W. Va. Code R. § 114-32-25

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 114-32-25 - Right to Reduce Coverage and Lower Premiums

25.1.

25.1.a. Every long-term care insurance policy and certificate shall include a provision that allows the policyholder or certificateholder to reduce coverage and lower the policy or certificate premium in at least one of the following ways:

25.1.a.1. Reducing the maximum benefit; or

25.1.a.2. Reducing the daily, weekly or monthly benefit amount.

25.1.b. The insurer may also offer other reduction options that are consistent with the policy or certificate design or the carrier's administrative processes.

25.2. The provision shall include a description of the ways in which coverage may be reduced and the process for requesting and implementing a reduction in coverage.

25.3. The age to determine the premium for the reduced coverage shall be based on the age used to determine the premiums for the coverage currently in force.

25.4. The insurer may limit any reduction in coverage to plans or options available for that policy form and to those for which benefits will be available after consideration of claims paid or payable.

25.5. If a policy or certificate is about to lapse, the insurer shall provide a written reminder to the policyholder or certificateholder of his or her right to reduce coverage and premiums in the notice required by subdivision c, subsection 5.1 of this rule.

25.6. This section does not apply to life insurance policies or riders containing accelerated long-term care benefits.

25.7. The requirements of this section shall apply to any long-term care policy issued in this state on or after twelve months after the effective date of this rule, amended in 2009.

W. Va. Code R. § 114-32-25