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Chapter 284-83 WAC

Last Update: 12/4/13

LONG-TERM CARE INSURANCE RULES

WAC Sections

Applicability and scope.
Definitions and standards.
Standards for policy definitions and terms.
Standards for policy provisions.
Unintentional lapse.
Required disclosure provisions.
Required disclosure of rating practices to consumers.
Initial rate filing requirements.
Prohibition against post-claims underwriting.
Minimum standards for home health and community care benefits in long-term care insurance policies.
Requirement to offer inflation protection.
Requirements for application forms and replacement coverage.
Notice to applicant regarding replacement of individual accident and sickness or long-term care insurance marketed by an insurance producer.
Notice to applicant regarding replacement of direct-marketed individual accident and sickness or long-term care insurance.
Reporting requirements.
Discretionary powers of commissioner.
Reserve standards.
Premium rate schedule increases.
Filing requirements.
Filing requirements for advertising.
Standards for marketing.
Suitability.
Prohibition against preexisting conditions and probationary periods in replacement policies or certificates.
Availability of new services or providers.
Right to reduce coverage and lower premiums.
Nonforfeiture benefit requirement.
Standards for benefit triggers.
Qualified long-term care insurance policiesAdditional standards for benefit triggers.
Standard format outline of coverage.
Requirement to deliver shopper's guide.
Prohibited practices.
Form for reporting rescission of long-term care policies.
Form of personal worksheet.
Disclosure form.
Response letter.
Sample claims denial reporting form.
Potential rate increase disclosure form.
Form for reporting replacement and lapse of long-term care insurance policies.
Definitions.
Grouping of policy forms for purposes of ratemaking and requests for rate increase.
Separation of data regarding certain policies.
Loss ratio requirements for long-term care insurance forms.
Experience records.
Evaluating experience data.
Life insurance policies that accelerate benefits for long-term care.
Standards for protecting patient privacy rights.
Right of insureds to receive confidential health services.
Standards for the issuer's timely review of a claim denial.
Prompt payment of clean claims.
Standard applied if there is a conflict between a master policy and certificate of insurance.
LONG-TERM CARE PARTNERSHIP PROGRAM
Purpose and authority.
Applicability and scope.
Minimum standards for long-term care partnership policies.
Long-term care partnership policy exchange or replacement.
Reporting.
Producer education.