BILL REQ. #:  H-0450.2 

Read first time 01/10/2007.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to long-term care insurance; amending RCW 48.84.020 and 48.84.040; and adding a new section to chapter 48.84 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 48.84 RCW to read as follows:
     The legislature intends that Washington state become qualified to participate in the long-term care partnership program as authorized in the federal deficit reduction act of 2005, P.L. 109-171, now or as hereafter amended. The commissioner may adopt by rule the provisions of the national association of insurance commissioners model long-term care act and model long-term care regulation that are required by the federal deficit reduction act of 2005, Public Law 109-171, or other federal requirements, to allow for the expansion of qualified long-term care insurance partnership programs in Washington.

Sec. 2   RCW 48.84.020 and 1986 c 170 s 2 are each amended to read as follows:
     Unless the context requires otherwise, the definitions in this section apply throughout this chapter.
     (1) "Long-term care insurance" or "long-term care benefit contract" means any insurance policy or benefit contract primarily advertised, marketed, offered, or designed to provide coverage or services for either institutional or community-based convalescent, custodial, chronic, or terminally ill care. Such terms do not include and this chapter shall not apply to policies or contracts governed by chapter 48.66 RCW and continuing care retirement communities.
     (2) "Loss ratio" means the incurred claims plus or minus the increase or decrease in reserves as a percentage of the earned premiums, or the projected incurred claims plus or minus the increase or decrease in projected reserves as a percentage of projected earned premiums, as defined by the commissioner.
     (3) "Preexisting condition" means a ((covered person's medical condition that caused that person to have received medical advice or treatment during the specified time period before the effective date of coverage)) condition for which medical advice or treatment was recommended by, or received from, a provider of health care services within six months preceding the effective date of coverage of an insured person.
     (4) "Medicare" means Title XVIII of the United States social security act, or its successor program.
     (5) "Medicaid" means Title XIX of the United States social security act, or its successor program.
     (6) "Nursing home" means a nursing home as defined in RCW 18.51.010.

Sec. 3   RCW 48.84.040 and 1986 c 170 s 4 are each amended to read as follows:
     No long-term care insurance policy or benefit contract may:
     (1) Use riders, waivers, endorsements, or any similar method to limit or reduce coverage or benefits;
     (2) Indemnify against losses resulting from sickness on a different basis than losses resulting from accidents;
     (3) Be canceled, nonrenewed, or segregated at the time of rerating solely on the grounds of the age or the deterioration of the mental or physical health of the covered person;
     (4) Exclude or limit coverage for preexisting conditions for a period of more than ((one year)) six months prior to the effective date of the policy or contract or more than six months after the effective date of the policy or contract;
     (5) Differentiate benefit amounts on the basis of the type or level of nursing home care provided;
     (6) Contain a provision establishing any new waiting period in the event an existing policy or contract is converted to a new or other form within the same company.