§ 27-34.2-14 - Standards for marketing.
SECTION 27-34.2-14
§ 27-34.2-14 Standards for marketing.– (a) Every insurer, health care services plan, or other entity marketing longterm care insurance coverage in this state, directly or through its producers,shall:
(1) Establish marketing procedures to assure that anycomparison of policies by its agents or other insurance producers and agenttraining requirements will be fair and accurate;
(2) Establish marketing procedures to assure excessiveinsurance is not sold or issued;
(3) Display prominently by type, stamp or other appropriatemeans, on the first page of the outline of coverage and policy the following:
"Notice to buyer: This policy may not cover all of the costsassociated with long term care incurred by the buyer during the period ofcoverage. The buyer is advised to carefully review all policy limitations."
(4) Inquire and make every reasonable effort to identifywhether a prospective applicant or enrollee for long term care insurancealready has long term care insurance and the types and amounts of anyinsurance; and
(5) Every insurer or entity marketing long term careinsurance shall establish auditable procedures for verifying compliance withthis subsection.
(6) If the state in which the policy or certificate is to bedelivered or issued for delivery has a senior insurance counseling programapproved by the commissioner, the insurer shall, at solicitation, providewritten notice to the prospective policyholder and certificateholder that theprogram is available and the name, address and telephone number of the program.
(7) For long-term care health insurance policies andcertificates, use the terms "noncancellable" or "level premium" only when thepolicy or certificate conforms to § 6A(3) of this regulation.
(8) Provide an explanation of contingent benefit upon lapseand, if applicable, the additional contingent benefit upon lapse provided topolicies with fixed or limited premium paying periods.
(b) In addition to the practices prohibited in chapter 29 ofthis title, the following acts and practices are prohibited:
(1) Twisting. Knowingly making any misleadingrepresentation or incomplete or fraudulent comparison of any insurance policiesor insurers for the purpose of inducing, or tending to induce, any person tolapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on orconvert any insurance policy or to take out a policy of insurance with anotherinsurer;
(2) High pressure tactics. Employing any method ofmarketing having the effect of or tending to induce the purchase of insurancethrough force, fright, threat, whether explicit or implied, or undue pressureto purchase or recommend the purchase of insurance; and
(3) Cold lead advertising. Making use directly orindirectly of any method of marketing which fails to disclose in a conspicuousmanner that a purpose of the method of marketing is solicitation of insuranceand that contact will be made by an insurance producer or insurance company.
(4) Misrepresentation of a material fact when selling oroffering to sell a long-term care insurance policy.
(c) With respect to the obligations set forth in thissection, the primary responsibility of an association as described in §27-34.2-4(4)(ii), when endorsing or selling long term care insurance shall beto educate its members concerning long term care issued in general so that itsmembers can make informed decisions. Associations shall provide objectiveinformation regarding long term care insurance policies or certificatesendorsed or sold by those associations to ensure that members of theassociations are fully informed of the benefits and limitations in the policiesor certificates that are being endorsed or sold.
(d) The insurer shall file with the insurance department thefollowing material:
(1) The policy and certificate;
(2) A corresponding outline of coverage; and
(3) All advertisements requested by the insurance department.
(e) The association shall disclose in any long term careinsurance solicitation:
(1) The specific nature and amount of the compensationarrangements, including all fees, commissions, administrative fees and otherforms of financial support, that the association receives from endorsement orsale of the policy or certificate to its members; and
(2) A brief description or outline of the process under whichthe policies and the insurer issuing the policies were selected.
(f) If the association and the insurer have interlockingdirectories or trustee arrangements, the association shall disclose that factto its members.
(g) The board of directors of associations selling orendorsing long term care insurance policies or certificates shall review andapprove the insurance policies as well as the compensation arrangements madewith the insurer.
(h) The association shall also:
(1) At the time of the association's decision to endorse,engage the services of a person with expertise in long term care insurance notaffiliated with the insurer to conduct an examination of the policies,including benefits, features, and rates and update the examination thereafterin the event of material change.
(2) Actively monitor the marketing efforts of the insurer andits insurance producers; and
(3) Review and approve all marketing materials or otherinsurance communications used to promote sales or sent to members regarding thepolicies or certificates.
(4) Subdivisions (h)(1), (h)(2) and (h)(3) shall not apply toqualified long-term care insurance contracts.
(i) No group long term care insurance policy or certificatemay be issued to an association unless the insurer files with the director theinformation required in this section.
(j) The insurer shall not issue a long term care policy orcertificate to an association or continue to market the policy or certificateunless the insurer certifies annually that the association has complied withthe requirements set forth in this section.