The Insurance Contract

KRS tit. XXV, ch. 304, subtit. 14

in effect

KRS 304.14-010 Scope of subtitle

304.14-010. Scope of subtitle This subtitle applies as to all insurance contracts and annuity contracts, other than: (1) Reinsurance. (2) Policies or contracts not issued for delivery in this state nor delivered in this state. (3) Wet marine and transportation insurance. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 1, effective June 18, 1970.

KRS 304.14-020 "Policy" defined

304.14-020. "Policy" defined "Policy" means the written contract of, or written agreement for, or effecting insurance, by whatever name called, and includes all clauses, riders, indorsements and papers which are attached thereto. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 2, effective June 18, 1970.

KRS 304.14-030 "Premium" defined -- "Late charge" authorized

304.14-030. "Premium" defined -- "Late charge" authorized "Premium" is the consideration for insurance, by whatever name called. Any "assessment," or any "membership," "policy," "survey," "inspection," "service" or similar fee or other charge in consideration for an insurance contract is deemed part of the premium. In addition to the ordinary premium charges there may be imposed a late charge not to exceed 18 percent per annum on insurance premium accounts once those accounts remain unpaid for a period of 30 days beyond the date that the original premium was due and owing. Such charges shall be clearly indicated on all bills and statements of account. Effective: June 19, 1976 History: Amended 1976 Ky. Acts ch. 357, sec. 2, effective June 19, 1976. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 3, effective June 18, 1970.

KRS 304.14-040 Insurable interest

304.14-040. Insurable interest (1) An employer or the employer's trustee may procure and effect an insurance contract upon the life or body of an employee for the purpose of funding a pension or other benefit plan established for the employee of the employer. Except as provided in subsection (4) of this section, no employer, nor employer's trustee, shall procure or cause to be procured any insurance contract on the life or body of an employee unless the benefits under the contract are payable to and utilized by an employee pension or other benefit plans. Nothing in this subsection shall be construed to require the employer or the employer's trustee to use or designate the benefits of any employee insurance contract for the specific benefit of the estate of the particular insured on whose life or body the insurance contract producing the benefits was procured. (2) Any individual of competent legal capacity may procure or effect an insurance contract upon his own life or body for the benefit of any person. No person shall procure or cause to be procured any insurance contract upon the life or body of another individual unless the benefits under the contract are payable to the individual insured or his personal representatives, or to a person having, at the time when the contract was made, an insurable interest in the individual insured. (3) If the beneficiary, assignee, or other payee under any contract made in violation of this section receives from the insurer any benefits thereunder accruing upon the death, disablement, or injury of the individual insured, the individual insured or his executor or administrator, as the case may be, may maintain an action to recover the benefits from the person so receiving them. (4) "Insurable interest" as to the personal insurance means that every individual has an insurable interest in the life, body, and health of himself, and of other persons as follows: (a) In the case of individuals related closely by blood or by law, a substantial interest engendered by love and affection; (b) In the case of other persons, a lawful and substantial economic interest in having the life, health, or bodily safety of the individual insured continue, as distinguished from an interest which would arise only by, or would be enhanced in value by, the death, disablement, or injury of the individual insured; (c) An individual heretofore or hereafter party to a contract or option for the purchase or sale of an interest in a business partnership or firm, or of shares of stock of a close corporation or of an interest in the shares, has an insurable interest in the life, health, or bodily safety of each individual party to the contract for the purpose of the contract only, in addition to any insurable interest which may otherwise exist as to the individual; and (d) Any domestic or foreign corporation which provides its active or retired employees with benefits under a retirement or other employee benefit plan governed by the Federal Employee Retirement Income Security Act of 1974, as amended, has an insurable interest in the life, health, or bodily safety of any active or retired employee of the corporation or of any of its subsidiaries who is covered by a plan, and any trustee of a trust established by the corporation for the sole benefit of the corporation shall have the same insurable interest in the employee as the corporation itself. (5) An insurer shall be entitled to rely upon all statements, declarations, and representations made by an individual applicant for insurance relative to the insurable interest of the applicant in the insured; and no insurer shall incur legal liability except as set forth in the policy, by virtue of any untrue statements, declarations, or representations so relied upon in good faith by the insurer. Effective: July 15, 1994 History: Amended 1994 Ky. Acts ch. 424, sec. 2, effective July 15, 1994. – Amended 1992 Ky. Acts ch. 203, sec. 1, effective July 14, 1992. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 4, effective June 18, 1970.

KRS 304.14-050 Insurable interest -- Exception when certain institutions designated beneficiary

304.14-050. Insurable interest -- Exception when certain institutions designated beneficiary (1) Life insurance contracts may be entered into in which the person paying the consideration for the insurance has no insurable interest in the life of the individual insured, where charitable, benevolent, educational, or religious institutions, or their agencies, are designated irrevocably as the beneficiaries thereof. (2) In making such contracts the person paying the premium shall make and sign the application therefor as owner, and shall designate a charitable, benevolent, educational or religious institution, or an agency thereof, irrevocably as the beneficiary or beneficiaries of such contract. The application shall be signed also by the individual whose life is to be insured. (3) Nothing in this section shall be deemed to prohibit any combination of the applicant, premium payer, owner, and beneficiary from being the same person. (4) Such a contract shall be valid and binding among the parties thereto, notwithstanding the absence otherwise of an insurable interest in the life of the individual insured. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 5, effective June 18, 1970.

KRS 304.14-060 Insurable interest, property

304.14-060. Insurable interest, property (1) No contract of insurance of property or of any interest in property or arising from property shall be enforceable as to the insurance except for the benefit of persons having an insurable interest in the things insured as at the time of the loss. (2) "Insurable interest" as used in this section means any actual, lawful, and substantial economic interest in the safety or preservation of the subject of the insurance free from loss, destruction, or pecuniary damage or impairment. (3) When the name of a person intended to be insured is specified in the policy, such insurance can be applied only to his own proper interest. This section shall not apply to life, health or title insurance. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 6, effective June 18, 1970.

KRS 304.14-065 Definitions for section -- Insurable interest in shared car in peer -to-peer car sharing program -- Construction

304.14-065. Definitions for section -- Insurable interest in shared car in peer -to-peer car sharing program -- Construction (1) As used in this section, the following have the same meaning as in KRS 365.520: (a) "Car sharing period"; (b) "Car sharing program agreement"; (c) "Peer-to-peer car sharing program"; (d) "Shared vehicle"; (e) "Shared vehicle driver"; and (f) "Shared vehicle owner." (2) Notwithstanding any other provision of this subtitle, a peer -to-peer car sharing program shall have an insurable interest in a shared vehicle during the car sharing period, which shall include owning and maintaining, as the named insured, one (1) or more policies of motor vehicle liability insurance that provides coverage for: (a) Liabilities assumed by the peer-to-peer car sharing program under a car sharing program agreement; (b) Any liability of the shared vehicle owner or shared vehicle driver; and (c) Damage or loss to the shared vehicle. (3) Nothing in this section creates liability on a peer-to-peer car sharing program to maintain the coverage required under KRS 365.522. Effective: January 1, 2023 History: Created 2022 Ky. Acts ch. 153, sec. 13, effective January 1, 2023.

KRS 304.14-070 Power to contract -- Purchase of insurance by minors

304.14-070. Power to contract -- Purchase of insurance by minors (1) Any person of competent legal capacity may contract for insurance. (2) Any minor not less than fifteen (15) years of age may, notwithstanding his minority, contract for or own annuities, or insurance upon his own life, body, health, property, liabilities, or other interests, or on the person of another in whom the minor has an insurable interest. Such a minor shall, notwithstanding such minority, be deemed competent to exercise all rights and powers with respect to or under: (a) Any contract for annuity or for insurance upon his own life, body, or health, or (b) Any contract such minor effected upon his own property, liabilities, or other interests, or (c) Any contract effected or owned by the minor on the person of another, as might be exercised by a person of full legal age, and may at any time surrender his interest in any such contract and give valid discharge for any benefit accruing or money payable thereunder. Such a minor shall not, by reason of his minority, be entitled to rescind, avoid or repudiate the contract, nor to rescind, avoid or repudiate any exercise of a right or privilege thereunder, except that such a minor not otherwise emancipated, shall not be bound by any unperformed agreement to pay by promissory note or otherwise, any premium on any such annuity or insurance contract. (3) Any annuity contract or policy of life or health insurance procured by or for a minor under subsection (2) of this section, shall be made payable either to the minor or his estate or to a person having an insurable interest in the life of the minor. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 7, effective June 18, 1970.

KRS 304.14-080 Consent of insured -- Life, health insurance

304.14-080. Consent of insured -- Life, health insurance No life or health insurance contract upon an individual, except a contract of group life insurance or of group or blanket health insurance, shall be made or effectuated unless at the time of the making of the contract the individual insured having the power to contract as provided in KRS 304.14-070 applies therefor or has consented thereto in writing, except in the following cases: (1) A spouse may effectuate the insurance upon the other spouse. (2) Any person having an insurable interest in the life of a minor, or any person upon whom a minor is dependent for support and maintenance, may effectuate insurance upon the life of or pertaining to the minor. (3) Family policies may be issued insuring any two (2) or more members of a family on an application signed by either parent, a step-parent, or by a husband or wife. Effective: July 15, 1994 History: Amended 1994 Ky. Acts ch. 424, sec. 3, effective July 15, 1994. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 8, effective June 18, 1970.

KRS 304.14-085 Violation of insurable interest for person without insurable interest to pay premiums on life insurance in exchange for ownership in death benefit

304.14-085. Violation of insurable interest for person without insurable interest to pay premiums on life insurance in exchange for ownership in death benefit Except as provided in KRS 304.14-050, it shall be a violation of insurable interest for any person or entity without insurable interest to provide or arrange for the funding ultimately used to pay premiums, or the majority of premiums, on a life insurance policy and, at policy inception, have an arrangement for such person or entity to have an ownership interest in the majority of the death benefit of that life insurance policy. Effective: July 15, 2008 History: Created 2008 Ky. Acts ch. 32, sec. 10, effective July 15, 2008.

KRS 304.14-090 Alteration of application

304.14-090. Alteration of application (1) Any application for insurance in writing by the applicant shall be altered solely by the applicant or by his written consent, except that insertions may be made by the insurer for administrative purposes only in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant. (2) No person shall falsify or cause to be falsified, in any application for insurance, any answer to a question propounded to the applicant therein, or insert or cause to be inserted therein, except as provided in subsection (1) of this section, any statement to be made by such applicant other than the statement made by the applicant. (3) An insurer issuing a policy upon an application which has been unlawfully altered by its officer, employee, or agent shall not have available in any action arising out of such policy, any defense based upon the fact of such alteration, or as to any item which was so altered. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 9, effective June 18, 1970.

KRS 304.14-100 Application as evidence

304.14-100. Application as evidence (1) No application for the issuance of any life insurance policy shall be admissible in evidence in any action relative to such policy, unless a true copy of the application was attached to or otherwise made a part of the policy when issued and delivered. A photostatic or other process copy or reduction of the application or medical examination, if any, may be so used if clearly legible. This provision shall not apply to industrial life insurance policies. (2) If any policy of life or health insurance delivered in this state is reinstated or renewed, and the insured or the beneficiary or assignee of the policy makes written request to the insurer for a copy of the application, if any, for such reinstatement or renewal, the insurer shall, within thirty (30) days after receipt of such request at its principal office or any of its branch offices, deliver or mail to the person making such request, a copy of such application. If such copy is not so delivered or mailed, the insurer shall be precluded from introducing such application as evidence in any action or proceeding based upon or involving the policy or its reinstatement or renewal. (3) As to the kinds of insurance other than life insurance, no application for insurance signed by or on behalf of the insured shall be admissible in evidence in any action between the insured and the insurer arising out of the policy so applied for, if the insurer has failed, within thirty (30) days after receipt by the insurer of written demand therefor by or on behalf of the insured, to furnish to the insured a copy of such application reproduced by any legible means. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 10, effective June 18, 1970.

