California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 3 - Insurers
Article 12 - Disability Insurance Advertisements
Section 2536.11 - Introductory, Initial or Special Offers

Universal Citation: 10 CA Code of Regs 2536.11

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a)

(1) An advertisement of an individual policy shall not directly or by implication represent that a contract or combination of contracts is an introductory, initial or special offer, or that applicants will receive substantial advantages not available at a later date, or that the offer is available only to a specified group of individuals, unless such is the fact. An advertisement shall not contain phrases describing an enrollment period as "special," "limited," or similar words or phrases when the insurer uses such enrollment periods as the usual method of advertising disability insurance.

GUIDELINE 2536.11(a)(1)

This Subsection prohibits advertising representing that a product is offered on an introductory, initial, special offer basis or otherwise which (a) will not be available later; or (b) is available only to certain individuals unless such is the fact. This rule prohibits the repetitive use of such advertisements. Where an insurer uses enrollment periods as the usual method of advertising these policies, the rule prohibits describing an enrollment period as a special opportunity or offer for the applicant.

(2) An enrollment period during which a particular insurance product may be purchased on an individual basis shall not be offered within a specified geographical area in this State unless there has been a lapse of not less than three months between the close of the immediately preceding enrollment period for the same product and the opening of the new enrollment period. The phrase "a specified geographical area" means one or more of the following groups of counties:
(A) San Francisco, Marin, Sonoma, Napa, Solano, Alameda, Contra Costa and San Mateo,

(B) Sacramento, Amador, Alpine and North to the Oregon border,

(C) Santa Clara, Santa Cruz, San Benito and Monterey,

(D) San Joaquin, Stanislaus, Merced, Fresno, Kings, Kern and East to the Nevada border. Kern County may be included in either this Area (D) or in Area (E) below at the option of the insurer.

(E) San Luis Obispo, Santa Barbara and Ventura,

(F) Los Angeles, Orange, Riverside and San Bernardino,

(G) San Diego and Imperial.

The advertisement shall indicate the date by which the applicant must mail the application which shall be not less than ten days and not more than forty days from the date that such enrollment period is advertised for the first time. This applies to all advertising media, i.e., mail, newspapers, radio, television, magazines and periodicals, used by any one insurer. The phrase "any one insurer" includes all the affiliated companies of a group of insurance companies under common management or control. This is inapplicable to solicitations of employees or members of a particular group or association which otherwise would be eligible under specific provisions of the Insurance Code for group, blanket or selected group (franchise) insurance.

GUIDELINE 2536.11(a)(2)

This Subsection restricts the repetitive use of enrollment periods. The requirement of reasonable closing dates and waiting periods between enrollment periods was adopted to eliminate the abuses which formerly existed. This rule does not limit just the use of enrollment periods. It requires that a particular insurance product offered in an enrollment period through any advertising media, including the prepared presentations of agents, cannot be offered again in a specified geographical area in this State until three months from the close of the enrollment period have expired. Thus, an insurer must choose whether to use enrollment periods or open enrollment for a product. (See Subsection 2536.11(a)(4) for definition of "a particular insurance product.")

This Subsection gives an insurer the option of applying the three month rule on a state-wide basis or on the basis of the geographical areas specified therein.

This Subsection does not prohibit multiple advertising during an enrollment period through any and all media published or transmitted within a specified geographical area in this state as long as the enrollment periods for all such advertisements have the same expiration date.

This Subsection does not prohibit the solicitation of members of a group or association for the same product even though there has not been a lapse of three months since the close of a preceding enrollment period which was open to the general public for the same product.

This Subsection does not require separation by three months of enrollment periods for the same insurance product in this state if the advertising material is directed by an admitted insurer to persons by direct mail on the basis that a common relationship exists with an entity, such as a bank and its depositors, a department store and its charge account customers or an oil company and its credit card holders, and more than one of such organizations is sponsoring such insurance product at different times if providing such insurance under such a method is not otherwise prohibited by law; provided, however, the three month rule does apply to one specific sponsor and the same persons in a specified geographical area in this state on the basis of their status as customers of that one specific entity only.

(3) This prohibits any statement or implication to the effect that only a specific number of policies will be sold, or that a time is fixed for the discontinuance of the sale of the particular policy advertised because of special advantages available in the policy, unless such is the fact.

GUIDELINE 2536.11(a)(3)

This Subsection is self-explanatory.

(4) The phrase "a particular insurance product" in subdivision (2) of this Section means an individual policy which provides substantially different benefits than those contained in any other policy. Different terms of renewability; an increase or decrease in the dollar amounts of benefits; an increase or decrease in any elimination period or waiting period from those available during an enrollment period for another policy shall not be sufficient to constitute the product being offered as a different product eligible for concurrent or overlapping enrollment periods.

GUIDELINE 2536.11(a)(4)

This Subsection defines the meaning of "a particular insurance product" in Section 2536.11(a)(2) and prohibits advertising of products having minor variations, such as different elimination periods or different amounts of daily hospital indemnity benefits, in a succession of enrollment periods.

(b) An advertisement shall not offer a policy which utilizes a reduced initial premium rate in a manner which overemphasizes the availability and the amount of the initial reduced premium. When an insurer charges an initial premium that differs in amount from the amount of the renewal premium payable on the same mode, the advertisement shall not display the amount of the reduced initial premium either more frequently or more prominently than the renewal premium, and both the initial reduced premium and the renewal premium must be stated in juxtaposition in each portion of the advertisement where the initial reduced premium appears.

GUIDELINE 2536.11(b)

This Subsection prohibits advertising which overemphasizes an initial reduced premium. The rule requires the renewal premium to appear as frequently as, as prominently as and in juxtaposition with the initial reduced premium wherever and as often as it appears. The term "juxtaposition" means side by side or immediately above or below.

(c) Special awards, such as a "safe drivers' award" shall not be used in connection with advertisements of disability insurance.

GUIDELINE 2536.11(c)

This Subsection prohibits the use in advertisements of so-called awards as an inducement to the purchase of insurance.

1. Amendment filed 11-29-74; effective thirtieth day thereafter (Register 74, No. 48).

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