Updated August 7, 2026. Quick answer: if your long-term-care premium has risen enough, the insurer may be required to let you stop paying and keep a smaller paid-up policy instead of losing everything. 🔴 It is called a contingent benefit upon lapse, and the threshold that triggers it depends on how old you were when you bought.
What you get if it triggers
The policy converts to a shortened benefit period: paid-up, no further premiums, with a reduced maximum. The regulation credits 100% of the premiums you have paid toward that maximum, with a floor of “thirty (30) times the daily nursing home benefit”.
⚠️ Read that floor precisely. It is thirty times the daily benefit amount — not thirty days of whatever care actually costs. If your daily benefit is below what care costs where you live, the floor is worth less than “a month of care” suggests.
What triggers it
The obligation attaches once cumulative premium increases since issue exceed a percentage set by issue age. 🔴 The threshold falls steeply with age — from around 200% for the youngest buyers down to about 10% at the oldest issue ages.
The practical reading: if you bought in your seventies or later, a fairly ordinary increase may already have crossed your threshold. If you bought in your forties, it takes a great deal more. There is also a defined window — the regulation gives 120 days after a lapse for the election — so this is not something to discover a year later.
⚠️ One caveat that applies to everything on this page. These are NAIC model rules. A model binds only where a state has adopted it, and states adopt different versions in different years. We have not surveyed which states adopted what. Treat this as the shape of the protection and confirm the detail with your own state insurance department.
What to ask, in writing
- “What is my issue age on this policy, and what is the cumulative premium increase since issue?” Both numbers, together.
- “Has the contingent benefit upon lapse been triggered, and if not, at what cumulative increase would it be?”
- “What would the paid-up maximum be if I elected it today?”
Then compare that paid-up figure against the other routes on the premium-increase menu — and check the partnership question before reducing anything.
Sources
Contingent benefit upon lapse, the issue-age trigger table, the 120-day election window and the shortened-benefit-period credit: NAIC Long-Term Care Insurance Model Regulation #641, Section 28. All read 7 August 2026. General information, not insurance, legal or tax advice on your policy. Your contract and your state’s rules govern.