10509.950. In order to protect consumers and foster consumer
education, this chapter shall govern the regulation of life insurance
policy illustrations. It is the intent of the Legislature in
enacting this chapter to ensure that illustrations do not mislead
purchasers of life insurance and to make illustrations more
understandable by providing illustration formats, prescribing
standards to be followed when illustrations are used, and specifying
the disclosures that are required in connection with illustrations.
Insurers should, as far as possible, eliminate the use of footnotes
and caveats and define terms used in the illustration in language
that is understandable by a typical person within the segment of the
public to which the illustration is directed.
10509.952. This chapter shall apply to all group and individual
life insurance policies and certificates except as follows:
(a) Variable life insurance.
(b) Individual and group annuity contracts.
(c) Credit life insurance.
(d) Life insurance policies with no illustrated death benefits on
any individual exceeding ten thousand dollars ($10,000).
10509.953. As used in this chapter:
(a) "Actuarial Standards Board" means the board established by the
American Academy of Actuaries to develop and promulgate standards of
actuarial practice.
(b) "Contract premium" means the gross premium that is required to
be paid under a fixed premium policy, including the premium for a
rider for which benefits are shown in the illustration.
(c) "Currently payable scale" means a scale of nonguaranteed
elements in effect for a policy form as of the preparation date of
the illustration or declared to become effective within the next 95
days.
(d) "Disciplined current scale" means a scale of nonguaranteed
elements constituting a limit on illustrations currently being
illustrated by an insurer that is reasonably based on actual recent
historical experience, as certified annually by an illustration
actuary designated by the insurer. Further guidance in determining
the disciplined current scale as contained in standards established
by the Actuarial Standards Board may be relied upon if the standards
meet all of the following:
(1) Have not been found to be inconsistent with the provisions of
this chapter by the commissioner after a hearing held in accordance
with Sections 11500 to 11530, inclusive, of the Government Code.
(2) Limit a disciplined current scale to reflect only actions that
have already been taken or events that have already occurred.
(3) Do not permit a disciplined current scale to include any
projected trends of improvements in experience or any assumed
improvements in experience beyond the illustration date.
(4) Do not permit assumed expenses to be less than minimum assumed
expenses.
(e) "Generic name" means a short title descriptive of the policy
being illustrated such as whole life, "term life" or "flexible
premium adjustable life."
(f) "Guaranteed elements" means the premiums, benefits, values,
credits or charges under a policy of life insurance that are
guaranteed and determined at issue.
(g) "Illustrated scale" means a scale of nonguaranteed elements
currently being illustrated that is not more favorable to the policy
owner than the lesser of either of the following:
(1) The disciplined current scale.
(2) The currently payable scale.
(h) "Illustration" means a presentation or depiction that includes
nonguaranteed elements of a policy of life insurance over a period
of years and that is one of the three types defined below:
(1) "Basic illustration" means a ledger or proposal used in the
sale of a life insurance policy that shows both guaranteed and
nonguaranteed elements.
(2) "Supplemental illustration" means an illustration furnished in
addition to a basic illustration that meets the applicable
requirements of this regulation, and that may be presented in a
format differing from the basic illustration, but may only depict a
scale of nonguaranteed elements that is permitted in a basic
illustration.
(3) "In force illustration" means an illustration furnished at any
time after the policy that it depicts has been in force for one year
or more.
(i) "Illustration actuary" means an actuary meeting the
requirements of Section 10509.960 who certifies to illustrations
based on the standard of practice promulgated by the Actuarial
Standards Board.
(j) "Lapse-supported illustration" means an illustration of a
policy form failing the test of self-supporting as defined in this
chapter, under a modified persistency rate assumption using
persistency rates underlying the disciplined current scale for the
first five years and 100 percent policy persistency thereafter.
(k) "Life insurance" means insurance upon the lives of persons or
appertaining thereto.
(l) (1) "Minimum assumed expenses" means the minimum expenses that
may be used in the calculation of the disciplined current scale for
a policy form. The insurer may choose to designate each year the
method of determining assumed expenses for all policy forms from all
of the following:
(A) Fully allocated expenses.
(B) Marginal expenses.
(C) A generally recognized expense table based on fully allocated
expenses representing a significant portion of insurance companies
and approved by the commissioner.
(2) Marginal expenses may be used only if greater than a generally
recognized expense table. If no generally recognized expense table
is approved, fully allocated expenses must be used.
(m) "Non-guaranteed elements" means the premiums, benefits,
values, credits or charges under a policy of life insurance that are
not guaranteed or not determined at issue.
(n) "Non-term group life" means a group policy or individual
policies of life insurance issued to members of an employer group or
other permitted group that includes all of the following:
(1) Every plan of coverage was selected by the employer or other
group representative.
(2) Some portion of the premium is paid by the group or through
payroll deduction.
(3) Group underwriting or simplified underwriting is used.
(o) "Policy owner" means the owner named in the policy or the
certificate holder in the case of a group policy.
(p) "Premium outlay" means the amount of premium assumed to be
paid by the policy owner or other premium payer out-of-pocket.
