reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.18 - Applications intended for use in mail order solicitations of life insurance

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A submission of
				an application intended for use in mail order solicitation of life insurance
				contains a detailed explanation of how the company will comply in the
				solicitation with Chapter 83 (relating to disclosures in solicitation of life
				insurance).
(b) Disclosures
				required by Chapter 83, Subchapter A (relating to required disclosures in the
				solicitation of life insurance) are provided in the sales material, in a
				separate individualized form or in a composite disclosure for applicable ages,
				amounts of insurance, and the like. This is pursuant to §
									83.3(a) (relating
				to disclosure statement).
(c)
				Disclosures required by Chapter 83, Subchapter B (relating to cost disclosures
				in the solicitation of life insurance) are provided in a separate
				individualized form pursuant to §
									83.55 (relating to
				delivery).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.19 - Applications for life insurance providing a "no money down" offer

Current through Register Vol. 54, No. 28, July 13, 2024
The application does not provide for the payment of the
				  initial premium within a period of time after policy delivery. This complies
				  with section 410(a) of The Insurance Company Law of 1921 (40 P. S. §
										510(a)).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.20 - Applications for life insurance and annuities sold in connection with a financial institution

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
				application does not permit a financial institution to apply for insurance on
				the life of an individual.
(b) If
				an application contains wording indicating that a financial institution is
				involved in the solicitation of insurance, the company provides a detailed
				explanation of the solicitation and the financial institution's involvement,
				including involvement with an insurance agent. The financial institution's
				renting or leasing of office space to an agent would constitute involvement
				with an agent.
(c) The application
				does not contain wording automatically naming a financial institution the
				assignee or beneficiary of insurance proceeds. The insurer does or does not
				permit assignment of the proceeds or naming the financial institution the
				beneficiary to the extent of that institution's interest, using the company's
				normal assignment and beneficiary designation procedures.
(d) If the application automatically provides
				for the payment of premiums through the financial institution, there is a
				statement on the application whereby the applicant acknowledges that this is
				the way premium payment is to be made.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.21 - Premiums paid by credit card

Current through Register Vol. 54, No. 28, July 13, 2024
A program for premium payment by credit card that complies
				  with the following is acceptable:
(1)
				Applications provide automatically for the payment of premiums by credit card
				or they provide for the election of a credit card payment method.
(2) Life insurance applications providing for
				the payment of premiums by credit card contain specific wording as to when the
				insurance coverage is effective. If immediate coverage is not provided, the
				disclosure as to when coverage is effective is in prominent type, unless a
				receipt is given. Prominent type means, for example, all capital letters,
				contrasting color, underlined or otherwise differentiated from the other type
				in the application.
(3) If the life
				insurance application is for use in direct response sales and the disclosure as
				to when coverage is effective specifies premium payment as a condition of
				coverage, then the disclosure as to when coverage is effective, indicates when
				the first premium is considered to be paid if it is paid by credit card. This
				indication as to when the first premium is considered to be paid does not
				indicate that it is considered to be paid after policy delivery unless the
				first page of the policy contains an express disclosure in prominent type that
				there is no insurance coverage until the effective date. Prominent type means,
				for example, all capital letters, contrasting color, underlined or otherwise
				differentiated from the other type in the policy.
(4) Individuals paying premiums through
				credit cards are provided with the same treatment as individuals paying
				premiums directly to the company, except with respect to the premium payment
				mode periods, and with respect to the amount of premium if the different
				premium amount is due to the establishment of a separate class for contracts
				paid through credit cards.
(5) The
				insurance contract provides that premiums billed on a credit card account
				statement are considered to have been paid to the insurer on the premium due
				date.
(6) The insurance company
				provides a certification with the submission letter that it has established
				procedures whereby insureds whose premium charges are not accepted by the card
				issuer are given the opportunity to change to a direct premium payment mode on
				a basis that will afford continuity of coverage.
(7) The insurance contract provides that the
				policyowner has the right to pay premiums directly to the insurer if the credit
				card used for billing is canceled, if the insurer cancels the credit card
				billing arrangement, or if the policyowner cancels the credit card billing
				arrangement.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.22 - Assignment or surrender of existing insurance policies as consideration for the insurance being applied for

