Date:November 21, 2008
To:All Life and Health Insurers Writing Long-Term Care Business in Wisconsin;
All Licensed Agents Selling, Soliciting or Negotiating Long-Term Care Insurance in Wisconsin
From:Sean Dilweg, Commissioner of Insurance
Subject:Insurance Agent Training Requirements for Long-Term Care Insurance Policies, Certificates and Riders

The purpose of this Bulletin is to notify all insurers and their licensed agents of the agent training and record keeping requirements concerning long-term care (LTC) insurance. Insurers are cautioned to take steps to prevent the sale of LTC policies, including but not limited to nursing home, home health care, life riders, annuity riders and qualified LTC partnership policies, by their appointed agents who have not met the qualification requirements. After January 1, 2009, it will be a violation of Wisconsin law for an insurance intermediary to sell, solicit or negotiate a LTC insurance policy without having completed the initial training and the ongoing training requirements in s. Ins 3.46 (26), Wis. Adm. Code.

Background

2007 Wisconsin Act 20 required that the Department of Health Services (DHS) and the Office of the Commissioner of Insurance (OCI) approve a training program for individuals who sell LTC insurance policies in Wisconsin. The act also created the LTC partnership program in Wisconsin. However, the agent training requirement applies to all agents selling LTC insurance, not just those selling LTC partnership program policies.

Section 628.348 (2), Wis. Stat., regarding the sale of long-term care insurance, prohibits an individual from selling, soliciting, or negotiating any LTC insurance product in Wisconsin unless the individual is a licensed intermediary (agent or broker) for accident and health insurance or life insurance and has completed an approved initial one-time training course by January 1, 2009. Licensed agents will also be required to complete ongoing training every 24 months thereafter. The statute also requires that insurers maintain and make available to the commissioner upon request verification that their licensed agents are in compliance with the agent training requirements.

Agent Training Requirements effective January 1, 2009

Section Ins 3.46 (26), Wis. Adm. Code, prohibits an individual from selling, soliciting or negotiating LTC insurance on or after January 1, 2009, unless the individual is duly licensed and appointed by an insurer, and has completed the initial training and ongoing training every 24 months as specified in s. 628.348 (1), Wis. Stat.

The initial training required shall be no less than 8 hours, of which 2 hours shall contain Wisconsin-specific Medicaid and LTC information. Training shall be completed in one 6-hour course for non-Wisconsin-specific Medicaid and LTC information training and one 2-hour course for Wisconsin-specific Medicaid and LTC information or one 8-hour course that includes the 2 hours of training containing specific Medicaid and LTC information.

The course content for the Wisconsin-specific Medicaid and LTC training developed by the Wisconsin Department of Health Services (DHS) can be viewed at http://www.uwosh.edu/ccdet/DHFS/lc/default.htm under the "Instructional Resources" heading.

Long-term care training may be approved for continuing education credits. LTC training classes approved for continuing education credit can be found at https://www.sircon.com/resource/layout.jsp?page=wisconsinLps&type=wisconsin.

Resident and nonresident insurance agents licensed prior to January 1, 2009, who have completed initial training courses on or after October 27, 2007, may count these courses towards completion of 6 hours of the initial 8-hour training requirement if the courses meet the requirements in s. Ins 3.46 (26) (a) 4 and 6, Wis. Adm. Code. Resident and nonresident agents who have completed the initial training are required to complete the initial 2 hours of Wisconsin-specific Medicaid and LTC information training.

After completion of the initial 8 hours of training, insurance agents shall complete one 4-hour training course specific to LTC insurance that incorporates updates to the Wisconsin partnership program. Insurance agents, who are licensed prior to and complete initial training by January 1, 2009, are required to complete the required 4-hour ongoing training by their first complete license renewal cycle. Agents completing initial training after January 1, 2009, shall complete the required 4-hour ongoing training by the date of their next complete license renewal cycle. An agent's license renewal date is biennial and based on the last day of the agent's birth month as identified on the agent's license.

Insurer Verification of Training and Insurer Record Keeping

Beginning January 1, 2009, an insurer must obtain and maintain verification that a licensed agent appointed with the insurer has completed the required initial training courses before the agent is permitted to sell, solicit or negotiate any of the insurer's LTC insurance products. An insurer also must obtain and maintain verification that a licensed agent appointed with the insurer receives the required ongoing training every 24 months. The insurer must maintain records of such verification in compliance with s. Ins 6.80, Wis. Adm. Code, regarding retention of records, and make that verification available to the commissioner upon request.

In addition, an insurer offering a qualified LTC partnership policy must maintain the records stated above and also maintain records that its appointed agents have demonstrated an understanding of Wisconsin's partnership program and the relationship of Wisconsin's partnership program to public and private coverage of LTC including Wisconsin Medicaid and LTC programs.

The reporting requirements in s. Ins 3.46 (26), Wis. Adm. Code, are intended to allow the commissioner to provide assurance to the DHS that an insurer's appointed intermediaries have received the LTC training.

Questions regarding this Bulletin should be directed to Diane Dambach at diane.dambach@wisconsin.gov, Linda Low at linda.low@wisconsin.gov or Kevin Zwart at kevin.zwart@wisconsin.gov.