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  • PART I ADMINISTRATION OF THE GOVERNMENT
  • TITLE XXII CORPORATIONS
  • CHAPTER 176U LONG-TERM CARE INSURANCE
  • Section 7 Promulgation of rules and regulations; notice and hearing on rate increases

[Text of section applicable as provided by 2012, 312, Sec. 5.]

Section 7. (a) The commissioner shall promulgate rules and regulations, under chapter 30A which, at a minimum, shall be consistent with the standards set forth in the 2009 National Association of Insurance Commissioners Long-Term Care Model Regulation, including standards for:

(i) full and fair disclosure, setting forth the manner, content and required disclosures for the sale of long-term care insurance policies and certificates;

(ii) policy definitions and provisions, terms of renewability, initial and subsequent conditions of eligibility, benefit triggers, home health and community care benefits, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, limitations, exceptions, reductions, elimination and probationary periods, requirements for replacement and unintentional lapse protection;

(iii) the promotion of premium adequacy and protections for the policyholder or certificate holder in the event of a substantial rate increase and disclosure;

(iv) the offer of inflation and nonforfeiture coverage, including rules for a contingent benefit upon lapse;

(v) marketing practices and suitability and producer professional education; and

(vi) filing requirements, reporting practices and requirements, reserve standards, independent review of benefit determinations and penalties.

(b) The division of insurance shall update, on a biennial basis, the consumer guide for long-term insurance. The division shall maintain a list of insurance companies selling long-term care insurance in the commonwealth and their Massachusetts rate increase history for the preceding 10 years on its website.

(c) The commissioner shall, in the commissioner’s discretion and may, on motion of the attorney general, initiate a hearing on any long-term care insurance rate increase before its effective date after at least 10 days’ notice.