N.Y. Comp. Codes R. & Regs. tit. 11 § 41.8

Current through Register Vol. 46, No. 43, October 23, 2024

Section 41.8 - Additional requirements for accelerated death benefits pursuant to Insurance Law section 1113(a)(1)(C) or (D)

Unless otherwise specifically indicated in this section a policy or certificate that provides for the accelerated payment of the death benefit pursuant to Insurance Law section 1113(a)(1)(C) or (D) shall meet the following standards:

(a) Pursuant to Insurance Law section 1113(a)(1)(C) accelerated payment of the death benefit shall be based on the qualifying event of certification by a licensed health care practitioner of any condition which requires continuous care for the remainder of the insured's life in an eligible facility or at home when the insured is chronically ill, provided that any such accelerated payments shall qualify under section 101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment.

(b) Pursuant to Insurance Law section 1113(a)(1)(D) accelerated payment of the death benefit shall be based on the qualifying event of certification by a licensed health care practitioner that the insured is chronically ill, provided that any such accelerated payments shall qualify under section 101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment.

(c) A policy or certificate intended to be a qualified long-term care insurance contract for Federal tax purposes shall:

(1) meet the applicable requirements of section 4980C of the Internal Revenue Code for a qualified long-term care insurance carrier;

(2) meet all the applicable requirements of section 7702B of the Internal Revenue Code, as amended for a qualified long-term care insurance contract or payments; and

(3) state that it is intended to be a qualified long-term care insurance contract under section 7702B of the Internal Revenue Code. Such statement shall be qualified by the disclosure to the effect that "This is not a health insurance (policy)(certificate) and is not subject to the minimum requirements of New York Law pertaining to Long-Term Care Insurance and does not qualify for the New York State Long-Term Care Partnership Program and is not a Medicare Supplement Policy. The (policy)(certificate) is intended to be a qualified long-term care insurance contract for Federal tax law only."

(d) A policy or certificate that is not intended to be a qualified long-term care insurance contract for Federal tax purposes shall state that it is not intended to be a qualified long-term care insurance contract under section 7702B of the Internal Revenue Code.

(e) The submission of the policy or certificate for approval to the superintendent shall include a written certification from a tax counsel that to the best of the counsel's knowledge and belief the policy or certificate provides for accelerated payments that qualify under section 101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment. The certification by tax counsel for policies and certificates that accelerate payment of the death benefit pursuant to Insurance Law section 1113(a)(1)(C) or (D) and is intended to be a qualified long-term care insurance contract for Federal tax purposes shall also certify that the policy or certificate meets all the applicable requirements of section 7702B of the Internal Revenue Code, as amended, for a qualified long-term care contract and the insurer issuing such policy or certificate meets the applicable requirements of section 4980C of the Internal Revenue Code.

(f) Payments made shall be for costs incurred for qualified long-term care services or made on a per diem basis without regard to the expenses incurred for qualified long-term care services.

(g) The policy or rider on its face page shall provide for a free look provision for the accelerated benefits in accordance with the requirements of Insurance Law section 3203(a)(11), which shall not be less than 30 days.

(h) No policy or certificate shall limit or exclude the payment of accelerated death benefits by type of illness, treatment, medical condition or accident, except as follows:

(1) mental or nervous disorders, however, this shall not permit exclusion or limitation of benefits on the basis of Alzheimer's Disease or demonstrable organic brain disease;

(2) alcoholism and drug addiction;

(3) illness, treatment or medical condition arising out of:

(i) war or act of war (whether declared or undeclared);

(ii) participation in a felony, riot or insurrection;

(iii) service in the armed forces or units auxiliary thereto;

(iv) suicide, attempted suicide or intentionally self-inflicted injury; or

(v) aviation (this exclusion applies only to non-fare paying passengers);

(4) treatment provided in a government facility (unless otherwise required by law), services for which benefits are provided under Medicare or other governmental program (except Medicaid), any State or Federal workers' compensation, employer's liability or occupational disease law, or any mandatory motor vehicle no-fault law, services provided by a member of the covered person's immediate family and services for which no charge is normally made in the absence of insurance; and

(5) treatment or care received by the insured outside the United States and its possessions.

