18 Del. Admin. Code § 1211-7.0
This Regulation shall become effective 30 days after the Commissioner's signature.
Regulation No. 64 was signed by the Insurance Commissioner on September 19, 1990.
FORM I
Dear [Retiree]:
[Name of corporation] has established and maintains a welfare benefit plan pursuant to the Federal Employee Retirement Income Security Act of 1984 ("ERISA"), in which you participate or are eligible to participate. In order to assist [name of corporation] to recover the cost of the welfare benefit plan, [name of corporation] may, under Delaware law, purchase corporate owned life insurance policies on the lives of its employees or retirees.
This notice is given for the purpose of informing you that [name of corporation] has purchased or intends to purchase corporate life insurance policies on the lives of its retirees, including yours, from [name of insurer], in the amount of [$ ______________________], the benefits of which are payable to [name of corporation] as beneficiary under and owner of such insurance policies.
You have the right to decline to be insured. To exercise that right you must send [name of insurer] a signed written notice, which includes your address and date of birth, stating that you decline to be insured. To be effective the notice must be received by [name of insurer] at the following address: [address] within 30 days of the date specified below.
If you elect not to reject the insurance coverage described above, neither you nor your successors in interest may contest the validity of the coverage.
Date:_________________________________
Very truly yours,
[name of insurer]
18 Del. Admin. Code § 1211-7.0