reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter P - ANNUITY MORTALITY TABLES › Section 3.1505 - Application of the 1994 GAR Table

Current through Reg. 49, No. 28; July 12, 2024
In using the 1994 GAR Table, the mortality rate for a
					 person age x in year (1994 + n) is calculated as follows:
Attached
					 Graphic
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter P - ANNUITY MORTALITY TABLES › Section 3.1506 - Application of the 2012 IAR Mortality Table

Current through Reg. 49, No. 28; July 12, 2024
In using the 2012 IAR Mortality Table, the mortality rate
					 for a person age x in year (2012 + n) is calculated as follows:
Attached
					 Graphic
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Q - ACTUARIAL OPINION AND MEMORANDUM REGULATION › Section 3.1601 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
The purpose of this subchapter is to prescribe guidelines
					 and standards for the activities described in paragraphs (1) - (3) of this
					 section:
(1) the submission of a
				  statement of actuarial opinion in accordance with Insurance Code §
										425.054
				  and for memoranda in support of such opinion;
(2) the appointment of an appointed actuary;
				  and
(3) guidance as to the meaning
				  of "adequacy of reserves."
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Q - ACTUARIAL OPINION AND MEMORANDUM REGULATION › Section 3.1602 - Scope and Applicability

Current through Reg. 49, No. 28; July 12, 2024
(a) This
				  subchapter shall apply to all life insurance companies doing business in this
				  state and to all life insurance companies which are authorized to reinsure life
				  insurance, annuities or accident and health insurance business in this
				  state.
(b) This subchapter shall be
				  applied in a manner that allows the appointed actuary to utilize his or her
				  professional judgment in performing the asset analysis and developing the
				  actuarial opinion and supporting memoranda, consistent with relevant actuarial
				  standards of practice; however, the commissioner shall have the authority to
				  specify specific methods of actuarial analysis and actuarial assumptions when,
				  in the commissioner's judgment, these specifications are necessary for an
				  acceptable opinion to be rendered relative to the adequacy of reserves and
				  related items.
(c) This subchapter
				  applies to the actuarial opinion for the 2005 valuation through the 2016
				  valuation. The requirements of the valuation manual adopted under Insurance
				  Code Chapter 425, Subchapter B, apply to actuarial opinions for valuations on
				  or after January 1, 2017.
(d) A
				  statement of opinion on the adequacy of the reserves and related actuarial
				  items based on an asset adequacy analysis in accordance with §
										3.1606
				  of this title (relating to Statement of Actuarial Opinion Based on an Asset
				  Adequacy Analysis), and a memorandum in support thereof in accordance with
				  §
										3.1607
				  of this title (relating to Description of Actuarial Memorandum Including an
				  Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary), shall be
				  required each year, unless exempt under §
										3.1608
				  of this title (relating to Asset Adequacy Analysis Exemption).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Q - ACTUARIAL OPINION AND MEMORANDUM REGULATION › Section 3.1603 - Commissioner Discretion

Current through Reg. 49, No. 28; July 12, 2024
The commissioner may require any company, otherwise exempt
					 from asset adequacy analysis requirements in this subchapter, to provide an
					 actuarial opinion and actuarial memorandum which complies with the asset
					 adequacy analysis requirements in this subchapter including requirements in
					 §
										3.1606
					 of this title (relating to Statement of Actuarial Opinion Based on an Asset
					 Adequacy Analysis) and in §
										3.1607
					 of this title (relating to Description of Actuarial Memorandum Including an
					 Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary) if, in
					 the opinion of the commissioner, an asset adequacy analysis is necessary with
					 respect to the company.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Q - ACTUARIAL OPINION AND MEMORANDUM REGULATION › Section 3.1605 - General Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) Submission
				  of statement of actuarial opinion. Any statement of actuarial opinion required
				  by this subchapter must be submitted in accordance with paragraphs (1) and (2)
				  of this subsection.
(1) There is to be
				  included on or attached to page one of the annual statement for each year
				  beginning with the year in which this subchapter becomes effective the
				  statement of an appointed actuary, entitled "Statement of Actuarial Opinion,"
				  setting forth an opinion relating to reserves and related actuarial items held
				  in support of policies and contracts, in accordance with §
											3.1606
				  of this title (relating to Statement of Actuarial Opinion Based on an Asset
				  Adequacy Analysis).
(2) Upon
				  written request by the company, the commissioner may grant an extension of the
				  date for submission of the statement of actuarial opinion.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Q - ACTUARIAL OPINION AND MEMORANDUM REGULATION › Section 3.1606 - Statement of Actuarial Opinion Based on an Asset Adequacy Analysis