(i) The policy or certificate shall not condition eligibility for any benefits on a prior hospitalization requirement or condition eligibility for benefits provided in an institutional care setting on the receipt of a higher level of care or condition eligibility of noninstitutional benefits on the prior receipt of institutional care.

(j) The policy or certificate shall provide in the incontestable provision in addition to the requirements of Insurance Law section 3203(a)(3) or 3220(a)(1), as applicable:

(1) that a policy or certificate that has been in force for at least six months but less than two years may be rescinded or an otherwise valid claim for accelerated benefits may be denied upon a showing of misrepresentation that is both material to the acceptance for coverage and which pertains to the condition for which benefits are sought; and

(2) if increases are permitted, that any increase in the policy or certificate that has been in effect for at least six months but less than two years which was applied for and subject to evidence of insurability may be rescinded or an otherwise valid claim for accelerated benefits on the amount of the increase may be denied upon a showing of misrepresentation that is both material to the acceptance for coverage and which pertains to the condition for which benefits are sought.

(k) The policy or certificate may provide for a maximum monthly amount that may be accelerated, which maximum amount may differ based on whether the insured is receiving qualified care services at home or in a long-term care facility.

(l) The insurer shall provide the policyowner or certificateholder with a report, at least monthly, of any benefits paid out during the prior month, an explanation of any changes to the policy or certificate, death benefits and cash values on account of the benefits being paid out, and the amount of the remaining benefits that can be accelerated at the end of the prior month. A calendar month or policy/certificate month may be utilized.

(m) The policy or certificate may provide that any option otherwise available to the insured to accelerate less than all of the remaining death benefit on account of a terminal illness diagnosis shall be suspended while the death benefit is being so accelerated in accordance with the requirements of this section.

(n) The conversion benefit available pursuant to Insurance Law section 3220(a)(6) or 3220(a)(7) shall include a benefit comparable to the acceleration benefit. This requirement may be satisfied by a separate policy or certificate. This requirement, subject to the approval of the superintendent, may be satisfied by arrangement with another insurer to provide the required coverage.

(o) The policy or certificate may pay a daily per diem benefit without regard to the amount of expenses the insured incurs for qualified long-term care services, provided that:

(1) the policy or certificate otherwise complies with all requirements of this section; and

(2) the per diem benefit does not exceed the maximum amount eligible under section 101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law for favorable tax treatment.

(p) In addition to any of the requirements of Part 51 of this Title the following shall apply:

(1) The insurer shall follow procedures consistent with those contained in section 52.29 of this Title with respect to determining whether the sale of any such policy or certificate is intended to replace any other similar life policy or any other long-term care insurance, nursing home insurance, home care insurance policy or coverage or long-term care insurance policy or coverage provided under the Partnership for Long-Term Care Program, as defined in Social Services Law section 367-f and Insurance Law section 3229. An insurer that determines that any such policy is intended to replace a similar life policy or any other long-term care insurance, nursing home insurance or home care insurance policy or coverage or long-term care insurance policy or coverage provided under the Partnership for Long-Term Care Program, as defined in Social Services Law section 367-f and Insurance Law section 3229, shall make the disclosures required by section 52.29 of this Title.

(2) The insurer shall follow procedures consistent with those contained in section 52.29 of this Title with respect to determining whether the sale of any life policy providing benefits subject to this section or any other long-term care insurance, nursing home insurance, home care insurance policy or coverage or long-term care insurance policy or coverage provided under the Partnership for Long-Term Care Program, as defined in Social Services Law section 367-f is intended to replace a policy or certificate providing benefits subject to this section. An insurer that determines that such sale is intended to replace a policy or certificate providing benefits subject to this section shall make the disclosures required by section 52.29 of this Title.

(3) If a group policy is replaced by another group policy issued to the same policyholder, the succeeding insurer shall offer coverage to all persons covered under the previous group policy on its date of termination. Coverage provided or offered to individuals by the insurer and premiums charged to persons under the new group policy shall not vary or otherwise depend on the individual's health or disability status, claim experience or use of long-term care services.

