Michigan Compiled Laws 218-1956-39 Chapter 39 Long-term Care Insurance (500.3901...500.3955)

• Section 500.3901 Long-term Care Insurance; Definitions.
  As used in this chapter: (a) "Acute condition" means that the individual is medically unstable, requiring frequent monitoring by medical professionals in order to...
• Section 500.3902 Offer Of Long-term Care Coverage By Subsidiary Of Health Care Corporation.
  A nonprofit health care corporation shall only offer long-term care coverage through a subsidiary of the health care corporation and as provided in this...
• Section 500.3903 Group Long-term Care Insurance; Coverage Offered To Groups Described In Mcl 500.3901(c)(iv) And 500.3901(c)(iii).
  (1) Group long-term care insurance coverage shall not be offered to a resident of this state under a group certificate issued in another state...
• Section 500.3905 Long-term Care Coverage; Requirements; Certain Coverages Requiring Care Recommendations.
  (1) Long-term care coverage shall meet all of the following requirements: (a) Shall include coverage for intermediate/basic care, which shall not be significantly less...
• Section 500.3906 Designation Of Person To Receive Notice Of Termination; Reinstatement Of Coverage; Effective Date Of Section.
  (1) An individual long-term care policy or certificate shall not be issued until the insurer has received from the applicant either a written designation...
• Section 500.3907 Individual Long-term Care Policy; Guaranteed Renewable Provision; Conversion; New Limitation Period; Intermediate Care Facility Or Skilled Nursing Facility; Home Care Services.
  (1) Each individual long-term care policy shall contain a guaranteed renewable provision. An insurer shall not cancel or otherwise terminate a long-term care insurance...
• Section 500.3908. Added Long-term Care Partnership Program Policy; Conversion Or Replacement.
  500.3908.added Long-term care partnership program policy; conversion or replacement.Sec. 3908. (1) Subject to subsection (2), long-term care insurance that is delivered or issued for delivery...
• Section 500.3909 Option To Purchase Inflation Protection; Summary Of Coverage; Applicability Of Section.
  (1) An insurer shall not offer a long-term care insurance policy unless the insurer also offers to the policyholder, in addition to any other...
• Section 500.3910 Option Of Purchasing Policy Or Certificate Including Nonforfeiture Benefits; Offer.
  (1) This section does not apply to life insurance policies or riders containing accelerated benefits for long-term care. (2) Except as provided in subsection...
• Section 500.3910a Nonforfeiture Benefits; Coverage Elements, Eligibility, Benefit Triggers, And Benefit Length; Contingent Benefit; Premium Increase; Notification; Duties Of Insurer; Limitation On Maximum Benefits; Effective Date Of Section; Premiums Subject To Loss Ratio Requirements; Conditions For Offering Nonforfeiture Benefit.
  (1) This section does not apply to life insurance policies or riders containing accelerated benefits for long-term care. (2) A policy or certificate offered...
• Section 500.3910b Reduction Options; Applicability Of Section To Long-term Care Policies And Certificates Issued On Or After June 1, 2007.
  500.3910b Reduction options; applicability of section to long-term care policies and certificates issued on or after June 1, 2007.Sec. 3910b. (1) A long-term care insurance...
• Section 500.3911 Preexisting Condition; Limitation Period; Definition.
  (1) A preexisting condition limitation period in a long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i), shall...
• Section 500.3913 Home Health Care Benefits.
  (1) A long-term care insurance policy shall not limit or exclude services for home health care benefits in any of the following ways: (a)...
• Section 500.3915 Certain Conditions Prohibited.
  A long-term care insurance policy sold before, on, or after June 2, 1992 shall not condition benefits on any of the following: (a) The...
• Section 500.3917 Replacement Policy; Waiver Of Time Periods Applicable To Preexisting Conditions And Probationary Periods.
  If a long-term care insurance policy or certificate replaces another long-term care policy or certificate, the replacing insurer shall waive any time periods applicable...
• Section 500.3919 Institutionalization; Extension Of Benefits; Limitations.
  Termination of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if such institutionalization began while the long-term care coverage...
• Section 500.3921 Application; Questions Relating To Health Condition; Delivery; Record Of Policy Rescissions; Annual Report To Commissioner.
  (1) All applications for long-term care insurance policies except those that are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the...
• Section 500.3923 Riders Or Endorsements; Certain Changes In Benefits Or Premiums; Definition, Explanation, Description, And Labeling Of Certain Terms.
  (1) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured under an individual long-term care...
• Section 500.3925 Applicability Of Section To Long-term Care Policy Or Certificate Issued On Or After June 1, 2007; Information To Be Provided On Forms; Acknowledgement Of Disclosure; Notice Of Premium Rate Schedule Increase; Personal Worksheet; Availability Of Free And Independent Insurance Purchasing And Public Benefits Counseling.
  500.3925 Applicability of section to long-term care policy or certificate issued on or after June 1, 2007; information to be provided on forms; acknowledgement of...
