Kansas Administrative Regulations › Agency 40 - INSURANCE DEPARTMENT › Article 4 - ACCIDENT AND HEALTH INSURANCE › Section 40-4-37i - Long-term care insurance; replacement; notice; waiver of waiting periods

Current through Register Vol. 43, No. 28, July 11, 2024
(a) Long-term care
			 insurance application forms shall request information as to other accident and
			 health insurance coverage in force and whether the insurance to be issued is
			 intended to replace any other accident and sickness policy presently in force.
			 A supplementary application or other form to be signed by the applicant
			 containing such a question may be used.
(b) Upon determining that a sale will involve
			 replacement, an insurer or its agent, other than a direct response insurer,
			 shall furnish the applicant, prior to issuance or delivery of the individual
			 long-term care insurance policy, notice regarding replacement of accident and
			 sickness coverage. One copy of the notice shall be retained by the applicant
			 and an additional copy signed by the applicant shall be retained by the
			 insurer. A direct response insurer shall deliver to the applicant upon issuance
			 of the policy the notice regarding replacement of accident and sickness
			 coverage.
(c) If a long-term care
			 policy replaces another long-term care policy issued by the company or an
			 affiliated company, the replacing insurer shall waive any time periods
			 applicable to pre-existing conditions, waiting periods, elimination periods and
			 probationary periods present in the new long-term care policy for similar
			 benefits to the extent such time was spent under the original policy.
(d) Solicitations other than
			 direct response. Upon determining that a sale will involve replacement, an
			 insurer or its agent, other than an insurer using direct response solicitation
			 methods, shall furnish the applicant, prior to issuance or delivery of the
			 individual long-term care insurance policy, a notice regarding replacement of
			 accident and sickness or long-term care coverage. One copy of such notice shall
			 be retained by the applicant and an additional copy signed by the applicant
			 shall be retained by the insurer. The required notice shall be provided in the
			 following form:
NOTICE TO APPLICANT REGARDING REPLACEMENT OF INDIVIDUAL
				ACCIDENT AND SICKNESS OR LONG-TERM CARE INSURANCE
(Insurance company's name and address)
SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE FUTURE.
According to (your application) (information you have
				furnished), you intend to lapse or otherwise terminate existing accident and
				sickness or long-term care insurance and replace it with an individual
				long-term care insurance policy to be issued by (company name) Insurance
				Company. Your new policy provides 30 days within which you may decide, without
				cost, whether you desire to keep the policy. For your own information and
				protection, you should be aware of and seriously consider certain factors which
				may affect the insurance protection available to you under the new policy.
You should review this new coverage carefully, comparing it
				with all accident and sickness or long-term care insurance coverage you now
				have, and terminate your present policy only if, after due consideration, you
				find that purchase of this long-term care coverage is a wise decision.
STATEMENT TO APPLICANT BY AGENT (BROKER OR OTHER
				REPRESENTATIVE):
(Use additional sheets, as necessary.)
I have reviewed your current medical or health insurance
				coverage. I believe the replacement of insurance involved in this transaction
				materially improves your position. My conclusion has taken into account the
				following considerations, which I call to your attention:
1. Health conditions which you may presently
			 have (preexisting conditions), may not be immediately or fully covered under
			 the new policy. This could result in denial or delay in payment of benefits
			 under the new policy, whereas a similar claim might have been payable under
			 your present policy.
2. State law
			 provides that your replacement policy or certificate may not contain new
			 preexisting conditions or probationary periods. The insurer will waive any time
			 periods applicable to preexisting conditions or probationary periods in the new
			 policy (or coverage) for similar benefits to the extent such time was spent
			 (depleted) under the original policy.
3. If you are replacing existing long-term
			 care insurance coverage, you may wish to secure the advice of your present
			 insurer or its agent regarding the proposed replacement of your present policy.
			 This is not only your right, but it is also in your best interest to make sure
			 you understand all the relevant factors involved in replacing your present
			 coverage.
4. If, after due
			 consideration, you still wish to terminate your present policy and replace it
			 with new coverage, be certain to truthfully and completely answer all questions
			 on the application concerning your medical health history. Failure to include
			 all material medical information on an application may provide a basis for the
			 company to deny any future claims and to refund your premium as though your
			 policy had never been in force. After the application has been completed and
			 before you sign it, reread it carefully to be certain that all information has
			 been properly recorded.
(Signature of Agent, Broker or Other Representative) (Typed
				Name and Address of Agent or Broker)
The above "Notice to Applicant" was delivered to me on:
(Date)
(Applicant's Signature)