R590. Insurance, Administration. (Effective
4-28-05)
R590-228. Submission of Credit Life and Credit Accident and Health Insurance
Form and Rate Filings.
R590-228-1. Authority.
This rule is promulgated by the insurance commissioner pursuant to
Subsection 31A-2-201(3), 31A-2-201.1, 31A-2-202(2), 31A-22-807.
R590-228-2. Purpose and Scope.
(1) The purpose of this rule is to set forth the procedures for
submitting:
(a) Credit life and credit accident and health insurance filings
required by Section 31A-21-201;
(b) Credit life and credit accident and health insurance rate filings
required by Section 31A-22-807, R590-91; and
(c) report filings required by R590-91.
(2) This rule applies to all credit life insurance and credit accident
and health insurance including group contracts issued to nonresident
policyholders, including trusts, when Utah residents are provided coverage by
certificates of insurance.
R590-228-3. Documents Incorporated by Reference.
(1) The department requires that documents described in this rule must
be used for all filings. Actual copies may be used or you may adapt them to
your word processing system. If adapted, the content, size, font, and format
must be similar.
(2) The following documents are hereby incorporated by reference and
are available at www.insurance.utah.gov.
(a) "NAIC Life, Accident & Health, Annuity, Credit Transmittal
Document," dated January 1, 2005;
(b) "NAIC Uniform Life, Accident & Health, Annuity and Credit Coding
Matrix," dated January 1, 2005;
(c) "NAIC Instruction Sheet for Life, Accident & Health, Annuity,
Credit Transmittal document," dated January 1, 2003;
(d) "NAIC Instruction Sheet for Life, Accident & Health, Annuity,
Credit Transmittal Document Form Filing Attachment," dated January 1, 2003;
(e) "Utah Credit Life and Credit Accident and Health Filing
Certification," dated January 1,2004;
(f) "Utah Life, Annuity, Credit Life, and Credit Accident and Health
Group Questionnaire," dated January 1, 2004;
(g) "Utah Annual Credit Life and Credit Accident and Health Insurance
Filing Checklist," dated January 1, 2004.
R590-228-4. Definitions.
In addition to the definitions of Section 31A-1-301, the following
definitions shall apply for the purpose of this rule:
| (1) "Alternate information” means:
(a) a list of the states to which the forms have been filed, the dates
submitted, and any state actions;
(b) the reason for not submitting the form to the domicile state; and
(c) identifying any points of conflict between the form and domicile
state laws or rules.
(d) "Certification" means
a statement that the filing being submitted is in compliance with Utah laws and
rules.
(3) “Data page” means the page
or pages in a policy and certificate that provide the specific data for the
insured detailing the coverage provided and may be titled by the insurer as
schedule page, schedule of benefits and premiums, etc.
(4) "Eligible group" means a
group that meets the definitions in Sections 31A-22-502 through 31A-22-508.
(5) “Endorsement” means a written agreement attached to a life
insurance policy that alters a provision of the policy. An example is a company
change of name.
(6) "File and Use" means a filing can be used, sold, or offered for
sale after it has been filed with the department.
(7) "File for Approval" means a filing can be used, sold, or offered
for sale after it has been filed and the filer has received written confirmation
that the filing was approved.
(8) “Filer" means a person or entity that submits a filing.
(9) “Filing,” when used as a noun, means an item required to be filed
with the department including:
(a) a policy;
(b) a rate, rate methodologies;
(c) a form;
(d) a document;
(e) an application;
(f) a report;
(g) a certificate;
(h) an endorsement;
(i) a rider; and
(j) an actuarial memorandum and certification.
(10) “Issue Ages” means the range of minimum and maximum ages for
which a policy or certificate will be issued.
(11) "Letter of Authorization" means a letter signed by an officer of
the insurer on whose behalf the filing is submitted that designates filing
authority to the filer.
(12) "Market type" means the type of policy that indicates the
targeted market such as individual or group.
(13) "Order to Prohibit Use" means an order issued by the commissioner
that forbids the use of a filing.
