No long-term care insurance
policy may:
(1) Be canceled, nonrenewed, or otherwise terminated on the
grounds of the age or the deterioration of the mental or physical
health of the insured individual or certificate holder;
(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;
(3) Provide coverage for skilled nursing care only or
provide significantly more coverage for skilled care in a
facility than coverage for lower levels of care;
(4) Condition eligibility for any benefits on a prior
hospitalization requirement;
(5) Condition eligibility for benefits provided in an
institutional care setting on the receipt of a higher level of
institutional care;
(6) Condition eligibility for any benefits other than waiver
of premium, postconfinement, postacute care, or recuperative
benefits on a prior institutionalization requirement;
(7) Include a postconfinement, postacute care, or
recuperative benefit unless:
(a) Such requirement is clearly labeled in a separate
paragraph of the policy or certificate entitled "Limitations or
Conditions on Eligibility for Benefits"; and
(b) Such limitations or conditions specify any required
number of days of preconfinement or postconfinement;
(8) Condition eligibility for noninstitutional benefits on
the prior receipt of institutional care;
(9) A long-term care insurance policy or certificate may be
field-issued if the compensation to the field issuer is not based
on the number of policies or certificates issued. For purposes
of this section, "field-issued" means a policy or certificate
issued by a producer or a third-party administrator of the policy
pursuant to the underwriting authority by an issuer and using the
issuer's underwriting guidelines.
[2008 c 145 § 6.]