(q) When payment of an accelerated benefit results in a pro rata reduction in cash value, the payment may be applied toward repaying a portion of loan equal to a pro rata portion of any outstanding policy loans, or may be applied entirely to pay qualified long-term care expenses or distributed as long-term care payments, if disclosure of the effect of acceleration upon any remaining death benefit, cash value or accumulation account, policy loan and premium payments, including a statement of the possibility of termination of any remaining death benefit, is provided to the policyowner or certificateholder. The policyowner or certificateholder shall provide written consent authorizing any other arrangement for the repayment of outstanding policy loans.

(r) The insurer shall, in addition to providing any other disclosures required by the applicable provisions of the Insurance Law pertaining to life insurance or by other provisions of this Part, provide the applicant with a disclosure statement or outline of coverage in the form set forth in section 4980C of the Internal Revenue Code, as amended, for those provisions under which the death benefit may be so accelerated.

(s) The policy summary required by Insurance Law section 3209 shall include, in addition to all other required information:

(1) an explanation of how the accelerated benefit interacts with other components of the policy, including deductions from death benefits;

(2) an explanation of the amount of benefits, the length of benefits, and the guaranteed lifetime benefits if any, for each covered person;

(3) any exclusions, reductions and limitations on the accelerated benefits; and

(4) if applicable to the policy type:

(i) a disclosure of the effects of exercising other rights under the policy;

(ii) a disclosure of guarantees related to the premium or charges for the accelerated benefit; and

(iii) current and projected maximum lifetime benefits.

If the policy or certificate is illustrated and such illustration is used to satisfy the requirement of Insurance Law section 3209 for a policy summary in accordance with Part 53 of this Title, then such illustration shall include the information listed in this subdivision.

(t) The policy or certificate shall be clear on how any increases or decreases in the face amount and/or death benefit other than decreases due to the payment of an accelerated death benefit affect the amount of the death benefit that may be accelerated.

(u)

(1) The policy and certificate shall not be advertised or marketed as long-term care insurance, nursing home insurance, home care insurance or long-term care insurance provided under the Partnership for Long-Term Care Program, as defined in Social Services Law section 367-f and Insurance Law section 3229. Any advertisement, description, comparison, marketing material or illustration shall state in bold that "This is a life insurance (policy)(certificate) that accelerates the death benefit for qualified long-term care services (The phrase "on account of chronic illness" may be substituted for the phrase "for qualified long-term care services" for policies that are not intended to be qualified long-term care insurance contracts for Federal tax purposes) and is not a health insurance (policy)(certificate) providing long-term care insurance subject to the minimum requirements of New York Law, does not qualify for the New York State Long-Term Care Partnership Program and is not a Medicare supplement (policy)(certificate)."

(2) An insurer may include in any advertisement or marketing materials for such policies that are not intended to be qualified long-term care insurance contracts for Federal tax purposes:

(i) a description of the benefits provided by the policy, including a description of the acceleration of the death benefit to pay for services when the insured has become chronically ill; and

(ii) a comparison between the benefits provided by such policies and the benefits provided by long-term care insurance.

(3) An insurer may include in any advertisement or marketing materials for such policies that are intended to be qualified long-term care insurance contracts for Federal tax purposes:

(i) a statement that the policy or certificate is intended to be a qualified long-term care insurance contract under section 7702B of the Internal Revenue Code;

(ii) a description of the benefits provided by the policy, including a description of the acceleration of the death benefit to pay for services when the insured has become chronically ill; and

(iii) a comparison between the benefits provided by such policies and the benefits provided by long-term care insurance.

(v) Every insurer marketing insurance under this section, directly or through its producers, shall:

(1) establish marketing procedures to ensure that any comparison of policies by its producers will be fair and accurate;

(2) establish marketing procedures to assure excessive insurance is not sold or issued;

(3) except as provided in paragraph (4) of this subdivision, display prominently by type, stamp or other appropriate means, on the first page of the outline of coverage and policy the following:

"Notice to buyer: This policy may not cover all of the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations";

(4) for policies that accelerate death benefits pursuant to Insurance Law section 1113(a)(1)(C) and provide benefits on a per diem basis and are not intended to be qualified long-term care insurance contracts for Federal tax purposes, display prominently by type, stamp or other appropriate means, on the first page of the outline of coverage and the policy the following:

"Notice to buyer: This policy may not cover all of the costs associated with the chronic illness of the insured. The buyer is advised to review carefully the policy benefits";

(5) inquire and otherwise make every reasonable effort to identify whether a prospective applicant or enrollee already has accident and sickness or long-term care insurance and the types and amounts of any such insurance; and

(6) establish auditable procedures for verifying compliance with paragraphs (1) through (5) of this subdivision.

