Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter Y - STANDARDS FOR LONG-TERM CARE INSURANCE, NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE COVERAGE UNDER INDIVIDUAL AND GROUP POLICIES AND ANNUITY CONTRACTS, AND LIFE INSURANCE POLICIES THAT PROVIDE LONG-TERM CARE BENEFITS WITHIN THE POLICY
Division 2 - NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE
Section 3.3849 - Requirements for Insurers that Issue Long-Term Care Policies to Associations and Marketing Standards for Associations that Market the Policies
Universal Citation: 28 TX Admin Code § 3.3849
Current through Reg. 50, No. 13; March 28, 2025
(a) Insurer requirements.
(1) Any insurer issuing long-term care
insurance to an association, as defined in the Insurance Code §
1251.052, must file
with the department in accordance with the requirements and procedures set
forth in Subchapter A of this chapter (relating to Submission Requirements for
Filings and Departmental Actions Related to Such Filings) the following:
(A) the long-term care policy and
certificate;
(B) a corresponding
outline of coverage; and
(C) annual
certification of the association's compliance with marketing standards for
long-term care policies and certificates in accordance with Form Number
LHL573(LTC) Insurer Certification of Association Compliance With Marketing
Standards for Long-Term Care Partnership and Non-Partnership Policies and
Certificates Form specified in Figure: 28 TAC §
3.3849(e)(1)(F).
(2) No group long-term care
insurance policy or certificate may be issued to an association unless the
insurer files with the department the information required in this
subsection.
(b) Advertisements. Advertisements for long-term care insurance must be filed with the department in accordance with § 3.3838(1) of this title (relating to Filing Requirements for Advertising).
(c) Association disclosure requirements.
(1) An association must disclose in any
long-term care insurance solicitation to its members:
(A) the specific nature and amount of the
compensation arrangements (including all fees, commissions, administrative fees
and other forms of financial support) that the association receives from
endorsement or sale of the policy or certificate to its members; and
(B) a brief description of the process under
which the policies and the insurer issuing the policies were
selected.
(2) If the
association and the insurer have interlocking directorates or trustee
arrangements, the association must disclose that fact to its members.
(d) Board approval requirements. The board of directors of associations selling or endorsing long-term care insurance policies or certificates must review and approve the insurance policies and certificates as well as the compensation arrangements made with the insurer.
(e) Insurer certification form.
(1) The following
requirements and procedures apply to Form Number LHL573(LTC) Insurer
Certification of Association Compliance With Marketing Standards for Long-Term
Care Partnership and Non-Partnership Policies and Certificates Form specified
in Figure: 28 TAC §
3.3849(e)(1)(F):
(A) The text must be in at least 10-point
type and must follow the order of the information presented in Figure: 28 TAC
§
3.3849(e)(1)(F).
(B) The text of Form Number LHL573(LTC)
Insurer Certification of Association Compliance With Marketing Standards for
Long-Term Care Partnership and Non-Partnership Policies and Certificates Form
as specified in Figure: 28 TAC §
3.3849(e)(1)(F)
is mandated; the format for the form is a recommended format. An insurer may
format the mandated text in a different format from that specified in Figure:
28 TAC §
3.3849(e)(1)(F)
if the insurer files the reformatted certification form for review and approval
by the commissioner.
(C) Any
reformatted certification form that is filed for approval pursuant to paragraph
(2) of this subsection must be filed no later than 60 days prior to use and is
subject to the requirements and procedures set forth in Subchapter A of this
chapter.
(D) Any reformatted
certification form filed pursuant to paragraph (2) of this subsection should be
filed with the Texas Department of Insurance, Life and Health Division, Filings
Intake, MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030.
(E) Form Number LHL573(LTC) Insurer
Certification of Association Compliance With Marketing Standards for Long-Term
Care Partnership and Non-Partnership Policies and Certificates Form may be
obtained from the Texas Department of Insurance, Life and Health Division, Life
and Health Lines, MC-LH-LHL, P.O. Box 12030, Austin, Texas 78711-2030, or from
the department's website at www.tdi.texas.gov/forms.
(F) A representation of Form Number
LHL573(LTC) Insurer Certification of Association Compliance With Marketing
Standards for Long-Term Care Partnership and Non-Partnership Policies and
Certificates Form is as follows:
(2) The initial certification must be
submitted to the department between January 1, 2010, and January 31, 2010, for
the calendar year 2009, and thereafter must be submitted annually between
January 1 and January 31 for the preceding calendar year.
(3) Form Number LHL573(LTC) is an
informational filing pursuant to §
3.5(b)(1) of
this title (relating to Filing Authorities and Categories) and is subject to
the requirements and procedures set forth in Subchapter A of this
chapter.
(4) The annual completed
certification form submitted pursuant to paragraphs (2) and (3) of this
subsection should be filed with the Texas Department of Insurance, Life and
Health Division, Filings Intake, MC-LH-LHL, P.O. Box 12030, Austin, Texas
78711-2030.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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