SF 1040

1st Engrossment - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to insurance; regulating the sale of 
  1.3             long-term care insurance; amending Minnesota Statutes 
  1.4             1994, section 62A.49, subdivision 1; Minnesota 
  1.5             Statutes 1995 Supplement, sections 62A.46, subdivision 
  1.6             2; and 62A.48, subdivision 1. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1995 Supplement, section 
  1.9   62A.46, subdivision 2, is amended to read: 
  1.10     Subd. 2.  [LONG-TERM CARE POLICY.] "Long-term care policy" 
  1.11  means an individual or group policy, certificate, subscriber 
  1.12  contract, or other evidence of coverage that provides benefits 
  1.13  for prescribed long-term care, including nursing facility 
  1.14  services and or home care services, or both nursing facility 
  1.15  services and home care services, pursuant to the requirements of 
  1.16  sections 62A.46 to 62A.56.  
  1.17     Sections 62A.46, 62A.48, and 62A.52 to 62A.56 do not apply 
  1.18  to a long-term care policy issued to (a) an employer or 
  1.19  employers or to the trustee of a fund established by an employer 
  1.20  where only employees or retirees, and dependents of employees or 
  1.21  retirees, are eligible for coverage or (b) to a labor union or 
  1.22  similar employee organization.  The associations exempted from 
  1.23  the requirements of sections 62A.31 to 62A.44 under 62A.31, 
  1.24  subdivision 1, clause (c) shall not be subject to the provisions 
  1.25  of sections 62A.46 to 62A.56 until July 1, 1988. 
  1.26     Sec. 2.  Minnesota Statutes 1995 Supplement, section 
  2.1   62A.48, subdivision 1, is amended to read: 
  2.2      Subdivision 1.  [POLICY REQUIREMENTS.] No individual or 
  2.3   group policy, certificate, subscriber contract, or other 
  2.4   evidence of coverage of nursing home care or other long-term 
  2.5   care services shall be offered, issued, delivered, or renewed in 
  2.6   this state, whether or not the policy is issued in this state, 
  2.7   unless the policy is offered, issued, delivered, or renewed by a 
  2.8   qualified insurer and the policy satisfies the requirements of 
  2.9   sections 62A.46 to 62A.56.  A long-term care policy must cover 
  2.10  prescribed long-term care in nursing facilities and at least or 
  2.11  the prescribed long-term home care services in section 62A.46, 
  2.12  subdivision 4, clauses (1) to (5), provided by a home health 
  2.13  agency.  A long-term care policy may cover both prescribed 
  2.14  long-term care in nursing facilities and the prescribed 
  2.15  long-term home care services in section 62A.46, subdivision 4, 
  2.16  clauses (1) to (5), provided by a home health agency.  Coverage 
  2.17  under a long-term care policy must include:  a minimum lifetime 
  2.18  benefit limit of: 
  2.19     (1) at least $25,000; or 
  2.20     (2) not less than one year for services, and. 
  2.21  If the minimum lifetime benefit is stated as a specific time 
  2.22  period, the amount of time covered must be of a duration to 
  2.23  yield not less than $25,000 of coverage.  Nursing facility and 
  2.24  home care coverages under a long-term care policy must not be 
  2.25  subject to separate lifetime maximums for policies that cover 
  2.26  both nursing facility and home health care.  Prior 
  2.27  hospitalization may not be required under a long-term care 
  2.28  policy. 
  2.29     The policy must cover preexisting conditions during the 
  2.30  first six months of coverage if the insured was not diagnosed or 
  2.31  treated for the particular condition during the 90 days 
  2.32  immediately preceding the effective date of coverage.  Coverage 
  2.33  under the policy may include a waiting period of up to 90 days 
  2.34  before benefits are paid, but there must be no more than one 
  2.35  waiting period per benefit period; for purposes of this 
  2.36  sentence, "days" can mean calendar or benefit days.  If benefit 
  3.1   days are used, an appropriate premium reduction and disclosure 
  3.2   must be made.  No policy may exclude coverage for mental or 
  3.3   nervous disorders which have a demonstrable organic cause, such 
  3.4   as Alzheimer's and related dementias.  No policy may require the 
  3.5   insured to be homebound or house confined to receive home care 
  3.6   services.  The policy must include a provision that the plan 
  3.7   will not be canceled or renewal refused except on the grounds of 
  3.8   nonpayment of the premium, provided that the insurer may change 
  3.9   the premium rate on a class basis on any policy anniversary 
  3.10  date.  A provision that the policyholder may elect to have the 
  3.11  premium paid in full at age 65 by payment of a higher premium up 
  3.12  to age 65 may be offered.  A provision that the premium would be 
  3.13  waived during any period in which benefits are being paid to the 
  3.14  insured during confinement in a nursing facility must be 
  3.15  included.  A nongroup policyholder may return a policy within 30 
  3.16  days of its delivery and have the premium refunded in full, less 
  3.17  any benefits paid under the policy, if the policyholder is not 
  3.18  satisfied for any reason. 
  3.19     No individual long-term care policy shall be offered or 
  3.20  delivered in this state until the insurer has received from the 
  3.21  insured a written designation of at least one person, in 
  3.22  addition to the insured, who is to receive notice of 
  3.23  cancellation of the policy for nonpayment of premium.  The 
  3.24  insured has the right to designate up to a total of three 
  3.25  persons who are to receive the notice of cancellation, in 
  3.26  addition to the insured.  The form used for the written 
  3.27  designation must inform the insured that designation of one 
  3.28  person is required and that designation of up to two additional 
  3.29  persons is optional and must provide space clearly designated 
  3.30  for listing between one and three persons.  The designation 
  3.31  shall include each person's full name, home address, and 
  3.32  telephone number.  Each time an individual policy is renewed or 
  3.33  continued, the insurer shall notify the insured of the right to 
  3.34  change this written designation. 
  3.35     The insurer may file a policy form that utilizes a plan of 
  3.36  care prepared as provided under section 62A.46, subdivision 5, 
  4.1   clause (1) or (2). 
  4.2      Sec. 3.  Minnesota Statutes 1994, section 62A.49, 
  4.3   subdivision 1, is amended to read: 
  4.4      Subdivision 1.  [GENERALLY.] Section 62A.48 does not 
  4.5   prohibit the sale of policies, certificates, subscriber 
  4.6   contracts, or other evidences of coverage that provide home care 
  4.7   services only.  This does not, however, remove the requirement 
  4.8   that home care service benefits must be provided as part of a 
  4.9   long-term care policy pursuant to that section.  Home care 
  4.10  services only policies may be sold, provided that they meet the 
  4.11  requirements set forth in sections 62A.46 to 62A.56, except that 
  4.12  they do not have to meet those conditions that relate to 
  4.13  long-term care in nursing facilities.  Disclosures and 
  4.14  representations regarding these policies must be adjusted 
  4.15  accordingly to remove references to coverage for nursing home 
  4.16  care. 
  4.17     Sec. 4.  [EFFECTIVE DATE.] 
  4.18     Sections 1 to 3 are effective the day following final 
  4.19  enactment.