SENATE BILL No. 586
An Act concerning long-term care insurance; relating to
restrictions on elimination periods;
amending K.S.A. 40-2228 and repealing the existing
Be it enacted by the Legislature of the State of Kansas:
Section 1. K.S.A. 40-2228 is hereby amended to
read as follows: 40-
2228. (a) The commissioner may adopt reasonable rules and
(1) To establish specific standards for
policy provisions of long-term
care insurance policies. Such standards shall be in addition to and
accordance with applicable laws of this state, and shall address
renewability, initial and subsequent conditions of eligibility,
tion of coverage provisions, coverage of dependents, preexisting
tions, termination of insurance, probationary periods, limitations,
tions, reductions, elimination periods, requirements for
recurrent conditions and definitions of terms, except that no
shall limit the number of days contained in an elimination
period of con-
finement in a nursing facility or for all confinements in a
which are due to the same or related causes and separated from
other by less than 180 days; and
(2) to specify prohibited policy
provisions not otherwise specifically
authorized by statute which, in the opinion of the commissioner,
just, unfair or unfairly discriminatory to any person insured under
term care insurance policy.
(b) Rules and regulations adopted by the
(1) Recognize the unique, developing and
experimental nature of
long-term care insurance; and
(2) recognize the appropriate
distinctions necessary between group
and individual long-term care insurance policies.
(c) The commissioner may adopt rules and
loss-ratio standards for long-term care insurance policies if a
erence to long-term care insurance policies is contained in the
(d) No long-term care insurance policy
(1) Be canceled, nonrenewed, or otherwise
terminated solely on the
grounds of the age or the deterioration of the mental or physical
of the insured individual or certificateholder; or
(2) contain a provision establishing any
new waiting period in the
event existing coverage is converted to or replaced by a new or
within the same company, except with respect to an increase in
voluntarily selected by the insured individual or group
(e) (1) No long-term insurance
policy or certificate shall use a defi-
nition of preexisting condition which is more restrictive than the
ing: ``Preexisting condition'' means a condition for which medical
or treatment was recommended by, or received from a provider of
care services, within six months preceding the effective date of
of an insured person.
(2) No long-term care insurance policy
shall exclude coverage for a
loss or confinement which is the result of a preexisting condition
such loss or confinement begins within six months following the
date of coverage of an insured person.
(3) The commissioner may extend the
limitation periods set forth in
subsections (e)(1) and (e)(2) above as to specific age group
specific policy forms upon finding that the extension is not
the best interest of the public.
(4) The definition of preexisting
condition shall not prohibit an in-
surer from using an application form designed to elicit the
health history of an applicant, and, on the basis of the answers on
application, from underwriting in accordance with that insurer's
lished underwriting standards.
(f) No long-term care insurance policy
shall require prior institution-
alization as a condition precedent to the payment of benefits.
(g) In order to provide for fair
disclosure in the sale of long-term care
(1) An outline of coverage shall be
delivered to an applicant for a
long-term care insurance policy at the time of application. In the
direct response solicitations, the insurer shall deliver the
outline of cov-
erage upon the applicant's request, but regardless of request,
such delivery no later than at the time of policy delivery. Such
coverage shall include:
(A) A description of the principal
benefits and coverage provided in
(B) a statement of the principal
exclusions, reductions and limitations
contained in the policy;
(C) a statement of the renewal
provisions, including any reservation
in the policy of a right to change premiums; and
(D) a statement that the outline of
coverage is a summary of the
policy issued or applied for, and that the policy should be
determine governing contractual provisions.
(2) A certificate issued pursuant to a
group long-term care insurance
policy which policy is delivered or issued for delivery in this
include the information required by subsection (g)(4) of K.S.A.
and amendments thereto.
(h) No policy shall be advertised,
marketed or offered as long-term
care insurance unless it complies with the provisions of this
Sec. 2. K.S.A. 40-2228 is hereby repealed.
Sec. 3. This act shall take effect and be in force
from and after its
publication in the statute book.
Approved May 29, 2002.