Current through Reg. 49, No. 28; July 12, 2024
(a) General description. The statement of
				  actuarial opinion required by this section must consist of the following
				  paragraphs:
(1) a paragraph identifying the
				  appointed actuary and his or her qualifications, recommended language is
				  provided in subsection (b)(1) of this section;
(2) a scope paragraph (recommended language
				  is provided in subsection (b)(2) of this section) identifying the subjects on
				  which an opinion is to be expressed and describing the scope of the appointed
				  actuary's work, including a tabulation delineating the reserves and related
				  actuarial items that have been analyzed for asset adequacy and the method of
				  analysis, and identifying the reserves and related actuarial items covered by
				  the opinion that have not been so analyzed;
(3) a reliance paragraph (recommended
				  language is provided in subsection (b)(3) of this section) describing those
				  areas, if any, where the appointed actuary has deferred to other experts in
				  developing data, procedures, or assumptions (e.g., anticipated cash flows from
				  currently owned assets, including variation in cash flows according to economic
				  scenarios), supported by a statement of each such expert with the information
				  prescribed by subsection (e) of this section; and
(4) an opinion paragraph expressing the
				  appointed actuary's opinion with respect to the adequacy of the supporting
				  assets to mature the liabilities (recommended language is provided in
				  subsection (b)(6) of this section).
(5) One or more additional paragraphs will be
				  needed in individual company cases as follows:
(A) if the appointed actuary considers it
				  necessary to state a qualification of his or her opinion;
(B) if the appointed actuary must disclose an
				  inconsistency in the method of analysis or basis of asset allocation used at
				  the prior opinion date with that used for this opinion;
(C) if the appointed actuary must disclose
				  whether additional reserves as of the prior opinion date are released as of
				  this opinion date, and the extent of the release; or
(D) if the appointed actuary chooses to add a
				  paragraph briefly describing the assumptions that form the basis for the
				  actuarial opinion.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Q - ACTUARIAL OPINION AND MEMORANDUM REGULATION › Section 3.1608 - Asset Adequacy Analysis Exemption

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Companies that do business only in Texas and no other state are not required to
				  perform the asset adequacy analysis required by §
										3.1605 of
				  this title (relating to General Requirements) unless required by the
				  commissioner pursuant to §
										3.1603 of
				  this title (relating to Commissioner Discretion).
(b) Companies exempted under subsection (a)
				  of this section shall submit with the annual statement an actuarial opinion
				  pursuant to this subchapter but not based on an asset adequacy
				  analysis.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 1 - GENERAL PROVISIONS › Section 3.1701 - Purpose and Severability

Current through Reg. 49, No. 28; July 12, 2024
(a) Purpose.
					 Under Insurance Code Chapter 1111A, the Life Settlements Act, the commissioner
					 implements this subchapter to:
(1) establish
					 life settlement requirements concerning license applications, renewal,
					 continuing education, and disclosures;
(2) establish form filing requirements for
					 life settlement contracts;
(3)
					 prohibit or require certain contractual provisions in life settlement
					 contracts; and
(4) establish annual
					 reporting requirements for life settlement providers.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 1 - GENERAL PROVISIONS › Section 3.1702 - Applicability and Scope

