Michigan Compiled Laws
218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)
Section 500.3923 - Riders or Endorsements; Certain Changes in Benefits or Premiums; Definition, Explanation, Description, and Labeling of Certain Terms.

Sec. 3923.
(1) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured under an individual long-term care insurance policy, all riders or endorsements added to a long-term care insurance policy after date of issue or at reinstatement or renewal that reduce or eliminate benefits or coverage in the policy shall require signed acceptance by the insured individual. After the date of policy issue, any rider or endorsement that increases benefits or coverage with a concomitant increase in premium during the policy term shall be agreed to in writing and signed by the insured, except if the increased benefits or coverage are required by law. If a separate additional premium is charged for benefits provided in connection with riders or endorsements, that premium charge shall be set forth in the policy, rider, or endorsement.
(2) A long-term care insurance policy that provides for the payment of benefits based on standards described as "usual and customary", "reasonable and customary", or words of similar import shall include a definition of the terms and an explanation of the terms in its accompanying summary of coverage.
(3) If a long-term care insurance policy contains any limitations with respect to preexisting conditions, the limitations shall appear as a separate paragraph of the policy and shall be labeled as "preexisting condition limitations".
(4) A long-term care insurance policy containing any limitations or conditions for eligibility shall set forth a description of the limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy and shall label the paragraph "limitations or conditions on eligibility for benefits".
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 500 - Insurance Code of 1956

Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)

218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)

Section 500.3901 - Long-Term Care Insurance; Definitions.

Section 500.3902 - Offer of Long-Term Care Coverage by Subsidiary of Health Care Corporation.

Section 500.3903 - Group Long-Term Care Insurance; Coverage Offered to Groups Described in MCL 500.3901(c)(iv) and 500.3901(c)(iii).

Section 500.3905 - Long-Term Care Coverage; Requirements; Certain Coverages Requiring Care Recommendations.

Section 500.3906 - Designation of Person to Receive Notice of Termination; Reinstatement of Coverage; Effective Date of Section.

Section 500.3907 - Individual Long-Term Care Policy; Guaranteed Renewable Provision; Conversion; New Limitation Period; Intermediate Care Facility or Skilled Nursing Facility; Home Care Services.

Section 500.3908 - Long-Term Care Partnership Program Policy; Conversion or Replacement.

Section 500.3909 - Option to Purchase Inflation Protection; Summary of Coverage; Applicability of Section.

Section 500.3910 - Option of Purchasing Policy or Certificate Including Nonforfeiture Benefits; Offer.

Section 500.3910a - Nonforfeiture Benefits; Coverage Elements, Eligibility, Benefit Triggers, and Benefit Length; Contingent Benefit; Premium Increase; Notification; Duties of Insurer; Limitation on Maximum Benefits; Effective Date of Section; Premiu...

Section 500.3910b - Reduction Options; Applicability of Section to Long-Term Care Policies and Certificates Issued on or After June 1, 2007.

Section 500.3911 - Preexisting Condition; Limitation Period; Definition.

Section 500.3913 - Home Health Care Benefits.

Section 500.3915 - Certain Conditions Prohibited.

Section 500.3917 - Replacement Policy; Waiver of Time Periods Applicable to Preexisting Conditions and Probationary Periods.

Section 500.3919 - Institutionalization; Extension of Benefits; Limitations.

Section 500.3921 - Application; Questions Relating to Health Condition; Delivery; Record of Policy Rescissions; Annual Report to Commissioner.

Section 500.3923 - Riders or Endorsements; Certain Changes in Benefits or Premiums; Definition, Explanation, Description, and Labeling of Certain Terms.

Section 500.3925 - Applicability of Section to Long-Term Care Policy or Certificate Issued on or After June 1, 2007; Information to Be Provided on Forms; Acknowledgement of Disclosure; Notice of Premium Rate Schedule Increase; Personal Worksheet; Ava...

Section 500.3926 - Applicability of Section to Long-Term Care Policy or Certificate Issued on or After June 1, 2007; Information to Be Provided to Commissioner; Premium Rate Schedule; Statement; Request by Commissioner for Actuarial Demonstration; Ad...

Section 500.3926a - Applicability of Section to Long-Term Care Policy or Certificate Issued on or After June 1, 2007; Notice of Pending Premium Rate Schedule Increase; Requirements; Review and Approval by Commissioner; Eligibility for Contingent Bene...

Section 500.3927 - Reasonableness of Benefits Relative to Premiums; Expected Loss Ratio; Evaluation of Factors; Applicability of Section.

Section 500.3928 - Fixed Indivisible Premium Life Insurance Policy Funding Long-Term Care Benefits by Accelerating Death Benefit; Reasonableness of Benefits Relative to Premiums; Provisions.

Section 500.3929 - Increasing Premiums Prohibited; Conditions.

Section 500.3930 - Acceleration of Benefits Under Group or Individual Life Policies or Riders; Determination of Policy Reserves.

Section 500.3931 - Rules.

Section 500.3933 - Summary of Coverage.

Section 500.3935 - Statement Relating to Request for Additional Information.

Section 500.3937 - Shopper's Guide; Format; Providing to Applicants; Exception.

Section 500.3939 - Application; Questions Relating to Other Policies in Force or Use as Replacement; Agent's List of Other Policies Sold; Notice to Applicant and Existing Insurer; Appropriateness of Recommended Purchase or Replacement.

Section 500.3941 - Advertising; Filing Copy With Commissioner.

Section 500.3941a - Inapplicability of Section to Life Insurance Policies or Riders Containing Accelerated Benefits; Development of Suitability Standards.

Section 500.3942 - Marketing; Duties of Insurer; Use of "Level Premium" or "Noncancelable" Prohibited; Exception.

Section 500.3942a - Reporting Requirements; Agent Activities; Preparation of Report.

Section 500.3943 - Right to Return Policy; Notice; “Direct Response Solicitation” Defined.

Section 500.3945 - Violation; Penalty.

Section 500.3949 - Life and Long-Term Care Benefits; Marketing; Compliance.

Section 500.3951 - Policy Summary; Compliance With MCL 500.3933; Additional Provisions; Monthly Report.

Section 500.3953 - Disclosure Statement.

Section 500.3955 - Compliance With Chapter and Applicable Laws.