Current through Register Vol. 54, No. 28, July 13, 2024
If the application contains a statement in the declaration
				  section or elsewhere that existing contracts are being assigned or surrendered
				  as consideration for the insurance being applied for, the company sends a
				  detailed explanation of this arrangement and copies of additional forms used
				  prior to approval of the application. Additionally, the company certifies that
				  there will not be any lapse of coverage under existing insurance until new
				  coverage is issued.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.23 - Applications of fraternal benefit societies

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Application form.
The
				words "A Fraternal Benefit Society" appear in conspicuous type on the
				application form. This complies with §
									89.102(d)(6)
				(relating to guidelines for approval of forms).
(b)
Separation of applications.
Membership and insurance applications are not combined. Questions
				relating to membership are not included in the insurance application. This
				complies with § 89.102(d)(1).
(c)
Indication of membership.
Each application, except an exchange or conversion application, for
				insurance on the life of an adult contains the following:
"Is the applicant a member of (
___
)?"
"Yes
___
No
___
"
"If not, apply for membership." This complies with §
				  89.102(d)(5).
(d)
Signatures.
(1) Signatures
				on life insurance applications are as follows:
(i) If the proposed insured is an adult (18
				or over), a member and is the applicant, the application for insurance
				contains:
"Proposed Insured's Signature
____________
"
(ii) If
				the proposed insured is an adult and not a member, the application for
				insurance contains:
"Proposed Insured's Signature
____________
"
"Member Applicant's Signature
____________
"
(iii) If
				the proposed insured is a child, the application for insurance contains:
"Adult Applicant's Signature
"
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.24 - Filing procedures for combination life or annuity and accident and health applications and combination group and individual applications

Current through Register Vol. 54, No. 28, July 13, 2024
In the case of a combination application, a single submission
				  or two separate submissions are made. If a single submission is made, the
				  submission letter is in triplicate. If two separate submissions are made, one
				  is made for life and the other for accident and health, or one for group and
				  the other for individual, as appropriate.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90c - INDIVIDUAL APPLICATIONS-STATEMENT OF POLICY › Section 90c.25 - AIDS

Current through Register Vol. 54, No. 28, July 13, 2024
Insurer practices that comply with the following are
				  acceptable:
(1) For underwriting
				purposes, AIDS is considered to be the same as other medical conditions, such
				as cancer or heart disease.
(2)
				Information obtained through the underwriting process is
				confidential.
(3) Proposed insureds
				who are determined to have AIDS or ARC are insured at standard premiums, at
				higher than standard premiums, or rejected as insureds based on underwriting
				and any complete test results.
(4)
				An individual life insurance policy or annuity contract does not include a
				provision applicable to all life insureds or annuitants that excludes claims
				from any specific condition, such as AIDS.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.1 - Scope

Current through Register Vol. 54, No. 28, July 13, 2024
An individual life accidental death benefit filing complying
				  with the standards of this chapter is acceptable.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.2 - General provisions

Current through Register Vol. 54, No. 28, July 13, 2024
An individual life accidental death benefit filing complying
				  with the following is acceptable:
(1)
				The submission letter for a form complies with applicable requirements of
				§
									89b.5 (relating to letter of
				submission).
(2) The form is
				submitted in duplicate. This complies with §
									89b.4(a)
				(relating to general filing procedure).
(3) The form is submitted in the final
				printed form intended for actual issue, unless the company requests tentative
				approval under §
									89.4(d)
				(Reserved). A form submitted for tentative
				approval is submitted in draft, printer's-proof, photocopied, "filer" or other
				legible form.
(4) The form number
				and the wording in the form are printed in easily readable type.
(5) Logos are or are not present and are more
				or less prominent than the company name.
(6) The full company name appears on a rider
				for filing purposes only. The name is printed or added by rubber stamp or other
				appropriate means. This complies with §
									89b.11(a)
				(relating to general contents of forms).
(7) An administrative office address or the
				home office address is or is not shown. If an address is captioned as "home
				office," it is the official home office address of record.
(8) The form contains a caption:
(i) Disclosing the coverage
				provided-accidental death or accidental death and dismemberment, as
				appropriate.
(ii) For a rider,
				disclosing that the form is a rider, endorsement, agreement or amendment. An
				alternative caption if the form provides that it is "attached to and made a
				part of the policy."
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.3 - Benefit design

