reglab/housing_qa huggingface dataset:
MT Code § 33-22-924 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 9. Medicare Supplement Insurance Minimum Standards|33-22-924. Renewal requirement

  33-22-924. Renewal requirement. (1) If a person pays a renewal premium on the date it is due or within 31 days after it is due, an insurer may not refuse to renew a medicare supplement policy or certificate unless the insurer:   (a) refuses to renew all policies or certificates in this state that are of the same form and issued to persons of the same class; and   (b) offers a replacement policy or certificate at actuarially justified rates.   (2) If an insurer refuses to renew all policies or certificates in this state that are of the same form and issued to persons of the same class, the policies or certificates will remain in force during the grace period stated in the replaced policy or certificate. An insurer's refusal to renew a policy or certificate may not affect a claim that arose under the discontinued policy or certificate during the period in which an insured was confined without interruption to a medical care facility for treatment.   History: En. Sec. 4, Ch. 125, L. 1987; amd. Sec. 14, Ch. 798, L. 1991.
MT Code § 33-22-1001 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 10. Home Health Care Coverage|33-22-1001. Definition of home health care

  33-22-1001. Definition of home health care. "Home health care" means services provided by a licensed home health agency to an insured in the insured's place of residence that is prescribed by the insured's attending physician as part of a written plan of care. Services provided by home health care include:   (1) nursing;   (2) home health aide services;   (3) physical therapy;   (4) occupational therapy;   (5) speech therapy;   (6) hospice service;   (7) medical supplies and equipment suitable for use in the home; and   (8) medically necessary personal hygiene, grooming, and dietary assistance.   History: En. Sec. 1, Ch. 508, L. 1981; amd. Sec. 1231, Ch. 56, L. 2009.
MT Code § 33-22-1002 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 10. Home Health Care Coverage|33-22-1002. Availability of coverage for home health care

  33-22-1002. Availability of coverage for home health care. Insurers and health service corporations transacting health insurance business in this state shall make available, under group insurance policies or certificates and under group hospital and medical service plan contracts, benefits for home health care. Applicants for a group policy, certificate, or contract may select any level of benefits that may be offered by the insurer or service plan corporation.   History: En. Sec. 2, Ch. 508, L. 1981; amd. Sec. 59, Ch. 227, L. 2001.
MT Code § 33-22-1003 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 10. Home Health Care Coverage|33-22-1003. Applicability

  33-22-1003. Applicability. This part applies to policies, certificates, or contracts delivered or issued for delivery in this state after January 29, 1981, but does not apply to blanket, short-term travel, accident-only, limited or specified disease, or individual conversion policies or contracts, to policies or contracts designed for coverage under Title XVIII of the Social Security Act, known as Medicare, or to any other similar coverage under federal governmental plans.   History: En. Sec. 3, Ch. 508, L. 1981; amd. Sec. 60, Ch. 227, L. 2001.
MT Code § 33-22-1101 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1101. Short title

  33-22-1101. Short title. This part may be cited as the "Long-Term Care Insurance Act".   History: En. Sec. 1, Ch. 355, L. 1989.
MT Code § 33-22-1102 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1102. Purpose

  33-22-1102. Purpose. The purpose of this part is to:   (1) promote the public interest;   (2) promote the availability of long-term care insurance;   (3) protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices;   (4) establish standards for long-term care insurance;   (5) facilitate public understanding and comparison of long-term care insurance policies; and   (6) facilitate flexibility and innovation in the development of long-term care insurance coverage.   History: En. Sec. 2, Ch. 355, L. 1989.
MT Code § 33-22-1103 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1103. Compliance required

  33-22-1103. Compliance required. A policy may not be advertised, marketed, or offered in this state as long-term care insurance or nursing home insurance unless it complies with this part.   History: En. Sec. 13, Ch. 355, L. 1989.
MT Code § 33-22-1104 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1104. Scope

  33-22-1104. Scope. This part is not intended to supersede the obligations of entities subject to this part to comply with the substance of other applicable insurance laws insofar as they do not conflict with this part. However, laws and regulations designed and intended to apply to medicare supplement insurance policies may not be applied to long-term care insurance.   History: En. Sec. 3, Ch. 32, L. 2007.
MT Code § 33-22-1105 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1105. and 33-22-1106 reserved