KRS 304.14-110 Representations in applications

304.14-110. Representations in applications All statements and descriptions in any application for an insurance policy or annuity contract, by or on behalf of the insured or annuitant, shall be deemed to be representations and not warranties. Misrepresentations, omissions, and incorrect statements shall not prevent a recovery under the policy or contract unless either: (1) Fraudulent; or (2) Material either to the acceptance of the risk, or to the hazard assumed by the insurer; or (3) The insurer in good faith would either not have issued the policy or contract, or would not have issued it at the same premium rate, or would not have issued a policy or contract in as large an amount, or would not have provided coverage with respect to the hazard resulting in the loss, if the true facts had been made known to the insurer as required either by the application for the policy or contract or otherwise. This subsection shall not apply to applications taken for workers' compensation insurance coverage. Effective: April 4, 1994 History: Amended 1994 Ky. Acts ch. 181, sec. 65, effective April 4, 1994. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 11, effective June 18, 1970.

KRS 304.14-120 Filing and approval of forms

304.14-120. Filing and approval of forms (1) (a) Except as otherwise provided in this section, a basic insurance policy or annuity contract form, or application form where written application is required and is to be made a part of the policy or contract, or printed rider or indorsement form or form of renewal certificate, shall not be delivered, or issued for delivery in this state, unless the form has been filed with and approved by the commissioner. (b) This subsection shall not apply to: 1. Any rates filed under Subtitle 17A of this chapter; 2. Surety bonds; 3. Specially rated inland marine risks; or 4. Policies, riders, indorsements, or forms of unique character: a. Designed for and used with relation to insurance upon a particular subject; or b. Which relate to the manner or distribution of benefits or to the reservation of rights and benefits under life or health insurance policies and are used at the request of the individual policyholder, contract holder, or certificate holder. (c) As to group insurance policies issued and delivered to an association outside this state but covering persons resident in this state, all or substantially all of the premiums for which are payable by the insured members, the group certificates to be delivered or issue d for delivery in this state shall be filed with and approved by the commissioner. (d) 1. As to forms for use in property, inland marine, casualty, and surety insurance coverages (other than accident and health), the filing required by this subsection may be made by advisory organizations or form providers on behalf of their members and subscribers. 2. This paragraph shall not be construed to prohibit any member or subscriber of an advisory organization or form provider from filing any forms on its own behalf. (e) Every advisory organization and form provider shall file with the commissioner for approval every property and casualty policy form and endorsement before distribution to members, subscribers, customers, or others. (f) Every property and casualty insurer shall file with the commissioner notice of adoption before use of any approved form filed by an advisory organization or form provider or filed by the insurer pursuant to paragraph (d) of this subsection. (2) (a) Every filing required under this sec tion shall be made not less than sixty (60) days in advance of any delivery of the form in this state. (b) At the expiration of sixty (60) days, the form so filed shall be deemed approved unless prior thereto it has been affirmatively approved or disapproved by order of the commissioner. (c) Approval of any filing by the commissioner under this section shall constitute a waiver of any unexpired portion of the waiting period established under this subsection. (d) The commissioner may extend the waiting period established under paragraph (a) of this subsection by not more than a thirty (30) day period, within which time he or she may affirmatively approve or disapprove any filing, by giving notice to the insurer of the extension before expiration of the initial sixty (60) day period. (e) At the expiration of any period extended under paragraph (d) of this subsection, and in the absence of a prior affirmative approval or disapproval, the filing shall be deemed approved. (f) The commissioner may at any time, afte r notice and for cause shown, withdraw approval of any filing. (3) (a) Any order of the commissioner disapproving any filing, or any notice of the commissioner withdrawing a previous approval, shall state the grounds therefor and the particulars thereof in such detail as reasonably to inform the insurer. (b) Any withdrawal of a previously approved filing shall be effective not less than thirty (30) days after the insurer receives notice of the withdrawal, as the commissioner shall in such notice prescribe. (4) Except as provided in subsection (6) of this section, the commissioner may, by order, exempt from the requirements of this section, for so long as he or she deems proper, any insurance document or form or type thereof, as specified in the commissioner's order, to which, in his or her opinion: (a) This section may not practicably be applied; or (b) The filing and approval of are not desirable or necessary for the protection of the public. (5) Appeals from orders of the commissioner disapproving any filin g or withdrawing a previous approval shall be taken as provided in Subtitle 2 of this chapter. (6) The commissioner shall: (a) Review every filing relating to a health plan, as defined in KRS 304.17A -591, for compliance with KRS 304.17A-591 to 304.17A-599; and (b) Not approve any filing referenced in paragraph (a) of this subsection that does not comply with KRS 304.17-591 to 304.17A-599. (7) As used in this section, unless the context requires otherwise: (a) "Advisory organization" has the same meaning as in KRS 304.13-011; and (b) "Form provider" has the same meaning as in KRS 304.13 -011. Effective: July 15, 2026 History: Amended 2026 Ky. Acts ch. 45, sec. 23, effective July 15, 2026. -- Amended 2024 Ky. Acts ch. 104, sec. 10, effective January 1, 2025. -- Amended 2010 Ky. Acts ch. 24, sec. 1150, effective July 15, 2010. -- Amended 2000 Ky. Acts ch. 380, sec. 21, effective July 14, 2000. -- Amended 1998 Ky. Acts ch. 496, sec. 47, effective April 10, 1998. -- Amended 1994 Ky. Acts ch. 512, sec. 65, effective July 15, 1994. -- Amended 1984 Ky. Acts ch. 322, sec. 11, effective July 13, 1984. -- Amended 1982 Ky. Acts ch. 123, sec. 15, effective July 15, 1982. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 12, effective June 18, 1970.

KRS 304.14-130 Grounds for disapproval

304.14-130. Grounds for disapproval (1) The commissioner shall disapprove any form filed under KRS 304.14-120, or withdraw any previous approval thereof, only on one (1) or more of the following grounds: (a) If it is in any respect in violation of, or does not comply with, this code. (b) If it contains or incorporates by reference, where the incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract. (c) If it has any title, heading, or other indication of its provisions which is misleading, or is printed in a size of type or manner of reproduction so as to be substantially illegible. (d) As to an individual, group, or blanket health insurance policy, if the benefits provided therein are unreasonable in relation to the premium charged. (e) If it excludes coverage for human immunodeficiency virus infection or acquired immunodeficiency syndrome or contains limitations in the benefits payable, or in the terms or conditions of the contract, for human immunodeficiency virus infection or acquired immunodeficiency syndrome which are different than those which apply to any other sickness or medical condition. (2) The insurer shall not use in this state any form after disapproval or withdrawal of approval. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1151, effective July 15, 2010. -- Amended 1998 Ky. Acts ch. 483, sec. 16, effective July 15, 1998; and ch. 496, sec. 45, effective April 10, 1998. -- Amended 1994 Ky. Acts ch. 512, sec. 66, effective July 15, 1994. -- Amended 1990 Ky. Acts ch. 443, sec. 55, effective July 13, 1990. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 13, effective June 18, 1970.

KRS 304.14-135 Uniform health insurance claim forms

304.14-135. Uniform health insurance claim forms (1) The commissioner shall prescribe the following uniform health insurance claim forms which shall be used by all insurers transacting health insurance in this state and by all state agencies that require health insurance claim forms for their records as the sole instrument for reimbursement: (a) The uniform health insurance claim form for an institutional provider shall consist of the UB-92 data set or its successor submitted on the designated paper or electronic format as adopted by the National Uniform Billing Committee; (b) The uniform health insurance claim form for a dentist shall consist of a data set and form approved by the American Dental Association; (c) The uniform health insurance claim form for all other health care providers shall consist of the HCFA 1500 data set or its successor submitted on the designated paper or electronic format as adopted by the National Uniform Claim Committee; and (d) A clean claim for pharmacists shall consist of: 1. For prescription drug claims, a universal claim form and data set approved by the National Council for Prescription Drug Programs; and 2. For all other claims for services or procedures that are within the scope of the practice of pharmacy, as defined in KRS 315.010, a 1500 Health Insurance Claim Form or its successor submitted on the designated paper or electronic format as adopted by the National Uniform Claim Committee. (2) An insurer shall not require a provider to: (a) Use a claim form that is different than the uniform claim form for the provider type as set out in subsection (1) of this section; (b) Modify the uniform claims form or its content; or (c) Submit additional claims forms. Effective: June 29, 2021 History: Amended 2021 Ky. Acts ch. 30, sec. 2, effective June 29, 2021. -- Amended 2010 Ky. Acts ch. 24, sec. 1152, effective July 15, 2010. -- Amended 2000 Ky. Acts ch. 436, sec. 18, effective July 14, 2000. -- Created 1980 Ky. Acts ch. 8, sec. 1, effective July 1, 1982.

KRS 304.14-140 Standard provisions, in general

304.14-140. Standard provisions, in general (1) Insurance contracts shall contain such standard or uniform provisions as are required by the applicable provisions of this code pertaining to contracts of particular kinds of insurance. The commissioner may waive the required use of a particular provision in a particular insurance policy form if: (a) The commissioner finds such provision unnecessary for or unrelated to the protection of the insured and inconsistent with the purposes of the policy, and (b) The policy is otherwise approved by the commissioner. (2) No policy shall contain any provision inconsistent with or contradictory to any standard or uniform provision used or required to be used, but the commissioner may approve any substitute provision which is, in his or her opinion, not less favorable in any particular to the insured or beneficiary than the provisions otherwise required. (3) In lieu of the provisions required by this code for contracts for particular kinds of insurance, substantially similar provisions required by the law of the domicile of a foreign or alien insurer may be used when approved by the commissioner. (4) A policy issued by a domestic insurer for delivery in another jurisdiction may contain any provision required or permitted by the laws of such jurisdiction. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1153, effective July 15, 2010. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 14, effective June 18, 1970.

KRS 304.14-150 Contents of policies in general

304.14-150. Contents of policies in general (1) Every policy shall specify: (a) The names of the parties to the contract. (b) The subject of the insurance. (c) The risks insured against. (d) The time when the insurance thereunder takes effect and the period during which the insurance is to continue. (e) The premium. (f) The conditions pertaining to the insurance. (g) Benefits payable. (2) If under the policy the exact amount of premium is determinable only at stated intervals or termination of the contract, a statement of the basis and rates upon which the premium is to be determined and paid shall be included. (3) Subsections (1) and (2) of this section shall not apply as to surety contracts, or to group insurance policies, or to title insurance policies. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 15, effective June 18, 1970.

KRS 304.14-160 Additional policy contents

304.14-160. Additional policy contents A policy may contain additional provisions not inconsistent with this code and which are: (1) Required to be inserted by the laws of the insurer's domicile; or (2) Necessary, on account of the manner in which the insurer is constituted or operated, in order to state the rights and obligations of the parties to the contract; or (3) Desired by the insurer and neither prohibited by law nor in conflict with any provisions required to be included therein. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 16, effective June 18, 1970.

