reglab/statecodes huggingface dataset:
2023 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 500.3915 - Certain Conditions Prohibited.

500.3915 Certain conditions prohibited.
Sec. 3915.
A long-term care insurance policy sold before, on, or after June 2, 1992 shall not condition benefits on any of the following:
(a) The prior institutionalization of the insured.
(b) Prior receipt of a higher level of institutional care.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2006, Act 442, Imd. Eff. Oct. 19, 2006
Popular Name:
Act 218
2023 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 500.3917 - Replacement Policy; Waiver of Time Periods Applicable to Preexisting Conditions and Probationary Periods.

500.3917 Replacement policy; waiver of time periods applicable to preexisting conditions and probationary periods.
Sec. 3917.
If a long-term care insurance policy or certificate replaces another long-term care policy or certificate, the replacing insurer shall waive any time periods applicable to preexisting conditions and probationary periods for similar benefits in the new long-term care policy to the extent that similar exclusions have been satisfied under the original policy.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name:
Act 218
2023 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
2023 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 500.3921 - Application; Questions Relating to Health Condition; Delivery; Record of Policy Rescissions; Annual Report to Commissioner.

500.3921 Application; questions relating to health condition; delivery; record of policy rescissions; annual report to commissioner.
Sec. 3921.
(1) All applications for long-term care insurance policies except those that are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the applicant's health condition.
(2) If an application for long-term care insurance contains a question that asks whether the applicant has had medication prescribed by a physician, it shall also ask the applicant to list the medication that has been prescribed.
(3) If any medications listed in an application were known by the insurer or should have been known at the time of application to be directly related to a medical condition for which coverage would otherwise be denied, then the policy shall not be rescinded for that condition.
(4) Except for policies that are guaranteed issue, all of the following apply:
(a) The following language shall be set out conspicuously and in close conjunction with the applicant's signature block on an application for a long-term care insurance policy:
"Caution: If your answers on this application are incorrect or untrue, [company] has the right to deny benefits or rescind your policy."
(b) The following language, or language substantially similar to the following, shall be set out conspicuously on the long-term care insurance policy at the time of delivery:
"Caution: The issuance of this long-term care insurance policy is based upon your responses to the questions on your application. A copy of your [application] [enrollment form] [is enclosed] [was retained by you when you applied]. If your answers are incorrect or untrue, the company has the right to deny benefits or rescind your policy. The best time to clear up any questions is now, before a claim arises! If, for any reason, any of your answers are incorrect, contact the company at this address: [insert address]"
(c) Prior to issuance of a long-term care policy to an applicant age 80 or older, the insurer shall obtain 1 of the following:
(i) A report of a physical examination.
(ii) An assessment of functional capacity.
(iii) An attending physician's statement.
(iv) Copies of medical records.
(5) A copy of the completed application or enrollment form, whichever is applicable, shall be delivered to the insured no later than at the time of delivery of the policy unless it was retained by the applicant at the time of application.
(6) Every insurer or other entity selling or issuing long-term care insurance benefits shall maintain a record of all policy rescissions, both state and countrywide, except those the insured voluntarily effectuated, and shall annually furnish this information to the commissioner.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name:
Act 218
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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
2023 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 500.3949 - Life and Long-Term Care Benefits; Marketing; Compliance.

500.3949 Life and long-term care benefits; marketing; compliance.
Sec. 3949.
(1) An insurer that has both life and disability authority in this state may market policies containing both life benefits and long-term care benefits.
(2) Except as otherwise provided in this act, if life insurance products contain long-term care benefits, the life insurance benefits in those products shall comply with the requirements of chapters 40 and 44 and the long-term care benefits shall comply with this chapter.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name:
Act 218
2023 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 500.3951 - Policy Summary; Compliance With MCL 500.3933; Additional Provisions; Monthly Report.

