Chapter 6. DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION

A. Renewability 1. An individual long-term care insurance policy shall contain a renewability provision which shall be either “guaranteed renewable” or “noncancellable.” The renewability provision shall be appropriately captioned, shall appear on the first page of the policy, and…

A. An insured may designate in writing at least one person to receive notice of lapse or termination of a long-term care insurance policy for nonpayment of premium, in addition to the insured. Designation shall not constitute acceptance of any liability by the third-party notice …

A. An insurer shall not offer a long-term care insurance policy unless the insurer offers to the policyholder, at the time of purchase, in addition to any other inflation protection, the option to purchase a policy with an inflation protection provision that provides for benefit …

A. Riders and endorsements. Except for riders or endorsements by which an insurer effectuates a request made in writing by the insured under an individual long-term care insurance policy, if an insurer adds a rider or endorsement to an individual long-term care insurance policy a…

A. This Section applies as follows: 1. Except as provided in subsection (A)(2), this Section applies to any long-term care policy or certificate issued in this state on or after May 10, 2005. 2. For certificates issued under an in-force, long-term care insurance policy issued to …

A. This Section applies to any long-term care policy issued in this state on or after May 10, 2005. B. At the time of making a filing under A.R.S. § 20-1691.08, an insurer shall provide to the Director a copy of the disclosure documents required under R20-6-1008 and an actuarial …

A. Scope. 1. Administrative Hearings. This Article and Title 20 of the Arizona Revised Statutes govern administrative hearings before the Department. The Department shall use the authority of A.R.S. Title 41, Chapter 6, Article 10, the Office of Administrative Hearings’ procedura…

A. An insurer’s application form for a long-term care insurance policy shall include the questions listed in this Section to elicit information as to whether, as of the date of the application, the applicant has another long-term care insurance policy or certificate in force or w…

A. An application for a long-term care insurance policy or certificate that is not guaranteed issue shall meet the requirements of this Section. 1. The application shall contain clear and unambiguous questions designed to ascertain the applicant’s health condition. a. If the appl…

A. If long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders, an insurer shall determine policy reserves for long-time care benefits under A.R.S. § 20-510. An insurer shall also establish claim reserves for a po…

A. This Section applies to policies and certificates issued any time prior to May 10, 2005. B. Benefits under an individual long-term care insurance policy are deemed reasonable in relation to premiums if the expected loss ratio is at least 60% calculated in a manner that provide…

A. This Section applies to any long-term care policy or certificate issued in this state on or after May 10, 2005 and prior to November 10, 2017. B. An insurer shall notify the Director of a proposed premium rate schedule increase, including an exceptional increase, at least 60 d…

A. This Section applies to any long-term care policy or certificate issued in this state on or after November 10, 2017. B. An insurer shall notify the Director of a proposed premium rate schedule increase, including an exceptional increase, at least 60 days before issuing notice …

A. Out-of-State Policies. Before an insurer or similar organization may offer group long-term care insurance to a resident of this state under A.R.S. § 20-1691.02(D), the insurer or organization shall file with the Director evidence that a state with statutory or regulatory long-…

A. Every insurer marketing long-term care insurance coverage in this state, directly or through an insurance producer shall: 1. Establish marketing procedures to assure that any comparison of policies by its insurance producers is fair and accurate, and that excessive insurance i…

A. This Section does not apply to life insurance policies that accelerate benefits for long-term care. B. Every insurer or other person marketing long-term care insurance, including an insurance producer or managing general agent, (the “issuer”) shall: 1. Develop and use suitabil…

A. This Section does not apply to life insurance policies or riders containing accelerated long-term care benefits. B. To comply with the requirement to offer a nonforfeiture benefit pursuant to the provisions of A.R.S. § 20-1691.11, an insurer shall meet the following requiremen…

A. A party may appear in their own behalf or through counsel. An insurer may appear through legal counsel or through a duly authorized officer of the corporation. B. When an attorney other than the Attorney General appears or intends to appear before the Director or the Departmen…

A. A long-term care insurance policy shall condition the payment of benefits on a determination of the insured’s ability to perform activities of daily living and on cognitive impairment. Except as otherwise provided in R20-6-1021, eligibility for the payment of benefits shall no…

