<html> <head> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <title>Rule 20:06:21 LONG-TERM CARE INSURANCE</title> <META NAME="Keywords" Content="Administrative Rules 20:06:21"> <META NAME="Description" Content="Administrative Rules 20:06:21 LONG-TERM CARE INSURANCE"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p align=center><b>CHAPTER 20:06:21</b></p> <p align=center><b>LONG-TERM CARE INSURANCE</b></p> <p>Section</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01">20:06:21:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Definitions.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01.01">20:06:21:01.01</a>&nbsp;&nbsp; Nature of care -- How defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01.02">20:06:21:01.02</a>&nbsp;&nbsp; Service providers -- How defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01.03">20:06:21:01.03</a>&nbsp;&nbsp; Long-term care insurance.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01.04">20:06:21:01.04</a>&nbsp;&nbsp; Similar policy forms.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01.05">20:06:21:01.05</a>&nbsp;&nbsp; Treatment of accelerated benefits in life insurance.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:01.06">20:06:21:01.06</a>&nbsp;&nbsp; Claim and clean claim -- Defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:02">20:06:21:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Minimum standards for long-term care insurance policies.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:02.01">20:06:21:02.01</a>&nbsp;&nbsp; Annuity policies with long-term care benefits subject to waiting period.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:03">20:06:21:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Renewability of group policies -- Required disclosures.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:04">20:06:21:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Permissible exclusions from coverage.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:05">20:06:21:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Loss ratios.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:05.01">20:06:21:05.01</a>&nbsp;&nbsp; Relation of benefits to premium for accelerated death benefit on life insurance.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:06">20:06:21:06</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Cost-of-living adjustments -- Basis.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:06.01">20:06:21:06.01</a>&nbsp;&nbsp; Cost-of-living adjustments -- Minimum standards.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:06.02">20:06:21:06.02</a>&nbsp;&nbsp; Group cost-of-living adjustments -- Exceptions.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:06.03">20:06:21:06.03</a>&nbsp;&nbsp; Cost-of-living adjustments -- Continuation of benefit increases.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:06.04">20:06:21:06.04</a>&nbsp;&nbsp; Cost-of-living adjustments -- Automatic increases -- Conspicuous offer of constant premium.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:06.05">20:06:21:06.05</a>&nbsp;&nbsp; Cost-of-living adjustments -- Rejection by policyholder.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:07">20:06:21:07</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Applicability of rules to long-term care insurance riders.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:08">20:06:21:08</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &quot;Medically necessary&quot; defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:09">20:06:21:09</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Basis for conversion of coverage from group defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:10">20:06:21:10</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:11">20:06:21:11</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group -- Time allowed for written application.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:12">20:06:21:12</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group -- Calculation of policy premium.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:13">20:06:21:13</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Continuation or conversion is mandatory -- Exceptions.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:14">20:06:21:14</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group to individual -- Reduction of benefits -- Exception.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:15">20:06:21:15</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group -- Benefits payable.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:16">20:06:21:16</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group -- Eligibility for coverage of relatives.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:17">20:06:21:17</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Converted policy from group -- Managed care plan defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:18">20:06:21:18</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Discontinuance and replacement of a group policy.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:19">20:06:21:19</a>&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; Premium increase prohibitions.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:20">20:06:21:20</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lapse or termination notice required.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:21">20:06:21:21</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lapse or termination for payment through payroll or pension deduction plan.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:22">20:06:21:22</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lapse or termination for nonpayment of premium.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:23">20:06:21:23</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure of renewability.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:24">20:06:21:24</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure of payment of benefits based on certain standards.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:25">20:06:21:25</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure of limitations on preexisting conditions.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:26">20:06:21:26</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure of other limitations or conditions on eligibility for benefits.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:26.01">20:06:21:26.01</a>&nbsp;&nbsp; Notice to claimants -- Temporary leave.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:27">20:06:21:27</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Outline of coverage.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:28">20:06:21:28</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Outline of coverage -- Standard format.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:28.01">20:06:21:28.01</a>&nbsp;&nbsp; Applications -- Questions about replacement.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:29">20:06:21:29</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Replacement notices.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:30">20:06:21:30</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Filing requirements for advertising -- Exemption.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:31">20:06:21:31</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Standards for marketing -- Requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:32">20:06:21:32</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Standards for marketing -- Prohibited practices.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:33">20:06:21:33</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Standards for marketing -- Associations.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:34">20:06:21:34</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Extension of benefits.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:35">20:06:21:35</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Basis for continuation or conversion from group coverage required.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:36">20:06:21:36</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Basis for continuation of coverage from group defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:37">20:06:21:37</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reinstatement.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:38">20:06:21:38</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure of riders and endorsements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:39">20:06:21:39</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure of tax consequences.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:40">20:06:21:40</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Applications -- Health and medication questions.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:41">20:06:21:41</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Applications -- Notice about incorrect answers.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:42">20:06:21:42</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Policies -- Notice about incorrect answers on applications.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:43">20:06:21:43</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Elderly applicants -- Required information.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:44">20:06:21:44</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Applications -- Delivery.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:44.01">20:06:21:44.01</a>&nbsp;&nbsp; Repealed.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:45">20:06:21:45</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Records of rescissions -- Maintaining and filing records.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:46">20:06:21:46</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Minimum standards for home health and community care benefits.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:47">20:06:21:47</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Policy summary for individual life insurance policy containing long-term care benefits.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:48">20:06:21:48</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Monthly report to policyholder.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:49">20:06:21:49</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Incontestability period.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:50">20:06:21:50</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Assisted living center or facility defined.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:51">20:06:21:51</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Assisted living centers -- Minimum benefit standards.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:52">20:06:21:52</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reporting requirements for insurers.