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General Assembly Substitute Bill No. 1269
January Session, 2025
AN ACT CONCERNING LONG -TERM CARE INSURANCE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (Effective from passage) Not later than February 1, 2026, the 1
Insurance Department shall prepare and submit a report, in accordance 2
with the provisions of section 11-4a of the general statutes, to the joint 3
standing committee of the General Assembly having cognizance of 4
matters relating to insurance. Such report shall include an evaluation of 5
an alternative pool for long-term care policyholders in excess of twenty 6
years. 7
Sec. 2. Section 38a-458 of the general statutes is repealed and the 8
following is substituted in lieu thereof (Effective January 1, 2026): 9
(a) As used in this section, "long-term care rider" means any provision 10
or endorsement attached to any annuity contract or certificate that 11
provides long-term care benefits for qualified long-term care services as 12
provided in Section 7702B(c)(1) of the Internal Revenue Code of 1986, or 13
any subsequent corresponding internal revenue code of the United 14
States, as amended from time to time. 15
[(a)] (b) Provided such company is licensed for both life and health 16
insurance in this state, any life insurance company doing business in this 17
state may issue life insurance policies or certificates, or riders or 18 Substitute Bill No. 1269
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endorsements thereto, that provide, within the terms and conditions of 19
the policy or certificate, long-term care benefits as described in section 20
38a-501 or 38a-528, as amended by this act, except as specified in 21
subsection [(c)] (d) of this section. The Insurance Commissioner may 22
adopt regulations, in accordance with chapter 54, to implement the 23
provisions of this section. 24
[(b)] (c) (1) Provided such company is licensed for both life and health 25
insurance in this state, any life insurance company doing business in this 26
state may issue annuity contracts or certificates, or riders, including 27
long-term care riders subject to the requirements of this subsection, and 28
any applicable requirement under this title or any regulation adopted 29
by the commissioner, in accordance with the provisions of chapter 54, 30
or endorsements thereto, that provide, within the terms and conditions 31
of the contract or certificate, long-term care benefits as described in 32
section 38a-501 or 38a-528, as amended by this act, except as specified in 33
subsection [(c)] (d) of this section, and that waive the surrender charges 34
under such contract or accelerate a specified portion of the annuity 35
value of such contract. 36
(2) Any life insurance company that issues any long-term care rider 37
that provides long-term care benefits pursuant to subdivision (1) of this 38
subsection shall provide each policyholder with a written disclosure for 39
such long-term care rider that includes (A) the cost of such long-term 40
care rider and any impact that such long-term care rider may have on 41
the annuity contract's benefits, including, but not limited to, reductions 42
in death benefits or surrender value, (B) any conditions or long-term 43
care benefit triggers required by state or federal law, including, but not 44
limited to, qualifying events, including an inability to perform at least 45
two activities of daily living or such conditions related to severe 46
cognitive impairment, and (C) any exclusions, limitations or 47
coordination of benefits with other insurance coverage. 48
(3) Any life insurance company that issues any long-term care rider 49
that provides long-term care benefits pursuant to subdivision (1) of this 50
subsection shall (A) comply with any applicable requirement under this 51 Substitute Bill No. 1269
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title concerning annuity contract suitability, long-term care insurance 52
and disclosure requirements, (B) comply with any applicable 53
requirements under federal law, including, but not limited to, tax-54
qualified long-term care policy requirements under the Health 55
Insurance Portability and Accountability Act of 1996, P.L. 104-191, as 56
amended from time to time, (C) include nonforfeiture benefits required 57
under this chapter and any applicable regulations adopted by the 58
commissioner in accordance with the provisions of chapter 54, and (D) 59
only provide coverage for long-term care rider benefits upon the 60
occurrence of a qualifying event, as defined in the policy and required 61
under this title, federal law and regulations adopted by the 62
commissioner in accordance with the provisions of chapter 54. 63
(4) Any policyholder may cancel, without penalty, any such long-64
term care rider issued pursuant to subdivision (1) of this subsection not 65
later than thirty days after receipt of such long-term care rider. 66
[(c)] (d) Long-term care benefits provided pursuant to subsection [(a)] 67
(b) or [(b)] (c) of this section shall not be subject to the requirements of 68
subsection (b) of section 38a-501, as amended by this act or subsection 69
(b) of section 38a-528, as amended by this act. 70
[(d)] (e) No insurance producer shall sell any such policy, certificate, 71
rider or endorsement unless the producer is licensed to sell both life and 72
