40-2136. Same; duties of issuers of long-term care partnership policies; exchange of certain long-term policies.
40-2136
40-2136. Same; duties of issuers of long-term carepartnership policies; exchange of certain long-term policies.Each issuer of qualified long-term care partnership programpolicies in thisstate shall: (a) Provide regular reports to both the secretary of the UnitedStates department of human services in accordance with federal law andregulations and to the Kansas health policy authority and the commissioner ofinsurance as provided in section 6021 of the federal deficit reduction act of2005, public law 109-171.
(b) Provide to consumers a notice explaining the benefits associated with apartnership policy and indicating that at the time issued, the policy is aqualified state long-term care insurance partnership policy at a time and in amanner to be determined by the commissioner of insurance.
(c) Submit a partnership certification form signed by an officer of thecompany with all policies submitted for certification as partnership policies.
(d) Obtain verification that producers receive training required by thecommissioner of insurance before a producer is permitted to sell, solicit ornegotiate the insurer's long-term care insurance products, maintain records ofcompliance, and make the verificationavailable to the commissioner of insurance upon request.
(e) Maintain records with respect to the training of its producers concerningthe distribution of its partnership policies that will allow the department ofinsurance to provide assurance to the Kansas health policy authority thatproducers have received the training required by the commissioner of insuranceand that producers have demonstrated an understanding of the partnershippolicies and their relationship to public and private coverage of long-termcare, including medical assistance in this state. These records shall bemaintained and made available to the commissioner of insurance upon request.
(f) (1) Offer, on a one time basis, in writing, to all existingpolicyholders that were issued long-term care coverage of the type certified bythe insurer on or after February 8, 2006, the option toexchange their existing long-term care coverage for coverage that is intendedto qualify underKansas' long-term care partnership program. The mandatory offer of an exchangeshall onlyapply to products issued by the insurer that are comparable to the type ofpolicy form, such asgroup policies and individual policies and on the policy series that thecompanyhas certified aspartnership qualified;
(2) the offer shall remain open for a minimum of 45 days from the date ofmailing by theinsurer;
(3) the offer shall be made on a nondiscriminatory basis without regard tothe age orhealth status of the insured. However, the insurer may underwrite if thepolicy is amended toprovide additional benefits or the exchange would require the issuance of a newpolicy. Anyportion of the policy that was issued prior to the exchange date shall bepriced based on thepolicyholder's age when the policy was originally issued. Any portion of thepolicy that is addedas a result of the exchange may be priced based on the policyholder's age atthe time of theexchange;
(4) if there is no change in coverage material to the risk, policiesexchanged under thisprovision shall not be subject to any medical underwriting;
(5) notwithstanding paragraphs (1) and (3), an insurer is not required tooffer an exchangeto an individual who is eligible for benefits within an elimination period, whois, or who has beenin claim status or who would not be eligible to apply for coverage due toissue age or plandesign limitations under the new policy. The insurer may require thatpolicyholders meet alleligibility requirements, including plan design, underwriting, if applicableand payment of therequired premium;
(6) policies issued pursuant to this section shall be considered exchangesand notreplacements and are not subject to K.A.R. 40-4-37i; and
(7) a policy received in an exchange after the effective date of thelong-termcare partnershipprogram act is treated as newly issued and is eligible for partnership policystatus. For purposesof applying the medicaid rules relating to Kansas' long-term care partnershipprogram, theaddition of a rider, endorsement or change in schedule page for a policy may betreated as givingrise to an exchange.
History: L. 2008, ch. 51, § 5;L. 2009, ch. 83, § 25; July 1.