Pennsylvania long-term care insurance practice questions

Last updated October 18, 2026

The Pennsylvania Accident and Health exam's section 9.0 (14% of the exam) includes "Long-Term Care Pennsylvania regulations and required provisions." The outline lists outline of coverage, the free look, pre-existing conditions, continuation and conversion, unintentional lapse, disclosure, inflation protection, nonforfeiture, benefit triggers, replacement, marketing, suitability, the shopper's guide, compensation and penalties. ^[1] This page covers those rules from the Insurance Company Law of 1921 and 31 Pa. Code Chapter 89a, then gives 12 practice questions.

Key rules

Policy limits (Insurance Company Law section 1105): a long-term care policy may not be canceled, nonrenewed or terminated because of the insured's age or declining health; may not start a new waiting period when coverage is converted or replaced within the same company (except for benefit increases the insured chooses); may not cover skilled nursing care only or much more skilled care than lower levels of care; and may not be designed to cover less than twelve consecutive months. ^[2]
Pre-existing conditions (section 1105): the definition can be no more restrictive than a condition for which advice or treatment was recommended or received within six months before coverage started, and an exclusion can apply only if the loss begins within six months after coverage starts. ^[2]
Right to return (section 1110): thirty days from delivery, with the premium refunded. ^[3]

Practice questions

1. Which of these is allowed in a Pennsylvania long-term care policy?
A. Canceling because the insured turned 85
B. Covering skilled nursing care only
C. Revising rates on a class basis under a guaranteed renewable policy
D. A policy designed to cover only six months

Answer: C. Guaranteed renewable lets the insurer revise rates on a class basis. The other three are barred. (31 Pa. Code 89a.105(a)(2); Insurance Company Law section 1105) ^[4]^[2]

2. What is the difference between "guaranteed renewable" and "noncancellable"?
Answer: Under noncancellable, the insurer cannot change the premium rate. Under guaranteed renewable, rates may be revised on a class basis. (31 Pa. Code 89a.105(a)(2), (3)) ^[4]

3. How many activities of daily living must a policy list at a minimum, and which are they?
Answer: Six: bathing, continence, dressing, eating, toileting and transferring. (31 Pa. Code 89a.124(b)) ^[5]

4. What is the most restrictive benefit trigger a policy may use?
Answer: A deficiency in not more than three activities of daily living, or the presence of cognitive impairment. (31 Pa. Code 89a.124(a)) ^[5]

5. Before an individual LTC policy is issued, what must the applicant do about lapse notices?
Answer: Name at least one other person to receive notice of lapse or termination for nonpayment, or sign a written waiver. (31 Pa. Code 89a.106(a)(1)) ^[6]

6. How much notice is required before an LTC policy lapses for nonpayment?
Answer: At least 30 days before the lapse, to the insured and the designee, and the notice may not be sent until 30 days after the premium is due and unpaid. (31 Pa. Code 89a.106(a)(3)) ^[6]

7. A policyholder with cognitive impairment let the policy lapse. How long do they have to request reinstatement?
Answer: 5 months after termination, with proof of the impairment or loss of functional capacity before the grace period expired. (31 Pa. Code 89a.106(b)) ^[6]

8. What inflation protection must insurers offer?
Answer: An option no less favorable than one of three features the rule lists, such as benefit increases compounded annually at a rate of at least 5%. (31 Pa. Code 89a.112(a)(1)) ^[7]

9. In a replacement, how soon must the replacing insurer notify the existing insurer?
Answer: Within 5 working days from the date the application is received or the policy is issued, whichever is sooner. (31 Pa. Code 89a.113(e)) ^[8]

10. When must a producer deliver the long-term care shopper's guide?
Answer: Before presenting an application or enrollment form. (31 Pa. Code 89a.127(1)) ^[9]

11. Under suitability rules, what worksheet must the applicant be shown at or before application?
Answer: The "Long-Term Care Insurance Personal Worksheet." The issuer must also give "Things You Should Know Before You Buy Long-Term Care Insurance." (31 Pa. Code 89a.121(b)(2), (e)) ^[10]

12. A group LTC member's coverage ends. How long do they have to apply for a converted policy?
Answer: Not later than 31 days after the group coverage ends, if they were continuously insured under the group for at least 6 months before termination. (31 Pa. Code 89a.105(d)(3), (5)) ^[4]

More rules to know

Outline of coverage (section 1111): it must be delivered at the time of initial solicitation. When an agent solicits, it must be delivered before the application is presented. ^[11]
Premium increases (89a.105(f)): premiums may not rise because the insured ages beyond 65 or because of how long they have been covered. ^[4]
Marketing notice (89a.120): "Notice to buyer: This policy may not cover all of the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations." ^[12]

Study tips

The numbers: 12 months minimum coverage, 6 months each way for pre-existing conditions, 30 days to return the policy, 30 days lapse notice, 5 months to reinstate after impairment, 5% inflation option, 5 working days in a replacement, 31 days to convert.
Remember the six ADLs and the "three or cognitive impairment" trigger ceiling.

Practice more with the free Pennsylvania Accident and Health practice test.

Prep Retention is independent and is not affiliated with PSI or the state.

Sources

Laws and exam documents quoted as of October 2026.

PSI, Pennsylvania Accident and Health outline, Series 16-02 (effective 3/1/2026): https://proctor2.psionline.com/media/programs/PAINS/16-02xx.pdf
Insurance Company Law of 1921 (Act of May 17, 1921, P.L. 682, No. 284), Section 1105, PA General Assembly: https://www.palegis.us/statutes/unconsolidated/law-information/view-statute?iFrame=true&txtType=HTM&SessYr=1921&SessInd=0&ActNum=0284
Same act, Section 1110: same URL as source 2
31 Pa. Code 89a.105: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.105.html&d=reduce
31 Pa. Code 89a.124: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.124.html&d=reduce
31 Pa. Code 89a.106: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.106.html&d=reduce
31 Pa. Code 89a.112: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.112.html&d=reduce
31 Pa. Code 89a.113: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.113.html&d=reduce
31 Pa. Code 89a.127: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.127.html&d=reduce
31 Pa. Code 89a.121: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.121.html&d=reduce
Insurance Company Law of 1921, Section 1111: same URL as source 2
31 Pa. Code 89a.120: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/031/chapter89a/s89a.120.html&d=reduce