Employers have no obligation under Rhode Island law to offer long-term care insurance to their employees. However, if long-term care insurance is among the benefits offered, certain state law requirements limit how the plan may be designed.
All long-term care insurance policies sold in Rhode Island must provide home healthcare benefits that meet the National Association of Insurance Commissioners' minimum standards for home healthcare benefits in long-term care insurance policies (RI Gen. Laws Sec. 27-34.2-6). These home health care benefits must be at least 50 percent of the benefits provided for care in a nursing home. No policy may provide coverage for skilled nursing care only or provide more coverage for skilled care in a facility than coverage for lower levels of care.
A long-term care insurance policy may not limit or exclude coverage by type of illness, treatment, medical condition, or accident, except for:
• Preexisting conditions or diseases;
• Mental or nervous disorders (but not Alzheimer's disease, other dementias, or organic brain disorders);
• Alcoholism and drug addiction;
• Illnesses, treatments, or medical conditions arising from war or act of war (whether declared or undeclared); participation in a felony, riot, or insurrection; service in the armed forces or auxiliary units; suicide, attempted suicide, or an intentional self-inflicted injury; or aviation for non-fare-paying passengers;
• Treatment provided in a government facility (unless otherwise required by law);
• Services to the extent benefits are available under Medicare or other governmental program (except Medicaid), any state or federal workers' compensation, employer's liability or ...