reglab/statecodes huggingface dataset:
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12 - Disability Insurance Advertisements › Section 2537.1 - Prior Inconsistent Regulations and Bulletins Superseded

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
These regulations supersede all prior regulations and
					 bulletins of this Department on the subject matter of disability insurance
					 advertisements to the extent that such prior regulations and bulletins are
					 inconsistent with these regulations. These regulations do not supersede
					 Bulletin No. NS-3 issued by the Commissioner on May 18, 1956, except to the
					 extent the Bulletin was applicable to disability insurance.
GUIDELINE 2537.1
This Section is self-explanatory.
1. Amendment
					 filed 11-29-74; effective thirtieth day thereafter (Register 74, No.
					 48).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12 - Disability Insurance Advertisements › Section 2537.2 - Severability Provision

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
If any Section or portion of a Section of these
					 regulations, or the applicability thereof to any person or circumstance is held
					 invalid by a court, the remainder of the regulations, or the applicability of
					 such provision to other persons or circumstances, shall not be affected
					 thereby.
GUIDELINE 2537.2
This Section is self-explanatory.
1. Amendment
					 filed 11-29-74; effective thirtieth day thereafter (Register 74, No.
					 48).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.1 - Authority and Purpose

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  These regulations are promulgated pursuant to authority granted to the
				  Insurance Commissioner under the provisions of California Insurance Code
				  sections
				  10133.8 and
				  10133.9 to
				  establish standards and requirements to provide insureds, free of charge, with
				  appropriate access to translated written materials and oral interpretation
				  services in obtaining covered benefits. These regulations are applicable to all
				  individual and group policies of health insurance and to all health insurers,
				  as defined in section
				  106 of the
				  California Insurance Code. Every health insurer shall comply with the
				  requirements and standards established by Insurance Code sections
				  10133.8 and
				  10133.9 and
				  these regulations.
(b) The purpose
				  of these regulations is to accomplish maximum accessibility to language
				  assistance services by limited English proficient insureds, including oral
				  interpretation and written translation assistance and to set forth:
a) the methods of surveying the language
				  preferences and linguistic needs of insureds;
b) the requirements, standards and quality
				  assurance for translation of vital documents;
c) the requirements, standards and quality
				  assurance for individual access to oral interpretation services; and
d) the reporting and data collection
				  requirements for health insurers.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.3 - Language Assistance Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) By April 1, 2009, every health insurer
				  shall have established and implemented a Language Assistance Program (LAP) that
				  complies with the requirements of Insurance Code sections
				  10133.8 and
				  10133.9 and
				  this regulation. The Commissioner shall allow health insurers a reasonable
				  degree of flexibility in the methods by which they achieve
				  compliance.
(b) The LAP shall be
				  documented in a plan with comprehensive written policies and procedures that
				  describe, at a minimum, the following elements: assessment of insureds;
				  provision of language assistance services; staff training; and compliance
				  monitoring. In addition, the policies and procedures shall include the
				  following:
(1) How insureds will be informed
				  of the availability of language assistance services at no charge to insureds
				  and how to access those services;
(2) How contracting providers will be
				  notified of the health insurer's LAP requirements for provision of language
				  assistance services including the notice of the availability of language
				  assistance services;
(3) How a
				  survey of the language preferences and assessment of the linguistic needs of
				  the insured population will be conducted including an explanation of the
				  methodology for collection of relevant data;
(4) How vital documents will be translated
				  into the indicated/threshold languages including standards to ensure the
				  quality and accuracy of the written translation;
(5) How the insurer will provide individual
				  access to interpretation services including an explanation of the standards to
				  ensure the quality and timeliness of oral interpretation services;
(6) A training plan for the provision of
				  adequate and ongoing training regarding the LAP for all health insurer staff
				  who have contact with LEP persons. The training shall include instruction on,
				  among other things, the health insurer's policies and procedures for accessing
				  language assistance, working effectively with LEP persons, working effectively
				  with in-person and telephonic interpreters, and, cultural differences among and
				  diversity of the health insurer's insured population; and,
(7) How the insurer will evaluate the LAP
				  including an analysis of complaints and satisfactions
				  surveys.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.4 - Needs Assessment of Insured Population

