61 sections in this chapter.
R.191—39.77 Definitions. For purposes of this division, the definitions in Iowa Code chapter 514H
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and rule 191—39.4(514G) shall apply. In addition, the following definitions shall apply: “Asset disregard” means, with regard to the state’s Medicaid program, disregarding assets in an amount equal to the insurance benefit payments that are made to or on behalf of an individual w…
R.191—39.78 Eligibility
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39.78(1) An individual who is a beneficiary of an Iowa long-term care partnership policy or certificate may be eligible for assistance under the state’s Medicaid program using the asset disregard as provided under Iowa Code chapter 514H as amended by 2009 Iowa Acts, House File 72…
R.191—39.79 Discontinuance of partnership program. If the Iowa long-term care partnership
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program established by this division and Iowa Code chapter 514H as amended by 2009 Iowa Acts, House File 723, is discontinued, any individual who purchased an Iowa long-term care partnership policy or certificate before the date the program was discontinued shall be eligible to r…
R.191—39.8 Prohibition against postclaims underwriting
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39.8(1) All applications for long-term care insurance policies or certificates except those which are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the health condition of the applicant. 39.8(2) If an application for long-term care insurance…
R.191—39.80 Required disclosures
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39.80(1) An insurer or a producer soliciting or offering to sell a partnership policy shall provide to each prospective applicant a Partnership Program Notice. The notice must be substantially similar to Appendix H of this chapter. The Partnership Program Notice shall be provided…
R.191—39.81 Form filings
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39.81(1) A partnership policy shall not be issued or issued for delivery in Iowa unless filed with and approved by the division. Any policy submitted for certification as a partnership policy shall be accompanied by a Partnership Issuer Certification. The Partnership Issuer Certi…
R.191—39.82 Exchanges
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39.82(1) An insurer must offer, on a one-time basis, in writing, to all existing policyholders that were issued long-term care policies between February 1, 2003, and January 1, 2010, the option to exchange their existing long-term care policies for an Iowa long-term care partners…
R.191—39.83 Required policy terms and disclosures
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39.83(1) A policy or certificate designed or marketed as a long-term care insurance policy or certificate must prominently disclose on the schedule page the following statements: “Some long-term care insurance [policies or certificates] may qualify under the state’s Long-Term Car…
R.191—39.84 Standards for marketing and suitability. The standards for marketing found in rule
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191—39.15(514D,514G) and the suitability requirements of rule 191—39.16(514D,514G) shall apply to the marketing and sale of long-term care partnership policies. [ARC 8271B, IAB 11/4/09, effective 12/9/09; ARC 5598C, IAB 5/5/21, effective 6/9/21]
R.191—39.85 Required reports
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39.85(1) Each issuer of partnership-qualified long-term care insurance in this state shall provide regular reports to the Secretary of the United States Department of Health and Human Services in accordance with federal law and regulations and to the Iowa department of human serv…
R.191—39.9 Minimum standards for home health care benefits in long-term care
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insurance policies. 39.9(1) A long-term care insurance policy or certificate may not, if it provides benefits for home health care services, limit or exclude benefits: a. By requiring that the insured/claimant would need skilled care in a nursing facility if home health care serv…