reglab/housing_qa huggingface dataset:
8 V.S.A. § 8012
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8012. Enforcement

§ 8012. Enforcement|(a) The Commissioner may, after notice and an opportunity for hearing, impose an administrative penalty of not more than $15,000.00 against any person who violates a provision of this chapter. The hearing before the Commissioner shall be a contested case subject to the provisions of 3 V.S.A. chapter 25.(b) A provider who violates a provision of this chapter shall be subject to a fine not to exceed $15,000.00, or imprisonment for a period not to exceed one year, or both.(c) The Department, or the Attorney General at the request of the Department, may bring an action to enforce the provisions of this chapter in the Superior Court. The Court may grant temporary and permanent injunctive relief and may exercise all the powers available to it. (Added 1987, No. 247 (Adj. Sess.), § 1; 1995, No. 167 (Adj. Sess.), § 25.)
8 V.S.A. § 8013
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8013. Hearing on denial of certificate or rate application

§ 8013. Hearing on denial of certificate or rate application|An adverse decision by the Commissioner under section 8002 of this title shall state the grounds and particulars on which the decision was based in such detail as to reasonably inform the affected party. Any party aggrieved by the decision may file a written notice and request a hearing before the Commissioner within 30 days of the decision. The appeal provisions set forth in 3 V.S.A. chapter 25 shall apply. (Added 1987, No. 247 (Adj. Sess.), § 1.)
8 V.S.A. § 8014
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8014. Rules

§ 8014. Rules|The Commissioner may adopt rules under 3 V.S.A. chapter 25 necessary to carry out the provisions of this chapter. (Added 1987, No. 247 (Adj. Sess.), § 1.)
8 V.S.A. § 8015
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8015. Nondiscrimination

§ 8015. Nondiscrimination|The provisions of 9 V.S.A. § 4503 as they relate to age shall not apply to providers offering continuing care under the provisions of this chapter. (Added 1987, No. 247 (Adj. Sess.), § 1.)
8 V.S.A. § 8016
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8016. Fees for administration of this chapter

§ 8016. Fees for administration of this chapter|(a) An application for a certificate of authority shall be accompanied by a fee of $1,500.00.(b) The Department shall be reimbursed for any expenses it reasonably incurs itself or by its agents in pursuing the following statutory duties:  (1) review of rates charged by operators; (2) review of contract forms; (3) monitoring compliance with statutory and regulatory requirements; (4) general enforcement of statutory requirements; and (5) preparation and publication of a consumers' guide. The Commissioner shall annually, before August 16, apportion the expenses incurred in performing the enumerated duties among providers based on their annual gross revenue for their most recent fiscal year.   (c) The Department shall be reimbursed by a provider for any expenses reasonably incurred by the Department or by its agents, in pursuing its financial and market conduct examinations, reviewing the sale or transfer of a facility to another operator, conducting specific enforcement actions, and carrying out investigations and rehabilitation activities under this chapter. (Added 1987, No. 247 (Adj. Sess.), § 1.)
8 V.S.A. § 8017
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8017. Consumers guide

§ 8017. Consumers guide|The Commissioner shall publish and distribute a consumers' guide to continuing care retirement communities and a directory of such facilities. (Added 1987, No. 247 (Adj. Sess.), § 1.)
8 V.S.A. § 8018
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 151 - Continuing Care Retirement Communities|§ 8018. Resident Assistance Fund

§ 8018. Resident Assistance Fund|(a) A provider shall establish a Resident Assistance Fund for the purpose of assisting residents who are unable to meet a portion of periodic or other charges of the provider.(b) The Fund shall be established by an initial contribution of at least $25,000.00 from the provider and may contain any additional amounts contributed by the provider or residents.(c) The Fund, including any interest earned on monies in the Fund, shall be used for the sole purpose of assisting residents who have financial difficulties which impair their ability to meet monthly fees and other charges.(d) The Fund shall be administered by the operator of the facility and a committee of residents, designated by the residents, for the exclusive benefit of the residents in a manner approved by the Commissioner.(e) The Fund shall be subject to an annual independent audit. The independent audit may be filed and submitted in accordance with one of the following methods:  (1) an audited financial statement of the Fund shall be included as a separate schedule of supplementary information in the provider's audited annual statement required under subsection 8002(g) of this title; or (2) an audited financial statement of the Fund shall be submitted annually to the residents and the Commissioner. (Added 1987, No. 247 (Adj. Sess.), § 1; amended 2009, No. 137 (Adj. Sess.), § 13.)
8 V.S.A. § 8081
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8081. Purpose

§ 8081. Purpose|The purpose of this chapter is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term care insurance policies, and to facilitate flexibility and innovation in the development of long-term care insurance coverage. (Added 2003, No. 124 (Adj. Sess.), § 2.)
8 V.S.A. § 8083
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8083. Extraterritorial jurisdiction

§ 8083. Extraterritorial jurisdiction|No group long-term care insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in subdivision 8082(4)(D) of this title, 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 such requirements have been met. All other jurisdiction shall be pursuant to section 4062 of this title. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8084
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8084. Disclosure standards

§ 8084. Disclosure standards|(a) The Commissioner shall adopt rules establishing standards for full and fair disclosure of the terms of a long-term care insurance policy.(b) The disclosure standards established under subsection (a) of this section shall include provisions 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, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation, conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8085
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8085. Minimum benefits and coverage; general

