Current through Reg. 50, No. 13; March 28, 2025
(a) In regards
to individual hospital, medical or surgical coverage, the term "guaranteed
renewable" shall not be defined more restrictively than set forth in §
3.3038 of this title (relating to
Mandatory Guaranteed Renewability Provisions for Individual Hospital, Medical
or Surgical Coverage; Exceptions). Unless the policy or coverage also is
noncancellable (as defined in §
3.3019 of this title (relating to
Policy Definition of Noncancellable), the policy definition of guaranteed
renewable shall state clearly that the insurer retains the right, at the time
of renewal of a policy, to make changes in premium rates by classes.
(b) In regards to excepted benefits:
(1) Except in the limited circumstances
delineated in paragraph (4) of this subsection the term "guaranteed renewable"
shall not be used unless the term is defined consistently with subsection (a)
of this section and mirrors all mandatory provisions of §
3.3038 of this title (relating to
Mandatory Guaranteed Renewability Provisions for Individual Hospital, Medical
or Surgical Coverage; Exceptions).
(2) An insurer may use the term "limited
guarantee of renewability," which shall not be defined more restrictively than
the right of the insured to continue the coverage in force by the timely
payment of premiums until at least age 50, or in the case of a policy issued
after age 44, for at least five years from its date of issue, during which
period the insurer has no right to unilaterally make any change in any
provision of the policy while the policy is in force, except that the insurer
may make changes in premium rates by classes.
(3) Unless the policy or coverage also is
noncancellable (as defined in §
3.3019 of this title (relating to
Policy Definition of Noncancellable), the policy definition of guaranteed
renewable or of limited guarantee of renewability shall state clearly that the
insurer retains the right, at the time of renewal of a policy, to make changes
in premium rates by classes.
(4) An
insurer may continue to issue through May 31, 1998, policies from printed stock
existing on the day before the effective date of this subchapter that contain a
policy definition of "guaranteed renewable" conforming to the definition of the
term allowed by rule before the effective date of this subchapter. The previous
definition, setting the minimum standard for a guaranteed renewable policy, was
the same as the definition of limited guarantee of renewability, as set forth
in paragraph (2) of this subsection. An insurer may not print any new policies
offering excepted benefits on or after the effective date of this subchapter
which use policy language describing the policy as "guaranteed renewable,"
unless such policy also conforms to the definition of "guaranteed renewable"
set forth in subsection (a) of this section and in §
3.3038 of this title (relating to
Mandatory Guaranteed Renewability Provisions for Individual Hospital, Medical
or Surgical Coverage; Exceptions) of this subchapter.
