Chapter Ins 2

Chapter Ins 2

LIFE INSURANCE

Ins 2.01   Estoppel by report of medical examiner.

Ins 2.03   Policies not dated back to lower insurance age.

Ins 2.05   Separate statement of premiums for certain disability insurance benefits included in life or endowment insurance policies.

Ins 2.07   Replacement of life insurance or annuity contracts; disclosure requirements.

Ins 2.08   Special policies and provisions; prohibitions, regulations, and disclosure requirements.

Ins 2.09   Separate and distinct representations of life insurance.

Ins 2.12   Exceptions to unfair discrimination.

Ins 2.13   Separate accounts and variable contracts.

Ins 2.14   Life insurance solicitation.

Ins 2.15   Annuity benefit solicitations.

Ins 2.16   Advertisements of and deceptive practices in life insurance and annuities.

Ins 2.17   Life insurance illustrations.

Ins 2.18   Life settlement contracts.

Ins 2.19   Military sales practices.

Ins 2.20   Unisex nonforfeiture values in certain life insurance policies.

Ins 2.30   Annuity mortality tables.

Ins 2.35   Smoker and nonsmoker mortality tables for minimum reserve liabilities and minimum nonforfeiture benefits.

Ins 2.40   Annuity contracts without life contingencies.

Ins 2.45   Charitable organizations; insurable interest.

Ins 2.80   Valuation of life insurance policies.

Ins 2.81   Recognition of the 2001 CSO mortality table for use in determining minimum reserve liabilities and nonforfeiture benefits.

Ins 2.01 Ins 2.01 Estoppel by report of medical examiner. No company or fraternal benefit society shall issue in this state a contract, based on a medical examination, providing for disability benefits, the provisions of which are in conflict with ss. 632.50 and 632.71, Stats., or shall indulge in any practice which is at variance with said section.

Ins 2.01 History History: 1-2-56; emerg. am. eff. 6-22-76; am. Register, September, 1976, No. 249, eff. 10-1-76.

Ins 2.03 Ins 2.03 Policies not dated back to lower insurance age.

Ins 2.03(1) (1) No company shall issue for delivery in this state any policy or contract of life insurance which purports to be issued or take effect as of a date more than 6 months before the application therefor was made, if thereby the premium on such policy or contract is reduced below the premium which would be payable thereon as determined by the nearest birthday of the insured at the time when such application was made. The date of application must be considered to be the date on which the application (Part I) or the medical examination (Part II) is completed, whichever is the later.

Ins 2.03(2) (2) This ruling does not prohibit the exchange, alteration or conversion of policies of life insurance as of the original date of such policies if the amount of insurance provided under the new policy does not exceed the amount of insurance under the original policy or the amount of insurance which the premium paid for the original policy would have purchased if the new policy had been originally applied for, whichever is greater; nor prohibit the exercise of any conversion privilege contained in any policy or contract.

Ins 2.05 Ins 2.05 Separate statement of premiums for certain disability insurance benefits included in life or endowment insurance policies.

Ins 2.05(1) (1) Purpose. This rule provides guidelines to determine which disability coverages may be included in life or endowment insurance policies without a separate statement of premium charge. This rule interprets and implements the separation of premium requirements stated in s. 632.44 (1), Stats., as they relate to the inclusion of disability insurance by policy provision or rider in life or endowment insurance policies such as authorized by s. Ins 6.70 and s. 627.06, Stats.

Ins 2.05(2) (2) Scope. This rule shall apply to the kinds of disability insurance authorized by s. Ins 6.75 (1) (a) and (c), when such insurance is provided in a life or endowment policy either by specific policy provision or by a rider attached to such policy.

Ins 2.05(3) (3) Definitions.

Ins 2.05(3)(a) (a) Life or endowment insurance. The basic life or endowment insurance coverage provided by the policy and additional disability benefits which have been determined by the standards in sub. (4) to be benefits which are life or endowment insurance or an integral part of such coverages.

