N.Y. Comp. Codes R. & Regs. tit. 11 § 39.8

Current through Register Vol. 46, No. 51, December 18, 2024

Section 39.8 - Disclosure explaining insurance regulatory issues and medicaid asset protection issues when covered under new york state partnership insurance or covered under partnership insurance of other states after replacement

(a) An insurer shall provide to an insured under a New York State partnership program qualified policy /certificate a disclosure setting forth that:

(1) A New York State partnership program qualified policy/certificate approved by the New York Superintendent of Financial Services is under the regulatory oversight of New York State.

(2) A policy/certificate of a partnership program of another state that replaces a New York State partnership program qualified policy/certificate shall be regulated by the other state.

(3) A New York State partnership program insured who leaves New York State may not be eligible for Medicaid asset protection in another state after insurance purchase if that state is no longer a reciprocal state, and therefore, New York State partnership program insureds leaving New York State should verify reciprocal participation after insurance purchase and until the insured is eligible and applying for Medicaid in another state.

(4) A New York State partnership program insured who replaces a New York State partnership program qualified policy/certificate with a policy/certificate under a partnership program of another state may not be eligible for Medicaid asset protection from New York State after replacement occurs if New York State is no longer a reciprocal state when the insured is eligible and applies for Medicaid in New York State.

(5) A New York State partnership program insured is ineligible for Medicaid asset protection in non-partnership states and non-reciprocal states.

(6) A New York State partnership program insured who replaces a New York State partnership program qualified policy/certificate with long term care insurance from a non-partnership state or non-reciprocal state is ineligible for Medicaid asset protection from New York State.

(7) A New York State partnership program insured who purchases a policy/certificate marketed as protecting all assets upon becoming eligible for Medicaid in New York State shall only be eligible for Medicaid asset protection in a reciprocal state in an amount equal to the benefits paid by the New York State partnership program qualified policy/certificate.

(8) A New York State partnership program insured who replaces a New York State partnership qualified policy/certificate with a policy/certificate under a partnership program of another state shall only be eligible for asset protection in New York State in an amount equal to the benefits paid by the policy/certificate under a partnership program of the other state.

(9) An insured who replaces a New York State partnership program qualified policy/certificate with an individual long term care insurance policy not approved by New York State shall be ineligible for the New York State long term care insurance income tax credit for the premiums paid for the replacing individual policy of the other state.

(b) A disclosure statement, including the explanations of this section, shall accompany or be incorporated in a qualified policy/certificate under the program when the qualified policy/certificate is delivered to the insured or delivered to the applicant at the time application is made for the qualified policy/certificate. The insurer shall obtain an acknowledgement of receipt or certification of delivery of a disclosure statement that included the explanations of this section. For in-force qualified policies/certificates under the program on June 1, 2012, the insurer shall provide a disclosure statement, including the explanations of this section, to the in-force insureds. However, an acknowledgement of receipt or certification of delivery shall not be required for qualified policies/certificates in-force as of June 1, 2012.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 39.8