health insurance in this state. 73
[(e)] (f) A life insurance policy or annuity contract with long-term care 74
benefits issued pursuant to this section may include a rider that 75
provides long-term care benefits that become payable upon exhaustion 76
of a specified amount of the death benefit under the life insurance policy 77
or a specified amount of the annuity value of the annuity contract. Any 78
elimination period limitations shall apply only to the acceleration phase 79
of the life insurance policy or annuity contract to which the rider is 80
attached. Such rider shall not contain an additional elimination period 81
and may calculate the waiver of premium from the time benefits are 82
payable under such rider. 83 Substitute Bill No. 1269
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Sec. 3. Subsection (a) of section 38a-430 of the general statutes is 84
repealed and the following is substituted in lieu thereof (Effective January 85
1, 2026): 86
(a) No life insurance or annuity policy or contract shall be delivered 87
or issued for delivery to any person in this state, nor shall any 88
application, rider, including a long-term care rider, as defined in section 89
38a-458, as amended by this act, or endorsement be used in connection 90
therewith, until a copy of the form thereof shall have been filed with and 91
approved by the commissioner. The commissioner shall adopt 92
regulations, in accordance with the provisions of chapter 54, 93
establishing a procedure for review of such policies and contracts. The 94
commissioner shall issue an order disapproving the use of any such 95
form at any time if it does not comply with the requirements of law, or 96
if it contains a provision or provisions that are unfair or deceptive or 97
that encourage misrepresentation of the policy. The commissioner shall 98
specify the reason for the commissioner's disapproval. The provisions 99
of section 38a-19 shall apply to any such order issued by the 100
commissioner. 101
Sec. 4. (NEW) (Effective January 1, 2026, and applicable to taxable years 102
commencing on or after January 1, 2026) Any eligible taxpayer subject to 103
the tax under chapter 229 of the general statutes shall be allowed a credit 104
against the tax imposed under said chapter, other than the liability 105
imposed under section 12-707 of the general statutes, in an amount 106
equal to twenty per cent of the premiums paid by such eligible taxpayer 107
during the taxable year for a long-term care policy, as defined in section 108
38a-501, as amended by this act, or 38a-528 of the general statutes, as 109
amended by this act, for which the eligible taxpayer is the insured. As 110
used in this section, (1) "eligible taxpayer" means any resident of this 111
state with a federal adjusted gross income of less than two hundred 112
thousand dollars, and (2) "resident of this state" has the same meaning 113
as provided in section 12-701 of the general statutes. 114
Sec. 5. (Effective from passage) Not later than February 1, 2026, the 115
Insurance Department shall prepare and submit a report, in accordance 116 Substitute Bill No. 1269
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with the provisions of section 11-4a of the general statutes, to the joint 117
standing committee of the General Assembly having cognizance of 118
matters relating to insurance. Such report shall include an evaluation of 119
the individual and group long-term care premium rate filing processes 120
established under sections 38a-501, as amended by this act, and 38a-528 121
of the general statutes, as amended by this act. 122
Sec. 6. Section 38a-501 of the general statutes is repealed and the 123
following is substituted in lieu thereof (Effective January 1, 2026): 124
(a) (1) As used in this section, [and section 38a-475a,] "long-term care 125
policy" means any individual health insurance policy delivered or 126
issued for delivery to any resident of this state on or after July 1, 1986, 127
that is designed to provide, within the terms and conditions of the 128
policy, benefits on an expense-incurred, indemnity or prepaid basis for 129
necessary care or treatment of an injury, illness or loss of functional 130
capacity provided by a certified or licensed health care provider in a 131
setting other than an acute care hospital, for at least one year after an 132
elimination period (A) not to exceed one hundred days of confinement, 133
or (B) of over one hundred days but not to exceed two years of 134
confinement, provided such period is covered by an irrevocable trust in 135
an amount estimated to be sufficient to furnish coverage to the grantor 136
of the trust for the duration of the elimination period. Such trust shall 137
create an unconditional duty to pay the full amount held in trust 138
exclusively to cover the costs of confinement during the elimination 139
period, subject only to taxes and any trustee's charges allowed by law. 140
Payment shall be made directly to the provider. The duty of the trustee 141
may be enforced by the state, the grantor or any person acting on behalf 142
of the grantor. A long-term care policy shall provide benefits for 143
confinement in a nursing home or confinement in the insured's own 144
home or both. Any additional benefits provided shall be related to long-145
term treatment of an injury, illness or loss of functional capacity. "Long-146