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Every health insurer shall survey the
				  language preferences and assess the linguistic needs of insureds within one
				  year of the effective date of these regulations. Health insurers may utilize
				  various survey methods, including, but not limited to, the use of existing
				  enrollment and renewal processes, newsletters, or other mailings. Health
				  insurers shall update the linguistic needs assessment, demographic profile, and
				  language translation requirements of their insured population every three
				  years.
(b) The LAP shall describe
				  the health insurer's methods and timelines for surveying and assessing the
				  language preferences and linguistic needs of the insured population, the
				  calculations to be used to determine indicated/threshold languages, the method
				  for collecting, summarizing and reporting the data to the Department, and how
				  the health insurer shall advise limited English proficient insureds of the
				  availability of translation and interpretation services.
1. New
					 section filed 9-19-2007; operative 10-19-2007 (Register 2007, No.
					 38).
Note: Authority cited: Sections
						10133.8 and
						10133.9,
						Insurance Code. Reference: Sections
						10133.8 and
						10133.9,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.5 - Written Translation of Vital Documents

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Every health insurer shall translate
				  vital documents, as defined above, into languages other than English,
				  hereinafter called "indicated/threshold languages" as follows:
(1) A health insurer with an insured
				  population of 1,000,000 or more shall translate vital documents into the top
				  two languages other than English as determined by the needs assessment and any
				  additional languages when 0.75 percent or 15,000 of the insured population,
				  whichever number is less, indicates in the needs assessment a preference for
				  written materials in that language.
(2) A health insurer with an insured
				  population of 300,000 or more but less than 1,000,000 shall translate vital
				  documents into the top one language other than English as determined by the
				  needs assessment and any additional languages when 1 percent or 6,000 of the
				  insured population, whichever number is less, indicates in the needs assessment
				  a preference for written materials in that language.
(3) A health insurer with an insured
				  population of less than 300,000 shall translate vital documents into a language
				  other than English when 3,000 or more or five percent of the insured
				  population, whichever number is less, indicates in the needs assessment a
				  preference for written materials in that language.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.6 - Individual Access to Oral Interpretation Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Every health insurer shall provide timely
				  individual access to interpretation services at no cost to LEP insureds at all
				  points of contact where language assistance is needed in accordance with these
				  regulations. For purposes of this section, "timely" means in a manner
				  appropriate for the situation in which language assistance is needed.
				  Interpreter services are not timely if delay results in the effective denial of
				  the service, benefit, or right at issue or the imposition of an undue burden on
				  or delay in important rights, benefits, or services to the LEP
				  insured.
(b) Every health insurer
				  shall develop policies and procedures that describe the health insurer's
				  methods for providing timely interpretation services, including, but not
				  limited to the following:
(1) The points of
				  contact where the need for interpreting may be reasonably
				  anticipated;
(2) The types of
				  resources necessary in order to provide effective interpreting to the health
				  insurer's insureds;
(3) The
				  arrangements that the health insurer will make to inform insureds of oral
				  interpretation services and to provide timely access to interpreting at all
				  points of contact at no charge to insureds;
(4) The range of interpreting services that
				  will be provided by trained and competent individuals to insureds as
				  appropriate for the particular point of contact. The range of services may
				  include, but is not limited to:
(A) Bilingual
				  health insurer or contractor/health care provider staff available for the
				  duration of the need;
(B) Hiring
				  staff interpreters;
(C) Contracting
				  with outside interpreters;
(D)
				  Making volunteer interpreters available; and
(E) Contracting for remote interpreting, as
				  defined, for an LEP person.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.7 - Health Insurer Monitoring, Evaluation & Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Every health insurer shall monitor the
				  implementation and provision of its LAP and make modifications as necessary to
				  ensure compliance with Insurance Code sections
				  10133.8 and
				  10133.9 and
				  these regulations. The health insurer's policies and procedures shall include a
				  description of the health insurer's method of (1) monitoring health insurer,
				  contractor, health care provider, and network compliance with the health
				  insurer's standards for the LAP Assistance Program, including the availability,
				  quality and utilization of language assistance services, (2) tracking
				  grievances and complaints related to its LAP Assistance Program, and (3)
				  documenting actions taken to correct problems.
(b) Every health insurer shall evaluate the
				  effectiveness of its LAP with regard to the following:
(1) Assessing indicated/threshold language(s)
				  based on data collected;
(2)
				  Assessing current language assistance needs of its insureds who are LEP
				  persons;
(3) Documenting and
				  responding to requests for translation and interpretation services;
(4) Whether the existing LAP Assistance
				  Program meets the needs of its insureds who are LEP insureds;
(5) Whether health insurer staff know the
				  health insurer's policies and procedures and how to implement them;
(6) Whether the resources and arrangements
				  for language assistance identified in the health insurer's policies and
				  procedures are still current and available; and
(7) Responding to communications from
				  insureds, including via surveys and complaints.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.1 - Health Care Language Assistance Program › Section 2538.8 - Department of Insurance Reporting