500.3951 Policy summary; compliance with MCL 500.3933; additional provisions; monthly report.
Sec. 3951.
(1) A policy summary shall be delivered for a life insurance policy or certificate that provides long-term care benefits. The summary shall comply with the requirements in section 3933. For direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request and shall make the delivery no later than at the time of policy delivery. In addition to the policy summary provisions in section 3933, the policy summary shall include all of the following:
(a) An explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits.
(b) An illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits, if any, for each covered person.
(c) Any exclusions, reductions, and limitations on benefits of long-term care.
(d) If applicable to the policy type, the summary shall also include all of the following:
(i) A disclosure of the effects of exercising other rights under the policy.
(ii) A disclosure of guarantees related to long-term care costs of insurance charges.
(iii) Current and projected maximum lifetime benefits.
(2) If 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 all of the following:
(a) Any long-term care benefits paid out during the month.
(b) An explanation of any changes in the policy, for example, death benefits or cash values due to long-term care benefits being paid out.
(c) The amount of long-term care benefits existing or remaining.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name:
Act 218
2023 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 500.3953 - Disclosure Statement.

500.3953 Disclosure statement.
Sec. 3953.
A life insurance policy that provides an accelerated benefit for long-term care shall provide a disclosure statement at the time of application for the policy or rider and at the time the accelerated benefit payment request is submitted stating that receipt of accelerated benefits may be taxable and that assistance should be sought from a personal tax adviser. The disclosure statement shall be prominently displayed on the first page of the policy or rider and any other related documents.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name:
Act 218
2023 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 500.3955 - Compliance With Chapter and Applicable Laws.

500.3955 Compliance with chapter and applicable laws.
Sec. 3955.
Each insurance policy that is advertised, marketed, or offered as long-term care insurance or nursing home insurance shall comply with this chapter and the other applicable provisions of this act.
History:
Add. 1992, Act 84, Imd. Eff. June 2, 1992
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-39A - Chapter 39a Long-Term Care Partnership Program Insurance (500.3957...500.3965) › Section 500.3957 - Definitions.

500.3957 Definitions.
Sec. 3957.
As used in this chapter:
(a) "Applicant" means that term as defined in section 3901.
(b) "Long-term care partnership program policy" or "partnership policy" means a policy that meets all of the requirements for the long-term care partnership program under section 112c of the social welfare act, 1939 PA 280, MCL 400.112c, and all of the following requirements:
(i) The policy covers an insured who was a resident of this state when coverage first became effective under the policy.
(ii) The policy is either a qualified long-term care insurance contract as that term is defined in section 7702B(b) of the internal revenue code of 1986, 26 USC 7702B, that is issued no earlier than the effective date of the amendatory act that added this chapter or a policy that has been converted or replaced under section 3908.
(iii) The policy meets all of the applicable requirements of chapter 39.
(iv) The policy meets the requirements of the National Association of Insurance Commissioners' model act and model regulation listed in section 1917(b)(5)(A) of title XIX of the social security act, 42 USC 1396p, as required under section 1917(b)(1)(C)(iii)(III) of title XIX of the social security act, 42 USC 1396p.
(v) The policy provides the following inflation protection features:
(A) If the policy is sold to an individual who has not attained age 61 as of the date of purchase, the policy must provide compound annual inflation protection.
(B) If the policy is sold to an individual who has attained age 61 but has not attained age 76 as of the date of purchase, the policy must provide some level of inflation protection.
(C) If the policy is sold to an individual who has attained age 76 as of the date of purchase, the policy may provide some level of inflation protection.
(c) "Policy" means that term as defined in section 3901.
History:
Add. 2015, Act 198, Eff. Feb. 22, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-39A - Chapter 39a Long-Term Care Partnership Program Insurance (500.3957...500.3965) › Section 500.3959 - Long-Term Care Partnership Program Policy; Applicability of Chapter and Applicable Sections of Chapter 39.

500.3959 Long-term care partnership program policy; applicability of chapter and applicable sections of chapter 39.
Sec. 3959.
Pursuant to section 6021 of the deficit reduction act of 2005, Public Law 109-171, and section 112c of the social welfare act, 1939 PA 280, MCL 400.112c, this chapter applies to a long-term care partnership program policy. The applicable sections of chapter 39 also apply to a long-term care partnership program policy.
History:
Add. 2015, Act 198, Eff. Feb. 22, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-39A - Chapter 39a Long-Term Care Partnership Program Insurance (500.3957...500.3965) › Section 500.3961 - Partnership Policy; Solicitation or Sale; Notice.