KRS 304.14-170 Charter, bylaw provisions

304.14-170. Charter, bylaw provisions No policy shall contain any provision, purporting to make any portion of the charter, bylaws or other constituent document of the insurer (other than the subscriber's agreement or power of attorney of a reciprocal insurer) a part of the contract unless such portion is set forth in full in the policy. Any policy provision in violation of this section shall be invalid. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 17, effective June 18, 1970.

KRS 304.14-180 Must contain entire contract -- Exception concerning additional benefits

304.14-180. Must contain entire contract -- Exception concerning additional benefits (1) No agreement in conflict with, modifying, or extending any contract of insurance shall be valid unless in writing and made a part of the policy. (2) No insurer or its representative shall make any insurance contract or agreement relative thereto other than as is plainly expressed in the policy. (3) The requirements of this section shall not apply to the granting of additional benefits to all policyholders of an insurer, or a class or classes of them, which do not require increases in premium rates or reduction or restrictions of coverage. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 18, effective June 18, 1970.

KRS 304.14-190 Execution of policies

304.14-190. Execution of policies (1) Every policy shall be executed in the name of and on behalf of the insurer by its officer, attorney-in-fact, employee, or representative duly authorized by the insurer. (2) A facsimile signature of any such executing officer, attorney-in-fact, employee, or representative may be used in lieu of an original signature. (3) No insurance contract heretofore or hereafter issued and which is otherwise valid shall be rendered invalid by reason of the apparent execution thereof on behalf of the insurer by the imprinted facsimile signature of any individual not authorized so to execute as of the date of the policy. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 19, effective June 18, 1970.

KRS 304.14-200 Underwriters' and combination policies

304.14-200. Underwriters' and combination policies (1) Two (2) or more authorized insurers may jointly issue, and shall be jointly and severally liable on, an underwriters' policy bearing their names. Any one (1) insurer may issue policies in the name of an underwriter's department and such policies shall plainly show the true name of the insurer. (2) Two (2) or more authorized insurers may, with the commissioner's approval, issue a combination policy which shall contain provisions substantially as follows: (a) That the insurers executing the policy shall be severally liable for the full amount of any loss or damage, according to the terms of the policy, or for specified percentages or amounts thereof, aggregating the full amount of insurance under the policy. (b) That service of process, or of any notice of proof of loss required by such policy, upon any of the insurers executing the policy, shall constitute service upon all such insurers. (3) This section shall not apply to co-surety obligations. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 20, effective June 18, 1970.

KRS 304.14-210 Validity and construction of noncomplying forms

304.14-210. Validity and construction of noncomplying forms (1) A policy hereafter delivered or issued for delivery to any person in this state in violation of this code but otherwise binding on the insurer, shall be held valid, but shall be construed as provided in this code. (2) Any insurance policy, rider, or indorsement hereafter issued and otherwise valid which contains any condition, omission or provision not in compliance with the requirements of this code, shall not thereby be rendered invalid but shall be construed and applied in accordance with such condition, omission or provision as would have applied had the same been in full compliance with this code. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 21, effective June 18, 1970.

KRS 304.14-220 Binders

304.14-220. Binders (1) Binders or other contracts for temporary insurance may be made orally or in writing, and shall be deemed to include all the usual terms of the policy as to which the binder was given together with such applicable endorsements as are designated in the binder, except as superseded by the clear and express terms of the binder. (2) No binder shall be valid beyond the issuance of the policy with respect to which it was given, or beyond ninety (90) days from its effective date, whichever period is the shorter. (3) If the policy has not been issued a binder may be extended or renewed beyond such ninety (90) days with the written approval of the commissioner, or in accordance with such rules and regulations relative thereto as the commissioner may promulgate. (4) This section shall not apply to life or health insurance or title insurance. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1154, effective July 15, 2010. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 22, effective June 18, 1970.

KRS 304.14-230 Delivery of policy

304.14-230. Delivery of policy (1) Subject to the insurer's requirements as to payment of premium, every policy shall be mailed or otherwise delivered to the insured or to the person entitled thereto within a reasonable period of time after its issuance, except where a condition required by the insurer has not been met by the insured. By agreement between the insurer and the insured or the person entitled to receive the policy, the policy may be delivered electronically. (2) In the event the original policy is delivered or is so required to be delivered to or for deposit with any vendor, mortgagee, or pledgee of any motor vehicle or aircraft, and in which policy any interest of the vendee, mortgagor, or pledgor in or with reference to such vehicle or aircraft is insured, a duplicate of such policy, or memorandum thereof setting forth the name and address of the insurer, type of coverage, limit of liability, premiums for the respective coverages, and duration of the policy, shall be delivered by the vendor, mortgagee, or pledgee to each such vendee, mortgagor, or pledgor named in the policy or coming within the group of persons designated in the policy to be so included. If the policy does not provide coverage of legal liability for injury to persons or damage to the property of third parties, a statement of such fact shall be printed, written, or stamped conspicuously on the face of such duplicate policy or memorandum. This subsection does not apply to inland marine floater policies. Effective: June 24, 2003 History: Amended 2003 Ky. Acts ch. 85, sec. 1, effective June 24, 2003. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 23, effective June 18, 1970.

KRS 304.14-240 Renewal of policy

304.14-240. Renewal of policy Any insurance policy terminating by its terms at a specified expiration date and not otherwise renewable, may be renewed or extended at the option of the insurer, upon a currently authorized policy form and at the premium rate then required therefor, for a specific additional period or periods by a certificate or by indorsement of the policy, and without requiring the issuance of a new policy. By agreement between the insurer and insured, the policy may be delivered electronically. Effective: June 24, 2003 History: Amended 2003 Ky. Acts ch. 85, sec. 2, effective June 24, 2003. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 24, effective June 18, 1970.

KRS 304.14-250 Assignability -- Rights of insurer, assignee

304.14-250. Assignability -- Rights of insurer, assignee Except as provided in KRS 304.17A-265, 304.17C-137, and 304.20-105: (1) A policy may be assignable or not assignable, as provided by its terms; (2) Subject to its terms relating to assignability, a life or health insurance policy, regardless of when it was issued, under the terms of which the beneficiary may be changed upon the sole request of the insured or owner, may be assigned either by pledge or transfer of title, by an assignment executed by the insured or owner alone and delivered to the insurer, whether or not the pledgee or assignee is the insurer; (3) Any assignment of a policy which is otherwise lawful and of which the insurer has received notice shall entitle the insurer to deal with the assignee as the owner or pledgee of the policy in accordance with the terms of the assignment, until the insurer has received at its principal office written notice of the termination of the assignment or pledge or written notice by or on behalf of some interest in the policy in conflict with the assignment; and (4) (a) Any individual insured under a group insurance policy or group annuity contract shall have the right, unless expressly prohibited under the terms of the policy or contract, to assign to any other person his or her rights and benefits under the policy or contract, including but not limited to the right to designate the beneficiary or beneficiaries and the rights as to conversion provided for in KRS 304.16-180 to 304.16-200, inclusive. (b) While the assignment is in effect, and regardless of when it wa s made, the insurer shall be entitled to deal with the assignee as the owner of the rights and benefits in accordance with the terms of the assignment and without prejudice to the insurer on account of any lawful action taken or payment made by the insurer prior to receipt by the insurer at its principal office of written notice of the assignment or of the termination thereof. (c) This subsection acknowledges, confirms, and codifies the existing right of assignment of interests under group life insurance po licies. Effective: January 1, 2026 History: Amended 2025 Ky. Acts ch. 147, sec. 2, effective January 1, 2026. -- Amended 2024 Ky. Acts ch. 27, sec. 5, effective April 2, 2024. -- Amended 2023 Ky. Acts ch. 86, sec. 2, effective June 29, 2023. -- Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 25, effective June 18, 1970. Legislative Research Commission Note (1/1/2026). 2025 Ky. Acts ch. 147, sec. 5, provides that the amendments to this statute in that Act shall apply to policies, plans, and contracts issued or renewed on or after January 1, 2026. Legislative Research Commission Note (4/2/2024). 2024 Ky. Acts ch. 27, sec. 6, provides that amendments made to this statute in that Act shall apply to insurance policies issued or renewed on or after April 2, 2024. Legislative Research Commission Note (6/29/2023). This statute was amended by 2023 Ky. Acts ch. 86, sec. 2. Section 8 of that Act provides that the Act applies to health insurance policies in effect on or after June 29, 2023, and to health insurance policies issued, delivered, or renewed on or after June 29, 2023.

KRS 304.14-260 Payment discharges insurer

304.14-260. Payment discharges insurer Whenever the proceeds of or payments under a life or health insurance policy or annuity contract heretofore or hereafter issued become payable in accordance with the terms of such policy or contract, or the exercise of any right or privilege thereunder, and the insurer makes payment thereof in accordance therewith or in accordance with any written assignment thereof, the person then designated as being entitled thereto shall be entitled to receive such proceeds or payments and to give full acquittance therefor, and such payments shall fully discharge the insurer from all claims under the policy or contract unless, before payment is made, the insurer has received at its principal office written notice by or on behalf of some other person that such other person claims to be entitled to such payment or some interest in the policy or contract. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 26, effective June 18, 1970.

KRS 304.14-270 Forms for proof of loss furnished

304.14-270. Forms for proof of loss furnished An insurer shall furnish upon written request of any person claiming to have a loss under any insurance contract, forms of proof of loss for completion by such person, but such insurer shall not, by reason of the requirement so to furnish forms, have any responsibility or liability for or with reference to the completion of such proof or the manner of any such completion or attempted completion. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 27, effective June 18, 1970.

KRS 304.14-280 Claims administration not waiver

304.14-280. Claims administration not waiver Without limitation of any right or defense of an insurer otherwise, none of the following acts by or on behalf of an insurer shall be deemed to constitute a waiver of any provision of a policy or of any defense of the insurer thereunder: (1) Acknowledgment of the receipt of notice of loss or claim under the policy. (2) Furnishing forms for reporting a loss or claim, for giving information relative thereto, or for making proof of loss, or receiving or acknowledging receipt of any such forms or proofs completed or uncompleted. (3) Investigating any loss or claim under any policy or engaging in negotiations looking toward a possible settlement of any such loss or claim. (4) Making advance or partial payments under insurance policies as an accommodation to or on behalf of any person suffering injury, loss or damage, and any such payment shall be credited to the final settlement or judgment. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 28, effective June 18, 1970.

KRS 304.14-290 Dividends payable to real party

304.14-290. Dividends payable to real party (1) Every insurer issuing participating policies, shall pay dividends, unused premium refunds or savings distributed on account of any such policy, only to the real party in interest entitled thereto as shown by the insurer's records, or to any person to whom the right thereto has been assigned in writing of record with the insurer, or given in the policy by such real party in interest. (2) Any person who is shown by the insurer's records to have paid for his own account, or to have been ultimately charged for, the premium for insurance provided by a policy in which another person is the nominal insured, shall be deemed such real party in interest proportionate to premium so paid or so charged. This subsection shall not apply as to any such dividend, refund, or distribution which would amount to less than one dollar ($1). (3) This section shall not apply to contracts of group life insurance, group annuities, or group disability insurance, nor to policies issued prior to September 1, 1950, nor to any policy which contains a provision specifying to whom the dividends shall be paid. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 29, effective June 18, 1970.