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Beginning on January 1, 2008, the Department shall report
					 biennially to the Legislature regarding health insurer compliance with the
					 standards established by Insurance Code section
					 10133.8 and
					 these regulations including results of compliance audits made in conjunction
					 with other audits and reviews. The Commissioner shall ensure that the reports
					 required by this section as well as the data collected from health insurers for
					 the reports do not require duplicative or conflicting data collection from
					 health insurers. The Commissioner shall use the reported information from
					 health insurers to make recommendations to health insurers for changes to their
					 LAP, including the development of forms to notify insureds of their rights
					 under these regulations and to further promote the purpose of these
					 regulations.
1. New
					 section filed 9-19-2007; operative 10-19-2007 (Register 2007, No.
					 38).
Note: Authority cited: Sections
						10133.8 and
						10133.9,
						Insurance Code. Reference: Sections
						10133.8 and
						10133.9,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540 - Authority

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
This Article is promulgated pursuant to the authority
					 granted to the Insurance Commissioner under the provisions of Sections
					 790.10 and
					 10608 of
					 the Insurance Code.
1. New
					 Article 12.2 (Sections
					 2540,
					 2540.1-2540.5) filed 4-10-75 as an
					 emergency; designated effective 4-15-75 (Register 75, No. 15).
2.
					 Certificate of Compliance filed 7-22-75 (Register 75, No. 30).
3.
					 Amendment filed 1-8-76; effective thirtieth day thereafter (Register 76, No.
					 2)
Note: Authority cited: Section
						10608,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540.1 - Purpose

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The purpose of this Article is to establish standard
					 supplemental disclosure forms for disability insurance as required by Chapter 7
					 of Part 2 of Division 2 of the Insurance Code, known as the "Health Insurance
					 Disclosure Act of 1974." In enacting that Chapter, the Legislature declared
					 that consumers seeking adequate health care insurance at prices they could
					 afford were faced with considerable difficulty in making optimum choices among
					 the great number of health care insurance coverages available. Confusing
					 claims, obscure language and inconspicuous policy details often resulted in
					 uniformed and inappropriate choices by the consumer. The availability of
					 certain minimum information relative to the benefits, limitations and costs of
					 health insurance coverages in a standard, readily comparable form would assist
					 consumers in making the best choices among such insurance coverages
					 commensurate with their respective incomes.
1. Amendment
					 filed 1-8-76; effective thirtieth day thereafter (Register 76, No.
					 2).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540.2 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
As used in this Article:
(a) "Policy" means any individual, family or
				  selected group ("franchise") disability insurance policy and any individual or
				  family benefit agreement issued by a non-profit hospital service
				  plan.
(b) "Certificate" means any
				  certificate of insurance issued pursuant to a blanket or group master
				  disability insurance policy, any benefit certificate issued pursuant to a group
				  benefit agreement issued by a non-profit hospital service plan and any document
				  issued to an employee setting forth the details of disability coverage under
				  any self-insured employee welfare plan.
1. Amendment
					 filed 1-8-76; effective thirtieth day thereafter (Register 76, No.
					 2).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540.3 - Disclosure Forms for Use with Policies