Current through Reg. 49, No. 28; July 12, 2024
This subchapter:
(1) applies to all persons involved in the
					 business of life settlements in this state as specified in Insurance Code
					 Chapter 1111A;
(2) does not
					 regulate the actions of an investor providing money to a life settlement
					 provider, and does not preempt, supersede, or limit any provision of any state
					 securities law or any rule, order, or notice issued under the law;
					 and
(3) becomes effective August 1,
					 2013.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 1 - GENERAL PROVISIONS › Section 3.1703 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
In this subchapter, the following terms have the meanings
						assigned by Insurance Code § 1111A.002, unless the context clearly
						indicates otherwise:
(1)
					 advertisement;
(2)
					 broker;
(3) business of life
					 settlements;
(4) insured;
(5) life expectancy;
(6) life insurance agent;
(7) life settlement contract;
(8) net death benefit;
(9) owner;
(10) person;
(11) policy;
(12) premium finance loan;
(13) provider;
(14) purchaser; and
(15) settled policy.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1720 - Forms

Current through Reg. 49, No. 28; July 12, 2024
(a) Application form. The commissioner adopts
					 by reference the License Application for a Life Settlement Provider or Broker
					 form (revised April 2013) as the application for license for each person
					 engaging in, or desiring to engage in, business as a life settlement broker or
					 life settlement provider in this state.
(b) Renewal, Surrender, or Change of
					 Information form. The commissioner adopts by reference the Application for
					 Renewal, Surrender, or Change of Information for a Life Settlement Provider or
					 Broker form (revised April 2013) for the renewal, nonrenewal, or surrender of
					 life settlement broker or provider licenses and for use in providing notice to
					 the department of a change to any license holder information or information in
					 an application previously submitted to the department.
(c) Life Agent Notification form. The
					 commissioner adopts by reference the Life Agent Notification to TDI to Act as a
					 Life Settlement Broker form (revised March 2013) for use by a life insurance
					 agent operating as a life settlement broker.
(d) Biographical Affidavit form. The
					 commissioner adopts by reference the Biographical Affidavit for Life Settlement
					 Providers or Brokers form (revised April 2013) for use as an attachment to the
					 License Application for a Life Settlement Provider or Broker form and as an
					 attachment to the Application for Renewal, Surrender, or Change of Information
					 for a Life Settlement Provider or Broker form, as applicable, for each owner,
					 partner, director, officer, key management personnel, employee having authority
					 to direct the management of the organization, and any person who has ownership
					 of 10% or greater of the applicant or the applicant's stock.
(e) Where to find and send forms. The forms
					 adopted in this section may be submitted to the Texas Department of Insurance,
					 Life and Health Division, Filings Intake, MC-LH-LHL, P.O. Box 12030, Austin,
					 Texas 78711-2030, or obtained at the department's website at
					 www.tdi.texas.gov/forms.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1721 - License Application; Fees

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Applicant. In this section, "applicant" means a person applying for a life
					 settlement broker or provider license.
(b) License requirements.
(1) A person engaging in business as a life
					 settlement broker or life settlement provider in this state must apply for and
					 obtain a license issued by the department as required by this subchapter,
					 except that:
(A) a person may operate as a
					 life settlement broker without a life settlement broker license if that person
					 has held a life insurance agent license in this state for at least one year and
					 holds an active license, or has held a life insurance agent license in that
					 person's home state for at least one year and is licensed as a nonresident
					 agent in this state. The life insurance agent must notify the department in
					 accord with §
													3.1725
					 of this title (relating to Life Insurance Agent Notification) and Insurance
					 Code Chapter 1111A; and
(B) a
					 person may operate as a life settlement broker without a life settlement broker
					 license if that person is a licensed attorney, certified public accountant, or
					 financial planner who is retained in the type of practice customarily performed
					 in a professional capacity to represent the owner and whose compensation for
					 the life settlement transaction is not paid directly or indirectly by the
					 provider or any other person, except the owner.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1722 - Renewal; Nonrenewal; Surrender; Change of Information; and Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) Renewal form. To renew an unexpired life
					 settlement provider's or broker's license, a license holder must submit to the
					 department a completed Application for Renewal, Surrender, or Change of
					 Information for a Life Settlement Provider or Broker form. The license holder
					 must submit with the renewal application a two-year renewal fee of $50 for a
					 life settlement broker license or $100 for a life settlement provider license.
					 All renewal fees are nonrefundable and nontransferable.
(b) Renewal application requirements. In
					 addition to the completed Application for Renewal, Surrender, or Change of
					 Information for a Life Settlement Provider or Broker form, a license holder
					 applying for renewal of a life settlement broker's license or provider's
					 license must submit:
(1) if a business entity:
(A) a certificate of account status issued by
					 the Texas Comptroller of Public Accounts reflecting that the licensee is in
					 good standing or temporary good standing; or
(B) a certification signed by an officer or
					 partner of the licensee attesting that the licensee is not subject to the Texas
					 Tax Code Chapter 171; and
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1723 - Course and Training Requirements for Brokers

