-
Consistent Terminology: Policies now uniformly use the term “long-term care services,” ensuring clear understanding for consumers and insurers.
-
Family Coverage Protections: Supplemental policies cannot exclude qualified family members, offering broader coverage for dependents.
-
Eligibility Verification: Insurance producers may confirm applicants’ eligibility and premium payment status through self-attestation, simplifying the process.
-
Rider Options: Accelerated death benefit riders are permitted for both supplemental and traditional long-term care insurance, providing flexibility for policyholders.
-
Benefit Dispute Rules: Appeals of benefit decisions are separated from continuity-of-care reviews, which are limited to specific coverage disputes.
Consumer Protections
The new rules also place a strong emphasis on consumer education and protection. Insurance companies are required to provide a dedicated Consumer’s Guide to Supplemental Long-Term Care Insurance to all applicants. This guide is separate from the existing guide for traditional long-term care policies and helps residents make informed decisions about coverage.
Additionally, policies must include inflation protection, allowing either a fixed 3% annual increase or an adjustment linked to the Seattle-area consumer price index for urban wage earners and clerical workers. These measures help ensure that benefits maintain their value over time.
