Key Takeaways
- Florida requires a 10-day free look period for disability insurance policies
- Long-term care policies in Florida must provide a 30-day free look period
- Florida participates in the Long-Term Care Partnership Program for Medicaid asset protection
- LTC policies must offer inflation protection options
- Producers must complete specific training to sell LTC insurance in Florida
Florida Disability and Long-Term Care Insurance
Florida has specific regulations for disability income insurance and long-term care insurance that protect consumers and ensure adequate coverage.
Disability Income Insurance
Free Look Period
Florida requires a 10-day free look period for individual disability insurance:
- Policyholder can return for full premium refund
- Begins when policy is delivered
- Applies to individual policies
Required Policy Provisions
Florida disability policies must include:
| Provision | Requirement |
|---|---|
| Grace Period | Minimum 31 days for annual premium |
| Reinstatement | Must allow reinstatement within 3 years |
| Notice of Claim | Written notice within 20 days |
| Time to Pay Claims | Within 60 days of proof of loss |
| Legal Actions | Not before 60 days after proof |
Definition of Disability
Florida allows different definitions:
- Own Occupation - Cannot perform duties of own occupation
- Any Occupation - Cannot perform duties of any suitable occupation
- Split Definition - Own occupation for period, then any occupation
Renewability Provisions
| Type | Description |
|---|---|
| Non-Cancellable | Cannot cancel or raise rates |
| Guaranteed Renewable | Must renew, can raise class rates |
| Conditionally Renewable | May not renew for stated reasons |
Long-Term Care Insurance
Florida has comprehensive LTC insurance regulations:
Free Look Period
- 30-day free look for LTC policies
- Applies to all individual LTC policies
- Policyholder can return for full refund
Required Provisions
| Provision | Requirement |
|---|---|
| Renewability | Must be guaranteed renewable |
| Pre-existing Conditions | Max 6-month look-back period |
| Elimination Period | Must disclose clearly |
| Inflation Protection | Must offer option |
| Nonforfeiture | Must offer option |
Benefit Triggers
Florida LTC policies must clearly define benefit triggers:
- Activities of Daily Living (ADLs) - Typically need help with 2 of 6 ADLs
- Cognitive Impairment - Substantial supervision required
- Medical Necessity - Certification by licensed health care practitioner
Six Activities of Daily Living
- Bathing
- Dressing
- Eating
- Toileting
- Transferring
- Continence
Inflation Protection Options
Insurers must offer at least one inflation protection option:
- Compound inflation (typically 3% or 5%)
- Simple inflation
- Future purchase option
- Consumer Price Index adjustment
Florida Long-Term Care Partnership Program
Florida participates in the Long-Term Care Partnership Program:
How It Works
- Purchase a Partnership-qualified LTC policy
- Use benefits to pay for care
- If benefits exhaust, apply for Medicaid
- Asset protection - Keep assets equal to benefits received
Example
| Scenario | Without Partnership | With Partnership |
|---|---|---|
| Benefits Used | N/A | $200,000 |
| Medicaid Asset Limit | ~$2,000 | $202,000 |
| Protected Assets | Almost none | Up to benefits paid |
Partnership Policy Requirements
To qualify as a Partnership policy:
- Must meet NAIC model requirements
- Must include specific inflation protection
- Insurer must be participating in program
- Policy must be tax-qualified
Producer Training Requirements
To sell LTC insurance in Florida:
Initial Training
- Complete 8 hours of LTC-specific training
- Must be completed before selling LTC
- Covers policy provisions, suitability, consumer protections
Ongoing Training
- 4 hours of LTC CE every renewal period
- Must stay current on product changes
- Included in 24-hour total CE requirement
Suitability Requirements
Before selling LTC, producers must:
- Complete suitability questionnaire with client
- Document financial ability to pay premiums
- Assess need for coverage
- Provide required disclosures
How long is the free look period for long-term care insurance in Florida?
What is the primary benefit of purchasing a Florida Partnership-qualified long-term care policy?
How many hours of initial training are required to sell LTC insurance in Florida?