SubTitle38a-640-1_38a-640-4. Approval of Form of Fraternal Benefit Society Policies and Contracts, Title38a Insurance Department, Regulations of Connecticut State Agencies

Regulations of Connecticut State Agencies (Last Updated: June 14,2023)

Title38a Insurance Department

SubTitle38a-640-1_38a-640-4. Approval of Form of Fraternal Benefit Society Policies and Contracts

Sec. 38a-640-1. Definitions

Latest version.

As used in Sections 38a-640-1 to 38a-640-4, inclusive, of the Regulations of Connecticut State Agencies:

(a) ‘‘Commissioner’’ means the Insurance Commissioner of the State of Connecticut.

(b) ‘‘Form’’ means a certificate or other evidence of a contract of accident insurance or health insurance or of a total and permanent disability contract, or application, rider or endorsement used in connection therewith.

(d) “SERFF” means National Association of Insurance Commissioners System for Electronic Rate and Form Filing.

(Effective September 25, 1992; Amended April 23, 2015)

Sec. 38a-640-2. Filing procedure

Latest version.

Any society required pursuant to Section 38a-640 of the Connecticut General Statutes to file a copy of a form with the Commissioner for approval, shall comply with the following standards:

(a) Filing.

(1) Filing shall be done electronically through SERFF or any subsequent corresponding system adopted by the National Association of Insurance Commissioners or the Commissioner. All fields in SERFF shall be filled out appropriately and accurately for each filing.

(2) The electronic filing shall contain a descriptive caption. The caption shall identify the society and include a brief description of the type of filing, and any applicable form identification number. All subsequent correspondence to the Insurance Department on the filing shall include the caption in the identical format as it was displayed in the original electronic filing and a reference to the previous filing’s State tracking number, in addition to the date of the original filing transmittal document and the Department’s file number, if known.

(3) All SERFF submissions shall include the following information in the filing description:

(A) A list of the documents submitted therewith;

(B) A brief outline of proposed changes;

(D) The proposed effective date; and

(E) Whether the form sought to be approved by the Commissioner is subject to the requirements of the Insurance Plain Language Act, Chapter 699a of the Connecticut General Statutes.

(b) Every form filing shall be completed in ‘‘John Doe’’ fashion.

(c) (1) Every form filing subject to the requirements of the Insurance Plain Language Act, Chapter 699a of the Connecticut General Statutes, shall be accompanied with a certificate signed by an officer of the society, that the form complies with the Insurance Plain Language Act.

(2) The certificate required by subdivision (1) of this subsection shall be in the following form:

(NAME OF COMPANY)

(COMPANY ADDRESS)

This is to certify that the forms listed below are in compliance with Chapter 699a of the Connecticut General Statutes.

A. Option Selected

_____1. Policy and its related forms are scored for the Flesch reading ease test as one

unit and the combined score is ____.

_____2. Policy and its related forms are scored separately for the Flesch

reading ease test. Scores for the policy and each form are indicated below:

Form Form Number Flesch Score

B. Test Option Selected

_____1. Test was applied to entire form(s).

_____2. Test was applied on sample basis. Form(s) contain(s) more than

10,000 words. Copy of form(s) enclosed indicating word samples tested.

C. Standards for Certification

A checked block indicates the standard has been achieved.

_____1. The policy text achieves a minimum score of 45 on the Flesch reading

ease test in accordance with the option chosen in Section A above.

_____2. It is printed in not less than ten point type, one point leaded. (This

does not apply to specification pages, schedules and tables.)

_____3. The layout and spacing of the policy separate the paragraphs from

each other and from the border of the paper.

_____4. The section titles are captioned in bold face type or otherwise stand

out significantly from the text.

_____5. Unnecessarily long, complicated or obscure words, sentences, para-

graphs or constructions are not used in the policy.

_____6. The style, arrangement and overall appearance of the policy give no

undue prominence to any portion of the policy or to any endorsement or

riders.

______7. A table of contents or an index of the principal sections is included

in the policy. (This applies only if the policy has more than 3,000 words or

consists of more than 3 pages.)

(SOCIETY NAME)

_________________ By: ______________________________

(Date) (Title)

(d) Each form filing shall be accompanied with the schedule of premium rates that will be used in connection with such form.

(e) When a society makes reference to another document in its filing, it shall include a copy or provide the tracking number for the referenced document.

(f) The Insurance Department is obligated to collect, pursuant to Section 38a-11(b) of the Connecticut General Statutes, form filing fees from foreign or alien societies, if the state in which they are domiciled imposes such and larger fees upon Connecticut’s domestic societies. Accordingly, each society domiciled in any other state which requires such fees shall remit the equivalent filing fee (in the form of a check made payable to the Treasurer, State of Connecticut or electronically through SERFF) together with each such filing submitted. The society shall also represent and certify that the fee payment remitted is the same amount required by its domiciliary state or jurisdiction.

(Effective September 25, 1992; Amended April 23, 2015; Amended April 4, 2017)

Sec. 38a-640-3. Policy form approval

Latest version.

(a) Each filing shall be state specific. Only filings with state specific language will be approved.

(b) Unless otherwise provided by law, the Insurance Department shall review all forms filed with the Insurance Commissioner for approval pursuant to Section 38a-640 of the Connecticut General Statutes in the order in which they are received by the Department; provided, however, that in appropriate circumstances the Commissioner may waive this requirement and direct the immediate review of a form filing. The Department shall employ a chronological logging system to facilitate the chronological review of such forms.

(c) Within ninety (90) days after a form is accepted for review, the Insurance Department shall review the form and either approve it or disapprove it. If, upon such review of the form, the Insurance Department determines that additional information from the society is necessary in order to ascertain whether the form is contrary to law, the Department shall make such request to the society. The society will then have ten (10) days from the date of the request to provide the Department with the additional information; provided that during such time, the society may request in writing that the period for responding to the request for information be extended for an additional period of time, not to exceed thirty (30) days. The request for extension shall be considered granted upon its receipt by the Insurance Department. During the pendency of the Insurance Department’s request for information, the ninety (90) day period for Department action shall be tolled. If the society fails to comply with such request within the allotted time, the society shall be deemed to have voluntarily withdrawn its filing and the Department shall close its file without further action.

(d) The Commissioner shall issue a decision disapproving the use of any such form if it does not comply with the requirements of law. Any such decision shall specify the reason for disapproval of the form.

(e) Forms that are approved by the Commissioner shall have the form labeled ‘‘Approved,’’ together with the name and signature of the staff member who acted upon the filing and the date of the approval.

(Effective September 25, 1992; Amended April 23, 2015)

Sec. 38a-640-3a. Electronic filing

Latest version.

Filings shall be considered received by the Commissioner when received at the Insurance Department. Filings received on a weekend or legal holiday shall be deemed received on the next business day. An electronic communication from the Insurance Department concerning a filing shall be deemed received by the person to whom the communication is addressed when the communication is sent to that person.

(Adopted effective January 2, 2002; Amended April 23, 2015)

Sec. 38a-640-4. Severability

Latest version.

If any provision of this regulation or application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the regulation and the application of such provision to other persons or circumstances shall not be affected thereby.

(Effective September 25, 1992)