reglab/housing_qa huggingface dataset:
MD. Insurance Code Ann. §  18-102 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-102 - Regulations

    The Commissioner may adopt regulations about long-term care insurance with respect to:         (1)    form and content of disclosures;        (2)    terms of renewals;        (3)    initial and subsequent conditions of eligibility;        (4)    nonduplication of coverage provisions;        (5)    preexisting conditions;        (6)    renewability of coverage;        (7)    continuation and conversion;        (8)    probationary periods, limitation of coverage provisions, and recurrent conditions;        (9)    coverage of dependents;        (10)    loss ratio standards; and        (11)    any other matter that the Commissioner determines is in the best interest of the public.
MD. Insurance Code Ann. §  18-103 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-103 - Compliance With Title Required; Advertising; Marketing

    (a)    A carrier may not advertise, market, or offer a policy, contract, or certificate in the State as long-term care insurance or long-term nursing home insurance unless the policy or contract complies with this title.    (b)    (1)    Before a carrier advertises, on television or radio or in writing, a policy or contract of long-term care insurance or long-term nursing home insurance that is offered for sale in the State, the carrier shall submit a copy of the advertisement to the Commissioner for review.        (2)    The carrier shall retain each advertisement for 3 years after the date the advertisement first was used.        (3)    The Commissioner may exempt a carrier or a carrier’s advertising form or material from the requirements of this section if in the opinion of the Commissioner the requirements may not reasonably be applied.    (c)    A carrier that markets long-term care insurance in the State shall:        (1)    establish marketing procedures to ensure that any comparison of policies by insurance producers of the carrier will be fair and accurate;        (2)    establish marketing procedures to prevent the sale or issuance of excessive insurance;        (3)    establish procedures for verifying compliance with this subsection;        (4)    provide, to the extent possible, information on any senior citizen counseling program;        (5)    display prominently on the first page of the outline of coverage and the policy the following:    “Notice to buyer: This policy may not cover all the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations.”; and        (6)    make every reasonable effort to identify whether a prospective applicant:            (i)    already has long-term care insurance and, if so, the types and amounts of the long-term care insurance;            (ii)    had long-term care insurance in force during the last 12 months;            (iii)    is covered under the medical assistance program; or            (iv)    intends to replace any existing medical or health insurance coverage with long-term care insurance.    (d)    An insurance producer who offers or sells policies or contracts of long–term care insurance in the State shall:        (1)    advise an individual considering the purchase of a long–term care insurance policy or contract about the availability and benefits of a policy that qualifies under the Qualified State Long–Term Care Insurance Partnership established under Title 15, Subtitle 4 of the Health – General Article;        (2)    provide a disclosure statement, approved by the Commissioner, to each applicant for long–term care insurance about the Qualified State Long–Term Care Insurance Partnership; and        (3)    make the disclosure statement required under item (2) of this subsection available to the Commissioner for inspection.
MD. Insurance Code Ann. §  18-104 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-104 - Questions in Applications

    (a)    Each application for long-term care insurance, except applications that are for long-term care insurance that is guaranteed issue, shall contain clear and unambiguous questions to ascertain the health condition of the applicant.    (b)    (1)    If an application for long-term care insurance asks whether the applicant has had medication prescribed by a physician, the application also shall ask the applicant to list the medication that has been prescribed.        (2)    If the carrier knew or should have known that the medication listed under paragraph (1) of this subsection at the time of application was directly related to a medical condition for which coverage would otherwise be denied, the policy or certificate of long-term care insurance may not be rescinded for that condition.
MD. Insurance Code Ann. §  18-105 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-105 - Applicants at Least 80 Years Old

    Before issuing a policy of long-term care insurance to an applicant who is at least 80 years old, unless the policy is guaranteed issue, the carrier shall obtain:         (1)    a report of a physical examination;        (2)    an assessment of functional capacity; or        (3)    copies of medical records.
MD. Insurance Code Ann. §  18-106 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-106 - Outline of Coverage and Buyer's Guide

