Montana Code 33-22-1121. Rules
33-22-1121. Rules. The commissioner may adopt rules necessary to implement this part, including but not limited to rules that:
Terms Used In Montana Code 33-22-1121
- Activities of daily living: means :
(a)eating;
(b)toileting;
(c)transferring;
(d)bathing;
(e)dressing; and
(f)continence. See Montana Code 33-22-1107
- Appropriate sale criteria: means the set of conditions that an insurance company is required to address with an applicant that help to determine whether or not a particular insurance policy or contract offered for sale is appropriate to the applicant. See Montana Code 33-22-1107
- 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
(1)establish loss ratio standards for long-term care insurance policies;
(2)promote premium adequacy and protect the policyholder in the event of substantial rate increases;
(3)establish minimum standards for insurance producer training, marketing practices, compensation, and testing;
(4)establish penalties and reporting practices for long-term care insurance;
(5)specify, with respect to nonforfeiture benefits and contingent benefits:
(a)the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies;
(b)the standards for nonforfeiture benefits;
(c)the rules regarding contingent benefits upon lapse, including:
(i)a determination of the specified period of time during which a contingent benefit upon lapse will be available;
(ii)the substantial premium rate increase that triggers a contingent benefit upon lapse as described in 33-22-1116; and
(d)the types of appropriate sale criteria to be communicated at the time of application;
(6)establish a requirement for the mandatory triggering of policy benefits based upon the number of activities of daily living that an individual is capable or incapable of performing; and
(7)are necessary to implement a determination made by the secretary of health and human services pursuant to 45 CFR, parts 160 and 164, as to who is a licensed health care practitioner.