§ 8085. Minimum benefits and coverage; general|(a) The Commissioner shall adopt rules establishing standards for minimum benefits and coverage that must be provided by a long-term care insurance policy to carry out the purposes of subsection (b) of this section. Nothing in this section prohibits an insurer from underwriting in accordance with that insurer's underwriting standards and the requirements of section 8086 of this title.(b) No long-term care insurance policy may:  (1) be cancelled, nonrenewed, or otherwise terminated on grounds other than by cancellation by the insured individual or certificate holder; nonpayment of premiums by the insured individual or certificate holder; all amounts potentially payable under the terms of the policy having been fully paid out; or except as provided for in section 8094 of this title; (2) contain a provision establishing a new waiting period in the event 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; (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; (4) deny benefits or coverage on the basis that the need for services arises from a mental condition or Alzheimer's disease and related disorders; (5) be issued without including a provision covering home health care benefits that complies with the standards for minimum benefits and coverage established by rule under subsection (a) of this section; (6) fail to offer adult day care benefits, either in the policy or as an optional rider, that comply with the standards for minimum benefits and coverage established by rule under subsection (a) of this section; (7) be offered without including an option for inflation adjustment protection that complies with the standards for minimum benefits and coverage established by rule under subsection (a) of this section; (8) include a deductible or elimination period in excess of 100 days, computed in a manner prescribed by the Commissioner by rule, for any covered benefit; (9) require payment of premiums more frequently than monthly; or (10) be represented as having a premium described as level, fixed, or by similar words, if the premium is not, in fact, fixed and may be increased. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005; amended 2013, No. 96 (Adj. Sess.), § 23.)
8 V.S.A. § 8086
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8086. Preexisting conditions

§ 8086. Preexisting conditions|(a) No long-term care insurance policy or certificate 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 may exclude coverage for a loss or confinement which is the result of a preexisting condition, unless such loss or confinement begins within six months following the effective date of coverage of an insured person.(c) The Commissioner may by rule extend the limitation periods established in subsections (a) and (b) of this section 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) of this section 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) of this section. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8087
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8087. Prior institutionalization

§ 8087. Prior institutionalization|No long-term care insurance policy shall condition benefits upon a period of prior hospitalization or upon admission to a facility for the same or related condition that led to hospitalization or admission to the facility. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8088
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8088. Loss ratio standards

§ 8088. Loss ratio standards|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. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8089
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8089. Right to return; free look

§ 8089. Right to return; free look|(a) Individual long-term care insurance policyholders shall have 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 policyholder is not satisfied for any reason. Individual long-term care insurance policies shall have a notice prominently printed on the first page of the policy stating in substance that the policyholder shall have 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 policyholder is not satisfied for any reason.(b) A person insured under a long-term care insurance policy issued pursuant to a direct response solicitation shall have the right to return the policy within 30 days of its delivery and to have the premium refunded if after examination the insured person is not satisfied for any reason. Long-term care insurance policies issued pursuant to a direct response solicitation shall have a notice prominently printed on the first page stating in substance that the insured person shall have the right to return the policy within 30 days of its delivery and to have the premium refunded if after examination the insured person is not satisfied for any reason. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8090
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8090. Outline of coverage for applicant; certificate

§ 8090. Outline of coverage for applicant; certificate|(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, overall appearance, and the content of an outline of coverage.(b) In the case of agent solicitations, an agent shall deliver the outline of coverage prior to the presentation of an application or enrollment form.(c) In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form.(d) In the case of a policy issued to a group defined in subdivision 8082(4)(A) of this chapter, an outline of coverage shall not be required to be delivered, provided that the information described in subsection (e) of this section is contained in other materials relating to enrollment. Upon request, these other materials shall be made available to the Commissioner.(e) 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 the premium refunded; (6) a brief description of the relationship of cost 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 Subsection 7702B(b) of the Internal Revenue Code of 1986, as amended.   (f) A certificate issued pursuant to a group long-term care insurance policy 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.   (g) 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 30 days after the date of approval. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8091
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8091. Policy summary for life insurance policy providing long-term care benefits

§ 8091. Policy summary for life insurance policy providing long-term care benefits|(a) If an individual life insurance policy provides long-term care benefits within the policy or by rider, a policy summary shall be delivered at the time of policy delivery. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request, but regardless of request shall make delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the 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 benefits, 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 subdivision 8085(b)(6) of this title is not available under this policy; (5) if applicable to the policy type, the summary shall also include:  (A) a disclosure of the effects of exercising other rights under the policy; (B) a disclosure of guarantees related to long-term care costs of insurance charges; and (C) current and projected maximum lifetime benefits.    (b) The provisions of the policy summary listed in this section may be incorporated into a basic illustration required to be delivered or into the life insurance policy summary which is required to be delivered in accordance with the Department's rules. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8092
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8092. Acceleration of life insurance death benefit; monthly report

§ 8092. Acceleration of life insurance death benefit; monthly report|Anytime 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, such as 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. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)
8 V.S.A. § 8093
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8093. Denial of claims; written explanation

§ 8093. Denial of claims; written explanation|(a) If a claim under a long-term care insurance contract is denied, the issuer shall, within 60 days of the date of a written request by the policyholder or certificate holder, or a representative thereof:  (1) provide a written explanation of the reasons for the denial; and (2) make available all information directly related to the denial.   (b) After completion of all internal appeals, the policyholder or certificate holder may appeal the insurer's benefit trigger determination to an independent review organization designated by the Commissioner, upon payment of a filing fee of no more than $15.00. The filing fee may be waived or reduced upon a finding by the Commissioner that the financial circumstances of the insured warrant a waiver or reduction. All other costs of the independent review shall be paid by the insurer. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005; amended 2009, No. 137 (Adj. Sess.), § 28.)
8 V.S.A. § 8094
2021 Vermont Statutes|Title 8 - Banking and Insurance|Chapter 154 - Long-Term Care Insurance|§ 8094. Incontestability period

§ 8094. Incontestability period|(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 for coverage.(b) 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 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 upon the grounds of misrepresentation alone, but may be contested only upon 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 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.(e) 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 sections 3731 and 4065 of this title. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005.)