    (a)    (1)    A carrier shall provide to each applicant an outline of coverage and buyer’s guide.        (2)    The carrier shall deliver the outline of coverage and buyer’s guide:            (i)    in the case of solicitation by the carrier or insurance producer of the carrier, before the presentation of an application or enrollment form; and            (ii)    in the case of direct response solicitation, with the application or enrollment form.    (b)    The outline of coverage shall include:        (1)    a description of the principal benefits and coverage provided in the policy or contract;        (2)    a statement of the principal exclusions, reductions, and limitations in the policy or contract;        (3)    a statement of the renewal provisions, including any reservation in the policy or contract of a right to change the schedule of premiums;        (4)    a statement that the outline of coverage is a summary of the policy or contract issued or applied for and the policy or contract should be consulted to determine the governing contractual provisions; and        (5)    any expected premium increases or additional premiums to pay for automatic or optional benefit increases, including a reasonable hypothetical or graphic demonstration of the potential premiums that the applicant will need to pay at age 75 for benefit increases.    (c)    The buyer’s guide shall include information about buying a policy of long–term care insurance, including a reference to the right of the buyer to cancel a policy during the first 30 days after the policy is delivered.    (d)    A carrier shall provide an applicant with a graphic comparison, over a period of at least 20 years, of the benefit levels of a policy that increases benefits over the policy or certificate period compared to the benefit levels of a policy that does not increase benefits.
MD. Insurance Code Ann. §  18-107 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-107 - Contents of Certificates

    A certificate that is issued under group long–term care insurance shall include:        (1)    a description of the principal benefits and coverage provided in the policy or contract;        (2)    a statement of the principal exclusions, reductions, and limitations of coverage in the policy or contract;        (3)    a statement that the group master policy or contract determines the governing contractual provisions; and        (4)    a statement as to whether the policy or contract is intended to qualify as a partnership policy under the Qualified State Long–Term Care Insurance Partnership under Title 15, Subtitle 4 of the Health – General Article.
MD. Insurance Code Ann. §  18-108 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-108 - Summaries of Long-Term Care Benefits in Life Insurance Policies

    (a)    If long-term care benefits are part of a life insurance policy or rider, the carrier shall provide a policy summary at the time of policy delivery.    (b)    The policy summary required to be delivered under subsection (a) of this section shall include:        (1)    information required to be included in an outline of coverage under § 18-106 of this title;        (2)    an explanation of how the long-term care benefits interact with other components of the life insurance policy, including deductions from death benefits;        (3)    an illustration of the amount of benefits, length of benefit, and guaranteed lifetime benefits if any, for each covered individual;        (4)    any exclusions, reductions, or limitations on benefits of long-term care; and        (5)    if applicable to the policy type:            (i)    a disclosure of the effects of exercising other rights under the policy;            (ii)    a disclosure of guarantees related to long-term care costs of insurance charges; and            (iii)    current and projected maximum lifetime benefits.
MD. Insurance Code Ann. §  18-109 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-109 - Policy Limitations and Exclusions -- in General

    (a)    Except as provided in subsection (b) of this section, a policy or certificate of long-term care insurance may not be delivered or issued for delivery in the State if the policy or certificate limits or excludes coverage by type of illness, treatment, medical condition, or accident.    (b)    A policy or certificate of long-term care insurance may limit or exclude coverage of:        (1)    preexisting conditions or diseases;        (2)    mental or nervous conditions or diseases other than Alzheimer’s disease;        (3)    alcohol or drug addiction;        (4)    unless otherwise provided by State or federal law, treatment provided in a government facility;        (5)    services provided by a member of the covered individual’s immediate family;        (6)    services for which a charge normally is not made in the absence of insurance;        (7)    services for which benefits are available under:            (i)    Medicare or other governmental programs except Medicaid; or            (ii)    a State or federal workers’ compensation, employer’s liability, or occupational disease law; and        (8)    illness, treatment, or medical conditions arising out of:            (i)    a declared or undeclared war or act of war;            (ii)    participation in a felony, riot, or insurrection;            (iii)    service in the armed forces or auxiliary units;            (iv)    suicide, attempted suicide, or intentionally self-inflicted injury; or            (v)    aviation, if the insured is a passenger who does not pay a fare.    (c)    This section does not prohibit:        (1)    exclusions and limitations by type of provider; or        (2)    limitations by territory.
MD. Insurance Code Ann. §  18-110 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-110 - Policy Limitations and Exclusions -- Home Health Care Services