  33-22-1105 and 33-22-1106 reserved.
MT Code § 33-22-1108 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1108. Preexisting condition -- definition

  33-22-1108. Preexisting condition -- definition. (1) A long-term care insurance policy or certificate other than a policy or certificate issued to a group, as specified in 33-22-1107(5)(a)(ii), (5)(a)(iii), or (5)(a)(iv), may not use a definition of preexisting condition that is more restrictive than the definition in 33-22-1107.   (2) A long-term care insurance policy or certificate may not exclude coverage for a loss or confinement that is the result of a preexisting condition unless the loss or confinement begins within 6 months following the effective date of coverage of an insured person.   (3) If a long-term care insurance policy or certificate replaces, with similar benefits, another long-term care insurance policy or certificate, the insurer issuing the replacing long-term care insurance policy or certificate shall waive any time periods applicable to preexisting conditions or probationary periods in the replacing long-term care insurance policy or certificate to the extent that similar time periods have been satisfied under the original policy.   (4) The commissioner may extend the limitation periods in subsections (1) and (2) as to specific age group categories in specific policy forms if extending the limitation periods is in the best interests of the public.   (5) An insurer may use an application form designed to elicit the complete health history of an applicant and on the basis of the answers on that application perform underwriting in accordance with the insurer's established underwriting standards. Unless otherwise provided in the long-term care insurance policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in subsection (2) expires. A long-term care insurance policy or certificate may not exclude or use a waiver or rider of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subsection (2).   History: En. Sec. 7, Ch. 355, L. 1989; amd. Sec. 151, Ch. 42, L. 1997; amd. Sec. 11, Ch. 416, L. 1997.
MT Code § 33-22-1109 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1109. and 33-22-1110 reserved

  33-22-1109 and 33-22-1110 reserved.
MT Code § 33-22-1111 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1111. Outline of coverage

  33-22-1111. Outline of coverage. (1) (a) An insurer shall deliver an outline of coverage as approved by the commissioner to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its purpose.   (b) The commissioner shall prescribe a standard format, including style, arrangement, and overall appearance, and the content of the outline of coverage.   (c) In the case of insurance producer solicitations, an insurance producer shall deliver the outline of coverage prior to the presentation of an application or enrollment form.   (d) In the case of direct response solicitations, the insurer shall deliver the outline of coverage upon the earlier of the applicant's request or the delivery of the policy.   (2) The outline of coverage must include:   (a) a description of the principal benefits and coverage provided in the policy;   (b) a statement of the principal exclusions, reductions, and limitations contained in the policy;   (c) a statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premiums. Continuation or conversion provisions of a group policy must be specifically described.   (d) a statement that the outline of coverage is only a summary of the policy issued or applied for, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions;   (e) a description of the terms under which the policy or certificate may be returned and the premium refunded;   (f) a brief description of the relationship of cost of care and benefits; and   (g) a statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract.   (3) The outline of coverage:   (a) must prominently display the name of the insurer;   (b) must be a freestanding document not dependent for purposes of reader comprehension upon any other document;   (c) must use no smaller than 12-point type; and   (d) may not contain material of an advertising nature.   History: En. Sec. 11, Ch. 355, L. 1989; amd. Sec. 1, Ch. 713, L. 1989; amd. Sec. 12, Ch. 416, L. 1997; amd. Sec. 5, Ch. 32, L. 2007.
MT Code § 33-22-1112 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1112. Required content for certificate

  33-22-1112. Required content for certificate. A certificate issued pursuant to a group long-term care insurance policy that is delivered or issued for delivery in this state must include:   (1) a description of the principal benefits and coverage provided in the policy;   (2) a statement of the principal exclusions, reductions, and limitations contained in the policy; and   (3) a statement that the group master policy determines governing contractual provisions.   History: En. Sec. 12, Ch. 355, L. 1989.
MT Code § 33-22-1113 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1113. Disclosure and performance standards for long-term care insurance