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Accidental death.
(1) The
				form discloses that a stated benefit amount will be paid if the insured's death
				results from an accident.
(2) The
				form discloses age requirements as to when the insured is eligible for benefits
				and when eligibility terminates.
(3) Children aged 5 and under are or are not
				excluded from eligibility.
(4)
				Eligibility will or will not be terminated for all insureds after age
				65.
(5) The form discloses the
				conditions for payment of the accidental death benefit. The death results from
				an accident occurring during the coverage period.
(6) Death also:
(i) Results from accidental bodily injury,
				directly and independently of all other causes.
(ii) Occurs after the effective date of
				coverage.
(iii) Occurs while the
				rider and policy, or the policy alone in the case of a built-in benefit, are in
				force.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.5 - Termination of coverage

Current through Register Vol. 54, No. 28, July 13, 2024
The form discloses the conditions under which the coverage
				  terminates.
(1) The following
				conditions are disclosed if the benefit is provided by a rider:
(i) Written request from the owner for
				termination.
(ii) Termination of
				the policy.
(iii) Nonpayment of
				premium.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.6 - Prohibited terminology

Current through Register Vol. 54, No. 28, July 13, 2024
The following terminology is not present:
(1) The term "special," unless used in
				reference to or to designate one or more of the following: a premium payment
				mode, a premium rating class, a settlement option or options under a policy.
				This complies with §
									89.13(c)
				(relating to use of certain words and terms).
(2) The term "deposit," unless used in
				conjunction with the word "premium" or the payment establishes a
				debtor-creditor relationship. This complies with §
									87.28 (relating to reference to
				payment as "deposit").
(3) The term
				"legal reserve," the absence of which complies with Chapter 139 (relating to
				prohibited phrases).
(4) The term
				"franchise."
(5) The term "sponsor"
				unless used in reference to an entity which pays all or part of the premium or
				is a pension or welfare plan sponsor under ERISA.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.7 - Inconsistent or contradictory language

Current through Register Vol. 54, No. 28, July 13, 2024
The form contains no inconsistent or contradictory language
				  or provisions.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.8 - Fraternal benefit society

Current through Register Vol. 54, No. 28, July 13, 2024
If a form will be issued by a fraternal benefit society,
				  nonstandard insurance terminology is or is not used. This complies with §
									89.102(b)(3)
				  (relating to guidelines for approval of forms).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.9 - Riders

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If a rider will
				be attached to a policy after issue, the form contains an officer's signature.
				If a rider will be attached to a policy only at issue, an officer's signature
				is or is not present.
(b) A rider
				contains a form number. This complies with §
									89b.11(b)
				(relating to general contents of form).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.2 - General provisions

Current through Register Vol. 54, No. 28, July 13, 2024
An individual IRA endorsement filing complying with the
				  following is acceptable:
(1) The
				submission letter for a form complies with applicable requirements of §
									89b.5 (relating to letter of
				submission).
(2) The form is
				submitted in duplicate. This complies with §
									89b.4(a)
				(relating to general filing procedure).
(3) The form is submitted in the final
				printed form intended for actual issue, unless the company requests tentative
				approval under §
									89.4(d)
				(Reserved). A form submitted for tentative
				approval is submitted in draft, printer's-proof, photocopied, "filer" or
				another legible form.
(4) The form
				number and the wording in the form are printed in easily readable
				type.
(5) Logos are or are not
				present and are more or less prominent than the company name.
(6) The full company name appears on the form
				for filing purposes only. The name is printed or added by rubber stamp or other
				appropriate means. This complies with §
									89b.11(a)
				(relating to general contents of forms).
(7) An administrative office address or the
				home office address is or is not shown. If an address is captioned as "home
				office," it is the official home office address of record.
(8) The form contains a caption disclosing
				that the form is a rider, endorsement, agreement or amendment. An alternative
				caption if the form provides that it is "attached to and made a part of the
				contract."
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.3 - Right to examine notice

Current through Register Vol. 54, No. 28, July 13, 2024
If the form is for use with a separate account annuity
				  contract and contains a right to examine ("free look") notice or provision for
				  the contract, the notice or provision complies with the last two sentences of
				  section 410E of The Insurance Company Law of 1921 (40 P. S. §
										510d). Among other things, this means that
				  the notice or provision provides that the amount that will be returned to the
				  contractholder will be the sum of the following:
(1) The difference between the premiums paid
				and the amounts allocated to any separate accounts under the
				contract.
(2) The contract value on
				the date of surrender attributable to the amounts allocated to any separate
				accounts under the contract.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.4 - Revocation of contract

