NAC687B.081. Notification of availability of new series of contracts.

     1. The provisions of this section do not apply to a policy of life insurance or a rider or endorsement to a policy of life insurance that contains accelerated benefits for long-term care.

     2. Except as otherwise provided in subsections 3, 6 and 7, an insurer shall notify each policyholder or certificate holder of the availability of any new series of long-term care insurance contracts that provides material coverage for long-term care services or providers that was not previously available through the insurer to the general public, not later than 12 months after the date the new series of long-term care insurance contracts is made available for sale in this State.

     3. The notification required by subsection 2 is not required for any long-term care insurance contract or certificate issued:

     (a) Before October 1, 2008; or

     (b) To any policyholder or certificate holder who:

          (1) Is currently eligible for benefits;

          (2) Is within an elimination period;

          (3) Is on a claim;

          (4) Previously received benefits under the long-term care insurance contract or certificate; or

          (5) Is not eligible to apply for the new coverage because of limitations under the new long-term care insurance contract relating to the issue age of the insured.

     4. The insurer may require that the insured meet all eligibility requirements, including, without limitation, any underwriting requirements and payment of premiums to add any new coverage described in subsection 2.

     5. The insurer shall make any new coverage described in subsection 2 available:

     (a) By adding a rider or endorsement to the existing long-term care insurance contract and charging a separate premium for the rider or endorsement based on the attained age of the insured;

     (b) By exchanging the existing long-term care insurance contract or certificate for one with an issue age based on the present age of the insured and recognizing past insured status by granting premium credits toward the premiums for the new long-term care insurance contract or certificate based on premiums paid or reserves held for the previous long-term care insurance contract or certificate;

     (c) By exchanging the existing long-term care insurance contract or certificate for a new long-term care insurance contract or certificate in which:

          (1) Consideration for past insured status must be recognized by setting the premium for the new long-term care insurance contract or certificate at the issue age of the insured for the long-term care insurance contract or certificate being exchanged; and

          (2) The cost for the new long-term care insurance contract or certificate may recognize the difference in reserves between the new long-term care insurance contract or certificate and the original long-term care insurance contract or certificate; or

     (d) By an alternative program developed by the insurer and approved by the Commissioner.

     6. An insurer is not required to notify policyholders of a new proprietary long-term care insurance contract series created and filed for use in a limited distribution channel except that the insurer must notify any policyholder who purchases such a proprietary long-term care insurance contract when a new series of long-term care insurance contracts that provides material coverage for new long-term care services or providers is made available to that limited distribution channel. As used in this subsection, “limited distribution channel” means a discrete entity, including, without limitation, a financial institution or brokerage, through or for which specialized products are available that are not available for sale to the general public.

     7. If the new series of long-term care insurance contracts is offered through an employer, labor organization, or professional, trade or occupational association, the insurer is only required to provide notice to the offering entity unless the policy is issued to a group described in subsection 4 of NAC 687B.025, in which case notice must be provided to each certificate holder.

     8. A long-term care insurance contract or certificate issued pursuant to this section:

     (a) Shall be deemed an exchange; and

     (b) Is not subject to the provisions of NAC 687B.125 to 687B.135, inclusive.

     9. The provisions of this section do not prohibit an insurer from offering any policy, rider, endorsement, certificate or change in coverage to any policyholder or certificate holder. The insurer may require that policyholders meet all eligibility requirements of the offered policy, rider, endorsement, certificate or change in coverage, including underwriting and the payment of the required premium to add such new services or providers.

     10. Upon request, any policyholder or certificate holder may apply for any currently available coverage that includes any new services or providers described in subsection 2.

     (Added to NAC by Comm’r of Insurance by R121-07, 9-18-2008, eff. 10-1-2008; A by R028-10, 12-16-2010, eff. 10-1-2011)