2606 POLICY PRACTICES AND PROVISIONS: DISCONTINUANCE AND REPLACEMENT

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2606

2606.1 If a group long-term care policy is replaced by another group long-term care policy issued to the same policyholder, the succeeding insurer shall offer coverage to all persons covered under the previous group policy on its date of termination. Coverage provided or offered to individuals by the succeeding insurer and premiums charged to persons under the new group policy shall not:

(a) Result in an exclusion for preexisting conditions that would have been covered under the group policy being replaced; or

(b) Vary or otherwise depend on the individual's health or disability status, claim experience, or use of long-term care services.

2606.2 The premium charged to an insured shall not increase due to either of the following:

(a) The increasing age of the insured at ages beyond sixty-five (65); or

(b) The duration the insured has been covered under the policy.

2606.3 The purchase of additional coverage shall not be considered a premium rate increase, but for the purposes of the calculation required under section 2639, the portion of the premium attributable to the additional coverage shall be added to and considered part of the initial annual premium.

2606.4 A reduction in benefits shall not be considered a premium change, but for the purposes of the calculation required under section 2639, the initial annual premium shall be based on the reduced benefits.

SOURCE: Final Rulemaking published at 52 DCR 10902 (December 16, 2005); as amended by Final Rulemaking published at 55 DCR 3759 (April 11, 2008).