California Insurance Code ARTICLE 4 - Implementation

• Section 10235.
  Except as provided in Section 10235.95, this article applies to all long-term care insurance policies delivered or issued for delivery in this state on or...
• Section 10235.2.
  No long-term care insurance policy delivered or issued for delivery in this state shall use the terms set forth below, unless the terms are defined...
• Section 10235.8.
  No policy may be delivered or issued for delivery in this state as long-term care insurance if the policy limits or excludes coverage by type...
• Section 10235.9.
  (a) Every insurer shall report annually by June 30 the total number of claims denied by each class of business in the state and the number...
• Section 10235.9a.
  For policies or certificates issued on or after January 1, 2017, that contain an alternate plan of care provision pursuant to Section 10231.3, if an...
• Section 10235.10.
  Termination of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if that institutionalization began while the long-term care insurance was...
• Section 10235.14.
  (a) Individual long-term care insurance policies shall contain a renewability provision. This provision shall be appropriately captioned, shall appear on the first page of the policy,...
• Section 10235.16.
  (a) Long-term care insurance application forms shall include a question designed to elicit information as to whether the proposed insurance is intended to replace any other...
• Section 10235.17.
  For purposes of this chapter, the commissioner shall define inappropriate replacement of long-term care insurance in consultation with other interested parties.(Added by Stats. 1992, Ch....
• Section 10235.18.
  (a) Insurers using direct response solicitation methods shall deliver a notice regarding replacement of accident and sickness or long-term care coverage to the applicant upon issuance...
• Section 10235.20.a.
  The commissioner may waive a specific provision or provisions of this article with respect to a specific long-term care insurance policy or certificate upon making...
• Section 10235.30.
  (a) No insurer may deliver or issue for delivery a long-term care policy in this state unless the insurer offers at the time of application an...
• Section 10235.35.
  (a) Notwithstanding any other law, the commissioner may require the administration by an insurer of the contingent benefit upon lapse, as described in Section 28 (A),...
• Section 10235.36.
  (a) When a shortened benefit period nonforfeiture benefit, as described in Section 10235.30, or a contingent benefit upon lapse, as described in Section 10235.35, is conferred,...
• Section 10235.40.
  (a) No individual long-term care policy or certificate shall be issued until the applicant has been given the right to designate at least one individual, in...
• Section 10235.50.
  Every policy or certificate shall include a provision that gives the policyholder or certificate holder the following rights to reduce coverage and lower premiums:(a) A right,...
• Section 10235.51.
  (a) Every policy or certificate shall include a provision that gives the insured the option to elect, no less frequently than on each anniversary date after...
• Section 10235.52.
  (a) Each policy shall contain a provision that, if the insurer develops new benefits or benefit eligibility or new policies with new benefits or benefit eligibility...
• Section 10235.91.
  In the event a non-medicaid national or state long-term care program is created through public funding that substantially duplicates benefits covered by the policy or...
• Section 10235.94.
  Every policy or certificate shall include a provision giving the policyholder or certificate holder the right to appeal decisions regarding benefit eligibility, care plans, services...
• Section 10235.95.
  (a) Notwithstanding Section 10235, this section applies to all long-term care policies in force, regardless of their dates of issuance.(b) Interest shall accrue and shall be payable...
• Section 10236.
  Every individual and group long-term care policy and certificate under a group long-term care policy shall be either guaranteed renewable or noncancelable.(a) “Guaranteed renewable” means that...
• Section 10236.1.
  (a) Benefits under individual long-term care insurance policies issued before new premium rate schedules are approved under Section 10236.11 shall be deemed reasonable in relation to...
• Section 10236.2.
  Except where the provisions of a group contract provide otherwise, the provisions of subdivisions (d) and (e) of Section 10236.1 shall apply to all group...
• Section 10236.5.
  (a) Every certificate of group insurance issued or delivered in California shall provide for continuation or conversion coverage for the certificate holder if the group coverage...
• Section 10236.8.
  If a group long-term care policy is replaced by another policy to the same master policyholder issued, the replacing insurer shall do all of the...
• Section 10236.11.
  The premium rate schedules for all individual and group long-term care insurance policies issued in this state shall be filed with and receive the prior...
• Section 10236.12.
  All actuaries used by the commissioner to review rate applications submitted by insurers pursuant to this chapter who are employees of the department shall be...
• Section 10236.13.
  No insurer may increase the premium for an individual or group long-term care insurance policy or certificate approved for sale under this chapter unless the...
• Section 10236.14.
  Approval of all premium rate schedule increases shall be subject to the following requirements:(a) (1) Premium rate schedule increases shall demonstrate that the sum of the accumulated...
• Section 10236.15.
  Premium rate schedule increases that have been approved shall be subject to the following:(a) For each rate increase that is implemented, the insurer shall file for...

Last modified: October 22, 2018