When a life insurance contract provides for payment of
long-term care expenses funded through an acceleration-of-life-insurance
benefit provision, the long-term care provisions of the contract must meet the
following requirements of Chapter 3, Subchapter Y of this title (relating to
Standards for Long-Term Care Insurance, Non-Partnership and Partnership
Long-Term Care Insurance Coverage Under Individual and Group Policies and
Annuity Contracts, and Life Insurance Policies that Provide Long-Term Care
Benefits Within the Policy):
(1) terms
must be defined consistently with §
3.3804 of this title (relating to
Definitions);
(2) definitions and
descriptions of providers must be consistent with the requirements of §
3.3812 of this title (relating to
Policy Standards for Provider);
(3)
to the extent that the acceleration-of-life-insurance provisions provide for
payment of home health or adult day care expenses, such provisions must meet
applicable standards contained in §
3.3815 of this title (relating to
Standards for Home Health and Adult Day Care Benefits);
(4) conditions triggering eligibility for
benefits must comply with §
3.3818 of this title (relating to
Standards for Eligibility for Benefits); and
(5) to the extent that the
acceleration-of-life-insurance benefit is intended to fund long-term care
expenses that will qualify for favorable tax treatment under federal law, the
long-term care provisions of the contract must further comply with the
provisions of §
4.1115 of this title (relating to
Requirements for Benefits Represented to Be Qualified for Favorable Federal Tax
Treatment) that are applicable to expenses paid for a "qualified long-term care
illness," as defined in §4.1115, and any additional federal requirements for
favorable tax treatment.
Notes
28
Tex. Admin. Code §
4.1114
Adopted by
Texas
Register, Volume 49, Number 03, January 19, 2024, TexReg
0258, eff.
1/24/2024