(q) "Self-supporting illustration" means an illustration of a
policy form for which it can be demonstrated that, when using
experience assumptions underlying the disciplined current scale, for
all illustrated points in time on or after the 15th policy
anniversary or the 20th policy anniversary for second-or-later-to-die
policies (or upon policy expiration if sooner), the accumulated
value of all policy cash-flows equals or exceeds the total policy
owner value available. For this purpose, policy owner value will
include cash surrender values and any other illustrated benefit
amounts available at the policy owner's election.
10509.954. (a) Each insurer marketing policies to which this
chapter is applicable shall notify the commissioner whether a policy
form is to be marketed with or without an illustration. For all
policy forms being actively marketed on the effective date of this
chapter, the insurer shall identify in writing those forms and
whether or not an illustration will be used with them. For policy
forms filed after the effective date of this chapter, the
identification shall be made at the time of filing. Any previous
identification may be changed by notice to the commissioner.
(b) If the insurer identifies a policy form as one to be marketed
without an illustration, any use of an illustration for any policy
using that form prior to the first policy anniversary is prohibited.
(c) If a policy form is identified by the insurer as one to be
marketed with an illustration, a basic illustration prepared and
delivered in accordance with this chapter is required, except that a
basic illustration need not be provided to individual members of a
group or to individuals insured under multiple lives coverage issued
to a single applicant unless the coverage is marketed to these
individuals. The illustration furnished an applicant for a group life
insurance policy or policies issued to a single applicant on
multiple lives may be either an individual or composite illustration
representative of the coverage on the lives of members of the group
or the multiple lives covered.
(d) Potential enrollees of nonterm group life subject to this
chapter shall be furnished a quotation with the enrollment materials.
The quotation shall show potential policy values for sample ages and
policy years on a guaranteed and nonguaranteed basis appropriate to
the group and the coverage. This quotation shall not be considered an
illustration for purposes of this chapter, but all information
provided shall be consistent with the illustrated scale. A basic
illustration shall be provided at delivery of the certificate to
enrollees for nonterm group life who enroll for more than the minimum
premium necessary to provide pure death benefit protection. In
addition, the insurer shall make a basic illustration available to
any nonterm group life enrollee who requests it.
10509.955. (a) An illustration used in the sale of a life insurance
policy shall satisfy the applicable requirements of this chapter, be
clearly labeled "life insurance illustration," and include, but not
be limited to, the following information:
(1) Name of insurer.
(2) Name and business address of producer or insurer's authorized
representative, if any.
(3) Name, age and sex of proposed insured, except where a
composite illustration is permitted under this chapter.
(4) Underwriting or rating classification upon which the
illustration is based.
(5) Generic name of the policy, the company product name, if
different, and form number.
(6) Initial death benefit.
(7) Dividend option election or application of nonguaranteed
elements, if applicable.
(b) When using an illustration in the sale of a life insurance
policy, an insurer or its producers or other authorized
representatives shall not do any of the following:
(1) Represent the policy as anything other than a life insurance
policy.
(2) Use or describe nonguaranteed elements in a manner that is
misleading or has the capacity or tendency to mislead.
(3) State or imply that the payment or amount of nonguaranteed
elements is guaranteed.
(4) Use an illustration that does not comply with the requirements
of this chapter.
(5) Use an illustration that at any policy duration depicts policy
performance more favorable to the policy owner than that produced by
the illustrated scale of the insurer whose policy is being
illustrated.
(6) Provide an applicant with an incomplete illustration.
(7) Represent in any way that premium payments will not be
required for each year of the policy in order to maintain the
illustrated death benefits, unless that is the fact.
(8) Use the term "vanishing" or "vanishing premium," or a similar
term that implies the policy becomes paid up, to describe a plan for
using nonguaranteed elements to pay a portion of future premiums.
(9) Except for policies that can never develop nonforfeiture
values, use an illustration that is "lapse-supported."
(10) Use an illustration that is not "self-supporting."
(c) If an interest rate used to determine the illustrated
nonguaranteed elements is shown, it shall not be greater than the
earned interest rate underlying the disciplined current scale.
10509.956. (a) A basic illustration shall conform with the
following requirements:
(1) The illustration shall be labeled with the date on which it
was prepared.
(2) Each page, including any explanatory notes or pages, shall be
numbered and show its relationship to the total number of pages in
the illustration.
(3) The assumed dates of payment receipt and benefit payout within
a policy year shall be clearly identified.
(4) If the age of the proposed insured is shown as a component of
the tabular detail, it shall be issue age plus the numbers of years
the policy is assumed to have been in force.
(5) The assumed payments on which the illustrated benefits and
values are based shall be identified as premium outlay or contract
premium, as applicable. For policies that do not require a specific
contract premium, the illustrated payments shall be identified as
premiums outlay.
(6) Guaranteed death benefits and values available upon surrender,
if any, for the illustrated premium outlay or contract premium shall
be shown and clearly labeled guaranteed.
(7) If the illustration shows any nonguaranteed elements, they
cannot be based on a scale more favorable to the policy owner than
the insurer's illustrated scale at any duration. These elements shall
be clearly labeled nonguaranteed.
(8) The guaranteed elements, if any, shall be shown before
corresponding nonguaranteed elements and shall be specifically
referred to on any page of an illustration that shows or describes
only the nonguaranteed elements.
(9) The account or accumulation value of a policy, if shown, shall
be identified by the name this value is given in the policy being
illustrated and shown in close proximity to the corresponding value
available upon surrender.
