An outline of coverage shall be delivered to an applicant for an individual long-term care insurance policy at the time of application for an individual policy. In the case of direct response solicitations, the insurer shall deliver the outline of coverage upon the applicant’s request, but regardless of request, shall make such delivery no later than at the time of policy delivery. Such outline of coverage shall include:

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Terms Used In Florida Regulations 69O-157.020

  • Contract: A legal written agreement that becomes binding when signed.
    (1) The name and principal address of the insurer or service association;
    (2) A statement of identification of the policy or contract;
    (3) A policy form number;
    (4) A description of the principal benefits and coverage provided in the policy;
    (5) A statement of the principal exclusions, reductions, and limitations contained in the policy;
    (6) If the policy is not expected to cover 100 percent of the cost of services for which coverage is provided, as statement clearly describing any such limitations;
    (7) A statement of the renewal provisions, including any reservation in the policy of a right to change premiums;
    (8) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions; and
    (9) A statement that the policy has been approved as a long-term care insurance policy meeting the requirements of Florida Law.
Rulemaking Authority Florida Statutes § 624.308(1), 627.9407(1) FS. Law Implemented 624.307(1), 627.9407(1), (9) FS. History-New 5-17-89, Formerly 4-81.020, 4-157.020.