TAX ADMINISTRATION

Except as otherwise authorized under the Lien Method for determining benefits under § 3.4306 (3) of this title (relating to Methods for Determining Benefits and Allowable Charges and Fees), if the cash values are reduced by the acceleration-of-life-insurance benefit, related char…

Unless the insurer is using the Lien Method for determining benefits under § 3.4306 (3) of this title (relating to Methods for Determining Benefits and Allowable Charges and Fees), if there is a loan on the life insurance contract, the insurer may deduct up to a pro rata portion …

An acceleration-of-life-insurance benefit provision or rider shall be disregarded in ascertaining nonforfeiture benefits under the Insurance Code Chapter 1105. Notes 28 Tex. Admin. Code § 3.4309 The provisions of this §3.4309 adopted to be effective March 1, 1998, 23 TexReg 1585;…

(a) Reserves for an acceleration-of-life-insurance benefit shall be based on tables of disablement, morbidity, or mortality appropriate for determining liability for the benefits provided. Such disablement or morbidity tables shall be certified as appropriate by a member of the A…

(a) Acceleration-of-life-insurance benefit provisions are subject to the Insurance Code Chapter 541 (concerning Unfair Methods of Competition and Unfair or Deceptive Acts or Practices) and rules promulgated under Chapter 541. (b) Insurers offering acceleration-of-life-insurance b…

(a) Except as otherwise stated in this section, every life insurance contract containing an acceleration-of-life-insurance benefit provision shall be subject to the notice and disclosure requirements in paragraphs (1)-(5) of this section. (1) Except as otherwise provided in this …

(a) Any "invitation to contract," as defined in § 21.102 of this title (relating to Scope), used in the marketing, solicitation or sale of a life insurance contract containing an acceleration-of-life-insurance provision shall clearly and concisely disclose the following: (1) the …

When a life insurance contract provides for payment of long-term care expenses funded through an acceleration-of-life-insurance benefit provision, the long-term care provisions of the contract must meet the following requirements of Subchapter Y of this chapter (relating to Stand…

(a) On or after the effective date of this subchapter, no life insurance contract providing for acceleration-of-life-insurance benefits may be represented to be tax-qualified under federal law governing taxation of such benefits unless such benefits meet the requirements set fort…

(a) Except as provided in subsection (e) of this section, on or after the effective date of this subchapter, if an insurer markets, delivers, issues for delivery or renews a life insurance contract in Texas that provides only acceleration-of-life-insurance benefits that are inten…

This subchapter, as adopted by the commissioner, applies to all life insurance contracts marketed, delivered, issued for delivery, or renewed in Texas on or after the effective date of the subchapter, which will be 20 days after the date the adopted subchapter is filed with the O…

(a) The purpose of this subchapter is to provide: (1) Tables of select mortality factors and rules for their use; (2) Rules concerning a minimum standard for the valuation of plans with nonlevel premiums or benefits; and (3) Rules concerning a minimum standard for the valuation o…

The six tables of select mortality factors adopted in this section are from the NAIC model regulation titled "Valuation of Life Insurance Policies Model Regulation" which was adopted by the NAIC on March 8, 1999. The six tables of base select mortality factors include: male aggre…

This subchapter applies to all life insurance policies, with or without nonforfeiture values, issued on or after January 1, 2000, and before January 1, 2017, subject to the following exceptions in paragraph (1) of this section and conditions in paragraph (2) of this section. For …

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Basic reserves--reserves calculated in accordance with the principles of the Insurance Code § 425.064 . (2) Contract segmentation me…

(a) At the election of the company for any one or more specified plans of life insurance, the minimum mortality standard for basic reserves may be calculated using the 1980 CSO valuation tables with select mortality factors (or any other valuation mortality table adopted by the N…

(a) Basic reserves. Basic reserves must be calculated as the greater of the segmented reserves and the unitary reserves. Both the segmented reserves and the unitary reserves for any policy must use the same valuation mortality table and selection factors. At the option of the ins…

(a) General. (1) Policies with a secondary guarantee include: (A) a policy with a guarantee that the policy will remain in force at the original schedule of benefits, subject only to the payment of specified premiums; (B) a policy in which the minimum premium at any duration is l…

This subchapter is effective January 1, 2000. Notes 28 Tex. Admin. Code § 3.4508 The provisions of this §3.4508 adopted to be effective January 1, 2000, 24 TexReg 9650

The 2001 CSO Mortality Table shall be used for purposes of this subchapter pursuant to the requirements of §§ 3.9101 - 3.9106 of this title (relating to 2001 CSO Mortality Table). Notes 28 Tex. Admin. Code § 3.4509 The provisions of this §3.4509 adopted to be effective April 14, …

(a) All filings submitted pursuant to this subchapter must be identified under specific filing authorities as defined by the Insurance Code or Administrative Code. The authorities under which all filings are identified are described in paragraphs (1) - (4) of this subsection as f…

A filing for any product for which an outline of coverage, written description of plan terms and conditions, or similar disclosure is required must include a copy of the required disclosure document for review or a reference to the filing ID that the disclosure document was separ…

This subchapter is adopted pursuant to the authority provided in Insurance Code, Chapter 1153. This subchapter applies to all life insurance and all accident and health insurance sold in connection with loans and other credit transactions, the premium for which is charged to or p…

The following words and terms, when used in this chapter, have the following meanings unless the context clearly indicates otherwise. (1) Account--The aggregate credit life insurance or credit accident and health coverage for a single class of business written through a single cr…

(a) The purpose of this subchapter is to implement Insurance Code Chapter 1698, concerning Rates for Certain Coverage, and to establish an effective rate review program in the individual and small group markets, consistent with 45 CFR § 154.301 , concerning CMS's Determinations o…

