Nev. Admin. Code § 687B.058

Current through November 8, 2024

Section 687B.058 - Partnership program notice

1. The provisions of this section apply to any qualified state long-term care insurance partnership contract.

2. An insurer or agent soliciting or offering to sell a long-term care insurance contract that is intended to qualify as a partnership contract shall provide to each prospective applicant a partnership program notice. The partnership program notice must:

(a) Outline the requirements and benefits of a partnership contract.

(b) Be provided with the required outline of coverage.

(c) Be in the following form, unless a similar form is filed with, and approved by, the Commissioner:

PARTNERSHIP PROGRAM NOTICE

Important Consumer Information Regarding the Nevada Long-Term Care Insurance Partnership Program

Some long-term care insurance contracts or certificates sold in Nevada may qualify for the Nevada Long-Term Care Insurance Partnership Program (the "Partnership Program"). The Partnership Program is a partnership between state government and private insurance companies to assist individuals in planning their long-term care needs. Insurance companies voluntarily agree to participate in the Partnership Program by offering long-term care insurance coverage that meets certain state and federal requirements. Long-term care insurance contracts or certificates that qualify as partnership contracts or partnership certificates may protect the policyholder's or certificate holder's assets through a feature known as "asset disregard" under Nevada's Medicaid program.

ASSET DISREGARD means that an amount of the policyholder's or certificate holder's assets equal to the amount of long-term care insurance benefits received under a qualified partnership contract or partnership certificate will be disregarded for the purpose of determining the insured's eligibility for Medicaid. This generally allows a person to keep assets equal to the insurance benefits received under a qualified partnership contract or partnership certificate without affecting the person's eligibility for Medicaid. All other Medicaid eligibility criteria will apply, and special rules may apply to persons whose home equity exceeds $500,000. Asset disregard is not available under a long-term care insurance contract or certificate that is not a partnership contract or partnership certificate. Therefore, you should consider if asset disregard is important to you, and whether a partnership contract or partnership certificate meets your needs. THE PURCHASE OF A PARTNERSHIP CONTRACT DOES NOT AUTOMATICALLY QUALIFY YOU FOR MEDICAID.

WHAT ARE THE REQUIREMENTS FOR A PARTNERSHIP CONTRACT OR PARTNERSHIP CERTIFICATE? In order for a long-term care insurance contract or certificate to qualify as a partnership contract or partnership certificate, it must, among other requirements:

* Be issued to a person on or after January 1, 2007;

* Cover a person who was a Nevada resident when coverage first became effective under the long-term care insurance contract or certificate;

* Be a federally tax-qualified long-term care insurance contract;

* Meet stringent consumer protection standards; and

* Meet the following inflation requirements:

o For persons 60 years of age or younger - provide compound annual inflation protection;

o For persons 61 to 75 years of age - provide some level of inflation protection; and

o For persons 76 years of age and older - no purchase of inflation protection is required.

If you apply and are approved for long-term care insurance coverage, your insurer will provide you with written documentation as to whether or not your long-term care insurance contract or certificate qualifies as a partnership contract or partnership certificate.

WHAT COULD DISQUALIFY A LONG-TERM CARE INSURANCE CONTRACT OR CERTIFICATE AS A PARTNERSHIP POLICY? Certain types of changes to a partnership contract or partnership certificate could affect whether or not such a contract or certificate continues to be a partnership contract or partnership certificate. If you purchase a partnership contract or partnership certificate and later decide to make ANY changes, you should first consult with your insurer to determine the effect of a proposed change. In addition, if you move to a state that does not maintain a partnership program or does not recognize your long-term care insurance contract or certificate as a partnership policy or partnership certificate, you would not receive beneficial treatment of your long-term care insurance contract or certificate under the Medicaid program of that state. The information contained in this disclosure is based on current Nevada and federal law. These laws may be subject to change. Any change in law could reduce or eliminate the beneficial treatment of your long-term care insurance contract or certificate under Nevada's Medicaid program.

