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Health · Chapter 22 · Long-Term Care

LTC Outline, Shopper's Guide and Advertising (FL)

Definition
Outline of coverage: delivered at the time of application (direct response insurers: on request, no later than policy delivery); must describe principal benefits, exclusions/reductions/limitations, renewal provisions and the insurer's right to change premiums, a summary-only statement, a graphic comparison of an increasing-benefit vs. level-benefit policy over at least twenty (20) years, and any premium increases for automatic/optional benefits — with age-based costs disclosed at ages 75 and 85. Shopper's Guide: every prospective applicant must receive the NAIC Shopper's Guide BEFORE the agent presents an application or enrollment form (direct response: with the application); life policies/riders with accelerated LTC benefits get a life Policy Summary instead. Advertising: insurers must FILE all Florida LTC advertising with the office — usable immediately upon filing, subject to disapproval. Every LTC policy must disclose prominently on both the policy and the outline whether it is intended as a tax-qualified LTC policy.
In plain English
Guide before the application, outline at the application, ads on file with the state, and the tax-qualified label stamped where you can't miss it.
Exam tip
⚠️ Timing trap: the Shopper's Guide comes BEFORE the application; the outline comes AT application.
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