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 3.3020 - Policy Definition of Guaranteed Renewable and Limited Guarantee of Renewability

Current through Reg. 49, No. 28; July 12, 2024
(a) In regards
				  to individual hospital, medical or surgical coverage, the term "guaranteed
				  renewable" shall not be defined more restrictively than set forth in §
										3.3038
				  of this title (relating to Mandatory Guaranteed Renewability Provisions for
				  Individual Hospital, Medical or Surgical Coverage; Exceptions). Unless the
				  policy or coverage also is noncancellable (as defined in §
										3.3019
				  of this title (relating to Policy Definition of Noncancellable), the policy
				  definition of guaranteed renewable shall state clearly that the insurer retains
				  the right, at the time of renewal of a policy, to make changes in premium rates
				  by classes.
(b) In regards to
				  excepted benefits:
(1) Except in the limited
				  circumstances delineated in paragraph (4) of this subsection the term
				  "guaranteed renewable" shall not be used unless the term is defined
				  consistently with subsection (a) of this section and mirrors all mandatory
				  provisions of §
											3.3038
				  of this title (relating to Mandatory Guaranteed Renewability Provisions for
				  Individual Hospital, Medical or Surgical Coverage; Exceptions).
(2) An insurer may use the term "limited
				  guarantee of renewability," which shall not be defined more restrictively than
				  the right of the insured to continue the coverage in force by the timely
				  payment of premiums until at least age 50, or in the case of a policy issued
				  after age 44, for at least five years from its date of issue, during which
				  period the insurer has no right to unilaterally make any change in any
				  provision of the policy while the policy is in force, except that the insurer
				  may make changes in premium rates by classes.
(3) Unless the policy or coverage also is
				  noncancellable (as defined in §
											3.3019
				  of this title (relating to Policy Definition of Noncancellable), the policy
				  definition of guaranteed renewable or of limited guarantee of renewability
				  shall state clearly that the insurer retains the right, at the time of renewal
				  of a policy, to make changes in premium rates by classes.
(4) An insurer may continue to issue through
				  May 31, 1998, policies from printed stock existing on the day before the
				  effective date of this subchapter that contain a policy definition of
				  "guaranteed renewable" conforming to the definition of the term allowed by rule
				  before the effective date of this subchapter. The previous definition, setting
				  the minimum standard for a guaranteed renewable policy, was the same as the
				  definition of limited guarantee of renewability, as set forth in paragraph (2)
				  of this subsection. An insurer may not print any new policies offering excepted
				  benefits on or after the effective date of this subchapter which use policy
				  language describing the policy as "guaranteed renewable," unless such policy
				  also conforms to the definition of "guaranteed renewable" set forth in
				  subsection (a) of this section and in §
											3.3038
				  of this title (relating to Mandatory Guaranteed Renewability Provisions for
				  Individual Hospital, Medical or Surgical Coverage; Exceptions) of this
				  subchapter.