Section 4.
Exemptions.
A. This regulation shall not
apply to solicitations or sales involving:
(1) Credit insurance;
(2) Group life insurance or group annuities
where there is no in-person, face-to-face solicitation of individuals by an
insurance producer or where the contract or certificate does not include a side
fund;
(3) An application to the
existing insurer that issued the existing policy or contract when a contractual
change or a conversion privilege is being exercised; or, when the existing
policy or contract is being replaced by the same insurer pursuant to a program
filed with and approved by the Director of Insurance; or, when a term
conversion privilege is exercised among corporate affiliates;
(4) Individual stand-alone health policies,
including disability income policies;
(5) Contracts offered by Service members'
Group Life Insurance (SGLI) or Veterans' Group Life Insurance (VGLI), as
authorized by 38 U.S.C. Section
1965 et seq.;
(6) Life insurance contracts offered through
or by a non-profit military association, qualifying under Section 501(c) (23)
of the Internal Revenue Code (IRC), and which are not underwritten by an
insurer; or
(7) Contracts used to
fund:
(a) An employee pension or welfare
benefit plan that is covered by the Employee Retirement and Income Security Act
(ERISA);
(b) A plan described by
Sections 401(a), 401(k), 403(b), 408(k) or 408(p) of the IRC, as amended, if
established or maintained by an employer;
(c) A government or church plan defined in
Section 414 of the IRC, a government or church welfare benefit plan, or a
deferred compensation plan of a state or local government or tax exempt
organization under Section 457 of the IRC;
(d) A nonqualified deferred compensation
arrangement established or maintained by an employer or plan sponsor;
(e) Settlements of or assumptions of
liabilities associated with personal injury litigation or any dispute or claim
resolution process; or
(f)
Prearranged funeral contracts.
B. Nothing herein shall be construed to
abrogate the ability of nonprofit organizations (and/or other organizations) to
educate members of the United States Armed Forces in accordance with Department
of Defense DoD Instruction 1344.07--Personal Commercial Solicitation on DoD
Installations or successor directive.
C. For purposes of this regulation, general
advertisements, direct mail and internet marketing shall not constitute
"solicitation." Telephone marketing shall not constitute "solicitation"
provided the caller explicitly and conspicuously discloses that the product
concerned is life insurance and makes no statements that avoid a clear and
unequivocal statement that life insurance is the subject matter of the
solicitation. Provided however, nothing in this subsection shall be construed
to exempt an insurer or insurance producer from this regulation in any
in-person, face-to-face meeting established as a result of the "solicitation"
exemptions identified in this subsection.
Section 5. Definitions.
A. "Active Duty" means full-time duty in the
active military service of the United States and includes members of the
reserve component (National Guard and Reserve) while serving under published
orders for active duty or full-time training. The term does not include members
of the reserve component who are performing active duty or active duty for
training under military calls or orders specifying periods of less than 31
calendar days.
B. "Department of
Defense (DoD) Personnel" means all active duty service members and all civilian
employees, including nonappropriated fund employees and special government
employees, of the Department of Defense.
C. "Door to Door" means a solicitation or
sales method whereby an insurance producer proceeds randomly or selectively
from household to household without prior specific appointment.
D. "General Advertisement" means an
advertisement having as its sole purpose the promotion of the reader's or
viewer's interest in the concept of insurance, or the promotion of the insurer
or the insurance producer.
E.
"Insurer" means an insurance company required to be licensed under the laws of
this state to provide life insurance products, including annuities.
F. "Insurance producer" means a person
required to be licensed under the laws of this state to sell, solicit or
negotiate life insurance, including annuities.
G. "Known" or "Knowingly" means, depending on
its use herein, the insurance producer or insurer had actual awareness, or in
the exercise of ordinary care should have known, at the time of the act or
practice complained of, that the person solicited:
(1) is a service member; or
(2) is a service member with a pay grade of
E-4 or below.
H. "Life
Insurance" means insurance coverage on human lives including benefits of
endowment and annuities, and may include benefits in the event of death or
dismemberment by accident and benefits for disability income and unless
otherwise specifically excluded, includes individually issued
annuities.
