CA
California Senate Bill SB1046

California 2017-2018 Regular Session

California Senate Bill SB1046 Compare Versions

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1-Senate Bill No. 1046 CHAPTER 352 An act to amend Section 10235.50 of the Insurance Code, relating to insurance. [ Approved by Governor September 11, 2018. Filed with Secretary of State September 11, 2018. ] LEGISLATIVE COUNSEL'S DIGESTSB 1046, Roth. Insurance: long-term care.Existing law generally regulates long-term care insurance policies delivered or issued after January 1, 1990. As to these policies, existing law requires a policy or certificate to include a provision that gives the policyholder or certificate holder certain specified rights to reduce coverage and lower premiums.This bill would provide that, if a premium increases, a policyholder or certificate holder has a right to retain a policy or certificate while reducing coverage and lowering the premium, and specifies options and information that an insurer would be required to provide under those circumstances. The bill would require an insurer offering a policy or certificate with an inflation protection provision to provide specified options if a policyholder or certificate holder opts to reduce coverage. The bill would provide that the premium for a reduced coverage policy or certificate shall be based on the issue age and underwriting class, as specified, and consistent with the approved rate table. The bill would require an insurer to provide specified options to retain a policy or certificate while reducing coverage and lowering the premium, including reducing or eliminating the benefit adjustments provided by an inflation protection provision for a policy issued or delivered on or after January 1, 2020.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 10235.50 of the Insurance Code is amended to read:10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
1+Enrolled August 28, 2018 Passed IN Senate August 24, 2018 Passed IN Assembly August 23, 2018 Amended IN Assembly August 06, 2018 Amended IN Assembly June 12, 2018 Amended IN Senate April 12, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 1046Introduced by Senator RothFebruary 08, 2018 An act to amend Section 10235.50 of the Insurance Code, relating to insurance. LEGISLATIVE COUNSEL'S DIGESTSB 1046, Roth. Insurance: long-term care.Existing law generally regulates long-term care insurance policies delivered or issued after January 1, 1990. As to these policies, existing law requires a policy or certificate to include a provision that gives the policyholder or certificate holder certain specified rights to reduce coverage and lower premiums.This bill would provide that, if a premium increases, a policyholder or certificate holder has a right to retain a policy or certificate while reducing coverage and lowering the premium, and specifies options and information that an insurer would be required to provide under those circumstances. The bill would require an insurer offering a policy or certificate with an inflation protection provision to provide specified options if a policyholder or certificate holder opts to reduce coverage. The bill would provide that the premium for a reduced coverage policy or certificate shall be based on the issue age and underwriting class, as specified, and consistent with the approved rate table. The bill would require an insurer to provide specified options to retain a policy or certificate while reducing coverage and lowering the premium, including reducing or eliminating the benefit adjustments provided by an inflation protection provision for a policy issued or delivered on or after January 1, 2020.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 10235.50 of the Insurance Code is amended to read:10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
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3- Senate Bill No. 1046 CHAPTER 352 An act to amend Section 10235.50 of the Insurance Code, relating to insurance. [ Approved by Governor September 11, 2018. Filed with Secretary of State September 11, 2018. ] LEGISLATIVE COUNSEL'S DIGESTSB 1046, Roth. Insurance: long-term care.Existing law generally regulates long-term care insurance policies delivered or issued after January 1, 1990. As to these policies, existing law requires a policy or certificate to include a provision that gives the policyholder or certificate holder certain specified rights to reduce coverage and lower premiums.This bill would provide that, if a premium increases, a policyholder or certificate holder has a right to retain a policy or certificate while reducing coverage and lowering the premium, and specifies options and information that an insurer would be required to provide under those circumstances. The bill would require an insurer offering a policy or certificate with an inflation protection provision to provide specified options if a policyholder or certificate holder opts to reduce coverage. The bill would provide that the premium for a reduced coverage policy or certificate shall be based on the issue age and underwriting class, as specified, and consistent with the approved rate table. The bill would require an insurer to provide specified options to retain a policy or certificate while reducing coverage and lowering the premium, including reducing or eliminating the benefit adjustments provided by an inflation protection provision for a policy issued or delivered on or after January 1, 2020.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
