Arizona Laws 20-1691.08. Rate and form review; disapproval
A. A person shall not deliver or issue for delivery in this state any long-term care insurance policy or rate unless the person has first filed the form or rate with the director and the director has approved the form or rate. Unless the director issues an order affirmatively approving or disapproving the form or rate within sixty days after filing, the form or rate is deemed approved. On written notice given to the insurer within the sixty-day period, the director may extend the sixty-day review period for up to fifteen additional days.
Terms Used In Arizona Laws 20-1691.08
- Long-term care insurance: means an individual or group insurance policy or rider issued by insurers, fraternal benefit societies, nonprofit health, hospital and medical service corporations, prepaid health plans, health care services organizations or any similar organization and advertised, marketed, offered or designed to provide coverage for each covered person on an expense-incurred, indemnity, prepaid or other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal or custodial care services provided in a setting other than an acute care unit of a hospital. See Arizona Laws 20-1691
- Person: includes a corporation, company, partnership, firm, association or society, as well as a natural person. See Arizona Laws 1-215
- Policy: means an individual or group policy, contract, subscriber agreement, rider or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, nonprofit health, hospital or medical service corporation, prepaid health plan or health care services organization or any similar organization. See Arizona Laws 20-1691
B. The director shall disapprove a rate or form if either:
1. The rate does not comply with this article or any rules adopted pursuant to this article.
2. The form contains provisions that are ambiguous, misleading or deceptive, that encourage misrepresentation of the coverage or that are contrary to this title or of any rule adopted pursuant to this title.
C. If the director disapproves a rate or form, the director shall send the insurer a written notice specifying the reason for the disapproval. The insurer may request a hearing pursuant to Title 41, Chapter 6, Article 10 to contest the disapproval. It is unlawful for the insurer to issue or use a rate or form that has been disapproved.
D. At any time after notice and for cause shown, the director may issue an order withdrawing approval of any form or rate for any reason listed in subsection B of this section. The insurer may request a hearing pursuant to Title 41, Chapter 6, Article 10 to contest the director’s order.
E. An insurer shall not issue or use a rate or form after the effective date of an order withdrawing approval.
F. The director, by order, may exempt from the requirements of this section for as long as the director deems proper any insurance rate or form specified in the order, to which, in the director’s opinion, this section may not practicably be applied or the filing and approval of which are, in the director’s opinion, not desirable or necessary for the protection of the public.