    (a)    (1)    In this section, “home health care services” means medical or nonmedical services provided to ill, disabled, or infirm individuals in their residences.        (2)    “Home health care services” includes:            (i)    homemaker services;            (ii)    assistance with activities of daily living; and            (iii)    respite care services.    (b)    A policy or certificate of long-term care insurance that provides benefits for home health care services may not limit or exclude benefits by:        (1)    requiring that the insured would need care in a nursing facility if home health care services were not provided;        (2)    requiring that the insured first or simultaneously receive nursing or therapeutic services at home or in a community setting before home health care services are covered.        (3)    limiting eligible services provided by registered nurses or licensed practical nurses;        (4)    requiring that a nurse or therapist provide services covered by the policy or certificate of long-term care insurance that can be provided by a home health aide or other licensed or certified home care worker who acts within the scope of licensure or certification;        (5)    requiring that the insured have an acute condition before home health care services are covered; or        (6)    limiting benefits to services provided by Medicare-certified agencies or providers.    (c)    Coverage for home health care services may be applied to the coverage for other benefits provided in the policy or certificate of long-term care insurance when determining maximum coverage under the terms of the policy or certificate.
MD. Insurance Code Ann. §  18-111 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-111 - Policy Limitations and Exclusions -- Alzheimer's Disease

    Except for coverage excluded under a preexisting condition provision, long-term care insurance shall provide coverage for Alzheimer’s disease or other senile dementia disorders without any condition, limitation, or reduction of coverage not applicable to coverage for other diseases or illnesses.
MD. Insurance Code Ann. §  18-112 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-112 - Continuation of Coverage or Conversion of Policies

    (a)    Each group policy of long-term care insurance shall provide covered individuals with a basis for continuation of coverage or conversion to an individual policy of long-term care insurance.    (b)    (1)    For purposes of this section, a group policy of long-term care insurance provides a basis for continuation of coverage if the group policy:            (i)    maintains coverage under the existing group policy when the coverage would otherwise terminate; and            (ii)    is subject only to the continued timely payment of premiums.        (2)    A group policy that restricts benefits and services to certain providers or facilities or contains incentives to use certain providers or facilities may provide continuation benefits that are substantially equivalent to the benefits of the existing group policy.    (c)    For purposes of this section, a group policy provides a basis for conversion of coverage if the group policy provides for issuance of a policy that provides benefits that are identical to, substantially equivalent to, or in excess of the benefits of the terminated group policy without evidence of insurability to each individual:        (1)    whose coverage under the group policy would otherwise be terminated for any reason; and        (2)    who has been continuously insured under the group policy for at least 6 months before the date of termination.    (d)    In determining whether benefits are substantially equivalent under this section, the Commissioner shall consider the difference between managed care plans and other plans.
MD. Insurance Code Ann. §  18-113 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-113 - Replacement Policies

    (a)    If a group policy of long-term care insurance is replaced by another group policy of long-term care insurance purchased by the same policyholder, the succeeding carrier shall offer coverage to each insured who was covered under the old group policy on its date of termination.    (b)    Coverage under the new group policy of long-term care insurance may not result in an exclusion for preexisting conditions that would have been covered under the group policy being replaced.
MD. Insurance Code Ann. §  18-114 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-114 - Inflation Protection Option

    (a)    The requirements of this section:        (1)    apply to individual and group policies of long-term care insurance; and        (2)    do not apply to life insurance policies or riders on life insurance policies that contain accelerated long-term care benefits.    (b)    (1)    A carrier may not offer a policy or certificate of long-term care insurance unless, at the time of purchase, the carrier also offers the applicant the option to purchase a policy or certificate with an inflation protection feature as described under paragraph (2) of this subsection.        (2)    The inflation protection feature under this subsection shall provide, in addition to any other inflation protection, that benefit levels will increase with benefit maximums or reasonable durations that are meaningful to account for reasonably anticipated increases in the costs of long-term care services covered by the policy or certificate.    (c)    The option to purchase a policy or certificate of long-term care insurance with an inflation protection feature under this section may not be less favorable than:        (1)    a policy or certificate that increases benefit levels annually in a manner so that the increases are compounded annually at a rate of at least 5%;        (2)    a policy or certificate that guarantees the insured the right to increase benefit levels periodically without providing evidence of insurability or health status so long as the option for the previous period has not been declined; or        (3)    a policy that covers a specific percentage of actual or reasonable charges and does not include a maximum specified indemnity amount or limit.    (d)    The amount of the additional benefit under subsection (c)(2) of this section may not be less than the difference between the benefit under an existing policy or certificate and that benefit compounded annually at a rate of at least 5% for the period beginning with the purchase of the existing benefit and extending until the year in which the offer is made.
MD. Insurance Code Ann. §  18-115 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-115 - Evaluating Expected and Actual Loss Ratios

