Except as otherwise specifically provided, this chapter applies to all long-term care insurance policies, contracts, subscriber agreements, riders and endorsements, and certificates, including qualified long-term care contracts and life insurance policies that accelerate benefits for long-term care, delivered or issued for delivery in this state on or after the effective date hereof, by insurers; fraternal benefit societies; nonprofit health, hospital and medical service corporations; prepaid health plans; health maintenance organizations and all similar organizations. Certain provisions of this chapter apply only to qualified long-term care insurance contracts as noted.

Additionally, this regulation is intended to apply to policies having indemnity benefits that are triggered by activities of daily living and sold as disability income insurance, if:

1. (1) The benefits of the disability income policy are dependent upon or vary in amount based on the receipt of long-term care services.
2. (2) The disability income policy is advertised, marketed or offered as insurance for long-term care services; or
3. (3) Benefits under the policy may commence after the policyholder has reached Social Security’s normal retirement age unless benefits are designed to replace lost income or pay for specific expenses other than long-term care services.

Author: Reyn Norman, Associate Counsel

Statutory Authority: Code of Ala. 1975, §§27-2-17, 27-19-100, et seq.

History: New Rule: June 14, 1991; effective October 1, 1991. Revised: August 16, 2000; effective January 1, 2001. Filed for codification in the Alabama Administrative Code by the Department of Insurance on January 17, 2003, pursuant to the Code of Ala. 1975, §27-7-43. Amended: Filed December 19, 2007. Filed with LRS December 19, 2007. Rule is not subject to the Alabama Administrative Procedure Act.