Senate Bill No. 1046
Public Act No. 21-150
AN ACT CONCERNING LONG -TERM CARE INSURANCE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 38a-1 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective January 1, 2022):
Terms used in this title and section 2 of this act, unless it appears from
the context to the contrary, shall have a scope and meaning as set forth
in this section.
(1) "Affiliate" or "affiliated" means a person that directly, or indirectly
through one or more intermediaries, controls, is controlled by or is
under common control with another person.
(2) "Alien insurer" means any insurer that has been chartered by or
organized or constituted within or under the laws of any jurisdiction or
country without the United States.
(3) "Annuities" means all agreements to make periodical payments
where the making or continuance of all or some of the series of the
payments, or the amount of the payment, is dependent upon the
continuance of human life or is for a specified term of years. This
definition does not apply to payments made under a policy of life
insurance. Senate Bill No. 1046
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(4) "Commissioner" means the Insurance Commissioner.
(5) "Control", "controlled by" or "under common control with" means
the possession, direct or indirect, of the power to direct or cause the
direction of the management and policies of a person, whether through
the ownership of voting securities, by contract other than a commercial
contract for goods or nonmanagement services, or otherwise, unless the
power is the result of an official position with the person.
(6) "Domestic insurer" means any insurer that has been chartered by,
incorporated, organized or constituted within or under the laws of this
state.
(7) "Domestic surplus lines insurer" means any domestic insurer that
has been authorized by the commissioner to write surplus lines
insurance.
(8) "Foreign country" means any jurisdiction not in any state, district
or territory of the United States.
(9) "Foreign insurer" means any insurer that has been chartered by or
organized or constituted within or under the laws of another state or a
territory of the United States.
(10) "Insolvency" or "insolvent" means, for any insurer, that it is
unable to pay its obligations when they are due, or when its admitted
assets do not exceed its liabilities plus the greater of: (A) Capital and
surplus required by law for its organization and continued operation;
or (B) the total par or stated value of its authorized and issued capital
stock. For purposes of this subdivision "liabilities" shall include but not
be limited to reserves required by statute or by regulations adopted by
the commissioner in accordance with the provisions of chapter 54 or
specific requirements imposed by the commissioner upon a subject
company at the time of admission or subsequent thereto. Senate Bill No. 1046
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(11) "Insurance" means any agreement to pay a sum of money,
provide services or any other thing of value on the happening of a
particular event or contingency or to provide indemnity for loss in
respect to a specified subject by specified perils in return for a
consideration. In any contract of insurance, an insured shall have an
interest which is subject to a risk of loss through destruction or
impairment of that interest, which risk is assumed by the insurer and
such assumption shall be part of a general scheme to distribute losses
among a large group of persons bearing similar risks in return for a
ratable contribution or other consideration.
(12) "Insurer" or "insurance company" includes any person or
combination of persons doing any kind or form of insurance business
other than a fraternal benefit society, and shall include a receiver of any
insurer when the context reasonably permits.
(13) "Insured" means a person to whom or for whose benefit an
insurer makes a promise in an insurance policy. The term includes
policyholders, subscribers, members and beneficiaries. This definition
applies only to the provisions of this title and does not define the
meaning of this word as used in insurance policies or certificates.
(14) "Life insurance" means insurance on human lives and insurances
pertaining to or connected with human life. The business of life
insurance includes granting endowment benefits, granting additional
benefits in the event of death by accident or accidental means, granting
additional benefits in the event of the total and permanent disability of
the insured, and providing optional methods of settlement of proceeds.
Life insurance includes burial contracts to the extent provided by
section 38a-464.
(15) "Mutual insurer" means any insurer without capital stock, the
managing directors or officers of which are elected by its members. Senate Bill No. 1046
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(16) "Person" means an individual, a corporation, a partnership, a
limited liability company, an association, a joint stock company, a
business trust, an unincorporated organization or other legal entity.
(17) "Policy" means any document, including attached endorsements
and riders, purporting to be an enforceable contract, which
memorializes in writing some or all of the terms of an insurance
contract.
(18) "State" means any state, district, or territory of the United States.
