SECTION 3.2. Definitions  


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  • The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

    (1) Alternate face page--A face page of a group policy, certificate, or contract, which may be used in place of the face page of a previously approved or exempted group policy, certificate, or contract when the group policy, certificate, or contract will be issued to a different or specific group (e.g., a policy that was filed as an "ABC Multiple Employer Trust (MET)" that is later issued to a specific MET).

    (2) Department--The Texas Department of Insurance.

    (3) Filing--A submission, made to the department by a company, that is accompanied by either a transmittal checklist or a transmittal form, and which may include policies, certificates, contracts, applications, certifications, informational materials, insert pages, riders, limited partial refilings, matrix filings, and rates.

    (4) General use--A filing that will be used with other forms submitted in the filing or with previously approved and exempted forms for a certain product or products or a subset of a product or type (e.g., an application that will be used with all life products; an application that will be used with all universal life products; an application that will be used with group life and accident and health products; an application that will be used with major medical and hospital surgical products).

    (5) Insert page--A page used to replace an existing page of a previously approved or exempted contract.

    (6) Limited, partial refilings--A change to a previously approved or exempted life or annuity form that meets one or more of the criteria set forth in subparagraphs (A) - (D) of this paragraph as follows:

    (A) a change in the text, interest rate, guaranteed charges, or mortality table used to compute nonforfeiture values for life insurance or annuities;

    (B) a change in the current interest rate, where such rates are guaranteed and shown in the policy or contract;

    (C) a change in the reserves (if the change in reserves impacts the text of the policy);

    (D) a change to the separate account for variable products when the separate account is bracketed as variable text on the initial filing.

    (7) Matrix filing--A filing consisting of individual provisions, each with its own unique identifiable form number, allowing the flexibility to create multiple policies, certificates, contracts or applications by using numerous combinations of the individual provisions approved or exempted.

    (8) New filing--A filing that has not been previously reviewed, approved, or disapproved by the department, or a filing that has been previously withdrawn and is being resubmitted as a new filing (not to include the withdrawal of a filing containing corrections to a form subsequent to the company receiving a disapproval from the department);

    (9) Purpose and use--For each submitted form, the purpose and use will be a brief description to include at least the following:

    (A) how a form will be used (e.g., the application will be used on a general use basis; or used with specific policy(ies) or contract form(s) previously approved or exempted);

    (B) the type of coverage provided by the form (e.g., whole life, term life, universal life, variable annuity, major medical, specified disease, accident only, or hospital indemnity);

    (C) any key or unique provisions contained in the form (e.g., for life and annuities--bonus interest, additional interest credits, two-tier values, bail-out, market value adjustments, and long term care; for accident and health--preferred provider benefits, prescription drugs, and innovative benefit in a Medicare supplement policy);

    (D) if applicable, how the form will be marketed (e.g., direct, agent, or electronic);

    (E) if applicable, to whom the form is to be marketed (e.g., specific groups such as an annuity contract marketed to issue ages 25 - 60, or a health benefit plan issued to children only, including Insurance Code Chapter 1502).

    (10) Rider--An amendment or endorsement that changes a policy, certificate, or contract to add, expand, limit, or remove provisions and/or benefits, which may be optional or mandatory, and when used, becomes a part of the policy, certificate, or contract.

Source Note: The provisions of this §3.2 adopted to be effective June 1, 2003, 28 TexReg 3954; amended to be effective May 11, 2022, 47 TexReg 2758