I. "Military
Installation" means any federally owned, leased, or operated base, reservation,
post, camp, building, or other facility to which service members are assigned
for duty, including barracks, transient housing, and family quarters.
J. "MyPay" is a Defense Finance and
Accounting Service (DFAS) web-based system that enables service members to
process certain discretionary pay transactions or provide updates to personal
information data elements without using paper forms.
K. "Service Member" means any active duty
officer (commissioned and warrant) or enlisted member of the United States
Armed Forces.
L. "Side Fund" means
a fund or reserve that is part of or otherwise attached to a life insurance
policy (excluding individually issued annuities) by rider, endorsement or other
mechanism which accumulates premium or deposits with interest or by other
means. The term does not include:
(1)
accumulated value or cash value or secondary guarantees provided by a universal
life policy;
(2) cash values
provided by a whole life policy which are subject to standard nonforfeiture law
for life insurance; or
(3) a
premium deposit fund which:
(a) contains only
premiums paid in advance which accumulate at interest;
(b) imposes no penalty for
withdrawal;
(c) does not permit
funding beyond future required premiums;
(d) is not marketed or intended as an
investment; and
(e) does not carry
a commission, either paid or calculated.
M. "Specific Appointment" means a prearranged
appointment agreed upon by both parties and definite as to place and
time.
N. "United States Armed
Forces" means all components of the Army, Navy, Air Force, Marine Corps, and
Coast Guard.
Section 6.
Practices Declared False, Misleading, Deceptive or Unfair on a Military
Installation
A. The following acts or
practices when committed on a military installation by an insurer or insurance
producer with respect to the in-person, face-to-face solicitation of life
insurance are declared to be false, misleading, deceptive or unfair:
(1) Knowingly soliciting the purchase of any
life insurance product "door to door" or without first establishing a specific
appointment for each meeting with the prospective purchaser.
(2) Soliciting service members in a group or
"mass" audience or in a "captive" audience where attendance is not
voluntary.
(3) Knowingly making
appointments with or soliciting service members during their normally scheduled
duty hours.
(4) Making appointments
with or soliciting service members in barracks, day rooms, unit areas, or
transient personnel housing or other areas where the installation commander has
prohibited solicitation.
(5)
Soliciting the sale of life insurance without first obtaining permission from
the installation commander or the commander's designee.
(6) Posting unauthorized bulletins, notices
or advertisements.
(7) Failing to
present DD Form 2885, Personal Commercial Solicitation Evaluation, to service
members solicited or encouraging service members solicited not to complete or
submit a DD Form 2885.
(8)
Knowingly accepting an application for life insurance or issuing a policy of
life insurance on the life of an enlisted member of the United States Armed
Forces without first obtaining for the insurer's files a completed copy of any
required form which confirms that the applicant has received counseling or
fulfilled any other similar requirement for the sale of life insurance
established by regulations, directives or rules of the DoD or any branch of the
Armed Forces.
B. The
following acts or practices when committed on a military installation by an
insurer or insurance producer constitute corrupt practices, improper influences
or inducements and are declared to be false, misleading, deceptive or unfair:
(1) Using DoD personnel, directly or
indirectly, as a representative or agent in any official or business capacity
with or without compensation with respect to the solicitation or sale of life
insurance to service members.
(2)
Using an insurance producer to participate in any United States Armed Forces
sponsored education or orientation program.
Section 7. Practices Declared False,
Misleading, Deceptive or Unfair Regardless of Location.
A. The following acts or practices by an
insurer or insurance producer constitute corrupt practices, improper influences
or inducements and are declared to be false, misleading, deceptive or unfair:
(1) Submitting, processing or assisting in
the submission or processing of any allotment form or similar device used by
the United States Armed Forces to direct a service member's pay to a third
party for the purchase of life insurance. The foregoing includes, but is not
limited to, using or assisting in using a service member's "MyPay" account or
other similar internet or electronic medium for such purposes. This subsection
does not prohibit assisting a service member by providing insurer or premium
information necessary to complete any allotment form.