(14) "Rejected" means a filing is:
(a) not submitted in accordance with applicable laws or rules; and
(b) returned to the insurer by the department with the reasons for
rejection; and
not considered filed with the department.
(15) “Rider” means a written agreement attached to a life insurance
policy or certificate that adds a benefit. An example is a credit accident and
health insurance rider.
(16) "Type of insurance" means a specific credit life and credit
accident and health insurance product, as defined in the NAIC Coding Matrix,
including, but not limited to, gross decreasing term, net decreasing term, level
term, or truncated coverage. Refer to the NAIC Coding Matrix.
R590-228-5. General Filing Information.
(1) Each filing submitted must be accurate, consistent, and complete
and contain all required documents in order for the filing to be processed in a
timely and efficient manner. The commissioner may request any additional
information deemed necessary.
(2) Insurers and filers are responsible for assuring compliance with
Utah laws and rules. Filings not in compliance with Utah laws and rules are
subject to regulatory action under Section 31A-2-308.
(3) Filings that do not comply with this rule may be rejected and
returned to the filer. Rejected filings are not considered filed with the
department.
(4) Prior filings will not be researched to determine the purpose of
the current filing.
(5) The department does not review or proofread every filing.
(a) Filings may be reviewed:
(i) when submitted;
(ii) as a result of a complaint;
(iii) during a regulatory examination or investigation; or
(iv) at any other time the department deems necessary.
(b) If a filing is reviewed and is found to be not in compliance with
Utah laws and rules, an Order To Prohibit Use will be issued to the filer. The
commissioner may require the filer to disclose deficiencies in forms or rating
practices to affected insureds.
(6) Filing Correction. A new filing is required if clerical or
typographical corrections are made more than 30-days after the filed date of the
original filing. The filer will need to reference the original filing.
R590-228-6. Filing Submission Requirements.
Filings must be submitted by market type and type of insurance. A
filing may not include more than one type of insurance; or request filing for
more than one insurer. A complete filing consists of the following documents
submitted in the following order:
(1) Transmittal. Note: Based on the use of the NAIC Transmittal Form,
a cover letter is not required. The "NAIC Life, Accident & Health, Annuity,
Credit Transmittal Document" must be used. It can be found at
www.insurance.utah.gov/LH_Trans.pdf.
(a) COMPLETE THE TRANSMITTAL BY USING THE FOLLOWING:
(i) "NAIC Coding Matrix"
www.insurance.utah.gov/LifeA&H_Matrix.pdf,
(ii) "NAIC" Instruction Sheet"
www.insurance.utah.gov/LH_Trans_Inst.pdf,
(iii) "Life Content Standards"
www.insurance.utah.gov/Life_STM.html
(iv) Do not submit the documents described in section (a)(i), (ii), and
(iii) with a filing.
(b) Filing Description. The following information must be included
in the Filing Description section of the transmittal and must be presented in
the order shown below.
(i) Domicile Approval. Foreign insurers and filers must first submit
filings to their domicile state.
(A) If a filing was submitted to the domicile state, provide a stamped
copy of the approval letter from the domicile state for the filing.
(B) If a filing was not submitted to the domicile state, or the domicile
state did not provide specific approval for the filing, then alternate
information must be provided.
(ii) Marketing Facts.
(A) List the issue ages.
(B) Identify the intended market.
(C) Identify and describe the type of group.
(D) Identify the types and durations of loans to be insured.
(E) Describe the methods of premium charge.
(F) Describe the marketing and advertising in detail, i.e. through mass
solicitation, financial institutions, telemarketing, or individually through
licensed producers.
(iii)..Description of Filing.
(A)..Provide a detailed description of the purpose of the filing.
(B)..Describe the benefits and features of each form.
(C)..List the types of coverage to be provided, such as gross, net, full term,
truncated and critical period.
(D) Identify and describe any new or nonstandard benefits or rating
methodologies.
(E) Indicate whether the insurer has a Rating and Benefits Plan on file
with the department.
(F) Identify any unresolved previously prohibited provisions and explain
why the provisions are included in the current filing.