3+ Enrolled August 28, 2018 Passed IN Senate August 24, 2018 Passed IN Assembly August 23, 2018 Amended IN Assembly August 06, 2018 Amended IN Assembly June 12, 2018 Amended IN Senate April 12, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Senate Bill No. 1046Introduced by Senator RothFebruary 08, 2018 An act to amend Section 10235.50 of the Insurance Code, relating to insurance. LEGISLATIVE COUNSEL'S DIGESTSB 1046, Roth. Insurance: long-term care.Existing law generally regulates long-term care insurance policies delivered or issued after January 1, 1990. As to these policies, existing law requires a policy or certificate to include a provision that gives the policyholder or certificate holder certain specified rights to reduce coverage and lower premiums.This bill would provide that, if a premium increases, a policyholder or certificate holder has a right to retain a policy or certificate while reducing coverage and lowering the premium, and specifies options and information that an insurer would be required to provide under those circumstances. The bill would require an insurer offering a policy or certificate with an inflation protection provision to provide specified options if a policyholder or certificate holder opts to reduce coverage. The bill would provide that the premium for a reduced coverage policy or certificate shall be based on the issue age and underwriting class, as specified, and consistent with the approved rate table. The bill would require an insurer to provide specified options to retain a policy or certificate while reducing coverage and lowering the premium, including reducing or eliminating the benefit adjustments provided by an inflation protection provision for a policy issued or delivered on or after January 1, 2020.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
4+
5+ Enrolled August 28, 2018 Passed IN Senate August 24, 2018 Passed IN Assembly August 23, 2018 Amended IN Assembly August 06, 2018 Amended IN Assembly June 12, 2018 Amended IN Senate April 12, 2018
6+
7+Enrolled August 28, 2018
8+Passed IN Senate August 24, 2018
9+Passed IN Assembly August 23, 2018
10+Amended IN Assembly August 06, 2018
11+Amended IN Assembly June 12, 2018
12+Amended IN Senate April 12, 2018
13+
14+ CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
415
516 Senate Bill No. 1046
6-CHAPTER 352
17+
18+Introduced by Senator RothFebruary 08, 2018
19+
20+Introduced by Senator Roth
21+February 08, 2018
722
823 An act to amend Section 10235.50 of the Insurance Code, relating to insurance.
9-
10- [ Approved by Governor September 11, 2018. Filed with Secretary of State September 11, 2018. ]
1124
1225 LEGISLATIVE COUNSEL'S DIGEST
1326
1427 ## LEGISLATIVE COUNSEL'S DIGEST
1528
1629 SB 1046, Roth. Insurance: long-term care.
1730
1831 Existing law generally regulates long-term care insurance policies delivered or issued after January 1, 1990. As to these policies, existing law requires a policy or certificate to include a provision that gives the policyholder or certificate holder certain specified rights to reduce coverage and lower premiums.This bill would provide that, if a premium increases, a policyholder or certificate holder has a right to retain a policy or certificate while reducing coverage and lowering the premium, and specifies options and information that an insurer would be required to provide under those circumstances. The bill would require an insurer offering a policy or certificate with an inflation protection provision to provide specified options if a policyholder or certificate holder opts to reduce coverage. The bill would provide that the premium for a reduced coverage policy or certificate shall be based on the issue age and underwriting class, as specified, and consistent with the approved rate table. The bill would require an insurer to provide specified options to retain a policy or certificate while reducing coverage and lowering the premium, including reducing or eliminating the benefit adjustments provided by an inflation protection provision for a policy issued or delivered on or after January 1, 2020.
1932
2033 Existing law generally regulates long-term care insurance policies delivered or issued after January 1, 1990. As to these policies, existing law requires a policy or certificate to include a provision that gives the policyholder or certificate holder certain specified rights to reduce coverage and lower premiums.
2134
2235 This bill would provide that, if a premium increases, a policyholder or certificate holder has a right to retain a policy or certificate while reducing coverage and lowering the premium, and specifies options and information that an insurer would be required to provide under those circumstances. The bill would require an insurer offering a policy or certificate with an inflation protection provision to provide specified options if a policyholder or certificate holder opts to reduce coverage. The bill would provide that the premium for a reduced coverage policy or certificate shall be based on the issue age and underwriting class, as specified, and consistent with the approved rate table. The bill would require an insurer to provide specified options to retain a policy or certificate while reducing coverage and lowering the premium, including reducing or eliminating the benefit adjustments provided by an inflation protection provision for a policy issued or delivered on or after January 1, 2020.