• Section 500.3926 Applicability Of Section To Long-term Care Policy Or Certificate Issued On Or After June 1, 2007; Information To Be Provided To Commissioner; Premium Rate Schedule; Statement; Request By Commissioner For Actuarial Demonstration; Additional Information.
  500.3926 Applicability of section to long-term care policy or certificate issued on or after June 1, 2007; information to be provided to commissioner; premium rate...
• Section 500.3926a Applicability Of Section To Long-term Care Policy Or Certificate Issued On Or After June 1, 2007; Notice Of Pending Premium Rate Schedule Increase; Requirements; Review And Approval By Commissioner; Eligibility For Contingent Benefit Upon Lapse; Applicability Of Subsections To Certain Policies Or Certificates; Exceptional Increases; Definitions.
  500.3926a Applicability of section to long-term care policy or certificate issued on or after June 1, 2007; notice of pending premium rate schedule increase; requirements;...
• Section 500.3927 Reasonableness Of Benefits Relative To Premiums; Expected Loss Ratio; Evaluation Of Factors; Applicability Of Section.
  (1) Benefits under individual long-term care insurance policies shall be considered reasonable in relation to premiums provided the expected loss ratio is at least...
• Section 500.3928 Fixed Indivisible Premium Life Insurance Policy Funding Long-term Care Benefits By Accelerating Death Benefit; Reasonableness Of Benefits Relative To Premiums; Provisions.
  A fixed indivisible premium life insurance policy that funds long-term care benefits entirely by accelerating the death benefit is considered to provide reasonable benefits...
• Section 500.3929 Increasing Premiums Prohibited; Conditions.
  The premiums charged to an insured for long-term care insurance shall not increase due to either of the following: (a) The increasing age of...
• Section 500.3930 Acceleration Of Benefits Under Group Or Individual Life Policies Or Riders; Determination Of Policy Reserves.
  (1) If long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders to those policies, policy...
• Section 500.3931 Rules.
  The commissioner may promulgate rules including the following: (a) Rules establishing standards for the sale of long-term care insurance policies, terms of renewability, initial...
• Section 500.3933 Summary Of Coverage.
  An insurer that offers long-term care insurance shall provide to a prospective applicant before application and upon request before renewal a summary of coverage...
• Section 500.3935 Statement Relating To Request For Additional Information.
  An application for a long-term care policy shall contain the following statement printed, stamped, or as part of a sticker permanently affixed to the...
• Section 500.3937 Shopper's Guide; Format; Providing To Applicants; Exception.
  (1) A long-term care insurance shopper's guide in the format developed by the national association of insurance commissioners, or a guide developed or approved...
• Section 500.3939 Application; Questions Relating To Other Policies In Force Or Use As Replacement; Agent's List Of Other Policies Sold; Notice To Applicant And Existing Insurer; Appropriateness Of Recommended Purchase Or Replacement.
  (1) Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant...
• Section 500.3941 Advertising; Filing Copy With Commissioner.
  Every insurer providing long-term care insurance coverage in this state shall file with the commissioner for review a copy of any written, radio, or...
• Section 500.3941a Inapplicability Of Section To Life Insurance Policies Or Riders Containing Accelerated Benefits; Development Of Suitability Standards.
  (1) This section does not apply to life insurance policies or riders containing accelerated benefits for long-term care. (2) Every insurer or other entity...
• Section 500.3942 Marketing; Duties Of Insurer; Use Of "Level Premium" Or "Noncancelable" Prohibited; Exception.
  (1) Every insurer marketing long-term care insurance coverage in this state, directly or through its producers, shall do all of the following: (a) Establish...
• Section 500.3942a Reporting Requirements; Agent Activities; Preparation Of Report.
  (1) Every insurer marketing long-term care insurance in Michigan shall comply with all of the following reporting requirements for the purpose of reviewing more...
• Section 500.3943 Right To Return Policy; Notice; “direct Response Solicitation” Defined.
  (1) Except as otherwise provided in subsection (2), an applicant for long-term care insurance shall have the right to return the policy within 30...
• Section 500.3945 Violation; Penalty.
  In addition to any other penalties provided by the laws of this state, any insurer and any agent found to have violated any requirement...
• Section 500.3949 Life And Long-term Care Benefits; Marketing; Compliance.
  (1) An insurer that has both life and disability authority in this state may market policies containing both life benefits and long-term care benefits....
• Section 500.3951 Policy Summary; Compliance With Mcl 500.3933; Additional Provisions; Monthly Report.
  (1) A policy summary shall be delivered for a life insurance policy or certificate that provides long-term care benefits. The summary shall comply with...
• Section 500.3953 Disclosure Statement.
  A life insurance policy that provides an accelerated benefit for long-term care shall provide a disclosure statement at the time of application for the...
• Section 500.3955 Compliance With Chapter And Applicable Laws.
  Each insurance policy that is advertised, marketed, or offered as long-term care insurance or nursing home insurance shall comply with this chapter and the...

Last modified: October 10, 2016