Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 89a - LONG-TERM CARE INSURANCE MODEL REGULATION › Section 89a.106 - Unintentional lapse

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Each insurer
				offering long-term care insurance shall, as a protection against unintentional
				lapse, comply with the following conditions:
(1)
Notice before lapse or
				termination.
An individual long-term care policy or certificate may
				not be issued until the insurer has received from the applicant either a
				written designation of at least one person, in addition to the applicant, who
				is to receive notice of lapse or termination of the policy or certificate for
				nonpayment of premium, or a written waiver dated and signed by the applicant
				electing not to designate additional persons to receive notice. The applicant
				has the right to designate at least one person who is to receive the notice of
				termination, in addition to the insured. Designation may not constitute
				acceptance of liability on the third party for services provided to the
				insured. The form used for the written designation must provide space clearly
				designated for listing at least one person. The designation shall include each
				person's full name and home address. In the case of an applicant who elects not
				to designate an additional person, the waiver shall state: "Protection against
				unintended lapse. I understand that I have the right to designate at least one
				person other than myself to receive notice of lapse or termination of this
				long-term care insurance policy for nonpayment of premium. I understand that
				notice will not be given until 30 days after a premium is due and unpaid. I
				elect not to designate a person to receive this notice." The insured shall be
				able to change the written designation at any time. The insurer shall notify
				the insured of the right to change this written designation, at least once
				every 2 years.
(2)
Deduction plans.
When the policyholder or certificateholder
				pays premium for a long-term care insurance policy or certificate through a
				payroll or pension deduction plan, the requirements contained in paragraph (1)
				need not be met until 60 days after the policyholder or certificateholder is no
				longer on the payment plan. The application or enrollment form for those
				policies or certificates shall clearly indicate the payment plan selected by
				the applicant.
(3)
Lapse or
				termination for nonpayment of premium.
No individual long-term care
				policy or certificate may lapse or be terminated for nonpayment of premium
				unless the insurer, at least 30 days before the effective date of the lapse or
				termination, has given notice to the insured and to those persons designated
				under paragraph (1), at the address provided by the insured for purposes of
				receiving notice of lapse or termination. Notice shall be given by first class
				United States mail, postage prepaid; and notice may not be given until 30 days
				after a premium is due and unpaid. Notice shall be deemed to have been given as
				of 5 days after the date of mailing.