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Supplemental disclosure forms for use with policies shall
					 contain the text and shall be in the format of the prototype forms set forth in
					 Section 2540.5 and shall contain no
					 material of an advertising nature, except for the insurer's logotype. Such
					 forms shall be plainly printed in no smaller than 11-point type. Text which is
					 capitalized or underscored in the prototype forms may be emphasized by other
					 means which provide prominence equivalent to such capitalization or
					 underscoring. Disclosure forms which are physically incorporated into
					 advertisements shall not be intermingled with the text of such advertisements
					 and shall be given prominence relative to that of surrounding text.
Where a policy is issued with benefits, exceptions,
					 reductions, limitations, renewal provisions or premiums different from those in
					 the policy as applied for, an amendment to the original disclosure form or a
					 new disclosure form shall be delivered with the policy. Such amendment,
					 together with the original disclosure form, or such new disclosure form shall
					 properly describe the policy as issued and shall contain a statement, which
					 shall be given prominence relative to that of surrounding text, to the
					 following effect: "NOTICE: Read this outline of coverage carefully. It is
not
identical to the outline of coverage provided upon
					 application and the coverage originally applied for has not been issued." Where
					 the only difference between the policy as applied for and the policy as issued
					 is the premium, the foregoing statement may be modified appropriately. An
					 amendment to the disclosure form or a new disclosure form need not be delivered
					 with the policy where modification of the policy features set forth above is
					 effected by a rider to the policy which must be signed by the insured upon
					 delivery of the policy.
1. Amendment
					 filed 1-8-76; effective thirtieth day thereafter (Register 76, No.
					 2).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540.5 - Prototype Standard Supplemental Disclosure Forms for Use with Policies

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Policies which
				  provide more than one category of coverage shall be accompanied by the
				  disclosure form for the category of coverage most appropriate to the coverage
				  provided. Benefits not included in the category selected shall be set forth in
				  an orderly manner following the disclosure of the benefits included in the
				  category selected. Where no prototype disclosure form is appropriate to the
				  coverage provided, a disclosure form shall be used which is based, to the
				  extent possible, upon the prototype forms set forth herein. Such disclosure
				  form shall contain information relative to benefits, exceptions, reductions,
				  limitations, renewability and premiums in the order set forth in the prototype
				  forms and shall disclose such information in accordance with subsection (a) and
				  subsections (c) through (f) of Section
				  2540.4, above.
(b) Prototype Standard Supplemental
				  Disclosure Form for Policies Providing Basic Hospital Expense Coverage. "Basic
				  Hospital Expense Coverage" provides benefits for expenses incurred for daily
				  hospital room and board and miscellaneous hospital services incurred as a
				  result of covered accident or sickness. Benefits may be subject to a deductible
				  amount and to a co-payment requirement.
(COMPANY NAME) BASIC HOSPITAL EXPENSE COVERAGE
					 OUTLINE OF COVERAGE
[1] Read
				  Your (Policy) Carefully. This outline of coverage provides a very brief
				  description of some important features of your (policy). This is not the
				  insurance contract and only the actual (policy) provisions will control. The
				  (policy) itself sets forth, in detail, the rights and obligations of both you
				  and (your insurance company). It is, therefore, important that you Read Your
				  (Policy) Carefully!
[2] Basic
				  Hospital Expense Coverage. This category of coverage is designed to provide to
				  persons insured benefits for hospital expenses incurred as a result of a
				  covered accident or sickness. Benefits may be provided for daily hospital room
				  and board, miscellaneous hospital services, and hospital outpatient services,
				  subject to any limitations, deductibles and co-payment requirements set forth
				  in the (policy). Benefits are not provided for physicians; or surgeons; fees or
unlimited
hospital expenses.
[3] Benefits of This (Policy).
(a) [Daily hospital room and board and
				  benefit period;]
(b) [Miscellaneous
				  hospital services;]
(c) [Hospital
				  outpatient services;]
(d) [Other
				  benefits, if any.]
[4]
				  Exceptions, Reductions and Limitations of This (Policy).
(Benefits are not provided for physicians' or surgeons'
					 fees.)
[5] (Renewability) of
				  This (Policy).
[6] (Premium) for
				  This (Policy).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540.7 - Prior Regulations Not Superseded

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
This Article does not supersede Article 12 of this
					 Subchapter or Article 1.5 of Subchapter 2 of this Title.
1. New
					 section filed 1-8-76; effective thirtieth day thereafter (Register 76, No.
					 2).
Note: Authority cited: Section
						10608,
						Insurance Code. Reference: Section
						10603,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.2 - Standard Supplemental Disclosure Forms for Disability Insurance › Section 2540.8 - Severability

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
If any Section or portion of a Section of this Article or
					 the applicability thereof to any person or circumstance, is held invalid by a
					 court, the remainder of this Article, or the applicability of such provision to
					 other persons or circumstances, shall not be affected
					 thereby.
1. New
					 section filed 1-8-76; effective thirtieth day thereafter (Register 76, No.
					 2).
Note: Authority cited: Section
						10608,
						Insurance Code. Reference: Section
						10603,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542 - Preamble