A. A qualified long-term care insurance contract shall pay only for qualified long-term care services received by a chronically ill individual provided under a plan of care prescribed by a licensed health care practitioner, which is not subject to approval or modification by the …

A. The outline of coverage prescribed in A.R.S. § 20-1691.06 shall be a free-standing document, using no smaller than 10 point type, and shall contain no advertising or promotional material. B. Text that is capitalized or underscored in the standard format outline of coverage may…

A. All prospective applicants of a long-term care insurance policy or certificate shall receive a long-term care insurance shopper’s guide approved by the Director. This requirement may be satisfied by delivery of the current edition of the long-term care insurance shopper’s guid…

A. An insurer shall notify policyholders of the availability of a new long-term policy series that provides coverage for new long-term care services or heath care providers material in nature and not previously available through the insurer to the general public. The notice shall…

A. Every long-term care insurance policy and certificate shall include a provision that allows the policyholder or certificateholder to reduce coverage and lower the policy or certificate premium in at least one of the following ways: 1. Reducing the maximum benefit; or 2. Reduci…

Information that is designated as a “Drafting Instruction” in a form appended to this Article is not required to be included as part of the form. Any person using the form shall abide by the instructions when drafting, preparing, or completing the form. Historical Note New Sectio…

A. A document filed by a party with the Department is filed on the date it is received by the Department as established by the Department’s earliest stamped date on the face of the document or by some other method of affixing a received date by the Department. B. If a party is re…

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-104 recodified from R4-14-104 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-105 recodified from R4-14-105 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

A. The Department may, in a notice of hearing, direct one or more parties to file a written answer to the allegations contained in the notice of hearing. Even if not directed to do so, any party to the proceeding may file an answer. B. A party directed to file an answer shall do …

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-107 recodified from R4-14-107 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-108 recodified from R4-14-108 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-109 recodified from R4-14-109 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-110 recodified from R4-14-110 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

A. The Department incorporates by reference the Model Regulation to Implement the National Association of Insurance Commissioners (NAIC) Medicare Supplement Insurance Minimum Standards Model Act, Fall 2023 (Model Regulation), and no future editions or amendments, which is on file…

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-111 recodified from R4-14-111 (Supp. 95-1). Section expired under A.R.S. § 41-1056(J) at 22 A.A.R. 3374, effective May 31, 2016 (Supp. 16-4). AUTHORITY: A.R.S. § 41-1056

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-112 recodified from R4-14-112 (Supp. 95-1). Section expired under A.R.S. § 41-1056(J) at 22 A.A.R. 3374, effective May 31, 2016 (Supp. 16-4). AUTHORITY: A.R.S. § 41-1056

Historical Note Adopted effective January 23, 1992 (Supp. 92-1). R20-6-113 recodified from R4-14-113 (Supp. 95-1). Section expired under A.R.S. § 41-1056(E) at 17 A.A.R. 1421, effective May 31, 2011 (Supp. 11-3). AUTHORITY: A.R.S. § 41-1056

A. Any party aggrieved by an administrative decision may file with the Director, within time limits and other procedural guidelines contained in A.R.S. § 41-1092.09, a written motion for a rehearing or review of the decision specifying the particular reason for the request. B. A …

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A. “AIDS” means Acquired Immune Deficiency Syndrome. B. “Applicant” means an applicant for a life or disability insurance policy or coverage under a health care plan, as well as any potential certificate holder or dependent covered under such policy or plan. C. “Insurer” means li…

A. Insurers shall not use questions on applications for life or disability policies or health care plans that inquire directly or indirectly about: 1. The sexual orientation of an applicant; 2. An applicant’s receipt of transfusions of blood or blood products; or 3. Whether or no…

A. An insurer may test for HIV infection in the same way that the insurer tests for other conditions that affect mortality and morbidity. No adverse underwriting decision shall be made on the basis of a positive result to an HIV-related test unless the result consists of both a p…

A. Except as required by law or authorized pursuant to a written consent to be tested, an insurer shall not disclose confidential HIV-related information to any person unless a written release form is executed by the applicant or, if the applicant lacks legal capacity to consent …