Issuers and their agents, if any, must determine whether issuing
long-term care insurance coverage to a particular person is
appropriate, except in the case of a life insurance policy that
accelerates benefits for long-term care.
(1) An issuer must:
(a) Develop and use suitability standards to determine
whether the purchase or replacement of long-term care coverage is
appropriate for the needs of the applicant or insured;
(b) Train its agents in the use of the issuer's suitability
standards; and
(c) Maintain a copy of its suitability standards and make
the standards available for inspection, upon request.
(2) The following must be considered when determining
whether the applicant meets the issuer's suitability standards:
(a) The ability of the applicant to pay for the proposed
coverage and any other relevant financial information related to
the purchase of or payment for coverage;
(b) The applicant's goals and needs with respect to
long-term care and the advantages and disadvantages of long-term
care coverage to meet those goals or needs; and
(c) The values, benefits, and costs of the applicant's
existing health or long-term care coverage, if any, when compared
to the values, benefits, and costs of the recommended purchase or
replacement.
(3) The sale or transfer of any suitability information
provided to the issuer or agent by the applicant to any other
person or business entity is prohibited.
(4)(a) The commissioner shall adopt, by rule, forms of
consumer-friendly personal worksheets that issuers and their
agents must use for applications for long-term care coverage.
(b) The commissioner may require each issuer to file its
current forms of suitability standards and personal worksheets
with the commissioner.
[2008 c 145 § 15.]