(a) Every group long-term care insurance policy sold after June 30, 2000, may conform to Subtitle C of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and to Section 7702B of the Internal Revenue Code of 1986, as amended; provided that if it does not conform, then it shall not qualify for federal or state income tax benefits.

Terms Used In Hawaii Revised Statutes 431:10H-301

  • Group long-term care insurance: means a long-term care insurance policy which is delivered or issued for delivery in this State and issued to:

    (1) One or more employers or labor organizations, or a trust or to the trustees of a fund established by one or more employers or labor organizations, or a combination thereof, for employees or former employees or a combination thereof or for members or former members or a combination thereof, of the labor organizations; or

    (2) Any professional, trade, or occupational association for its members or former or retired members, or combination thereof, if the association:

    (A) Is composed of individuals all of whom are or were actively engaged in the same profession, trade, or occupation; and

    (B) Has been maintained in good faith for purposes other than obtaining insurance; or

    (3) An association or a trust or the trustees of a fund established, created, or maintained for the benefit of members of one or more associations. See Hawaii Revised Statutes 431:10H-104

  • Long-term care insurance: means any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for not less than twelve consecutive months for each covered person on an expense incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting other than an acute care unit of a hospital. See Hawaii Revised Statutes 431:10H-104
  • Policy: means , for the purposes of this article, any policy, contract, subscriber agreement, rider, or endorsement delivered or issued for delivery in this State by an insurer; fraternal benefit society; nonprofit health, hospital, or medical service corporation; prepaid health plan; health maintenance organization; or any similar organization. See Hawaii Revised Statutes 431:10H-104
(b) A group long-term care insurance policy may provide coverage, at a minimum, for “qualified long-term care services”, as defined in Subtitle C of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and in Section 7702B of the Internal Revenue Code of 1986, as amended.
(c) For the purpose of subsection (b) and for the purpose of describing examples of services typically found in this State, coverage shall be one or more of the following services or any combination of services:

(1) Home health care services, as defined in § 431:10H-201;
(2) Adult day care, as defined in § 431:10H-201;
(3) Adult residential care home, as defined in section 321-15.1;
(4) Extended care adult residential care home, as defined in § 323D-2;
(5) Nursing home, as defined in § 457B-2;
(6) Skilled nursing facilities and intermediate care facilities, as referenced in section 321-11(10);
(7) Hospices, as referenced in section 321-11;
(8) Assisted living facility, as defined in § 323D-2;
(9) Personal care, as defined in § 431:10H-201;
(10) Respite care, as defined in § 333F-1; and
(11) Any other care as provided by rule of the commissioner.
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