Section 3 AAC 28.579 - Availability of new services or providers(a) An insurer shall notify policyholders of the availability of a new long-term policy series that provides coverage for new long-term care services or providers material in nature and not previously available through the insurer to the general public. The notice shall be provided not later than 12 months after the date the new policy series is made available for sale in this state.(b) Notwithstanding (a) of this section, notification is not required for a policy issued before March 27, 2022 or to a policyholder or certificate holder who is currently eligible for benefits, within an elimination period or on a claim, or who previously had been in claim status, or who would not be eligible to apply for coverage due to issue age limitations under the new policy. The insurer may require that policyholders meet all eligibility requirements, including underwriting and payment of the required premium to add new services or providers.(c) The insurer shall make the new coverage available in one of the following ways:(1) by adding a rider to the existing policy and charging a separate premium for the new rider based on the insured's attained age;(2) by exchanging the existing policy or certificate for one with an issue age based on the present age of the insured and recognizing past insured status by granting premium credits toward the premiums for the new policy or certificate. The premium credits shall be based on premiums paid or reserves held for the prior policy or certificate;(3) by exchanging the existing policy or certificate for a new policy or certificate in which consideration for past insured status shall be recognized by setting the premium for the new policy or certificate at the issue age of the policy or certificate being exchanged, the cost for the new policy or certificate may recognize the difference in reserves between the new policy or certificate and the original policy or certificate; or(4) by an alternative program developed by the insurer that meets the purpose intent of this section if the program is filed with and approved by the director.(d) An insurer is not required to notify policyholders of a new proprietary policy series created and filed for use in a limited distribution channel. For purposes of this subsection, limited distribution channel" means through a discrete entity, similar to a financial institution or brokerage, for which specialized products are available that are not available for sale to the general public. Policyholders that purchased a new proprietary policy shall be notified when a new long-term care policy series that provides coverage for new long-term care services or providers material in nature is made available to that limited distribution channel.(e) Policies issued under this section are exchanges, not replacements. These exchange are not subject to 3 AAC 28.562 or 3 AAC 28.577, or the reporting requirements of 3 AAC 28.563(a) - (d).(f) If the policy is offered through an employer, labor organization, or professional, trade, or occupational association, the required notification in (a) of this section shall be made to the offering entity. However, if the policy is issued to a group defined in AS 21.53.200(3)(D), the notification shall be made to each certificate holder.(g) Nothing in this section prohibit's an insurer from offering a policy, rider, certificate, or coverage change to a policyholder or certificate holder. However, upon request a policyholder may apply for currently available coverage that includes the new services or providers. The insurer may require that policyholders meet all eligibility requirements, including underwriting and payment of the required premium to add new services or providers.(h) This section does not apply to life insurance policies or riders containing accelerated long-term care benefits.Eff. 3/27/2022, Register 241, April 2022Authority:AS 21.06.090
AS 21.53.050
AS 21.53.090