(10) The value available upon surrender shall be identified by the
name this value is given in the policy being illustrated and shall
be the amount available to the policy owner in a lump sum after
deduction of surrender charges, policy loans, and policy loan
interest, as applicable.
(11) Illustrations may show policy benefits and values in graphic
or chart form in addition to the tabular form.
(12) Any illustration of nonguaranteed elements shall be
accompanied by a statement indicating that:
(A) The benefits and values are not guaranteed.
(B) The assumptions on which they are based are subject to change
by the insurer.
(C) Actual results may be more or less favorable.
(13) If the illustration shows that the premium payer may have the
option to allow policy charges to be paid using nonguaranteed
values, the illustration shall clearly disclose that a charge
continues to be required and that, depending on actual results, the
premium payer may need to continue or resume premium outlays. Similar
disclosure shall be made for premium outlay of lesser amounts or
shorter durations than the contract premium. If a contract premium is
due, the premium outlay display shall not be left blank or show zero
unless accompanied by an asterisk or similar mark to draw attention
to the fact that the policy is not paid up.
(14) If the applicant plans to use dividends or policy values,
guaranteed or nonguaranteed, to pay all or a portion of the contract
premium or policy charges, or for any other purpose, the illustration
may reflect those plans and the impact on future policy benefits and
values.
(b) A basic illustration shall include all of the following:
(1) A brief description of the policy being illustrated, including
a statement that it is a life insurance policy.
(2) A brief description of the premium outlay or contract premium,
as applicable, for the policy. For a policy that does not require
payment of a specific contract premium, the illustration shall show
the premium outlay that must be paid to guarantee coverage for the
term of the contract, subject to maximum premiums allowable to
qualify as a life insurance policy under the applicable provisions of
the Internal Revenue Code.
(3) A brief description of any policy features, riders or options,
guaranteed or nonguaranteed, shown in the basic illustration and the
impact they may have on the benefits and values of the policy.
(4) Identification and a brief definition of column headings and
key terms used in the illustration.
(5) A statement as follows: "This illustration assumes that the
currently illustrated nonguaranteed elements will continue unchanged
for all years shown. This is not likely to occur, and actual results
may be more or less favorable than those shown."
(c) (1) Following the narrative summary, a basic illustration
shall include a numeric summary of the death benefits and values and
the premium outlay and contract premium, as applicable. For a policy
that provides for a contract premium, the guaranteed death benefits
and values shall be based on the contract premium. This summary shall
be shown for at least policy years 5, 10, and 20 and at age 70, if
applicable, on the three bases shown below. For multiple life
policies the summary shall show policy years 5, 10, 20, and 30.
(A) Policy guarantees.
(B) Insurer's illustrated scale.
(C) Insurer's illustrated scale used but with the nonguaranteed
elements reduced as follows:
(i) Dividends at 50 percent of the dividends contained in the
illustrated scale used.
(ii) Nonguaranteed credited interest at rates that are the average
of the guaranteed rates and the rates contained in the illustrated
scale used.
(iii) All nonguaranteed charges, including but not limited to,
term insurance charges, mortality and expense charges, at rates that
are the average of the guaranteed rates and the rates contained in
the illustrated scale used.
(2) In addition, if coverage would cease prior to policy maturity
or age 100, the year in which coverage ceases shall be identified for
each of the three bases.
(d) Statements substantially similar to the following shall be
included on the same page as the numeric summary and signed by the
applicant, or the policy owner in the case of an illustration
provided at time of delivery, as required in this chapter.
(1) A statement to be signed and dated by the applicant or policy
owner reading as follows: "I have received a copy of this
illustration and understand that any nonguaranteed elements
illustrated are subject to change and could be either higher or
lower. The agent has told me they are not guaranteed."
(2) A statement to be signed and dated by the insurance producer
or other authorized representative of the insurer reading as follows:
"I certify that this illustration has been presented to the
applicant and that I have explained that any nonguaranteed elements
illustrated are subject to change. I have made no statements that are
inconsistent with the illustration."
(e) (1) A basic illustration shall include the following
information for at least each policy year from 1 to 10 and for every
fifth policy year thereafter ending at age 100, policy maturity or
final expiration; and except for term insurance beyond the 20th year,
for any year in which the premium outlay and contract premium, if
applicable, is to change:
(A) The premium outlay and mode the applicant plans to pay and the
contract premium, as applicable.
(B) The corresponding guaranteed death benefit, as provided in the
policy.
(C) The corresponding guaranteed value available upon surrender,
as provided in the policy.
(2) For a policy that provides for a contract premium, the
guaranteed death benefit and value available upon surrender shall
correspond to the contract premium.
(3) Nonguaranteed elements may be shown if described in the
contract. In the case of an illustration for a policy on which the
insurer intends to credit terminal dividends, they may be shown if
the insurer's current practice is to pay terminal dividends. If any
nonguaranteed elements are shown they must be shown at the same
durations as the corresponding guaranteed elements, if any. If no
guaranteed benefit or value is available at any duration for which a
nonguaranteed benefit or value is shown, a zero shall be displayed in
the guaranteed column.
10509.957. (a) A supplemental illustration may be provided if it
meets all of the following requirements:
(1) It is appended to, accompanied by, or preceded by a basic
illustration that complies with this chapter.