KRS 304.14-300 Exemptions of proceeds, life insurance

304.14-300. Exemptions of proceeds, life insurance (1) If a policy of insurance whether heretofore or hereafter issued, is effected by any person on his own life, or on another life, in favor of a person other than himself, or, except in cases of transfer with intent to defraud creditors, if a policy of life insurance is assigned or in any way made payable to any such person, the lawful beneficiary or assignee thereof, other than the insured or the person so effecting such insurance or executors or administrators of such insured or the person so effecting such insurance, shall be entitled to its proceeds and avails against the creditors and representatives of the insured and of the person effecting the same, whether or not the right to change the beneficiary is reserved or permitted and whether or not the policy is made payable to the person whose life is insured if the beneficiary or assignee shall predecease such person, and such proceeds and avails shall be exempt from all liability for any debt of the beneficiary existing at the time the policy is made available for his use: provided, that subject to the statute of limitations, the amount of any premiums for such insurance paid with intent to defraud creditors, with interest thereon, shall inure to their benefit from the proceeds of the policy; but the insurer issuing the policy shall be discharged of all liability thereon by payment of its proceeds in accordance with its terms, unless, before such payment, the insurer shall have received written notice at its principal office, by or in behalf of a creditor, of a claim to recover for transfer made or premiums paid with intent to defraud creditors, with specification of the amount claimed. (2) For the purposes of subsection (1) of this section, a policy shall also be deemed to be payable to a person other than the insured if and to the extent that a facility-of- payment clause or similar clause in the policy permits the insurer to discharge its obligation after the death of the individual insured by paying the death benefits to a person as permitted by such clause. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 30, effective June 18, 1970.

KRS 304.14-310 Exemption of proceeds, health insurance

304.14-310. Exemption of proceeds, health insurance Except as may otherwise be expressly provided by the policy or contract, the proceeds or avails of all contracts of health insurance and of provisions providing benefits on account of the insured's disability which are supplemental to life insurance or annuity contracts heretofore or hereafter effected shall be exempt from all liability for any debt of the insured, and from any debt of the beneficiary existing at the time the proceeds are made available for his use. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 31, effective June 18, 1970.

KRS 304.14-320 Exemption of proceeds, group insurance

304.14-320. Exemption of proceeds, group insurance (1) A policy of group life insurance or group health insurance or the proceeds thereof payable to the individual insured or to the beneficiary thereunder, shall not be liable, either before or after payment, to be applied by any legal or equitable process to pay any debt or liability of such insured individual or his beneficiary or of any other person having a right under the policy. The proceeds thereof, when made payable to a named beneficiary or to a third person pursuant to a facility-of-payment clause, shall not constitute a part of the estate of the individual insured for the payment of his debts. (2) This section shall not apply to group insurance issued pursuant to this code to a creditor covering his debtors, to the extent that such proceeds are applied to payment of the obligation for the purpose of which the insurance was so issued. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 32, effective June 18, 1970.

KRS 304.14-330 Exemption of proceeds, annuity contracts -- Assignability of rights

304.14-330. Exemption of proceeds, annuity contracts -- Assignability of rights (1) The benefits, rights, privileges and options which under any annuity contract heretofore or hereafter issued are due or prospectively due the annuitant, shall not be subject to execution nor shall the annuitant be compelled to exercise any such rights, powers, or options, nor shall creditors be allowed to interfere with or terminate the contract, except: (a) As to amounts paid for or as premium on any such annuity with intent to defraud creditors, with interest thereon, and of which the creditor has given the insurer written notice at its principal office prior to the making of the payment to the annuitant out of which the creditor seeks to recover. Any such notice shall specify the amount claimed or such facts as will enable the insurer to ascertain such amount, and shall set forth such facts as will enable the insurer to ascertain the annuity contract, the annuitant and the payment sought to be avoided on the ground of fraud. (b) The total exemption of benefits presently due and payable to any annuitant periodically or at stated times under all annuity contracts under which he is an annuitant, shall not at any time exceed $350 per month for the length of time represented by such installments, and that such periodic payments in excess of $350 per month shall be subject to garnishee execution to the same extent as are wages and salaries. (c) If the total benefits presently due and payable to any annuitant under all annuity contracts under which he is an annuitant, shall at any time exceed payment at the rate of $350 per month, then the court may order such annuitant to pay to a judgment creditor or apply on the judgment, in installments, such portion of such excess benefits as to the court may appear just and proper, after due regard for the reasonable requirements of the judgment debtor and his family, if dependent upon him, as well as any payments required to be made by the annuitant to other creditors under prior court orders. (2) If the contract so provides, the benefits, rights, privileges or options accruing under such contract to a beneficiary or assignee shall not be transferable nor subject to commutation, and if the benefits are payable periodically or at stated times, the same exemptions and exceptions contained herein for the annuitant, shall apply with respect to such beneficiary or assignee. (3) An annuity contract within the meaning of this section shall be any obligation to pay sums at stated times, during life or lives, or for a specified term or terms, issued for a valuable consideration, regardless of whether or not such sums are payable to one (1) or more persons, jointly or otherwise, but does not include payments under life insurance contracts at stated times during life or lives, or for a specified term or terms. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 33, effective June 18, 1970.

KRS 304.14-340 Rights of married women in life insurance

304.14-340. Rights of married women in life insurance (1) Every life insurance policy made payable to or for the benefit of or duly assigned or transferred to a married woman, or to any person in trust for her, shall inure to her separate use and benefit and that of her children, independently of her husband or his creditors or any other person effecting or transferring the policy, or his creditors. (2) A married woman may, without consent of her husband, contract, pay for, take out and hold a policy on the life or health of her husband or children, or against loss by his or their disablement by accident. The premiums paid on the policy shall be held to have been her separate estate, and the policy shall inure to her separate use and benefit and that of her children, free from any claim of her husband or others. (3) If the premium on any such policy is paid by any person with intent to defraud his creditors, an amount equal to the premium so paid, with interest thereon, shall inure to the benefit of the creditors, subject to the statute of limitations. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 34, effective June 18, 1970.

KRS 304.14-350 Retention of proceeds of policy by company

304.14-350. Retention of proceeds of policy by company (1) Any life insurer shall have power to hold the proceeds of any life or endowment insurance or annuity contract issued by it: (a) Upon such terms and restrictions as to revocation by the insured and control by beneficiaries, (b) With such exemptions from legal process and the claims of creditors of beneficiaries, other than the insured, and (c) Upon such other terms and conditions, irrespective of the time and manner of payment of proceeds, as shall have been agreed to in writing by the insurer and the insured or beneficiary. The insurer shall not be required to segregate funds so held but may hold them as a part of its general corporate assets. (2) The provisions of this section shall not impair or affect any rights of creditors under KRS 304.14-300 and 304.14-330. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 35, effective June 18, 1970.

KRS 304.14-360 Construction of policies

304.14-360. Construction of policies Every insurance contract shall be construed according to the entirety of its terms and conditions as set forth in the policy, and as amplified, extended, or modified by any rider, indorsement, or application attached to and made a part of the policy. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 36, effective June 18, 1970.

KRS 304.14-370 Jurisdiction of courts, limitation of actions

304.14-370. Jurisdiction of courts, limitation of actions No conditions, stipulations or agreements in a contract of insurance shall deprive the courts of this state of jurisdiction of actions against foreign insurers, or limit the time for commencing actions against such insurers to a period of less than one (1) year from the time when the cause of action accrues. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 37, effective June 18, 1970.

KRS 304.14-375 Time limit for seeking reimbursement of health insurance overpayment

304.14-375. Time limit for seeking reimbursement of health insurance overpayment An action or request for reimbursement for any overpayment of a health insurance claim pursuant to any health insurance contract shall be brought not more than two (2) years from the date the claim was filed. No insurer, assignee of the insurer, or other person, whether acting for himself or another in connection with a health insurance transaction, shall make any claim or seek recovery for reimbursement for any overpayment pursuant to any health insurance contract from any person more than two (2) years after the claim was filed, unless the claim was false or fraudulent. Effective: July 14, 2000 History: Created 2000 Ky. Acts ch. 492, sec. 3, effective July 14, 2000.

KRS 304.14-380 Venue of suits against insurers

304.14-380. Venue of suits against insurers Suit upon causes of action arising within this state against an insurer upon an insurance contract shall be brought in the county where the cause of action arose or in the county where the policyholder instituting such action resides. Effective: June 18, 1970 History: Created 1970 Ky. Acts ch. 301, subtit. 14, sec. 38, effective June 18, 1970.

KRS 304.14-400 Interest on payment from insuring company

304.14-400. Interest on payment from insuring company Any resident of this state who is the person named as the insured in any policy of fire insurance issued or delivered in this state on property located in this state and who sustained a loss of or to such property, which loss is covered under such policy, for which he becomes entitled to receive payment in cash from the insuring company shall also be entitled to receive payment of interest at the rate of eight percent (8%) per annum from such insuring company on any portion of such payment entitlement which is not paid nor tendered to such resident within thirty (30) days after receipt by the insuring company of a proof of loss executed and sworn by such resident, to the best of his knowledge and belief claiming any such amount to be due. Effective: July 15, 1980 History: Created 1980 Ky. Acts ch. 237, sec. 1, effective July 15, 1980.

KRS 304.14-410 Use by insurer of itemized statement furnished to paying patient prohibited

304.14-410. Use by insurer of itemized statement furnished to paying patient prohibited No insurer shall use an itemized statement furnished pursuant to KRS 216B.250 for insurance payment purposes where benefits have been assigned. Effective: Juy 15, 1986 History: Created 1986 Ky. Acts ch. 288, sec. 3, effective July 15, 1986.

KRS 304.14-420 Minimum standards regulations

304.14-420. Minimum standards regulations (1) No insurance policy for homeowners, dwelling fire, automobile, accident and health, life or other forms of personal insurance shall be delivered, issued for delivery, amended or renewed in this state after the effective date set out in subsection (2) of this section unless the policy is in compliance with the provisions of this section and KRS 304.14-430 to 304.14-450. (2) The commissioner shall, within one (1) year from July 15, 1988, promulgate administrative regulations in accordance with the provisions of KRS Chapter 13A to carry out the provisions of this section and KRS 304.14-430 to 304.14-450 and to establish minimum standards for the readability and intelligibility of insurance contracts. Within one (1) year of the effective date of the administrative regulations all insurers licensed to transact business shall comply with the standards set out by this section and KRS 304.14-430 to 304.14-450 and promulgated by the commissioner. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1155, effective July 15, 2010. -- Created 1988 Ky. Acts ch. 225, sec. 12, effective July 15, 1988.