    In evaluating the expected and actual loss ratios, the Commissioner shall consider:         (1)    the statistical credibility of incurred claims experience and earned premiums;        (2)    the period for which rates are computed to provide coverage;        (3)    experienced and projected trends;        (4)    the concentration of experience within early policy duration;        (5)    expected claim fluctuation;        (6)    experienced refunds, adjustments, or dividends;        (7)    renewability features;        (8)    all appropriate expense factors;        (9)    interest;        (10)    the experimental nature of the coverage;        (11)    policy reserves;        (12)    the mix of business by risk classification; and        (13)    product features, including long elimination periods, high deductibles, and high maximum limits.
MD. Insurance Code Ann. §  18-116 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-116 - Increases to Premiums

    (a)    Except as provided in subsection (b) of this section, a premium increase under long-term care insurance may not be based on the age of the insured or certificate holder.    (b)    A carrier may impose an across-the-board premium increase on policies or contracts of long-term care insurance that the carrier issues or delivers in the State after the carrier:        (1)    submits to the Commissioner an actuarial memorandum that supports the proposed premium increase; and        (2)    obtains the approval of the Commissioner.    (c)    This section does not prohibit age-banding.
MD. Insurance Code Ann. §  18-116.1 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-116.1 - Contingent Benefit Upon Lapse

    (a)    This section applies only to policies or contracts of long–term care insurance issued or delivered in the State before April 1, 2003, for which rate increase filings have been approved by the Commissioner on or after June 1, 2019.    (b)    Subject to subsection (c) of this section, a carrier shall provide to an insured under a policy or contract of long–term care insurance a contingent benefit upon lapse if:        (1)    the carrier increases the premium rate for the insured;        (2)    the insured has maintained the policy or contract of long–term care insurance through the carrier for at least 20 years; and        (3)    the insured terminates the policy or contract of long–term care insurance within 120 days after the date the premium rate increase becomes effective for the policy or contract of long–term care insurance maintained by the insured.    (c)    (1)    The contingent benefit upon lapse required under subsection (b) of this section shall be a paid–up coverage:            (i)    with no additional premiums due; and            (ii)    with a reduced lifetime maximum benefit equal to the sum of all premiums paid minus any claims paid.        (2)    Except for the maximum lifetime benefit calculated in accordance with paragraph (1) of this subsection, all other benefits of the policy or contract of long–term care insurance in effect on the date of the lapse of the policy or contract shall remain unchanged and may not be increased after the date of the lapse of the policy or contract.
MD. Insurance Code Ann. §  18-117 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-117 - Reports About Benefits Funded by Acceleration of Death Benefits

    (a)    Whenever a long-term care benefit that is funded through a life insurance vehicle by the acceleration of the death benefit is in benefit payment status, the carrier shall provide a monthly report to the policyholder.    (b)    A report under this section shall include:        (1)    any long-term care benefits paid out during the month;        (2)    an explanation of any changes in the policy, including changes to death benefits or cash values, that result from the payment of long-term care benefits; and        (3)    the amount of long-term care benefits that remain.
MD. Insurance Code Ann. §  18-117.1 (2021)
2021 Maryland Statutes|Insurance|Title 18 - Long-Term Care Insurance|Section 18-117.1 - Notice Containing Policy Form Number and Carrier's Customer Service Telephone Number

    Each carrier shall provide to each insured under a policy or contract of long–term care insurance in the State an annual notice, in writing or electronically, containing the insured’s policy form number and the carrier’s customer service telephone number.