(w) The following acts and practices in the sale of insurance under this section are prohibited:

(1) Twisting. Knowingly making any misleading representation or incomplete or fraudulent comparison of any insurance policies or insurers for the purpose of inducing, or tending to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on or convert any insurance policy or to take out a policy of insurance with another insurer.

(2) High pressure tactics. Employing any method of marketing having the effect of or tending to induce the purchase of insurance through force, fright, threat, whether explicit or implied, or undue pressure to purchase or recommend the purchase of insurance.

(3) Cold lead advertising. Making use directly or indirectly of any method of marketing that fails to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contact will be made by an insurance producer or insurer.

(x)

(1) For purposes of this subdivision, association shall mean any professional, trade or occupational association for its members or former or retired members, or combination thereof, if the association:

(i) is composed of individuals all of whom are or were actively engaged in the same profession, trade or occupation; and

(ii) has been maintained in good faith for purposes other than obtaining insurance.

(2) An insurer shall not issue insurance under this section to an association, as defined in paragraph (1) of this subdivision, or its members unless the insurer has filed with the superintendent:

(i) the policy and certificate;

(ii) a corresponding outline of coverage;

(iii) all advertisements; and

(iv) any other material requested by the superintendent.

(3) The insurer shall certify to the superintendent, before a new policy and the first certificate is issued, and annually thereafter by December 31st:

(i) that all compensation to the association complies with all applicable statutes and regulations;

(ii) when making insurance under this section available to its members, the association has:

(a) taken steps to educate its members concerning long-term care issues so that its members can make informed decisions; and

(b) furnished only objective information as provided by the insurer regarding the policies or certificates that are available to the association's members;

(iii) in any solicitation for insurance under this section the solicitation:

(a) discloses the specific nature of any compensation arrangements, including the amount that the association or any of its related entities receives, with respect to the insurance;

(b) includes a brief description of the process under which such policies or certificates and the insurer issuing such policies or certificates were selected; and

(c) if the association and the insurer have interlocking directorates or trustee arrangements, discloses such fact to the members;

(iv) the board of directors of an association making the insurance policies or certificates available to its members has reviewed and approved such insurance policies or certificates as well as the compensation arrangements made with the insurer; and

(v) the association has:

(a) engaged the services of a licensed insurance consultant or licensed insurance producer with expertise in long-term care insurance not affiliated with the insurer to conduct an examination of the policies and certificates, including benefits, features, and rates, at the time of the association's decision to have the insurance made available to its members and at the time of any material change;

(b) established procedures to actively monitor the marketing efforts of the insurer and its agents; and

(c) reviewed and approved all marketing materials or other insurance communications used to promote sales or sent to members regarding the policies or certificates.

(4) This subdivision shall not apply to any individual policy of life insurance issued to a member of an association where the sale of the policy was entirely independent from the association.

(y) Except as otherwise provided in Part 224 of this Title (Insurance Regulation 187), in recommending the purchase or replacement of any policy or certificate issued under this section a producer shall make reasonable efforts to determine the appropriateness of a recommended purchase or replacement.

(z) Accelerated death benefit payments subject to this section shall be designed such that, on a standalone basis, the benefit payments will be subject to favorable tax treatment by the Federal government. Accordingly, on a standalone basis, accelerated payments shall only be made if they qualify under section 101(g)(3) of the Internal Revenue Code and all other applicable sections of Federal law in order to maintain favorable tax treatment. An insurer may, on a non-discriminatory basis, coordinate the insurer's benefit payments with payments made by other insurers, and may deny claims for payments that would not receive favorable tax treatment by the Federal government.

