Long-Term Care Insurance Model Regulation

What this document is

Long-Term Care Insurance Model Regulation is a naic model law published by National Association of Insurance Commissioners (NAIC). It is one of the documents that insurance license exam questions are written from, including life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• NAIC Model #641: Section 7 (Unintentional Lapse)

  “No individual long-term care policy or certificate shall lapse or be terminated for nonpayment of premium unless the insurer, at least thirty (30) days before the effective date of the lapse or termination, has given notice to the insured and to those persons designated pursuant to Subsection A(1),...”

• NAIC Model #641 - Section 8D (Limitations), Required Disclosure Provisions

  “If a long-term care insurance policy or certificate contains any limitations with respect to preexisting conditions, the limitations shall appear as a separate paragraph of the policy or certificate and shall be labeled as “Preexisting Condition Limitations.”

• NAIC Model #641: Section 6 (Limitations and Exclusions)

  “(2) Mental or nervous disorders; however, this shall not permit exclusion or limitation of benefits on the basis of Alzheimer’s Disease;”

• NAIC Model #641 - Appendix C (Things You Should Know Before You Buy Long-Term Care Insurance)

  “you have the right to return the policy within 30 days and get back any premium you have paid if you are dissatisfied for any reason or choose not to purchase the policy.”

• NAIC Model #641: Section 28 (Nonforfeiture Benefit Requirement)

  “(2) For purposes of this subsection, the nonforfeiture benefit shall be of a shortened benefit period providing paid-up long-term care insurance coverage after lapse. The same benefits (amounts and frequency in effect at the time of lapse but not increased thereafter) will be payable for a...”

• NAIC Model #641: Section 24 (Suitability)

  “At the same time as the personal worksheet is provided to the applicant, the disclosure form entitled “Things You Should Know Before You Buy Long-Term Care Insurance” shall be provided.”

• NAIC Model NAIC 641 (Section 14 (Requirements for Application Forms and Replacement Coverage), prescribed Notice to Applicant Regarding Replacement)

  “Your new policy provides thirty (30) days within which you may decide, without cost, whether you desire to keep the policy.”

• NAIC Model NAIC 641: Section 34A(1) (Requirement to Deliver Shopper’s Guide)

  “In the case of agent solicitations, an agent must deliver the shopper’s guide prior to the presentation of an application or enrollment form.”

• NAIC Model NAIC 641: Section 24B(1) (Suitability Standards)

  “Develop and use suitability standards to determine whether the purchase or replacement of long-term care insurance is appropriate for the needs of the applicant;”

• NAIC Long-Term Care Insurance Model Regulation § 14C (replacement notice, solicitations other than direct response)

  “Solicitations Other than Direct Response. Upon determining that a sale will involve replacement, an insurer; other than an insurer using direct response solicitation methods, or its agent; shall furnish the applicant, prior to issuance or delivery of the individual long-term care insurance policy,...”

• NAIC Long-Term Care Insurance Model Regulation § 5.A (policy definitions, activities of daily living)

  “No long-term care insurance policy delivered or issued for delivery in this state shall use the terms set forth below, unless the terms are defined in the policy and the definitions satisfy the following requirements: A. “Activities of daily living” means at least bathing, continence, dressing,...”

• NAIC Long-Term Care Insurance Model Regulation § 13G(1), inclusion of inflation protection absent a signed rejection

  “Inflation protection as provided in Subsection A(1) of this section shall be included in a long-term care insurance policy unless an insurer obtains a rejection of inflation protection signed by the policyholder as required in this subsection. The rejection may be either in the application or on a separate form.”

Practice this material

Questions about this source

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