(2) Knowingly receiving funds from a service
member for the payment of premium from a depository institution with which the
service member has no formal banking relationship. For purposes of this
section, a formal banking relationship is established when the depository
institution:
(a) provides the service member
a deposit agreement and periodic statements and makes the disclosures required
by the Truth in Savings Act, 12 U.S.C. Section
4301et seq. and the regulations
promulgated thereunder; and
(b)
permits the service member to make deposits and withdrawals unrelated to the
payment or processing of insurance premiums.
(3) Employing any device or method or
entering into any agreement whereby funds received from a service member by
allotment for the payment of insurance premiums are identified on the service
member's Leave and Earnings Statement or equivalent or successor form as
"Savings" or "Checking" and where the service member has no formal banking
relationship as defined in subsection
7(A)(2).
(4) Entering into any agreement with a
depository institution for the purpose of receiving funds from a service member
whereby the depository institution, with or without compensation, agrees to
accept direct deposits from a service member with whom it has no formal banking
relationship.
(5) Using DoD
personnel, directly or indirectly, as a representative or agent in any official
or unofficial capacity with or without compensation with respect to the
solicitation or sale of life insurance to service members who are junior in
rank or grade, or to the family members of such personnel.
(6) Offering or giving anything of value,
directly or indirectly, to DoD personnel to procure their assistance in
encouraging, assisting or facilitating the solicitation or sale of life
insurance to another service member.
(7) Knowingly offering or giving anything of
value to a service member with a pay grade of E-4 or below for his or her
attendance to any event where an application for life insurance is
solicited.
(8) Advising a service
member with a pay grade of E-4 or below to change his or her income tax
withholding or State of legal residence for the sole purpose of increasing
disposable income to purchase life insurance.
B. The following acts or practices by an
insurer or insurance producer lead to confusion regarding source, sponsorship,
approval or affiliation and are declared to be false, misleading, deceptive or
unfair:
(1) Making any representation, or
using any device, title, descriptive name or identifier that has the tendency
or capacity to confuse or mislead a service member into believing that the
insurer, insurance producer or product offered is affiliated, connected or
associated with, endorsed, sponsored, sanctioned or recommended by the U.S.
Government, the United States Armed Forces, or any state or federal agency or
government entity. Examples of prohibited insurance producer titles include,
but are not limited to, "Battalion Insurance Counselor," "Unit Insurance
Advisor," "Servicemen's Group Life Insurance Conversion Consultant" or
"Veteran's Benefits Counselor." Nothing herein shall be construed to prohibit a
person from using a professional designation awarded after the successful
completion of a course of instruction in the business of insurance by an
accredited institution of higher learning. Such designations include, but are
not limited to, Chartered Life Underwriter (CLU), Chartered Financial
Consultant (ChFC), Certified Financial Planner (CFP), Master of Science in
Financial Services (MSFS), or Masters of Science Financial Planning
(MS).
(2) Soliciting the purchase
of any life insurance product through the use of or in conjunction with any
third party organization that promotes the welfare of or assists members of the
United States Armed Forces in a manner that has the tendency or capacity to
confuse or mislead a service member into believing that either the insurer,
insurance producer or insurance product is affiliated, connected or associated
with, endorsed, sponsored, sanctioned or recommended by the U.S. Government, or
the United States Armed Forces.
C. The following acts or practices by an
insurer or insurance producer lead to confusion regarding premiums, costs or
investment returns and are declared to be false, misleading, deceptive or
unfair:
(1) Using or describing the credited
interest rate on a life insurance policy in a manner that implies that the
credited interest rate is a net return on premium paid.
(2) Excluding individually issued annuities,
misrepresenting the mortality costs of a life insurance product, including
stating or implying that the product "costs nothing" or is "free."
D. The following acts or practices
by an insurer or insurance producer regarding SGLI or VGLI are declared to be
false, misleading, deceptive or unfair:
(1)
Making any representation regarding the availability, suitability, amount,
cost, exclusions or limitations to coverage provided to a service member or
dependents by SGLI or VGLI, which is false, misleading or deceptive.
(2) Making any representation regarding
conversion requirements, including the costs of coverage, or exclusions or
limitations to coverage of SGLI or VGLI to private insurers which is false,
misleading or deceptive.
