§431:10H-112  Outline of coverage required. 
(a)  An outline of coverage shall be delivered to a prospective applicant for
long-term care insurance at the time of initial solicitation through means that
prominently direct the attention of the recipient to the document and its
purpose.  The commissioner shall prescribe a standard format, including style,
arrangement, and overall appearance, and the content of an outline of
coverage.  In the case of producer solicitations, a producer shall deliver the
outline of coverage prior to the presentation of an application or enrollment
form.  In the case of direct response solicitation, the outline of coverage
shall be presented in conjunction with any application or enrollment form.  In
the case of a policy issued to a group defined in paragraph (1) of the
definition of "group long-term care insurance" in section
431:10H-104, an outline of coverage shall not be required to be delivered;
provided that the information described in subsection (b) is contained in other
materials relating to enrollment.  Upon request, these other materials shall be
made available to the commissioner.



(b)  The outline of coverage shall include:



(1)  A description of the principal benefits and
coverage provided in the policy;



(2)  A statement of the principal exclusions,
reductions, and limitations contained in the policy;



(3)  A statement of the terms under which the policy
or certificate, or both, may be continued in force or discontinued, including
any reservation in the policy of a right to change premium.  Continuation or
conversion provisions of group coverage shall be specifically described;



(4)  A statement that the outline of coverage is a
summary only, not a contract of insurance, and that the policy or group master
policy contains governing contractual provisions;



(5)  A description of the terms under which the policy
or certificate may be returned and premium refunded;



(6)  A brief description of the relationship of costs
of care and benefits; and



(7)  A statement that discloses to the policyholder or
certificate holder whether the policy is intended to be a federally
tax-qualified long-term care insurance contract under section 7702B(b) of the
Internal Revenue Code of 1986, as amended. [L 1999, c 93, pt of §2; am L 2003,
c 212, §93; am L 2007, c 233, §8]