191—39.15 (514D,514G) Standards for marketing.
	 39.15(1) Every insurer, health care service plan or other entity marketing long-term care insurance coverage in this state, directly or through its producers, shall:
	  a.   	 Establish marketing procedures to ensure that any comparison of policies by its agents or other producers will be fair and accurate.
	  b.   	 Establish marketing procedures to ensure that excessive insurance is not sold or issued.
	  c.   	 Display prominently by type, stamp or other appropriate means, on the first page of the outline of coverage and policy, the following:
“Notice to buyer: This policy may not cover all of the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations.”
	  d.   	 Inquire and otherwise make every reasonable effort to identify whether a prospective applicant or enrollee for long-term care insurance already has accident and sickness or long-term care insurance and the types and amounts of any such insurance.
	  e.   	 Every insurer or entity marketing long-term care insurance shall establish auditable procedures for verifying compliance with this subrule.
	  f.   	 If the state in which the policy or certificate is to be delivered or issued for delivery has a senior insurance counseling program approved by the commissioner, the insurer shall, at solicitation, provide written notice to the prospective policyholder and certificate holder that such a program is available and the name, address and telephone number of the program.
	  g.   	 For long-term care health insurance policies and certificates, use the terms “noncancellable” or “level premium” only when the policy or certificate conforms to paragraph 39.6(1)“b.”
	  h.   	 Provide an explanation of contingent benefit upon lapse provided for in 39.29(6)“c.”
	 39.15(2) In addition to the practices prohibited in Iowa Code chapter 507B, the following acts and practices are prohibited:
	  a.   	 Twisting. Knowingly making any misleading representation or incomplete or fraudulent comparison of any insurance policies or insurers for the purpose of inducing, or tending to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on, or convert any insurance policy or to take out a policy of insurance with another insurer.
	  b.   	 High-pressure tactics. Employing any method of marketing having the effect of or tending to induce the purchase of insurance through force, fright, threat, whether explicit or implied, or undue pressure to purchase or recommend the purchase of insurance.
	  c.   	 Cold-lead advertising. Making use directly or indirectly of any method of marketing which fails to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contact will be made by an insurance agent or insurance company.
	  d.   	 Misrepresentation. Misrepresenting a material fact in selling or offering to sell a long-term care insurance policy.
	 39.15(3) Association marketing.
	  a.   	 When a group long-term care insurance policy is issued to 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, the association or associations, or the insurer of the association or associations, shall, prior to advertising, marketing or offering the policy within this state, file evidence with the commissioner that the association or associations have at the outset a minimum of 100 persons and have been organized and maintained in good faith for purposes other than that of obtaining insurance; have been in active existence for at least one year; and have a constitution and bylaws that provide that:
	 (1) 	 The association or associations hold regular meetings not less than annually to further purposes of the members;
	 (2) 	 Except for credit unions, the association or associations collect dues or solicit contributions from members; and
	 (3) 	 The members have voting privileges and representation on the governing board and committees.
Thirty days after the filing, the association or associations will be deemed to satisfy the organizational requirements, unless the commissioner makes a finding that the association or associations do not satisfy those organizational requirements.
	  b.   	 When a professional, trade, or occupational association is issued a group long-term care policy for its members or retired members or combination thereof, the association shall have as its primary responsibility, when endorsing or selling long-term care insurance, to educate its members concerning long-term care issues in general so that its members can make informed decisions. Associations shall provide objective information regarding long-term care insurance policies or certificates endorsed or sold by such associations to ensure that members of such associations receive a balanced and complete explanation of the features in the policies or certificates that are being endorsed or sold.
	 (1) 	 The insurer shall file with the insurance division the following material:
	  1. 	 The policy and certificate;
	  2. 	 A corresponding outline of coverage; and
	  3. 	 All advertisements requested by the insurance division.
	 (2) 	 The association shall disclose in any long-term care insurance solicitation the specific nature and amount of the compensation arrangements (including all fees, commissions, administrative fees and other forms of financial support) that the association receives from endorsement or sale of the policy or certificate to its members; and a brief description of the process under which the policies and the insurer issuing the policies were selected.
	 (3) 	 If the association and the insurer have interlocking directorates or trustee arrangements, the association shall disclose that fact to its members.