(G) If the filing is replacing or modifying a previous submission, provide
information that identifies the filing being replaced or modified, the Utah
filed date, and a detailed description of the changes and highlight the changed
provisions.
(H) if the filing includes forms for informational purposes, provide the
dates the forms were filed.
(I) if filing a rider, endorsement or application and the filing does not
contain a policy, identify the affected policy form number, the Utah filed date,
and describe the effect of the submitted forms on the base policy.
(iv) Underwriting Methods. Provide an explanation of the
underwriting applicable to the filing.
(2) Certification.
In addition to completing the certification on the NAIC transmittal, the filer
must complete and submit the "Utah Credit Life and Credit Accident and Health
Filing Certification". A filing will be rejected if the certification is
missing or incomplete. A certification that is inaccurate may subject the filer
to administrative action.
(3) Group Questionnaire.
All group filings must include a completed group questionnaire.
(4) Letter of
Authorization. When the filer is not the insurer, include a letter of
authorization from the insurer. The insurer remains responsible for the
filing being in compliance with Utah laws and rules.
(5) Statement of
Variability. Any information that is variable must be bracketed in the
form and must be explained in a statement of variability. If after filing,
the information contained within the brackets changes, the filing must be
refiled.
(6) Items being submitted
for filing. Include all forms, rates, and reports to be filed. Refer
to each applicable subsection of this rule for procedures on how to submit
forms, rates, and reports with required filing documents.
(7) Actuarial Memorandum,
Demonstration, and Certification of Compliance. An actuarial memorandum
with sample rate calculations and a certification of compliance are required in
each filing. The memorandum must be currently dated and signed by the
actuary representing the insurer.
(8) Rates. All
rates must be filed prior to use. All rates must be in compliance with
31A-22-807 and R590-91. A rate filing is required with each form filing.
(9) Return Notification
Materials.
(a) Return notification materials are limited to a copy of the transmittal
and a self-addressed, stamped envelope.
(b) Notice of filing will not be provided unless return notification
materials are submitted.
R590-228-7. Procedures for Filings.
(1) Forms in General.
(a) Forms are "File and Use" filings.
(b) Each form must be identified by a unique form number. The form
number may not be variable.
(c) Forms must be in final printed form or printer's proof format.
(d) The form must be completed in John Doe fashion to accurately
represent the intended market, purpose, and use. All John Doe data in the
forms, including the premium rates and benefits, must be accurate and consistent
with the actuarial memorandum and rate schedule. Forms may include variable
data in brackets. All variable data must be identified within the brackets or a
statement of variability must be included with the submission.
(2) Policy Filings. A policy filing consists of one policy form for a
single type of insurance and its related forms, including the application,
enrollment form, certificate, actuarial memorandum, certification, and rate
schedule.
(3) Rider or Endorsement Filings. A rider or endorsement that
provides benefits must include all filing documents required for a policy filing
including:
(a) a listing of the base policy form number, title and dates filed
with the department;
(b) a description of how the rider affects the base policy; and
(c) appropriate actuarial memorandum and rate schedule.
(4) Application Filings. An application or enrollment form may be
submitted as a separate filing or filed with its related policy and certificate.
If an application has been previously filed or is filed separately, an
informational copy of the application must be included with a policy or
certificate filing.
(5) Rates. Rates are considered "File for Approval".
R590-228-8. Additional Procedures for Credit Life
and Credit Accident and Health Form and Rate Filings.
(1) Insurers are advised to review the following code sections and
rules prior to submitting a filing:
(a) Section 31A-21 Part III, "Specific Clauses in Contracts;"
(b) Section 31A-22 Part IV, "Life insurance and Annuities;"
(c) Section 31A-22 Part V, "Group Life Insurance;"
(d) Section 31A-22 Part VI, "Accident and Health Insurance;"
(e) Section 31A-22 Part VIII, “Credit Life and Accident and Health;”
(f) R590-91, “Credit Life and Disability;” and
(g) R590-191, " Unfair Life Insurance Claims Settlement
Practice;"
(h) R590-192, "Unfair Health and Disability Claims Settlement
Practices."
(2) A policy must be included with each certificate filing along with
a master application and enrollment form.