KRS 304.14-430 Policy cover sheet -- Commissioner approval

304.14-430. Policy cover sheet -- Commissioner approval (1) All insurance policies subject to the provisions of KRS 304.14-420 to 304.14-450 shall contain as the first page or first page of text, if it is preceded by a title page or pages, a cover sheet or sheets as provided in this section. The cover sheet or sheets shall be printed in legible type and readable language and shall contain at least the following: (a) A brief statement that the policy is a legal contract between the policy owner and the company; (b) The statement "READ YOUR POLICY CAREFULLY. This cover sheet provides only a brief outline of some of the important features of your policy. This cover sheet is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth, in detail, the rights and obligations of both you and your insurance company. IT IS THEREFORE IMPORTANT THAT YOU READ YOUR POLICY." and (c) An index of the major provisions of the policy or contract and the pages on which they are found which may include the following items: 1. The person or persons insured by the policy; 2. The applicable events, occurrences, conditions, losses, or damages covered by the policy; 3. The limitations or conditions on the coverage of the policy; 4. Definitional sections of the policy; 5. Provision governing the procedure for filing a claim under the policy; 6. Provisions governing cancellation, renewal, or amendment of the policy by either the insurer or the policyowner; 7. Any options under the policy; and 8. Provisions governing the insurer's duties and powers in the event that suit is filed against the insured. (2) The cover sheet may include, either as part of the index or as a separate section, a brief summary of the extent and types of coverage in the policy. (3) No cover sheet shall be used unless it has been filed with and approved by the commissioner. The cover sheet shall be deemed approved sixty (60) days after filing unless disapproved by the commissioner within the sixty (60) day period, subject to a reasonable extension of times as the commissioner may require by notice given within the sixty (60) day period. The commissioner shall disapprove any cover sheet which does not meet the requirements of this section. Any disapproval shall be delivered to the insurer in writing, stating the grounds therefor. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1156, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 304, sec. 9, effective July 15, 2002. -- Created 1988 Ky. Acts ch. 225, sec. 13, effective July 15, 1988.

KRS 304.14-435 English language requirement for forms, policy, and claim-related information -- Requirements for non-English version -- Use and effect of translations

304.14-435. English language requirement for forms, policy, and claim-related information -- Requirements for non-English version -- Use and effect of translations (1) All policy forms filed with the department, and any other insurance policy or claim- related information, shall be written in the English language. (2) An insurer may provide applicants and insureds with a policy, application, or claim- related information in a language other than English if the conditions of subsection (3) of this section have been satisfied. (3) The non-English version of the policy, application, or claim-related information shall: (a) Be a certified translation of a policy, application, or claim-related information that has been filed with and approved by the department; (b) Be accompanied by a certification written in English that the non-English version is a complete and accurate translation of the English form filed; (c) Be in the same format as the English version; (d) Contain a disclosure, both in the non-English language and in English, that is attached to the front of the policy, application, or claim-related information, including a statement indicating that: 1. The policy, application, or claim-related information is a translation that has not been approved by the department; and 2. The English version of the policy, application, or claim-related information shall control in any disputes, complaints, or litigation; and (e) Identify the English form number that corresponds to the non-English version. (4) If an insurer offers a non-English policy, application, or claim-related information in accordance with subsections (2) and (3) of this section, the insurer shall file the translator certification and disclosure required by paragraph (d) of subsection (3) with the department as an information filing. (5) This section shall not prohibit an insurer from advertising or providing information related to the policy or claims with translations to consumers in a language other than English. (6) If there is a dispute between the English version and the non-English version, the English version shall control and the non-English version shall carry a disclaimer in the non-English language to this effect. The insurance policy is controlling and any advertisements or informational materials used by an insurer shall not be construed to modify or change the insurance policy. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1157, effective July 15, 2010; and ch. 166, sec. 3, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 304, sec. 10, effective July 15, 2002. -- Created 1998 Ky. Acts ch. 483, sec. 34, effective July 15, 1998. Legislative Research Commission Note (7/15/2010). References to the "office" of insurance in subsections (3) and (4) of this section, as amended by 2010 Ky. Acts ch. 166, sec. 3, have been changed in codification to the "department" of insurance to reflect the reorganization of certain parts of the Executive Branch, as set forth in Executive Order 2009-535 and confirmed by the General Assembly in 2010 Ky. Acts ch. 24. These changes were made by the Reviser of Statutes pursuant to 2010 Ky. Acts ch. 24, sec. 1938. Legislative Research Commission Note (7/15/2010). This section was amended by 2010 Ky. Acts chs. 24 and 166. Where these Acts are not in conflict, they have been codified together. Where a conflict exists, Acts ch. 166, which was last enacted by the General Assembly, prevails under KRS 446.250.

KRS 304.14-440 Policies to be readable -- Factors to be considered

304.14-440. Policies to be readable -- Factors to be considered (1) All insurance policies subject to the provisions of KRS 304.14-420 to 304.14-450 shall be written in language easily readable and understandable by a person of average intelligence and education. (2) In determining whether a policy or contract is readable within the meaning of this section the commissioner shall consider, at least, the following factors: (a) The simplicity of the sentence structure and the shortness of the sentences used; (b) The extent to which commonly used and understood words are employed; (c) The extent to which legal terms are avoided; (d) The extent to which references to other sections or provisions of the contract are minimized; (e) The extent to which definitional provisions are incorporated in the text of the policy or contract; and (f) Any additional factors relevant to the readability or understandability of an insurance policy or contract which the commissioner may prescribe by regulation. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1158, effective July 15, 2010. -- Created 1988 Ky. Acts ch. 225, sec. 14, effective July 15, 1988.

KRS 304.14-450 Policies to be legible -- Factors to be considered -- Type face style approved by commissioner

304.14-450. Policies to be legible -- Factors to be considered -- Type face style approved by commissioner (1) All insurance policies subject to the provisions of KRS 304.14-420 to 304.14-450 shall be printed in legible type and in a type face style approved by the commissioner. The commissioner shall by regulation establish a list of type face styles approved as acceptable. (2) In determining whether a policy is legible the commissioner shall consider, in addition to the requirements of subsection (1) of this section relating to type face size and style, the following factors: (a) Margin size; (b) Contrast and legibility of the color of the ink and paper; (c) The amount and use of space to separate sections of the policy; (d) The use of contrasting titles or headings for sections or similar aids; and (e) Any additional factors relevant to legibility which the commissioner may prescribe by regulation. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1159, effective July 15, 2010. -- Created 1988 Ky. Acts ch. 225, sec. 15, effective July 15, 1988.

KRS 304.14-500 Definitions for KRS 304.14-510 to 304.14-550

304.14-500. Definitions for KRS 304.14-510 to 304.14-550 For the purpose of KRS 304.14-510 to 304.14-550: (1) "Applicant" means: (a) In the case of an individual Medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and (b) In the case of a group Medicare supplement policy or subscriber contract, the proposed certificate holder. (2) "Certificate" means, for the purposes of KRS 304.14-510 to 304.14-550, any certificate issued under a group Medicare supplement policy, which policy has been delivered or issued for delivery in this state. (3) "Medicare supplement policy" means a group or individual policy of (accident and sickness) insurance or a subscriber contract (of hospital and medical service associations or health maintenance organizations) other than a policy issued pursuant to a contract under Section 1876 of the Federal Social Security Act (42 U.S.C. secs. 1395 et seq.) or an issued policy under a demonstration project specified in 42 U.S.C. sec. 1395ss(g)(1), which is advertised, marketed, or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical, or surgical expenses of persons eligible for Medicare. Such policy does not include: (a) Medicare Advantage plans established under Medicare Part C; (b) Prescription drug plans established under Medicare Part D; or (c) Health care prepayment plans that provide benefits pursuant to an agreement under 42 U.S.C. sec. 1395l(a)(1)(A). (4) "Medicare" means the "Health Insurance for the Aged Act," Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended. Effective: March 31, 2005 History: Amended 2005 Ky. Acts ch. 183, sec. 1, effective March 31, 2005. -- Amended 1996 Ky. Acts ch. 288, sec. 1, effective July 15, 1996. -- Amended 1994 Ky. Acts ch. 222, sec. 1, effective July 15, 1994. -- Created 1982 Ky. Acts ch. 37, sec. 1, effective February 26, 1982.

KRS 304.14-510 Minimum standards regulations

304.14-510. Minimum standards regulations The commissioner may make reasonable rules and regulations establishing minimum standards for Medicare supplement insurance policies delivered or issued for delivery in the state. Such regulations may cover but are not limited to: (1) Establishing specific standards for policy provisions; (2) Prohibiting policy provisions which in the opinion of the commissioner are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a Medicare supplement policy; (3) Establishing minimum standards for benefits under Medicare supplement policies; (4) Prescribing the format and content of the outline of coverage required by KRS 304.14-540. For purposes of this section, "format" means style, arrangements, and overall appearance, including such items as the size, color, and prominence of type and the arrangement of text and captions. Such outline of coverage shall include: (a) A description of the principal benefits and coverage provided in the policy; (b) A statement of the exceptions, reductions, and limitations contained in the policy; (c) A statement of the renewal provisions, including any reservation by the insurer of a right to change premiums; (d) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions. (5) Prescribing a standard form and the contents of an informational brochure for persons eligible for Medicare which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare. Except in the case of direct response insurance policies, the commissioner may require by regulation that the information brochure be provided to any prospective insureds eligible for Medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the commissioner may require by regulation that the prescribed brochure be provided upon request to any prospective insureds eligible for Medicare, but in no event later than the time of policy delivery. (6) Establishing reasonable captions and notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages, for all accident and sickness insurance policies sold to persons eligible for Medicare, other than: (a) Medicare supplement policies; or (b) Disability income policies. (7) Governing the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, subscriber contracts, or certificates by persons eligible for Medicare. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1160, effective July 15, 2010. -- Amended 1996 Ky. Acts ch. 288, sec. 2, effective July 15, 1996. -- Amended 1994 Ky. Acts ch. 222, sec. 2, effective July 15, 1994. -- Created 1982 Ky. Acts ch. 37, sec. 1, effective February 26, 1982.

KRS 304.14-520 Claim denial restriction

304.14-520. Claim denial restriction Notwithstanding any other provision of state law except KRS 304.14-525(3)(b)3., a Medicare supplement policy shall not: (1) Deny a claim for losses incurred more than six (6) months from the effective date of coverage for a pre-existing condition; or (2) Define a pre-existing condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage. Effective: January 1, 2024 History: Amended 2023 Ky. Acts ch. 182, sec. 2, effective January 1, 2024. -- Created 1982 Ky. Acts ch. 37, sec. 2, effective February 26, 1982. Legislative Research Commission Note (1/1/2024). 2023 Ky. Acts ch. 182, sec. 3, provides that the amendments to KRS 304.14-520 in 2023 Ky. Acts ch. 182, sec. 2, apply to Medicare supplement policies available, issued, or renewed in this state on or after January 1, 2024. Legislative Research Commission Note (1/1/2024). When this statute was amended in 2023 Ky. Acts ch. 182, sec. 2, the internal numbering and lettering did not conform to the format used in the Kentucky Revised Statutes. Under the authority of KRS 7.136(1), the Reviser of Statutes has modified the numbering and lettering. No words were changed in the proce ss.

