reglab/housing_qa huggingface dataset:
HI Rev Stat § 431:10H-102 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-102 Scope.

 §431:10H-102 Scope. The requirements of this article shall apply to policies delivered or issued for delivery in this State on or after July 1, 2000. This article is not intended to supersede the obligations of entities subject to this article to comply with the substance of other applicable insurance laws insofar as they do not conflict with this article, except that laws and regulations designed and intended to apply to medicare supplement insurance policies shall not be applied to long-term care insurance. [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-103 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-103 Short title.

 §431:10H-103 Short title. This article may be known and cited as the "Long-Term Care Insurance Act". [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-105 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-105 Extraterritorial jurisdiction; group policies.

  §431:10H-105 Extraterritorial jurisdiction; group policies. No group long-term insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in paragraph (4) under the definition of "group long-term care insurance" in section 431:10H-104, unless this State or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this State has made a determination that these requirements have been met. [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-106 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-106 Rules.

 §431:10H-106 Rules. The commissioner may adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, non-duplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definition of terms. [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-107 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-107 Basic standards.

 §431:10H-107 Basic standards. No long-term care insurance policy may:  (1) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder;  (2) 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  (3) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care. [L 1999, c 93, pt of §2] Revision Note  Subsection designation deleted pursuant to §23G-15.
HI Rev Stat § 431:10H-108 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-108 Preexisting conditions--group and individual policies.

 §431:10H-108 Preexisting conditions--group and individual policies. (a) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group as defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104 shall use a definition of "preexisting condition" which 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) No long-term care insurance policy or certificate other than a policy or certificate thereunder issued to a group as defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104 may exclude coverage for a loss or confinement which 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 commissioner may extend the limitation periods in subsections (a) and (b) as to specific age group categories in specific policy forms upon findings that the extension is in the best interest of the public.  (d) The definition of "preexisting condition" does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on that application, from underwriting in accordance with that insurer's established underwriting standards. Unless otherwise provided in the 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 (b) expires. No long-term care insurance policy or certificate may exclude 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 beyond the waiting period described in subsection (b). [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-109 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-109 Prior hospitalization; prior institutionalization.

 §431:10H-109 Prior hospitalization; prior institutionalization. (a) No long-term care insurance policy may be delivered or issued for delivery in this State if the policy:  (1) Conditions eligibility for any benefits on a prior hospitalization requirement;  (2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or  (3) Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement.  (b) A long-term care insurance policy containing post-confinement, post-acute care, or recuperative benefits shall clearly label, in a separate paragraph of the policy or certificate, entitled "Limitations or Conditions on Eligibility for Benefits", such limitations or conditions including any required number of days of confinement.  (c) A long-term care insurance policy that conditions eligibility of non-institutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty days. [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-110 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-110 Loss ratio standards; factors; commissioner approval.

  §431:10H-110 Loss ratio standards; factors; commissioner approval. The commissioner may adopt rules establishing loss ratio standards for long-term care insurance policies; provided that a specific reference to long-term care insurance policies is contained in the rule. [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-111 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-111 Right to return; free look provision.

  §431:10H-111 Right to return; free look provision. Long-term care insurance applicants shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance policies and certificates shall have a notice prominently printed on the first page or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, other than a certificate issued pursuant to a policy issued to a group defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104, the applicant is not satisfied for any reason. This section shall also apply to a denial of an application for a long-term care contract. Any refund shall be made within thirty days of the return or denial. [L 1999, c 93, pt of §2; am L 2007, c 233, §7]
HI Rev Stat § 431:10H-112 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-112 Outline of coverage required.

  §431:10H-112 Outline of coverage required. (a) An outline of coverage shall be delivered 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. The commissioner shall prescribe a standard format, including style, arrangement, and overall appearance, and the content of an outline of coverage. In the case of producer solicitations, a producer shall deliver the outline of coverage prior to the presentation of an application or enrollment form. In the case of direct response solicitation, the outline of coverage shall be presented in conjunction with any application or enrollment form. In the case of a policy issued to a group defined in paragraph (1) of the definition of "group long-term care insurance" in section 431:10H-104, an outline of coverage shall not be required to be delivered; provided that the information described in subsection (b) is contained in other materials relating to enrollment. Upon request, these other materials shall be made available to the commissioner.  (b) The outline of coverage shall 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;  (3) 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 premium. Continuation or conversion provisions of group coverage shall be specifically described;  (4) A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions;  (5) A description of the terms under which the policy or certificate may be returned and premium refunded;  (6) A brief description of the relationship of costs of care and benefits; and  (7) 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 under section 7702B(b) of the Internal Revenue Code of 1986, as amended. [L 1999, c 93, pt of §2; am L 2003, c 212, §93; am L 2007, c 233, §8]
HI Rev Stat § 431:10H-113 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-113 Group policy certificate requirements.

  §431:10H-113 Group policy certificate requirements. A certificate issued pursuant to a group long-term care insurance policy which is delivered or issued for delivery in this State shall 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. [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-114 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-114 Life insurance policies offering long-term care benefits.