(19) "Subsidiary" of a specified person means an affiliate controlled
by the person directly, or indirectly through one or more intermediaries.
(20) "Unauthorized insurer" or "nonadmitted insurer" means an
insurer that has not been granted a certificate of authority by the
commissioner to transact the business of insurance in this state or an
insurer transacting business not authorized by a valid certificate.
(21) "United States" means the United States of America, its territories
and possessions, the Commonwealth of Puerto Rico and the District of
Columbia.
Sec. 2. (NEW) (Effective January 1, 2022) (a) For the purposes of this
section, "long-term care policy" has the same meaning as provided in
section 38a-501 of the general statutes, as amended by this act, or section
38a-528 of the general statutes, as amended by this act, as applicable.
(b) The commissioner shall, after consulting with other state
governments and conducting a nation-wide review, develop and
prescribe a minimum set of affordable benefit options to be offered by
an insurance company, fraternal benefit society, hospital service
corporation, medical service corporation or health care center that files
a rate filing under section 38a-501 of the general statutes, as amended
by this act, or section 38a-528 of the general statutes, as amended by this Senate Bill No. 1046
Public Act No. 21-150 5 of 20
act, for an increase in premium rates for a long-term care policy that is
for twenty per cent or more. The commissioner shall send to each
insurance company, fraternal benefit society, hospital service
corporation, medical service corporation or health care center that files
such a rate filing a notice disclosing such minimum set of affordable
benefit options.
(c) The commissioner may adopt regulations, in accordance with the
provisions of chapter 54 of the general statutes, to carry out the purposes
of this section.
Sec. 3. Section 38a-501 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective January 1, 2022):
(a) (1) As used in this section and section 2 of this act, "long-term care
policy" means any individual health insurance policy delivered or
issued for delivery to any resident of this state on or after July 1, 1986,
that is designed to provide, within the terms and conditions of the
policy, benefits on an expense-incurred, indemnity or prepaid basis for
necessary care or treatment of an injury, illness or loss of functional
capacity provided by a certified or licensed health care provider in a
setting other than an acute care hospital, for at least one year after an
elimination period (A) not to exceed one hundred days of confinement,
or (B) of over one hundred days but not to exceed two years of
confinement, provided such period is covered by an irrevocable trust in
an amount estimated to be sufficient to furnish coverage to the grantor
of the trust for the duration of the elimination period. Such trust shall
create an unconditional duty to pay the full amount held in trust
exclusively to cover the costs of confinement during the elimination
period, subject only to taxes and any trustee's charges allowed by law.
Payment shall be made directly to the provider. The duty of the trustee
may be enforced by the state, the grantor or any person acting on behalf
of the grantor. A long-term care policy shall provide benefits for
confinement in a nursing home or confinement in the insured's own Senate Bill No. 1046
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home or both. Any additional benefits provided shall be related to long-
term treatment of an injury, illness or loss of functional capacity. "Long-
term care policy" does not include any such policy that is offered
primarily to provide basic Medicare supplement coverage, basic
medical-surgical expense coverage, hospital confinement indemnity
coverage, major medical expense coverage, disability income protection
coverage, accident only coverage, specified accident coverage or limited
benefit health coverage.
(2) (A) Notwithstanding any provision of the general statutes, no
insurance company, fraternal benefit society, hospital service
corporation, medical service corporation or health care center may
deliver, issue for delivery, renew, continue or amend any long-term care
policy in this state on or after January 1, 2022, unless the insurance
company, fraternal benefit society, hospital service corporation, medical
service corporation or health care center is authorized or licensed to sell
long-term care insurance and at least one other line of insurance in this
state.
[(2) (A)] (B) No insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
delivering, issuing for delivery, renewing, continuing or amending any
long-term care policy in this state may refuse to accept, or refuse to make
reimbursement pursuant to, a claim for benefits submitted by or
prepared with the assistance of a managed residential community, as
defined in section 19a-693, in accordance with subdivision (7) of
subsection (a) of section 19a-694, solely because such claim for benefits
was submitted by or prepared with the assistance of a managed
residential community.
