28 Tex. Admin. Code § 3.3807 - Policy or Certificate Standards for Guaranteed Renewability
(a) The term "guaranteed renewability" may be
used only when the policyholder has the right to continue the long-term care
insurance in force by the timely payment of premiums and when the insurer has
no unilateral right to make any change in any provision of the policy or rider
while the insurance is in force and cannot decline to renew, except that rates
may be revised by the insurer on a class basis. The policyholder retains the
right to cancel the long-term care insurance contract with the required notice
of cancellation, as outlined in the contract. Upon such cancellation by the
policyholder, the insurer must return any unearned premium to the
policyholder.
(b) A group long-term
care policy may not be described as a guaranteed renewable policy unless the
insurer and policyholder have agreed by policy contract provision that the
policy cannot be terminated by either the insurer or the policyholder until
there are no certificates remaining thereunder. The term "guaranteed
renewability" may apply to a group certificate of coverage if and only if the
certificate form provides that:
(1) In
accordance with the provisions of §
3.3828 of this title (relating to
Continuation or Conversion; Discontinuance and Replacement):
(A) a conversion policy will be issued with
substantially equivalent benefits upon termination of coverage under the group
policy for any reason, including termination of the group policy; or
(B) the certificate may be continued in force
under the group policy when the certificate holder is no longer a member of the
group, pursuant to a written agreement between the certificate holder and the
policyholder regarding such continuation, and that a conversion policy with
substantially equivalent benefits must be provided in the event of policy
termination; and
(2)
provisions of the policy may not be changed unilaterally.
Notes
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