19 MAC Pt. 3, R. 8.08
Required Disclosure Provisions
Cite as 19 Miss. Admin. Code Pt. 3, R. 8.08
Required Disclosure Provisions
A. Renewability. Individual long-term care insurance policies shall contain a renewability
provision. Such provision shall be appropriately captioned, shall appear on the first
page of the policy, and shall clearly state the duration, where limited, of renewability
and the duration of the term of coverage for which the policy is issued and for which it
may be renewed. This provision shall not apply to policies which do not contain a
renewability provision, and under which the right to non-renew is reserved solely to the
policyholder.
B. Riders and Endorsements. Except for riders or endorsements by which the insurer
effectuates a request made in writing by the insured under an individual long-term
care insurance policy, all riders or endorsements added to an individual long-
term
care insurance policy after date of issue or at reinstatement or renewal
which
reduce or eliminate benefits or coverage in the policy shall require
signed
acceptance by the individual insured. After the date of policy
issue, any rider or
endorsement which increases benefits or coverage with a
concomitant increase in
premium during the policy term must be agreed to
in writing signed by the
insured, except if the increased benefits or
coverage are required by law. Where a
separate additional premium is charge for
benefits provided in connection with
riders or endorsements, such premium
charge shall be set forth in the policy, rider
or endorsement.
C. Payment of benefits: A long-term care insurance policy which provides for the
payment of benefits based on standards described as “usual and customary,”
“reasonable and customary” or words of similar import shall include a definition of
such terms and an explanation of such terms in its accompanying outline of coverage.
D. Limitations. If a long-term care insurance policy or certificate contains anylimitations
with respect to preexisting conditions, such limitations shall appear asa separate
paragraph of the policy or certificate and shall be labeled as “Preexisting Condition
Limitations.”
E. Other Limitations or Conditions on Eligibility for Benefits. A long-term care
insurance policy or certificate containing any limitations or conditions for
eligibility other than those prohibited in Section 6C(2) of the Regulation shall
set
forth a description of such limitations or conditions, including any
required
number of days of confinement, in a separate paragraph of the
policy or certificate
and shall label such paragraph “Limitations or Conditions on
Eligibility for
Benefits.”