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Section
					 10489.94 of
					 the California Insurance Code authorizes the commissioner to promulgate
					 regulations to provide tables of select mortality factors and rules for their
					 use, rules concerning a minimum standard for the valuation of plans with
					 nonlevel premiums or benefits, and rules concerning a minimum standard for the
					 valuation of plans with secondary guarantees.
This Article 12.3 shall supersede Department of Insurance
					 Bulletin Number 2000-02, effective July 1, 2000, issued by the commissioner
					 under the authority of Section
					 10489.94 of
					 the California Insurance Code.
1. New
					 article 12.3 (sections
					 2542-2542.8) and section filed
					 11-19-2002; operative 1-1-2003 (Register 2002, No.
					 47).
Note: Authority cited: Section
						10489.94,
						Insurance Code. Reference: Section
						10489.94,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.1 - Purpose

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The purpose of
				  this article is to provide:
(1) Tables of
				  select mortality factors and rules for their use;
(2) Rules concerning a minimum standard for
				  the valuation of plans with nonlevel premiums or benefits; and
(3) Rules concerning a minimum standard for
				  the valuation of plans with secondary guarantees.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.2 - Applicability

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
This Article 12.3 shall apply to all life insurance
					 policies, with or without nonforfeiture values, issued on or after the
					 effective date of this article, subject to the following exceptions and
					 conditions.
(a) Exceptions
(1) This article shall not apply to any
				  individual life insurance policy issued on or after the effective date of this
				  article if the policy is issued in accordance with and as a result of the
				  exercise of a reentry provision contained in the original life insurance policy
				  of the same or greater face amount, issued before the effective date of this
				  article, that guarantees the premium rates of the new policy. This article also
				  shall not apply to subsequent policies issued as a result of the exercise of
				  such a provision, or a derivation of the provision, in the new
				  policy.
(2) This article shall not
				  apply to any universal life policy that meets all the following requirements:
(A) Secondary guarantee period, if any, is
				  five (5) years or less;
(B)
				  Specified premium for the secondary guarantee period is not less than the net
				  level reserve premium for the secondary guarantee period based on the CSO
				  valuation tables as defined in Section
				  2542.3(f) and the
				  applicable valuation interest rate; and
(C) The initial surrender charge is not less
				  than 100 percent of the first year annualized specified premium for the
				  secondary guarantee period.
(3) This article shall not apply to any
				  variable life insurance policy that provides for life insurance, the amount or
				  duration of which varies according to the investment experience of any separate
				  account or accounts.
(4) This
				  article shall not apply to any variable Universal Life Insurance Policy that
				  provides for life insurance, the amount or duration of which varies according
				  to the investment experience of any separate account or accounts.
(5) This article shall not apply to a group
				  life insurance certificate unless the certificate provides for a stated or
				  implied schedule of maximum gross premiums required in order to continue
				  coverage in force for a period in excess of one year.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.3 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
For purposes of this article:
(a) "Basic Reserves" means reserves
				  calculated in accordance with California Insurance Code Section
				  10489.5.
(b) "Contract Segmentation Method" means the
				  method of dividing the period from issue to mandatory expiration of a policy
				  into successive segments, with the length of each segment being defined as the
				  period from the end of the prior segment (from policy inception, for the first
				  segment) to the end of the latest policy year as determined below. All
				  calculations are made using the 1980 CSO Valuation Tables, as defined in
				  Subdivision (f) of this Section
				  2542.3 (or any other valuation
				  mortality table adopted by the National Association of Insurance Commissioners
				  (NAIC) after July 1, 2000 and approved by regulation promulgated or bulletin
				  issued by the commissioner for this purpose), and, if elected, the optional
				  minimum mortality standard for Deficiency Reserves stipulated in Section
				  2542.4(b) of this
				  article.
The length of a particular contract segment shall be set
					 equal to the minimum of the value
t
for which
					 Gt is greater than Rt (if
					 Gt never exceeds Rt the segment
					 length is deemed to be the number of years from the beginning of the segment to
					 the mandatory expiration date of the policy), where Gt
					 and Rt are defined as follows:
GPx+k+t
Gt =
___________________________
GPx+k+t-1
where:
x = original issue age;
k = the number of years from the date of issue to the
					 beginning of the segment;
t = 1, 2, ...;
t
is reset to 1 at the
					 beginning of each segment;
GPx+k+t-1 = Guaranteed gross premium
					 per thousand of face amount for year
t
of the segment,
					 ignoring policy fees only if level for the premium paying period of the
					 policy.
qx+k+t
Rt =
___________________________
however,
							 Rt may be increased or decreased by
qx+k+t-1
one
							 percent in any policy year, at the company's option, but
							 Rt shall not be less than one;
where:
x, k and t are as defined above, and
qx+k+t-1 = valuation mortality rate
					 per 1000 for Deficiency Reserves in policy year k+t but using the mortality of
					 Section 2542.4(b)(2) if
					 Section 2542.4(b)(3) is
					 elected for Deficiency Reserves.
However, if GPx+k+t is greater than
					 0 and GPx+k+t-1 is equal to 0, Gt
					 shall be deemed to be 1000. If GPx+k+t and
					 GPx+k+t-1 are both equal to 0, Gt
					 shall be deemed to be 0.
(c)
				  "Deficiency Reserves" means the excess, if greater than zero, of
(1) Minimum reserves calculated in accordance
				  with California Insurance Code Section
				  10489.9
				  over
(2) Basic
				  Reserves.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.4 - General Calculation Requirements for Basic Reserves and Premium Deficiency Reserves