Current through Reg. 49, No. 28; July 12, 2024
(a) Individual continuing education
					 requirement. A life settlement broker must complete at least 15 hours of
					 department-certified life settlement continuing education during each two-year
					 license period.
(b) Entity
					 continuing education requirement. A partnership, corporation, or other entity
					 must have each owner, partner, director, member, officer, and designated
					 employee named in the license application or in any supplement to the
					 application that performs the acts of a life settlement broker under Insurance
					 Code § 1111A.002(2), and is not exempt under subsection (c) of this
					 section, complete at least 15 hours of department-certified life settlement
					 continuing education during the two-year license period.
(c) Exempt persons. A life settlement broker
					 is not subject to the requirements of this section if:
(1) the life settlement broker or the owner,
					 partner, director, member, officer, or designated employee of the life
					 settlement broker has been associated with the licensed entity for less than
					 two years; or
(2) the life
					 settlement broker holds a life insurance agent license or acts solely as a life
					 expectancy estimator. A life insurance agent must continue to meet all
					 applicable license and continuing education requirements for the life insurance
					 agent license.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1724 - Continuing Education Providers

Current through Reg. 49, No. 28; July 12, 2024
(a) A
					 continuing education provider for life settlement broker continuing education
					 must comply with:
(1) Sections
					 19.1005,
					 19.1007,
					 and
					 19.1008
					 of this title (relating to Provider Registration, Instructor, and Speaker
					 Criteria; Course Certification Submission Applications, Course Expirations, and
					 Resubmissions; and Certified Course Advertising, Modification, and Assignment,
					 respectively);
(2) Section
					 19.1009 of this
					 title (relating to Types of Courses);
(3) Section
					 19.1010 of this
					 title (relating to Hours of Credit);
(4) Section
					 19.1011
					 of this title (relating to Requirements for Successful Completion of Continuing
					 Education Courses); and
(5) Section
					 19.1014
					 of this title (relating to Provider Compliance Records).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1725 - Life Insurance Agent Notification

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Operating as a life settlement broker. A licensed life insurance agent may
					 operate as a life settlement broker, provided that:
(1) the life insurance agent has held a
					 license as a life insurance agent:
(A) in
					 this state for at least one year; or
(B) in the person's home state for at least
					 one year and is licensed as a nonresident agent in this state;
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1726 - Life Expectancy Estimators

Current through Reg. 49, No. 28; July 12, 2024
(a) Insurance Code
					 §§ 1111A.003(p), 1111A.012, and 1111A.014(l) and (m) do not apply to
					 a life settlement broker who acts solely as a life expectancy
					 estimator.
(b) A life settlement
					 broker or life insurance agent who solely performs estimates of life expectancy
					 must indicate on the License Application for a Life Settlement Provider or
					 Broker form; the Application for Renewal, Surrender, or Change of Information
					 for a Life Settlement Provider or Broker form; or the Life Agent Notification
					 to TDI to Act as a Life Settlement Broker form, as applicable, that the broker
					 or life insurance agent will act solely as a life expectancy
					 estimator.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1727 - Unauthorized Insurance