Current through Register Vol. 54, No. 28, July 13, 2024
If the form is for use with a separate account annuity
				  contract and provides that the contractholder may revoke the contract within a
				  specified period of time after the contract date or after the contractholder is
				  notified of a contract amendment, the amount that will be refunded to the
				  contractholder upon revocation complies with the next-to-last sentence of
				  section 410E of The Insurance Company Law of 1921 (40 P. S. §
										510d). That is, the amount will be the sum of
				  the difference between the premiums paid and the amounts allocated to any
				  separate accounts under the contract and the contract value on the date of
				  surrender, revocation, attributable to the amounts allocated to any separate
				  accounts under the contract. Alternatively, the company certifies that the
				  revocation period will always precede and never coincide with or overlap the
				  10-day right to examine period under section 410E of The Insurance Company Law
				  of 1921. This alternative complies with section 410E of The Insurance Company
				  Law of 1921.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.5 - Contract maturity date

Current through Register Vol. 54, No. 28, July 13, 2024
The form does not provide for a contract maturity date beyond
				  the age shown as follows for the issue age of the annuitant:
ISSUE AGE
MAXIMUM MATURITY AGE
70 OR LESS
85
71-75
86
76-80
88
81-85
90
86-90
93
91-93
96
94-95
98
96-97
99
98-99
101
100-101
102
102
103
103
104
104
105
105
106
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.6 - Amendment of contract

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
				form does not give the company the right to unilaterally amend the contract to
				comply with future requirements of the tax laws or of the Internal Revenue Code
				(IRC) or Internal Revenue Service (IRS). The form provides that a future
				amendment that affect the benefits or coverage provided by the contract will be
				subject, at the time the amendment is offered, to the contractholder's signed
				acceptance, or at least to the contractholder's right of rejection. This
				complies with §
									89.16(c)
				(relating to riders and endorsements).
(b) Similarly, the contract does not state
				that the contractholder agrees to future changes in the contract for the
				purpose of complying with tax law, IRC or IRS requirements. The form provides
				that a future change in the contract will be subject to the contractholder's
				signed acceptance or right of rejection at the time that the change is
				proposed.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.7 - Prohibitions

Current through Register Vol. 54, No. 28, July 13, 2024
The form does not contain the following:
(1) A provision that the terms of the form
				are subject to the provisions of a plan under which the contract and form are
				issued.
(2) A provision that the
				terms of the contract and form are subject to the provisions of a plan under
				which the contract and form are issued.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.8 - Prohibited terminology

Current through Register Vol. 54, No. 28, July 13, 2024
The following terminology is not present:
(1) The term "special," unless used in
				reference to or to designate one or more of the following: a premium payment
				mode, a premium rating class, a settlement option or options under a policy.
				This complies with §
									89.13(c)
				(relating to use of certain words and terms).
(2) The term "deposit," unless used on
				conjunction with the word "premium" or the payment establishes a
				debtor-creditor relationship. This complies with §
									87.28 (relating to reference to
				payment as "deposit").
(3) The term
				"legal reserve", the absence of which complies with Chapter 139 (relating to
				prohibited phrases).
(4) The term
				"franchise".
(5) The term "sponsor"
				unless used in reference to an entity which pays all or part of the premium or
				is a pension or welfare plan sponsor under ERISA.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.9 - Inconsistent or contradictory language

Current through Register Vol. 54, No. 28, July 13, 2024
The form contains no inconsistent or contradictory language
				  or provisions.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.10 - Fraternal benefit society

Current through Register Vol. 54, No. 28, July 13, 2024
If a form will be issued by a fraternal benefit society,
				  nonstandard insurance terminology is or is not used. This complies with §
									89.102(b)(3)
				  (relating to guidelines for approval of forms).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.11 - Riders

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If a rider will
				be attached to a policy after issue, the form contains an officer's signature.
				If a rider will be attached to a policy only at issue, an officer's signature
				is or is not present.
(b) A rider
				contains a form number. This complies with §
									89b.11(b)
				(relating to general contents of forms).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.12 - Change in contract expense or surrender changes