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  At the election of the company for any one or more specified plans of life
				  insurance, the minimum mortality standard for Basic Reserves may be calculated
				  using the 1980 CSO Valuation Tables, with or without select mortality factors
				  (or any other valuation mortality table adopted by the NAIC after July 1, 2000
				  and approved by regulation promulgated or bulletin issued by the commissioner
				  for this purpose). If select mortality factors are elected, they may be:
(1) The Ten-year Select Factors;
(2) The select mortality factors in Section
				  2542.8 of this article;
				  or
(3) Any other table of select
				  mortality factors adopted by the NAIC after July 1, 2000 and approved by
				  regulation promulgated or bulletin issued by the commissioner for the purpose
				  of calculating Basic Reserves.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.5 - Calculation of Minimum Valuation Standard for Policies with Guaranteed Nonlevel Gross Premiums or Guaranteed Nonlevel Benefits (Other than Universal Life Policies)

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Basic Reserves. Basic Reserves shall be calculated as the greater of the
				  Segmented Reserves and the Unitary Reserves. Both the Segmented Reserves and
				  the Unitary Reserves for any policy shall use the same valuation mortality
				  table and select factors. At the option of the insurer, in calculating
				  Segmented Reserves and net premiums, either the adjustment described in
				  Paragraph (1) below or the adjustment described in Paragraph (2) below may be
				  made:
(1) Treat the Unitary Reserve, if
				  greater than zero, applicable at the end of each segment as a pure endowment
				  and subtract the Unitary Reserve, if greater than zero, applicable at the
				  beginning of each segment from the present value of guaranteed life insurance
				  and endowment benefits for each segment.
(2) Treat the guaranteed cash surrender
				  value, if greater than zero, applicable at the end of each segment as a pure
				  endowment; and subtract the guaranteed cash surrender value, if greater than
				  zero, applicable at the beginning of each segment from the present value of
				  guaranteed life insurance and endowment benefits for each
				  segment.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.6 - Calculation of Minimum Valuation Standard for Flexible Premium and Fixed Premium Universal Life Insurance Policies that Contain Provisions Resulting in the Ability of a Policyowner to Keep a Policy in Force over a Secondary Guarantee Period

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  General
(1) Policies with a secondary
				  guarantee include:
(A) A policy with a
				  guarantee that the policy will remain in force at the original schedule of
				  benefits, subject only to the payment of specified premiums;
(B) A policy in which the minimum premium at
				  any duration is less than the corresponding one year valuation premium,
				  calculated using the Maximum Valuation Interest Rates and the 1980 CSO
				  Valuation Tables with or without Ten-year Select Factors, or any other table
				  adopted by the NAIC after July 1, 2000 and approved by regulation promulgated
				  or bulletin issued by the commissioner for this purpose; or
(C) A policy with any combination of
				  Subparagraphs (a)(1)(A) and (a)(1)(B) above.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.7 - Effective Date

