Bill Text: IN HB1558 | 2013 | Regular Session | Introduced
Bill Title: Consumer lawsuit lending.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Passed) 2013-05-13 - Public Law 75 [HB1558 Detail]
Download: Indiana-2013-HB1558-Introduced.html
Citations Affected: IC 12-15-39.6; IC 27-8-12.
Synopsis: Long term care insurance. Specifies that a life insurance
policy or rider with an accelerated death benefit for long term care
coverage is long term care insurance for purposes of the asset disregard
for Medicaid eligibility under the long term care partnership program.
Effective: July 1, 2013.
January 22, 2013, read first time and referred to Committee on Insurance.
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in
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A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
(b) The term does not include payment:
(1) of coinsurance, deductibles, or premiums for other insurance policies;
(2) for services covered by other insurance policies; or
(3) for services covered by Parts A and B of the Medicare program (42 U.S.C. 1395 et seq.).
(c) The term includes coverage under a life insurance policy or rider with an accelerated death benefit that is specifically available to pay for long term care.
FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 8. An individual who
is: either:
(1) the beneficiary of a qualified long term care policy approved
by the department of insurance; or
(2) enrolled in a health maintenance organization that both
provides long term care services and meets the requirements
under sections 4 and 5 of this chapter; or
(3) covered under a life insurance policy or rider with an
accelerated death benefit that is specifically available to pay
for long term care;
is eligible for assistance under the Medicaid program using the asset
disregard under section 10 of this chapter.
(1) A one dollar ($1) increase in the amount of assets an individual who:
(A) purchases a qualified long term care policy; and
(B) meets the requirements under section 8 of this chapter;
may retain under IC 12-15-3 for each one dollar ($1) of benefit paid out under the individual's long term care policy for long term care services.
(2) The total assets an individual owns and may retain under IC 12-15-3 and still qualify for benefits under IC 12-15 at the time the individual applies for benefits if the individual:
(A) is the beneficiary of a qualified long term care policy that:
(i) if the qualified long term care policy is not described in section 3(c) of this chapter, provides maximum benefits at time of purchase of at least one hundred forty thousand dollars ($140,000) and includes a provision under which the daily benefit increases by at least five percent (5%) per year, compounded at least annually; and
(ii) if the qualified long term care policy is described in section 3(c) of this chapter, provides maximum benefits at time of purchase of at least two hundred fifty thousand dollars ($250,000);
(B) meets the requirements under section 8 of this chapter; and
(C) has exhausted the benefits of the qualified long term care policy.
(b) When the office determines whether an individual is eligible for Medicaid under IC 12-15-3, the office shall make an asset disregard adjustment for any individual who purchases a qualified long term care
policy. The asset disregard must be available after benefits of the long
term care policy have been applied to the cost of long term care as
required under this chapter.
(c) The qualified long term care policy an individual must purchase
to be eligible for the asset disregard under subsection (a)(2) must have:
(1) if the qualified long term care policy is not described in
section 3(c) of this chapter, maximum benefits at time of
purchase equal to at least one hundred forty thousand dollars
($140,000), plus five percent (5%) interest compounded annually
beginning January 1, 1999; and
(2) if the qualified long term care policy is described in section
3(c) of this chapter, maximum benefits at time of purchase
equal to at least two hundred fifty thousand dollars
($250,000).
(b) The term includes the following:
(1) A policy advertised, marketed, or offered as long term care insurance.
(2) A group or individual annuity, a life insurance policy, or riders that provide directly or supplement long term care insurance.
(3) A policy or rider that provides for payment of benefits based upon cognitive impairment or the loss of functional capacity.
(4) A life insurance policy or rider with an accelerated death benefit that is specifically available for coverage of long term care.
(c) The term does not include the following:
(1) An insurance policy that is offered primarily to provide basic hospital expense coverage, basic medical-surgical expense coverage, hospital confinement indemnity coverage, major medical expense coverage, disability income protection coverage, accident only coverage, specified disease or specified accident coverage, comprehensive coverage, catastrophic coverage, or limited benefit health coverage.
(2) A life insurance policy that accelerates the death benefit specifically for terminal illness, a medical condition requiring
extraordinary medical intervention, or a permanent institutional
confinement, and that provides the option of a lump sum payment
for those benefits and in which neither the benefits nor the
eligibility for the benefits is conditioned upon the receipt of long
term care.
(3) An insurance policy that is offered primarily to provide basic
Medicare supplemental coverage (as defined under IC 27-8-13).
(b) The rules adopted under this section must include the following:
(1) The standards adopted under section 7 of this chapter.
(2) The requirement that an insurer or other person who issues a qualified long term care policy must at a minimum offer to each policyholder or prospective policyholder a policy that provides both:
(A) long term care facility coverage; and
(B) home and community care coverage.
(3) A provision that an insurer or other person who complies with subdivision (2) may elect to also offer a qualified long term care policy that provides only long term care facility coverage.
(4) The submission of data by insurers that will allow the department of insurance, the office of Medicaid policy and planning, and the division of aging to administer the Indiana long term care program under IC 12-15-39.6.
(5) Other standards needed to administer the Indiana long term care program.
(c) The rules adopted under this section must not include a requirement that a long term care insurance policy described in section 5(b)(4) of this chapter include a benefit that periodically changes based on a certain percentage rate.
