South Dakota Administrative Rules › Title 20 - PUBLIC SAFETY › Article 20:06 - INSURANCE › Chapter 20:06:21 - Long-term care insurance › Appendix A - Outline of Coverage

Current through Register Vol. 51, page 10, July 15, 2024
Appendix A.
Outline of Coverage. Note: A slant mark indicates alternatives. Parentheses indicate instructions or blanks to be filled in. The remaining language is intended to be used verbatim.
The caution statement referred to in §
									20:06:21:28  must appear as follows in the outline of coverage:
Caution: The issuance of this long-term care insurance policy/certificate 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).
(1) This policy is an individual policy of insurance/a group policy which was issued in (indicate the jurisdiction in which the group policy was issued).
(2) Purpose of outline of coverage. This outline of coverage provides a very brief description of the important features of the policy. You should compare this outline of coverage to outlines of coverage for other policies available to you. This is not an insurance contract, but only a summary of coverage. Only the individual or group policy contains governing contractual provisions. This means that the policy or group policy sets forth in detail the rights and obligations of both you and the insurance company. Therefore, if you purchase this coverage, or any other coverage, it is important that you
READ YOUR POLICY OR CERTIFICATE CAREFULLY!
(3) Federal tax consequences.
This [POLICY] [CERTIFICATE] is intended to be a federally tax-qualified long-term care insurance contract under Section 7702B(b) of the Internal Revenue Code of 1986, as amended.
OR
Federal Tax Implications of this [POLICY] [CERTIFICATE]. This [POLICY] [CERTIFICATE] is not intended to be a federally tax-qualified long-term care insurance contract under Section 7702B(b) of the Internal Revenue Code of 1986 as amended. Benefits received under the [POLICY] [CERTIFICATE] may be taxable as income.
(4) Terms under which the policy or certificate may be continued in force or discontinued.
(a) (For long-term care health insurance policies or certificates describe one of the following permissible policy renewability provisions:)
(i) (Policies and certificates that are guaranteed renewable shall contain the following statement:)
RENEWABILITY: THIS POLICY OR CERTIFICATE IS GUARANTEED RENEWABLE
. This means you have the right, subject to the terms of your policy or certificate to continue this policy as long as you pay your premiums on time. (Company Name) cannot change any of the terms of your policy on its own, except that, in the future,
IT MAY INCREASE THE PREMIUM YOU PAY
.
(ii) (Policies and certificates that are noncancelable shall contain the following statement:)
RENEWABILITY: THIS POLICY OR CERTIFICATE IS NONCANCELABLE
. This means that you have the right, subject to the terms of your policy, to continue this policy as long as you pay your premiums on time. (Company Name) cannot change any of the terms of your policy on its own and cannot change the premium you currently pay. However, if your policy contains an inflation protection feature where you choose to increase your benefits, (Company Name) may increase your premium at that time for those additional benefits.