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
This article shall become effective January 1,
					 2003.
1. New
					 section filed 11-19-2002; operative 1-1-2003 (Register 2002, No.
					 47).
Note: Authority cited: Section
						10489.94,
						Insurance Code. Reference: Section
						10489.94,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.3 - Valuation of Life Insurance Policies › Section 2542.8 - Select Mortality Factors

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
This Section
					 2542.8 contains tables of select
					 mortality factors that are the bases to which the respective percentages of
					 Paragraph (b)(3) of Section
					 2542.4 are applied.
The six tables of select mortality factors contained herein
					 include:
(1) male aggregate,
(2) male nonsmoker,
(3) male smoker,
(4) female aggregate,
(5) female nonsmoker, and
(6) female smoker.
These tables apply to both age last birthday and age
					 nearest birthday mortality tables.
For sex-blended mortality tables, compute select mortality
					 factors in the same proportion as the underlying mortality. For example, for
					 Table B of the Blended 1980 CSO Tables, the calculated select mortality factors
					 are eighty percent (80%) of the appropriate male table in this Section
					 2542.8, plus twenty percent (20%)
					 of the appropriate female table in this Section
					 2542.8.
1. New
					 section filed 11-19-2002; operative 1-1-2003 (Register 2002, No.
					 47).
Note: Authority cited: Sections
						10489.2 and
						10489.94,
						Insurance Code. Reference: Sections
						790.03,
						10489.2 and
						10489.94,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2544 - Preamble

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Section
					 10489.93 of
					 the California Insurance Code authorizes the Commissioner to promulgate
					 regulations concerning minimum reserves in the case of any plan of life
					 insurance which provides for future premium determination, the amounts of which
					 are to be determined by the insurance company based on then estimates of future
					 experience, or in the case of any plan of life insurance or annuity which is of
					 such a nature that the minimum reserves cannot be determined by the methods
					 described in Sections
					 10489.5,
					 10489.6 and
					 10489.9. Universal life insurance
					 plans come within the category of plans defined by Section
					 10489.93.
The purpose of these regulations is to delineate certain
					 methods for determining minimum reserves specifically applicable to universal
					 life insurance policies in accordance with California Insurance Code Section
					 10489.93.
1. New
					 section filed 10-17-91; operative 11-18-91 (Register 92, No. 3).
2.
					 Amendment of section and NOTE filed 3-22-2016; operative 7-1-2016 (Register
					 2016, No. 13).
Note: Authority cited: Sections
						720,
						790.10,
						10489.93,
						12921 and
						12926,
						Insurance Code. Reference: Section
						10489.93,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2544.1 - Effective Date

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
All insurance companies authorized to write life insurance
					 in the State of California shall set up reserves on Universal Life Insurance
					 Policies according to the specifications set forth in these regulations. These
					 specifications will be effective for all policies issued after December 31,
					 1991.
1. New
					 section filed 10-17-91; operative 11-18-91 (Register 92, No. 3).
2.
					 Amendment of NOTE filed 3-22-2016; operative 7-1-2016 (Register 2016, No.
					 13).
Note: Authority cited: Sections
						720,
						790.10,
						10489.93,
						12921 and
						12926,
						Insurance Code. Reference: Section
						10489.93,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2544.2 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
As used in these regulations:
(a) "Universal Life Insurance Policy" means
				  any individual or group life insurance policy under the provisions of which
				  separately identified interest credits (other than in connection with dividend
				  accumulations, premium deposit funds, or other supplementary accounts) and
				  mortality and expense charges are made to the policy. A universal life
				  insurance policy may provide for other credits and charges for the cost of
				  benefits provided by rider;
(b)
				  "Flexible Premium Universal Life Insurance Policy" means a universal life
				  insurance policy which permits the policyowner to vary, independently of each
				  other, the amount or timing of one or more premium payments or the amount of
				  insurance;
(c) "Fixed Premium
				  Universal Life Insurance Policy" means a universal life insurance policy other
				  than a flexible premium universal life insurance policy;
(d) "Net Cash Surrender Value" means the
				  maximum amount payable to the policyowner upon surrender;
(e) "Cash Surrender Value" means the net cash
				  surrender value plus any amounts outstanding as policy loans;
(f) "Policy Value" means the amount to which
				  separately identifiable interest credits and mortality, expense, or other
				  charges are made under a universal life insurance policy.
1. New
					 section filed 10-17-91; operative 11-18-91 (Register 92, No. 3).
2.
					 Amendment of NOTE filed 3-22-2016; operative 7-1-2016 (Register 2016, No.
					 13).
Note: Authority cited: Sections
						720,
						790.10,
						10489.93,
						12921 and
						12926,
						Insurance Code. Reference: Section
						10489.93,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2544.4 - Alternate Minimum Reserves

