Weekly Tip: Long-Term Care Filings

 

Weekly Tips

Long-Term Care Filings

6/12/2013

In this week's Weekly Tip, we want to remind you about a few important items as you are preparing your long-term care product for IIPRC review and approval.

When you are drafting the Definitions for your long-term care product, please remember that the definitions for providers of services, i.e.: "skilled nursing facility," "convalescent nursing home," and "personal care facility," must have three (3) parts. The three (3) parts are when the state requires they be licensed/certified; when the state does NOT require licensing; and when the state calls it a different name it is still covered. See Section 3.I.2 of the Core Standards for Individual Long-Term Care Insurance Policies, IIPRC-LTC-I-3-CORE.

The Uniform Standards require that the application provide an option for home health care benefits at 100% of nursing home benefits and the policy must provide home health care benefits equal to at least one-half of nursing home benefits. See Section 4.D of the Individual Long-Term Care Insurance Application Standards, IIPRC-LTC-I-3-APP, and Section 3.O of the Core Standards for Individual Long-Term Care Insurance Policies, IIPRC-LTC-I-3-CORE.

Be mindful that the only Limitations and Exclusions allowed are those shown in Section 3.R. of the LTC Core Standards. This means that mental and nervous disorders are covered. The Uniform Standards say benefits may not be limited or excluded by type of illness. Also remember that the benefit payments cannot be limited if the insured has more than one policy.

In addition to reviewing the long-term care Uniform Standards, do not forget to take a look at the Filing Information Notices (FINS) on the IIPRC website. FIN 2013-2 was drafted for the purpose of providing additional guidance with the submission of long-term care product filings.

Want to learn more tips to make your long-term care product filing submission smoother, it is not too late to sign up and participate in our webinar on Thursday, June 13th at 2 pm ET / 1 pm CT / 12 pm MT / 11 am PT. More information may be found on the Event Calendar located on the IIPRC website.