NAIC Limited Long-Term Care Insurance Model Act (#642)

What this document is

NAIC Limited Long-Term Care Insurance Model Act (#642) 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 Limited Long-Term Care Insurance Model Act (#642), Section 4D

  ““Limited long-term care insurance” means any insurance policy or rider advertised, marketed, offered or designed to provide coverage for less than twelve (12) consecutive months for each covered person on an expense-incurred, indemnity, prepaid or other basis;”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 7E

  “If an insurer has paid benefits under the limited long-term care insurance policy or certificate, the benefit payments may not be recovered by the insurer in the event that the policy or certificate is rescinded.”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 4G

  ““Elimination Period” means, for purposes of this Act, the length of time between meeting the eligibility for benefit payment and receiving benefit payments from an insurer.”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 7C

  “After a policy or certificate has been in force for two (2) years, it is not contestable upon the grounds of misrepresentation alone; such policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured’s health.”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 6A(2)

  “Contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder;”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 8A

  “the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 6F(2)(h)

  “(h) A statement that discloses to the policyholder or certficateholder that the policy is not long-term care insurance.”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 6C(1)

  “No limited long-term care insurance policy may be delivered or issued for delivery in this state if the policy: (a) Conditions eligibility for any benefits on a prior hospitalization requirement;”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 6A(1)

  “Be cancelled, non-renewed or otherwise terminated on the grounds of the age, gender or the deterioration of the mental or physical health of the insured individual or certificate holder;”

• NAIC Limited Long-Term Care Insurance Model Act (#642), Section 6I

  “If a claim under a limited long-term care insurance contract is denied, the issuer shall, within sixty (60) days of the date of a written request by the policyholder or certificateholder, or a representative thereof:”

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