3. A partnership contract delivered or issued for delivery in Nevada must be accompanied by a partnership status disclosure notice. The partnership status disclosure notice must:

(a) Explain the benefits associated with a partnership contract;

(b) Indicate that the long-term care insurance contract is, at the time of issuance, intended to be a qualified state long-term care insurance partnership contract;

(c) Include a statement which indicates that the insured does not automatically qualify for Medicaid by purchasing this partnership policy; and

(d) Be in the following form, unless a similar form is filed with, and approved by, the Commissioner:

PARTNERSHIP STATUS DISCLOSURE NOTICE

Important Information Regarding Your Long-Term Care Insurance Contract's or Certificate's Long-Term Care Insurance Partnership Status

This disclosure notice is issued in conjunction with your long-term care insurance contract.

Some long-term care insurance contracts or certificates sold in Nevada qualify for the Nevada Long-Term Care Insurance Partnership Program. Insurance companies voluntarily agree to participate in the Partnership Program by offering long-term care insurance coverage that meets certain state and federal requirements. Long-term care insurance contracts or certificates that qualify as partnership policies or partnership certificates may be entitled to special treatment and, in particular, an "asset disregard" under Nevada's Medicaid program.

ASSET DISREGARD means that an amount of the policyholder's or certificate holder's assets equal to the amount of long-term care insurance benefits received under a qualified partnership contract or partnership certificate will be disregarded for the purposes of determining the insured's eligibility for Medicaid. This generally allows a person to keep assets equal to the insurance benefits received under a qualified partnership policy or partnership certificate without affecting the person's eligibility for Medicaid. All other Medicaid eligibility criteria will apply, and special rules may apply to persons whose home equity exceeds $500,000. Asset disregard is NOT available under a long-term care insurance contract or certificate that is not a partnership contract or partnership certificate. THE PURCHASE OF A PARTNERSHIP CONTRACT DOES NOT AUTOMATICALLY QUALIFY YOU FOR MEDICAID.

PARTNERSHIP CONTRACT OR PARTNERSHIP CERTIFICATE STATUS. Your long-term care insurance contract or certificate is intended to qualify as a partnership contract or partnership certificate under the Nevada Long-Term Care Insurance Partnership Program as of your contract's or certificate's effective date.

WHAT COULD DISQUALIFY YOUR LONG-TERM CARE INSURANCE CONTRACT OR CERTIFICATE AS A PARTNERSHIP CONTRACT OR PARTNERSHIP CERTIFICATE? If you make any changes to your long-term care insurance contract or certificate, such changes could affect whether your long-term care insurance contract or certificate continues to be a partnership contract or partnership certificate. BEFORE YOU MAKE ANY CHANGES, YOU SHOULD CONSULT WITH YOUR INSURER TO DETERMINE THE EFFECT OF A PROPOSED CHANGE. In addition, if you move to a state that does not maintain a partnership program or does not recognize your long-term care insurance contract or certificate as a partnership contract or partnership certificate, you would not receive beneficial treatment of your long-term care insurance contract or certificate under the Medicaid program of that state. The information contained in this Notice is based on current state and federal law. These laws may be subject to change. Any change in law could reduce or eliminate the beneficial treatment of your long-term care insurance contract or certificate under Nevada's Medicaid program.

ADDITIONAL INFORMATION. If you have questions regarding your long-term care insurance contract or certificate, please contact your insurer. If you have questions regarding current laws governing Medicaid eligibility, you should contact the Nevada Medicaid office.

4. A partnership contract or partnership certificate must not be delivered or issued for delivery in Nevada unless filed with and approved by the Commissioner.

5. Any long-term care insurance contract submitted for certification as a partnership contract must be accompanied by an Issuer Certification Form and a Partnership Certification Form. Unless a similar form is filed with and approved by the Commissioner:

(a) Form NDOI-951 must be used as, or provide substantially the format for, the Issuer Certification Form; and

(b) Form NDOI-952 must be used as, or provide substantially the format for, the Partnership Certification Form.

6. Insurers requesting to make use of a previously approved long-term care insurance contract form as a qualified state long-term care insurance partnership contract must submit to the Commissioner an Issuer Certification Form signed by an officer of the insurance company. An Issuer Certification Form is required for each long-term care insurance contract form submitted for partnership qualification.

Nev. Admin. Code § 687B.058

Added to NAC by Comm'r of Insurance by R028-10, 12-16-2010, eff. 10-1-2011

NRS 679B.130