Illinois Administrative Code › Title 50 - INSURANCE › Part 2012 - LONG-TERM CARE INSURANCE › Exhibit L - Long-Term Care Insurance Partnership Disclosure Notice

Current through Register Vol. 48, No. 28, July 12, 2024
Long-Term Care Insurance Partnership
				Disclosure Notice
(Company Name)
(Company Address)
(Policyholder/Certificateholder) Name:
(Policy/Certificate) Number/Identifier:
Effective Date:
Important Information Regarding Your
				Policy's (Certificate's)
Long-Term Care Insurance Partnership
				Status
NOTE: Please keep this notice with your
				long term care insurance policy (certificate)
Partnership Policy (Certificate) Status. Your long-term
				care insurance policy (certificate) is intended to qualify as a Partnership
				Policy (Certificate) under the Illinois Long-Term Care Partnership Program as
				of your Policy's (Certificate's) effective date.
The long-term care insurance policy (certificate) recently
				purchased and enclosed qualifies for the Illinois Long-Term Care Insurance
				Partnership Program. Insurance companies voluntarily agree to participate in
				the Partnership Program by offering long term care insurance coverage that
				meets certain state and federal requirements. Long-Term Care Insurance Policies
				(Certificates) that qualify as Partnership Policies (Certificates) may protect
				your assets through a feature known as "Asset Disregard" under Illinois'
				Medicaid Program.
Asset Disregard
means that an amount of the
				policyholder's (certificateholder's) assets equal to the amount of long-term
				care insurance benefits received under a qualified Partnership Policy
				(Certificate) will be disregarded for the purpose of determining the insured's
				eligibility for Medicaid. This generally allows a person to keep assets equal
				to the insurance benefits received under a qualified Partnership Policy
				(Certificate) without affecting the person's eligibility for Medicaid.
In
				addition, the purchase of this Partnership Policy does not automatically
				qualify you for Medicaid.
What Could Disqualify Your Policy (Certificate) as a
				Partnership Policy.
If you make any changes to your policy
				(certificate), such changes could affect whether your policy (certificate)
				continues to be a Partnership Policy (Certificate).
Before you
				make any changes, you should consult with (carrier name) to determine the
				effect of a proposed change
.
In addition, if you move to a
				state that does not maintain a Partnership Program or does not recognize your
				policy (certificate) as a Partnership Policy (Certificate), you would not
				receive beneficial treatment of your policy (certificate) under the Medicaid
				program of that state. The information contained in this disclosure is based on
				current Illinois and Federal law. These laws may be subject to change. Any
				change in law could reduce or eliminate the beneficial treatment of your policy
				(certificate) under Illinois' Medicaid Program.
Additional Information.
If you have questions
				regarding long-term care insurance policies (certificates), please contact
				(carrier name). If you have questions regarding current laws governing Medicaid
				eligibility, you should contact the Illinois Department of Healthcare and
				Family Services.