500.3961 Partnership policy; solicitation or sale; notice.
Sec. 3961.
(1) If an insurer or its agent solicits or offers to sell a policy that is intended to qualify as a partnership policy, the insurer or its agent shall provide to a prospective applicant the notice described in section 112c of the social welfare act, 1939 PA 280, MCL 400.112c, or, if filed with and approved by the department, a notice similar to the notice described in section 112c of the social welfare act, 1939 PA 280, MCL 400.112c.
(2) An insurer or its agent shall provide the notice required under subsection (1) to a prospective applicant with the summary of coverage described in section 3933.
History:
Add. 2015, Act 198, Eff. Feb. 22, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-39A - Chapter 39a Long-Term Care Partnership Program Insurance (500.3957...500.3965) › Section 500.3963 - Partnership Policy; Delivery or Issuance for Delivery; Filing and Approval Required; Submission of Completed Partnership Certification Form or Similar Form to Department; "Partnership Certification Form" Defined.

500.3963 Partnership policy; delivery or issuance for delivery; filing and approval required; submission of completed partnership certification form or similar form to department; "partnership certification form" defined.
Sec. 3963.
(1) A partnership policy shall not be delivered or issued for delivery in this state unless the partnership policy is filed with the department and approved by the director under section 2236(1).
(2) A policy submitted to the department for approval as a partnership policy under subsection (1) must be submitted with a completed partnership certification form or a similar form. The completed partnership certification form or similar form also must be approved by the director of the department.
(3) As used in this section, "partnership certification form" means a form developed by the department in consultation with the state department of health and human services.
History:
Add. 2015, Act 198, Eff. Feb. 22, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-39A - Chapter 39a Long-Term Care Partnership Program Insurance (500.3957...500.3965) › Section 500.3965 - Regular Reports to Be Provided to Department of Health and Human Services.

500.3965 Regular reports to be provided to department of health and human services.
Sec. 3965.
An insurer that issues a partnership policy shall provide copies of the regular reports described in 45 CFR 144.200 to 144.214 to the state department of health and human services.
History:
Add. 2015, Act 198, Eff. Feb. 22, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4000 - Scope of Chapter.

500.4000 Scope of chapter.
Sec. 4000.
(1) This chapter applies to life insurance policies, other than reinsurance, group life insurance, group annuities, and industrial life insurance. However, sections 4004 (policy must contain entire contract), 4040 (supplementary benefits), 4048 (provisions required by laws of other states, countries), 4052 (preliminary term insurance), 4054 (insurer may hold proceeds; exemption from creditors), 4060 (standard nonforfeiture law), 4062 (loan value; deferment), and 4064 (computation of loan indebtedness) apply to industrial life insurance policies.
(2) This chapter applies to annuity contracts only to the extent provided in sections 4070, 4072 and 4073.
(3) This chapter applies to life insurance contracts on a variable basis. However, the commissioner may by rule prescribe appropriate modifications to sections 4022, 4024, 4026, 4028, 4060, 4062, and 4064 applicable to life insurance contracts on a variable basis. The commissioner may by rule set reasonable standards for life insurance contracts on a variable basis which do all of the following:
(a) Require insurers to establish and file with the commissioner standards for marketing life insurance on a variable basis.
(b) Define terms to be used.
(c) Prescribe conditions under which life insurance on a variable basis may be issued, redeemed, or exchanged for a nonvariable contract.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 1974, Act 225, Eff. Nov. 1, 1974 ;-- Am. 1980, Act 58, Eff. Oct. 1, 1980
Popular Name:
Act 218
Admin Rule:
R 500.402 et seq. and R 500.841 et seq. of the Michigan Administrative Code.
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4001 - Universal Life Insurance; Definitions.