KRS 304.14-525 Restrictions on denying, conditioning, or discriminating in pricing of Medicare supplement policies for applicants who meet requirements relating to age, health conditions, and enrollment

304.14-525. Restrictions on denying, conditioning, or discriminating in pricing of Medicare supplement policies for applicants who meet requirements relating to age, health conditions, and enrollment (1) As used in this section: (a) "Non-age eligible person": 1. Means a person who is: a. Under the age of sixty -five (65); and b. Eligible for Medicare by reason other than age; and 2. Includes persons entitled to benefits under 42 U.S.C. sec. 426(b) or 426 - 1, as amended; and (b) "Weighted average aged premium rate" means a premium rate calculated as follows: 1. First, multiply the premium rate for each age band, age sixty -five (65) and over, by the number of Kentucky insureds in -force in that age band to arrive at the total Kentucky premium for each a ge band age sixty-five (65) and over; 2. Then, calculate the sum of the Kentucky premium for all age bands age sixty-five (65) and over to arrive at the total Kentucky premium for all age bands age sixty-five (65) and over; 3. Then, calculate the sum of the Kentucky insureds in -force for all age bands age sixty-five (65) and over to arrive at the total number of Kentucky insureds in -force for all age bands age sixty -five (65) and over; and 4. Last, divide the total determined under subparagraph 2. of this paragraph by the total determined under su bparagraph 3. of this paragraph to arrive at the weighted average aged premium rate. (2) Except as provided in subsection (3)(b)1. of this section, an insurer shall not deny, condition the issuance or effectiveness of, or discriminate in the pricing of a Medicare supplement policy available for sale in this state because of the health status, claims experience, receipt of health care, or medical condition of an applicant if the applicant: (a) Submits an application for the policy prior to or during the six (6) month period beginning on the first day of the first month in which the applicant is both: 1. Sixty-five (65) years of age or older; and 2. Timely enrolled for benefits under Medicare Part B without penalty under federal law; (b) Is a non-age eligible person and: 1. Submits an application for the policy prior to or during the six (6) month period beginning on the first day of the first month in which the non -age eligible person is enrolled for benefits under Medicare Part B; or 2. Satisfies both of the following requirements: a. The applicant was enrolled for benefits under Medicare Part B prior to January 1, 2024; and b. Either: i. The applicant submits an application for the policy during the six (6) month period beginning on January 1, 2024; or ii. If an application is not available for the applicant to submit under subpart i. of this subdivision on or before January 1, 2024, the applicant makes a request for an application for the policy during the six (6) month period beginning on January 1, 2024; or (c) Satisfies all of the following requirements: 1. At the time the application is submitted, the applicant is insured under a Medicare supplement policy; 2. The application for the policy is submitted: a. To an insurer that is different than the insurer that issued the applicant's current Medicare supplement policy; and b. Within sixty (60) days of the applicant's birthday date; and 3. The applicant seeks to maintain the same Medicare supplement plan. (3) (a) Subject to paragraph (b) of this subsection, a ll Medicare supplement policies available for sale in this state shall be made available to the applicants referenced in subsection (2)(b) of this section. (b) For policies made available to applicants referenced in subsection (2)(b) of this section: 1. The applicant shall not be charged more than the weighted average aged premium rate for the policy; 2. The insurer shall demonstrate compliance with subparagraph 1. of this paragraph; and 3. The policy shall not contain any waiting period or pre-existing condition limitation or exclusion. Effective: January 1, 2024 History: Created 2023 Ky. Acts ch. 182, sec. 1, effective January 1, 2024. Legislative Research Commission Note (1/1/2024). 2023 Ky. Acts ch. 182, sec. 3, provides that this statute applies to Medicare supplement policies available, issued, or renewed in this state on or after January 1, 2024. Legislative Research Commission Note (1/1/2024). 2023 Ky. Acts ch. 182, sec. 4, effective June 29, 2023, reads as follows: "(1) Insurers shall file all policy forms and rates and comply with any other regulatory requirements in a timely manner so as to ensure that applications are available for applicants to submit under Section 1 of this Act [this statute] on or before January 1, 2024. (2) The Department of Insurance shall take any and all regulatory action necessary in a timely manner so as to ensure that applications are available for applicants to submit under Section 1 of this Act [this statute] on or before January 1, 2024, including but not limited to: (a) Reviewing policy forms, rates, and other information and forms; and (b) Promulgating any administrative regulations necessary to implement Section 1 of this Act [this statute]."

KRS 304.14-530 Regulations establishing minimum standards for loss ratios

304.14-530. Regulations establishing minimum standards for loss ratios Medicare supplement policies shall be expected to return to policyholders benefits which are reasonable in relation to the premium charged. The commissioner shall issue reasonable regulations to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience and earned premiums for the entire period for which rates are computed to provide coverage and in accordance with accepted actuarial principles and practices. For purposes of regulations issued pursuant to this section, Medicare supplement policies issued as a result of solicitations of individuals through the mail or mass media advertising, including both print and broadcast advertising, shall be treated as individual policies. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1161, effective July 15, 2010. -- Created 1982 Ky. Acts ch. 37, sec. 3, effective February 26, 1982.

KRS 304.14-540 Outline of coverage to be delivered to applicant

304.14-540. Outline of coverage to be delivered to applicant In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy shall be delivered or issued for delivery in this state and no certificate shall be delivered pursuant to a group Medicare supplement policy delivered or issued for delivery in this state unless an outline of coverage is delivered to the applicant at the time application is made. Effective: February 26, 1982 History: Created 1982 Ky. Acts ch. 37, sec. 4, effective February 26, 1982.

KRS 304.14-545 Cancellation of Medicare supplement -- Return of unearned premium

304.14-545. Cancellation of Medicare supplement -- Return of unearned premium If an individually marketed Medicare supplement insurance policy is canceled, the insurer shall return promptly the unearned portion of any premium paid beyond the month in which the cancellation is effective. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 166, sec. 4, effective July 15, 2010. -- Created 2006 Ky. Acts ch. 121, sec. 1, effective July 12, 2006.

KRS 304.14-550 Notice of policy return right and premium refund

304.14-550. Notice of policy return right and premium refund Medicare supplement policies or certificates shall have a notice prominently printed on the first page of the policy or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Effective: July 15, 1994 History: Amended 1994 Ky. Acts ch. 222, sec. 3, effective July 15, 1994. -- Created 1982 Ky. Acts ch. 37, sec. 5, effective February 26, 1982.

KRS 304.14-560 Consumer's guide to long-term care insurance -- Compilation -- Distribution -- Payment

304.14-560. Consumer's guide to long-term care insurance -- Compilation -- Distribution -- Payment (1) The commissioner of insurance shall biennially compile a consumer's guide to long- term care insurance in Kentucky. The consumer's guide shall cover all insurers offering health insurance policies in Kentucky, including health maintenance organizations, which provide coverage for services provided in long-term care facilities as defined in KRS 216.510(1). The purpose of the consumer's guide shall be to improve the buyer's ability to select the most appropriate long-term care coverage and to improve the buyer's understanding of long-term care. The consumer's guide shall contain, at a minimum, the following information: (a) Definitions of long-term care services provided in Kentucky, the cost of services, sources of payment for long-term care, and eligibility for assistance programs; (b) Factors that affect premium rates, such as age, deductibles, duration of benefits, and daily benefits paid; (c) An explanation of the types of limitations contained in long-term care policies; (d) A check list for the use of potential buyers of long-term care insurance which covers items that should be considered when selecting a long-term care insurance policy; and (e) A comparison of the long-term care policies offered for sale in Kentucky. The comparison shall be updated at least annually, shall not recommend one policy over another, and shall provide the following information for policies: premiums at ages fifty-five (55), sixty-five (65), and seventy-five (75); services covered; length of coverage; limitations on coverage; prior institutionalization requirements; elimination period; and any other information the commissioner deems appropriate. (2) The commissioner shall issue administrative regulations setting forth specific information to be provided by insurers writing long-term health care insurance in Kentucky to the department to complete the biennially compiled consumer's guide to long-term care insurance in Kentucky. (3) The commissioner shall distribute, free of charge, a copy of the consumer's guide to long-term care insurance to any person upon request. (4) The commissioner shall assess against insurers writing long-term health care insurance in Kentucky on an equitable basis the cost of compiling, printing, and distributing the consumer's guide to long-term care. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1162, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 304, sec. 11, effective July 15, 2002. -- Amended 1994 Ky. Acts ch. 93, sec. 7, effective July 15, 1994. -- Created 1990 Ky. Acts ch. 178, sec. 1, effective July 13, 1990.

KRS 304.14-600 Definitions for KRS 304.14-600 to 304.14-625

304.14-600. Definitions for KRS 304.14-600 to 304.14-625 As used in KRS 304.14-600 to 304.14-625, unless the context requires otherwise: (1) "Incidental" indicates that the value of the long-term care benefits provided in a policy is less than ten percent (10%) of the total value of the benefits provided over the life of the policy. Policies may include life insurance, disability insurance, and annuities. These values shall be measured as of the date of issue; (2) "Long-term care insurance" means any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for not less than twelve (12) consecutive months for each covered person on an expense-incurred, indemnity, prepaid, or other basis for one (1) 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 unless the hospital or unit is licensed or certified to provide long-term services. This term includes group and individual annuities and life insurance policies or riders which provide directly or which supplement long-term care insurance. This term includes a policy or rider which provides for payment of benefits based upon cognitive impairment or the loss of functional capacity. This term also includes qualified long-term care insurance contracts as defined in 26 U.S.C. sec. 7702B(b). Long- term care insurance may be issued by insurers, fraternal benefit societies, nonprofit hospital, medical-surgical, dental, and health service corporations, health maintenance organizations, or any similar organization to the extent they are otherwise authorized to issue life or health insurance. Long-term care insurance shall not include any insurance policy which is offered primarily to provide basic Medicare supplement coverage, basic hospital expense coverage, basic medical- surgical expense coverage, hospital confinement indemnity coverage, major medical expense coverage, disability income or related asset-protection coverage, accident only coverage, specified disease or specified accident coverage, or limited benefit coverage. With regard to life insurance, this term does not include life insurance policies which accelerate the death benefit specifically for one (1) or more of the qualifying events of terminal illness, medical conditions requiring extraordinary medical intervention, or permanent institutional confinement, and which provide the option of a lump-sum payment for those benefits and in which neither the benefits nor the eligibility for the benefits is conditioned upon the receipt of long-term care. Any product advertised, marketed, or offered as long-term care insurance or nursing home insurance which otherwise meets the definition of long-term care insurance shall be subject to the provisions of KRS 304.14-600 to 304.14-625; (3) "Applicant" means: (a) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and (b) In the case of a group long-term care insurance policy, the proposed certificate holder; (4) "Certificate" means any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in Kentucky, except as provided in KRS 304.14-610; (5) "Group long-term care insurance" means a long-term care insurance policy which is delivered or issued for delivery in Kentucky by an insurer, fraternal benefit society, nonprofit health service corporation, or health maintenance organization, and which is issued to: (a) One (1) or more employers or labor organizations, or to a trust or to the trustees of a fund established by one (1) 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; (b) Any professional, trade, or occupational association for its members or former or retired members, or combination thereof, if the association: 1. Is composed of individuals all of whom are or were actively engaged in the same profession, trade, or occupation; and 2. Has been maintained in good faith for purposes other than obtaining insurance; (c) An association or a trust or the trustee of a fund established, created, or maintained for the benefit of members of one (1) or more associations. Prior to advertising, marketing, or offering the policy within Kentucky, the insurer of the association shall file with the commissioner evidence that the association has at the outset a minimum of one hundred (100) persons and has been organized and maintained in good faith for purposes other than that of obtaining insurance, has been in active existence for at least one (1) year, and has a constitution and bylaws which provide: 1. The association holds regular meetings not less than annually to further the purposes of the members; 2. Except for credit unions, the association collects dues or solicits contributions from members; and 3. The members have voting privileges and representation on the governing board and committees. The association shall be deemed to satisfy the organizational requirements unless the commissioner makes a finding that the association does not satisfy those organizational requirements within the time set forth in KRS 304.14- 120; or (d) A group other than that described in paragraphs (a), (b), and (c) of this subsection, subject to a finding by the commissioner that: 1. The issuance of the group policy is not contrary to the best interest of the public; 2. The issuance of the group policy would result in economies of acquisition or administration; and 3. The benefits are reasonable in relation to the premiums charged; and (6) "Policy" means any policy, contract, subscriber, agreement, enrollment agreement, rider, or endorsement delivered or issued for delivery in Kentucky. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1163, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 304, sec. 12, effective July 15, 2002. -- Created 1992 Ky. Acts ch. 423, sec. 1, effective July 14, 1992.