term care policy" does not include any such policy that is offered 147
primarily to provide basic Medicare supplement coverage, basic 148
medical-surgical expense coverage, hospital confinement indemnity 149
coverage, major medical expense coverage, disability income protection 150 Substitute Bill No. 1269
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coverage, accident only coverage, specified accident coverage or limited 151
benefit health coverage. 152
(2) (A) Notwithstanding any provision of the general statutes, no 153
insurance company, fraternal benefit society, hospital service 154
corporation, medical service corporation or health care center may 155
deliver, issue for delivery, renew, continue or amend any long-term care 156
policy in this state on or after January 1, 2022, unless the insurance 157
company, fraternal benefit society, hospital service corporation, medical 158
service corporation or health care center is authorized or licensed to sell 159
long-term care insurance and at least one other line of insurance in this 160
state. 161
(B) No insurance company, fraternal benefit society, hospital service 162
corporation, medical service corporation or health care center 163
delivering, issuing for delivery, renewing, continuing or amending any 164
long-term care policy in this state may refuse to accept, or refuse to make 165
reimbursement pursuant to, a claim for benefits submitted by or 166
prepared with the assistance of a managed residential community, as 167
defined in section 19a-693, in accordance with subdivision (7) of 168
subsection (a) of section 19a-694, solely because such claim for benefits 169
was submitted by or prepared with the assistance of a managed 170
residential community. 171
(C) Each insurance company, fraternal benefit society, hospital 172
service corporation, medical service corporation or health care center 173
delivering, issuing for delivery, renewing, continuing or amending any 174
long-term care policy in this state shall, upon receipt of a written 175
authorization executed by the insured, (i) disclose information to a 176
managed residential community for the purpose of determining such 177
insured's eligibility for an insurance benefit or payment, and (ii) provide 178
a copy of the initial acceptance or declination of a claim for benefits to 179
the managed residential community at the same time such acceptance 180
or declination is made to the insured. 181
(b) (1) No insurance company, fraternal benefit society, hospital 182 Substitute Bill No. 1269
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service corporation, medical service corporation or health care center 183
may deliver or issue for delivery any long-term care policy that has a 184
loss ratio of less than sixty per cent for any individual long-term care 185
policy. An issuer shall not use or change premium rates for a long-term 186
care policy unless the rates have been filed with and approved by the 187
commissioner. Any rate filings or rate revisions shall demonstrate that 188
anticipated claims in relation to premiums when combined with actual 189
experience to date can be expected to comply with the loss ratio 190
requirement of this section. A rate filing shall include the factors and 191
methodology used to estimate irrevocable trust values if the policy 192
includes an option for the elimination period specified in subdivision 193
(1) of subsection (a) of this section. 194
(2) (A) [Any] Except as provided in subdivision (3) of this subsection, 195
any insurance company, fraternal benefit society, hospital service 196
corporation, medical service corporation or health care center that files 197
a rate filing for an increase in premium rates for a long-term care policy 198
[that is for twenty per cent or more shall spread the increase over a 199
period of not less than three years and not file a rate filing for] shall not 200
request in such filing an increase in premium rates for [the] such long-201
term care policy [during the period chosen. Such company, society, 202
corporation or center shall use a periodic rate increase that is actuarially 203
equivalent to a single rate increase and a current interest rate for the 204
period chosen] that exceeds ten per cent. 205
(B) Prior to implementing a premium rate increase, each such 206
company, society, corporation or center shall: 207
(i) Notify its policyholders of such premium rate increase and make 208
available to such policyholders the additional choice of reducing the 209
policy benefits to reduce the premium rate. [or electing coverage that 210
reflects the minimum set of affordable benefit options developed by the 211
commissioner pursuant to section 38a-475a.] Such notice shall include a 212
description of such policy benefit reductions. [and minimum set of 213
affordable benefit options.] The premium rates for any benefit 214
reductions shall be based on the new premium rate schedule; 215 Substitute Bill No. 1269
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(ii) Provide policyholders not less than thirty calendar days to elect a 216
reduction in policy benefits; [or coverage that reflects the minimum set 217
of affordable benefit options developed by the commissioner pursuant 218
to section 38a-475a;] and 219
(iii) Include a statement in such notice that if a policyholder fails to 220
