Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter Y - STANDARDS FOR LONG-TERM CARE INSURANCE, NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE COVERAGE UNDER INDIVIDUAL AND GROUP POLICIES AND ANNUITY CONTRACTS, AND LIFE INSURANCE POLICIES THAT PROVIDE LONG-TERM CARE BENEFITS WITHIN THE POLICY › Division 2 - NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE › Section 3.3841 - Unintentional Lapse and Reinstatement

Current through Reg. 49, No. 28; July 12, 2024
Each insurer offering long-term care insurance shall, as
						a protection against unintentional lapse, comply with the following:
(1) Procedures applicable to unintentional
					 lapse.
(A) Notice before lapse or
					 termination. No individual long-term care policy or certificate shall be issued
					 until the insurer has received from the applicant either a written designation
					 of at least one person, in addition to the applicant, who is to receive notice
					 of lapse or termination of the policy or certificate for nonpayment of premium,
					 or a written waiver dated and signed by the applicant electing not to designate
					 additional persons to receive notice. The applicant has the right to designate
					 at least one person who is to receive the notice of termination, in addition to
					 the insured. Designation shall not constitute acceptance of any liability on
					 the third party for services provided to the insured. The form used for the
					 written designation must provide space clearly designated for listing at least
					 one person. The designation shall include each person's full name and home
					 address. In the case of an applicant who elects not to designate an additional
					 person, the waiver shall state: "Protection against unintended lapse. I
					 understand that I have the right to designate at least one person other than
					 myself to receive notice of lapse or termination of this long-term care
					 insurance policy for nonpayment of premium. I understand that notice will not
					 be given until 30 days after a premium is due and unpaid. I elect NOT to
					 designate a person to receive this notice." The insurer shall notify the
					 insured of the right to change this written designation, no less often than
					 once every two years.
(B) Payroll
					 or pension deduction. When the policyholder or certificate holder pays premium
					 for a long-term care insurance policy or certificate through a payroll or
					 pension deduction plan, the requirements contained in paragraph (1)(A) of this
					 section need not be met until 60 days after the policyholder or certificate
					 holder is no longer on such a payment plan. The application or enrollment form
					 for such policies or certificates shall clearly indicate the payment plan
					 selected by the applicant.
(C)
					 Lapse or termination for nonpayment of premium. No individual long-term care
					 policy or certificate shall lapse or be terminated for nonpayment of premium
					 unless the insurer, at least 30 days before the effective date of the lapse or
					 termination, has given notice to the insured and to those persons designated
					 pursuant to paragraph (1)(A) of this section at the address provided by the
					 insured for purposes of receiving notice of lapse or termination. Notice shall
					 be given by first class United States mail, postage prepaid; and notice may not
					 be given until 30 days after a premium is due and unpaid. Notice shall be
					 deemed to have been given as of five days after the date of mailing.