(2) The nonguaranteed elements shown are not more favorable to the
policy owner than the corresponding elements based on the scale used
in the basic illustration.
(3) It contains the same statement as required of a basic
illustration under subdivision (d) of Section 10509.956 that
nonguaranteed elements are not guaranteed.
(4) For a policy that has a contract premium, the contract premium
underlying the supplemental illustration is equal to the contract
premium shown in the basic illustration. For policies that do not
require a contract premium, the premium outlay underlying the
supplemental illustration shall be equal to the premium outlay shown
in the basic illustration.
(b) The supplemental illustration shall include a notice referring
to the basic illustration for guaranteed elements and other
important information.
(c) If cost indices are required by Chapter 5.6 (commencing with
Section 10509.970), they may be provided by means of a supplemental
illustration or included in the basic illustration. Those indices
shall be based on nonguaranteed elements calculated according to the
standards required in this chapter.
10509.958. (a) (1) If a basic illustration is used by an insurance
producer or other authorized representative of the insurer in the
sale of a life insurance policy and the policy is applied for as
illustrated, a copy of that illustration, signed in accordance with
this chapter, shall be submitted to the insurer at the time of the
policy application. A copy also shall be provided to the applicant.
(2) If the policy is issued other than as applied for, a revised
basic illustration conforming to the policy as issued shall be sent
with the policy. The revised illustration shall conform to the
requirements of this chapter, shall be labeled "Revised Illustration"
and shall be signed and dated by the applicant or policy owner and
producer or other authorized representative of the insurer no later
than the time the policy is delivered. A copy shall be provided to
the insurer and the policy owner.
(b) (1) If no illustration is used by an insurance producer or
other authorized representative in the sale of a life insurance
policy or if the policy is applied for other than as illustrated, the
producer or representative shall certify to that effect in writing
on a form provided by the insurer. On the same form the applicant
shall acknowledge that no illustration conforming to the policy
applied for was provided and shall further acknowledge an
understanding that an illustration conforming to the policy as issued
will be provided no later than at the time of policy delivery. This
form shall be submitted to the insurer at the time of policy
application.
(2) If the policy is issued, a basic illustration conforming to
the policy as issued shall be sent with the policy and signed by the
policy owner no later than the time the policy is delivered. A copy
shall be provided to the insurer and the policy owner.
(c) If the basic illustration or revised illustration is sent by
the insurer to the applicant or policy owner by mail, it shall
include instructions for the applicant or policy owner to sign the
duplicate copy of the numeric summary page of the illustration for
the policy issued and return the signed copy to the insurer. The
insurer's obligation under this subdivision shall be satisfied if it
can demonstrate that it has made a diligent effort to secure a signed
copy of the numeric summary page. The requirement to make a diligent
effort shall be deemed satisfied if the insurer includes in the
mailing a self-addressed postage prepaid envelope with instructions
for the return of the signed numeric summary page.
(d) A copy of the basic illustration and a revised basic
illustration, if any, signed as applicable, along with any
certification that either no illustration was used or that the policy
was applied for other than as illustrated, shall be retained by the
insurer until three years after the policy is no longer in force. A
copy need not be retained if no policy is issued.
10509.959. (a) In the case of a policy designated as one for which
illustrations will be used, the insurer shall provide each policy
owner with an annual report on the status of the policy that shall
include, but not be limited to, the following information:
(1) For universal life policies, the report shall include the
following:
(A) The beginning and end date of the current report period.
(B) The policy value at the end of the previous report period and
at the end of the current report period.
(C) The total amounts that have been credited or debited to the
policy value during the current report period, identifying each by
type, including, but not limited to, interest, mortality, expense and
riders.
(D) The current death benefit at the end of the current report
period on each life covered by the policy.
(E) The net cash surrender value of the policy as of the end of
the current report period.
(F) The amount of outstanding loans, if any, as of the end of the
current report period.
(G) For fixed premium policies:
If, assuming guaranteed interest, mortality and expense loads and
continued scheduled premium payments, the policy's net cash surrender
value is such that it would not maintain insurance in force until
the end of the next reporting period, a notice to this effect shall
be included in the report.
(H) For flexible premium policies:
If, assuming guaranteed interest, mortality and expense loads, the
policy's net cash surrender value will not maintain insurance in
force until the end of the next reporting period unless further
premium payments are made, a notice to this effect shall be included
in the report.
(2) For all other policies, the report shall include the
following, where applicable:
(A) Current death benefit.
(B) Annual contract premium.
(C) Current cash surrender value.
(D) Current dividend.
(E) Application of current dividend.
(F) Amount of outstanding loan.
(3) Insurers writing life insurance policies that do not build
nonforfeiture values shall only be required to provide an annual
report with respect to these policies for those years when a change
has been made to nonguaranteed policy elements by the insurer.
(b) If the annual report does not include an in force
illustration, it shall contain the following notice displayed
prominently: "IMPORTANT POLICY OWNER NOTICE: You should consider
requesting more detailed information about your policy to understand
how it may perform in the future. You should not consider replacement
of your policy or make changes in your coverage without requesting a
current illustration. You may annually request, without charge, such
an illustration by calling
10509.950. In order to protect consumers and foster consumer
education, this chapter shall govern the regulation of life insurance
policy illustrations. It is the intent of the Legislature in
enacting this chapter to ensure that illustrations do not mislead
purchasers of life insurance and to make illustrations more
understandable by providing illustration formats, prescribing
standards to be followed when illustrations are used, and specifying
the disclosures that are required in connection with illustrations.