Ins 2.05(3)(b) (b) Disability insurance benefit. Insurance coverages written under the authority of s. Ins 6.75 (1) (a) and (c), to indemnify persons in whole or in part for financial loss due to bodily injury, death by accident, or health of persons.

Ins 2.05(3)(c) (c) Separate statement of premium. Individual statement of the exact gross premium charged for each distinct disability insurance coverage required by this rule to be stated separately from the premium charge for the basic life or endowment insurance coverage.

Ins 2.05(4) (4) Standards and procedures for determination. The following criteria or standards in pars. (a) through (e) shall be used to determine whether a disability benefit, coverage, or clause may be included in the basic life or endowment policy without a separate statement of the premium charged for such disability benefit. Subject to the approval of the commissioner of insurance, a disability benefit, coverage, or clause which satisfies the standards listed below may be included in the basic life or endowment coverage without a separate statement of cost. Disability coverages not meeting these standards may be included in or attached to the policy only with a separate statement of the premium if they otherwise meet the statutory requirements in respect to combination of coverages. The rule in no way requires that a disability benefit, coverage, or clause be included in the premium charge for the basic life or endowment coverage if the company desires to show the premium separately.

Ins 2.05(4)(a) (a) Small or very nominal cost for the disability coverage when compared with the cost of the basic life or endowment coverage.

Ins 2.05(4)(b) (b) Logical reason for including the disability benefit without a separate statement of premium.

Ins 2.05(4)(c) (c) There is a demonstrated need for, and the applicant would usually desire, the inclusion of the disability benefit.

Ins 2.05(4)(d) (d) Inclusion of the disability coverage could be easily understood by the applicant and is not subject to possible misinterpretation.

Ins 2.05(4)(e) (e) Custom of the insurance business has classed the disability coverage as basically a life insurance benefit.

Ins 2.05(5) (5) Disability benefits which require a separate statement. The following list constitutes a partial listing of disability coverages considered by the commissioner to be additional benefits which generally require a separate statement of premium charge if they are attached to or included in life or endowment coverage in accordance with other statutory requirements. Any such benefit may be included in a life or endowment insurance policy without a separate statement of premium if it is demonstrated that it meets the requirements listed in sub. (4).

Ins 2.05(5)(a) (a) Waiver of premium benefit for death and/or disability of payor.

Ins 2.05(5)(b) (b) Loss of sight and/or dismemberment benefit.

Ins 2.05(5)(c) (c) Disability income benefit.

Ins 2.05(5)(d) (d) Hospital insurance.

Ins 2.05(5)(e) (e) Basic or primary medical insurance.

Ins 2.05(5)(f) (f) Major medical benefit.

Ins 2.05(5)(g) (g) Surgical benefit.

Ins 2.05(6) (6) Disability benefits not listed. Disability benefits which are not specifically listed above will be examined at the time of filing to determine whether a separate statement of premium is required.

Ins 2.05(7) (7) Reserve values. Reserve values, on account of included provisions, will be based upon the requirements of s. 623.06, Stats., or other applicable statutes or, in the absence of specific requirements, on such additional standards as the commissioner of insurance may prescribe.

Ins 2.05(8) (8) Effective date. On or after April 1, 1965, no life insurance policy shall be approved for use and no such policy heretofore approved shall be issued or delivered in this state unless it meets the requirements of this rule.

Ins 2.05 Note Note: See historical note relating to s. Ins 2.05 as printed with this rule as released in December, 1984.

Ins 2.05 History History: 1-2-56; r. and recr. Register, March, 1965, No. 111, eff. 4-1-65; emerg. am. (1), (2) and (3) (b), eff. 6-22-76; am. (1), (2) and (3)(b), Register, September, 1976, No. 249, eff. 10-1-76; am. (1), (2) and (3) (b), Register, March, 1979, No. 279, eff. 4-1-79; r. (9) under s. 13.93 (2m) (b) 16., Stats., Register December, 1984, No. 348; corrections made under s. 13.93 (2m) (b) 6., Stats., Register, June, 1997, No. 498.

Ins 2.07 Ins 2.07 Replacement of life insurance or annuity contracts; disclosure requirements.

