Issuers and their agents, if any, must determine whether issuing long-term care insurance coverage to a particular person is appropriate, except in the case of a life insurance policy that accelerates benefits for long-term care.
(1) An issuer must:
- (a) Develop and use suitability standards to determine whether the purchase or replacement of long-term care coverage is appropriate for the needs of the applicant or insured;
- (b) Train its agents in the use of the issuer's suitability standards; and
- (c) Maintain a copy of its suitability standards and make the standards available for inspection, upon request.
(2) The following must be considered when determining whether the applicant meets the issuer's suitability standards:
- (a) The ability of the applicant to pay for the proposed coverage and any other relevant financial information related to the purchase of or payment for coverage;
- (b) The applicant's goals and needs with respect to long-term care and the advantages and disadvantages of long-term care coverage to meet those goals or needs; and
- (c) The values, benefits, and costs of the applicant's existing health or long-term care coverage, if any, when compared to the values, benefits, and costs of the recommended purchase or replacement.
- (3) The sale or transfer of any suitability information provided to the issuer or agent by the applicant to any other person or business entity is prohibited.
(4)
- (a) The commissioner shall adopt, by rule, forms of consumer-friendly personal worksheets that issuers and their agents must use for applications for long-term care coverage.
- (b) The commissioner may require each issuer to file its current forms of suitability standards and personal worksheets with the commissioner.
[ 2008 c 145 s 15.]