NAC687B.125. Replacement of contract: Questions on applications.

Application forms for individual long-term care insurance contracts must include the following questions designed to elicit information as to whether the proposed long-term care insurance contract is intended to replace any other contract for accident and sickness or long-term care insurance contract presently in force:

TO BE COMPLETED BY THE APPLICANT

     1. Do you currently have another contract or certificate of long-term care insurance in force (including a contract for health care services or a contract with a health maintenance organization)?

     2. Have you had another contract or certificate of long-term care insurance in force during the last 12 months? If so, please answer questions (a) and (b).

     (a) With what company was your contract or certificate?

     (b) If your contract or certificate lapsed, when did it lapse?

     3. Do you currently have coverage under Medicaid?

     4. Do you intend to replace any of your current medical or health insurance coverage with this [contract] [certificate]?

TO BE COMPLETED BY THE AGENT

     1. Have you sold any other contract of health insurance to this applicant? If so, please answer questions 2 and 3.

     2. List each contract you have sold to the applicant that is still in force.

     3. List each contract you have sold to the applicant within the past 5 years that is no longer in force.

A supplementary application or other form to be signed by the applicant and, if the coverage is sold by an agent, the agent, containing such questions may be used. For a replacement long-term care insurance contract issued to a group described in subsection 1 of NAC 687B.025, the questions may be modified only to the extent necessary to elicit information about contracts for health insurance or long-term care insurance contracts other than the group long-term care insurance contract being replaced, if the certificate holder has been notified of the replacement.

     (Added to NAC by Comm’r of Insurance, eff. 11-21-88; A 12-15-94; R028-10, 12-16-2010, eff. 10-1-2011)