elect a reduction in policy benefits [or coverage that reflects the 221
minimum set of affordable benefit options developed by the 222
commissioner pursuant to section 38a-475a] by the end of the notice 223
period and has not cancelled the policy, the policyholder will be deemed 224
to have elected to retain the existing policy benefits. 225
(3) Notwithstanding the provisions of subparagraph (A) of 226
subdivision (2) of this subsection, any insurance company, fraternal 227
benefit society, hospital service corporation, medical service corporation 228
or health care center that files a rate filing for an increase in premium 229
rates for a long-term care policy shall not request in such filing an 230
increase in premium rates for such long-term care policy that exceeds 231
the most recent calendar year average in the consumer price index for 232
urban consumers, as published by the United States Department of 233
Labor, Bureau of Labor Statistics, provided the policyholder of such 234
long-term care policy has held such long-term care policy for not less 235
than fifteen years. 236
(c) (1) No such company, society, corporation or center may deliver 237
or issue for delivery any long-term care policy without providing, at the 238
time of solicitation or application for purchase or sale of such coverage, 239
full and fair written disclosure of the benefits and limitations of the 240
policy. 241
(2) (A) The applicant shall sign an acknowledgment at the time of 242
application for such policy that the company, society, corporation or 243
center has provided the written disclosure required under this 244
subsection to the applicant. If the method of application does not allow 245
for such signature at the time of application, the applicant shall sign 246
such acknowledgment not later than at the time of delivery of such 247 Substitute Bill No. 1269
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policy. 248
(B) Except for a long-term care policy for which no applicable 249
premium rate revision or rate schedule increases can be made or as 250
otherwise provided in subdivision (3) of this subsection, such disclosure 251
shall include: 252
(i) A statement that the policy may be subject to rate increases in the 253
future; 254
(ii) An explanation of potential future premium rate revisions and the 255
policyholder's option in the event of a premium rate revision; 256
(iii) The premium rate or rate schedule applicable to the applicant 257
that will be in effect until such company, society, corporation or center 258
files a request with the commissioner for a revision to such premium 259
rate or rate schedule; 260
(iv) An explanation of how a premium rate or rate schedule revision 261
will be applied that includes a description of when such rate or rate 262
schedule revision will be effective; and 263
(v) Information regarding each premium rate increase, if any, over 264
the past ten years on such policy form or similar policy forms for this 265
state or any other state, that identifies, at a minimum, (I) the policy forms 266
for which premium rates have been increased, (II) the calendar years 267
when each such policy form was available for purchase, and (III) the 268
amount or percentage of each increase. The percentage may be 269
expressed as a percentage of the premium rate prior to the increase or 270
as minimum and maximum percentages if the rate increase is variable 271
by rating characteristics. 272
(C) The company, society, corporation or center may provide, in a fair 273
manner, any additional explanatory information related to a premium 274
rate or rate schedule revision. 275
(3) (A) Any such company, society, corporation or center may 276
exclude from the disclosure required under subparagraph (B) of 277 Substitute Bill No. 1269
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subdivision (2) of this subsection premium rate increases that only 278
apply to blocks of business or long-term care policies acquired from a 279
nonaffiliated company, society, corporation or center and that occurred 280
prior to the acquisition. 281
(B) If an acquiring company, society, corporation or center files a 282
request for a premium rate increase on or before January 1, 2015, or the 283
end of a twenty-four-month period after the acquisition, whichever is 284
later, for a block of policy forms or long-term care policies acquired from 285
a nonaffiliated company, society, corporation or center, such acquiring 286
company, society, corporation or center may exclude from the 287
disclosure required under subparagraph (B) of subdivision (2) of this 288
subsection such premium rate increase, except that the nonaffiliated 289
company, society, corporation or center selling such block of policy 290
forms or long-term care policies shall include such premium rate 291
increase in such disclosure. 292
(C) If an acquiring company, society, corporation or center under 293
subparagraph (B) of this subdivision files a subsequent request, even 294
within the twenty-four-month period specified in said subparagraph, 295
for a premium rate increase on the same block of policy forms or long-296
term care policies set forth in said subparagraph, the acquiring 297
company, society, corporation or center shall include in the disclosure 298
required under subparagraph (B) of subdivision (2) of this subsection 299