  33-22-1113. Disclosure and performance standards for long-term care insurance. (1) The commissioner may by rule adopt standards for full and fair disclosure, setting forth the manner, content, and disclosures required to be made in a long-term care insurance policy, including but not limited to:   (a) terms of renewability;   (b) initial and subsequent conditions of eligibility;   (c) nonduplication of coverage provisions;   (d) coverage of dependents;   (e) preexisting conditions;   (f) termination of insurance;   (g) continuation or conversion;   (h) probationary periods;   (i) limitations;   (j) exceptions;   (k) reductions;   (l) elimination periods;   (m) requirements for replacement;   (n) recurrent conditions;   (o) definition of terms;   (p) prohibitions on limitations and exclusions;   (q) extension of benefits;   (r) discontinuance and replacement of policies;   (s) unintentional lapse;   (t) prohibitions against postclaim underwriting;   (u) minimum standards for home health and community care benefits;   (v) inflation protection;   (w) incontestability period; and   (x) tax consequences.   (2) A group long-term care insurance policy must include a provision relating to conversion on termination of eligibility as described in 33-22-508 or include a provision for continuation of coverage that maintains coverage under the existing group policy if the coverage would otherwise terminate.   History: En. Sec. 5, Ch. 355, L. 1989; amd. Sec. 13, Ch. 416, L. 1997.
MT Code § 33-22-1114 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1114. Prohibited practices and policy provisions

  33-22-1114. Prohibited practices and policy provisions. (1) An insurance company may not issue a refund to a person other than the owner of the policy or certificate.   (2) A long-term care insurance policy may not:   (a) be canceled, nonrenewed, or otherwise terminated on any grounds other than the insured's or certificate holder's failure to pay the premium;   (b) contain a provision establishing a new waiting period if existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or   (c) provide coverage for only skilled nursing care or provide substantially more coverage for skilled nursing care in a facility than coverage for lower levels of care.   History: En. Sec. 6, Ch. 355, L. 1989; amd. Sec. 2, Ch. 240, L. 1995; amd. Sec. 14, Ch. 416, L. 1997.
MT Code § 33-22-1115 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1115. Prior hospitalization or institutionalization

  33-22-1115. Prior hospitalization or institutionalization. (1) A long-term care insurance policy may not be delivered or issued for delivery in Montana if the policy conditions eligibility for a benefit:   (a) on a prior hospitalization requirement;   (b) provided in an institutional care setting on the receipt of a higher level of institutional care; or   (c) other than waiver of premium, postconfinement benefits, postacute care benefits, or recuperative benefits, on a prior institutionalization requirement.   (2) A long-term care insurance policy containing a limitation or condition for eligibility other than those prohibited in subsection (1) must clearly label, in a separate paragraph of the policy or certificate entitled "Limitations or Conditions on Eligibility for Benefits", the limitations or conditions, including any required number of days of confinement.   (3) A long-term care insurance policy that contains a benefit advertised, marketed, or offered as a home health care benefit may not condition receipt of a benefit on a prior institutionalization requirement.   (4) A long-term care insurance policy that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than 30 days.   (5) A long-term care insurance policy that provides benefits only following institutionalization may not condition the benefits upon admission to a facility for the same or a related condition within a period of less than 30 days after discharge from the institution.   History: En. Sec. 8, Ch. 355, L. 1989; amd. Sec. 15, Ch. 416, L. 1997; amd. Sec. 6, Ch. 32, L. 2007.
MT Code § 33-22-1116 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1116. Nonforfeiture benefits -- offer requirement

  33-22-1116. Nonforfeiture benefits -- offer requirement. (1) Except as provided in subsection (3), a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy that includes a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy.   (2) If a policyholder or certificate holder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that must be available for a specified period of time following a substantial increase in premium rates.   (3) When a group long-term care insurance policy is issued, the offer required in subsection (1) must be made to the group policyholder. However, if the policy is issued as group long-term care insurance as defined in 33-22-1107(5)(d), other than to a continuing care retirement community or other similar entity, the offer must be made to each proposed certificate holder.   History: En. Sec. 4, Ch. 240, L. 1995; amd. Sec. 7, Ch. 32, L. 2007.
MT Code § 33-22-1117 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1117. Appropriate sale criteria

  33-22-1117. Appropriate sale criteria. (1) Appropriate sale criteria must be established and communicated to the consumer prior to the insurance company's acceptance of a person's application for long-term care insurance.   (2) This section may not preclude the purchase of a long-term care insurance policy by a consumer.   History: En. Sec. 5, Ch. 240, L. 1995.
MT Code § 33-22-1118 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1118. reserved

