Montana Code 33-22-1114. Prohibited practices and policy provisions
33-22-1114. Prohibited practices and policy provisions. (1) An insurance company may not issue a refund to a person other than the owner of the policy or certificate.
Terms Used In Montana Code 33-22-1114
- Certificate: means a certificate issued under a group long-term care insurance policy that has been delivered or issued for delivery in this state. See Montana Code 33-22-1107
- Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
- Policy: means any policy, certificate, contract, membership contract, subscriber agreement, health care services agreement, rider, or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, health service corporation, prepaid health plan, health maintenance organization, or similar organization. See Montana Code 33-22-1107
- Waiting period: means , with respect to a group health plan and an individual who is a potential participant or beneficiary in the group health plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the group health plan. See Montana Code 33-22-140
(2)A long-term care insurance policy may not:
(a)be canceled, nonrenewed, or otherwise terminated on any grounds other than the insured’s or certificate holder’s failure to pay the premium;
(b)contain a provision establishing a new waiting period if existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or
(c)provide coverage for only skilled nursing care or provide substantially more coverage for skilled nursing care in a facility than coverage for lower levels of care.