Current through Register Vol. 54, No. 44, November 2, 2024
(a)
A and H benefit plans.
The prima facie premium rate standards referenced in §
73.109 (relating to A and H
insurance rate standards) apply to a plan of credit A and H insurance benefits,
if the plan provides the features listed in paragraphs (1)-(7). This plan shall
be described in a group policy and group certificate or in an individual
policy.
(1) Single A and H coverage or joint
A and H coverage for all eligible debtors.
(2) A monthly benefit payable upon the
debtor's disability, subject to any maximum dollar amount of coverage specified
in the group policy and group certificate or individual policy, equal to any of
the following:
(i) The monthly installment
payment required under the contract of indebtedness, for closed end
loans.
(ii) The benefit amount
provided in §
73.139(f)
(relating to credit insurance on open end loans), for open end loans.
(iii) The benefit amount provided in §
73.140(d)
(relating to credit insurance on closed end variable interest loans), for
closed end variable interest loans.
(iv) The benefit amount as provided in §
73.141(f)
(relating to credit insurance on lease transactions), for lease
transactions.
(3) A
coverage period equal to the lesser of the following:
(i) The term of the indebtedness remaining at
the time coverage is elected.
(ii)
The term of the indebtedness remaining at the time coverage is elected to the
time the insured debtor attains an age at which the group policy and group
certificate or individual policy provides for coverage to terminate.
(iii) The term of the indebtedness remaining
at the time coverage is elected until truncated coverage
terminates.
(4) An
elimination period as provided by the policy or certificate of either 14 days
or 30 days following the commencement of disability, with benefits becoming
payable on either a retroactive or nonretroactive basis.
(5) A requirement for proof of disability in
the form of one or both of the following:
(i)
During the first 12 months of disability, proof that the insured debtor is
unable to perform all of the important or significant occupational duties at
the time the disability commences. After 12 months of disability, proof that
the debtor is unable to perform the duties required of any gainful occupation
for which the debtor is reasonably suited by education, training or
experience.
(ii) A medical
determination of the insured debtor's total disability.
(6) A preexisting condition exclusion for
disability that commences within 6 months after the effective date of coverage
and is the result of an illness, disease or physical condition for which the
debtor received medical advice, consultation or treatment within 6 months prior
to the effective date of coverage. The effective date of coverage for each
portion of the insurance attributable to a different advance under an open end
loan is the date on which the advance occurs, or the date on which coverage is
elected, if later.
(7) The payment
of an A and H benefit shall cease at the scheduled expiration date of the group
certificate or individual policy, or when the indebtedness is
prepaid.
(b)
Alternate benefit plans. Insurers may offer credit A and H
insurance benefit plans that differ from the plan described in subsection (a).
An alternate plan shall be described in a group policy and group certificate,
or in an individual policy, and shall conform to the standards of section 7(b)
of the act (40 P. S. §
1007.7(b)) and the
applicable standards of section 618 of The Insurance Company Law of 1929
(40
P. S. §
753). The premium rate standards
of §
73.109 apply to alternate benefit
plans.
This section cited in 31 Pa. Code §
73.109 (relating to A and H
insurance rate standards); 31 Pa. Code §
73.114 (relating to insurability
requirements); 31 Pa. Code §
73.115 (relating to benefit
exclusions); 31 Pa. Code §
73.116 (relating to age
requirements); and 31 Pa. Code §
73.117 (relating to employment
eligibility requirements).
