§431:10H-112  Outline of coverage required. (a)  An outline of coverage shall be delivered to a prospective applicant forlong-term care insurance at the time of initial solicitation through means thatprominently direct the attention of the recipient to the document and itspurpose.  The commissioner shall prescribe a standard format, including style,arrangement, and overall appearance, and the content of an outline ofcoverage.  In the case of producer solicitations, a producer shall deliver theoutline of coverage prior to the presentation of an application or enrollmentform.  In the case of direct response solicitation, the outline of coverageshall be presented in conjunction with any application or enrollment form.  Inthe case of a policy issued to a group defined in paragraph (1) of thedefinition of "group long-term care insurance" in section431:10H-104, an outline of coverage shall not be required to be delivered;provided that the information described in subsection (b) is contained in othermaterials relating to enrollment.  Upon request, these other materials shall bemade available to the commissioner.

(b)  The outline of coverage shall include:

(1)  A description of the principal benefits andcoverage 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 policyor certificate, or both, may be continued in force or discontinued, includingany reservation in the policy of a right to change premium.  Continuation orconversion provisions of group coverage shall be specifically described;

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

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

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

(7)  A statement that discloses to the policyholder orcertificate holder whether the policy is intended to be a federallytax-qualified long-term care insurance contract under section 7702B(b) of theInternal 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]