28 Tex. Admin. Code § 3.5202

Current through Reg. 49, No. 25; June 21, 2024
Section 3.5202 - Reasonable Relation of Benefits to Premiums for Approved Deviations

As the basic test of the reasonableness of the relation of benefits to the premium charges for approved deviations, to be applied separately by policy form number, it is hereby declared that the benefits of credit life insurance or credit accident and health insurance, individual or group, shall not be considered to be reasonable in relation to the premium charges, unless it can be reasonably anticipated that a loss ratio of "claims incurred" to "earned premiums" will, after the increase becomes effective, be no less than the following:

(1) Loss Ratios For Class E Only:
(A) credit life--43%;
(B) credit accident and health:
(i) 46% for Plans 10 - 14 and 22 - 26 on the Presumptive Premium Rate Chart found at § 3.5206 of this subchapter (relating to Presumptive Premium Rates); and
(ii) 44% for Plans 16 - 19 on the Presumptive Premium Rate Chart found at § 3.5206 of this subchapter.
(2) Loss Ratios For All Other Classes:
(A) credit life--48%;
(B) credit accident and heath:
(i) 51% for Plans 10 - 14 and 22 - 26 on the Presumptive Premium Rate Chart found at § 3.5206 of this subchapter; and
(ii) 46% for Plans 16 - 19 on the Presumptive Premium Rate Chart found at § 3.5206 of this subchapter.

28 Tex. Admin. Code § 3.5202

The provisions of this §3.5202 adopted to be effective October 1, 1980, 5 TexReg 2772; amended to be effective June 30, 1992, 17 TexReg 4345; amended to be effective June 7, 2005, 30 TexReg 3210