Current through Reg. 49, No. 28; July 12, 2024
For purposes of Insurance Code §
											101.051(b)(8)
						and (9), unauthorized insurance includes
						participation of a life settlement broker or provider in connection with a life
						settlement contract for which the insured resides in this state but for which
						the owner is a trust or similar entity domiciled in another state and created
						primarily to avoid the requirements of Insurance Code Chapter
						1111A.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1728 - Life Settlement Broker Fiduciary Duty

Current through Reg. 49, No. 28; July 12, 2024
Breach of a life settlement broker's fiduciary duty
						includes, but is not limited to:
(1)
					 receiving compensation for negotiating a life settlement contract that would
					 result in the owner receiving less than either the cash surrender value or
					 accelerated death benefit, if such accelerated death benefit may be claimed at
					 the time the owner enters into the life settlement contract, of the life
					 insurance policy payable at the time of application for a life settlement
					 contract.
(2) a contractual
					 agreement or arrangement to directly or indirectly exclusively negotiate life
					 settlement contracts with a single life settlement provider.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1729 - Maintenance of Records

Current through Reg. 49, No. 28; July 12, 2024
A life settlement broker or provider must maintain a copy
						of the life settlement contract, verification of coverage, and any life
						expectancy estimate for each settled policy for five years from the date of
						execution of the contract.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 2 - LICENSE APPLICATION AND RENEWAL; COURSE AND TRAINING REQUIREMENTS; MAINTENANCE OF RECORDS › Section 3.1730 - Health Status Verification

Current through Reg. 49, No. 28; July 12, 2024
(a) Who can
					 verify health status. Only a licensed life settlement broker, licensed life
					 settlement provider, or authorized representative of a licensed life settlement
					 broker or licensed life settlement provider may contact an insured to determine
					 the insured's health status or to verify the insured's address.
(b) Written delegation. An authorized
					 representative must have a written authorization from a licensed life
					 settlement broker or provider to be an authorized representative. An authorized
					 representative must agree in writing to adhere to the privacy provisions in
					 Insurance Code Chapter 1111A.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 3 - FORM FILING AND USAGE REQUIREMENTS › Section 3.1740 - Form Filing Requirements and Approval, Disapproval, or Withdrawal of Forms; Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) General form
					 filing requirement. A person must not use a form used to effectuate a life
					 settlement in this state unless the form has been filed with and approved by
					 the commissioner under this section, if prior approval is required by
					 subsection (f) of this section.
(b)
					 Required life settlement contract form filings. Forms that must be filed
					 include the following:
(1) settlement
					 contracts, including any amendments;
(2) disclosures;
(3) verification of coverage forms;
(4) escrow or trust agreements;
(5) documents used to obtain or release
					 confidential information, including documents used by the life settlement
					 broker or provider that in any way refer to, affect, request, or relate to a
					 life settlement broker or provider obtaining or releasing confidential
					 information;
(6) owner consent
					 forms;
(7) power of attorney
					 forms;
(8) settlement
					 applications;
(9) premium finance
					 loan documents as specified in Insurance Code §
												1111A.002(11)(B),
					 unless exempted by §1111A.002(11-A); and
(10) any other form used by a life settlement
					 broker or provider to effectuate a life settlement contract in this
					 state.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 3 - FORM FILING AND USAGE REQUIREMENTS › Section 3.1741 - Required Form Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a) Life settlement
					 contracts. All contracts used to effectuate life settlements must contain the
					 provisions set forth in paragraphs (1) - (8) of this subsection, as follows:
(1) a provision that the life settlement
					 contract or the contract together with the application, including any
					 amendments and attachments, constitute the entire contract between the
					 parties;
(2) a provision that any
					 change to the life settlement contract is valid only on written approval by an
					 executive officer of the life settlement provider designated in the contract
					 with authority to bind the provider and that such approval must be endorsed in
					 or attached to the life settlement contract. The provision must also state that
					 no person, other than an executive officer of the provider, has the authority
					 to change the life settlement contract or to waive any of its
					 provisions;
(3) a provision that,
					 in the absence of fraud, all statements made by the owner and insured are
					 representations and not warranties;
(4) a provision that the owner may designate
					 any individual of legal age, in regular contact with the insured, as a contact
					 for inquiries about the insured's health status on written notice providing the
					 name, address, and telephone number of such individual. The provision must
					 include a statement that the owner may change a designation at any time on
					 written notice to the life settlement provider;
(5) a provision that the licensed life
					 settlement provider must provide to the insured the name, address, and
					 telephone number of the life settlement broker, provider, or authorized
					 representative of the provider or broker that will contact the insured or the
					 insured's designee for tracking purposes and must notify the insured of any
					 change in such information;
(6) a
					 provision defining how any notice required or permitted under the contract must
					 be given and delivered;
(7) a
					 provision disclosing what effect the life settlement contract will have on
					 payment of premiums and disposition of proceeds, cash values, and dividends;
					 and
(8) a provision disclosing
					 that, if the policy that is the subject of the life settlement contract is a
					 joint policy, or contains riders or other provisions insuring the lives of a
					 spouse, dependents, or anyone else other than the owner, there may be a
					 possible loss of coverage, and that the owner should contact the owner's
					 insurance company or agent to determine if the coverage may be converted to
					 avoid losing the coverage.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 3 - FORM FILING AND USAGE REQUIREMENTS › Section 3.1742 - Shopper's Guide