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:53">20:06:21:53</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Appropriateness of recommended purchase or replacement.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:53.01">20:06:21:53.01</a>&nbsp;&nbsp; Suitability standards.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:53.02">20:06:21:53.02</a>&nbsp;&nbsp; Suitability -- Long-term care insurance personal worksheet.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:53.03">20:06:21:53.03</a>&nbsp;&nbsp; Suitability -- Response letter.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:53.04">20:06:21:53.04</a>&nbsp;&nbsp; Suitability -- Policies not included.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:53.05">20:06:21:53.05</a>&nbsp;&nbsp; Suitability -- Overinsurance.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:54">20:06:21:54</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Requirement to deliver shopper's guide.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:55">20:06:21:55</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Standards for benefit triggers.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:56">20:06:21:56</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Additional standards for benefit triggers for qualified long-term care insurance contracts.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:57">20:06:21:57</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nonforfeiture benefits.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:58">20:06:21:58</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nonforfeiture benefit requirement.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:59">20:06:21:59</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Electronic enrollment for group policies.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:60">20:06:21:60</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Required disclosure of rating practices to consumers -- Rate stabilization.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:61">20:06:21:61</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Initial filing requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:62">20:06:21:62</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reserve standards.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:63">20:06:21:63</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Notice of pending increase.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:64">20:06:21:64</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increase requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:65">20:06:21:65</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Review by the director</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:66">20:06:21:66</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Adverse lapsation.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:67">20:06:21:67</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Policies to which does not apply.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:68">20:06:21:68</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Group insurance policies.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:69">20:06:21:69</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Adoption of rules.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:70">20:06:21:70</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Premium rate schedule increases -- Exceptional increases.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:71">20:06:21:71</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Permitted compensation arrangements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:72">20:06:21:72</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Disclosure to applicant for a claim denial.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:73">20:06:21:73</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Providers in a different state.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:74">20:06:21:74</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Agent training required to market long-term care plans.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:75">20:06:21:75</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Insurers required to verify agent training and maintain records.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:76">20:06:21:76</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Long-term care partnership policies -- Inflation protection requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:77">20:06:21:77</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Long-term care partnership policies -- Required policy disclosures.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:78">20:06:21:78</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Long-term care partnership policies -- Filing requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:79">20:06:21:79</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Long-term care -- Minimum benefit requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:80">20:06:21:80</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Long-term care partnership policies -- Policy amendments.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:81">20:06:21:81</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Long-term care policies -- Policy amendments.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:82">20:06:21:82</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Availability of new services or providers.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:83">20:06:21:83</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Policies issued considered exchanges.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:84">20:06:21:84</a>&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; Policies offered through employers, labor unions, and associations.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:85">20:06:21:85</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Applicability of new provider or service requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:86">20:06:21:86</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Right to reduce coverage and lower premiums.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:87">20:06:21:87</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Authorized representative.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:88">20:06:21:88</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Notice to insured.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:89">20:06:21:89</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Internal appeal.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:90">20:06:21:90</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Internal appeal notice requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:91">20:06:21:91</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Independent review of benefit trigger determination.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:92">20:06:21:92</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Independent review process.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:93">20:06:21:93</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Additional appeal information.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:94">20:06:21:94</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Independent review notification.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:95">20:06:21:95</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Independent review organization selection.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:96">20:06:21:96</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Review of information.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:97">20:06:21:97</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Additional information to independent review.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:98">20:06:21:98</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Process if determination overturned.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:99">20:06:21:99</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Review decision requirements.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:100">20:06:21:100</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Acceptance of state certification.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:101">20:06:21:101</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Certification of long-term care insurance independent review organizations.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:102">20:06:21:102</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Maintenance of records and reporting obligations by independent review organizations.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:103">20:06:21:103</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Additional rights.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:104">20:06:21:104</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Applicability.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:105">20:06:21:105</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Payment of clean claim.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:106">20:06:21:106</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Claim timeframes.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:107">20:06:21:107</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Unpaid claims.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:108">20:06:21:108</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Violations.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0A">Appendix A</a>&nbsp;&nbsp; Outline of Coverage.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0B">Appendix B</a>&nbsp;&nbsp; Replacement of Individual Accident and Sickness or Long-Term Care Coverage.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0C">Appendix C</a>&nbsp;&nbsp; Replacement of Accident and Sickness or Long-Term Care Coverage.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0D">Appendix D</a>&nbsp;&nbsp; Rescission Reporting Form.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0E">Appendix E</a>&nbsp;&nbsp;&nbsp; Personal Worksheet.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0F">Appendix F</a>&nbsp;&nbsp;&nbsp; Disclosure Form.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0G">Appendix G</a>&nbsp;&nbsp; Response Letter.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0H">Appendix H</a>&nbsp;&nbsp; Sample Claims Denial Format.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0I">Appendix I</a>&nbsp;&nbsp;&nbsp;&nbsp; Potential Rate Increase Disclosure Form.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0J">Appendix J</a>&nbsp;&nbsp;&nbsp; Replacement and Lapse Reporting Form.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0K">Appendix K</a>&nbsp;&nbsp; Partnership Disclosure Form.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0L">Appendix L</a>&nbsp;&nbsp;&nbsp; Partnership Certification Form.</p> <p><a href="DisplayRule.aspx?Rule=20:06:21:0M">Appendix M</a>&nbsp; Guidelines for Long-Term Care Independent Review Entities.</p> </div> </body> </html>