reglab/housing_qa huggingface dataset:
MI Comp L § 500.3919 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3919 - Institutionalization; Extension of Benefits; Limitations.

500.3919 Institutionalization; extension of benefits; limitations. Sec. 3919.  Termination of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if such institutionalization began while the long-term care coverage was in force and continues without interruption after termination. An extension of benefits beyond the period the long-term care insurance was in force may be limited to the duration of the benefit period, if any, or to payment of the maximum benefits and may be subject to any policy waiting period and all other applicable provisions of the policy. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3923 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3923 - Riders or Endorsements; Certain Changes in Benefits or Premiums; Definition, Explanation, Description, and Labeling of Certain Terms.

500.3923 Riders or endorsements; certain changes in benefits or premiums; definition, explanation, description, and labeling of certain terms. Sec. 3923.  (1) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured under an individual long-term care insurance policy, all riders or endorsements added to a long-term care insurance policy after date of issue or at reinstatement or renewal that reduce or eliminate benefits or coverage in the policy shall require signed acceptance by the insured individual. After the date of policy issue, any rider or endorsement that increases benefits or coverage with a concomitant increase in premium during the policy term shall be agreed to in writing and signed by the insured, except if the increased benefits or coverage are required by law. If a separate additional premium is charged for benefits provided in connection with riders or endorsements, that premium charge shall be set forth in the policy, rider, or endorsement.  (2) A long-term care insurance policy that provides for the payment of benefits based on standards described as "usual and customary", "reasonable and customary", or words of similar import shall include a definition of the terms and an explanation of the terms in its accompanying summary of coverage.  (3) If a long-term care insurance policy contains any limitations with respect to preexisting conditions, the limitations shall appear as a separate paragraph of the policy and shall be labeled as "preexisting condition limitations".  (4) A long-term care insurance policy containing any limitations or conditions for eligibility shall set forth a description of the limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy and shall label the paragraph "limitations or conditions on eligibility for benefits". History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3927 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3927 - Reasonableness of Benefits Relative to Premiums; Expected Loss Ratio; Evaluation of Factors; Applicability of Section.

500.3927 Reasonableness of benefits relative to premiums; expected loss ratio; evaluation of factors; applicability of section.Sec. 3927.  (1) Benefits under individual long-term care insurance policies shall be considered reasonable in relation to premiums provided the expected loss ratio is at least 60%, calculated in a manner that provides for adequate reserving of the long-term care insurance risk. In evaluating the expected loss ratio, due consideration shall be given to all relevant factors, including:  (a) Statistical credibility of incurred claims experience and earned premiums.  (b) The period for which rates are computed to provide coverage.  (c) Experienced and projected trends.  (d) Concentration of experience within early policy duration.  (e) Expected claim fluctuation.  (f) Experience refunds, adjustments, or dividends.  (g) Renewability features.  (h) All appropriate expense factors.  (i) Interest.  (j) Experimental nature of the coverage.  (k) Policy reserves.  (l) Mix of business by risk classification.  (m) Product features such as long elimination periods, high deductibles, and high maximum limits.  (n) Premiums charged and losses incurred for other similar policies.  (2) This section does not apply to fixed indivisible premium life insurance policies that fund long-term care benefits entirely by accelerating the death benefit.  (3) This section applies to all long-term care insurance policies or certificates except those described in sections 3926(1) and 3926a(1) and (2). History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3928 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3928 - Fixed Indivisible Premium Life Insurance Policy Funding Long-Term Care Benefits by Accelerating Death Benefit; Reasonableness of Benefits Relative to Premiums; Provisions.

500.3928 Fixed indivisible premium life insurance policy funding long-term care benefits by accelerating death benefit; reasonableness of benefits relative to premiums; provisions. Sec. 3928.  A fixed indivisible premium life insurance policy that funds long-term care benefits entirely by accelerating the death benefit is considered to provide reasonable benefits in relation to premiums provided that the policy complies with all of the following provisions:  (a) Premiums required to be paid are fixed and guaranteed for the life of the policy.  (b) The guaranteed cash surrender value is stated in the policy.  (c) The death benefit and long-term care benefits are guaranteed for the life of the policy, and the policy contains the schedule of the guarantees.  (d) The risk charges for mortality and morbidity benefits and any other charges made internally to determine cash value accumulations, if any, are guaranteed not to exceed the maximum charges set forth in the policy.   (e) The interest credited internally to determine cash value accumulations, if any, are guaranteed not to be less than the minimum interest rate set forth in the policy.  (f) The benefits cannot be terminated by the insurer except for nonpayment of premium.  (g) The policy meets the nonforfeiture requirements of chapter 40.  (h) At the time of issue, the policy is accompanied by an illustration that clearly discloses the year-by-year progression of cash values and face amount.  (i) The policy provides that the policy owner is supplied annually with a report showing the current cash value, death benefit, and long-term care benefits, and shows the calculation of the change in the cash value from the previous report by the addition of interest and premium payments, if any, and the deduction of the risk charges and any other charges. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3929 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3929 - Increasing Premiums Prohibited; Conditions.

