REPEALED EFFECTIVE 4-23-04,
Replaced by R590-220, 226, 227 & 228
R590. Insurance, Administration.
[R590-86. Filing of Life and Disability Forms and Rates.
R590-86-1. Authority.
This rule is promulgated by the
insurance commissioner pursuant to the general authority to adopt a rule granted
under Subsection 31A-2-201(3) and the more specific rulemaking authority granted
under Section 31A-21-201 and Subsection 31A-30-106(1)(k).
R590-86-2.
Purpose.
This rule is issued
in order to implement Sections 31A-21-201, 31A-22-602, 31A-22-605, 31A-22-807
and Chapter 30 of Title 31A. It is essential that each filing submitted to the
department be accurate in detail and complete with the required documents in
order for the filing to be processed in a timely and efficient manner. This
rule sets forth the requirements for filing life and disability forms and rates
for use in the State of Utah.
R590-86-3.
General Filing Requirements.
A. Form filings.
All individual and group life, annuity, and disability forms must be filed with
this department. No form may be used prior to filing. Only one copy of the
form is required. Each form submitted for filing shall be identified by a form
number in an accompanying cover letter or on an attached list. All submitted
forms must be in printer's proof format, and the form number must be printed on
the form. The proper disability or life transmittal form must be included with
each submission. Cover letters shall be in duplicate and must concisely
describe each form. Included in the description shall be:
1. the purpose of the form, the title, the benefits and provisions of the
form including an explanation of any change in benefits or premiums which occur
while the contract is in force. Include in the description any riders,
endorsements or options that may be added to the form;
2. the method of marketing, for example, mass merchandised through mass
media, individually issued through licensed agents, association membership,
franchise membership, union membership, or other method;
3. market intended, the issue ages, particularly note any specialized
market;
4. an explanation of any deviation from normal underwriting, for example,
medical, nonmedical, guaranteed issue, simplified application, or other
deviation; and
5. if the filing includes only riders, endorsements or applications,
describe the effect of the form on the base policy and identify the base policy,
including form numbers and dates filed in Utah. Also describe any change in the
marketing.
B. Rate filings.
1. Rates for individual disability policies, riders or endorsements must
be filed, excluding individual policies subject to Chapter 30 that comply with
Rule R590-167. Any rates for these forms must also be filed in accordance with
the requirements of Rules R590-85 "Filing of Rates for Individual Disability
Insurance Forms and Individual and Group Medicare Rates," R590-146 "Medicare
Supplement Insurance Minimum Standards," and R590-148 "Long-Term Care Insurance
Rule," in addition to the requirements of this rule.
Each disability rate submission shall include an actuarial memorandum
describing the basis on which rates were determined and shall indicate and
describe the calculation of the loss ratio as required by Rules R590-85,
R590-146 and R590-148. The rate filing must be in compliance with Utah laws and
rules and the benefits must be reasonable in relation to premiums. In addition,
these calculations must be accompanied by a certification signed by a qualified
actuary who certifies that the calculations were made according to formulas
that, to the best of his knowledge, satisfy legal minimum requirements of the
State of Utah. Refer to Bulletin 92-4(b), "Procedures for the Submission of
Disability Form and Rate Filings."
2. Credit life and credit disability forms and rates must be in compliance
with Utah laws and rules and the benefits must be reasonable in relation to
premiums. The filing must be submitted in accordance with the requirements of
Rule R590-91, "Credit Life and Disability Insurance."
3. The rates for any small employer or individual policy to which
31A-30-104 applies, must comply with the requirements of Rule R590-167,
"Individual and Small Employer Health Insurance Rule."
C. Filing fees. Each form or rate submitted must be accompanied by the
appropriate filing fee. Retaliatory filing fees are due at the time of
submission. The retaliatory fee is the greater of:
(1) the Utah filing fee, or
(2) the filing fee that would be payable to the company's domiciliary
state by a Utah company filing the same form or rate. Refer to Section
31A-3-401.
D. Domiciliary approval. For non-domestic companies each form and rate
submitted to this department for filing must have been previously filed with and
reviewed by the domiciliary state. If, in the domiciliary state, the form is
deemed filed, exempt from filing, filed for informational purposes, or if the
form is not intended for marketing in the domiciliary state, then alternate
information is required as follows:
1. a list of all states to which the form, rate, or both have been filed,
together with any state actions to date on the forms and rates; and
2. an explanation of why the form is not intended for marketing in the
domiciliary state and any points of conflict between the form, rate, or both and
domiciliary state laws or regulations.
E. Actuarial Filings.
1. A signed actuarial memorandum is required with all credit life and
disability filings and all life and annuity forms which are subject to "The
Standard Nonforfeiture Law for Life Insurance," "The Standard Nonforfeiture Law
for Individual Deferred Annuities," and "The Standard Valuation Law," Sections
31A-22-408, 31A-22-409, and Title 31A, Chapter 17, Part 5 respectively. The
memorandum must specify the mortality and morbidity tables, interest rates, and
methods used in calculating nonforfeiture values and reserves, together with an
actuarial demonstration of compliance showing methods used to calculate these
values.
2. All individual disability policy forms, riders, or endorsements
affecting benefits subject to Section 31A-22-602, must include a signed
actuarial memorandum including information as required by Utah Rule R590-85,
"Filing of Rates for Individual Disability Insurance Forms and Individual and
Group Medicare Rates." Individual policies subject to Chapter 30 are excluded
from this requirement.
3. An actuarial certification as described in Rule R590-167, "Individual
and Small Employer Health Insurance Rule", must be filed for any small employer
or individual policy to which 31A-30-104 applies.
F. Policy Summary.
1. Life. Each policy form which is required to be issued with a Policy
Summary, entitled "Statement of Policy Cost and Benefit Information," as
required by Rule R590-79, "Life Insurance Disclosure," must file the Policy
Summary with the submission. Each policy form which is an illustrated form as
defined in Rule R590-177, Life Insurance Illustrations, must file an
illustration with the submission in accordance with the requirements of
R590-177.
2. Disability. Each policy form which is required to be issued with a
Policy Outline of Coverage as required by Rule R590-126, "Individual and
Franchise Disability Insurance, Minimum Standards," Rule R590-146, "Medicare
Supplement Insurance Minimum Standards," and Rule R590-148, "Long Term Care
Insurance Rule," must file the Policy Outline with the submission.
G. Application. Any policy form that requires a copy of an application to
be attached when issued shall be submitted with the application form attached.
H. Sample information. All blank spaces of each form must be filled in
and completed with hypothetical data to indicate the purpose and use of the
form.
I. Group Information. Every group filing must identify the type of group
as defined by Sections 31A-22-502 through 508, and 701. Any group which does
not clearly meet the definitions of Sections 31A-22-502 through 508, and 701, is
subject to Section 31A-22-509. Approval for these groups, subject to
31A-22-509, must be obtained from the commissioner prior to the submission of
any form filing. A copy of the group approval letter must accompany all form
filings for groups subject to Section 31A-22-509.
R590-86-4.
Filing Process.
All form and rate
submissions will be handled in accordance with the procedures described in the
disability filing Bulletin 96-2, and the life filing Bulletin 96-1, or any
replacements. Refer to each respective filing bulletin for specific
instructions for submitting form and rate filings and for a sample of the
required transmittal form.
R590-86-5.
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.
R590-86-6.
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: insurance
law
January 1, 1997
Notice of Continuation April 23, 2002
31A-21-201
31A-30-106]
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