| (a) Submission. Companies must submit one copy of the
filing to the Life and Health Division at the address set forth in §3.3(a)
of this title (relating to Transmittal Information). A filing submitted
electronically must be submitted in such form and format as determined
by the department.
(b) Contact person. A company submitting a filing to
the department must:
(1) have one person designated as the contact person
for that filing;
(2) provide the contact person's name, address, telephone
number, and if available, email address on the transmittal checklist
or transmittal form;
(3) provide, for any filing submitted by anyone other
than the company, a dated letter of specific authorization which must:
(A) designate the consulting firm, actuary, legal counsel,
or other person as the designated contact person for that filing;
and
(B) be signed by an officer of the company or a person
with authority to bind the company; and
(4) notify the department immediately of any change
of information with regard to the contact person for a pending filing,
regardless of whether the contact person is the company's employee
or other authorized representative.
(c) Form specifications. Any filing submitted pursuant
to this subchapter must comply with the following:
(1) Filings submitted in paper format must:
(A) be submitted on 8 1/2-by-11-inch paper;
(B) not be submitted in bound booklets;
(C) be legible;
(D) be in typewritten, computer generated, or printer's
proof format; and
(E) not contain any color highlighting.
(2) Any form submitted must be designated by a form
number that:
(A) is sufficient to distinguish it from all other
forms used by the company;
(B) is located in the lower left-hand corner of the
cover page or on the first page of the form if the form number is
visible with the cover closed;
(C) has the additional identifying form number requirements
set forth in Subchapter FF of this chapter (relating to Credit Life
and Accident and Health Insurance), if the form is submitted for consideration
pursuant to Insurance Code Chapter 1153; and
(D) has the additional identifying form number requirements
set forth in §26.14(g) of this title (relating to Coverage),
if the form is submitted for consideration pursuant to Insurance Code
Chapter 1501.
(d) Specimen language and specimen fill-in material.
(1) For all forms, specimen language and fill-in material
must reflect the most restrictive option available under variability.
Additional descriptions of variability options must be provided upon
request or as otherwise required.
(2) Life and annuity forms must be completed with fill-in
material for specimen age 35. If the form is not issued at age 35,
the fill-in material should be completed for the youngest age at which
the form may be issued. If reduced death benefits are provided for
any age at issue, the specimen form must be filled in for the age
at issue for which the greatest reduction in benefits is made. The
fill-in material must be for the longest premium paying period available
under the form.
(e) Variable material.
(1) For all forms, any variable material in a form
must be bracketed and contain a clear explanation of how the material
will vary. It is acceptable for certain materials to vary due solely
to the age, sex, classification of the insured, plan type such as
403(b) and IRA, telephone numbers, and addresses, depending on the
manner in which the company intends to use the variations. The unique
form number on a form may not be bracketed as variable.
(2) For individual life forms, the text and specifications
of nonforfeiture assumptions generally cannot be considered variable
material.
(f) Matrix filings. Policies, certificates, contracts,
or applications may be submitted as a matrix filing. Any company submitting
a matrix filing:
(1) must identify each provision with a unique form
number that:
(A) is sufficient to distinguish it from all other
provisions used by the company; and
(B) is located at the lower left-hand corner of the
provision;
(2) may use the same provision filed under one form
number for all products, provided the language is applicable to each
product; however, any changes in the language to comply with the requirements
for each product will require a unique form number;
(3) must list the form number for each provision on
the transmittal checklist and provide a statement indicating how the
provision will be used and the type of product for which the provision
will be used; and
(4) must provide the certifications required in §3.6(a)(8)
of this title (relating to Certifications, Attachments, and Additional
Information Requirements).
(g) Insert page filings. Policies, certificates, and
contracts may be submitted with insert pages, or an insert page may
be filed subsequent to the approval of a policy, certificate, or contract.
Any company submitting an insert page filing:
(1) must identify each insert page with a unique form
number that:
(A) is sufficient to distinguish it from all other
forms used by the company; and
(B) is located in the lower left-hand corner of the
page;
(2) may use the same insert page filed under one form
number for all products, provided the language is applicable to each
product type; however, any changes in the language to comply with
the requirements for each product type will require a unique form
number;
(3) may use the same insert page to replace an existing
page of a previously approved or exempted contract; if used in this
manner, the replaced page, as originally filed, must reflect a unique
form number that distinguishes it from the other pages of the form
or contract;
(4) must list the form number for each insert page
on the transmittal checklist and provide a statement indicating how
the insert page will be used and the type of product for which the
insert page will be used; and
(5) must provide the certifications required in §3.6(a)(8)
of this title.
(h) Limited, partial refilings. Limited, partial refilings
must contain the change and any additional actuarial information necessary
for a comprehensive review of the filing(s).
(i) Outline of coverage. An outline of coverage must
be filed with each individual accident and health policy, group or
individual Medicare supplement policy and/or certificate, or group
or individual long-term care policy and/or certificate.
(j) Supplemental coverages.
(1) Individual accident and health forms submitted
pursuant to §3.3080 of this title (relating to Supplemental Coverage)
must be accompanied by the certification required in §3.6(a)(7)
of this title;
(2) Group life forms submitted pursuant to Insurance
Code §1131.051 or §1131.053 must be accompanied by the certification
required in §3.6(a)(7) of this title.
(k) Complete submission of policy or contract forms.
For a submission to be considered complete, the submission must include
the following:
(1) the toll-free notice unless the company is exempt
under §1.601(c) of this title (relating to Notice of Toll-Free
Telephone Numbers and Information and Complaint Procedures) or has
on file a toll-free notice which is current with the requirements
set forth in §1.601 of this title;
(2) the application, if applicable;
(3) in the case of group policies or contracts, the
certificate;
(4) any rider which will or can be included in all
issues of the form; and
(5) disclosures and other information, if applicable.
(l) Riders included with filing. For any rider included
with the policy or contract filing, indicate whether the rider is
to be used:
(1) only with the policy being filed; or
(2) with other clearly identified previously approved
or exempted forms.
(m) Previously approved or exempted forms. Any previously
approved or exempted form (e.g., application or rider) to be used
with the policy or contract filing need not be resubmitted; however,
the filing must indicate the type of form (e.g., rider, policy, application,
etc.), form number, and the approval or exemption date of the previously
approved or exempted form. If there is a change in the use of the
previously approved or exempted form, the filing must state the form
number of the form(s) with which the previously approved or exempted
form was designed to be exclusively used, as well as the updated forms
list.
Cont'd... |