  33-22-1118 reserved.
MT Code § 33-22-1119 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1119. Right to return policy -- free look -- refunds upon denial of application

  33-22-1119. Right to return policy -- free look -- refunds upon denial of application. (1) A long-term care insurance applicant and insured has the right to return the policy within 30 days of the policy's delivery and to have the premium refunded if, after examination of the policy, the applicant or insured is not satisfied for any reason. A long-term care insurance policy must have a notice prominently printed on the first page of the policy or attached to the policy stating that the applicant or insured has the right to return the policy within 30 days of the policy's delivery and to have the premium refunded if, after examination of the policy, other than a certificate issued to a group defined in 33-22-1107(5)(a), the applicant or insured is not satisfied for any reason.   (2) An applicant or a person insured under a long-term care insurance policy issued pursuant to a direct response solicitation has the right to return the policy within 30 days of its delivery and to have the premium refunded if, after examination of the policy, the applicant or the insured is not satisfied for any reason. A long-term care insurance policy issued pursuant to a direct response solicitation must have a notice prominently printed on the first page or attached to it stating that the applicant or the insured has the right to return the policy within 30 days of its delivery and to have the premium refunded if, after examination of the policy, the applicant or the insured is not satisfied for any reason.   (3) If the application of a person for long-term care insurance is denied, any refund due the person must be refunded within 30 days of the denial or return of the application.   History: En. Sec. 10, Ch. 355, L. 1989; amd. Sec. 3, Ch. 240, L. 1995; amd. Sec. 8, Ch. 32, L. 2007.
MT Code § 33-22-1120 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1120. Extraterritorial jurisdiction

  33-22-1120. Extraterritorial jurisdiction. A group long-term care insurance policy or certificate may not be delivered or issued for delivery to a resident of Montana under a group policy issued in another state unless it is approved by:   (1) the commissioner; and   (2) the insurance regulatory official of a state that has statutory and regulatory long-term care insurance requirements substantially similar to those adopted in Montana.   History: En. Sec. 4, Ch. 355, L. 1989; amd. Sec. 64, Ch. 379, L. 1995.
MT Code § 33-22-1121 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1121. Rules

  33-22-1121. Rules. The commissioner may adopt rules necessary to implement this part, including but not limited to rules that:   (1) establish loss ratio standards for long-term care insurance policies;   (2) promote premium adequacy and protect the policyholder in the event of substantial rate increases;   (3) establish minimum standards for insurance producer training, marketing practices, compensation, and testing;   (4) establish penalties and reporting practices for long-term care insurance;   (5) specify, with respect to nonforfeiture benefits and contingent benefits:   (a) the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies;   (b) the standards for nonforfeiture benefits;   (c) the rules regarding contingent benefits upon lapse, including:   (i) a determination of the specified period of time during which a contingent benefit upon lapse will be available;   (ii) the substantial premium rate increase that triggers a contingent benefit upon lapse as described in 33-22-1116; and   (d) the types of appropriate sale criteria to be communicated at the time of application;   (6) establish a requirement for the mandatory triggering of policy benefits based upon the number of activities of daily living that an individual is capable or incapable of performing; and   (7) are necessary to implement a determination made by the secretary of health and human services pursuant to 45 CFR, parts 160 and 164, as to who is a licensed health care practitioner.   History: (1)En. Sec. 14, Ch. 355, L. 1989; (2)En. Sec. 9, Ch. 355, L. 1989; amd. Sec. 6, Ch. 240, L. 1995; amd. Sec. 16, Ch. 416, L. 1997; amd. Sec. 9, Ch. 32, L. 2007.
MT Code § 33-22-1122 (2021)
2021 Montana Code Annotated|Title 33. Insurance and Insurance Companies|Chapter 22. Disability Insurance|Part 11. Long-Term Care Insurance Act|33-22-1122. Policy waiting periods not cumulative

  33-22-1122. Policy waiting periods not cumulative. A waiting or elimination period contained in a long-term care insurance policy under which an insured is required to wait a specified period of time before receiving policy benefits must be concurrent with any 90-day period used to determine whether an individual is a chronically ill individual.   History: En. Sec. 46, Ch. 416, L. 1997.