[(B)] (C) Each insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
delivering, issuing for delivery, renewing, continuing or amending any
long-term care policy in this state shall, upon receipt of a written Senate Bill No. 1046
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authorization executed by the insured, (i) disclose information to a
managed residential community for the purpose of determining such
insured's eligibility for an insurance benefit or payment, and (ii) provide
a copy of the initial acceptance or declination of a claim for benefits to
the managed residential community at the same time such acceptance
or declination is made to the insured.
(b) (1) No insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
may deliver or issue for delivery any long-term care policy that has a
loss ratio of less than sixty per cent for any individual long-term care
policy. An issuer shall not use or change premium rates for a long-term
care policy unless the rates have been filed with and approved by the
[Insurance Commissioner] commissioner. Any rate filings or rate
revisions shall demonstrate that anticipated claims in relation to
premiums when combined with actual experience to date can be
expected to comply with the loss ratio requirement of this section. A rate
filing shall include the factors and methodology used to estimate
irrevocable trust values if the policy includes an option for the
elimination period specified in subdivision (1) of subsection (a) of this
section.
(2) (A) Any insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
that files a rate filing for an increase in premium rates for a long-term
care policy that is for twenty per cent or more shall spread the increase
over a period of not less than three years and not file a rate filing for an
increase in premium rates for the long-term care policy during the
period chosen. Such company, society, corporation or center shall use a
periodic rate increase that is actuarially equivalent to a single rate
increase and a current interest rate for the period chosen.
(B) Prior to implementing a premium rate increase, each such
company, society, corporation or center shall: Senate Bill No. 1046
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(i) Notify its policyholders of such premium rate increase and make
available to such policyholders the additional choice of reducing the
policy benefits to reduce the premium rate or electing coverage that
reflects the minimum set of affordable benefit options developed by the
commissioner pursuant to section 2 of this act. Such notice shall include
a description of such policy benefit reductions and minimum set of
affordable benefit options. The premium rates for any benefit reductions
shall be based on the new premium rate schedule;
(ii) Provide policyholders not less than thirty calendar days to elect a
reduction in policy benefits or coverage that reflects the minimum set of
affordable benefit options developed by the commissioner pursuant to
section 2 of this act; and
(iii) Include a statement in such notice that if a policyholder fails to
elect a reduction in policy benefits or coverage that reflects the
minimum set of affordable benefit options developed by the
commissioner pursuant to section 2 of this act by the end of the notice
period and has not cancelled the policy, the policyholder will be deemed
to have elected to retain the existing policy benefits.
(c) (1) No such company, society, corporation or center may deliver
or issue for delivery any long-term care policy without providing, at the
time of solicitation or application for purchase or sale of such coverage,
full and fair written disclosure of the benefits and limitations of the
policy.
(2) (A) The applicant shall sign an acknowledgment at the time of
application for such policy that the company, society, corporation or
center has provided the written disclosure required under this
subsection to the applicant. If the method of application does not allow
for such signature at the time of application, the applicant shall sign
such acknowledgment not later than at the time of delivery of such
policy. Senate Bill No. 1046
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(B) Except for a long-term care policy for which no applicable
premium rate revision or rate schedule increases can be made or as
otherwise provided in subdivision (3) of this subsection, such disclosure
shall include:
(i) A statement that the policy may be subject to rate increases in the
future;
(ii) An explanation of potential future premium rate revisions and the
policyholder's option in the event of a premium rate revision;
(iii) The premium rate or rate schedule applicable to the applicant
that will be in effect until such company, society, corporation or center
files a request with the [Insurance Commissioner] commissioner for a
revision to such premium rate or rate schedule;
(iv) An explanation of how a premium rate or rate schedule revision
will be applied that includes a description of when such rate or rate
schedule revision will be effective; and
(v) Information regarding each premium rate increase, if any, over
the past ten years on such policy form or similar policy forms for this
state or any other state, that identifies, at a minimum, (I) the policy forms
for which premium rates have been increased, (II) the calendar years
when each such policy form was available for purchase, and (III) the
amount or percentage of each increase. The percentage may be
expressed as a percentage of the premium rate prior to the increase or
as minimum and maximum percentages if the rate increase is variable
by rating characteristics.
