reglab/housing_qa huggingface dataset:
MN Stat § 62S.13 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.13 — Incontestability Period.

62S.13 INCONTESTABILITY PERIOD. Subdivision 1. Rescission before six months. For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to acceptance for coverage. Subd. 2. Rescission after six months. For a policy or certificate that has been in force for at least six months, but less than two years, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is both material to the acceptance for coverage and that pertains to the condition for which benefits are sought. Subd. 3. Contested policy after two years. After a policy or certificate has been in force for two years, it is not contestable upon the grounds of misrepresentation alone. The policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health. Subd. 4. Field issue prohibition. A long-term care insurance policy or certificate may not be field issued based on medical or health status. For purposes of this section, "field issued" means a policy or certificate issued by an agent or a third-party administrator under the underwriting authority granted to the agent or third-party administrator by an insurer and using the insurer's underwriting guidelines. Subd. 5. Benefit payments not recoverable. If an insurer has paid benefits under the long-term care insurance policy or certificate, the benefit payments may not be recovered by the insurer in the event that the policy or certificate is rescinded. Subd. 6. Death of insured. In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by section 61A.03, subdivision 1, paragraph (c). In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care. History:  1997 c 71 art 1 s 13; 2006 c 255 s 40; 2006 c 282 art 17 s 6; 2008 c 344 s 22
MN Stat § 62S.14 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.14 — Renewability.

62S.14 RENEWABILITY. Subdivision 1. Guaranteed renewable. A qualified long-term care insurance policy must be guaranteed renewable. Subd. 2. Terms. The terms "guaranteed renewable" and "noncancelable" may not be used in an individual long-term care insurance policy without further explanatory language that complies with the disclosure requirements of section 62S.20. The term "level premium" may only be used when the insurer does not have the right to change the premium. Subd. 3. Authorized renewal provisions. A policy issued to an individual may not contain renewal provisions other than guaranteed renewable or noncancelable. History:  1997 c 71 art 1 s 14; 2006 c 255 s 41; 2006 c 282 art 17 s 7
MN Stat § 62S.15 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.15 — Authorized Limitations And Exclusions.

62S.15 AUTHORIZED LIMITATIONS AND EXCLUSIONS. (a) No policy may be delivered or issued for delivery in this state as long-term care insurance if the policy limits or excludes coverage by type of illness, treatment, medical condition, or accident, except as follows: (1) preexisting conditions or diseases; (2) mental or nervous disorders; except that the exclusion or limitation of benefits on the basis of Alzheimer's disease is prohibited; (3) alcoholism and drug addiction; (4) illness, treatment, or medical condition arising out of war or act of war; participation in a felony, riot, or insurrection; service in the armed forces or auxiliary units; suicide, attempted suicide, or intentionally self-inflicted injury; or non-fare-paying aviation; (5) treatment provided in a government facility unless otherwise required by law, services for which benefits are available under Medicare or other government program except Medicaid, state or federal workers' compensation, employer's liability or occupational disease law, motor vehicle no-fault law; services provided by a member of the covered person's immediate family; and services for which no charge is normally made in the absence of insurance; (6) expenses for services or items available or paid under another long-term care insurance or health insurance policy; and (7) in the case of a qualified long-term care insurance contract, expenses for services or items to the extent that the expenses are reimbursable under title XVIII of the Social Security Act or would be so reimbursable but for the application of a deductible or coinsurance amount. (b) This subdivision does not prohibit exclusions and limitations by type of provider or territorial limitations. However, no long-term care issuer may deny a claim because services are provided in a state other than the state of policy issued under the following conditions: (1) when the state other than the state of policy issue does not have the provider licensing, certification, or registration required in the policy, but where the provider satisfies the policy requirements outlined for providers in lieu of licensure, certification, or registration; or (2) when the state other than the state of policy issue licenses, certifies, or registers the provider under another name. For purposes of this paragraph, "state of policy issue" means the state in which the individual policy or certificate was originally issued. History:  1997 c 71 art 1 s 15; 2006 c 255 s 42; 2006 c 282 art 17 s 8; 2008 c 344 s 23
MN Stat § 62S.16 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.16 — Extension Of Benefits.