such premium rate increase and any premium rate increase filed and 300
approved pursuant to subparagraph (B) of this subdivision. 301
(4) If the offering for any long-term care policy includes an option for 302
the elimination period specified in subdivision (1) of subsection (a) of 303
this section, the application form for such policy and the face page of 304
such policy shall contain a clear and conspicuous disclosure that the 305
irrevocable trust may not be sufficient to cover all costs during the 306
elimination period. 307
(d) No such company, society, corporation or center may deliver or 308
issue for delivery any long-term care policy on or after July 1, 2008, 309 Substitute Bill No. 1269
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without offering, at the time of solicitation or application for purchase 310
or sale of such coverage, an option to purchase a policy that includes a 311
nonforfeiture benefit. Such offer of a nonforfeiture benefit may be in the 312
form of a rider attached to such policy. In the event the nonforfeiture 313
benefit is declined, such company, society, corporation or center shall 314
provide a contingent benefit upon lapse that shall be available for a 315
specified period of time following a substantial increase in premium 316
rates. Not later than July 1, 2008, the commissioner shall adopt 317
regulations, in accordance with chapter 54, to implement the provisions 318
of this subsection. Such regulations shall specify the type of 319
nonforfeiture benefit that may be offered, the standards for such benefit, 320
the period of time during which a contingent benefit upon lapse will be 321
available and the substantial increase in premium rates that trigger a 322
contingent benefit upon lapse in accordance with the Long-Term Care 323
Insurance Model Regulation adopted by the National Association of 324
Insurance Commissioners. 325
(e) The commissioner shall adopt regulations, in accordance with 326
chapter 54, that address (1) the insured's right to information prior to 327
the insured replacing an accident and sickness policy with a long-term 328
care policy, (2) the insured's right to return a long-term care policy to 329
the insurer, within a specified period of time after delivery, for 330
cancellation, and (3) the insured's right to accept by the insured's 331
signature, and prior to it becoming effective, any rider or endorsement 332
added to a long-term care policy after the issuance date of such policy. 333
The commissioner shall adopt such additional regulations as the 334
commissioner deems necessary in accordance with chapter 54 to carry 335
out the purpose of this section. 336
(f) The commissioner may, upon written request by any such 337
company, society, corporation or center, issue an order to modify or 338
suspend a specific provision of this section or any regulation adopted 339
pursuant thereto with respect to a specific long-term care policy upon a 340
written finding that: (1) The modification or suspension would be in the 341
best interest of the insureds; (2) the purposes to be achieved could not 342
be effectively or efficiently achieved without such modification or 343 Substitute Bill No. 1269
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suspension; and (3) (A) the modification or suspension is necessary to 344
the development of an innovative and reasonable approach for insuring 345
long-term care, (B) the policy is to be issued to residents of a life care or 346
continuing care retirement community or other residential community 347
for the elderly and the modification or suspension is reasonably related 348
to the special needs or nature of such community, or (C) the 349
modification or suspension is necessary to permit long-term care 350
policies to be sold as part of, or in conjunction with, another insurance 351
product. Whenever the commissioner decides not to issue such an order, 352
the commissioner shall provide written notice of such decision to the 353
requesting party in a timely manner. 354
(g) Upon written request by any such company, society, corporation 355
or center, the commissioner may issue an order to extend the preexisting 356
condition exclusion period, as established by regulations adopted 357
pursuant to this section, for purposes of specific age group categories in 358
a specific long-term care policy form whenever the commissioner makes 359
a written finding that such an extension is in the best interest to the 360
public. Whenever the commissioner decides not to issue such an order, 361
the commissioner shall provide written notice of such decision to the 362
requesting party in a timely manner. 363
(h) The provisions of section 38a-19 shall be applicable to any such 364
requesting party aggrieved by any order or decision of the 365
commissioner made pursuant to subsections (f) and (g) of this section. 366
Sec. 7. Section 38a-528 of the general statutes is repealed and the 367
following is substituted in lieu thereof (Effective January 1, 2026): 368
(a) (1) As used in this section, [and section 38a-475a,] "long-term care 369
policy" means any group health insurance policy or certificate delivered 370
or issued for delivery to any resident of this state on or after July 1, 1986, 371
that is designed to provide, within the terms and conditions of the policy 372
