reglab/housing_qa huggingface dataset:
AK Stat § 21.51.310 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 51. Health Insurance Policies|Sec. 21.51.310. Conforming to statute.

(a) A policy provision that is not subject to this chapter may not make a policy, or any portion of a policy, less favorable to the insured or the beneficiary than the provisions of the policy that are subject to this chapter. (b) A policy delivered or issued for delivery to a person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When a provision in a policy subject to this chapter is in conflict with a provision of this chapter, the rights, duties, and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter.
AK Stat § 21.51.320 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 51. Health Insurance Policies|Sec. 21.51.320. Age limit.

If the policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if the date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after that date, the coverage provided by the policy will continue in force until the end of the period for which premium has been accepted. If the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased before the acceptance of the premium or premiums, the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
AK Stat § 21.51.330 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 51. Health Insurance Policies|Sec. 21.51.330. Franchise health insurance.

(a) Health insurance on a franchise plan is that form of health insurance issued to (1) five or more employees of a corporation, copartnership, or individual employer or a governmental corporation, agency, or department of them; or (2) 10 or more members, employees, or employees of members of a trade or professional association or of a labor union or of any other association having had an active existence for at least two years if the association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance. (b) If these persons, with or without their dependents, are issued the same form of an individual policy varying only in amounts and kinds of coverage applied for by the persons under an arrangement whereby the premiums on the policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the association for its members, or by some designated person acting on behalf of the employer, association, or union, the term “employees” as used herein may be considered to include the officers, managers, and employees and retired employees of the employer and the individual proprietor or partners if the employer is an individual proprietor or partnership.
AK Stat § 21.51.400 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 51. Health Insurance Policies|Sec. 21.51.400. Renewability and certification.

A health care insurer that offers a health care insurance plan in the individual market shall comply with the guaranteed renewability requirements established under 42 U.S.C. 300gg-42 and shall comply with the certification of coverage requirements established under 42 U.S.C. 300gg-43.
AK Stat § 21.51.405 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 51. Health Insurance Policies|Sec. 21.51.405. Rate requirements; filings; regulations.

(a) Rates charged for a health insurance policy may not be excessive, inadequate, or unfairly discriminatory. (b) An insurer shall file with the director the premium rates charged for an individual health care insurance plan before using them. A premium rate or premium rate change must be on file with the director for a waiting period of at least 45 days before the effective date of the premium rate. That period may be extended by the director or the insurer for an additional 15 days if, during the initial 45-day waiting period, notice is given stating that additional time for consideration of the filing is needed. A filing may become effective at the end of the waiting period unless disapproved by the director during the waiting period. If an insurer fails to provide information requested by the director during the waiting period, the filing is considered withdrawn by the insurer, and the premium rate does not become effective. (c) The director shall adopt regulations (1) establishing procedures for filing and use of rates; and (2) specifying information that must be submitted in a filing required under (b) of this section.
AK Stat § 21.51.500 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 51. Health Insurance Policies|Sec. 21.51.500. Definitions.

In this chapter, (1) “health care exchange” means an American Health Benefit Exchange established under 42 U.S.C. 18031. (2) “health care insurance plan” has the meaning given in AS 21.54.500; (3) “health care insurer” has the meaning given in AS 21.54.500; (4) “individual market” means the market for health care insurance offered to individuals other than in connection with a health benefit plan as defined in AS 21.54.500.
AK Stat § 21.53.010 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.010. Prohibited sale or advertising.

An insurer, hospital or medical service corporation, or fraternal benefit society may not advertise, market, sell, deliver, or offer for delivery a long-term care insurance policy unless the policy complies with this chapter, AS 21.18, AS 21.45, the health insurance requirements imposed under AS 21.51, and, if a group policy, the group health insurance requirements imposed under AS 21.54, or unless it has been approved by and complies with the Interstate Insurance Product Regulation Compact under AS 21.42.700.
AK Stat § 21.53.020 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.020. Disclosure and performance standards.

An insurer, hospital or medical service corporation, or fraternal benefit society that delivers or issues for delivery a long-term care insurance policy may not (1) cancel, fail to renew, or otherwise terminate the policy on the grounds of age or deterioration of the mental or physical health of the insured; (2) include a provision requiring a new waiting period in the event existing coverage is converted to or replaced by a new or another form of health insurance within the same company, unless there is an increase in benefits voluntarily selected by the insured or group policyholder; or (3) provide coverage only for skilled nursing care or provide significantly more coverage for skilled care in a facility than is provided for coverage for lower levels of care.
AK Stat § 21.53.030 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.030. Preexisting conditions.