Current through Register Vol. 54, No. 28, July 13, 2024
If the form changes contract expense or surrender charges,
				  the company's submission of the form includes an actuarial memorandum
				  supporting the change.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90e - INDIVIDUAL IRA ENDORSEMENTS FOR LIFE INSURANCE AND ANNUITIES-STATEMENT OF POLICY › Section 90e.13 - Right to accept or reject form

Current through Register Vol. 54, No. 28, July 13, 2024
If the form will be attached to existing in force contracts,
				  the company's submission of the form includes an explanation of how existing
				  contractholders will be given the right to accept or reject the
				  form.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.1 - Scope

Current through Register Vol. 54, No. 28, July 13, 2024
An individual imminent death/lifetime health care facility
				  confinement benefit filing complying with the standards of this chapter is
				  acceptable.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.2 - General provisions

Current through Register Vol. 54, No. 28, July 13, 2024
An individual imminent death/lifetime health care facility
				  confinement benefit complying with the following is acceptable:
(1) The submission letter for a form complies
				with applicable requirements of §
									89b.5 (relating to letter of
				submission). For a rider, the submission letter includes a list of the
				contracts to which the rider will be attached.
(2) The form is submitted in duplicate. This
				complies with §
									89b.4(a)
				(relating to general filing procedure).
(3) The form is submitted in the final
				printed form intended for actual issue, unless the insurer requests tentative
				approval under §
									89.4(d)
				(Reserved). A form submitted for tentative
				approval is in draft, printer's-proof, photocopied, "filer" or some other
				legible form.
(4) The wording in a
				form and the form number are printed in easily readable type.
(5) Logos are or are not present and are more
				or less prominent than the company name.
(6) The full company name appears on the
				rider for filing purposes. The name is printed or added by rubber stamp or
				other appropriate means. This complies with §
									89b.11(a)
				(relating to general contents of forms).
(7) An administrative office address or the
				home office address is or is not shown. If an address is captioned as "home
				office," it is the official home office address of record.
(8) The form contains a caption:
(i) Disclosing the coverage
				provided-premature death, premature death/lifetime health care facility
				confinement or other descriptive disclosure.
(ii) For a rider, disclosing that the form is
				a rider, endorsement, agreement or amendment. An alternative caption may be
				used if the form provides that the form is "attached to and made a part of the
				policy."
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.5 - Conditions for filing claim

Current through Register Vol. 54, No. 28, July 13, 2024
The form discloses the conditions for the filing of
				  claims.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.6 - Facility of payment after death

Current through Register Vol. 54, No. 28, July 13, 2024
The form does not provide for the use of a facility of
				  payment to disburse benefit payments after the insured's death. The payments
				  are paid in accordance with the terms of the policy or an
				  assignment.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.7 - Facility of payment while living

Current through Register Vol. 54, No. 28, July 13, 2024
The form does or does not provide for the use of a facility
				  of payment to disburse benefit payments while the insured is
				  living.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.8 - Termination of coverage

Current through Register Vol. 54, No. 28, July 13, 2024
The form discloses the conditions under which the coverage
				  terminates.
(1)
Benefit
				provided by rider.
The following conditions are disclosed if the
				benefit is provided by a rider:
(i) Written
				request from the owner for termination.
(ii) Termination of the policy.
(iii) Nonpayment of premium.
(iv) The benefit is paid. This condition is
				disclosed if the benefit is built into a policy.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.9 - Prohibited terminology

Current through Register Vol. 54, No. 28, July 13, 2024
The following terminology is not present:
(1) The term "special," unless used in
				reference to or to designate one or more of the following: a premium payment
				mode, a premium rating class, a settlement option or options under a policy.
				This complies with §
									89.13(c)
				(relating to use of certain words and terms).
(2) The term "deposit," unless used in
				conjunction with the word "premium" or the payment establishes a
				debtor-creditor relationship. This complies with §
									87.28 (relating to reference to
				payment as "deposit").
(3) The term
				"legal reserve", the absence of which complies with Chapter 139 (relating to
				prohibited phrases).
(4) The term
				"franchise."
(5) The term
				"sponsor," unless used in reference to an entity which pays all or part of the
				premium or is a pension or welfare plan sponsor under ERISA.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.10 - Inconsistent or contradictory language

