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23-97-312. Outline of coverage.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-97-312. Outline of coverage.
(a)(1) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the outline of coverage and its purpose.
(2) The Insurance Commissioner shall prescribe a standard format for the outline, including style, arrangement, overall appearance, and content.
(3) In the case of agent solicitations, an agent shall deliver the outline of coverage prior to the presentation of an application or enrollment form.
(4) In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form.
(5)(A) In the case of a policy issued to a group approved by the commissioner under § 23-97-304(6)(B), an outline of coverage shall not be required to be delivered if the information described in subsection (b) of this section is provided to applicants in other materials relating to enrollment.
(B) Materials relating to enrollment shall be made available to the commissioner upon request.
(b) The outline of coverage shall include:
(1) A description of the principal benefits and coverage provided in the policy;
(2) A statement of the principal exclusions, reductions, and limitations contained in the policy;
(3)(A) A statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premium.
(B) Continuation or conversion provisions of group coverage shall be specifically described;
(4) A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains g
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-97-312
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. A text match is a research starting point; applicability is not established.
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Record provenance
Stable record: arkansas_code:legal_authorities:23-97-312
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: 5aa4a9ad432593b12697deb746a89316a030d0f1afe56e252afc9201bc27581d
Source location: content.xml paragraph 57989
Stored source content
23-97-312. Outline of coverage.
(a)(1) An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the outline of coverage and its purpose.
(2) The Insurance Commissioner shall prescribe a standard format for the outline, including style, arrangement, overall appearance, and content.
(3) In the case of agent solicitations, an agent shall deliver the outline of coverage prior to the presentation of an application or enrollment form.
(4) In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form.
(5)(A) In the case of a policy issued to a group approved by the commissioner under § 23-97-304(6)(B), an outline of coverage shall not be required to be delivered if the information described in subsection (b) of this section is provided to applicants in other materials relating to enrollment.
(B) Materials relating to enrollment shall be made available to the commissioner upon request.
(b) The outline of coverage shall include:
(1) A description of the principal benefits and coverage provided in the policy;
(2) A statement of the principal exclusions, reductions, and limitations contained in the policy;
(3)(A) A statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premium.
(B) Continuation or conversion provisions of group coverage shall be specifically described;
(4) A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions;
(5) A description of the terms under which the policy or certificate may be returned and premium refunded;
(6) A brief description of the relationship between cost of care and benefits; and
(7) A statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract under section 7702B(b) of the Internal Revenue Code of 1986.
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Arkansas Code — all titles (historical 2020) · legal_authorities
23-97-304. Definitions.
As used in this subchapter:
(1) “Applicant” means:
(A) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and
(B) In the case of a group long-term care insurance policy, the proposed certificate holder;
(2) “Association” means a professional, trade, or occupational association or associations, if the association:
(A) Is composed entirely of individuals that are or were actively engaged in the same profession, trade, or occupation; and
(B) Has been maintained in good faith for purposes other than obtaining insurance;
(3) “Certificate” means any certificate issued under a group long-term care insurance policy delivered or issued for delivery in this state;
(4) “Commissioner” means the Insurance Commissioner;
(5) “Federally tax-qualified long-term care insurance contract” means:
(A) An individual or group insurance contract that meets the following requirements of section 7702B(b) of the Internal Revenue Code of 1986:
(i)(a) The only insurance protection provided under the contract is coverage of qualified long-term care services.
(b) A contract satisfies the requirements of this subdivision (5)(A)(i) even though payments are made on a per diem or other periodic basis without regard to the expenses incurred during the period to which the payments relate;
(ii)(a) The contract does not pay or reimburse expenses incurred for services or items to the extent that the expenses:
(1) Are reimbursable under Title XVIII of the Social Security Act; or
(2) Would be reimbursable but for the application of a deductible or coinsurance amount.
(b) The requirements of this subdivision (5)(A)(ii) do not apply to expenses that are reimbursable under Title XVIII of the Social Sec
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-97-304
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. The source passage cites 23-97-304. This identifies an authority to review, not proof of applicability.