(C) The company, society, corporation or center may provide, in a fair
manner, any additional explanatory information related to a premium
rate or rate schedule revision.
(3) (A) Any such company, society, corporation or center may Senate Bill No. 1046
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exclude from the disclosure required under subparagraph (B) of
subdivision (2) of this subsection premium rate increases that only
apply to blocks of business or long-term care policies acquired from a
nonaffiliated company, society, corporation or center and that occurred
prior to the acquisition.
(B) If an acquiring company, society, corporation or center files a
request for a premium rate increase on or before January 1, 2015, or the
end of a twenty-four-month period after the acquisition, whichever is
later, for a block of policy forms or long-term care policies acquired from
a nonaffiliated company, society, corporation or center, such acquiring
company, society, corporation or center may exclude from the
disclosure required under subparagraph (B) of subdivision (2) of this
subsection such premium rate increase, except that the nonaffiliated
company, society, corporation or center selling such block of policy
forms or long-term care policies shall include such premium rate
increase in such disclosure.
(C) If an acquiring company, society, corporation or center under
subparagraph (B) of this subdivision files a subsequent request, even
within the twenty-four-month period specified in said subparagraph,
for a premium rate increase on the same block of policy forms or long-
term care policies set forth in said subparagraph, the acquiring
company, society, corporation or center shall include in the disclosure
required under subparagraph (B) of subdivision (2) of this subsection
such premium rate increase and any premium rate increase filed and
approved pursuant to subparagraph (B) of this subdivision.
(4) If the offering for any long-term care policy includes an option for
the elimination period specified in subdivision (1) of subsection (a) of
this section, the application form for such policy and the face page of
such policy shall contain a clear and conspicuous disclosure that the
irrevocable trust may not be sufficient to cover all costs during the
elimination period. Senate Bill No. 1046
Public Act No. 21-150 11 of 20
(d) No such company, society, corporation or center may deliver or
issue for delivery any long-term care policy on or after July 1, 2008,
without offering, at the time of solicitation or application for purchase
or sale of such coverage, an option to purchase a policy that includes a
nonforfeiture benefit. Such offer of a nonforfeiture benefit may be in the
form of a rider attached to such policy. In the event the nonforfeiture
benefit is declined, such company, society, corporation or center shall
provide a contingent benefit upon lapse that shall be available for a
specified period of time following a substantial increase in premium
rates. Not later than July 1, 2008, the [Insurance Commissioner]
commissioner shall adopt regulations, in accordance with chapter 54, to
implement the provisions of this subsection. Such regulations shall
specify the type of nonforfeiture benefit that may be offered, the
standards for such benefit, the period of time during which a contingent
benefit upon lapse will be available and the substantial increase in
premium rates that trigger a contingent benefit upon lapse in
accordance with the Long-Term Care Insurance Model Regulation
adopted by the National Association of Insurance Commissioners.
(e) The [Insurance Commissioner] commissioner shall adopt
regulations, in accordance with chapter 54, that address (1) the insured's
right to information prior to the insured replacing an accident and
sickness policy with a long-term care policy, (2) the insured's right to
return a long-term care policy to the insurer, within a specified period
of time after delivery, for cancellation, and (3) the insured's right to
accept by the insured's signature, and prior to it becoming effective, any
rider or endorsement added to a long-term care policy after the issuance
date of such policy. The [Insurance Commissioner] commissioner shall
adopt such additional regulations as the commissioner deems necessary
in accordance with chapter 54 to carry out the purpose of this section.
(f) The [Insurance Commissioner] commissioner may, upon written
request by any such company, society, corporation or center, issue an Senate Bill No. 1046
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order to modify or suspend a specific provision of this section or any
regulation adopted pursuant thereto with respect to a specific long-term
care policy upon a written finding that: (1) The modification or
suspension would be in the best interest of the insureds; (2) the purposes
to be achieved could not be effectively or efficiently achieved without
such modification or suspension; and (3) (A) the modification or
suspension is necessary to the development of an innovative and
reasonable approach for insuring long-term care, (B) the policy is to be
issued to residents of a life care or continuing care retirement
community or other residential community for the elderly and the
modification or suspension is reasonably related to the special needs or
nature of such community, or (C) the modification or suspension is
necessary to permit long-term care policies to be sold as part of, or in
conjunction with, another insurance product. Whenever the
commissioner decides not to issue such an order, the commissioner shall
provide written notice of such decision to the requesting party in a
timely manner.