Insurers should, as far as possible, eliminate the use of footnotes
and caveats and define terms used in the illustration in language
that is understandable by a typical person within the segment of the
public to which the illustration is directed.
10509.952. This chapter shall apply to all group and individual
life insurance policies and certificates except as follows:
(a) Variable life insurance.
(b) Individual and group annuity contracts.
(c) Credit life insurance.
(d) Life insurance policies with no illustrated death benefits on
any individual exceeding ten thousand dollars ($10,000).
10509.953. As used in this chapter:
(a) "Actuarial Standards Board" means the board established by the
American Academy of Actuaries to develop and promulgate standards of
actuarial practice.
(b) "Contract premium" means the gross premium that is required to
be paid under a fixed premium policy, including the premium for a
rider for which benefits are shown in the illustration.
(c) "Currently payable scale" means a scale of nonguaranteed
elements in effect for a policy form as of the preparation date of
the illustration or declared to become effective within the next 95
days.
(d) "Disciplined current scale" means a scale of nonguaranteed
elements constituting a limit on illustrations currently being
illustrated by an insurer that is reasonably based on actual recent
historical experience, as certified annually by an illustration
actuary designated by the insurer. Further guidance in determining
the disciplined current scale as contained in standards established
by the Actuarial Standards Board may be relied upon if the standards
meet all of the following:
(1) Have not been found to be inconsistent with the provisions of
this chapter by the commissioner after a hearing held in accordance
with Sections 11500 to 11530, inclusive, of the Government Code.
(2) Limit a disciplined current scale to reflect only actions that
have already been taken or events that have already occurred.
(3) Do not permit a disciplined current scale to include any
projected trends of improvements in experience or any assumed
improvements in experience beyond the illustration date.
(4) Do not permit assumed expenses to be less than minimum assumed
expenses.
(e) "Generic name" means a short title descriptive of the policy
being illustrated such as whole life, "term life" or "flexible
premium adjustable life."
(f) "Guaranteed elements" means the premiums, benefits, values,
credits or charges under a policy of life insurance that are
guaranteed and determined at issue.
(g) "Illustrated scale" means a scale of nonguaranteed elements
currently being illustrated that is not more favorable to the policy
owner than the lesser of either of the following:
(1) The disciplined current scale.
(2) The currently payable scale.
(h) "Illustration" means a presentation or depiction that includes
nonguaranteed elements of a policy of life insurance over a period
of years and that is one of the three types defined below:
(1) "Basic illustration" means a ledger or proposal used in the
sale of a life insurance policy that shows both guaranteed and
nonguaranteed elements.
(2) "Supplemental illustration" means an illustration furnished in
addition to a basic illustration that meets the applicable
requirements of this regulation, and that may be presented in a
format differing from the basic illustration, but may only depict a
scale of nonguaranteed elements that is permitted in a basic
illustration.
(3) "In force illustration" means an illustration furnished at any
time after the policy that it depicts has been in force for one year
or more.
(i) "Illustration actuary" means an actuary meeting the
requirements of Section 10509.960 who certifies to illustrations
based on the standard of practice promulgated by the Actuarial
Standards Board.
(j) "Lapse-supported illustration" means an illustration of a
policy form failing the test of self-supporting as defined in this
chapter, under a modified persistency rate assumption using
persistency rates underlying the disciplined current scale for the
first five years and 100 percent policy persistency thereafter.
(k) "Life insurance" means insurance upon the lives of persons or
appertaining thereto.
(l) (1) "Minimum assumed expenses" means the minimum expenses that
may be used in the calculation of the disciplined current scale for
a policy form. The insurer may choose to designate each year the
method of determining assumed expenses for all policy forms from all
of the following:
(A) Fully allocated expenses.
(B) Marginal expenses.
(C) A generally recognized expense table based on fully allocated
expenses representing a significant portion of insurance companies
and approved by the commissioner.
(2) Marginal expenses may be used only if greater than a generally
recognized expense table. If no generally recognized expense table
is approved, fully allocated expenses must be used.
(m) "Non-guaranteed elements" means the premiums, benefits,
values, credits or charges under a policy of life insurance that are
not guaranteed or not determined at issue.
(n) "Non-term group life" means a group policy or individual
policies of life insurance issued to members of an employer group or
other permitted group that includes all of the following:
(1) Every plan of coverage was selected by the employer or other
group representative.
(2) Some portion of the premium is paid by the group or through
payroll deduction.
(3) Group underwriting or simplified underwriting is used.
(o) "Policy owner" means the owner named in the policy or the
certificate holder in the case of a group policy.
(p) "Premium outlay" means the amount of premium assumed to be
paid by the policy owner or other premium payer out-of-pocket.
(q) "Self-supporting illustration" means an illustration of a
policy form for which it can be demonstrated that, when using
experience assumptions underlying the disciplined current scale, for
all illustrated points in time on or after the 15th policy
anniversary or the 20th policy anniversary for second-or-later-to-die
policies (or upon policy expiration if sooner), the accumulated
value of all policy cash-flows equals or exceeds the total policy
owner value available. For this purpose, policy owner value will
include cash surrender values and any other illustrated benefit
amounts available at the policy owner's election.