or certificate, benefits on an expense-incurred, indemnity or prepaid 373
basis for necessary care or treatment of an injury, illness or loss of 374
functional capacity provided by a certified or licensed health care 375 Substitute Bill No. 1269
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provider in a setting other than an acute care hospital, for at least one 376
year after a reasonable elimination period. A long-term care policy shall 377
provide benefits for confinement in a nursing home or confinement in 378
the insured's own home or both. Any additional benefits provided shall 379
be related to long-term treatment of an injury, illness or loss of 380
functional capacity. "Long-term care policy" does not include any such 381
policy or certificate that is offered primarily to provide basic Medicare 382
supplement coverage, basic medical-surgical expense coverage, hospital 383
confinement indemnity coverage, major medical expense coverage, 384
disability income protection coverage, accident only coverage, specified 385
accident coverage or limited benefit health coverage. 386
(2) (A) Notwithstanding any provision of the general statutes, no 387
insurance company, fraternal benefit society, hospital service 388
corporation, medical service corporation or health care center may 389
deliver, issue for delivery, renew, continue or amend any long-term care 390
policy in this state on or after January 1, 2022, unless the insurance 391
company, fraternal benefit society, hospital service corporation, medical 392
service corporation or health care center is authorized or licensed to sell 393
long-term care insurance and at least one other line of insurance in this 394
state. 395
(B) No insurance company, fraternal benefit society, hospital service 396
corporation, medical service corporation or health care center 397
delivering, issuing for delivery, renewing, continuing or amending any 398
long-term care policy in this state may refuse to accept, or refuse to make 399
reimbursement pursuant to, a claim for benefits submitted by or 400
prepared with the assistance of a managed residential community, as 401
defined in section 19a-693, in accordance with subdivision (7) of 402
subsection (a) of section 19a-694, solely because such claim for benefits 403
was submitted by or prepared with the assistance of a managed 404
residential community. 405
(C) Each insurance company, fraternal benefit society, hospital 406
service corporation, medical service corporation or health care center 407
delivering, issuing for delivery, renewing, continuing or amending any 408 Substitute Bill No. 1269
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long-term care policy in this state shall, upon receipt of a written 409
authorization executed by the insured, (i) disclose information to a 410
managed residential community for the purpose of determining such 411
insured's eligibility for an insurance benefit or payment, and (ii) provide 412
a copy of the initial acceptance or declination of a claim for benefits to 413
the managed residential community at the same time such acceptance 414
or declination is made to the insured. 415
(b) (1) No insurance company, fraternal benefit society, hospital 416
service corporation, medical service corporation or health care center 417
may deliver or issue for delivery any long-term care policy or certificate 418
that has a loss ratio of less than sixty-five per cent for any group long-419
term care policy. An issuer shall not use or change premium rates for a 420
long-term care policy or certificate unless the rates have been filed with 421
the commissioner. Deviations in rates to reflect policyholder experience 422
shall be permitted, provided each policy form shall meet the loss ratio 423
requirement of this section. Any rate filings or rate revisions shall 424
demonstrate that anticipated claims in relation to premiums when 425
combined with actual experience to date can be expected to comply with 426
the loss ratio requirement of this section. On an annual basis, an insurer 427
shall submit to the commissioner an actuarial certification of the 428
insurer's continuing compliance with the loss ratio requirement of this 429
section. Any rate or rate revision may be disapproved if the 430
commissioner determines that the loss ratio requirement will not be met 431
over the lifetime of the policy form using reasonable assumptions. 432
(2) (A) [Any] Except as provided in subdivision (3) of this subsection, 433
any insurance company, fraternal benefit society, hospital service 434
corporation, medical service corporation or health care center that files 435
a rate filing for an increase in premium rates for a long-term care policy 436
[that is for twenty per cent or more shall spread the increase over a 437
period of not less than three years and not file a rate filing for] shall not 438
request in such filing an increase in premium rates for [the] such long-439
term care policy [during the period chosen. Such company, society, 440
corporation or center shall use a periodic rate increase that is actuarially 441
equivalent to a single rate increase and a current interest rate for the 442 Substitute Bill No. 1269
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period chosen] that exceeds ten per cent. 443
(B) Prior to implementing a premium rate increase, each such 444
