Maine Code § 24-A-5082

Long-term Care Partnership Program; availability of qualified policies
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1. Definitions. As used in this section, unless the context otherwise indicates, the following terms
have the following meanings.
A. "Eligible policyholder" means:
(1) An individual who holds a qualified individual policy issued before or during the notice
period by an insurer that actively markets individual partnership policies in this State on or
after the effective date of this section and is not receiving benefits or in a waiting period to
receive benefits; or
(2) An employer or other group policyholder that holds a qualified group policy issued before
or during the notice period by an insurer that actively markets group partnership policies in this
State on or after the effective date of this section. [PL 2011, c. 198, §1 (NEW).]
B. "Long-term Care Partnership Program" means the Long-term Care Partnership Program
established in Title 22, section 3174-GG. [PL 2011, c. 198, §1 (NEW).]
C. "Notice period" means the period between July 1, 2004 and the date an insurer begins actively
marketing partnership policies in this State. [PL 2011, c. 198, §1 (NEW).]
D. "Partnership policy" means a long-term care insurance policy with an effective date of July 1,
2009 or later that is offered with the intent to meet the requirements of the Long-term Care
Partnership Program. [PL 2011, c. 198, §1 (NEW).]
E. "Qualified policy" means a long-term care insurance policy that is offered with the intent to
meet the requirements of 26 United States Code, Section 7702B(b). [PL 2011, c. 198, §1 (NEW).]
[PL 2011, c. 198, §1 (NEW).]
2. Notice. The following provisions apply to an insurer that actively markets a partnership policy
in this State on or after the effective date of this section. With respect to an employer group, an insurer
shall provide any notice required under this section to the employer that is the policyholder of a
qualified policy.
A. An insurer that actively markets partnership policies in this State as of the effective date of this
section shall provide notice to an eligible policyholder that purchased a qualified policy during the
notice period that the policyholder may be able to participate in the Long-term Care Partnership
Program. The insurer shall initiate the exchange process in accordance with subsection 4 within
12 months of the effective date of this section. [PL 2011, c. 198, §1 (NEW).]
B. An insurer that begins to actively market partnership policies in this State after the effective
date of this section shall provide notice to an eligible policyholder that purchased a qualified policy
during the notice period that the policyholder may be able to participate in the Long-term Care
Partnership Program. The insurer shall initiate the exchange process in accordance with subsection
4 within 12 months of the date the insurer begins to market partnership policies in this State. [PL
2011, c. 198, §1 (NEW).]
[PL 2011, c. 198, §1 (NEW).]

3. Request for review. In addition to the requirements of subsection 2, at the request of an eligible
policyholder of a qualified policy issued prior to the notice period, an insurer that actively markets
partnership policies in this State shall review the qualified policy to identify whether the qualified
policy meets the requirements of the Long-term Care Partnership Program and take an action described
in subsection 4, paragraph A or B. If a request for review under this subsection is made more than 12
months after the effective date of this section, the insurer has no obligation to review the policy.
[PL 2011, c. 198, §1 (NEW).]
4. Exchange process. An insurer that actively markets partnership policies in this State shall
identify those qualified policies issued during the notice period that currently meet all the requirements
of the Long-term Care Partnership Program as specified in Bureau of Insurance Bulletin 368 dated
January 22, 2010 for use with the Long-term Care Partnership Program and those that do not meet all
of the requirements and:
A. For those qualified policies that currently meet all of the requirements, issue to each
policyholder the Important Notice Regarding Your Policy's Long-term Care Insurance Partnership
Status, as prescribed in the Appendix of Bureau of Insurance Bulletin 368 dated January 22, 2010,
along with a policy amendment reflecting the effective date of the partnership status; and [PL
2011, c. 198, §1 (NEW).]
B. For those qualified policies that do not meet all of the requirements, notify each policyholder
that the policy may be eligible for an exchange to a partnership policy. The insurer shall also notify
the policyholder that the exchange is subject to underwriting and that the premium for the new
policy is based on the policyholder's attained age on the date of the exchange. The policyholder has
60 days from the date of the notice to consider this offer. If the policyholder accepts the offer after
60 days, the insurer is not obligated to process an exchange. If the policyholder requests additional
coverage, the additional coverage is also subject to underwriting and the premium for the additional
coverage must be based on the policyholder's attained age on the date the changes take effect. [PL
2011, c. 198, §1 (NEW).]
[PL 2011, c. 198, §1 (NEW).]
5. Individual policyholder no longer receiving benefits. If an individual policyholder is not an
eligible policyholder because the policyholder is receiving benefits or is in a waiting period to receive
benefits, that individual policyholder has 12 months from the expiration of any waiting period after
which the policyholder does not begin to receive benefits or from the expiration of any period when
benefits have ended to request a review by an insurer as otherwise provided under subsection 3.
[PL 2011, c. 198, §1 (NEW).]
6. Applicability. If an insurer does not actively market both individual and group partnership
policies in this State, this section applies to that insurer only with respect to the particular market in
which the insurer actively markets partnership policies.
[PL 2011, c. 198, §1 (NEW).]

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