62S.16 EXTENSION OF BENEFITS. Termination of long-term care insurance must be without prejudice to any benefits payable for institutionalization if the institutionalization began while the long-term care insurance was in force and continues without interruption after termination. The extension of benefits beyond the period the long-term care insurance was in force may be limited to the duration of the benefit period or to payment of the maximum benefits and may be subject to a policy waiting period, and all other applicable provisions of the policy. History:   1997 c 71 art 1 s 16
MN Stat § 62S.18 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.18 — Discontinuance And Replacement.

62S.18 DISCONTINUANCE AND REPLACEMENT. Subdivision 1. Required coverage. If a group long-term care policy is replaced by another group long-term care policy issued to the same policyholder, the succeeding insurer shall offer coverage to all persons covered under the previous group policy on its date of termination. Coverage provided or offered to individuals by the insurer and premiums charged to persons under the new group policy shall not result in any exclusion for preexisting conditions that would have been covered under the group policy being replaced and shall not vary or otherwise depend on the individual's health or disability status, claim experience, or use of long-term care services. Subd. 2. Premiums. (a) The premiums charged to an insured for long-term care insurance replaced under subdivision 1 shall not increase due to either the increasing age of the insured at ages beyond 65 or the duration the insured has been covered under this policy. (b) The purchase of additional coverage must not be considered a premium rate increase, but for purposes of the calculation required under section 62S.291, the portion of the premium attributable to the additional coverage must be added to and considered part of the initial annual premium. (c) A reduction in benefits must not be considered a premium change, but for purpose of the calculation required under section 62S.291, the initial annual premium must be based on the reduced benefits. History:  1997 c 71 art 1 s 18; 2008 c 344 s 24
MN Stat § 62S.181 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.181 — Electronic Enrollment For Group Policies.

62S.181 ELECTRONIC ENROLLMENT FOR GROUP POLICIES. Subdivision 1. Employers or labor unions. In the case of a group defined in section 62S.01, subdivision 15, clause (1), any requirement that a signature of an insured be obtained by an agent or insurer is satisfied if: (1) the consent is obtained by telephonic or electronic enrollment by the group policyholder or insurer. A verification of enrollment information must be provided to the enrollee; (2) the telephonic or electronic enrollment provides necessary and reasonable safeguards to ensure the accuracy, retention, and prompt retrieval of records; and (3) the telephonic or electronic enrollment provides necessary and reasonable safeguards to ensure that the confidentiality of individually identifiable information and "privileged information" as defined by section 72A.491, subdivision 19, is maintained. Subd. 2. Availability of insurer records. The insurer shall make available, upon request of the commissioner, records that will demonstrate the insurer's ability to confirm enrollment and coverage amounts. History:   2008 c 344 s 25
MN Stat § 62S.22 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.22 — Minimum Standards For Home Health And Community Care Benefits.

62S.22 MINIMUM STANDARDS FOR HOME HEALTH AND COMMUNITY CARE BENEFITS. Subdivision 1. Prohibited limitations. A long-term care insurance policy or certificate shall not, if it provides benefits for home health care or community care services, limit or exclude benefits by: (1) requiring that the insured would need care in a skilled nursing facility if home health care services were not provided; (2) requiring that the insured first or simultaneously receive nursing or therapeutic services in a home, community, or institutional setting before home health care services are covered; (3) limiting eligible services to services provided by a registered nurse or licensed practical nurse; (4) requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide or other licensed or certified home care worker acting within the scope of licensure or certification; (5) excluding coverage for personal care services provided by a home health aide; (6) requiring that the provision of home health care services be at a level of certification or licensure greater than that required by the eligible service; (7) requiring that the insured have an acute condition before home health care services are covered; (8) limiting benefits to services provided by Medicare-certified agencies or providers; (9) excluding coverage for adult day care services; or (10) excluding coverage based upon location or type of residence in which the home health care services would be provided. Subd. 2. Required coverage amount. A long-term care insurance policy or certificate, if it provides for home health or community care services, must provide total home health or community care coverage that is a dollar amount equivalent to at least one-half of one year's coverage available for nursing home benefits under the policy or certificate, at the time covered home health or community care services are being received. This requirement does not apply to policies or certificates issued to residents of continuing care retirement communities. Subd. 3. Application of home health care coverage. Home health care coverage may be applied to the nonhome health care benefits provided in the policy or certificate when determining maximum coverage under the terms of the policy or certificate. History:  1997 c 71 art 1 s 22; 1Sp2003 c 14 art 2 s 5
MN Stat § 62S.25 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.25 — Reporting Requirements.