500.3929 Increasing premiums prohibited; conditions. Sec. 3929.  The premiums charged to an insured for long-term care insurance shall not increase due to either of the following:  (a) The increasing age of the insured at ages beyond 65.  (b) The duration the insured has been covered under the policy. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3930 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3930 - Acceleration of Benefits Under Group or Individual Life Policies or Riders; Determination of Policy Reserves.

500.3930 Acceleration of benefits under group or individual life policies or riders; determination of policy reserves.Sec. 3930.  (1) If long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders to those policies, policy reserves for the benefits must be determined in accordance with section 834(1)(g). Claim reserves must also be established if the policy or rider is in claim status.  (2) Reserves for policies and riders subject to subsection (1) must be based on the multiple decrement model utilizing all relevant decrements except for voluntary termination rates. Single decrement approximations may be used 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, the reserves for the long-term care benefit and the life insurance benefit must not be less than the reserves for the life insurance benefit assuming no long-term care benefit.  (3) In the development and calculation of reserves for policies and riders subject to subsection (1), due regard must be given to the applicable policy provisions, marketing methods, administrative procedures, and all other considerations that have an impact on projected claim costs, including, but not limited to, all of the following:  (a) Definition of insured events.  (b) Covered long-term care facilities.  (c) Existence of home convalescence care coverage.  (d) Definition of facilities.  (e) Existence or absence of barriers to eligibility.  (f) Premium waiver provision.  (g) Renewability.   (h) Ability to raise premiums.  (i) Marketing method.  (j) Underwriting procedures.  (k) Claims adjustment procedures.  (l) Waiting period.  (m) Maximum benefit.  (n) Availability of eligible facilities.  (o) Margins in claim costs.  (p) Optional nature of benefit.  (q) Delay in eligibility for benefit.  (r) Inflation protection provisions.  (s) Guaranteed insurability option.  (4) Any applicable valuation morbidity table must be certified as appropriate as a statutory valuation table by a member of the American academy of actuaries. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2014, Act 571, Eff. Mar. 31, 2015 Popular Name: Act 218
MI Comp L § 500.3931 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3931 - Rules.

500.3931 Rules. Sec. 3931.  The commissioner may promulgate rules including the following:  (a) Rules establishing standards 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 if provided in the policy, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, definitions of terms, and for full and fair disclosure setting forth the manner, content, and required disclosures.  (b) Rules establishing loss ratio standards for long-term care insurance policies. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3935 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3935 - Statement Relating to Request for Additional Information.

500.3935 Statement relating to request for additional information.Sec. 3935.  An application for a long-term care policy shall contain the following statement printed, stamped, or as part of a sticker permanently affixed to the application in capital letters on the first page:  "For additional information about long-term care coverage write to the office of financial and insurance services, P.O. Box 30220, Lansing, MI 48909 or call the area agency on aging in your community.". History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3937 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3937 - Shopper's Guide; Format; Providing to Applicants; Exception.

500.3937 Shopper's guide; format; providing to applicants; exception. Sec. 3937.  (1) 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 in the following manner:  (a) For agent solicitations, an agent shall deliver the shopper's guide prior to the presentation of an application or enrollment form.  (b) For direct response solicitations, the shopper's guide shall be presented in conjunction with any application or enrollment form.  (2) Life insurance policies or riders containing long-term care benefits are not required to furnish a shopper's guide pursuant to subsection (1), but shall furnish a summary of coverage as provided in section 3951.  History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3941 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3941 - Advertising; Filing Copy With Commissioner.

500.3941 Advertising; filing copy with commissioner. Sec. 3941.  Every insurer providing long-term care insurance coverage in this state shall file with the commissioner for review a copy of any written, radio, or television advertisement for long-term care insurance intended for use in this state at least 45 days before the date the insurer desires to use the advertising. The filing shall include a sample or photocopy of all applicable long-term care policies and related forms and the approval status of the policies and forms. In addition, all advertisements shall be retained by the insurer or other entity for at least 3 years from the date the advertisement was first used. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3941a (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3941a - Inapplicability of Section to Life Insurance Policies or Riders Containing Accelerated Benefits; Development of Suitability Standards.