(a) An insurer, hospital or medical service corporation, or fraternal benefit society may not include, in a long-term care insurance policy or certificate, a definition of “preexisting condition” that is more restrictive than the following: preexisting condition means a condition for which medical advice or treatment was recommended by, or received from, a provider of health care services within six months preceding the effective date of coverage of an insured person. (b) In a long-term care insurance policy, an insurer, hospital or medical service corporation, or fraternal benefit society may not exclude coverage for a loss or confinement that is the result of a preexisting condition, unless the loss or confinement begins within six months following the effective date of coverage of an insured person. (c) The director may extend the limitation periods established under (a) and (b) of this section for specific age group categories or specific policy forms, if the director finds that the extension is in the best interest of the public. (d) This section does not prohibit an insurer, hospital or medical service corporation, or fraternal benefit society from using an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on the application, from applying that insurer's, hospital or medical service corporation's, or fraternal benefit society's established underwriting standards. Unless otherwise provided in the policy, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in (b) of this section expires. A long-term care insurance policy may not exclude, limit, or reduce, or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions after the waiting period described in (b) of this section, unless the waiver or rider has been specifically approved by the director.
AK Stat § 21.53.040 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.040. Prior hospital or institutional care conditions prohibited.

(a) A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility (1) on a prior hospitalization requirement; (2) on the receipt of a higher level of institutional care, when care is provided in an institutional setting; (3) for noninstitutional benefits on a prior institutional stay of more than 30 days for which benefits are paid; (4) on admission to an institutional care facility for the same or a related condition within a period of less than 30 days after discharge from the institution, if the policy provides benefits only following institutionalization; or (5) for a benefit, other than a waiver of premium, postconfinement, postacute care, or recuperative benefit, on a prior institutionalization. (b) A long-term care insurance policy containing a postconfinement, postacute care, or recuperative benefit must clearly label the limitations or conditions, including any required number of days of confinement, “Limitations or Conditions on Eligibility for Benefits” in a separate paragraph of the policy.
AK Stat § 21.53.060 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.060. Long-term care benefits under life insurance policies; denial of claims.

(a) In addition to the requirements of AS 21.45, at the time of policy delivery, a policy summary shall be included with an individual life insurance policy if the policy or policy rider provides long-term care benefits. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request but, regardless of request, shall deliver a policy summary not later than the time of policy delivery. The summary must include (1) an explanation of how the long-term care benefits interact with other components of the policy, including deductions from death benefits; (2) an illustration of the amount and length of benefits, and guaranteed lifetime benefits, if any, for each covered person; (3) an explanation of each exclusion, reduction, and limitation on long-term care benefits; (4) if applicable to the policy type, (A) disclosure of the effects of exercising other rights under the policy; (B) disclosure of guarantees related to the long-term care costs of insurance charges; and (C) current and projected maximum lifetime benefits; and (5) if the director adopts a regulation that permits but does not require inflation protection, and the policy does not provide for inflation protection, a statement that inflation protection is not available under the policy. (b) If a long-term care benefit is paid under a life insurance policy by the acceleration of the policy death benefit, and is in benefit payment status, a monthly report shall be provided to the policyholder. The report must include (1) long-term care benefits paid out during the month; (2) an explanation of changes in the policy, including changes in death benefits or cash values, due to long-term care benefits being paid out; and (3) the amount of long-term care benefits remaining. (c) If a claim under a long-term care insurance policy is denied by an insurer, the insurer shall, within 60 days after the date of a written request by a policyholder or a representative of a policyholder, (1) provide a written explanation of the reasons for the denial; and (2) make available all information directly related to the denial.
AK Stat § 21.53.062 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.062. Incontestability period.

(a) If a long-term care insurance policy has been in force for less than six months, an insurer may rescind the policy or deny an otherwise valid long-term care claim under the policy on a showing of misrepresentation that is material to the acceptance for coverage. (b) If a long-term care insurance policy has been in force for at least six months but less than two years, an insurer may rescind the policy or deny an otherwise valid long-term care claim under the policy on a showing of misrepresentation that is both material to the acceptance for coverage and pertains to the condition for which benefits are sought. (c) If a long-term care insurance policy has been in force for two years or more, the policy is not contestable on the grounds of misrepresentation alone and may only be contested on a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health. (d) If an insurer has paid benefits under a long-term care insurance policy, the insurer may not recover the benefit payments if the policy is rescinded. (e) This section applies to a life insurance policy that accelerates benefits for long-term care. However, if an insured dies, this section does not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care, and the remaining death benefit under the policy is subject to AS 21.45.040.
AK Stat § 21.53.064 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.064. Nonforfeiture benefits.

(a) Except as provided in (b) of this section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder has been offered the option of purchasing a policy including a nonforfeiture benefit. The insurer may offer a nonforfeiture benefit in the form of a rider to the policy. If a policyholder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that is available for a specified period of time following a substantial increase in premium rates. (b) With respect to group long-term care insurance, an insurer shall make the offer required in (a) of this section to the group policyholder. For a policy issued as group long-term care insurance, other than a continuing care retirement community or other similar entity, the insurer shall make the offer required in (a) of this section to each proposed certificate holder.
AK Stat § 21.53.068 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.068. Limitations related to producers and third-party administrators.

An insurer that authorizes issuance of a long-term care insurance policy by a producer or a third-party administrator under the underwriting authority of the insurer granted to the producer or third-party administrator using the insurer's underwriting guidelines may issue a long-term care insurance policy through the producer or third-party administrator only if the insurer does not compensate the issuer based on the number of policies issued.
AK Stat § 21.53.070 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.070. Group long-term care insurance.

