Sec. 351A-8. Outline of coverage.

287 words·~1 min read·/il/chapter-215/act-5/351a-8

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(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 which prominently direct the attention of the recipient to the document and its purpose.

(1)The Director shall prescribe a standard format including style, arrangement and

overall appearance and the content of an outline of coverage.

(2)In the case of agent solicitations, an agent must deliver the outline of coverage

prior to the presentation of an application or enrollment form.

(3)In the case of direct response solicitations, the outline of coverage must be

presented in conjunction with any application or enrollment form.

(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 contain 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 cost of care and benefits.

(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 7702B(b) of the Internal Revenue Code of 1986, as amended.