62S.25 REPORTING REQUIREMENTS. Subdivision 1. Insurer records. Each insurer shall maintain records for each agent of that agent's amount of replacement sales as a percent of the agent's total annual sales and the amount of lapses of long-term care insurance policies sold by the agent as a percent of the agent's total annual sales. Subd. 2. Required information on agents. Each insurer shall report annually by June 30 the ten percent of its agents with the greatest percentages of lapses and replacements as measured under subdivision 1. Subd. 3. Intent. Reported replacement and lapse rates do not alone constitute a violation of insurance laws or necessarily imply wrongdoing. The reports are for the purpose of reviewing more closely agent activities regarding the sale of long-term care insurance. Subd. 4. Lapsed policies. Each insurer shall report annually by June 30 the number of lapsed long-term care insurance policies as a percent of its total annual sales and as a percent of its total number of long-term care insurance policies in force as of the end of the preceding calendar year. Subd. 5. Replacement policies. Each insurer shall report annually by June 30 the number of replacement long-term care insurance policies sold as a percent of its total annual sales and as a percent of its total number of long-term care insurance policies in force as of the preceding calendar year. Subd. 6. Claims denied. Each insurer shall report annually by June 30 the number of claims denied for any reason during the reporting period for each class of business, expressed as a percentage of claims denied, other than claims denied for failure to meet the waiting period or because of any applicable preexisting condition. For purposes of this subdivision, "claim" means a request for payment of benefits under an in-force policy regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met. Subd. 7. Reports.  Reports under this section shall be done on a statewide basis and filed with the commissioner. They shall include, at a minimum, the information in the format contained in Appendix E (Claim Denial Reporting Form) and in Appendix G (Replacement and Lapse Reporting Form) of the Long-Term Care Model Regulation adopted by the National Association of Insurance Commissioners. History:  1997 c 71 art 1 s 25; 2006 c 255 s 50,51; 2006 c 282 art 17 s 16,17
MN Stat § 62S.251 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.251 — Reserve Standards.

62S.251 RESERVE STANDARDS. Subdivision 1. Benefits provided through acceleration of benefits under life policies. When long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders to these policies, policy reserves for the benefits must be determined in accordance with section 61A.25. Claim reserves must also be established in the case when the policy or rider is in claim status. Reserves for policies and riders subject to this section must be based on the multiple decrement model utilizing all relevant decrements except for voluntary termination rates. Single decrement approximations are acceptable if the calculation produces essentially similar reserves, if the reserve is clearly more conservative, or if the reserve is immaterial. The calculations may take into account the reduction in life insurance benefits due to the payment of long-term care benefits. However, in no event must the reserves for the long-term care benefit and the life insurance benefit be less than the reserves for the life insurance benefit assuming no long-term care benefit. In the development and calculation of reserves for policies and riders subject to this subdivision, due regard must be given to the applicable policy provisions, marketing methods, administrative procedures, and all other considerations which have an impact on projected claim costs, including, but not limited to, the following: (1) definition of insured events; (2) covered long-term care facilities; (3) existence of home convalescence care coverage; (4) definition of facilities; (5) existence or absence of barriers to eligibility; (6) premium waiver provision; (7) renewability; (8) ability to raise premiums; (9) marketing method; (10) underwriting procedures; (11) claims adjustment procedures; (12) waiting period; (13) maximum benefit; (14) availability of eligible facilities; (15) margins in claim costs; (16) optional nature of benefit; (17) delay in eligibility for benefit; (18) inflation protection provisions; and (19) guaranteed insurability option. Any applicable valuation morbidity table shall be certified as appropriate as a statutory valuation table by a member of the American Academy of Actuaries. Subd. 2. Benefits provided otherwise. When long-term care benefits are provided other than as in subdivision 1, reserves must be determined in accordance with sections 60A.76 to 60A.768. History:   2008 c 344 s 30
MN Stat § 62S.267 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.267 — Standards For Benefit Triggers.

