Reference is to the bill as introduced.
Amend the bill, as and if amended, by deleting all after the enacting words and inserting:
/ SECTION 1. Chapter 72, Title 38 of the 1976 Code is amended to read:
"Section 38-72-66.
Each insurer offering long term care insurance shall, as a
protection against unintentional lapse, comply with the
following:
(1)(a)(i) No individual
long term care policy or certificate may be issued until the
insurer has received from the applicant either a written
designation of at least one person, in addition to the
applicant, who is to receive notice of lapse or termination of
the policy or certificate for nonpayment of premium. The
applicant has the right to designate at least one person who is
to receive the notice of termination, in addition to the
insured. Designation must not constitute acceptance of any
liability on the third party for services provided to the
insured. The form used for the written designation must provide
space clearly designated for listing at least one person. The
designation must include each person's full name and
home address. In the case of an applicant who elects not
to designate an additional person, the waiver must state:
'Protection against unintended lapse. I understand that I have
the right to designate at least one person other than myself to
receive notice of lapse or termination of this long term care
insurance policy for nonpayment of premium. I understand that
notice will not be given until thirty (30) days after a premium
is due and unpaid. I elect NOT to designate a person to receive
this notice.' The insurer shall notify the insured of the right
to change this written designation no less often than once every
two years.
(ii)
For existing long term care policies, the insurer must
provide written notice to the insured that they may make a
written designation of a least one person, in addition to the
insured, who is to receive notice of lapse or termination of the
policy or certificate. The notice called for in this subsection
must be provided to the insured within ninety days of the
effective date of this section. As provided in this subitem,
the insurer shall notify the insured of the right to change this
written designation no less often than once every two years.
(b)
When the policyholder or certificate holder pays premium
for a long term care insurance policy or certificate through a
payroll or pension deduction plan, the requirements contained in
sub-subitem (i) of item (a) need not be met until sixty days
after the policyholder or certificate holder is no longer on
such a payment plan. The application or enrollment form for such
policies or certificates must clearly indicate the payment plan
selected by the applicant.
(c)
Lapse or termination for nonpayment of premium. No
individual long term care policy or certificate shall lapse or
be terminated for nonpayment of premium unless the insurer, at
least thirty days before the effective date of the lapse or
termination, has given notice to the insured and to those
persons designated pursuant to sub-subitem (i) of item (a), at
the address provided by the insured for purposes of receiving
notice of lapse or termination. Notice must be given by first
class United States mail, postage prepaid, and notice may not be
given until thirty days after a premium is due and unpaid.
Notice must be considered to have been given as of five days
after the date of mailing.
(2) In addition to the
requirement in item (1), a long term care insurance policy or
certificate shall include a provision that provides for
reinstatement of coverage in the event of lapse or termination
if the insurer is provided proof that the policyholder or
certificate holder was cognitively impaired or had a loss of
functional capacity before the grace period contained in the
policy expired. This option must be available to the insured if
requested within five months after termination and must allow
for the collection of past due premium, where appropriate. The
standard of proof of cognitive impairment or loss of functional
capacity must not be more stringent than the benefit eligibility
criteria on cognitive impairment or the loss of functional
capacity contained in the policy and certificate."
SECTION 2. This act takes effect upon approval by the Governor. /
Renumber sections to conform.
Amend title to conform.