KRS 304.14-605 Purpose and application to policies of KRS 304.14-600 to 304.14-625

304.14-605. Purpose and application to policies of KRS 304.14-600 to 304.14-625 (1) The purpose of KRS 304.14-600 to 304.14-625 is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term care insurance policies, and to facilitate flexibility and innovation in the development of long-term care insurance coverage. (2) The requirements of KRS 304.14-600 to 304.14-625 shall apply to policies delivered or issued for delivery in this Commonwealth on or after July 14, 1992, except as stated in KRS 304.14-610. KRS 304.14-600 to 304.14-625 are not intended to supersede the obligations of entities subject to KRS 304.14-600 to 304.14-625 to comply with the substance of other applicable insurance laws insofar as they do not conflict with KRS 304.14-600 to 304.14-625, except that laws and administrative regulations designed and intended to apply to Medicare supplement insurance policies shall not be applied to long-term care insurance. Effective: July 14, 1992 History: Created 1992 Ky. Acts ch. 423, sec. 2, effective July 14, 1992.

KRS 304.14-610 Group policy issued in another state

304.14-610. Group policy issued in another state Group long-term care insurance coverage shall not be offered to a resident of Kentucky under a group policy issued in another state to a group described in KRS 304.14- 600(5)(d) unless the commissioner or the insurance supervisory official of another state having statutory and regulatory long-term care insurance requirements substantially similar to KRS 304.14-600 to 304.14-625, has made a determination that these requirements have been met. Certificates of group long-term care insurance shall be filed with the commissioner as required by KRS 304.14-120. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1164, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 304, sec. 13, effective July 15, 2002. -- Created 1992 Ky. Acts ch. 423, sec. 3, effective July 14, 1992.

KRS 304.14-615 Required standards and disclosures -- "Pre-existing condition" defined -- Right to return policy

304.14-615. Required standards and disclosures -- "Pre-existing condition" defined -- Right to return policy (1) The commissioner shall promulgate administrative regulations that include standards for full and fair disclosure setting forth the manner, content, and require disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, pre-existing conditions, incidental benefits, lapse of insurance, termination of insurance, continuation of conversion, probationary periods, limitations, exceptions, reductions, elimination periods, premium rating practices and rating increases, requirements for replacement, recurrent conditions, and definitions of terms. (2) A long-term care insurance policy shall not: (a) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder; (b) Contain a provision establishing a new waiting period in the event existing coverage is covered to or replaced by a new or other form within the same insurer, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or (c) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care. (3) (a) A long-term care insurance policy or certificate, other than a policy or certificate thereunder issued to a group defined in KRS 304.14-600(5)(a), shall not use a definition of "pre-existing condition" which is more restrictive than the following: "Pre-existing condition means a condition for which medical services or treatment was recommended by, or received from, a provider of health care services within six (6) months preceding the effective date of coverage of an insured person." (b) A long-term care insurance policy or certificate, other than a policy or certificate under a policy issued to a group as defined in KRS 304.14- 600(5)(a), shall not exclude coverage for a loss or confinement which is the result of a pre-existing condition unless that loss or confinement begins within six (6) months following the effective date of coverage of an insured person. (c) The commissioner may extend the limitation periods set forth in subsection (3)(a) and (b) of this section as to specific age group categories in specific policy forms upon finding that the extension is in the best interest of the public. (d) The definition of "pre-existing condition" does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on that application, from underwriting in accordance with that insurer's established underwriting standards. Unless otherwise provided in the policy or certificate, a pre-existing condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in paragraph (b) of this subsection expires. A long-term care insurance policy or certificate shall not exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described pre-existing diseases or physical conditions beyond the waiting period described in paragraph (b) of this subsection. (4) (a) A long-term care insurance policy shall not be delivered or issued for delivery in this Commonwealth if the policy: 1. Conditions eligibility for any benefits on a prior hospitalization requirement; 2. Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or 3. Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement. (b) 1. A long-term care insurance policy containing post-confinement, post- acute care, or recuperative benefits shall clearly label in a separate paragraph of the policy or certificate entitled "limitations or conditions on eligibility for benefits" the limitations or conditions, including any required number of days of confinement. 2. A long-term care insurance policy or rider which conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than thirty (30) days. (5) The commissioner may promulgate administrative regulations establishing loss ratio standards for long-term care insurance policies if a specific reference to long-term care insurance policies is contained in the administrative regulations. (6) Long-term care insurance applicants shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance policies and certificates shall have a notice prominently printed on the first page or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, other than a certificate issued pursuant to a policy issued to a group defined in KRS 304.14-600(5)(a), the applicant is not satisfied for any reason. (7) (a) An outline of coverage shall be delivered to a prospective applicant for long- term care insurance at the time of initial solicitation through means which prominently direct the attention of the recipient to the document and its purpose. 1. The commissioner shall prescribe a standard format, including style, arrangement, and overall appearance, and the content of an outline of coverage. 2. In the case of agent solicitations, an agent shall deliver the outline of coverage prior to the presentation of an application or enrollment form. 3. In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form. (b) The outline of coverage shall include: 1. A description of the principal benefits and coverage provided in the policy; 2. A statement of the principal exclusions, reductions, and limitations contained in the policy; 3. A statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premium. Continuation or conversion provisions of group coverage shall be specifically described; 4. A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions; 5. A description of the terms under which the policy or certificate may be returned and premium refunded; and 6. A brief description of the relationship of the cost of care and benefits. (8) A certificate issued pursuant to a group long-term care insurance policy which is delivered or issued for delivery in this Commonwealth or a certificate subject to approval by the commissioner shall include: (a) A description of the principal benefits and coverage provided in the policy; (b) A statement of the principal exclusions, reductions, and limitations contained in the policy; and (c) A statement that the group master policy determine governing contract provisions. (9) At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy which provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request, but regardless of any request, the insurer shall deliver the policy summary no later than at the time of policy delivery. In addition to complying with all applicable requirements, the summary shall also include: (a) An explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits; (b) An illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits, if any, for each covered person; (c) Any exclusions, reductions, and limitations on benefits of long-term care insurance; and (d) If applicable to the policy type, the summary shall also include: 1. A disclosure of the effects of exercising other rights under the policy; 2. A disclosure of guarantees related to long-term care costs of insurance charges; and 3. Current and projected maximum lifetime benefits. (10) When a long-term care benefit funded through a life insurance vehicle by the acceleration of the death benefit is in benefit payment status, a monthly report shall be provided to the policyholder by the insurer. The report shall include: (a) Any long-term care benefits paid out during the month; (b) An explanation of any changes in the policy, such as death benefits or cash values, due to long-term care benefits being paid out; and (c) The amount of long-term care benefits existing or remaining. (11) Any policy or rider advertised or marketed, or offered as long-term care or nursing home insurance shall comply with the provisions of KRS 304.14-600 to 304.14- 625. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1165, effective July 15, 2010; and ch. 166, sec. 5, effective July 15, 2010. -- Amended 2002 Ky. Acts ch. 304, sec. 14, effective July 15, 2002. -- Amended 1994 Ky. Acts ch. 93, sec. 8, effective July 15, 1994. – Created 1992 Ky. Acts ch. 423, sec. 4, effective July 14, 1992. Legislative Research Commission Note (7/15/2010). This section was amended by 2010 Ky. Acts chs. 24 and 166, which do not appear to be in conflict and have been codified together.

KRS 304.14-617 Services required to be included in coverage for assisted living benefits and for adult day care services

304.14-617. Services required to be included in coverage for assisted living benefits and for adult day care services (1) Any long-term care policy, issued on or after June 21, 2001, which provides coverage for assisted living benefits shall cover services received in any assisted living community that: (a) Meets the requirements of KRS 194A.700 to 194A.729 and any administrative regulations promulgated under KRS 194A.700 to 194A.729; and (b) Meets any additional requirements of an assisted living community set forth in the long-term care policy approved by the commissioner. (2) Any long-term care policy, issued on or after June 21, 2001 but before July 15, 2020, which provides coverage for adult day care services shall cover services received in any adult day care facility that: (a) Meets the requirements of KRS 216B.0443 and any administrative regulations promulgated under KRS 216B.0443; and (b) Meets any additional requirements of an adult day care center set forth in the long-term care policy approved by the commissioner. (3) Any long-term care policy, issued on or after July 15, 2020, that provides coverage for adult day health care services shall cover services received in any adult day health care facility that: (a) Meets the requirements of KRS 216B.0441 and 216B.0443 and any administrative regulations promulgated under KRS 216B.0441 and 216B.0443; and (b) Meets any additional requirements of an adult day health care center set forth in the long-term care policy approved by the commissioner. Effective: July 15, 2020 History: Amended 2020 Ky. Acts ch. 36, sec. 40, effective July 15, 2020. -- Amended 2010 Ky. Acts ch. 24, sec. 1166, effective July 15, 2010. -- Created 2001 Ky. Acts ch. 145, sec. 1, effective June 21, 2001.

KRS 304.14-620 Administrative regulations on marketing practices

304.14-620. Administrative regulations on marketing practices The commissioner shall issue administrative regulations to establish minimum standards for marketing practices, agent compensation, agent testing, penalties, and reporting practices for long-term care insurance. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1167, effective July 15, 2010. -- Created 1992 Ky. Acts ch. 423, sec. 5, effective July 14, 1992.

KRS 304.14-622 Cancellation of long-term care insurance policy -- Return of unearned premium

304.14-622. Cancellation of long-term care insurance policy -- Return of unearned premium If an individually marketed individual long-term care insurance policy is canceled, the insurer shall return promptly the unearned portion of any premium paid beyond the month in which the cancellation is effective. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 166, sec. 6, effective July 15, 2010. -- Created 2006 Ky. Acts ch. 121, sec. 2, effective July 12, 2006.

KRS 304.14-625 Short title for KRS 304.14-600 to 304.14-625

304.14-625. Short title for KRS 304.14-600 to 304.14-625 KRS 304.14-600 to 304.14-625 may be cited as the Long-term Care Insurance Act. Effective: July 14, 1992 History: Created 1992 Ky. Acts ch. 423, sec. 6, effective July 14, 1992.

KRS 304.14-630 Administrative regulations relating to premium rates for long-term care benefits

304.14-630. Administrative regulations relating to premium rates for long-term care benefits The commissioner shall issue administrative regulations to establish standards for premium rate practices and rate increases for long-term care benefits. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1168, effective July 15, 2010. -- Created 2002 Ky. Acts ch. 304, sec. 7, effective July 15, 2002.

KRS 304.14-635 Administrative regulations relating to incidental long-term care benefits

304.14-635. Administrative regulations relating to incidental long-term care benefits The commissioner shall promulgate administrative regulations to establish standards for incidental long-term care benefits. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1169, effective July 15, 2010. -- Created 2002 Ky. Acts ch. 304, sec. 8, effective July 15, 2002.