500.3941a Inapplicability of section to life insurance policies or riders containing accelerated benefits; development of suitability standards.Sec. 3941a.  (1) This section does not apply to life insurance policies or riders containing accelerated benefits for long-term care.  (2) Every insurer or other entity marketing long-term care insurance shall do all of the following:  (a) Develop and use suitability standards to determine whether the purchase or replacement of long-term care insurance is appropriate for the needs of the applicant.  (b) Train its producers in the use of and require producers to use its suitability standards.  (c) Maintain a copy of its suitability standards and make them available for inspection upon request by the commissioner.  (d) To determine whether the applicant meets the developed suitability standards, the insurer shall make reasonable efforts to obtain all of the following information:  (i) The applicant's ability to pay for the proposed coverage and other pertinent financial information related to the purchase of the coverage.  (ii) The applicant's goals or needs with respect to long-term care and the advantages and disadvantages of insurance to meet these goals or needs.  (iii) The values, benefits, and costs of the applicant's existing insurance, if any, when compared to the values, benefits, and costs of the recommended purchase or replacement.  (3) If the insurer determines that the applicant does not meet its suitability standards, or if the applicant has declined to provide the necessary information, the insurer may reject the application for long-term care insurance. History: Add. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3942 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3942 - Marketing; Duties of Insurer; Use of "Level Premium" or "Noncancelable" Prohibited; Exception.

500.3942 Marketing; duties of insurer; use of "level premium" or "noncancelable" prohibited; exception.Sec. 3942.  (1) Every insurer marketing long-term care insurance coverage in this state, directly or through its producers, shall do all of the following:  (a) Establish marketing procedures to assure that any comparison of policies by its producers or other producers are fair and accurate.  (b) Establish marketing procedures to assure excessive insurance is not sold or issued.  (c) Display prominently by type, stamp, or other appropriate means, on the first page of the outline of coverage and policy the following:  "Notice to buyer: This policy may not cover all of the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations.".  (d) Inquire and otherwise make every reasonable effort to identify whether a prospective applicant or enrollee for long-term care insurance already has accident and sickness or long-term care insurance and the types and amounts of such insurance.  (e) Establish auditable procedures for verifying compliance with this section.  (2) An insurer marketing long-term care insurance coverage in this state shall not use the term "level premium" or "noncancelable" unless the insurer does not have the right to change the premium for the product being marketed. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3942a (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3942a - Reporting Requirements; Agent Activities; Preparation of Report.

500.3942a Reporting requirements; agent activities; preparation of report. Sec. 3942a.  (1) Every insurer marketing long-term care insurance in Michigan shall comply with all of the following reporting requirements for the purpose of reviewing more closely agent activities regarding the sale of long-term care insurance:  (a) 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 and report annually by June 30 the top 10% of its agents that have the greatest percentages of lapses and replacements.  (b) Report annually by June 30 the number of lapsed policies as a percent of its total annual sales and as a percent of its total number of policies in force as of the end of the preceding calendar year.  (c) Report annually by June 30 the number of replacement policies sold as a percent of its total annual sales and as a percent of its total number of policies in force as of the preceding calendar year.  (2) All reports prepared pursuant to subsection (1) shall be on a statewide basis. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3943 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3943 - Right to Return Policy; Notice; “Direct Response Solicitation” Defined.

500.3943 Right to return policy; notice; “direct response solicitation” defined. Sec. 3943.  (1) Except as otherwise provided in subsection (2), an applicant for long-term care insurance shall have the right to return the policy within 30 days after its delivery and to have the entire premium refunded if, after examination of the policy, the applicant is not satisfied for any reason and benefits have not been incurred under the policy. Long-term care insurance policies shall have a notice prominently printed on the first page of the policy and the summary of coverage stating in substance that the applicant has the right to return the policy within 30 days after its delivery and to have the entire premium refunded if, after examination of the policy, the applicant is not satisfied for any reason.  (2) 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 after its delivery and to have the entire 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 of the policy and the summary of coverage stating in substance that the insured person shall have the right to return the policy within 30 days after its delivery and to have the entire premium refunded if, after examination, the insured person is not satisfied for any reason. As used in this section, "direct response solicitation" means solicitation in which a representative of the insurer does not contact the applicant in person and explain the coverage available, such as, but not limited to, solicitation through direct mail or through advertisements in periodicals and other media. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3945 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3945 - Violation; Penalty.

500.3945 Violation; penalty. Sec. 3945.  In addition to any other penalties provided by the laws of this state, any insurer and any agent found to have violated any requirement of this state relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a fine of up to 3 times the amount of any commissions paid for each policy involved in the violation or up to $10,000.00, whichever is greater. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218