Long-Term Care Forms (14VAC5-200-210.1)

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Rescission Reporting Form, Form A (used by insurers only)

Long-Term Care Insurance Personal Worksheet, Form B

Things You Should Know Before You Buy Long-Term Care Insurance, Form C (Rev. 09/07)

Long-Term Care Insurance Suitability Letter, Form D (Rev. 02/02)

Claim Denial Reporting Form, Form E (Rev. 09/07)

Potential Rate Increase Disclosure Form, Form F (Rev. 09/07)

Long-Term Care Insurance Replacement and Lapse Reporting Form, Form G (Rev. 09/07)

Partnership Program Notice, Form 200-A (effective 9/07)

Partnership Disclosure Notice, Form 200-B (effective 9/07)

Long-Term Care Partnership Certification, Form 200-C (effective 9/07)