company, society, corporation or center shall: 445
(i) Notify its certificate holders of such premium rate increase and 446
make available to such certificate holders the additional choice of 447
reducing the policy benefits to reduce the premium rate. [or electing 448
coverage that reflects the minimum set of affordable benefit options 449
developed by the commissioner pursuant to section 38a-475a.] Such 450
notice shall include a description of such policy benefit reductions. [and 451
minimum set of affordable benefit options.] The premium rates for any 452
benefit reductions shall be based on the new premium rate schedule; 453
(ii) Provide certificate holders not less than thirty calendar days to 454
elect a reduction in policy benefits; [or coverage that reflects the 455
minimum set of affordable benefit options developed by the 456
commissioner pursuant to section 38a-475a;] and 457
(iii) Include a statement in such notice that if a certificate holder fails 458
to elect a reduction in policy benefits [or coverage that reflects the 459
minimum set of affordable benefit options developed by the 460
commissioner pursuant to section 38a-475a] by the end of the notice 461
period and has not cancelled the policy, the certificate holder will be 462
deemed to have elected to retain the existing policy benefits. 463
(3) Notwithstanding the provisions of subparagraph (A) of 464
subdivision (2) of this subsection, any insurance company, fraternal 465
benefit society, hospital service corporation, medical service corporation 466
or health care center that files a rate filing for an increase in premium 467
rates for a long-term care policy shall not request in such filing an 468
increase in premium rates for such long-term care policy that exceeds 469
the most recent calendar year average in the consumer price index for 470
urban consumers, as published by the United States Department of 471
Labor, Bureau of Labor Statistics, provided the certificate holder of such 472
long-term care policy has held such long-term care policy for not less 473
than fifteen years. 474 Substitute Bill No. 1269
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(c) (1) No such company, society, corporation or center may deliver 475
or issue for delivery any long-term care policy without providing, at the 476
time of solicitation or application for purchase or sale of such coverage, 477
full and fair written disclosure of the benefits and limitations of the 478
policy. The provisions of this subsection shall not be applicable to 479
noncontributory plans. 480
(2) (A) The applicant shall sign an acknowledgment at the time of 481
application for such policy that the company, society, corporation or 482
center has provided the written disclosure required under this 483
subsection to the applicant. If the method of application does not allow 484
for such signature at the time of application, the applicant shall sign 485
such acknowledgment not later than at the time of delivery of such 486
policy. 487
(B) The policyholder shall provide a copy of such disclosure to each 488
eligible individual. 489
(3) (A) Except for a long-term care policy for which no applicable 490
premium rate revision or rate schedule increases can be made or as 491
otherwise provided in subdivision (4) of this subsection, such disclosure 492
shall include: 493
(i) A statement that the policy may be subject to rate increases in the 494
future; 495
(ii) An explanation of potential future premium rate revisions and the 496
policyholder's or certificate holder's option in the event of a premium 497
rate revision; 498
(iii) The premium rate or rate schedule applicable to the applicant 499
that will be in effect until such company, society, corporation or center 500
files a request with the commissioner for a revision to such premium 501
rate or rate schedule; 502
(iv) An explanation of how a premium rate or rate schedule revision 503
will be applied that includes a description of when such rate or rate 504 Substitute Bill No. 1269
LCO 17 of 20
schedule revision will be effective; and 505
(v) Information regarding each premium rate increase, if any, over 506
the past ten years on such policy form or similar policy forms for this 507
state or any other state, that identifies, at a minimum, (I) the policy forms 508
for which premium rates have been increased, (II) the calendar years 509
when each such policy form was available for purchase, and (III) the 510
amount or percentage of each increase. The percentage may be 511
expressed as a percentage of the premium rate prior to the increase or 512
as minimum and maximum percentages if the rate increase is variable 513
by rating characteristics. 514
(B) The company, society, corporation or center may provide, in a fair 515
manner, any additional explanatory information related to a premium 516
rate or rate schedule revision. 517
(4) (A) Any such company, society, corporation or center may 518
exclude from the disclosure required under subdivision (3) of this 519
subsection premium rate increases that only apply to blocks of business 520
or long-term care policies acquired from a nonaffiliated company, 521
society, corporation or center and that occurred prior to the acquisition. 522
(B) If an acquiring company, society, corporation or center files a 523
request for a premium rate increase on or before January 1, 2015, or the 524