62S.267 STANDARDS FOR BENEFIT TRIGGERS. Subdivision 1. Benefit payment determinations. A long-term care insurance policy must condition the payment of benefits on a determination of the insured's ability to perform activities of daily living and on cognitive impairment. Eligibility for the payment of benefits must not be more restrictive than requiring either a deficiency in the ability to perform not more than two of the activities of daily living or the presence of cognitive impairment. Activities of daily living include at least the following as defined in section 62S.01 and in the policy: bathing, continence, dressing, eating, toileting, and transferring. Insurers may use activities of daily living to trigger covered benefits in addition to those contained in this subdivision as long as they are defined in the policy. Subd. 2. Additional provisions for determining benefit payments. An insurer may use additional provisions for the determination of when benefits are payable under a policy or certificate if the provisions do not restrict, and are not in lieu of, the requirements contained in subdivision 1. Subd. 3. Deficiency determination. For purposes of this section, the determination of a deficiency must not be more restrictive than requiring the hands-on assistance of another person to perform the prescribed activities of daily living, or if the deficiency is due to the presence of a cognitive impairment, supervision or verbal cueing by another person is needed in order to protect the insured or others. Subd. 4. Assessments. Assessments of activities if daily living and cognitive impairment must be performed by licensed or certified professionals, such as physicians, nurses, or social workers. Subd. 5. Appeal process. Long-term care insurance policies must include a clear description of the process for appealing and resolving benefit determinations. History:   2008 c 344 s 34
MN Stat § 62S.27 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.27 — Filing Requirement.

62S.27 FILING REQUIREMENT. Before an insurer or similar organization offers group long-term care insurance to a resident of this state under section 62S.03, it must file with the commissioner evidence that the group policy or certificate has been approved by a state having statutory or regulatory long-term care insurance requirements substantially similar to those adopted in this state. History:   1997 c 71 art 1 s 27
MN Stat § 62S.28 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.28 — Filing Requirements For Advertising.

62S.28 FILING REQUIREMENTS FOR ADVERTISING. Subdivision 1. Advertisement copy. An insurer or other entity providing long-term care insurance or benefits in this state shall provide a copy of any long-term care insurance advertisement intended for use in this state whether through written, radio, or television medium to the commissioner for review or approval by the commissioner, to the extent it may be required under state law. All advertisements must be retained by the insurer or other entity for at least three years from the date the advertisement was first used. Subd. 2. Exemption. The commissioner may exempt from these requirements any advertising form or material when, in the commissioner's opinion, this requirement may not be reasonably applied. History:   1997 c 71 art 1 s 28
MN Stat § 62S.292 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.292 — Right To Reduce Coverage And Lower Premiums.

62S.292 RIGHT TO REDUCE COVERAGE AND LOWER PREMIUMS. Subdivision 1. Required policy or certificate provision. Every long-term care insurance policy and certificate shall include a provision that allows the policyholder or certificate holder to reduce coverage and lower the policy or certificate premium in at least one of the following ways: (1) reducing the maximum benefit; or (2) reducing the daily, weekly, or monthly benefit amount. The insurer may also offer other reduction options that are consistent with the policy or certificate design or the carrier's administrative processes. The provision shall include a description of the ways in which coverage may be reduced and the process for requesting and implementing a reduction in coverage. Subd. 2. Age determination. The age to determine the premium for the reduced coverage shall be based on the age used to determine the premiums for the coverage currently in force. Subd. 3. Limitation. The insurer may limit any reduction in coverage to plans or options available for that policy form and to those for which benefits will be available after consideration of claims paid or payable. Subd. 4. Written reminder. If a policy or certificate is about to lapse, the insurer shall provide a written reminder to the policyholder or certificate holder of the right to reduce coverage and premiums in the notice required by section 62S.19, subdivision 3. Subd. 5. Nonapplication. This section does not apply to life insurance policies or riders containing accelerated long-term care benefits. History:  2008 c 344 s 40; 2009 c 86 art 1 s 11
MN Stat § 62S.31 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.31 — Requirement To Deliver Shopper's Guide.

62S.31 REQUIREMENT TO DELIVER SHOPPER'S GUIDE. Subdivision 1. Shopper's guide. A long-term care insurance shopper's guide in the format developed by the National Association of Insurance Commissioners, or a guide developed or approved by the commissioner, shall be provided to all prospective applicants of a long-term care insurance policy or certificate: (1) in the case of agent solicitations, an agent must deliver the shopper's guide before the presentation of an application or enrollment form; and (2) in the case of direct response solicitations, the shopper's guide must be presented in conjunction with an application or enrollment form. Subd. 2. Exception. Subdivision 1 does not apply to life insurance policies or riders containing accelerated long-term care benefits. The policy summary required under section 62S.10 must be furnished with a life insurance policy or rider containing accelerated long-term care benefits. History:   1997 c 71 art 1 s 31