 §431:10H-114 Life insurance policies offering long-term care benefits. (a) At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request, but regardless of the request shall make delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the policy summary shall also include:  (1) An explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits;  (2) An illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits if any, for each covered person;  (3) Any exclusions, reductions, and limitations on benefits of long-term care;   (4) A statement that any long-term care inflation protection option required by section 431:10H-220 is not available under this policy;  (5) If applicable to the policy type, the summary shall also include a disclosure of the effects of exercising other rights under the policy, a disclosure of guarantees related to long-term care costs of insurance charges, and current and projected maximum lifetime benefits; and  (6) The provisions of the policy summary listed above may be incorporated into a basic illustration required to be delivered or into the life insurance policy summary that is required to be delivered.  (b) Any time a long-term care benefit funded through a life insurance vehicle by the acceleration of the death benefit is in benefit payment status, a monthly report shall be provided to the policyholder. The report shall include:  (1) Any long-term care benefits paid out during the month;  (2) An explanation of any changes in the policy, for example death benefits or cash values, due to long-term care benefits being paid out; and  (3) The amount of long-term care benefits existing or remaining.  (c) Any policy advertised, marketed, or offered as long-term care or nursing home insurance shall comply with this article. [L 1999, c 93, pt of §2; am L 2007, c 233, §9]
HI Rev Stat § 431:10H-115 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-115 Incontestability period--group and individual policies.

  §431:10H-115 Incontestability period--group and individual policies. (a) 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 the acceptance of coverage.  (b) For a policy or certificate that has been in force 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 of coverage and which pertains to the condition for which benefits are sought.  (c) After a policy or certificate has been in force for two years it is not contestable solely 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.  (d) No long-term care insurance policy or certificate may be field issued based on medical or health status. For purposes of this subsection, "field issued" means a policy or certificate issued by a producer or a third-party administrator pursuant to the underwriting authority granted to the producer or third party administrator by an insurer.  (e) 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 if the policy or certificate is rescinded.  (f) 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 article 10D of this chapter. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care. [L 1999, c 93, pt of §2; am L 2003, c 212, §94]
HI Rev Stat § 431:10H-116 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-116 Nonforfeiture benefits.

 §431:10H-116 Nonforfeiture benefits. (a) Except as provided in subsection (b), a long-term care insurance policy shall not be delivered or issued for delivery in this State unless the policyholder or certificate holder has been offered an option to purchase a policy or certificate 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. If the policyholder or certificate holder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.  (b) For a group long-term care insurance policy, the offer of a nonforfeiture benefit under subsection (a) shall be made to the group policyholder. However, if the policy is issued as a group long-term care insurance, other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificate holder.  (c) The commissioner shall adopt rules to specify the type of nonforfeiture benefits to be offered as part of long-term care insurance policies or certificates, the standards for nonforfeiture benefits, and the rules for contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse shall be available and the substantial premium rate increase that triggers a contingent benefit upon lapse as provided in subsection (a). [L 1999, c 93, pt of §2]
HI Rev Stat § 431:10H-116.5 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-116.5 Delivery of the contract or certificate of insurance.

 §431:10H-116.5 Delivery of the contract or certificate of insurance. If an application for a long-term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than thirty days after the date of approval. [L 2007, c 233, pt of §3]
HI Rev Stat § 431:10H-116.6 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-116.6 Denial of claims; compliance requirements.

  §431:10H-116.6 Denial of claims; compliance requirements. (a) If a claim under a long-term care insurance contract is denied, the issuer, within sixty days of the date of a written request by the policyholder or certificate holder, or a representative thereof shall:  (1) Provide a written explanation of the reasons for the denial; and  (2) Make available all information directly related to the denial.  (b) Any policy or rider advertised, marketed, or offered as long-term care or nursing home insurance shall comply with this article. [L 2007, c 233, pt of §3]
HI Rev Stat § 431:10H-117 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-117 Authority to adopt rules.

  §431:10H-117 Authority to adopt rules. The commissioner may adopt reasonable rules to promote premium adequacy and to protect the policyholder in the event of substantial rate increases, and to establish minimum standards for marketing practices, producer compensation, producer testing, penalties, and reporting practices for long-term care insurance. [L 1999, c 93, pt of §2; am L 2003, c 212, §95]
HI Rev Stat § 431:10H-202 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-202 Renewability.

 §431:10H-202 Renewability. (a) The terms "guaranteed renewable" and "noncancellable" shall not be used in any individual long-term care insurance policy without further explanatory language in accordance with the disclosure requirements of section 431:10H-211. A policy issued to an individual shall not contain renewal provisions other than guaranteed renewable or noncancellable.  (b) The term "guaranteed renewable" may be used only when the insured has the right to continue the long-term care insurance in force by the timely payment of premiums and when the insurer has no unilateral right to make any change in any provision of the policy or rider while the insurance is in force, and cannot decline to renew, except that rates may be revised by the insurer on a class basis.  (c) The term "noncancellable" means the insured has the right to continue the long-term care insurance in force by the timely payment of premiums during which period the insurer has no right to unilaterally make any change in any provision of the insurance or in the premium rate.  (d) The term "level premium" may only be used when the insurer does not have the right to change the premium.  (e) In addition to the other requirements of this section, a qualified long-term care insurance contract shall be guaranteed renewable, within the meaning of section 7702B(b)(1)(C) of the Internal Revenue Code of 1986, as amended. [L 1999, c 93, pt of §2; am L 2007, c 233, §11]
HI Rev Stat § 431:10H-202.5 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|431. Insurance Code|431:10H-202.5 Licensing.

 §431:10H-202.5 Licensing. A producer is not authorized to sell, solicit, or negotiate with respect to long-term care insurance except as authorized by article 9A. [L 2007, c 233, pt of §4]