KRS 304.14-640 Definitions for KRS 205.619 and 304.14-640 to 304.14-644

304.14-640. Definitions for KRS 205.619 and 304.14-640 to 304.14-644 As used in KRS 205.619 and 304.14-640 to 304.14-644, unless the context requires otherwise: (1) "Asset disregard" means a one dollar ($1) increase in the amount of assets the policyholder may own and retain for each one dollar ($1) of benefit paid under a long-term care partnership insurance policy qualified under KRS 205.619 and 304.14-640 to 304.14-644 when the policyholder applies for benefits of the Medicaid program; (2) "Kentucky Long-Term Care Partnership Insurance Program" means a joint Kentucky Medicaid and private long-term care insurance program established by KRS 205.619 and 304.14-640 to 304.14-644 that incorporates asset disregard and exempts a policyholder from estate recovery requirements of the Medicaid program up to the amount of the asset disregard if the policyholder receives Medicaid benefits while or after accessing the benefits of the qualified long-term care partnership policy; (3) "Long-term care" means 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 unless the hospital or unit is licensed or certified to provide long-term care services; and (4) "Long-term care partnership insurance" means insurance coverage or an insurance policy that meets the requirements of KRS 304.14-642. Long-term care partnership insurance benefits shall not include payment of coinsurance, deductibles, or premiums for services covered by other insurance policies, services covered by other insurance policies, or services covered by Parts A, B, or D of the Medicare program specified by 42 U.S.C. sec. 1395 et seq. Effective: July 15, 2008 History: Created 2008 Ky. Acts ch. 16, sec. 1, effective July 15, 2008.

KRS 304.14-642 Kentucky Long-Term Care Partnership Insurance Program -- Policy component requirements -- Administrative regulations

304.14-642. Kentucky Long-Term Care Partnership Insurance Program -- Policy component requirements -- Administrative regulations (1) The Kentucky Long-Term Care Partnership Insurance Program is established as a partnership between the Department for Medicaid Services and the Department of Insurance to: (a) Provide incentives for an individual to insure against the cost of providing for his or her long-term care needs; (b) Increase utilization of long-term care insurance policies; (c) Assist in alleviating the financial burden of Kentucky's Medicaid program by encouraging the use of private insurance; and (d) Provide a mechanism for individuals to qualify for Medicaid services for costs of long-term care without exhausting all of their assets and resour ces. (2) A long-term care partnership insurance policy shall: (a) Provide coverage for expenses for at least twelve (12) months for each covered person on an expense-incurred, indemnity, or prepaid basis for one (1) or more long-term care services provided in a setting other than an acute care unit of a hospital; (b) Be qualified under Section 7702B(b) of the Internal Revenue Code of 1986; (c) Provide coverage for long-term care services for a policyholder who is a resident of a state with a qualified long -term care partnership program when coverage first became effective; and (d) Not be issued prior to the effective date of an approved amendment to the State Medicaid Plan. (3) The Department of Insurance shall have responsibility to approve, pursuant to KRS 304.14-120, any long-term care partnership insurance policy available in Kentucky that meets and continues to meet all applicable federal and state laws and regulations. The state shall not impose any requirement affecting the terms or benefits of such a policy unless the state imposes such requirement on long -term care insurance policies without regard to whether the policy is covered under the partnership or is offered in connection with the partnership. (4) The Department of Insurance shall ensure that any agent who sells a long -term care partnership insurance policy can demonstrate an understanding of long -term care partnership insurance and how it relates to other public a nd private coverage of long-term care expenses. The Department for Medicaid Services shall provide consultation, materials, and other information to the Department of Insurance to enable the Department of Insurance to facilitate the development and issuanc e of uniform training materials for agents who sell long -term care insurance policies. The Department of Insurance may contract with another entity to conduct agent training and testing. Training and certification may be conducted at the expense of the insurance agent. (5) Within sixty (60) days of notice of approval of the amendment to the State Medicaid Plan required under KRS 205.619, the Department of Insurance shall promulgate an administrative regulation pursuant to KRS Chapter 13A to implement the Kentucky Long-Term Care Partnership Insurance Program. (6) The Department of Insurance and the Department for Medicaid Services shall report no later than September 30 each year to the Interim Joint Committee on Banking and Insurance and the Interim Joint Committee on Health Services on the number of partnership insurance policies sold in Kentucky, utilization of the partnership insurance policies, and expenditures and cost savings associated with implementation, utilization, and maintenance of the partnership program. If national data reporting standards become available, the report submitted to the federal agency shall meet the requirements of this subsection. Effective: June 29, 2023 History: Amended 2023 Ky. Acts ch. 25, sec. 33, effective June 29, 2023. -- Amended 2010 Ky. Acts ch. 24, sec. 1170, effective July 15, 2010. -- Created 2008 Ky. Acts ch. 16, sec. 2, effective July 15, 2008.

KRS 304.14-644 Required disclosure of availability of Kentucky Long-Term Care Partnership Insurance Program

304.14-644. Required disclosure of availability of Kentucky Long-Term Care Partnership Insurance Program (1) Each insurer or its agent, soliciting or offering to sell a policy that is intended to qualify as a partnership policy, shall provide each prospective applicant a Partnership Program Notice disclosing the availability of the Kentucky Long-Term Care Partnership Insurance Program as authorized in Section 6021 of the Deficit Reduction Act of 2005 and outlining the requirements and benefits of a partnership policy. (2) The manner and content of the disclosure described in subsection (1) of this section shall be established through promulgation of administrative regulations by the Department of Insurance in coordination with the Cabinet for Health and Family Services. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1171, effective July 15, 2010. -- Created 2008 Ky. Acts ch. 16, sec. 3, effective July 15, 2008. Legislative Research Commission Note ((7/15/2008). A reference to "42 U.S.C. sec. 6021" in subsection (1) of this section as it appears in 2008 Ky. Acts ch. 16, sec. 3, has been replaced with "Section 6021 of the Deficit Reduction Act of 2005" by the Reviser of Statutes during codification to correct a manifest clerical or typographical error. Consultation with the drafter and examination of the materials in the bill folder for House Bill 259 (which became 2008 Ky. Acts ch. 16) show that the former reference was intended to have been to the amendments made by Section 6021 of the Deficit Reduction Act of 2005 to various sections of 42 U.S.C. secs. 1395 et seq., and not to Section 6021 of that title, an unrelated section that was repealed in 2000. This correction has been made under the authority of KRS 7.136(1).

KRS 304.14-650 Definition for KRS 304.14-650 to 304.14-675

304.14-650. Definition for KRS 304.14-650 to 304.14-675 As used in KRS 304.14-650 to 304.14-675, "short-term nursing home insurance policies" means any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for less than twelve (12) consecutive months for each covered person on an expense-incurred, indemnity, prepaid, or other basis for one (1) or more necessary or medically necessary diagnostic, preventative, therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting other than an acute care unit of a hospital unless the hospital or unit is licensed or certified to provide services in a skilled nursing facility, extended care facility, intermediate care facility, convalescent nursing home, personal care facility, home health care agency, adult day care facility, and assisted living facility. This term shall also include a policy or rider that provides for payment of benefits based upon cognitive impairment or loss of functional capacity. Short-term nursing home insurance policies may be issued by insurers, fraternal benefit societies, nonprofit hospitals, medical-surgical, dental, and health services corporations, health maintenance organizations, or any similar organization to the extent they are otherwise authorized to issued life or health insurance. Short-term nursing home insurance policies shall not include any insurance policy which is offered primarily to provide basic Medicare supplement coverage, basic hospital expense coverage, basic medical-surgical expense coverage, hospital confinement indemnity, major medical expense coverage, disability income or related-asset protection coverage, accident only coverage, specified disease or specified accident coverage. Effective: July 13, 2004 History: Amended 2004 Ky. Acts ch. 157, sec. 1, effective July 13, 2004. -- Created 2002 Ky. Acts ch. 304, sec. 1, effective July 15, 2002.

KRS 304.14-655 Short-term nursing home products subject to statutes

304.14-655. Short-term nursing home products subject to statutes Any short-term nursing home product issued on or after July 15, 2002, shall be subject to the provisions of this section and KRS 304.14-660, 304.14-665, 304.14-670 and 304.14- 675. Effective: July 15, 2002 History: Created 2002 Ky. Acts ch. 304, sec. 2, effective July 15, 2002.

KRS 304.14-660 Administrative regulations relating to short-term nursing home insurance policies

304.14-660. Administrative regulations relating to short-term nursing home insurance policies The commissioner shall promulgate administrative regulations that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for sale of short-term nursing home insurance policies, terms of renewability, initial and subsequent conditions or eligibility, nonduplication of coverage provisions, coverage of dependents, pre-existing conditions, termination of insurance, continuation of conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1172, effective July 15, 2010. -- Created 2002 Ky. Acts ch. 304, sec. 3, effective July 15, 2002.

KRS 304.14-665 Administrative regulations establishing loss ratio standards

304.14-665. Administrative regulations establishing loss ratio standards The commissioner may promulgate administrative regulations establishing loss ratio standards for short-term nursing home insurance policies. Effective: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1173, effective July 15, 2010. -- Created 2002 Ky. Acts ch. 304, sec. 4, effective July 15, 2002.

KRS 304.14-670 Right to return policy or certificate and to have premium refunded -- Notice -- Proof of delivery of policy

304.14-670. Right to return policy or certificate and to have premium refunded -- Notice -- Proof of delivery of policy Short-term nursing home insurance policy applicants shall have the right to return the policy or certificate within thirty (30) days of its delivery from the insurer to the policyowner and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Short-term nursing home insurance policies and certificates shall have a notice prominently printed on the first page or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. The insurer shall retain proof of receipt of the delivery of the policy from the insurer to the policyowner. Effective: July 15, 2002 History: Created 2002 Ky. Acts ch. 304, sec. 5, effective July 15, 2002.

KRS 304.14-675 Coverage for services received in an assisted living community or adult day care facility

304.14-675. Coverage for services received in an assisted living community or adult day care facility (1) Any short-term nursing home insurance policy issued on or after July 15, 2002, which provides coverage for assisted living benefits shall cover services received in any assisted living community which: (a) Meets the requirements of KRS 194A.700 to 194A.729 and any administrative regulations promulgated under KRS 194A.700 to 194A.729; and (b) Meets any additional requirements of an assisted living community set forth in the short-term nursing home insurance policy approved by the commissioner. (2) Any short-term nursing home insurance policy issued on or after July 15, 2002, but before July 15, 2020, which provides coverage for adult day care services shall cover services received in any adult day care facility that: (a) Meets the requirements of KRS 216B.0443 and any administrative regulations promulgated under KRS 216B.0443; and (b) Meets any additional requirements of an adult day care center set forth in the short-term nursing home insurance policy approved by the commissioner. (3) Any short-term nursing home insurance policy issued on or after July 15, 2020, that provides coverage for adult day health care services, shall cover services received in any adult day health care facility that: (a) Meets the requirements of KRS 216B.0441 and 216B.0443 and any administrative regulations promulgated under KRS 216B.0441 and 216B.0443; and (b) Meets any additional requirements of an adult day health care center set forth in the short-term nursing home insurance policy approved by the commissioner. Effective: July 15, 2020 History: Amended 2020 Ky. Acts ch. 36, sec. 41, effective July 15, 2020. -- Amended 2010 Ky. Acts ch. 24, sec. 1174, effective July 15, 2010. -- Created 2002 Ky. Acts ch. 304, sec. 6, effective July 15, 2002.

Source: Kentucky Legislative Research Commission (legislature.ky.gov)URL: https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38704Fetched: 10/20/2026