of life insurance policies or riders
containing accelerated long-term care benefits.
(4) Issuers shall include the following information in or with the outline of
coverage:
(a) a
graphic comparison of the benefit levels of a policy or certificate that
increases benefits over the policy period with a policy or certificate that
does not increase benefits. The graphic comparison shall show benefit levels
over at least a 20-year period; and
(b) any
expected premium increases or additional premiums to pay for automatic or
optional benefit increases. If premium increases or additional premiums will be
based on the attained age of the applicant at the time of the increase, the
issuer shall also disclose the magnitude of the potential premiums the
applicant would need to pay at ages 75 and 85 for benefit increases,
(c) an
issuer may use a reasonable hypothetical, or a graphic demonstration, for the
purposes of this disclosure.
(5) Inflation protection benefit increases under a policy or certificate which
contains these benefits shall continue without regard to an insured's age,
claim status or claim history, or the length of time the person has been
insured under the policy or certificate.
(6) An
offer of inflation protection that provides for automatic benefit increases
shall include an offer of a premium which the issuer expects to remain
constant. The offer shall disclose in a conspicuous manner that the premium may
change in the future unless the premium is guaranteed to remain constant.
(7) Inflation protection as provided in (1) ,(a) of this section shall be included
in a long-term care insurance policy or certificate unless an issuer
obtains a rejection of inflation protection signed by the policyholder as
required in this section. The rejection shall be considered a part of the
application and shall state:
(a) I
have received the outline of the coverage and the graphs that compare the
benefits and premiums of this policy or certificate with and without inflation
protection. Specifically, I have reviewed Plans__________, and I reject
inflation protection.