Current through Register Vol. 54, No. 28, July 13, 2024
The form contains no inconsistent or contradictory language
				  or provisions.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.11 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The form contains a definition or explanation of any
				  terminology that in the absence of definition or explanation would not be
				  understood by a lay person of average intelligence.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.12 - Fraternal benefit society

Current through Register Vol. 54, No. 28, July 13, 2024
If a form will be issued by a fraternal benefit society,
				  nonstandard insurance terminology is or is not used. This complies with §
									89.102(b)(3)
				  (relating to guidelines for approval of forms).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.13 - Riders

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If a rider will
				be attached to a policy after issue, the form contains an officer's signature.
				If a rider will be attached to a policy only at issue, an officer's signature
				is or is not present.
(b) A rider
				contains a form number. This complies with §
									89b.11(b)
				(relating to general contents of forms).
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.14 - Tax consequences notice

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				The form contains a clear statement that the tax status of the accelerated
				death benefit payment is not clear at this time and that the owner should seek
				additional information from his personal tax advisor. The statement appears in
				a prominent position in prominent type on the first page of the rider, or the
				policy if the benefit is built into the policy. Prominent type means, for
				example, all capital letters, contrasting color, underlined or otherwise
				differentiated from the other type in the form.
(b) If the tax status is determined by
				legislation or Internal Revenue Service ruling, a tax consequences notice will
				not be required until further notification.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.15 - Disclosure and benefit payment notice

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The insurer certifies that no later than
				the time the application for the benefit is signed, the agent, broker or
				insurer will provide the applicant with a written disclosure of the benefit
				providing:
(1) An explanation of how payment
				of the benefit affects the death benefit and any policy accumulation values,
				cash values, loan balance and premium.
(2) An explanation of how the termination or
				maturity of the policy affects the benefit.
(3) A description of the amount of the
				benefit.
(4) A disclosure of
				exclusions, reductions or limitations.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.16 - Actuarial considerations

Current through Register Vol. 54, No. 28, July 13, 2024
Actuarial considerations for forms designed as a settlement
				  of the life insurance proceeds based on a reduced life expectancy of the
				  insured.
(1) The insurer files the
				current mortality and interest and the formula used to determine the settlement
				amount. The insurer also files sample settlement amounts per $1,000 insurance
				for representative ages and plans and a sample calculation in the format that
				the Insurance Department can reproduce the settlement amount.
(2) The insurer certifies in writing that it
				will file future changes on the basis of the calculation of the settlement
				amount. It will file changes in the mortality table or formula and changes in
				the interest rate of more than 1/2 of 1%.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.1 - Scope

Current through Register Vol. 54, No. 28, July 13, 2024
An individual health care facility benefit filing complying
				  with the standards of this chapter is acceptable.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.2 - General provisions

Current through Register Vol. 54, No. 28, July 13, 2024
An individual health care facility benefit filing complying
				  with the following is acceptable:
(1)
				The submission letter for a form complies with applicable requirements of
				§
									89b.5 (relating to letter of
				submission). For a rider, the submission letter includes a list of the
				contracts to which the rider will be attached.
(2) The form is submitted in duplicate. This
				complies with §
									89b.4(a)
				(relating to general filing procedure).
(3) The form is submitted in the final
				printed form intended for actual issue, unless the insurer requests tentative
				approval under §
									89.4(d)
				(Reserved). A form submitted for tentative
				approval is in draft, printer's-proof, photocopied, "filer" or some other
				legible form.
(4) The form number
				and the wording of the form are printed in easily readable type.
(5) Logos are or are not present and are more
				or less prominent than the company name.
(6) The full company name appears on a rider
				for filing purposes. The name is printed or added by rubber stamp or other
				appropriate means. This complies with §
									89b.11(a)
				(relating to general contents of forms).
(7) An administrative office address or the
				home office address is or is not shown. If an address is captioned as "home
				office," it is the official home office address of record.
(8) The form contains a caption:
(i) Disclosing the coverage provided-health
				care facilities, long term care or other descriptive disclosure.
(ii) For a rider, disclosing that the form is
				a rider, endorsement, agreement or amendment. An alternative caption may be
				used if the form provides that the form is "attached to and made a part of the
				policy."
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.3 - Benefit design

