State RegulationsOH specificDifficulty 2/5
A producer in Youngstown replaces an insured's existing group long-term care certificate with an individual LTC policy. Under Ohio rules, which protection applies to the insured?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
OAC 3901-4-01(N) governs LTC replacements and provides that a replacement must not result in an exclusion for preexisting conditions that would have been covered under the replaced group policy. This prevents insurers from using a new sale to strip away accrued protection, and the Ohio Department of Insurance enforces the rule as part of its LTC replacement standards.
Why the other options are wrong
- A) Imposing new preexisting-condition exclusions on conditions the old policy covered is exactly what Ohio's replacement rule forbids.
- C) No rule requires requalification through a prior institutional stay upon replacement.
- D) The replaced group policy does not remain liable; the new policy must honor the covered preexisting conditions.
Memory hook
Replacement can't reset the clock — conditions the group plan covered stay covered.