(g) Upon written request by any such company, society, corporation
or center, the [Insurance Commissioner] commissioner may issue an
order to extend the preexisting condition exclusion period, as
established by regulations adopted pursuant to this section, for
purposes of specific age group categories in a specific long-term care
policy form whenever the commissioner makes a written finding that
such an extension is in the best interest to the public. Whenever the
commissioner decides not to issue such an order, the commissioner shall
provide written notice of such decision to the requesting party in a
timely manner.
(h) The provisions of section 38a-19 shall be applicable to any such
requesting party aggrieved by any order or decision of the
commissioner made pursuant to subsections (f) and (g) of this section.
Sec. 4. Section 38a-528 of the general statutes is repealed and the Senate Bill No. 1046
Public Act No. 21-150 13 of 20
following is substituted in lieu thereof (Effective January 1, 2022):
(a) (1) As used in this section and section 2 of this act, "long-term care
policy" means any group health insurance policy or certificate delivered
or issued for delivery to any resident of this state on or after July 1, 1986,
that is designed to provide, within the terms and conditions of the policy
or certificate, benefits on an expense-incurred, indemnity or prepaid
basis for necessary care or treatment of an injury, illness or loss of
functional capacity provided by a certified or licensed health care
provider in a setting other than an acute care hospital, for at least one
year after a reasonable elimination period. A long-term care policy shall
provide benefits for confinement in a nursing home or confinement in
the insured's own home or both. Any additional benefits provided shall
be related to long-term treatment of an injury, illness or loss of
functional capacity. "Long-term care policy" does not include any such
policy or certificate that is offered primarily to provide basic Medicare
supplement coverage, basic medical-surgical expense coverage, hospital
confinement indemnity coverage, major medical expense coverage,
disability income protection coverage, accident only coverage, specified
accident coverage or limited benefit health coverage.
(2) (A) Notwithstanding any provision of the general statutes, no
insurance company, fraternal benefit society, hospital service
corporation, medical service corporation or health care center may
deliver, issue for delivery, renew, continue or amend any long-term care
policy in this state on or after January 1, 2022, unless the insurance
company, fraternal benefit society, hospital service corporation, medical
service corporation or health care center is authorized or licensed to sell
long-term care insurance and at least one other line of insurance in this
state.
[(2) (A)] (B) No insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
delivering, issuing for delivery, renewing, continuing or amending any Senate Bill No. 1046
Public Act No. 21-150 14 of 20
long-term care policy in this state may refuse to accept, or refuse to make
reimbursement pursuant to, a claim for benefits submitted by or
prepared with the assistance of a managed residential community, as
defined in section 19a-693, in accordance with subdivision (7) of
subsection (a) of section 19a-694, solely because such claim for benefits
was submitted by or prepared with the assistance of a managed
residential community.
[(B)] (C) Each insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
delivering, issuing for delivery, renewing, continuing or amending any
long-term care policy in this state shall, upon receipt of a written
authorization executed by the insured, (i) disclose information to a
managed residential community for the purpose of determining such
insured's eligibility for an insurance benefit or payment, and (ii) provide
a copy of the initial acceptance or declination of a claim for benefits to
the managed residential community at the same time such acceptance
or declination is made to the insured.
(b) (1) No insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
may deliver or issue for delivery any long-term care policy or certificate
that has a loss ratio of less than sixty-five per cent for any group long-
term care policy. An issuer shall not use or change premium rates for a
long-term care policy or certificate unless the rates have been filed with
the [Insurance Commissioner] commissioner. Deviations in rates to
reflect policyholder experience shall be permitted, provided each policy
form shall meet the loss ratio requirement of this section. Any rate filings
or rate revisions shall demonstrate that anticipated claims in relation to
premiums when combined with actual experience to date can be
expected to comply with the loss ratio requirement of this section. On
an annual basis, an insurer shall submit to the [Insurance
Commissioner] commissioner an actuarial certification of the insurer's Senate Bill No. 1046
Public Act No. 21-150 15 of 20
continuing compliance with the loss ratio requirement of this section.