2336
2437 ## Digest Key
2538
2639 ## Bill Text
2740
2841 The people of the State of California do enact as follows:SECTION 1. Section 10235.50 of the Insurance Code is amended to read:10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
2942
3043 The people of the State of California do enact as follows:
3144
3245 ## The people of the State of California do enact as follows:
3346
3447 SECTION 1. Section 10235.50 of the Insurance Code is amended to read:10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
3548
3649 SECTION 1. Section 10235.50 of the Insurance Code is amended to read:
3750
3851 ### SECTION 1.
3952
4053 10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
4154
4255 10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
4356
4457 10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:(A) Reducing the lifetime maximum benefit.(B) Reducing the daily, weekly, or monthly benefit amounts.(C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.(D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.(2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.(3) The insurer may offer other reduction options in addition to those required by paragraph (1).(4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.(b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:(A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.(B) Consistent with the policys approved rate table.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:(A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.(B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.(2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.(d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.(e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.(1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).(A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.(B) An insurer may offer other reduction options in addition to the option required by paragraph (1).(C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.(D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.(2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.
4558
4659
4760
4861 10235.50. (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year, to retain the policy or certificate while reducing coverage and lowering the premium.
4962
5063 (1) The policyholder or certificate holder shall have the option to reduce coverage and lower the premium in the following ways:
5164
5265 (A) Reducing the lifetime maximum benefit.
5366
5467 (B) Reducing the daily, weekly, or monthly benefit amounts.
5568
5669 (C) Converting a comprehensive long-term care policy or certificate to a Nursing Facility and Residential Care Facility Only or a Home Care Only policy or certificate, if the insurer issues those policies or certificates for sale in the state.
5770
5871 (D) Reducing or eliminating the benefit adjustments provided by an inflation protection provision.
5972
6073 (2) Subparagraph (D) of paragraph (1) shall apply to a policy issued or delivered on or after January 1, 2020.
6174
6275 (3) The insurer may offer other reduction options in addition to those required by paragraph (1).
6376
6477 (4) For a policy issued or delivered on or after January 1, 2020, the provision shall include a description of the process for requesting and implementing a reduction in coverage. For a policy issued or delivered before January 1, 2020, an insurer shall notify the policyholder or certificate holder of the process to request and implement a reduction in coverage.
6578
6679 (b) (1) The premium for a policy or certificate that is reduced in coverage shall be both of the following:
6780
6881 (A) Based on the issue age and underwriting class used to determine the premium for the coverage currently in force.
6982
7083 (B) Consistent with the policys approved rate table.
7184
7285 (2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.
7386
7487 (c) (1) If a policy or certificate contains an inflation protection provision, both of the following shall apply to a reduction in coverage:
7588
7689 (A) If a policyholder or certificate holder chooses to reduce a daily, weekly, monthly, or lifetime benefit amount, then he or she shall be given the option to continue inflation protection benefit adjustments in the same manner and in the same amount as the contract in force before the reduction in coverage.
7790
7891 (B) If a policyholder or certificate holder chooses to reduce or eliminate the benefit adjustments provided by an inflation protection provision, then he or she shall be given the option to continue the daily, weekly, monthly, and lifetime benefit amounts in effect at the time of the reduction.
7992
8093 (2) This subdivision shall apply to any reduction in coverage, regardless of the original policy issue date.
8194
8295 (d) If a policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subdivision (a) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subdivision (a). The notice shall provide the insured at least 30 days in which to elect to reduce coverage and the policy shall be reinstated without underwriting if the insured elects the reduced coverage.
8396
8497 (e) If a premium increases, the policyholder or certificate holder shall have the right to retain the policy or certificate while reducing coverage and lowering the premium.
8598
8699 (1) The policyholder or certificate holder shall be offered the option to reduce coverage as provided in subparagraphs (A), (B), and (D) of paragraph (1) of subdivision (a).
87100
88101 (A) At least one option to reduce coverage shall allow the policyholder or certificate holder to retain the policy for a premium reasonably equivalent to the one that was in effect before the rate increase.
89102
90103 (B) An insurer may offer other reduction options in addition to the option required by paragraph (1).
91104
92105 (C) An insurers offer shall include a disclosure stating that all of the reduction options may not be of equal value.
93106
94107 (D) The policyholder or certificate holder of a policy or certificate offered under the California Partnership for Long-Term Care Program shall be offered options to reduce coverage that would maintain certification under the program. The insurer may also offer other reduction options that may result in a loss of partnership status, but the offer shall include a disclosure that identifies the benefit reduction options that may result in a loss of partnership status and explains that loss of partnership status may reduce or eliminate policyholder protections.
95108
96109 (2) This subdivision shall apply to any premium rate increase, regardless of the original policy issue date.