Current through Reg. 49, No. 28; July 12, 2024
The commissioner adopts by reference the form Important
						Information You Should Know Before Entering Into A Life Settlement (revised
						April 2013), as a shopper's guide for delivery to owners during the
						solicitation process. The life settlement broker, or the provider if the
						transaction does not have a broker, must deliver the guide to the owner prior
						to the execution of the life settlement contract. The form is available from
						the Texas Department of Insurance, Life and Health Division, Filings Intake,
						MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030, or by accessing the
						department's website at www.tdi.texas.gov/forms. The delivery of the shopper's
						guide satisfies only the requirements of Insurance Code §
											1111A.012(10)
						and this section.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 3 - FORM FILING AND USAGE REQUIREMENTS › Section 3.1743 - Prohibited Life Settlements

Current through Reg. 49, No. 28; July 12, 2024
A life settlement provider may not offer an owner a life
						settlement contract with a minimum value that is less than the cash surrender
						value or accelerated death benefit, if such accelerated death benefit may be
						claimed at the time the owner enters into the life settlement contract, of the
						life insurance policy payable at the time of application for a life settlement
						contract.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 3 - FORM FILING AND USAGE REQUIREMENTS › Section 3.1744 - Advertising, Sales, and Solicitation Materials; Filing Prior to Use

Current through Reg. 49, No. 28; July 12, 2024
(a) Filing requirement. Each life settlement
					 broker or provider must file with the department any advertisement or other
					 solicitation materials used to market life settlement contracts or broker's or
					 provider's services to owners in this state on or before the date such
					 materials are disseminated. Advertising filings should be filed with the
					 department at the address specified in §
											21.120 of this
					 title (relating to Filing for Review).
(b) Information filing. The filings required
					 by this section are for informational purposes only. Life settlement brokers or
					 providers may use or disseminate the materials referenced in this section
					 without prior review by the department.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter R - LIFE SETTLEMENT › Division 4 - ANNUAL REPORTING › Section 3.1760 - Reporting Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) General
					 reporting requirements applicable to all life settlement providers. All life
					 settlement providers must comply with the general reporting requirements set
					 forth in paragraphs (1) and (2) of this subsection.
(1) On or after January 1 and before March 1
					 of each year, each life settlement provider must submit electronically via
					 email in Excel format to lifehealth@tdi.texas.gov, for the previous calendar
					 year, the life settlement provider data report form that is adopted by
					 reference in this section, whether or not the provider conducted any
					 transactions during the reporting period.
(2) In complying with the requirements of
					 this section, a life settlement provider may not include any confidential
					 information in the report or in any other way compromise the anonymity of any
					 owner, owner's family members, or owner's spouse.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3001 - Applicability and Scope

