Iowa Administrative Code › Agency 191 - Insurance Division › Life and Health Insurance › Chapter 39 - Long-term Care Insurance › Rule 191-39.82 - Exchanges

Current through Register Vol. 47, No. 3, July 24, 2024
(1) An insurer must
				offer, on a one-time basis, in writing, to all existing policyholders that were
				issued long-term care policies between February 1, 2003, and January 1, 2010,
				the option to exchange their existing long-term care policies for an Iowa
				long-term care partnership policy. The insurer must make this offer within 18
				months of the date the insurer begins the first marketing efforts for any
				long-term care partnership insurance product.
(2) Under an exchange program, an insurer
				must comply with all of the following:
a. The
				mandatory offer of an exchange shall apply only to products issued by the
				insurer that are comparable to the type of policy, such as group policies and
				individual policies, and to the policy series that the company has certified as
				partnership-qualified.
b. An
				insurer must provide the insured a minimum of 90 days from the date of mailing
				of the offer by the insurer to accept or reject the offer
c. An insurer must make the offer on a
				nondiscriminatory basis without regard to the age or health status of the
				insured. However, the insurer may underwrite if the policy is amended to
				provide additional benefits or if the exchange would require the issuance of a
				new policy, except as described in paragraph 39.82(2)
"d"
below. Any portion of the policy that was issued prior to the exchange date
				shall be priced based on the policyholder's age when the policy was originally
				issued. Any portion of the policy that is added as a result of the exchange may
				be priced based on the policyholder's age at the time of the
				exchange.
d. If there is no change
				in coverage that is material to the risk, policies exchanged under this rule
				shall not be subject to any medical underwriting.
e. Coverage under the new policy shall not
				result in any exclusion for preexisting conditions that would have been covered
				under the policy or certificate being replaced.
f. Any portion of the policy that was issued
				prior to the exchange date shall maintain the policy's original price based on
				the policyholder's age when the policy was originally issued. Any portion of
				the policy that is added as a result of the exchange may be priced based on the
				policyholder's age at the time of the exchange.
g. When the policy is issued to a group, the
				offer required in subrule 39.82(1) shall be made to the group
				policyholder
h. Notwithstanding
				paragraphs 39.82(2)
"a"
and
"c,"
an insurer is
				not required to offer an exchange to an individual who is eligible for benefits
				within an elimination period, who is or who has been in claim status, or who
				would not be eligible to apply for coverage due to issue age or plan design
				limitations under the new policy. The insurer may require that policyholders
				meet all eligibility requirements, including plan design, underwriting, if
				applicable, and payment of the required premium.