us/statute/42/1396p/b/1/C/iii

For purposes of this paragraph, the term “qualified State long-term care insurance partnership” means an approved State plan amendment under this subchapter that provides for the disregard of any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a long-term care insurance policy if the following requirements are met:

(I)#

The policy covers an insured who was a resident of such State when coverage first became effective under the policy.

(II)#

The policy is a qualified long-term care insurance policy (as defined in section 7702B(b) of the Internal Revenue Code of 1986) issued not earlier than the effective date of the State plan amendment.

(III)#

The policy meets the model regulations and the requirements of the model Act specified in paragraph (5).

(IV)#

If the policy is sold to an individual who—

(aa) has not attained age 61 as of the date of purchase, the policy provides compound annual inflation protection;

(bb) has attained age 61 but has not attained age 76 as of such date, the policy provides some level of inflation protection; and

(cc) has attained age 76 as of such date, the policy may (but is not required to) provide some level of inflation protection.

(IV)(aa)#

has not attained age 61 as of the date of purchase, the policy provides compound annual inflation protection;

(IV)(bb)#

has attained age 61 but has not attained age 76 as of such date, the policy provides some level of inflation protection; and

(IV)(cc)#

has attained age 76 as of such date, the policy may (but is not required to) provide some level of inflation protection.

(V)#

The State Medicaid agency under section 1396a(a)(5) of this title provides information and technical assistance to the State insurance department on the insurance department’s role of assuring that any individual who sells a long-term care insurance policy under the partnership receives training and demonstrates evidence of an understanding of such policies and how they relate to other public and private coverage of long-term care.

(VI)#

The issuer of the policy provides regular reports to the Secretary, in accordance with regulations of the Secretary, that include notification regarding when benefits provided under the policy have been paid and the amount of such benefits paid, notification regarding when the policy otherwise terminates, and such other information as the Secretary determines may be appropriate to the administration of such partnerships.

(VII)#

The State does not impose any requirement affecting the terms or benefits of such a policy unless the State imposes such requirement on long-term care insurance policies without regard to whether the policy is covered under the partnership or is offered in connection with such a partnership.

In the case of a long-term care insurance policy which is exchanged for another such policy, subclause (I) shall be applied based on the coverage of the first such policy that was exchanged. For purposes of this clause and paragraph (5), the term “long-term care insurance policy” includes a certificate issued under a group insurance contract.

← 42 U.S.C. § 1396p(b)(1)(C)(vi)

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References

This rule cites 1 other rule.

42 USC § 1396a (a)(5)inferredUS Federal › Statutes › Title 42 › § 1396a › (a)(5)