Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 65.00 - Long-term Care Insurance › Section 65.09 - Requirements for Disclosure

Current through Register 1525, July 5, 2024
All individual and group policies of long-term care insurance
				must adequately disclose all policy provisions, including but not limited to
				the following provisions.
(1)
The first page of the policy must disclose the
			 following
:
(a) If the policy
			 does not provide coverage for care in a nursing home, a notation of the fact
			 shall be prominently attached to the first page of the policy in not less than
			 18-point type or in some other manner that distinguishes it from the print
			 otherwise appearing in the policy.
(b) The following statement: "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."
(c) A section in boldface type highlighted on
			 the first page of the policy shall either list all preexisting condition
			 exclusions or limitations or refer the individual to the section within the
			 policy that lists all pre-existing condition exclusions or
			 limitations.
(d) A renewability
			 section notice shall clearly identify whether the policy is noncancelable or
			 guaranteed renewable, and whether it is being issued on other than an
			 individual basis (policies providing conversion privileges must specify the
			 benefits to be provided or must state that the converted coverage shall be on
			 the policy form then being issued by the carrier for this purpose).
(e)
Qualification for Federal
			 Income Tax Exemptions and Certain Massachusetts Mass Health (Medicaid)
			 Exemptions.
1. All individual,
			 group and employment-based group policies that are intended to qualify for
			 certain federal income tax exemptions must comply with standards set forth in
			 the federal Internal Revenue Code and related regulations.
2. All individual, group and employment-based
			 policies issued on or after March 15, 1999 that are intended to qualify for
			 exemptions from certain Massachusetts Mass Health (Medicaid) provisions
			 including the financial eligibility exemption in M.G.L. c. 118E, §25 and
			 the liability exemption in M.G.L. c. 118E, § 33, must comply with the
			 individual policy requirements of
			 211 CMR
			 65.05 and the minimum coverage requirements
			 of
			 130
			 CMR 515.014. All such policies issued prior
			 to March 15, 1999, need only comply with the minimum standards of
			 211 CMR
			 65.05, and the limitations and exclusions
			 provisions of
			 211 CMR
			 65.06 that were effective from April 1, 1989
			 through September 2, 1999. The provisions of 211 CMR 65.09(1)(e)2. shall apply
			 regardless of whether the policy is issued within or outside
			 Massachusetts.
3. There shall be on
			 the face of the policy or certificate, or a sticker attached to the first page
			 of the policy or certificate, a notice that includes the following in
			 substantially the same language and format:
FEDERAL INCOME TAX EXEMPTIONS:
This policy (
IS)
(
IS NOT
) intended to be a federally qualified
				long-term care insurance contract under section 7702B(b) of the Internal
				Revenue Code of 1986, as amended.
STATE MASS HEALTH (MEDICAID) EXEMPTIONS:
This
				policy
(IS) (IS NOT)
intended to satisfy Massachusetts' minimum
				long-term care insurance coverage requirements as of the policy's effective
				date for certain as set and liability exemptions under the Massachusetts Mass
				Health (Medicaid) Program. Please note that there may be other Mass Health
				(Medicaid) requirements to qualify for these exemptions.
Please read
Your Options for Financing Long-Term Care:
				A Massachusetts Guide
for important information about the federal and
				state exemptions. PLEASE NOTE THAT STATE AND FEDERAL LAWS ARE SUBJECT TO CHANGE
				AND THAT FEDERAL AND STATE EXEMPTIONS MAY NOT APPLY TO THIS POLICY AT A FUTURE
				DATE.