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1 Long-Term Care Insurance Act; Rulemaking Provision Relocated. Amend RSA 415-D:5, I to read as follows:
I. Full and fair disclosure, that set forth the manner, content, and required disclosures for the sale of long-term care insurance policies and certificates, terms of renewability, initial and subsequent conditions of eligibility, non-duplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms .
2 Disclosure and Performance Standards for Long-Term Care Insurance. Amend RSA 415-D:5, IV to read as follows:
IV.(a) No long-term care insurance policy may be delivered or issued for delivery in this state if such policy:
(1) Conditions eligibility for any benefits on a prior hospitalization requirement;
(2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
(3) Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement.
(b) A long-term care insurance policy containing post-confinement, post-acute care, or recuperative benefits shall clearly label in a separate paragraph of the policy or certificate entitled "Limitations or Conditions on Eligibility for Benefits" such limitations or conditions, including any required number of days of confinement.
(c) A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than 30 days.
(d) No long-term care insurance policy or rider that provides benefits only following institutionalization shall condition such benefits upon admission to a facility for the same or related conditions within a period of less than 30 days after discharge from the institution.
(e) The commissioner may adopt rules establishing loss ratio standards for long-term care insurance policies provided that a specific reference to long-term care insurance policies is contained in the rule.
3 Long-Term Care Insurance Act; Denial of Forms RSA 415-D:12 is repealed and reenacted to read as follows:
415-D:12 Denial of Forms.
I. The commissioner may, within 30 days after the filing of any such form, disapprove such form if:
(a) The benefits provided therein are unreasonable in relation to the premium charged;
(b) It contains a provision or premium rate or rate increase which is unjust, unfair, inequitable, misleading, deceptive, or encourage misrepresentation of such policy; or
(c) It does not comply with the requirements of law or rules adopted under this chapter.
II. The 30-day period under paragraph I may be extended by the commissioner if the insurer has not provided all necessary information required to make a determination under paragraph I or if the commissioner elects to hold a hearing pursuant to RSA 400-A:15-f, IV.
III. If the commissioner notifies the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for such insurer to issue such form or use it in connection with any policy. In such notice, the commissioner shall specify the reasons for his or her disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer.
4 New Paragraph; Confidentiality; Forms and Rates. Amend RSA 400-A:15-f by inserting after paragraph III the following new paragraph:
IV. The commissioner may hold a public hearing prior to approving or denying any form or rate filing. Notwithstanding any other law in title XXXVII, the filing in whole or in part may be subject to disclosure as the commissioner may determine necessary in the course of holding a public hearing.
5 Effective Date. This act shall take effect 60 days after its passage.
Text to be added highlighted in green.
1 Long-Term Care Insurance Act; Rulemaking Provision Relocated. Amend RSA 415-D:5, I to read as follows:
I. Full and fair disclosure, that set forth the manner, content, and required disclosures for the sale of long-term care insurance policies and certificates, terms of renewability, initial and subsequent conditions of eligibility, non-duplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, definitions of terms , loss ratio standards, filing requirements, agent compensation, agent testing, penalties and reporting practices .
2 Disclosure and Performance Standards for Long-Term Care Insurance. Amend RSA 415-D:5, IV to read as follows:
IV.(a) No long-term care insurance policy may be delivered or issued for delivery in this state if such policy:
(1) Conditions eligibility for any benefits on a prior hospitalization requirement;
(2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
(3) Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement.
(b) A long-term care insurance policy containing post-confinement, post-acute care, or recuperative benefits shall clearly label in a separate paragraph of the policy or certificate entitled "Limitations or Conditions on Eligibility for Benefits" such limitations or conditions, including any required number of days of confinement.
(c) A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than 30 days.
(d) No long-term care insurance policy or rider that provides benefits only following institutionalization shall condition such benefits upon admission to a facility for the same or related conditions within a period of less than 30 days after discharge from the institution.
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V. Notwithstanding any other provision in this chapter, the insurance commissioner may approve innovative short or long-term care policies or certificates and the rates, provided the commissioner finds that:
(a) Issuance or delivery is not contrary to the best interest of the public, and
(b) The benefits are reasonable in relation to the premium charged.
3 Long-Term Care Insurance Act; Denial of Forms RSA 415-D:12 is repealed and reenacted to read as follows:
415-D:12 Denial of Forms.
I. The commissioner may, within 30 days after the filing of any such form, disapprove such form if:
(a) The benefits provided therein are unreasonable in relation to the premium charged;
(b) It contains a provision or premium rate or rate increase which is unjust, unfair, inequitable, misleading, deceptive, or encourage misrepresentation of such policy; or
(c) It does not comply with the requirements of law or rules adopted under this chapter.
II. The 30-day period under paragraph I may be extended by the commissioner if the insurer has not provided all necessary information required to make a determination under paragraph I or if the commissioner elects to hold a hearing pursuant to RSA 400-A:15-f, IV.
III. If the commissioner notifies the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for such insurer to issue such form or use it in connection with any policy. In such notice, the commissioner shall specify the reasons for his or her disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer.
4 New Paragraph; Confidentiality; Forms and Rates. Amend RSA 400-A:15-f by inserting after paragraph III the following new paragraph:
IV. The commissioner may hold a public hearing prior to approving or denying any form or rate filing. Notwithstanding any other law in title XXXVII, the filing in whole or in part may be subject to disclosure as the commissioner may determine necessary in the course of holding a public hearing.
5 Effective Date. This act shall take effect 60 days after its passage.