Group long-term care insurance coverage may not be offered to a resident of this state under a group policy issued in another state, unless the state in which the policy is issued has statutory or regulatory provisions applicable to group long-term care insurance that are substantially similar to this chapter and the director determines that the issuance of the group policy is not contrary to the best interest of the public, results in economies of acquisition or administration, and the benefits are reasonable in relation to the premiums charged.
AK Stat § 21.53.080 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.080. Organizational requirements of associations.

An insurer, hospital or medical service corporation, or a fraternal benefit society may not issue group long-term care insurance to an association or a trust or the trustee of a fund established, created, or maintained for the benefit of members of one or more associations, unless the association or the insurer of the association files evidence with the director that the association has (1) a minimum of 100 members; (2) been organized and maintained in good faith for purposes other than that of obtaining insurance; (3) been in active existence for at least one year; and (4) a constitution and by-laws that require (A) the association to hold regular meetings not less than annually to further purposes of the members; (B) except for credit unions, the association to collect dues or solicit contributions from members; and (C) the members to have voting privileges and representation on the governing board and committees.
AK Stat § 21.53.090 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 53. Long-term Care Insurance|Sec. 21.53.090. Required regulations.

The director shall adopt regulations regarding (1) the sale of long-term care insurance that provide minimum standards for (A) terms of renewability; (B) initial and subsequent conditions of eligibility; (C) nonduplication of coverage provisions; (D) coverage of dependents; (E) benefit triggers; (F) preexisting conditions and recurrent conditions; (G) termination of insurance, including incontestability periods; (H) continuation or conversion; (I) probationary periods, limitations, exceptions, reductions, and elimination periods; (J) requirements for replacement; (K) producer training, education, compensation, and testing; (L) marketing practices; (M) independent review of benefit determinations; (N) penalties and reporting practices; and (O) premium rates, including rate filing requirements; (2) standard definitions of long-term care insurance terms; (3) nonforfeiture or minimum value requirements; (4) consumer protection standards, including standards for full and fair disclosure setting out the manner and content of required disclosures; and (5) the standard format and content of the outline of coverage required under AS 21.53.050.
AK Stat § 21.56.110 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 56. Small Employer Health Insurance|Sec. 21.56.110. Applicability.

(a) A health care insurance plan offered, issued for delivery, delivered, or renewed to small employers in this state is subject to the provisions of this chapter, except as prohibited under federal law. (b) [Repealed, § 115 ch 81 SLA 1997.]  (c) Except as provided in this subsection, for purposes of this chapter, insurers that are affiliated companies or that are eligible to file a consolidated tax return shall be treated as one insurer and a restriction or limitation imposed under this chapter shall apply as if all health care insurance plans delivered or issued for delivery to a small employer in this state by an affiliated insurer were issued by one insurer. An affiliated insurer that is a health maintenance organization having a certificate of authority under AS 21.86 may be considered to be a separate insurer for the purposes of this chapter. (d) [Repealed, § 115 ch 81 SLA 1997.]  (e) The requirements of this chapter continue to apply with respect to coverage offered to a small employer until the plan anniversary following the date the employer no longer meets the definition of a “small employer” in AS 21.54.500.
AK Stat § 21.56.160 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 56. Small Employer Health Insurance|Sec. 21.56.160. Exemption from required offer of coverage.

(a) A small employer insurer offering health care insurance through a network plan is not required to offer or renew coverage or accept applications under AS 21.56.140(a) if (1) the small employer does not have eligible employees or dependents who live, work, or reside in the service area for the network plan; or (2) the small employer insurer demonstrates to the director that the small employer insurer (A) will not have the capacity to deliver services adequately to eligible employees or dependents of additional groups because of the small employer insurer's obligation to existing group contract holders and covered employees or dependents; and (B) applies this subsection uniformly without regard to the claims experience of the employers and their employees and dependents or to a health status factor relating to the employees and dependents. (b) A small employer insurer offering health care insurance is not required to offer or accept applications under AS 21.56.140(a) if (1) the small employer insurer is only maintaining in-force business and has ceased enrolling new employer groups on or before January 1, 1993; or (2) the certificate of authority or bylaws of an insurer does not permit the insurer to issue coverage on a marketwide basis; however, an insurer described in this paragraph shall comply with AS 21.56.140 regarding small employers that meet the requirements of the insurer's certificate of authority or bylaws. (c) A small employer insurer who denies health care insurance coverage in a service area under (a) of this section may not offer coverage in the small employer market within that service area for a period of 180 days after the date the coverage is denied. (d) If a small employer insurer demonstrates or the director determines under AS 21.09.175 that a small employer insurer does not have the financial reserves necessary to underwrite additional coverage, the small employer insurer may not offer or renew health care insurance coverage in the small employer group market. The small employer insurer may not reenter the small employer group market until the director has determined that the insurer has sufficient financial reserves to underwrite additional coverage.