ARTICLE 4. Implementation

Article 4 added by Stats. 1989, Ch. 767, Sec. 2.

§§ 10235–10236.15 · 32 sections

§ 10235 Except as provided in Section 10235.95, this article applies to all long-term care insurance policies delivered or issued for delivery in this state on or…
§ 10235.2 No long-term care insurance policy delivered or issued for delivery in this state shall use the terms set forth below, unless the terms are defined in the…
§ 10235.8 No policy may be delivered or issued for delivery in this state as long-term care insurance if the policy limits or excludes coverage by type of illness,…
§ 10235.9 (a) Every insurer shall report annually by June 30 the total number of claims denied by each class of business in the state and the number of these claims…
§ 10235.9a For policies or certificates issued on or after January 1, 2017, that contain an alternate plan of care provision pursuant to Section 10231.3, if an insurer…
§ 10235.10 Termination of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if that institutionalization began while…
§ 10235.14 (a) Individual long-term care insurance policies shall contain a renewability provision. This provision shall be appropriately captioned, shall appear on the…
§ 10235.16 (a) Long-term care insurance application forms shall include a question designed to elicit information as to whether the proposed insurance is intended to…
§ 10235.17 For purposes of this chapter, the commissioner shall define inappropriate replacement of long-term care insurance in consultation with other interested parties.
§ 10235.18 (a) Insurers using direct response solicitation methods shall deliver a notice regarding replacement of accident and sickness or long-term care coverage to the…
§ 10235.20 The commissioner may waive a specific provision or provisions of this article with respect to a specific long-term care insurance policy or certificate upon…
§ 10235.30 (a) No insurer may deliver or issue for delivery a long-term care policy in this state unless the insurer offers at the time of application an option to…
§ 10235.35 (a) Notwithstanding any other law, the commissioner may require the administration by an insurer of the contingent benefit upon lapse, as described in Section…
§ 10235.36 (a) When a shortened benefit period nonforfeiture benefit, as described in Section 10235.30, or a contingent benefit upon lapse, as described in Section…
§ 10235.40 (a) An individual long-term care policy or certificate shall not be issued until the applicant has been given the right to designate at least one individual,…
§ 10235.45 (a) If a life insurance policy contains long-term care benefits and permits policy loans or cash withdrawals, then access to those loans or withdrawals shall…
§ 10235.50 (a) A policy or certificate shall include a provision that gives the policyholder or certificate holder the right, exercisable any time after the first year,…
§ 10235.51 (a) Every policy or certificate shall include a provision that gives the insured the option to elect, no less frequently than on each anniversary date after…
§ 10235.52 (a) Each policy shall contain a provision that, if the insurer develops new benefits or benefit eligibility or new policies with new benefits or benefit…
§ 10235.91 In the event a non-medicaid national or state long-term care program is created through public funding that substantially duplicates benefits covered by the…
§ 10235.94 Every policy or certificate shall include a provision giving the policyholder or certificate holder the right to appeal decisions regarding benefit…
§ 10235.95 (a) Notwithstanding Section 10235, this section applies to all long-term care policies in force, regardless of their dates of issuance. (b) Interest shall…
§ 10236 Every individual and group long-term care policy and certificate under a group long-term care policy shall be either guaranteed renewable or noncancelable. (a)…
§ 10236.1 (a) Benefits under individual long-term care insurance policies issued before new premium rate schedules are approved under Section 10236.11 shall be deemed…
§ 10236.2 Except where the provisions of a group contract provide otherwise, the provisions of subdivisions (d) and (e) of Section 10236.1 shall apply to all group…
§ 10236.5 (a) Every certificate of group insurance issued or delivered in California shall provide for continuation or conversion coverage for the certificate holder if…
§ 10236.8 If a group long-term care policy is replaced by another policy to the same master policyholder issued, the replacing insurer shall do all of the following: (a)…
§ 10236.11 The premium rate schedules for all individual and group long-term care insurance policies issued in this state shall be filed with and receive the prior…
§ 10236.12 All actuaries used by the commissioner to review rate applications submitted by insurers pursuant to this chapter who are employees of the department shall be…
§ 10236.13 No insurer may increase the premium for an individual or group long-term care insurance policy or certificate approved for sale under this chapter unless the…
§ 10236.14 Approval of all premium rate schedule increases shall be subject to the following requirements: (a) (1) Premium rate schedule increases shall demonstrate that…
§ 10236.15 Premium rate schedule increases that have been approved shall be subject to the following: (a) For each rate increase that is implemented, the insurer shall…