(1) For insurers that elect to coordinate benefits and that will only make payments if the payments will receive favorable tax treatment by the Federal government, the claim form to receive benefits pursuant to this section shall include the following statement: "Benefit payments will only be made if the payments are subject to favorable tax treatment by the Federal government. Receipt of benefit payments from multiple policies exceeding the applicable limits may result in tax consequences. Therefore, when determining whether the benefit payments will receive favorable tax treatment, the payment of benefits from all insurance policies must be considered."

(i) The claim form shall include a question as to whether the insured is covered by other insurance policies that will pay similar benefits.

(ii) The insurer shall have written procedures for use during the claim handling process for confirming that the benefit payments at the time of their payment are expected to receive favorable tax treatment by the Federal government.

(2) For insurers that do not elect to coordinate benefits, the claim form to receive benefits pursuant to this section shall include the following statement: "Benefit payments may not be subject to favorable tax treatment by the Federal government. When determining whether the benefit payments will receive favorable tax treatment, the payment of benefits from all insurance policies must be considered. Receipt of benefit payments under multiple policies exceeding the applicable limits may result in tax consequences. This insurer does not coordinate benefits to ensure that the payments receive favorable tax treatment by the Federal government. Accordingly, prior to applying for benefits, you should seek assistance from a qualified tax advisor."

(aa) Policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes shall provide the following protections against unintentional lapse:

(1) No individual policy or certificate shall be issued until the insurer has received from the applicant either, a written designation of at least one person, in addition to the applicant, who is to receive notice of lapse or termination of the policy or certificate for nonpayment of premium; or a written waiver dated and signed by the applicant electing not to designate additional persons to receive notice. The applicant has the right to designate at least one person who is to receive the notice of termination, in addition to the insured. Designation shall not constitute acceptance of any liability on the third party for services provided to the insured. The form used for the written designation shall provide space clearly designated for listing at least one person. The designation shall include each person's full name and home address. In the case of an applicant who elects not to designate an additional person, the waiver shall state: "Protection against unintended lapse. I understand that I have the right to designate at least one person other than myself to receive notice of lapse or termination of this long-term care insurance policy for nonpayment of premium. I understand that notice will not be given until thirty (30) days after a premium is due and unpaid. I elect NOT to designate any person to receive such notice." The insurer shall notify the insured of the right to change this written designation, no less often than once every two years.

(2) When the policyowner or certificateholder pays premium for the policy or certificate through a payroll or pension deduction plan, the requirements contained in paragraph (1) of this subdivision need not be met until 60 days after the policyowner or certificateholder is no longer on such a payment plan. The application or enrollment form for such policies or certificates shall clearly indicate the payment plan selected by the applicant.

(3) No individual policy or certificate shall lapse or be terminated for nonpayment of premium unless the insurer, at least 30 days before the effective date of the lapse or termination, has given notice to the insured and to those persons designated to receive notice, at the address provided by the insured for purposes of receiving notice of lapse or termination. Notice shall be given by first class United States mail, postage prepaid; and notice may not be given until 30 days after a premium is due and unpaid. Notice shall be deemed to have been given as of five days after the date of mailing.

(4) In addition to the requirements of Insurance Law section 3203(a)(10), the policy or certificate shall include a provision which provides for reinstatement of coverage, in the event of lapse if the insurer is provided proof of the policyowner's or certificateholder's cognitive impairment or the loss of functional capacity. This option shall be available to the insured if requested within five months after termination and shall allow for the collection of past due premium, where appropriate. The standard of proof of cognitive impairment or loss of functional capacity shall not be more stringent than the benefit eligibility criteria on cognitive impairment or the loss of functional capacity, if any, contained in the policy and certificate.

(ab) For policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes the insurer shall provide the following:

(1) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured under a policy, all riders or endorsements added to a policy after date of issue or at reinstatement or renewal which reduce or eliminate benefits or coverage in the policy shall require signed acceptance by the individual insured.

(2) After the date of policy issue, any rider or endorsement which increases benefits or coverage with a concomitant increase in premium during the policy term shall be agreed to in writing signed by the insured, except if the increased benefits or coverage are required by law.

(3) Where a separate additional premium is charged for benefits provided in connection with riders or endorsements, such premium charge shall be set forth in the policy, rider or endorsement.

