3.2 New Hampshire Disability and Long-Term Care Insurance
Key Takeaways
- Disability income policies must carry the NAIC uniform provisions NH adopts: 31-day grace, 20-day notice of claim, proof of loss within 90 days, and claim payment timing.
- Renewability ranks from strongest to weakest: noncancelable, guaranteed renewable, conditionally renewable, optionally renewable, and cancelable.
- NH long-term care policies must be at least guaranteed renewable, limit pre-existing look-back to 6 months, and offer inflation protection and nonforfeiture options.
- LTC applicants get a 30-day free-look and an Outline of Coverage delivered at or before application.
- Partnership-qualified LTC policies grant dollar-for-dollar Medicaid asset disregard equal to benefits paid, protecting assets that would otherwise have to be spent down.
Disability Income Insurance in New Hampshire
New Hampshire adopts the NAIC Uniform Individual Accident and Sickness Policy Provisions (Title XXXVII RSA). These standardized provisions appear verbatim on most disability income (DI) contracts, and the exam tests the exact time periods.
Mandatory Uniform Provisions — Know the Numbers
| Provision | New Hampshire standard |
|---|---|
| Grace period | 7 days (weekly premium), 10 days (monthly), 31 days (other modes) |
| Notice of claim | Within 20 days of the loss, or as soon as reasonably possible |
| Claim forms | Insurer furnishes forms within 15 days of notice |
| Proof of loss | Within 90 days of the end of the covered period |
| Time of payment of claims | Periodic benefits paid at least monthly; other benefits immediately on proof |
| Legal actions | No suit before 60 days after proof; none after 3 years |
| Reinstatement | Allowed; lapsed policy may be reinstated, with a 10-day sickness waiting window |
Worked example: An insured is hurt January 1. Notice of claim is due by January 21 (20 days). If the insurer does not supply claim forms by the 16th day, the insured may submit proof of loss in any written form, due within 90 days of the loss period's end. Memorizing 20 / 15 / 90 / 60 / 3-years earns easy points.
Renewability Provisions — Strongest to Weakest
The renewal clause controls whether and how a carrier can keep, reprice, or drop a DI policy:
- Noncancelable — strongest. Insurer can neither cancel nor raise the premium; guaranteed to a stated age (often 65).
- Guaranteed renewable — insurer cannot cancel, must renew, but may raise premiums by an entire class (never one insured).
- Conditionally renewable — renewal limited to conditions stated in the contract (e.g., still employed).
- Optionally renewable — insurer may decline renewal on a premium-due date.
- Cancelable — weakest; insurer may cancel anytime with notice.
Trap: "Guaranteed renewable" lets the insurer raise rates by class — many candidates confuse it with noncancelable, which freezes both renewal and premium.
Long-Term Care (LTC) Insurance in New Hampshire
New Hampshire's LTC rules track the NAIC Long-Term Care Insurance Model Act and Regulation, with strong consumer protections that the NHID enforces.
Required Policy Features
| Provision | New Hampshire requirement |
|---|---|
| Renewability | At least guaranteed renewable |
| Pre-existing condition look-back | Maximum 6 months before effective date; exclusion no longer than 6 months after |
| Free-look period | 30 days to return for full refund |
| Outline of Coverage | Delivered at or before the time of application |
| Inflation protection | Must be offered (commonly 5% compound); applicant may reject in writing |
| Nonforfeiture benefit | Must be offered; applicant may reject in writing |
| Benefit triggers | Inability to perform 2 of 6 activities of daily living (ADLs) or severe cognitive impairment |
The six activities of daily living are bathing, dressing, transferring, toileting, continence, and eating. Most policies pay once the insured cannot perform two of the six, or has a cognitive impairment such as Alzheimer's. "Offered" is the operative word for inflation and nonforfeiture — the carrier must put the option on the table, but the buyer may decline it in writing.
Elimination Period
The elimination period is the deductible measured in days (often 30, 60, or 90) during which the insured pays out of pocket before benefits begin. A longer elimination period lowers premium. It must be clearly disclosed in the Outline of Coverage.
Producer Suitability and Training
To sell LTC in New Hampshire a producer must complete an initial 8-hour LTC training course and 4 hours of ongoing LTC continuing education each license cycle, follow suitability standards (matching the product to the client's finances and needs), and deliver the required disclosures. Replacing an existing LTC policy triggers additional replacement notices.
The New Hampshire Long-Term Care Partnership Program
The Long-Term Care Partnership Program is the most heavily tested LTC topic for New Hampshire. It is a public-private arrangement between the state and approved insurers that lets a policyholder shelter assets from the Medicaid spend-down requirement.
How It Works — Dollar-for-Dollar Asset Disregard
- The consumer buys a Partnership-qualified LTC policy (it must include the state-required inflation protection for buyers under set ages).
- The insured uses the policy benefits to pay for covered care.
- When benefits are exhausted, the insured may apply for NH Medicaid.
- Medicaid disregards assets equal to the total benefits the policy paid when determining eligibility — and protects the same amount from later estate recovery.
Worked example: A NH resident's Partnership policy pays out $200,000 of LTC benefits. When she applies for Medicaid, the state ignores $200,000 of her countable assets that would normally have to be spent down to roughly the $2,500 individual asset limit. She keeps that $200,000 and Medicaid still cannot recover it from her estate after death.
Why It Matters
| Without Partnership policy | With Partnership policy |
|---|---|
| Spend down nearly all assets to qualify for Medicaid | Protect assets equal to benefits paid |
| Estate subject to Medicaid recovery | Protected assets shielded from recovery |
| LTC paid privately until impoverished | Insurance pays first, then Medicaid |
Exam tip: The single benefit of a Partnership-qualified policy that examiners want is Medicaid asset protection (dollar-for-dollar asset disregard) — not lower premiums, not tax-free benefits, and not the elimination of a waiting period.
Common Traps
- Partnership policies are not cheaper; the value is the asset disregard, not premium savings.
- The asset protection equals benefits paid, not the policy's face or premium total.
- A non-Partnership LTC policy provides care coverage but no special Medicaid asset disregard.
Under New Hampshire's adopted NAIC uniform provisions, within how many days of a loss must an insured normally give notice of a disability claim?
Which disability income renewability provision prohibits cancellation and requires renewal but allows the insurer to raise premiums for an entire class of insureds?
A New Hampshire client buys a Partnership-qualified LTC policy that ultimately pays $200,000 in benefits before he applies for Medicaid. What is the primary advantage of the Partnership policy?
What is the maximum pre-existing condition look-back period New Hampshire permits on a long-term care insurance policy?