NAC687B.030. “Long-term care insurance” defined.  


Latest version.
  •      1. “Long-term care insurance” means any group or individual insurance advertised, marketed, offered or designed to provide coverage for not less than 12 consecutive months for each person covered by the insurance on an expense-incurred, indemnity, prepaid or other basis, for necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance or personal care services provided in a setting other than an acute care unit of a hospital.

         2. The term includes insurance that provides for payment of benefits based upon cognitive impairment or the loss of functional capacity.

         3. The term does not include insurance which is offered primarily to provide:

         (a) Basic coverage to supplement Medicare;

         (b) Basic coverage for hospital expenses;

         (c) Basic coverage for medical-surgical expenses;

         (d) Indemnity coverage for confinement in a hospital;

         (e) Coverage for major medical expenses;

         (f) Coverage to protect income received for or to protect assets in the event of a disability, unless the conditions set forth in paragraph (b) of subsection 6 of NAC 687B.035 are met;

         (g) Coverage for accidents only;

         (h) Coverage for specified diseases or accidents; or

         (i) Limited benefit health coverage.

         4. The term does not include a life insurance policy that:

         (a) Accelerates the death benefit specifically for one or more of the following qualifying events:

              (1) Terminal illness;

              (2) Medical conditions requiring extraordinary medical intervention; or

              (3) Medical conditions requiring permanent institutional confinement; and

         (b) Provides the option of a lump-sum payment for those benefits where neither the benefits nor the eligibility for the benefits is conditioned upon the receipt of long-term care.

     (Added to NAC by Comm’r of Insurance, eff. 11-21-88; A by R028-10, 12-16-2010, eff. 10-1-2011)