Ins 2.07(1) (1) Purpose. The purpose of this section is:

Ins 2.07(1)(a) (a) To regulate the activities of insurers and producers with respect to the replacement of existing life insurance and annuities.

Ins 2.07(1)(b) (b) To protect the interests of life insurance and annuity purchasers by establishing minimum standards of conduct to be observed in replacement or financed purchase transactions to assure that purchasers receive information with which a decision can be made in the purchaser’s best interest, reduce the opportunity for misrepresentation and incomplete disclosure, and establish penalties for failure to comply with requirements of this section.

Ins 2.07(2) (2) Scope. This section shall apply to the solicitation of life insurance and annuities authorized by s. Ins 6.75 (1) (a) and (b), covering residents of this state, and issued by insurers including insurance corporations, fraternal benefit societies, or the State Life Insurance Fund. Except as specifically stated, this section shall not apply to transactions involving any of the following:

Ins 2.07(2)(a) (a) Credit life insurance.

Ins 2.07(2)(b) (b) Group life insurance or group annuities where there is no direct solicitation of individuals by a producer. Direct solicitation shall not include any group meeting held by a producer solely for the purpose of educating or enrolling individuals or, when initiated by an individual member of the group, assisting with the selection of investment options offered by a single insurer in connection with enrolling that individual. Group life insurance or group annuity certificates marketed through direct response solicitation shall be subject to the provisions of sub. (8).

Ins 2.07(2)(c) (c) Group life insurance and annuities used to fund prearranged funeral contracts.

Ins 2.07(2)(d) (d) An application to the existing insurer that issued the existing policy or contract when a contractual change or a conversion privilege is being exercised; or, when the existing policy or contract is being replaced by the same insurer pursuant to a program filed with and approved by the commissioner; or, when a term conversion privilege is exercised among corporate affiliates.

Ins 2.07(2)(e) (e) Proposed life insurance that is to replace life insurance under a binding or conditional receipt issued by the same insurer.

Ins 2.07(2)(f) (f) Policies or contracts used to fund an employee pension or welfare benefit plan that is covered by the Employee Retirement Income Security Act, ERISA, 29 USC 1001 et. seq., a plan described by sections 401(a), 401(k) or 403(b) of the Internal Revenue Code, where the plan, for purposes of ERISA, is established or maintained by an employer, a governmental or church plan defined in section 414 of the Internal Revenue Code, a governmental or church welfare benefit plan, or a deferred compensation plan of a state or local government or tax exempt organization under Section 457 of the Internal Revenue Code, or a nonqualified deferred compensation arrangement established or maintained by an employer or plan sponsor. This section shall apply to policies or contracts used to fund any plan or arrangement that is funded solely by contributions an employee elects to make, whether on a pre-tax or after-tax basis, and where the insurer has been notified that plan participants may choose from among 2 or more insurers and there is a direct solicitation of an individual employee by a producer for the purchase of a contract or policy. As used in this subsection, direct solicitation shall not include any group meeting held by a producer solely for the purpose of educating individuals about the plan or arrangement or enrolling individuals in the plan or arrangement or, when initiated by an individual employee, assisting with the selection of investment options offered by a single insurer in connection with enrolling that individual employee.

Ins 2.07(2)(g) (g) Where new coverage is provided under a life insurance policy or contract and the cost is borne wholly by the insured’s employer or by an association of which the insured is a member.

Ins 2.07(2)(h) (h) Existing life insurance that is a non-convertible term life insurance policy that will expire in 5 years or less from the date of issue and cannot be renewed.

Ins 2.07(2)(i) (i) Immediate annuities that are purchased with proceeds from an existing annuity contract. Immediate annuities purchased with proceeds from an existing life insurance policy are not exempted from the requirements of this section.

Ins 2.07(2)(j) (j) Structured settlements.

Ins 2.07(2)(k) (k) Registered contracts shall be exempt from the requirements of subs. (6) (a) 2. and (7) (b) with respect to the provision of illustrations or policy summaries; however, premium or contract contribution amounts and identification of the appropriate prospectus or offering circular shall be required instead.