Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 21 - Rules Governing Advertisements of Accident and Sickness Insurance › Section 21-6 - Advertisements of Benefits Payable, Losses Covered or Premiums Payable

Current through July 13, 2024
(a) Covered Benefits:
(i) The use of deceptive words, phrases, or
				illustrations in accident and sickness insurance advertisements is
				prohibited.
(ii) An advertisement
				that fails to state clearly the type of insurance coverage being offered is
				prohibited.
(iii) An advertisement
				shall not omit information or use words, phrases, statements, references, or
				illustrations if the omission or use has the capacity, tendency, or effect of
				misleading or deceiving purchasers or prospective purchasers as to the nature
				or extent of any policy benefit payable, loss covered, or premium payable. The
				fact the policy offered is made available to a prospective insured for
				inspection prior to consummation of the sale or an offer is made to refund the
				premium if the purchaser is not satisfied, does not remedy misleading
				statements.
(iv) An advertisement
				shall not contain or use words or phrases such as "all," "full," "complete,"
				"comprehensive," "unlimited," "up to," "as high as," "this policy will help
				fill some of the gaps Medicare and your present insurance leave out," "this
				policy will help replace your income," (when used to express loss of time
				benefits), or similar words and phrases, in a manner that exaggerates any
				benefits beyond the policy's terms.
(v) An advertisement of a hospital or other
				similar facility confinement benefit referencing direct payment of the benefit
				to the policyholder is prohibited unless, in making the reference, the
				advertisement includes a statement that the benefits may be paid directly to
				the hospital or other health care facility if the policyholder assigns their
				benefits. An advertisement of medical and surgical expense benefits shall
				comply with this regulation. Phrases such as "you collect," "you get paid,"
				"pays you," or other words or phrases of similar import may be used so long as
				the advertisement indicates it is payable to the insured or someone designated
				by the insured.
(vi) An
				advertisement for limited benefit health coverage or coverage of only certain
				types of loss is prohibited if:
(A) The
				advertisement refers to a total benefit maximum limit payable under the policy
				in any headline, lead-in, or caption without also in the same headline,
				lead-in, or caption specifying the applicable daily limits and other internal
				limits;
(B) The advertisement
				states a total benefit limit without stating the periodic benefit payment, if
				any, and the length of time the periodic benefit would be payable to reach the
				total benefit limit; or
(C) The
				advertisement prominently displays a total benefit limit that would not, as a
				general rule, be payable under an average claim.
(vii) Section 6(a)(vi) does not apply to
				individual major medical expense coverage, individual basic medical expense
				coverage, or disability income insurance.
(viii) Advertisements emphasizing total
				amounts payable under hospital, medical, or surgical accident and sickness
				insurance coverage or other benefits in a policy, such as benefits for private
				duty nursing, are prohibited unless the actual amounts payable per day for the
				indemnity or benefits are stated.
(ix) Advertisements examples of benefits
				payable under a policy shall not use examples in a way that implies the maximum
				payable benefit under the policy will be paid when less than maximum benefits
				are paid in an average claim.
(x)
				When an advertisement sets forth a range of benefit levels, it shall be clear
				the insured will receive only the benefit level written or printed in the
				policy selected and issued. Language implying the insured may select the
				benefit level at the time of filing claims is prohibited.
(xi) Language in an advertisement implying
				the amount of benefits payable under a loss-of-time policy may be increased at
				the time of claim or disability according to the needs of the insured is
				prohibited.
(xii) Advertisements
				for policies with modest premiums due to limited coverage or limited amounts of
				benefits shall not describe premiums as "low," "low cost," "budget," or use
				qualifying words of similar import. The use of words such as "only" and "just"
				in conjunction with statements of premium amounts when used to imply a bargain
				is prohibited.
(xiii)
				Advertisements stating or implying premiums will not be changed in the future
				are prohibited unless the advertised policies expressly provide that the
				premiums will not be changed in the future.
(xiv) An advertisement for a policy that does
				not require the premium to accompany the application shall not overemphasize
				that fact and shall clearly indicate under what circumstances coverage will
				become effective.
(xv) An
				advertisement exaggerating the effects of statutorily mandated benefits or
				required policy provisions or implying the provisions are unique to the
				advertised policy is prohibited.
(xvi) An advertisement implying that a common
				type of policy or a combination of common benefits is "new," "unique," "a
				bonus," "a breakthrough," or is otherwise unusual is prohibited. The addition
				of a novel method of premium payment to an otherwise common plan of insurance
				does not render it new.
(xvii)
				Language in an advertisement stating or implying that each member under a
				family contract is covered as to the maximum benefits advertised where that is
				not the fact is prohibited.
(xviii)
				An advertisement containing statements such as "anyone can apply," or "anyone
				can join," other than with respect to a guaranteed issue policy for which
				administrative procedures exist to assure the policy is issued within a
				reasonable period of time after the application is received by the insurer, is
				prohibited.
(xix) An advertisement
				stating or implying immediate coverage of a policy is prohibited unless
				administrative procedures exist so the policy is issued within fifteen (15)
				working days after the insurer receives the completed application.