Any rate or rate revision may be disapproved if the commissioner
determines that the loss ratio requirement will not be met over the
lifetime of the policy form using reasonable assumptions.
(2) (A) Any insurance company, fraternal benefit society, hospital
service corporation, medical service corporation or health care center
that files a rate filing for an increase in premium rates for a long-term
care policy that is for twenty per cent or more shall spread the increase
over a period of not less than three years and not file a rate filing for an
increase in premium rates for the long-term care policy during the
period chosen. Such company, society, corporation or center shall use a
periodic rate increase that is actuarially equivalent to a single rate
increase and a current interest rate for the period chosen.
(B) Prior to implementing a premium rate increase, each such
company, society, corporation or center shall:
(i) Notify its certificate holders of such premium rate increase and
make available to such certificate holders the additional choice of
reducing the policy benefits to reduce the premium rate or electing
coverage that reflects the minimum set of affordable benefit options
developed by the commissioner pursuant to section 2 of this act. Such
notice shall include a description of such policy benefit reductions and
minimum set of affordable benefit options. The premium rates for any
benefit reductions shall be based on the new premium rate schedule;
(ii) Provide certificate holders not less than thirty calendar days to
elect a reduction in policy benefits or coverage that reflects the
minimum set of affordable benefit options developed by the
commissioner pursuant to section 2 of this act; and
(iii) Include a statement in such notice that if a certificate holder fails
to elect a reduction in policy benefits or coverage that reflects the Senate Bill No. 1046
Public Act No. 21-150 16 of 20
minimum set of affordable benefit options developed by the
commissioner pursuant to section 2 of this act by the end of the notice
period and has not cancelled the policy, the certificate holder will be
deemed to have elected to retain the existing policy benefits.
(c) (1) No such company, society, corporation or center may deliver
or issue for delivery any long-term care policy without providing, at the
time of solicitation or application for purchase or sale of such coverage,
full and fair written disclosure of the benefits and limitations of the
policy. The provisions of this subsection shall not be applicable to
noncontributory plans.
(2) (A) The applicant shall sign an acknowledgment at the time of
application for such policy that the company, society, corporation or
center has provided the written disclosure required under this
subsection to the applicant. If the method of application does not allow
for such signature at the time of application, the applicant shall sign
such acknowledgment not later than at the time of delivery of such
policy.
(B) The policyholder shall provide a copy of such disclosure to each
eligible individual.
(3) (A) Except for a long-term care policy for which no applicable
premium rate revision or rate schedule increases can be made or as
otherwise provided in subdivision (4) of this subsection, such disclosure
shall include:
(i) A statement that the policy may be subject to rate increases in the
future;
(ii) An explanation of potential future premium rate revisions and the
policyholder's or certificate holder's option in the event of a premium
rate revision; Senate Bill No. 1046
Public Act No. 21-150 17 of 20
(iii) The premium rate or rate schedule applicable to the applicant
that will be in effect until such company, society, corporation or center
files a request with the [Insurance Commissioner] commissioner for a
revision to such premium rate or rate schedule;
(iv) An explanation of how a premium rate or rate schedule revision
will be applied that includes a description of when such rate or rate
schedule revision will be effective; and
(v) Information regarding each premium rate increase, if any, over
the past ten years on such policy form or similar policy forms for this
state or any other state, that identifies, at a minimum, (I) the policy forms
for which premium rates have been increased, (II) the calendar years
when each such policy form was available for purchase, and (III) the
amount or percentage of each increase. The percentage may be
expressed as a percentage of the premium rate prior to the increase or
as minimum and maximum percentages if the rate increase is variable
by rating characteristics.
(B) The company, society, corporation or center may provide, in a fair
manner, any additional explanatory information related to a premium
rate or rate schedule revision.