Current through Reg. 49, No. 28; July 12, 2024
(a) Unless
				  otherwise specified, this subchapter applies to all individual accident and
				  sickness insurance policies and subscriber contracts of hospital and medical
				  and dental service associations, delivered, issued for delivery, or renewed in
				  this state on and after the effective date of this section, except they do not
				  apply to individual policies or contracts issued pursuant to a conversion
				  privilege under a policy or contract of group insurance; individual policies
				  issued pursuant to a conversion privilege under an individual policy delivered
				  or issued for delivery in this state prior to January 1, 1978; policies issued
				  to employees or members as additions to franchise plans in existence on January
				  26, 1977; or credit accident and sickness insurance policies written under
				  Insurance Code Chapter 1153. Individual accident and sickness insurance
				  policies and subscriber contracts of hospital and medical and dental service
				  associations, delivered, issued for delivery, or renewed in this state prior to
				  the effective date of this section are subject to the regulations in effect at
				  the time the policy or contract was delivered, issued for delivery, or
				  renewed.
(b) The requirements
				  contained in this subchapter are in addition to any other applicable
				  regulations previously adopted; however, this subchapter governs wherein any
				  conflict or difference exists. The provisions of applicable statutes govern
				  where ambiguity or difference exists between this subchapter and such
				  statutes.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3005 - Definitions in Policies

Current through Reg. 49, No. 28; July 12, 2024
Except as otherwise provided by law or these sections, no
					 individual accident and sickness insurance policy or hospital, medical and
					 dental service corporation subscriber contract delivered or issued for delivery
					 in this state may contain definitions respecting the matters set forth in
					 §§
										3.3006-3.3029
					 of this title (relating to Minimum Standards and Benefits and Readability for
					 Accident and Health Insurance Policies) unless such definitions comply with the
					 requirements of said sections.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3006 - Policy Definition of Hospital

Current through Reg. 49, No. 28; July 12, 2024
The term "hospital" may be defined in relation to its
					 status, facilities, and available services. The definition may not stipulate as
					 a condition that a hospital be incorporated or that it be recognized by any
					 accrediting organizations.
(1) Except
				  as provided in these sections, the definition of the term "hospital" may not be
				  more restrictive than one requiring that the facility:
(A) be licensed as a hospital and operated
				  pursuant to law; and
(B) be
				  primarily engaged in providing or operating (either on its premises or in
				  facilities available to the hospital on a contractual prearranged basis and
				  under the supervision of a staff of one or more duly licensed physicians),
				  medical, diagnostic, and major surgery facilities for the medical care and
				  treatment of sick or injured persons on an inpatient basis for which a charge
				  is made; and
(C) provide 24-hour
				  nursing service by or under the supervision of a registered graduate
				  professional nurse (RN); and
(D) be
				  an institution which maintains and operates a minimum of five beds;
				  and
(E) have x-ray and laboratory
				  facilities either on the premises or available on a contractual prearranged
				  basis; and
(F) maintain permanent
				  medical history records.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3007 - Policy Definition of Convalescent Nursing Home or Extended Care Facility

Current through Reg. 49, No. 28; July 12, 2024
The term "convalescent nursing home" or "extended care
					 facility" shall be defined in relation to its status, facilities, and available
					 services.
(1) Except as provided in
				  these sections, a definition of such home or facility may not be more
				  restrictive than one requiring that it:
(A)
				  be an institution licensed and operated pursuant to law; and
(B) be primarily engaged in providing, in
				  addition to room and board accommodations, skilled nursing care under the
				  supervision of a duly licensed physician; and
(C) provide continuous 24 hours a day nursing
				  service by or under the supervision of a registered graduate professional nurse
				  (RN); and
(D) maintain a daily
				  medical record on each patient.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3008 - Policy Definitions of Accident, Accidental Injury, Injury

