Ill. Admin. Code tit. 50 § 1407.30

Current through Register Vol. 48, No. 43, October 25, 2024

Section 1407.30 - Form Requirements

No policies, contracts, riders, endorsements or amendments which provide for accelerated benefits may be issued for delivery in this State unless they meet the following requirements.

a) General Standards and Practices

1) The name given to the coverage must be descriptive of the coverage provided and the terminology "accelerated benefit" shall be included in the descriptive title. Products regulated under this Part shall not be described or marketed as long-term care insurance, as providing long-term care benefits, or as long-term care partnership insurance.

2) The death benefit net of any outstanding policy loans shall not be reduced by more than the amount of the accelerated benefits and any applicable accrued interest, or any applicable actuarial present value discount appropriate to the policy design.

3) The renewability and cost of any accelerated benefit life insurance policy must be guaranteed for the term of the policy or rider. This requirement will not apply to coverage in which the insurer pays the present value of the life insurance face amount based on an applicable actuarial discount. The requirements of this subsection are not applicable to group insurance.

b) Filing Requirements

1) All policy forms and certificate forms pertaining to an accelerated benefit shall be filed with the Department of Insurance for its review and approval pursuant to 50 Ill. Adm. Code 916 prior to their use in this State.

2) If the filing is other than a policy or contract, the insurer shall provide the form number of the policy or contract form or forms with which the accelerated benefit filing is to be used.

3) If a form provides for a reduction in policy values following payment of the accelerated benefit, the insurer shall provide the Department with an actuarial explanation of the policy value reductions and the remaining premium, if any.

4) The insurer shall file with the Department the disclosure statements it will utilize to comply with Section 1407.50 of this Part.

5) Concurrently with the accelerated benefit policy form filing required by this Section, the insurer shall file the actuarial memorandum required by Section 1407.70 of this Part.

c) Effective Date of the Accelerated Benefits. The accelerated benefit provision shall be effective for accidents on the effective date of the policy or rider. The accelerated benefit provision shall be effective for illness no more than 30 days following the effective date of the policy or rider.

d) Waiver of Premiums. The insurer may offer a waiver of premium for the accelerated benefit provision in the absence of a regular waiver of premium provision being in effect. At the time the benefit is claimed, the insurer shall explain any continuing premium requirement to keep the policy in force.

e) Discrimination. An insurer shall not unfairly discriminate among insureds with differing qualifying events covered under the policy or among insureds with similar qualifying events covered under the policy. An insurer shall not apply further conditions on the payment of the accelerated benefits other than those conditions specified in the policy or rider.

Ill. Admin. Code tit. 50, § 1407.30

Amended at 23 Ill. Reg. 14688, effective December 14, 1999