| (a) Insurer requirements.
(1) Any insurer issuing long-term care insurance to
an association, as defined in the Insurance Code §1251.052, must
file with the department in accordance with the requirements and procedures
set forth in Subchapter A of this chapter (relating to Submission
Requirements for Filings and Departmental Actions Related to Such
Filings) the following:
(A) the long-term care policy and certificate;
(B) a corresponding outline of coverage; and
(C) annual certification of the association's compliance
with marketing standards for long-term care policies and certificates
in accordance with Form Number LHL573(LTC) Insurer Certification of
Association Compliance With Marketing Standards for Long-Term Care
Partnership and Non-Partnership Policies and Certificates Form specified
in Figure: 28 TAC §3.3849(e)(1)(F).
(2) No group long-term care insurance policy or certificate
may be issued to an association unless the insurer files with the
department the information required in this subsection.
(b) Advertisements. Advertisements for long-term care
insurance must be filed with the department in accordance with §3.3838(1)
of this title (relating to Filing Requirements for Advertising).
(c) Association disclosure requirements.
(1) An association must disclose in any long-term care
insurance solicitation to its members:
(A) the specific nature and amount of the compensation
arrangements (including all fees, commissions, administrative fees
and other forms of financial support) that the association receives
from endorsement or sale of the policy or certificate to its members;
and
(B) a brief description of the process under which
the policies and the insurer issuing the policies were selected.
(2) If the association and the insurer have interlocking
directorates or trustee arrangements, the association must disclose
that fact to its members.
(d) Board approval requirements. The board of directors
of associations selling or endorsing long-term care insurance policies
or certificates must review and approve the insurance policies and
certificates as well as the compensation arrangements made with the
insurer.
(e) Insurer certification form.
(1) The following requirements and procedures apply
to Form Number LHL573(LTC) Insurer Certification of Association Compliance
With Marketing Standards for Long-Term Care Partnership and Non-Partnership
Policies and Certificates Form specified in Figure: 28 TAC §3.3849(e)(1)(F):
(A) The text must be in at least 10-point type and
must follow the order of the information presented in Figure: 28 TAC §3.3849(e)(1)(F).
(B) The text of Form Number LHL573(LTC) Insurer Certification
of Association Compliance With Marketing Standards for Long-Term Care
Partnership and Non-Partnership Policies and Certificates Form as
specified in Figure: 28 TAC §3.3849(e)(1)(F) is mandated; the
format for the form is a recommended format. An insurer may format
the mandated text in a different format from that specified in Figure:
28 TAC §3.3849(e)(1)(F) if the insurer files the reformatted
certification form for review and approval by the commissioner.
(C) Any reformatted certification form that is filed
for approval pursuant to paragraph (2) of this subsection must be
filed no later than 60 days prior to use and is subject to the requirements
and procedures set forth in Subchapter A of this chapter.
(D) Any reformatted certification form filed pursuant
to paragraph (2) of this subsection should be filed with the Texas
Department of Insurance, Life and Health Division, Filings Intake,
MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030.
(E) Form Number LHL573(LTC) Insurer Certification of
Association Compliance With Marketing Standards for Long-Term Care
Partnership and Non-Partnership Policies and Certificates Form may
be obtained from the Texas Department of Insurance, Life and Health
Division, Life and Health Lines, MC-LH-LHL, P.O. Box 12030, Austin,
Texas 78711-2030, or from the department's website at www.tdi.texas.gov/forms.
(F) A representation of Form Number LHL573(LTC) Insurer
Certification of Association Compliance With Marketing Standards for
Long-Term Care Partnership and Non-Partnership Policies and Certificates
Form is as follows:
Attached Graphic
(2) The initial certification must be submitted to
the department between January 1, 2010, and January 31, 2010, for
the calendar year 2009, and thereafter must be submitted annually
between January 1 and January 31 for the preceding calendar year.
(3) Form Number LHL573(LTC) is an informational filing
pursuant to §3.5(b)(1) of this title (relating to Filing Authorities
and Categories) and is subject to the requirements and procedures
set forth in Subchapter A of this chapter.
(4) The annual completed certification form submitted
pursuant to paragraphs (2) and (3) of this subsection should be filed
with the Texas Department of Insurance, Life and Health Division,
Filings Intake, MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030.
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