(xx) An advertisement containing statements
				such as "here is all you do to apply," "simply," or "merely" to refer to the
				act of applying for a policy that is not a guaranteed issue policy is
				prohibited unless it refers to the fact that the application is subject to
				acceptance of approval by the insurer.
(xxi) An advertisement of accident and
				sickness insurance sold by direct response shall not state or imply that
				because no insurance agent will call and no commissions will be paid to agents
				that it is a low cost plan, or use other similar words or phrases because the
				cost of advertising and servicing the policies is a substantial cost in the
				marketing by direct response.
(xxii) Applications, request forms for
				additional information, and similar related materials are prohibited if they
				resemble paper currency, bonds, stock certificates, etc., or use any name,
				service mark, slogan, symbol, or device in a manner implying the insurer or the
				policy advertised is connected with a government agency, such as the Social
				Security Administration or the Department of Health and Human
				Services.
(xxiii) An advertisement
				implying in any manner that the prospective insured may realize a profit from
				obtaining hospital, medial, or surgical insurance coverage is
				prohibited.
(xxiv) An advertisement
				using words such as "extra," "special," or "added" to describe a benefit in the
				policy is prohibited. No advertisement of a benefit for which payment is
				conditioned upon confinement in a hospital or similar facility shall use words
				or phrases such as "tax free," "extra cash," "extra income," "extra pay," or
				substantially similar words or phrases because these words and phrases have the
				capacity, tendency, or effect of misleading the public into believing the
				policy advertised will, in some way, enable them to make a profit from being
				hospitalized.
(xxv) An
				advertisement of a hospital or other similar facility confinement benefit shall
				not advertise that the amount of the benefit is payable on a monthly or weekly
				basis when, in fact, the amount of the benefit payable is based upon a daily
				pro rata basis relating to the number of days of confinement unless the
				statements of the monthly or weekly benefit amounts are juxtaposed with equally
				prominent statements of the benefit payable on a daily basis. The term
				"juxtaposed" means side by side or immediately above or below. When the policy
				contains a limit on the number of days of coverage provided, such limit must
				appear in the advertisement.
(xxvi)
				An advertisement of a policy covering only one disease or a list of specified
				diseases shall not imply coverage beyond the policy terms. Synonymous terms
				shall not be used to refer to any disease so as to imply broader coverage than
				is the fact.
(xxvii) An
				advertisement that is an invitation to contract for a specified disease policy
				that provides lesser benefit amounts for a particular subtype of disease, shall
				clearly disclose the subtype and its benefits. This provision shall not apply
				to institutional advertisements.
(xxviii) An advertisement of a specified
				disease policy providing expense benefits shall not use the term "actual" when
				the policy only pays up to a limited amount for expenses. Instead, the term
				"charges" or substantially similar language should be used which does not
				create the misleading impression that there is full coverage for
				expenses.
(xxix) An advertisement
				describing any benefits which vary by age shall disclose that fact.
(xxx) An advertisement using a phrase such as
				"no age limit" if benefits or premiums vary by age or if age is an underwriting
				factor shall disclose that fact.
(xxxi) A television, radio, mail, or
				newspaper advertisement, or lead-generating device designed to produce leads
				either by use of a coupon, a request to write or to call the company, or a
				subsequent advertisement prior to contact shall include information disclosing
				that an agent may contact the applicant.
(xxxii) Advertisements, applications,
				requests for additional information, and similar materials are prohibited if
				they state or imply that the recipient has been individually selected to be
				offered insurance or has had his or her eligibility for the insurance
				individually determined in advance when the advertisement is directed to all
				persons in a group or to all persons whose names appear on a mailing
				list.
(xxxiii) An advertisement,
				including invitations to inquire or invitations to contract, shall not employ
				devices designed to create undue fear or anxiety in those to whom they are
				directed. Examples of prohibited devices are:
(A) Using phrases such as "cancer kills
				somebody every two minutes" and "total number of accidents" without reference
				to the total population from which the statistics are drawn;
(B) Exaggerating the importance of diseases
				rarely or seldom found in the class of persons to whom the policy is
				offered;
(C) Using phrases such as
				"the finest kind of treatment," implying that the treatment would be
				unavailable without insurance;
(D)
				Reproducing newspaper articles, magazine articles, information from the
				Internet, or other similar published material containing irrelevant facts and
				figures;
(E) Using images unduly
				emphasizing automobile accidents, disabled persons or persons confined in beds
				who are in obvious distress, persons receiving hospital or medical bills, or
				persons being evicted from their homes due to their medical bills.
(F) Using phrases such as "financial
				disaster," "financial distress," "financial shock," or another phrase implying
				financial ruin is likely without insurance. Using such phrases is only
				permissible in advertising major medical expense coverage, individual basic
				medical expense coverage, or disability income coverage, and only if the phrase
				does not dominate the advertisement;
(G) Using phrases or devices that unduly
				excite fear of dependence upon relatives or charity; and
(H) Using phrases or devices implying that
				long sicknesses or hospital stays are common among the elderly.