Ins 6.06(5)(d) (d) When used, any premium adjustment factors and loss adjustment factors by year and an explanation of methods and judgments underlying each factor. Loss adjustment factors include but are not limited to loss development factors, frequency trend factors, and severity trend factors. Premium adjustment factors include but are not limited to rate level factors.

Ins 6.06(6) (6) Other supplemental rate information. The commissioner may accept supplemental information other than that required by sub. (5) if the insurer or rate service organization can demonstrate to the commissioner that this information fully supports the rate filing and complies with s. 625.11, Stats.

Ins 6.06(7) (7) Use of rate service organization rates. A member of or subscriber to a rate service organization licensed under s. 625.32, Stats., shall file supplementary rate information if its rates deviate from those filed on its behalf by the rate service organization. Such a filing shall be as required by subs. (5) and (6).

Ins 6.06(8) (8) Additional information. The commissioner may require additional rate filing information if the commissioner determines that the original filing does not explain the proposed rate. Such additional information shall be provided within 30 days of the request.

Ins 6.06 History History: Cr. Register, March, 1988, No. 387, eff. 4-1-88; am. (5) (a) 1. intro. and (9), Register, November, 1988, No. 395, eff. 12-1-88; r. (9) and Appendix, Register, January, 1995, No. 469, eff. 2-1-95; correction in (1) made under s. 13.93 (2m) (b) 7., Stats., Register, February, 2000, No. 530.

Ins 6.07 Ins 6.07 Insurance policy language simplification.

Ins 6.07(1) (1) Purpose. The purpose of this rule is to establish minimum standards for legibility, coherence and understandability in consumer insurance policies delivered or issued for delivery in the state of Wisconsin on or after the effective dates stipulated in sub. (8). Sections of statutes interpreted or implemented by this rule are ss. 631.20 (2) (a) and 631.22, Stats.

Ins 6.07(2) (2) Scope. This rule shall apply to “consumer insurance policies”as defined in sub. (3) and not exempted under sub. (5).

Ins 6.07(3) (3) Definitions.

Ins 6.07(3)(a) (a) In this section “consumer insurance policy”means a life, disability, property or casualty insurance policy, or a certificate or a substitute for a certificate for group life, disability, property or casualty insurance coverage, which is issued to a person for personal, family or household purpose and a copy of which is customarily, in the insurance industry, delivered or is required by law, rule or agreement to be delivered to the person obtaining insurance coverage.

Ins 6.07(3)(b) (b) The term “text” as used in this section shall include all printed or electronic matter except the following:

Ins 6.07(3)(b)1. 1. The name and address of the insurer; the name, number or title of the consumer insurance policy; the table of contents or index; captions and subcaptions; specification pages, schedules or tables; and

Ins 6.07(3)(b)2. 2. Any such form language that is drafted to conform to the requirements of any federal law, regulation or agency interpretation; any form language required by any collectively bargained agreement; any medical terminology; any words which are defined in the form; and any form language required by state law or regulation; provided, however, the insurer identifies the language or terminology excepted by this subdivision and certifies, in writing to the commissioner, that the language or terminology is entitled to be excepted by this subdivision.

Ins 6.07(4) (4) Minimum standards.

Ins 6.07(4)(a) (a) In addition to any other requirements of law, no consumer insurance policy, unless excepted under sub. (5), shall be delivered or issued for delivery in this state on or after the dates such forms must be approved under this section, unless:

Ins 6.07(4)(a)1. 1. The text achieves a minimum score of 50 for those policies labeled as Medicare supplement policies as defined by s. Ins 3.39 and a minimum score of 40 for all other policies included under this rule, on the Flesch reading ease test as described in par. (b), or an equivalent score on any other comparable test as provided in par. (c) or this subsection unless a lower score is authorized under sub. (7);

Ins 6.07(4)(a)2. 2. It is printed, except for specification pages, schedules and tables, in not less than 10 point type, one point leaded;

Ins 6.07(4)(a)3. 3. It is appropriately divided and captioned, presented in a meaningful sequence, and the style, arrangement and overall appearance of the policy enhance its understandability;

Ins 6.07(4)(a)4. 4. It contains a table of contents or an index of the principal sections of the policy if the policy contains more than 3,000 words or if the policy has more than 3 pages;

Ins 6.07(4)(a)5. 5. It contains a single section listing exclusions or the exclusions are listed within the form and given at least equal prominence including same type size;

Ins 6.07(4)(a)6. 6. It defines words and expressions which are not commonly understood, or whose commonly understood meaning is not intended;

Ins 6.07(4)(a)7. 7. Cross-referencing between sections of the policy is maintained at a minimum.

Ins 6.07(4)(b) (b) For the purpose of this section, a Flesch reading ease test score shall be measured by the following method:

Ins 6.07(4)(b)1. 1. For consumer insurance policies containing 10,000 words or less of text, the entire form shall be analyzed. For such forms containing more than 10,000 words, the readability of two 200-word samples per page may be analyzed instead of the entire form. The samples shall be separated by at least 20 printed lines.

Ins 6.07(4)(b)2. 2. The number of words and sentences in the text shall be counted and the total number of words divided by the total number of sentences. The figure obtained shall be multiplied by a factor of 1.015.

Ins 6.07(4)(b)3. 3. The total number of syllables shall be counted and divided by the total number of words. The figure obtained shall be multiplied by a factor of 84.6.

Ins 6.07(4)(b)4. 4. The sum of the figures computed under subds. 2. and 3. subtracted from 206.835 equals the Flesch reading ease score for the consumer insurance policy.

Ins 6.07(4)(b)5. 5. For purposes of subds. 2., 3., and 4., the following procedures shall be used:

Ins 6.07(4)(b)5.a. a. A contraction, hyphenated word, or numbers and letters, when separated by spaces, shall be counted as one word;