500.4001 Universal life insurance; definitions.
Sec. 4001.
As used in this chapter, the following definitions apply only to universal life insurance:
(a) "Cash surrender value" means the net cash surrender value plus any amounts outstanding as policy loans.
(b) "Fixed premium universal life insurance policy" means a universal life insurance policy other than a flexible premium universal life insurance policy.
(c) "Flexible premium universal life insurance policy" means a universal life insurance policy that permits the policyowner to vary, independently of each other, the amount or timing of 1 or more premium payments or the amount of insurance.
(d) "Interest-indexed universal life insurance policy" means any universal life insurance policy where the interest credits are linked to an external referent.
(e) "Net cash surrender value" means the maximum amount payable to the policyowner upon surrender.
(f) "Policy value" means the amount to which separately identified interest credits and mortality, expense, or other charges are made under a universal life insurance policy.
(g) "Universal life insurance" means any individual or group life insurance policy under the policy provisions of which separately identified interest credits, other than in connection with dividend accumulations, premium deposit funds, or other supplementary accounts, and mortality and expense charges are made to the policy. A universal life insurance policy may provide for other credits and charges, such as charges for the cost of benefits provided by rider.
History:
Add. 1993, Act 349, Eff. Oct. 1, 1994
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4002 - Life Insurance Policies; Discrimination Against Living Donors; Prohibition; Definitions.

500.4002 Life insurance policies; discrimination against living donors; prohibition; definitions.
Sec. 4002.
(1) This section applies to life insurance policies or certificates delivered or issued for delivery after December 31, 2023.
(2) Unless there is an additional actuarial risk, as determined in accordance with sound actuarial principles as well as the individual's actual and reasonably anticipated experience, an insurer shall not do any of the following with respect to a life insurance policy or certificate based solely on the individual's status as a living donor:
(a) Deny coverage.
(b) Cancel coverage.
(c) Refuse to issue the policy or certificate.
(d) Determine the price or premium for the policy or certificate.
(e) Otherwise vary a term or condition of the policy or certificate.
(3) As used in this section:
(a) "Living donor" means an individual who is not deceased and has donated any of the following:
(i) All or part of an organ.
(ii) A tissue.
(b) "Organ" means a human kidney, liver, heart, lung, pancreas, esophagus, stomach, or small or large intestine, a portion of the gastrointestinal tract, or another part of the human body designated by the department by rule.
(c) "Tissue" means a portion of the human body other than an organ, including, but not limited to, an eye, skin, bone, bone marrow, a heart valve, a spermatozoon, an ova, an artery, a vein, a tendon, a ligament, blood, blood derivatives, a pituitary gland, or fluid.
History:
Add. 2023, Act 192, Imd. Eff. Nov. 7, 2023
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4004 - Entire Contract.

500.4004 Entire contract.
Sec. 4004.
Every policy of life insurance hereafter issued or delivered within this state by any life insurer doing business within this state shall contain the entire contract between the parties. And nothing shall be incorporated therein by reference to any constitution, bylaws, rules, application or other writing unless the same are endorsed upon or attached to the policy when issued.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4008 - Life Insurance; Provisions Required; Single Premium Policies.

500.4008 Life insurance; provisions required; single premium policies.
Sec. 4008.
(1) No policy of life insurance shall be issued in this state unless it contains the provisions set forth in sections 4010 through 4036.
(2) Any of such provisions or portion thereof relating to premiums not applicable to single premium policies, shall to that extent not be incorporated therein.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4010 - Premiums; Payment; Provision Required.

500.4010 Premiums; payment; provision required.
Sec. 4010.
There shall be a provision that all premiums shall be payable in advance, either at the home office of the company or to an agent of the company, upon delivery of a receipt signed by 1 or more of the officers who shall be named in the policy.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-40 - Chapter 40 Life Insurance Policies and Annuity Contract (Other Than Industrial or Group) (500.4000...500.4073) › Section 500.4012 - Life Insurance Policy; Provision Required.

500.4012 Life insurance policy; provision required.
Sec. 4012.
Each life insurance policy shall contain the following provisions:
(a) A grace period of 1 month for the payment of every premium after the first year, which may be subject to an interest charge, during which month the insurance shall continue in force and which provision may contain a stipulation that if the insured dies during the month of the grace period, the overdue premium will be deducted in any settlement under the policy.
(b) That written notice shall be sent by the insurer to the policyowner's last known address at least 30 days prior to termination of coverage. This subdivision does not apply to an insurer that collects a majority of its annual premium in person.
History:
1956, Act 218, Eff. Jan. 1, 1955 ;-- Am. 1993, Act 349, Eff. Oct. 1, 1994 ;-- Am. 1994, Act 226, Eff. Oct. 1, 1994
Popular Name:
Act 218