Ga. Comp. R. & Regs. R. 120-2-16-.13 - Requirement to Offer Inflation Protection
(1) No insurer may offer a long-term care
insurance policy unless the insurer also offers to the policyholder in addition
to any other inflation protection the option to purchase a policy that provides
for benefit levels to increase with benefit maximums or reasonable durations
which are meaningful to account for reasonably anticipated increases in the
costs of long-term care services covered by the policy. Insurers must offer to
each policyholder, at the time of purchase, the option to purchase a policy
with an inflation protection feature no less favorable than one of the
following:
(a) Increases benefit levels
annually in a manner so that the increases are compounded annually at a rate
not less than five percent (5%);
(b) Guarantees the insured individual the
right to periodically increase benefit levels without providing evidence of
insurability or health status so long as the option for the previous period has
not been declined. The amount of the additional benefit shall be no less than
the difference between the existing policy benefit and that benefit compounded
annually at a rate of at least five percent (5%) for the period beginning with
the purchase of the existing benefit and extending until the year in which the
offer is made; or
(c) Covers a
specified percentage of actual or reasonable charges and does not include a
maximum specified indemnity amount or limit.
(2) Where the policy is issued to a group,
the required offer in subsection (1) above shall be made to the group
policyholder; except, if the policy is issued to a group defined in O.C.G.A.
Section 33-42-4other than to a continuing
care retirement community, the offering shall be made to each proposed
certificateholder.
(3) The offer in
subsection (1) above shall not be required of life insurance policies or riders
containing accelerated long-term care benefits.
(4)
(a)
Insurers shall include the following information in or with the outline of
coverage:
(i) A graphic comparison of the
benefit levels of a policy that increases benefits over the policy period with
a policy that does not increase benefits. The graphic comparison shall show
benefit levels over at least a 20 year period.
(ii) Any expected premium increases or
additional premiums to pay for automatic or optional benefit
increases.
(b) An
insurer may use a reasonable hypothetical, or a graphic demonstration, for the
purposes of this disclosure.
(5) Inflation protection benefit increases
under a policy which contains these benefits shall continue without regard to
an insured's age, claim status or claim history, or the length of time the
person has been insured under the policy.
(6) An offer of inflation protection that
provides for automatic benefit increases shall include an offer of a premium
which the insurer expects to remain constant. The offer shall disclose in a
conspicuous manner that the premium may change in the future unless the premium
is guaranteed to remain constant.
(7)
(a)
Inflation protection as provided in paragraph (1)(a) of this section shall be
included in a long-term care insurance policy unless an insurer obtains a
rejection of inflation protection signed by the policyholder as required in
this subsection. The rejection may be either in the application or on a
separate form.
(b) The rejection
shall be considered a part of the application and shall state:
I have reviewed the outline of coverage and the graphs that compare the benefits and premiums of this policy with and without inflation protection. Specifically, I have reviewed Plans ______, and I reject inflation protection.
Notes
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