	 (4) 	 The board of directors of associations selling or endorsing long-term care insurance policies or certificates shall review and approve the insurance policies as well as the compensation arrangements made with the insurer.
	 (5) 	 The association shall also:
	  1. 	 At the time of the association’s decision to endorse, engage the services of a person with expertise in long-term care insurance who is not affiliated with the insurer to conduct an examination of the policies, including its benefits, features, and rates and update the examination thereafter in the event of material change;
	  2. 	 Actively monitor the marketing efforts of the insurer and its agents; and
	  3. 	 Review and approve all marketing materials or other insurance communications used to promote sales or sent to members regarding the policies or certificates.
Numbered paragraphs “1” through “3” shall not apply to qualified long-term care insurance contracts.
	 (6) 	 No group long-term care insurance policy or certificate may be issued to an association unless the insurer files with the insurance division the information required in this subrule.
	 (7) 	 The insurer shall not issue a long-term care policy or certificate to an association or continue to market such a policy or certificate unless the insurer certifies annually that the association has complied with the requirements set forth in this subrule.
	 (8) 	 Failure to comply with the filing and certification requirements of this subrule constitutes an unfair trade practice in violation of Iowa Code chapter 507B.
	 39.15(4) Producer training requirements.
	  a.   	 Purpose. The purpose of this subrule is to require certain specific minimum training for insurance producers who wish to sell long-term care insurance in Iowa. This additional training is necessary due to the complex nature of long-term care insurance products and to ensure that insurance producers are able to determine whether long-term care insurance products are suitable for consumers and that producers are able to adequately explain to consumers how the long-term care insurance products work. The ultimate goal of this subrule is to ensure that purchasers of long-term care insurance products understand basic features of the products. This subrule applies to all long-term care insurance products sold on or after January 1, 2009.
	  b.   	 Requirements for insurers. An insurer subject to this subrule shall obtain verification that a producer has received training required by this subrule before a producer is permitted to sell, solicit or negotiate the insurer’s long-term care insurance products.
	  c.   	 Required training. The training required by paragraph “b” is as follows:
	 (1) 	 To sell, solicit or negotiate long-term care insurance for an insurer on or after January 1, 2009, a producer must have completed a one-time training course of at least four credits and as set forth in paragraph “d.”
	 (2) 	 In addition to the one-time training course required in subparagraph (1) to sell, solicit or negotiate long-term care insurance for an insurer on or after January 1, 2009, a producer shall complete ongoing training of no less than three credits every CE term and as set forth in paragraph “d.”
	 (3) 	 For purposes of this subrule, “credit” and “CE term” shall be defined as they are defined in rule 191—11.2(505,522B).
	  d.   	 Training content. The training required under this subrule shall consist of topics related to long-term care insurance, long-term care services and, if applicable, qualified state long-term care asset preservation programs, pursuant to 191—Chapter 72, including, but not limited to:
	 (1) 	 State and federal regulations and requirements and the relationship between qualified state long-term care asset preservation programs and other public and private coverage of long-term care services, including Medicaid;
	 (2) 	 Available long-term care services and providers;
	 (3) 	 Changes or improvements in long-term care services or providers;
	 (4) 	 Alternatives to the purchase of private long-term care insurance;
	 (5) 	 The effect of inflation on benefits and the importance of inflation protection; and
	 (6) 	 Consumer suitability standards and guidelines.
	  e.   	 General training. The training required by this subrule shall not include training that is specific to an insurer’s or company’s product or that includes any sales or marketing information, materials, or training, other than that required by state or federal law.
	  f.   	 Approval of courses. The training requirements of paragraph “c” must be approved as continuing education courses under 191—Chapter 11.
	  g.   	 Maintenance of records. An insurer subject to this subrule shall maintain records in accordance with the state’s record retention requirements.
	  h.   	 Training obtained from another insurer. An insurer may use verification from another insurer or another provider that a producer has received the required training for the purpose of meeting the requirements of this subrule.
	  i.   	 Records available to commissioner. An insurer subject to this subrule shall make the verification and records available to the commissioner upon request.
	  j.   	 Training obtained in other states. The satisfaction of these training requirements in any state shall be deemed to satisfy the training requirements in this state.
This rule is intended to implement Iowa Code section 514D.9 and chapter 514G.