Employers have no obligation under South Carolina 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.
A "preexisting condition" may not be defined more restrictively than as a condition for which medical advice or treatment was recommended by or received from a provider of healthcare services within six months preceding the effective date of coverage of an insured person. Generally, long-term care insurance policies may not exclude coverage for a loss or confinement resulting from a preexisting condition unless the loss or confinement begins within six months following the effective date of coverage of an insured person (SC Code Sec. 38-72-60).
Long-term care insurance may not limit or exclude coverage by type of illness, treatment, medical condition, or accident. However, there are certain exceptions, including, for example, preexisting conditions or diseases, mental or nervous disorders (not including Alzheimer's disease), alcoholism, drug addiction, and attempted suicide (SC Code Regs. 69-44).
Generally, group long-term care insurance issued in South Carolina must provide covered individuals with a basis for continuation or conversion of coverage (SC Code Regs. 69-44).