28 Tex. Admin. Code § 3.18 - Variable Material
(a) Variable material
generally. As specified in this section, an issuer may file forms, advertising,
or provider contracts using variable material to illustrate the ways an issued
document may vary from the filed material. Any variable material must be
identified using brackets and include specimen language or fill-in material
that reflects the most restrictive option, if applicable, within the range of
variability. Variable material may not be used in an issued form. The issued
form must clearly state the actual benefits and contract terms.
(b) Statement of variability. When variable
material is included in a filing, the issuer must submit a statement of
variability to accompany the filing that:
(1)
provides a clear explanation of how the material will vary for each variable
option or range that appears in the brackets on the form; and
(2) demonstrates compliance with applicable
requirements.
(c)
Permitted uses of variable material. It is acceptable for an issuer to use
variable material to illustrate:
(1) how a
document may vary due solely to the age, sex, or classification of the insured
or enrollee;
(2) the range of
benefit levels or options that will be offered to consumers;
(3) nonsubstantive administrative items in
the document, such as phone numbers, addresses, or third-party
administrators;
(4) the type of
group the policy will be issued to if different review standards do not apply
based on the group type; and
(5)
how a form may vary based on clearly specified options selected by a group
policyholder.
(d)
Prohibited uses of variable material. It is not acceptable for:
(1) a unique form number on a form to be
bracketed as variable;
(2) the
issuer name to be bracketed as variable;
(3) a form to use variability to create
different types of products using a single form number, rather than making
separate product filings;
(4) a
form to specify a range of variability that exceeds the range supported in the
issuer's filed rates or schedule of charges and actuarial memorandum, if
applicable; or
(5) an issuer to use
variability to an extent that the department is unable to fully understand how
the product will appear when issued.
(e) Fill-in material for individual life and
annuity forms. Individual life and annuity forms must contain fill-in material
for a 35-year-old insured. If the form is not issued at age 35, the fill-in
material must contain the youngest issue age. If any form includes reduced
death benefits, the fill-in material must include the age with the greatest
reduction in benefits at issue. The fill-in material must be for the longest
premium-paying period available.
(f) Life and annuity standards.
(1) For life forms, the text and
specifications of nonforfeiture assumptions cannot include variable
material;
(2) For life and annuity
forms, a zero entry in a range of values on the specifications page:
(A) is acceptable for tiering levels, expense
charges, or other fees applicable under the contract; and
(B) is not acceptable for any benefit or
credit provided for in the language of the contract.
(g) Changes to variability. Any
change to a statement of variability is considered a change to the form itself
and must be filed in conjunction with the form.
(h) Examples upon request. The department
reserves the right to request that the issuer supplement its filing with
examples of forms without variability, including examples of forms actually
issued to consumers (with confidential information redacted).
Notes
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