(ac) For policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes the insurer shall be subject to the following:

(1) insurers, whether or not they have obtained information concerning the applicant's health condition prior to the issuance of the policy or certificate, are prohibited from post-claim underwriting;

(2) if an insurer requests information on an application concerning medications being taken by the applicant and the medications listed in such application were known to the insurer, or should have been known by the insurer at the time of application to be directly related to a medical condition for which coverage would have been otherwise denied, then the policy or certificate shall not be rescinded for that condition; and

(3) except for policies or certificates that are guaranteed issue:

(i) the following language shall be set out in bold type, conspicuously and in close conjunction with the applicant's signature block on an application for a policy or enrollment form for a certificate:

Caution: If your answers on this (application)(enrollment form) fail to include all material information requested, (company) has the right to deny benefits or rescind your (policy)(certificate).; and

(ii) the following language, or language substantially similar to the following, shall be set out conspicuously in bold type on the policy or certificate at the time of delivery:

Caution: The issuance of this (policy)(certificate) is based upon your responses to the questions on your (application)(enrollment form). A copy of your (application)(enrollment form) (is enclosed)(was retained by you when you applied). If your answers fail to include all material information requested, the company has the right to deny benefits or rescind your (policy)(certificate). The best time to clear up any questions is now, before a claim arises! If for any reason, any of your answers are incorrect, contact the company at this address: (insert address).

(4) A copy of the completed application or enrollment form (whichever is applicable) shall be delivered to the insured no later than at the time of delivery of the policy or certificate unless it was retained by the applicant at the time of application.

(5) Prior to the issuance of a policy or certificate to an applicant age 80 or older, the insurer shall obtain one or more of the following:

(i) a report of a physical examination;

(ii) an assessment of functional capacity;

(iii) an attending physician's statement; or

(iv) copies of medical record.

(ad) Every insurer selling or issuing policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes shall maintain a record of all policy or certificate rescissions, both State and countrywide, except those which the insured voluntarily effectuated and shall annually furnish this information in the format prescribed by the superintendent.

(ae) For policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes the insurer shall comply with the following:

(1) a policy shall not, if it provides benefits for home health care or community care services, limit or exclude benefits:

(i) by requiring that the insured/claimant would need care in a skilled nursing facility if home health care services were not provided;

(ii) by requiring that the insured/claimant first or simultaneously receive nursing and/or therapeutic services in a home, community or institutional setting before home health care services are covered;

(iii) by limiting eligible services to services provided by registered nurses or licensed practical nurses;

(iv) by requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide, or other licensed or certified home care worker acting within the scope of his or her licensure or certification;

(v) by excluding coverage for personal care services provided by a home health aide;

(vi) by requiring that the provision of home health care services be at a level of certification or licensure greater than that required by the eligible service;

(vii) by requiring that the insured/claimant have an acute condition before home health care services are covered;

(viii) by limiting benefits to services provided by Medicare-certified agencies or providers; and

(ix) by excluding coverage for adult day care services.

(2) A policy, if it provides for home health or community care services, shall provide total home health or community care coverage that is a dollar amount equivalent to at least one-half of one year's coverage available for nursing home benefits under the policy or certificate, at the time covered home health or community care services are being received. This requirement shall not apply to policies issued to residents of continuing care retirement communities.

(3) Home health care coverage may be applied to the nonhome health care benefits provided in the policy or certificate when determining maximum coverage under the terms of the policy or certificate.

(af) For policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes, the termination of the accelerated death benefits shall be without prejudice to any benefits payable for any claim pursuant to Insurance Law section 1113(a)(1)(C) or (D) if such claim began while the accelerated death benefits were in force and continues without interruption after termination. Such extension of benefits beyond the period the insurance was in force may be limited to the duration of the benefit period, if any, or to payment of the maximum benefits and may be subject to any policy waiting period, and all other applicable provisions of the policy.

(ag) For policies or certificates that are intended to be qualified long-term care insurance contracts for Federal tax purposes the insurer shall maintain records of replacement sales and the number of lapses of such policies and certificates as set forth in section 4980C of the Internal Revenue Code as amended.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 41.8

Amended New York State Register November 27, 2019/Volume XLI, Issue 48, eff. 11/27/2019