10509.954. (a) Each insurer marketing policies to which this
chapter is applicable shall notify the commissioner whether a policy
form is to be marketed with or without an illustration. For all
policy forms being actively marketed on the effective date of this
chapter, the insurer shall identify in writing those forms and
whether or not an illustration will be used with them. For policy
forms filed after the effective date of this chapter, the
identification shall be made at the time of filing. Any previous
identification may be changed by notice to the commissioner.
(b) If the insurer identifies a policy form as one to be marketed
without an illustration, any use of an illustration for any policy
using that form prior to the first policy anniversary is prohibited.
(c) If a policy form is identified by the insurer as one to be
marketed with an illustration, a basic illustration prepared and
delivered in accordance with this chapter is required, except that a
basic illustration need not be provided to individual members of a
group or to individuals insured under multiple lives coverage issued
to a single applicant unless the coverage is marketed to these
individuals. The illustration furnished an applicant for a group life
insurance policy or policies issued to a single applicant on
multiple lives may be either an individual or composite illustration
representative of the coverage on the lives of members of the group
or the multiple lives covered.
(d) Potential enrollees of nonterm group life subject to this
chapter shall be furnished a quotation with the enrollment materials.
The quotation shall show potential policy values for sample ages and
policy years on a guaranteed and nonguaranteed basis appropriate to
the group and the coverage. This quotation shall not be considered an
illustration for purposes of this chapter, but all information
provided shall be consistent with the illustrated scale. A basic
illustration shall be provided at delivery of the certificate to
enrollees for nonterm group life who enroll for more than the minimum
premium necessary to provide pure death benefit protection. In
addition, the insurer shall make a basic illustration available to
any nonterm group life enrollee who requests it.
10509.955. (a) An illustration used in the sale of a life insurance
policy shall satisfy the applicable requirements of this chapter, be
clearly labeled "life insurance illustration," and include, but not
be limited to, the following information:
(1) Name of insurer.
(2) Name and business address of producer or insurer's authorized
representative, if any.
(3) Name, age and sex of proposed insured, except where a
composite illustration is permitted under this chapter.
(4) Underwriting or rating classification upon which the
illustration is based.
(5) Generic name of the policy, the company product name, if
different, and form number.
(6) Initial death benefit.
(7) Dividend option election or application of nonguaranteed
elements, if applicable.
(b) When using an illustration in the sale of a life insurance
policy, an insurer or its producers or other authorized
representatives shall not do any of the following:
(1) Represent the policy as anything other than a life insurance
policy.
(2) Use or describe nonguaranteed elements in a manner that is
misleading or has the capacity or tendency to mislead.
(3) State or imply that the payment or amount of nonguaranteed
elements is guaranteed.
(4) Use an illustration that does not comply with the requirements
of this chapter.
(5) Use an illustration that at any policy duration depicts policy
performance more favorable to the policy owner than that produced by
the illustrated scale of the insurer whose policy is being
illustrated.
(6) Provide an applicant with an incomplete illustration.
(7) Represent in any way that premium payments will not be
required for each year of the policy in order to maintain the
illustrated death benefits, unless that is the fact.
(8) Use the term "vanishing" or "vanishing premium," or a similar
term that implies the policy becomes paid up, to describe a plan for
using nonguaranteed elements to pay a portion of future premiums.
(9) Except for policies that can never develop nonforfeiture
values, use an illustration that is "lapse-supported."
(10) Use an illustration that is not "self-supporting."
(c) If an interest rate used to determine the illustrated
nonguaranteed elements is shown, it shall not be greater than the
earned interest rate underlying the disciplined current scale.
10509.956. (a) A basic illustration shall conform with the
following requirements:
(1) The illustration shall be labeled with the date on which it
was prepared.
(2) Each page, including any explanatory notes or pages, shall be
numbered and show its relationship to the total number of pages in
the illustration.
(3) The assumed dates of payment receipt and benefit payout within
a policy year shall be clearly identified.
(4) If the age of the proposed insured is shown as a component of
the tabular detail, it shall be issue age plus the numbers of years
the policy is assumed to have been in force.
(5) The assumed payments on which the illustrated benefits and
values are based shall be identified as premium outlay or contract
premium, as applicable. For policies that do not require a specific
contract premium, the illustrated payments shall be identified as
premiums outlay.
(6) Guaranteed death benefits and values available upon surrender,
if any, for the illustrated premium outlay or contract premium shall
be shown and clearly labeled guaranteed.
(7) If the illustration shows any nonguaranteed elements, they
cannot be based on a scale more favorable to the policy owner than
the insurer's illustrated scale at any duration. These elements shall
be clearly labeled nonguaranteed.
(8) The guaranteed elements, if any, shall be shown before
corresponding nonguaranteed elements and shall be specifically
referred to on any page of an illustration that shows or describes
only the nonguaranteed elements.
(9) The account or accumulation value of a policy, if shown, shall
be identified by the name this value is given in the policy being
illustrated and shown in close proximity to the corresponding value
available upon surrender.