(3) Actuarial Memorandum, Demonstration and Certification of
Compliance. Each form and rate fling must include an actuarial memorandum,
demonstration, and certification of compliance with Utah laws, signed and dated
by the actuary representing the insurer.
(a) Actuarial memorandum must include a description of the following:
(i) types of coverage, such as gross or net decreasing, single or
joint life, full term or truncated, critical period;
(ii) types of loans to be insured, such as open end, closed end,
(iii) types of premium charge: single premium, monthly outstanding
balance, or other method explained in detail;
(iv) durations of loans and durations of coverage. Refer to
31A-22-801(2)(a);
(v) rates per unit, rating and premium methodologies including:
(A) formulas used for each type of coverage and premium method; and
(B) sample calculations for each type of coverage and premium method;
(vi) an explanation of whether the company has a Rating and Benefits
Plan on file and if so, whether the submitted rates are consistent with the
filed plan;
(vii) demonstration of compliance with applicable code and rules;
(viii) refund methods and calculation including formulas for each type
of coverage; and
(ix) reserve bases including methods used.
(b) The actuarial certification must include certification of
compliance that formulas and methods used produce rates that are in compliance
with applicable Utah laws and rules for each type of coverage and duration in
the filing.
(4) Rate Schedules.
(a) Rate schedules must be included for each type of coverage and for
representative durations.
(b) Rates must be identified as prima facie rates, rates previously
filed for compliance with the Rating & Benefits Plan required in R590-91-10, or
deviated rates submitted pursuant to 31A-22-807, or rates on nonstandard
coverage pursuant to R590-91-5.
(5) All benefits must be reasonable in relation to the premium
charge. Insurers filing for approval of a rate higher than prima facie rates
must comply with the requirements of 31A-22-807 and R590-91- 10. Include
a demonstration that the rates are reasonable in relation to the benefits.
R590-228-9. Insurer Annual Reports.
(1) All insurer annual reports must be properly identified and must be
filed separately from other filings. Each annual report must be submitted along
with the properly completed report checklist.
(2) “Credit Life and Credit Accident and Health Annual Report.”
(a) Filings must comply with R590-91-10. Every Credit Life, and
Credit Accident and Health insurer marketing must file annually.
(b) The report must include:
(i) Utah Credit Life, and Credit Accident and Health Report Checklist;
(ii) a cover letter along with a self-addressed stamped envelope; and
all required documents.
(iii) Annual report filings are due May 1 each year.
R590-228-10. Additional Procedures for Electronic
Filings.
Filers submitting electronic filings must follow the requirements for
both the electronic system and this rule, as applicable.
R590-228-11. Correspondence, Inquiries, and
Responses.
(1) Correspondence. When corresponding with the department, filers
must provide sufficient information to identify the original filing.
Information should include:
(a) type of insurance;
(b) date of filing;
(c) form numbers; and
(d) copy of the original transmittal.
(2) Status Checks. Filers can request the status of their filing by
telephone, or email 60 days after the date of submission.
(3) Response to an Order.
(a) A response to an order must include:
(i) a response cover letter identifying the changes made;
(ii) a copy of the Order to Prohibit Use;
(iii) one copy of the revised documents with all changes highlighted;
and
(iv) return notification materials, which consist of a copy of the
response cover letter and a self-addressed stamped envelope.
(4) Rejected Filings. A rejected filing is NOT considered filed. If
resubmitted it is considered a new filing. If resubmitting a previously
rejected filing, the new filing must include a copy of the rejection notice.
R590-228-12. Penalties.
Persons found, after a hearing or other regulatory process, to be in
violation of this rule shall be subject to penalties as provided under Section
31A-2-308.
R590-228-13. Enforcement Date.
The commissioner will begin enforcing the provision of this rule May 1,
2004.
R590-228-14. Severability.
If any provision of this rule or the application of it to any person or
circumstance is for any reason held to be invalid, the remainder of the rule and
the application of the provision to other persons or circumstances may not be
affected by it.
KEY: credit insurance filings
2005
31A-2-201
31A-2-201.1
31A-2-202
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