Current through Register Vol. 38, No. 18, March 15, 2024
(a) Descriptive Title. The
term "accelerated benefit" shall be included in the descriptive title printed on the first page of the policy
or rider. Products regulated under this Section shall not be described or marketed as long-term care
insurance or as providing long-term care benefits.
(b) Tax
Consequences. A disclosure statement is required at the time of application for the policy or rider and at
the time the accelerated benefit payment request is submitted, which statement shall advise that receipt of
accelerated benefits may be taxable and that assistance should be sought from a personal tax advisor. The
statement shall be prominently displayed on the first page of the policy or rider and on any other related
documents.
(c) Solicitation:
(1) A written disclosure including, but not limited to, a brief description
of the accelerated benefit and definitions of the conditions or occurrences triggering payment of the
benefits shall be given to the applicant. The description shall include an explanation of any effect of the
payment of a benefit on the policy's cash value, accumulation account, death benefit, premium, policy loans
and policy liens:
(A) In the case of agent solicited insurance, the agent
shall provide the disclosure form to the applicant prior to or concurrently with the application.
Acknowledgement of the disclosure shall be signed by the applicant and writing agent.
(B) In the case of a solicitation by direct response methods, the insurer
shall incorporate the disclosure in the application or attach a disclosure form thereto.
(C) In the case of group insurance policies, the disclosure form shall be
contained as part of the certificate of coverage or any related document furnished by the insurer for the
certificate holder.
(2) If there is a premium or cost
of insurance charge, the insurer shall give the applicant a generic illustration numerically demonstrating
any effect of the payment of a benefit on the policy's cash value, accumulation account, death benefit,
premium, policy loans and policy liens:
(A) In the case of agent solicited
insurance, the agent shall provide the illustration to the applicant prior to or concurrently with the
application.
(B) In the case of a solicitation by direct response
methods, the insurer shall provide the illustration to the applicant at the time the policy is
delivered.
(C) In the case of group insurance policies, the
disclosure form shall be contained as part of the certificate of coverage or any related document furnished
by the insurer for the certificate holder.
(3)
Disclosure of Premium Charge:
(A) Insurers with financing options other than
those described in 11 NCAC 12
.1210(a)(2) shall disclose to the policy owner any premium or cost
of insurance charge for the accelerated benefit. Each insurer shall make a reasonable effort to assure that
the certificate holder is aware of any additional premium or cost of insurance charge if the certificate
holder is required to pay such charge.
(B) Each insurer shall
furnish an actuarial demonstration to the Department when filing a policy form containing an accelerated
benefit, which demonstration shall disclose the method of arriving at the insurer's cost for the accelerated
benefit.
(4) Disclosure of Administrative Expense
Charge. Each insurer shall disclose to each policy owner any administrative expense charge. Each insurer
shall make a reasonable effort to assure that each certificate holder is aware of any administrative expense
charge if the certificate holder is required to pay such charge.
(d) Effect of the Benefit Payment. When a policy owner or certificate
holder requests an acceleration, the insurer shall send a statement to the policy owner or certificate holder
and irrevocable beneficiary showing any effect that the payment of the accelerated benefit will have on the
policy's cash value, accumulation account, death benefit, premium, policy loans and policy liens. The
statement shall disclose that:
(1) receipt of accelerated benefit payments
may adversely affect the recipient's eligibility for Medicaid or other government benefits or entitlement;
and that
(2) receipt of an accelerated benefit payment may be
taxable and assistance should be sought from a personal tax advisor.
Each time an accelerated benefit option is exercised the policy owner and
certificate holder shall be given an endorsement, rider or schedule page that reflects any revisions to cash
values, death benefits, accumulation accounts, premiums, policy loans, policy liens and any other values that
change as a result of the payment or payments. When a previous disclosure statement becomes invalid as a
result of an acceleration of the death benefit, the insurer shall send a revised disclosure statement to the
policy owner or certificate holder and irrevocable beneficiary. When the insurer agrees to accelerate death
benefits, the insurer shall issue an amended schedule page to the policyholder or notify the certificate
holder under a group policy to reflect any new, reduced in-force face amount of the
contract.
Authority
G.S.
58-2-40;
58-3-150;
58-7-15(1);
58-58-1;
Eff. March 1, 1992;
Pursuant to
G.S.
150B-21.3A, rule is necessary without substantive public interest Eff. May
1, 2018.