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Benefit paid if elected by owner.
(1) The form discloses that a benefit will be
				paid if elected by the owner when the insured receives care from a designated
				health care facility. The form designates one or more types of health care
				facilities. The following are types of health care facilities: skilled nursing
				facility, extended care facility, intermediate care facility, convalescent care
				facility, personal care facility, home care facility or hospice facility. This
				is not an all inclusive list of types of health care facilities which may be
				designated.
(2) The form does or
				does not provide that the cause for the need of care from the health care
				facility is sickness or injury.
(3)
				The cause for the need of care from the health care facility is not restricted
				to one or more specific medical condition. A medical condition, except as
				excluded in accordance with §
										90g.4 (relating to exclusions and
				restrictions), is acceptable.
(4)
				The form does not provide that the cause may not be sickness.
(5) The form does not provide that the cause
				may not be injury.
(6) The form
				does or does not provide that the care from health care facilities is medically
				necessary. If the form provides that the care from health care facilities is
				medically necessary, the form contains a definition of "medically
				necessary."
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.5 - Claim provisions

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
				form contains the following claim provisions:
(1)
Notice of claim.
Written
				notice of claim is to be given to the insurer within 20 days after the
				occurrence or commencement of a covered loss or as soon thereafter as is
				reasonably possible. Notice given by or on behalf of the insured to the insurer
				at
(insert the location of the office as the insurer may
				  designate) or to an authorized agent of the insurer, with information
				  sufficient to identify the insured, is deemed notice to the insurer.
(2)
Claim forms.
The insurer upon receipt of a notice of claim, is required to furnish to the
				claimant forms as are usually furnished by it for filing proofs of loss. If the
				forms are not furnished within 15 days after the giving of the notice of claim,
				it is considered that the claimant complied with the requirements of this
				contract as to proof of loss if the claimant submits, within the time fixed in
				the contract for filing proofs of loss, written proof covering the occurrence,
				the character and the extent of the loss for which claim is made.
(3)
Proofs of loss.
Written
				proof of loss is to be furnished to the insurer at its office, in case of claim
				for loss for which this contract provides a periodic payment contingent upon
				continuing loss, within 90 days after the termination of the period for which
				the insurer is liable, and in case of claim for another loss, within 90 days
				after the date of the loss. Failure to furnish proof within the time required
				does not invalidate nor reduce a claim if it was not reasonably possible to
				give proof within that time, if the proof is furnished as soon as reasonably
				possible and in no event, except in the absence of legal capacity, later than 1
				year from the time proof is otherwise required.
(4)
Time of payment of
				claims.
Indemnities payable under this contract for any loss other
				than loss for which this contract provides any periodic payment are due
				immediately upon receipt of due written proof of such loss. Subject to due
				written proof of loss, all accrued indemnities for loss for which this contract
				provides periodic payment are to be paid
(insert period for payment).
(5)
Payment of claims.
Benefits are to be paid to the owner or owner's estate while the insured is
				living, unless they have been assigned elsewhere.
(6)
Physical examinations.
The insurer as its own expense has the right and opportunity to examine the
				person of the insured when and as often as it may reasonably require during the
				pendency of a claim thereunder.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.6 - Facility of payment after death

Current through Register Vol. 54, No. 28, July 13, 2024
The form does not provide for the use of a facility of
				  payment to disburse health care facilities benefit payments after the insured's
				  death. The payments are paid in accordance with the terms of the policy or any
				  assignment.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.7 - Facility payment while living

Current through Register Vol. 54, No. 28, July 13, 2024
The form does or does not provide for the use of a facility
				  of payment to disburse health care facilities benefit payments while the
				  insured is living.
Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90g - INDIVIDUAL HEALTH CARE FACILITY BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90g.8 - Termination of coverage

Current through Register Vol. 54, No. 28, July 13, 2024
The form discloses the conditions under which the coverage
				  terminates.
(1)
Benefit
				provided by rider.
(i) The following
				conditions are disclosed if the benefit is provided by a rider:
(A) Written request from the owner for
				termination.
(B) Termination of the
				policy.
(C) Nonpayment of
				premium.
(D) The total amount of
				the paid benefits equals the maximum lifetime benefit amount. This condition is
				disclosed if a benefit is built into a policy.