WSR 08-09-131




[ Insurance Commissioner Matter No. R 2008-09 -- Filed April 23, 2008, 8:19 a.m. ]

     Subject of Possible Rule Making: Adoption of long-term care rules, as required by recently enacted legislation. It is planned that this state's rules will mirror the NAIC model long-term care model regulation, plus some state-specific rules, as required by the legislation. The rules will be effective January 1, 2009 (the same effective date as the long-term care legislation).

     Statutes Authorizing the Agency to Adopt Rules on this Subject: Sections 12, 13, 14, 15, and 18, chapter 145, Laws of 2008.

     Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: These rules will establish standards for long-term care insurance, including rules to:

Establish loss ratio standards for long-term care insurance policies.
Prescribe a standard format including style, arrangement, overall appearance, and the content of an outline of coverage.
Establish minimum standards for inflation protection features.
Specify the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies and certificates, the standards for nonforfeiture benefits, and the rules regarding contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse will be available and the substantial premium rate increase that triggers a contingent benefit upon lapse.
Promote premium adequacy and to protect policyholders in the event of proposed substantial rate increases, and to establish minimum standards for producer education, marketing practices, producer compensation, producer testing, penalties, and reporting practices for long-term care insurance.
Establish standards to protect patient privacy rights, rights to receive confidential health care services, and standards for an issuer's timely review of a claim denial upon request of a covered person.
Establish standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms.

     Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.

     Process for Developing New Rule: Submit written comments by May 30, 2008, to Kacy Scott, P.O. Box 40255, Olympia, WA 98504-0255, fax (360) 586-3109, e-mail

     Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kacy Scott, P.O. Box 40255, Olympia, WA 98504-0255, fax (360) 586-3109, e-mail

April 23, 2008

Mike Kreidler

Insurance Commissioner

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