Rule 20:06:21:01.03 Long-term care insurance.
20:06:21:01.03. Long-term care insurance. The term,
long-term care insurance, includes group and individual annuities and life
insurance policies or riders that provide direct coverage or supplement
long-term care insurance. The term also includes a policy or rider that
provides for payment of benefits based upon cognitive impairment or the loss of
functional capacity. The term also includes qualified long-term care insurance
contracts. Long-term care insurance does not include any insurance policy that
is offered primarily to provide hospital confinement indemnity coverage, major
medical expense coverage, or disability income or related asset-protection
coverage. With regard to life insurance, this term does not include life
insurance policies that accelerate the death benefit specifically for one or
more of the qualifying events of terminal illness, medical conditions requiring
extraordinary medical intervention, or permanent institutional confinement, and
that provide the option of a lump-sum payment for those benefits, and where
neither the benefits nor the eligibility for the benefits is conditioned upon
the receipt of long-term care. However, any rider to a life insurance policy
that accelerates benefits and:
amount of the accelerated benefit is unrelated to the reimbursement of
long-term care services;
no separate premium for the rider; and
not marketed as long-term care insurance
is not subject to the requirements for long-term care
Notwithstanding any other provision of
SDCL chapter 58-17B, any product advertised, marketed, or offered as long-term care insurance or as an alternative to long-term care or nursing home insurance that conditions benefits based upon activities of daily living (ADLs) is subject to the provisions of chapter 20:06:21.
28 SDR 157, effective May 19, 2002; 32 SDR 203, effective June 5, 2006.
Authority: SDCL 58-17B-4.
Implemented: SDCL 58-17B-2.
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