Current through Reg. 49, No. 49; December 6, 2024
Section 3.3847 - Qualified Long-Term Care Insurance Contracts: Prohibited Representations(a) In marketing and issuing long-term care insurance contracts in Texas, no person shall state that any such contract is intended to be a "qualified long-term care insurance contract" as defined in § 3.3804 of this title (relating to Definitions) unless the contract: (1) provides insurance protection only for services which are "qualified long-term care services," as defined in § 3.3804 of this title (relating to Definitions);(2) does not provide for a cash surrender value or other money that can be paid, assigned or pledged as collateral for a loan or borrowed, except on a complete surrender or cancellation of the contract;(3) provides that all refunds of premium and all policyholder dividends or similar amounts are applied as a reduction in future premiums or to increase future benefits, except for any refund on the death of the insured, or on a complete surrender or cancellation of the contract, which cannot exceed the aggregate premiums paid under the contract;(4) does not pay or reimburse expenses incurred under Medicare or which would be reimbursable under Medicare but for the application of a deductible or coinsurance amount, except expenses which are reimbursable under Medicare only as a secondary payor; and(5) otherwise meets the applicable requirements of this subchapter.(b) Neither this section, nor any other provision of law, shall be construed or applied so as to prohibit the offering of a long-term care insurance contract on the basis that the contract coordinates its benefits with those provided under Medicare.28 Tex. Admin. Code § 3.3847
The provisions of this §3.3847 adopted to be effective May 8, 1997, 22 TexReg 3786