For purposes of this subchapter, the following terms have the meanings indicated, except where the context clearly indicates otherwise: (1) Actuarial value (AV)--As defined in 45 CFR § 156.20 , concerning Definitions. (2) Cost-sharing reductions (CSRs)--As defined in 45 CFR § 155…

A rate filing filed under this subchapter must comply with all applicable state and federal requirements, including: (1) Insurance Code Chapter 560, concerning Prohibited Rates; (2) Insurance Code § 843.2071 , concerning Notice of Increase in Charge for Coverage; (3) Insurance Co…

(a) An issuer may vary rates based on rating area, which is determined: (1) in the individual market, using the primary policyholder's or contract holder's address; and (2) in the small group market, using the group policyholder's or contract holder's principal business address. …

(a) An issuer may not use a rate with respect to a plan if: (1) the issuer has not filed the rate with TDI for review; (2) the rate filing does not comply with the standards in § 3.503 of this title (relating to Rating Standards); or (3) the rate filing has been withdrawn. (b) Ea…

(a) Upon receipt of a rate filing under this subchapter, TDI will evaluate whether the issuer has provided sufficient data and documentation for TDI to make the determinations specified in this section. If the level of detail provided by the issuer under § 3.505 of this title (re…

(a) Information related to proposed annual rate increases of 15% or more will be publicly available on the website published by the Centers for Medicare and Medicaid Services (CMS). A link to the CMS website will be posted on TDI's website: www.tdi.texas.gov/health/ratereview.htm…

(a) An issuer may not impose any restriction on the form or manner of the payment of premiums or cost-sharing for accident, health, or HMO coverage, unless the restriction is clearly disclosed in the application and the policy, certificate, or contract. (b) A policy, certificate,…

When credit life or credit accident and health insurance is required as additional security for any indebtedness, the person processing the indebtedness transaction shall advise the debtor prior to completion of the transaction of the debtor's right to furnish the required amount…

All credit life insurance and credit accident and health insurance shall be evidenced by an individual policy, or in the case of group insurance by a certificate of insurance, which in either case shall be delivered to the debtor. Notes 28 Tex. Admin. Code § 3.5102 The provisions…

Each individual policy or group certificate of credit life insurance or credit accident and health insurance delivered or issued for delivery in this state must, in addition to the other requirements of law, set forth: (1) the name and home office mailing address of the insurer, …

(a) Refunds will be due as follows. (1) If an accident and health insurance claim is in progress at the time of discharge of the indebtedness, such claim shall continue during the originally scheduled term of insurance, as if there had been no such discharge of indebtedness. Upon…

(a) If said individual policy or group certificate of insurance is not delivered to the debtor at the time the indebtedness is incurred, a copy of the application for such individual policy or a notice of such proposed group insurance coverage shall be delivered to the debtor at …

(a) The policy or certificate of insurance shall not contain provisions which would encourage misrepresentation or are unjust, unfair, inequitable, misleading, deceptive, or contrary to law or to the public policy of this state. A policy, certificate of insurance, notice of propo…

(a) If a debtor is covered by a group credit insurance policy providing for the payment of single premiums to the insurer, provision shall be made by the insurer that in the event of termination of the group policy for any reason, insurance coverage with respect to any debtor the…

If the creditor adds identifiable insurance charges or premiums for credit insurance to the indebtedness, and any direct or indirect finance, carrying, credit, or service charge is made to the debtor on such insurance charges or premiums, the creditor must remit and the insurer s…

(a) The group policy and certificate of insurance shall set forth that the debtor will be furnished a statement each billing cycle (but not less frequently than quarterly) which contains the following: (1) the amount of the debtor's insurance charge, shown separately for credit l…

(a) Any issuer required to provide notice to the department related to a termination by discontinuance or refusal to renew all guaranteed renewable major medical coverage in a given market or service area under § 3.3038 of this title (relating to Mandatory Guaranteed Renewability…

(a) Every insurance company, when submitting a schedule of rates for automatic or approved deviations from the presumptive premium rate, shall identify the rates to be used with the policy form submitted for approval. The face page of every form or schedule submitted to the commi…

As the basic test of the reasonableness of the relation of benefits to the premium charges for approved deviations, to be applied separately by policy form number, it is hereby declared that the benefits of credit life insurance or credit accident and health insurance, individual…

"Earned premium" means the total gross premiums which become due the insurance company, without reduction of any kind, except for premiums refunded or adjusted on account of termination of coverage, appropriately adjusted for changes in unearned premium reserve calculated as foll…

"Claims incurred" means the liability resulting from the happening of the contingency insured against whether paid, reported, not reported or resisted on accounting dates, valued by date of occurrence and, without reduction for reinsurance, at amounts, excluding claims expenses, …

Any individual policy, application, group policy, group certificate of insurance, or notice of proposed insurance shall be in full compliance with the law and this subchapter. All certificates of insurance shall be reflective of and not in contradiction to the provisions of the g…

The following presumptive premium rates are adopted by the commissioner and shall be used on or after January 1, 2006. Attached Graphic Notes 28 Tex. Admin. Code § 3.5206 The provisions of this §3.5206 adopted to be effective June 7, 2005, 30 TexReg 3210

(a) Joint lives, for purposes of credit life insurance written under Insurance Code Chapter 1153, mean only spouses or business partners, and such persons must be jointly and severally liable for repayment of the single indebtedness and be joint signers of the instrument of indeb…

Premiums and premium rates for insurance covering obligations payable in other than substantially equal monthly installments during the period of coverage shall be determined in a manner resulting in a rate not exceeding the mathematical equivalent of the foregoing rates. Notes 2…