§ 431:10H-101 Purpose
§ 431:10H-102 Scope
§ 431:10H-103 Short title
§ 431:10H-104 Definitions
§ 431:10H-105 Extraterritorial jurisdiction; group policies
§ 431:10H-106 Rules
§ 431:10H-106.5 Producer training requirements
§ 431:10H-107 Basic standards
§ 431:10H-108 Preexisting conditions-group and individual policies
§ 431:10H-109 Prior hospitalization; prior institutionalization
§ 431:10H-110 Loss ratio standards; factors; commissioner approval
§ 431:10H-111 Right to return; free look provision
§ 431:10H-112 Outline of coverage required
§ 431:10H-113 Group policy certificate requirements
§ 431:10H-114 Life insurance policies offering long-term care benefits
§ 431:10H-115 Incontestability period-group and individual policies
§ 431:10H-116 Nonforfeiture benefits
§ 431:10H-116.5 Delivery of the contract or certificate of insurance
§ 431:10H-116.6 Denial of claims; compliance requirements
§ 431:10H-117 Authority to adopt rules

Terms Used In Hawaii Revised Statutes > Chapter 431 > Article 10H > Part I - Long-Term Care Insurance Model Act

  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Applicant: means :

    (1) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and

    (2) In the case of a group long-term care insurance policy, the proposed certificate holder. See Hawaii Revised Statutes 431:10H-104

  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Certificate: means , for the purposes of this article, any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this State. See Hawaii Revised Statutes 431:10H-104
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • county: includes the city and county of Honolulu. See Hawaii Revised Statutes 1-22
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Decedent: A deceased person.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Director: means the director of labor and industrial relations. See Hawaii Revised Statutes 381-1
  • Employee: means any person, whether or not a member of a labor organization, in the employ of a public utility and whose duties pertain or relate to the public utility service in which the public utility is engaged. See Hawaii Revised Statutes 381-1
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • federally tax-qualified long-term care insurance contract: means an individual or group insurance contract that meets the requirements of section 7702B (b) of the Internal Revenue Code of 1986, as amended, as follows:

    (1) The only insurance protection provided under the contract is coverage of qualified long-term care services. See Hawaii Revised Statutes 431:10H-104

  • Fiduciary: A trustee, executor, or administrator.
  • Fraud: Intentional deception resulting in injury to another.
  • 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

  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Internal Revenue Code: means subtitle A, chapter 1, of the federal Internal Revenue Code of 1986, as amended as of December 31, 2022, as it applies to the determination of gross income, adjusted gross income, ordinary income and loss, and taxable income, except those provisions of the Internal Revenue Code which, pursuant to this chapter, do not apply or are otherwise limited in application. See Hawaii Revised Statutes 235-2.3
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • labor dispute: includes any controversy concerning terms or conditions of employment, or concerning the association or representation of persons in negotiating, fixing, maintaining, changing, or seeking to arrange terms or conditions of employment, regardless of whether or not the disputants stand in the proximate relation of employer and employee. See Hawaii Revised Statutes 380-13
  • Labor organization: means any organization of employees which exists for the purpose, in whole or in part, of collective bargaining or of dealing with employers concerning wages, hours, and other terms and conditions of employment. See Hawaii Revised Statutes 381-1
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Lockout: means the refusal of a public utility to furnish work to employees as a result of a labor dispute. See Hawaii Revised Statutes 381-1
  • 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
  • month: means a calendar month; and the word "year" a calendar year. See Hawaii Revised Statutes 1-20
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • oath: includes a solemn affirmation. See Hawaii Revised Statutes 1-21
  • Oath: A promise to tell the truth.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Personal property: All property that is not real property.
  • 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
  • Public utility: has the meaning given that term in § 269-1, excluding, however, the State or any county or any commission or board of the State or of any county, and any person subject to the Federal Railway Labor Act, as amended from time to time. See Hawaii Revised Statutes 381-1
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Representative: means any person or persons, labor organization, organization, or corporation designated either by a public utility or by employees to act for it or them. See Hawaii Revised Statutes 381-1
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Strike: means the temporary stoppage of work, slowdown, or retarding of production or operations by the concerted action of two or more employees as a result of a labor dispute. See Hawaii Revised Statutes 381-1
  • Subpoena: A command to a witness to appear and give testimony.
  • Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trustee: A person or institution holding and administering property in trust.