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North Dakota drafts short-term care insurance regs

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The North Dakota Department of Insurance may add a section on short-term care insurance (STCI) to the state administrative code.

The department has posted a draft version of STCI regulations on its website. 

The state would define STCI as any type of insurance policy, certificate or rider designed to provide coverage for less than 12 consecutive months for care provided in a setting other than the acute care unit of a hospital.

The definition would include benefits for care in an adult day care facility or an assisted living facility as well as a skilled nursing facility, extended care facility or convalescent nursing home.

The definition also would include policies that provide benefits for home health care, and any policy advertised or offered as being a short-term care insurance policy.

The draft regulations include many of the types of provisions present in states’ long-term care insurance (LTCI) regulations, such as safeguards against unintentional lapse, minimum standards for benefits triggers, and a standard format outline for coverage.

The regulations would require an issuer to base benefits payments on a “determination of the insured’s ability to perform activities of daily living” (ADLs). 

The list of ADLs for STCI would include bathing, continence, dressing and eating, toileting and transferring. The list of triggers also would have to include a cognitive impairment trigger. 

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