(1) An outline of
coverage must be delivered to a prospective applicant for
long-term care insurance at the time of initial solicitation
through means that prominently direct the attention of the
recipient to the document and its purpose.
(a) The commissioner must prescribe a standard format,
including style, arrangement, overall appearance, and the content
of an outline of coverage.
(b) When an insurance producer makes a solicitation in
person, he or she must deliver an outline of coverage before
presenting an application or enrollment form.
(c) In a direct response solicitation, the outline of
coverage must be presented with an application or enrollment
form.
(d) If a policy is issued to a group as defined in RCW 48.83.020(6)(a), an outline of coverage is not required to be
delivered, if the information that the commissioner requires to
be included in the outline of coverage is in other materials
relating to enrollment. Upon request, any such materials must be
made available to the commissioner.
(2) If an issuer approves an application for a long-term
care insurance contract or certificate, the issuer must deliver
the contract or certificate of insurance to the applicant within
thirty days after the date of approval. A policy summary must be
delivered with an individual life insurance policy that provides
long-term care benefits within the policy or by rider. In a
direct response solicitation, the issuer must deliver the policy
summary, upon request, before delivery of the policy, if the
applicant requests a summary.
(a) The policy summary shall include:
(i) An explanation of how the long-term care benefit
interacts with other components of the policy, including
deductions from any applicable death benefits;
(ii) An illustration of the amount of benefits, the length
of benefits, and the guaranteed lifetime benefits if any, for
each covered person;
(iii) Any exclusions, reductions, and limitations on
benefits of long-term care;
(iv) A statement that any long-term care inflation
protection option required by RCW 48.83.110 is not available
under this policy; and
(v) If applicable to the policy type, the summary must also
include:
(A) A disclosure of the effects of exercising other rights
under the policy;
(B) A disclosure of guarantees related to long-term care
costs of insurance charges; and
(C) Current and projected maximum lifetime benefits.
(b) The provisions of the policy summary may be incorporated
into a basic illustration required under chapter 48.23A RCW, or
into the policy summary which is required under rules adopted by
the commissioner.
[2008 c 145 § 8.]