(4) (A) Any such company, society, corporation or center may
exclude from the disclosure required under subdivision (3) of this
subsection premium rate increases that only apply to blocks of business
or long-term care policies acquired from a nonaffiliated company,
society, corporation or center and that occurred prior to the acquisition.
(B) If an acquiring company, society, corporation or center files a
request for a premium rate increase on or before January 1, 2015, or the
end of a twenty-four-month period after the acquisition, whichever is
later, for a block of policy forms or long-term care policies acquired from
a nonaffiliated company, society, corporation or center such acquiring Senate Bill No. 1046
Public Act No. 21-150 18 of 20
company, society, corporation or center may exclude from the
disclosure required under subdivision (3) of this subsection such
premium rate increase, except that the nonaffiliated company, society,
corporation or center selling such block of policy forms or long-term
care policies shall include such premium rate increase in such
disclosure.
(C) If an acquiring company, society, corporation or center under
subparagraph (B) of this subdivision files a subsequent request, even
within the twenty-four-month period specified in said subparagraph,
for a premium rate increase on the same block of policy forms or long-
term care policies set forth in said subparagraph, the acquiring
company, society, corporation or center shall include in the disclosure
required under subdivision (3) of this subsection such premium rate
increase and any premium rate increase filed and approved pursuant to
subparagraph (B) of this subdivision.
(d) The [Insurance Commissioner] commissioner shall adopt
regulations, in accordance with chapter 54, that address (1) the insured's
right to information prior to his replacing an accident and sickness
policy with a long-term care policy, (2) the insured's right to return a
long-term care policy to the insurer, within a specified period of time
after delivery, for cancellation, and (3) the insured's right to accept by
the insured's signature, and prior to it becoming effective, any rider or
endorsement added to a long-term care policy after the issuance date of
such policy, provided (A) any regulations adopted pursuant to
subdivisions (1) and (2) of this subsection shall not be applicable to (i)
any long-term care policy that is delivered or issued for delivery to one
or more employers or labor organizations, or to a trust or to the trustees
of a fund established by one or more employers or labor organizations,
or a combination thereof or for members or former members or a
combination thereof, of the labor organizations, or (ii) noncontributory
plans, and (B) any regulations adopted pursuant to subdivision (3) of Senate Bill No. 1046
Public Act No. 21-150 19 of 20
this subsection shall not be applicable to any group long-term care
policy. The [Insurance Commissioner] commissioner shall adopt such
additional regulations as the commissioner deems necessary in
accordance with said chapter 54 to carry out the purpose of this section.
(e) The [Insurance Commissioner] commissioner may, upon written
request by any such company, society, corporation or center, issue an
order to modify or suspend a specific provision of this section or any
regulation adopted pursuant thereto with respect to a specific long-term
care policy upon a written finding that: (1) The modification or
suspension would be in the best interest of the insureds; (2) the purposes
to be achieved could not be effectively or efficiently achieved without
such modification or suspension; and (3) (A) the modification or
suspension is necessary to the development of an innovative and
reasonable approach for insuring long-term care, (B) the policy is to be
issued to residents of a life care or continuing care retirement
community or other residential community for the elderly and the
modification or suspension is reasonably related to the special needs or
nature of such community, or (C) the modification or suspension is
necessary to permit long-term care policies to be sold as part of, or in
conjunction with, another insurance product. Whenever the
commissioner decides not to issue such an order, the commissioner shall
provide written notice of such decision to the requesting party in a
timely manner.
(f) Upon written request by any such company, society, corporation
or center, the [Insurance Commissioner] commissioner may issue an
order to extend the preexisting condition exclusion period, as
established by regulations adopted pursuant to this section, for
purposes of specific age group categories in a specific long-term care
policy form whenever he makes a written finding that such an extension
is in the best interest to the public. Whenever the commissioner decides
not to issue such an order, the commissioner shall provide written notice Senate Bill No. 1046
Public Act No. 21-150 20 of 20
of such decision to the requesting party in a timely manner.
(g) The provisions of section 38a-19 shall be applicable to any such
requesting party aggrieved by any order or decision of the
commissioner made pursuant to subsections (e) and (f) of this section.