(3)
Suggesting, recommending or encouraging a service member to cancel or terminate
his or her SGLI policy or issuing a life insurance policy which replaces an
existing SGLI policy unless the replacement shall take effect upon or after the
service member's separation from the United States Armed Forces.
E. The following acts or practices
by an insurer and or insurance producer regarding disclosure are declared to be
false, misleading, deceptive or unfair:
(1)
Deploying, using or contracting for any lead generating materials designed
exclusively for use with service members that do not clearly and conspicuously
disclose that the recipient will be contacted by an insurance producer, if that
is the case, for the purpose of soliciting the purchase of life
insurance.
(2) Failing to disclose
that a solicitation for the sale of life insurance will be made when
establishing a specific appointment for an in-person, face-to-face meeting with
a prospective purchaser.
(3)
Excluding individually issued annuities, failing to clearly and conspicuously
disclose the fact that the product being sold is life insurance.
(4) Failing to make, at the time of sale or
offer to an individual known to be a service member, the written disclosures
required by Section
10 of the "Military Personnel Financial
Services Protection Act,"
Pub. L. No. 109-290,
p.16.
(5) Excluding individually
issued annuities, when the sale is conducted in-person face-to-face with an
individual known to be a service member, failing to provide the applicant at
the time the application is taken:
(a) an
explanation of any free look period with instructions on how to cancel if a
policy is issued; and
(b) either a
copy of the application or a written disclosure. The copy of the application or
the written disclosure shall clearly and concisely set out the type of life
insurance, the death benefit applied for and its expected first year cost. A
basic illustration that meets the requirements of Regulation Regulation
69-40,
Life Insurance Policy Illustration Rules, shall be deemed sufficient to meet
this requirement for a written disclosure.
F. The following acts or practices by an
insurer or insurance producer with respect to the sale of certain life
insurance products are declared to be false, misleading, deceptive or unfair:
(1) Excluding individually issued annuities,
recommending the purchase of any life insurance product which includes a side
fund to a service member in pay grades E-4 and below unless the insurer has
reasonable grounds for believing that the life insurance death benefit,
standing alone, is suitable.
(2)
Offering for sale or selling a life insurance product which includes a side
fund to a service member in pay grades E-4 and below who is currently enrolled
in SGLI, is presumed unsuitable unless, after the completion of a needs
assessment, the insurer demonstrates that the applicant's SGLI death benefit,
together with any other military survivor benefits, savings and investments,
survivor income, and other life insurance are insufficient to meet the
applicant's insurable needs for life insurance.
(a) "Insurable needs" are the risks
associated with premature death taking into consideration the financial
obligations and immediate and future cash needs of the applicant's estate
and/or survivors or dependents.
(b)
"Other military survivor benefits" include, but are not limited to: the Death
Gratuity, Funeral Reimbursement, Transition Assistance, Survivor and
Dependents' Educational Assistance, Dependency and Indemnity Compensation,
TRICARE Healthcare benefits, Survivor Housing Benefits and Allowances, Federal
Income Tax Forgiveness, and Social Security Survivor Benefits.
(3) Excluding individually issued
annuities, offering for sale or selling any life insurance contract which
includes a side fund:
(a) unless interest
credited accrues from the date of deposit to the date of withdrawal and permits
withdrawals without limit or penalty;
(b) unless the applicant has been provided
with a schedule of effective rates of return based upon cash flows of the
combined product. For this disclosure, the effective rate of return will
consider all premiums and cash contributions made by the policyholder and all
cash accumulations and cash surrender values available to the policyholder in
addition to life insurance coverage. This schedule will be provided for at
least each policy year from one (1) to ten (10) and for every fifth policy year
thereafter ending at age 100, policy maturity or final expiration;
and
(c) which by default diverts or
transfers funds accumulated in the side fund to pay, reduce or offset any
premiums due.
(4)
Excluding individually issued annuities, offering for sale or selling any life
insurance contract which after considering all policy benefits, including but
not limited to endowment, return of premium or persistency, does not comply
with standard nonforfeiture law for life insurance.
(5) Selling any life insurance product to an
individual known to be a service member that excludes coverage if the insured's
death is related to war, declared or undeclared, or any act related to military
service except for an accidental death coverage, e.g., double indemnity, which
may be excluded.