(10) The value available upon surrender shall be identified by the
name this value is given in the policy being illustrated and shall
be the amount available to the policy owner in a lump sum after
deduction of surrender charges, policy loans, and policy loan
interest, as applicable.
(11) Illustrations may show policy benefits and values in graphic
or chart form in addition to the tabular form.
(12) Any illustration of nonguaranteed elements shall be
accompanied by a statement indicating that:
(A) The benefits and values are not guaranteed.
(B) The assumptions on which they are based are subject to change
by the insurer.
(C) Actual results may be more or less favorable.
(13) If the illustration shows that the premium payer may have the
option to allow policy charges to be paid using nonguaranteed
values, the illustration shall clearly disclose that a charge
continues to be required and that, depending on actual results, the
premium payer may need to continue or resume premium outlays. Similar
disclosure shall be made for premium outlay of lesser amounts or
shorter durations than the contract premium. If a contract premium is
due, the premium outlay display shall not be left blank or show zero
unless accompanied by an asterisk or similar mark to draw attention
to the fact that the policy is not paid up.
(14) If the applicant plans to use dividends or policy values,
guaranteed or nonguaranteed, to pay all or a portion of the contract
premium or policy charges, or for any other purpose, the illustration
may reflect those plans and the impact on future policy benefits and
values.
(b) A basic illustration shall include all of the following:
(1) A brief description of the policy being illustrated, including
a statement that it is a life insurance policy.
(2) A brief description of the premium outlay or contract premium,
as applicable, for the policy. For a policy that does not require
payment of a specific contract premium, the illustration shall show
the premium outlay that must be paid to guarantee coverage for the
term of the contract, subject to maximum premiums allowable to
qualify as a life insurance policy under the applicable provisions of
the Internal Revenue Code.
(3) A brief description of any policy features, riders or options,
guaranteed or nonguaranteed, shown in the basic illustration and the
impact they may have on the benefits and values of the policy.
(4) Identification and a brief definition of column headings and
key terms used in the illustration.
(5) A statement as follows: "This illustration assumes that the
currently illustrated nonguaranteed elements will continue unchanged
for all years shown. This is not likely to occur, and actual results
may be more or less favorable than those shown."
(c) (1) Following the narrative summary, a basic illustration
shall include a numeric summary of the death benefits and values and
the premium outlay and contract premium, as applicable. For a policy
that provides for a contract premium, the guaranteed death benefits
and values shall be based on the contract premium. This summary shall
be shown for at least policy years 5, 10, and 20 and at age 70, if
applicable, on the three bases shown below. For multiple life
policies the summary shall show policy years 5, 10, 20, and 30.
(A) Policy guarantees.
(B) Insurer's illustrated scale.
(C) Insurer's illustrated scale used but with the nonguaranteed
elements reduced as follows:
(i) Dividends at 50 percent of the dividends contained in the
illustrated scale used.
(ii) Nonguaranteed credited interest at rates that are the average
of the guaranteed rates and the rates contained in the illustrated
scale used.
(iii) All nonguaranteed charges, including but not limited to,
term insurance charges, mortality and expense charges, at rates that
are the average of the guaranteed rates and the rates contained in
the illustrated scale used.
(2) In addition, if coverage would cease prior to policy maturity
or age 100, the year in which coverage ceases shall be identified for
each of the three bases.
(d) Statements substantially similar to the following shall be
included on the same page as the numeric summary and signed by the
applicant, or the policy owner in the case of an illustration
provided at time of delivery, as required in this chapter.
(1) A statement to be signed and dated by the applicant or policy
owner reading as follows: "I have received a copy of this
illustration and understand that any nonguaranteed elements
illustrated are subject to change and could be either higher or
lower. The agent has told me they are not guaranteed."
(2) A statement to be signed and dated by the insurance producer
or other authorized representative of the insurer reading as follows:
"I certify that this illustration has been presented to the
applicant and that I have explained that any nonguaranteed elements
illustrated are subject to change. I have made no statements that are
inconsistent with the illustration."
(e) (1) A basic illustration shall include the following
information for at least each policy year from 1 to 10 and for every
fifth policy year thereafter ending at age 100, policy maturity or
final expiration; and except for term insurance beyond the 20th year,
for any year in which the premium outlay and contract premium, if
applicable, is to change:
(A) The premium outlay and mode the applicant plans to pay and the
contract premium, as applicable.
(B) The corresponding guaranteed death benefit, as provided in the
policy.
(C) The corresponding guaranteed value available upon surrender,
as provided in the policy.
(2) For a policy that provides for a contract premium, the
guaranteed death benefit and value available upon surrender shall
correspond to the contract premium.
(3) Nonguaranteed elements may be shown if described in the
contract. In the case of an illustration for a policy on which the
insurer intends to credit terminal dividends, they may be shown if
the insurer's current practice is to pay terminal dividends. If any
nonguaranteed elements are shown they must be shown at the same
durations as the corresponding guaranteed elements, if any. If no
guaranteed benefit or value is available at any duration for which a
nonguaranteed benefit or value is shown, a zero shall be displayed in
the guaranteed column.
10509.957. (a) A supplemental illustration may be provided if it
meets all of the following requirements:
(1) It is appended to, accompanied by, or preceded by a basic
illustration that complies with this chapter.
