69O-157.002. Applicability and Scope

(1) Except as otherwise specifically provided, the provisions of Chapter 69O-157, F.A.C., shall apply to long-term care insurance policies delivered or issued for delivery in this state, and to policies delivered or issued for delivery outside this state to the extent provided in Section 627.9406, F.S., and Rule 69O-157.004, F.A.C., by an insurer, a fraternal benefit society as defined in Section 632.601, Florida Statutes, a health care services plan as defined in Section 641.01, Florida Statutes, a prepaid health clinic as defined in Section 641.402, Florida Statutes, or a multiple-employer welfare arrangement as defined in Section 624.437, Florida Statutes. A policy which is advertised, marketed, or offered as a long-term care policy and as a Medicare supplement policy shall meet the requirements of the rules contained in this chapter and such statutes or rules specifically applicable to Medicare supplement policies and, to the extent of a conflict, be subject to the requirement that is more favorable to the policyholder or certificate holder.

(2) The provisions of Chapter 69O-157, F.A.C., shall apply to such long-term care policies issued or renewed on or after the effective date of Chapter 69O-157, F.A.C.; however, the provisions of Chapter 69O-157, F.A.C., do not apply to any policy that is not subject to the provisions of Sections 627.9401-627.9408, Florida Statutes, as presently existing or as hereafter amended.

(3) The provisions of Part I shall apply to all long-term care policies and certificates issued in this state which are not included in the scope of Part II.

(4) All appendices incorporated by reference are available from the Division of Life and Health Product Review, Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0328.

Specific Authority 624.308(1), 627.9407(1) FS. Law Implemented 624.307(1), 627.9403, 627.9406, 627.9407(1) FS. History–New 5-17-89, Formerly 4-81.002, Amended 1-13-03, Formerly 4-157.002.