Current through Reg. 49, No. 28; July 12, 2024
(a) These terms shall be defined to employ
				  "result" language and may not include words which establish an accidental means
				  test. Except for accidental death or dismemberment, said definitions may not
				  include words such as "external, violent, visible wounds" or similar words of
				  description or characterization and may not be more restrictive than the
				  following: Injury or injuries for which benefits are provided means accidental
				  bodily injuries sustained by an insured person which are the direct cause of
				  the loss independent of disease, bodily infirmity, or any other cause and
				  occurs while the policy is in force.
(b) Such definition may exclude, unless
				  prohibited by law, injuries for which benefits are provided under any workmen's
				  compensation, employer's liability or similar statute or injuries occurring
				  while the insured person is engaged in any activity pertaining to any trade,
				  business, employment, or occupation for wage or profit.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3009 - Policy Definitions of Sickness

Current through Reg. 49, No. 28; July 12, 2024
Except as provided in this subchapter, the definition of
					 "sickness" may not be more restrictive than the following: Sickness means
					 illness or disease of an insured person which first manifested itself after the
					 effective date of insurance and while the insurance is in force. A definition
					 of sickness which anticipates the exclusion of coverage of pre-existing
					 conditions subject to the limitations expressed in Insurance Code §
										1201.208
					 may not use the phrase "the cause of which originates" or any similar phrase.
					 The definition may be modified to exclude sickness or disease for which
					 benefits are provided under any workmen's compensation, occupational disease,
					 employer's liability, or similar statute.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3010 - Policy Definition of Physician

Current through Reg. 49, No. 28; July 12, 2024
This term may be defined by including words such as "duly
					 qualified physician" or "duly licensed physician." The use of such terms
					 requires an insurer to recognize and to accept to the extent of its obligation
					 under the contract all providers of medical care and treatment when such
					 services are within the scope of the providers' licensed authority and are
					 provided pursuant to applicable laws. This definition may not be construed so
					 as to be in conflict with Insurance Code §
										1451.001.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3011 - Policy Definition of Nurse

Current through Reg. 49, No. 28; July 12, 2024
The definition or description of "nurse" may be restricted
					 to a type of nurse, such as registered graduate professional nurse (RN), or a
					 licensed vocational nurse (LVN), or its equivalent under other state laws. If
					 the words "nurse," "trained nurse," or similar terms are used without specific
					 instruction, the use of such terms requires the insurer to recognize the
					 services of any individual who qualifies under such terminology in accordance
					 with the applicable statutes or administrative rules of the licensing or
					 registry board of the state.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3012 - Policy Definition of Total Disability

Current through Reg. 49, No. 28; July 12, 2024
(a) A general definition of "total
				  disability" may not be more restrictive than one requiring the individual to be
				  totally disabled from engaging in any employment or occupation for which he or
				  she is or becomes qualified by reason of education, training, or experience,
				  and such individual is not in fact engaged in any employment or occupation for
				  wage or profit.
(b) "Total
				  disability" may be defined in relation to the inability of the person to
				  perform duties, but such inability may not be based solely upon an individual's
				  inability to:
(1) perform "any occupation
				  whatsoever" or "any occupational duty"; or
(2) engage in any training or rehabilitation
				  program; however, an insurer may specify the requirement of the inability of
				  the person to perform all of the substantial and material duties pertaining to
				  his or her regular occupation, or words of similar import.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3013 - Policy Definition of Partial Disability

Current through Reg. 49, No. 28; July 12, 2024
This term shall be defined in relation to the insured's
					 inability to perform one or more, but not all, of the "major," "important," or
					 "essential" duties of employment or occupation or may be related to a
					 "percentage" of time worked or to a "specified number of hours" or to
					 "compensation." If a policy provides total disability benefits and partial
					 disability benefits, only one elimination period may be
					 required.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES › Section 3.3014 - Policy Definition of Residual Disability

Current through Reg. 49, No. 28; July 12, 2024
Residual disability shall be defined in relation to the
					 insured's reduction in earnings and may be related either to the inability to
					 perform one or more, but not all, of the "major," "important," or "essential"
					 duties of employment or occupation, or to the inability to perform all usual
					 business duties for as long as is usually required. A policy which provides for
					 residual disability benefits may require a qualification period, during which
					 the insured must be continuously totally disabled before residual disability
					 benefits are payable. The qualification period for residual disability benefits
					 may be longer than the elimination period for total
					 disability.