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
If, in any policy year, the Guaranteed Maturity Premium on
					 any universal life insurance policy is less than the valuation net premium for
					 such policy, calculated by the valuation method actually used in calculating
					 the reserve thereon but using the minimum valuation standards of mortality and
					 rate of interest, the minimum reserve required for such contract shall be the
					 greater of subparts (1) or (2) of this section:
(1) The reserve calculated according to the
				  method, the mortality table, and the rate of interest actually used;
				  or,
(2) The reserve calculated
				  according to the method actually used, but using the minimum valuation
				  standards of mortality and rate of interest and replacing the valuation net
				  premium by the Guaranteed Maturity Premium in each policy year for which the
				  valuation net premium exceeds the Guaranteed Maturity Premium.
For universal life reserves on a net level premium basis,
					 the valuation net premium shall be PVFB/ax and for reserves on a Commissioners
					 Reserve Valuation Method, the valuation net premium shall be
					 (PVFB/äx) +
					 ([(a)-(b)]/äx).
1. New
					 section filed 10-17-91; operative 11-18-91 (Register 92, No. 3).
2.
					 Amendment of NOTE filed 3-22-2016; operative 7-1-2016 (Register 2016, No.
					 13).
Note: Authority cited: Sections
						720,
						790.10,
						10489.93,
						12921 and
						12926,
						Insurance Code. Reference: Section
						10489.93,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2544.5 - Excess Interest Guarantee Reserves

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
In the event a guarantee of interest greater than the
					 maximum valuation interest rate permitted by Section
					 10489.4 of
					 the California Insurance Code extends more than one year beyond the policy
					 anniversary date previous to the date of valuation, the greatest of the present
					 values of future guaranteed cash values and death benefits payable less
					 required future premiums will be determined at the date of valuation using such
					 maximum valuation interest rate (or rates) for policies issued in the same year
					 as the year of issue of the policy valued and the mortality rates specified by
					 Section
					 10489.2 of
					 the California Insurance Code. The minimum reserve shall be the greatest of the
					 values calculated in accordance with Sections
					 2544.3,
					 2544.4 or
					 2544.5 of this
					 Regulation.
1. New
					 section filed 10-17-91; operative 11-18-91 (Register 92, No. 3).
2.
					 Amendment of NOTE filed 3-22-2016; operative 7-1-2016 (Register 2016, No.
					 13).
Note: Authority cited: Sections
						720,
						790.10,
						10489.93,
						12921 and
						12926,
						Insurance Code. Reference: Section
						10489.93,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2544.6 - Scope

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
These regulations are applicable to all individual and
					 group universal life insurance policies except variable life insurance (covered
					 by Bulletin 87-3).
1. New
					 section filed 10-17-91; operative 11-18-91 (Register 92, No. 3).
2.
					 Amendment of NOTE filed 3-22-2016; operative 7-1-2016 (Register 2016, No.
					 13).
Note: Authority cited: Sections
						720,
						790.10,
						10489.93,
						12921 and
						12926,
						Insurance Code. Reference: Section
						10489.93,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2545 - Authority. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New
					 article 12.5 (Sections
					 2545,
					 2545.1-2545.5) filed 7-17-94;
					 effective thirtieth day thereafter (Register 74, No. 29).
2.
					 Amendment of article title filed 6-9-78; effective thirtieth day thereafter
					 (Register 78, No. 23).
3. Repealer of article 12.5 and section filed
					 4-28-94; operative 11-24-94 (Register 94, No.
					 17).
Note: Authority cited: Section
						790.10,
						Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2545.1 - Purpose. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Repealer
					 filed 4-28-94; operative 11-24-94 (Register 94, No.
					 17).
California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 12.4 - Valuation of Universal Life Insurance Policies › Section 2545.2 - Disclosure Requirements. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Amendment
					 filed 6-7-78; effective thirtieth day thereafter (Register 78, No.
					 23).
2. Repealer filed 4-28-94; operative 11-24-94 (Register 94, No.
					 17).