end of a twenty-four-month period after the acquisition, whichever is 525
later, for a block of policy forms or long-term care policies acquired from 526
a nonaffiliated company, society, corporation or center such acquiring 527
company, society, corporation or center may exclude from the 528
disclosure required under subdivision (3) of this subsection such 529
premium rate increase, except that the nonaffiliated company, society, 530
corporation or center selling such block of policy forms or long-term 531
care policies shall include such premium rate increase in such 532
disclosure. 533
(C) If an acquiring company, society, corporation or center under 534
subparagraph (B) of this subdivision files a subsequent request, even 535
within the twenty-four-month period specified in said subparagraph, 536 Substitute Bill No. 1269
LCO 18 of 20
for a premium rate increase on the same block of policy forms or long-537
term care policies set forth in said subparagraph, the acquiring 538
company, society, corporation or center shall include in the disclosure 539
required under subdivision (3) of this subsection such premium rate 540
increase and any premium rate increase filed and approved pursuant to 541
subparagraph (B) of this subdivision. 542
(d) The commissioner shall adopt regulations, in accordance with 543
chapter 54, that address (1) the insured's right to information prior to his 544
replacing an accident and sickness policy with a long-term care policy, 545
(2) the insured's right to return a long-term care policy to the insurer, 546
within a specified period of time after delivery, for cancellation, and (3) 547
the insured's right to accept by the insured's signature, and prior to it 548
becoming effective, any rider or endorsement added to a long-term care 549
policy after the issuance date of such policy, provided (A) any 550
regulations adopted pursuant to subdivisions (1) and (2) of this 551
subsection shall not be applicable to (i) any long-term care policy that is 552
delivered or issued for delivery to one or more employers or labor 553
organizations, or to a trust or to the trustees of a fund established by one 554
or more employers or labor organizations, or a combination thereof or 555
for members or former members or a combination thereof, of the labor 556
organizations, or (ii) noncontributory plans, and (B) any regulations 557
adopted pursuant to subdivision (3) of this subsection shall not be 558
applicable to any group long-term care policy. The commissioner shall 559
adopt such additional regulations as the commissioner deems necessary 560
in accordance with said chapter 54 to carry out the purpose of this 561
section. 562
(e) The commissioner may, upon written request by any such 563
company, society, corporation or center, issue an order to modify or 564
suspend a specific provision of this section or any regulation adopted 565
pursuant thereto with respect to a specific long-term care policy upon a 566
written finding that: (1) The modification or suspension would be in the 567
best interest of the insureds; (2) the purposes to be achieved could not 568
be effectively or efficiently achieved without such modification or 569
suspension; and (3) (A) the modification or suspension is necessary to 570 Substitute Bill No. 1269
LCO 19 of 20
the development of an innovative and reasonable approach for insuring 571
long-term care, (B) the policy is to be issued to residents of a life care or 572
continuing care retirement community or other residential community 573
for the elderly and the modification or suspension is reasonably related 574
to the special needs or nature of such community, or (C) the 575
modification or suspension is necessary to permit long-term care 576
policies to be sold as part of, or in conjunction with, another insurance 577
product. Whenever the commissioner decides not to issue such an order, 578
the commissioner shall provide written notice of such decision to the 579
requesting party in a timely manner. 580
(f) Upon written request by any such company, society, corporation 581
or center, the commissioner may issue an order to extend the preexisting 582
condition exclusion period, as established by regulations adopted 583
pursuant to this section, for purposes of specific age group categories in 584
a specific long-term care policy form whenever [he] the commissioner 585
makes a written finding that such an extension is in the best interest to 586
the public. Whenever the commissioner decides not to issue such an 587
order, the commissioner shall provide written notice of such decision to 588
the requesting party in a timely manner. 589
(g) The provisions of section 38a-19 shall be applicable to any such 590
requesting party aggrieved by any order or decision of the 591
commissioner made pursuant to subsections (e) and (f) of this section. 592
Sec. 8. Section 38a-475a of the general statutes is repealed. (Effective 593
January 1, 2026) 594
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Sec. 2 January 1, 2026 38a-458
Sec. 3 January 1, 2026 38a-430(a)
Sec. 4 January 1, 2026, and
applicable to taxable years
commencing on or after
January 1, 2026
New section Substitute Bill No. 1269
LCO 20 of 20
Sec. 5 from passage New section
Sec. 6 January 1, 2026 38a-501
Sec. 7 January 1, 2026 38a-528
Sec. 8 January 1, 2026 Repealer section
INS Joint Favorable Subst.