Session Law

Identifying Information:L. 2002 ch. 168
Other Identifying Information:2002 Senate Bill 586
Tax Type:Other
Brief Description:An Act concerning long-term care insurance; relating to restrictions on elimination periods; amending K.S.A. 40-2228 and repealing the existing section.
Keywords:


Body:

CHAPTER 168

SENATE BILL No. 586


An Act concerning long-term care insurance; relating to restrictions on elimination periods;

amending K.S.A. 40-2228 and repealing the existing section.

Be it enacted by the Legislature of the State of Kansas:

Section 1. K.S.A. 40-2228 is hereby amended to read as follows: 40-

2228. (a) The commissioner may adopt reasonable rules and regulations:

(1) To establish specific standards for policy provisions of long-term

care insurance policies. Such standards shall be in addition to and in

accordance with applicable laws of this state, and shall address terms of

renewability, initial and subsequent conditions of eligibility, nonduplica-

tion of coverage provisions, coverage of dependents, preexisting condi-

tions, termination of insurance, probationary periods, limitations, excep-

tions, reductions, elimination periods, requirements for replacement,

recurrent conditions and definitions of terms, except that no regulation

shall limit the number of days contained in an elimination period of con-

finement in a nursing facility or for all confinements in a nursing facility

which are due to the same or related causes and separated from each

other by less than 180 days; and

(2) to specify prohibited policy provisions not otherwise specifically

authorized by statute which, in the opinion of the commissioner, are un-

just, unfair or unfairly discriminatory to any person insured under a long-

term care insurance policy.

(b) Rules and regulations adopted by the commissioner shall:

(1) Recognize the unique, developing and experimental nature of

long-term care insurance; and

(2) recognize the appropriate distinctions necessary between group

and individual long-term care insurance policies.

(c) The commissioner may adopt rules and regulations establishing

loss-ratio standards for long-term care insurance policies if a specific ref-

erence to long-term care insurance policies is contained in the rules and

regulations.

(d) No long-term care insurance policy may:

(1) Be canceled, nonrenewed, or otherwise terminated solely on the

grounds of the age or the deterioration of the mental or physical health

of the insured individual or certificateholder; or

(2) contain a provision establishing any new waiting period in the

event existing coverage is converted to or replaced by a new or other form

within the same company, except with respect to an increase in benefits

voluntarily selected by the insured individual or group policyholder.

(e) (1) No long-term insurance policy or certificate shall use a defi-

nition of preexisting condition which is more restrictive than the follow-

ing: ``Preexisting condition'' means a condition for which medical advice

or treatment was recommended by, or received from a provider of health

care services, within six months preceding the effective date of coverage

of an insured person.

(2) No long-term care insurance policy shall exclude coverage for a

loss or confinement which is the result of a preexisting condition unless

such loss or confinement begins within six months following the effective

date of coverage of an insured person.

(3) The commissioner may extend the limitation periods set forth in

subsections (e)(1) and (e)(2) above as to specific age group categories or

specific policy forms upon finding that the extension is not contrary to

the best interest of the public.

(4) The definition of preexisting condition shall not prohibit an in-

surer from using an application form designed to elicit the complete

health history of an applicant, and, on the basis of the answers on that

application, from underwriting in accordance with that insurer's estab-

lished underwriting standards.

(f) No long-term care insurance policy shall require prior institution-

alization as a condition precedent to the payment of benefits.

(g) In order to provide for fair disclosure in the sale of long-term care

insurance policies:

(1) An outline of coverage shall be delivered to an applicant for a

long-term care insurance policy at the time of application. In the case of

direct response solicitations, the insurer shall deliver the outline of cov-

erage upon the applicant's request, but regardless of request, shall make

such delivery no later than at the time of policy delivery. Such outline of

coverage shall include:

(A) A description of the principal benefits and coverage provided in

the policy;

(B) a statement of the principal exclusions, reductions and limitations

contained in the policy;

(C) a statement of the renewal provisions, including any reservation

in the policy of a right to change premiums; and

(D) a statement that the outline of coverage is a summary of the

policy issued or applied for, and that the policy should be consulted to

determine governing contractual provisions.

(2) A certificate issued pursuant to a group long-term care insurance

policy which policy is delivered or issued for delivery in this state shall

include the information required by subsection (g)(4) of K.S.A. 40-2209,

and amendments thereto.

(h) No policy shall be advertised, marketed or offered as long-term

care insurance unless it complies with the provisions of this act.

Sec. 2. K.S.A. 40-2228 is hereby repealed.

Sec. 3. This act shall take effect and be in force from and after its

publication in the statute book.

Approved May 29, 2002.


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Date Composed: 10/10/2002 Date Modified: 10/10/2002