(2) The nonguaranteed elements shown are not more favorable to the
policy owner than the corresponding elements based on the scale used
in the basic illustration.
(3) It contains the same statement as required of a basic
illustration under subdivision (d) of Section 10509.956 that
nonguaranteed elements are not guaranteed.
(4) For a policy that has a contract premium, the contract premium
underlying the supplemental illustration is equal to the contract
premium shown in the basic illustration. For policies that do not
require a contract premium, the premium outlay underlying the
supplemental illustration shall be equal to the premium outlay shown
in the basic illustration.
(b) The supplemental illustration shall include a notice referring
to the basic illustration for guaranteed elements and other
important information.
(c) If cost indices are required by Chapter 5.6 (commencing with
Section 10509.970), they may be provided by means of a supplemental
illustration or included in the basic illustration. Those indices
shall be based on nonguaranteed elements calculated according to the
standards required in this chapter.
10509.958. (a) (1) If a basic illustration is used by an insurance
producer or other authorized representative of the insurer in the
sale of a life insurance policy and the policy is applied for as
illustrated, a copy of that illustration, signed in accordance with
this chapter, shall be submitted to the insurer at the time of the
policy application. A copy also shall be provided to the applicant.
(2) If the policy is issued other than as applied for, a revised
basic illustration conforming to the policy as issued shall be sent
with the policy. The revised illustration shall conform to the
requirements of this chapter, shall be labeled "Revised Illustration"
and shall be signed and dated by the applicant or policy owner and
producer or other authorized representative of the insurer no later
than the time the policy is delivered. A copy shall be provided to
the insurer and the policy owner.
(b) (1) If no illustration is used by an insurance producer or
other authorized representative in the sale of a life insurance
policy or if the policy is applied for other than as illustrated, the
producer or representative shall certify to that effect in writing
on a form provided by the insurer. On the same form the applicant
shall acknowledge that no illustration conforming to the policy
applied for was provided and shall further acknowledge an
understanding that an illustration conforming to the policy as issued
will be provided no later than at the time of policy delivery. This
form shall be submitted to the insurer at the time of policy
application.
(2) If the policy is issued, a basic illustration conforming to
the policy as issued shall be sent with the policy and signed by the
policy owner no later than the time the policy is delivered. A copy
shall be provided to the insurer and the policy owner.
(c) If the basic illustration or revised illustration is sent by
the insurer to the applicant or policy owner by mail, it shall
include instructions for the applicant or policy owner to sign the
duplicate copy of the numeric summary page of the illustration for
the policy issued and return the signed copy to the insurer. The
insurer's obligation under this subdivision shall be satisfied if it
can demonstrate that it has made a diligent effort to secure a signed
copy of the numeric summary page. The requirement to make a diligent
effort shall be deemed satisfied if the insurer includes in the
mailing a self-addressed postage prepaid envelope with instructions
for the return of the signed numeric summary page.
(d) A copy of the basic illustration and a revised basic
illustration, if any, signed as applicable, along with any
certification that either no illustration was used or that the policy
was applied for other than as illustrated, shall be retained by the
insurer until three years after the policy is no longer in force. A
copy need not be retained if no policy is issued.
10509.959. (a) In the case of a policy designated as one for which
illustrations will be used, the insurer shall provide each policy
owner with an annual report on the status of the policy that shall
include, but not be limited to, the following information:
(1) For universal life policies, the report shall include the
following:
(A) The beginning and end date of the current report period.
(B) The policy value at the end of the previous report period and
at the end of the current report period.
(C) The total amounts that have been credited or debited to the
policy value during the current report period, identifying each by
type, including, but not limited to, interest, mortality, expense and
riders.
(D) The current death benefit at the end of the current report
period on each life covered by the policy.
(E) The net cash surrender value of the policy as of the end of
the current report period.
(F) The amount of outstanding loans, if any, as of the end of the
current report period.
(G) For fixed premium policies:
If, assuming guaranteed interest, mortality and expense loads and
continued scheduled premium payments, the policy's net cash surrender
value is such that it would not maintain insurance in force until
the end of the next reporting period, a notice to this effect shall
be included in the report.
(H) For flexible premium policies:
If, assuming guaranteed interest, mortality and expense loads, the
policy's net cash surrender value will not maintain insurance in
force until the end of the next reporting period unless further
premium payments are made, a notice to this effect shall be included
in the report.
(2) For all other policies, the report shall include the
following, where applicable:
(A) Current death benefit.
(B) Annual contract premium.
(C) Current cash surrender value.
(D) Current dividend.
(E) Application of current dividend.
(F) Amount of outstanding loan.
(3) Insurers writing life insurance policies that do not build
nonforfeiture values shall only be required to provide an annual
report with respect to these policies for those years when a change
has been made to nonguaranteed policy elements by the insurer.
(b) If the annual report does not include an in force
illustration, it shall contain the following notice displayed
prominently: "IMPORTANT POLICY OWNER NOTICE: You should consider
requesting more detailed information about your policy to understand
how it may perform in the future. You should not consider replacement
of your policy or make changes in your coverage without requesting a
current illustration. You may annually request, without charge, such
an illustration by calling
10509.950. In order to protect consumers and foster consumer
education, this chapter shall govern the regulation of life insurance
policy illustrations. It is the intent of the Legislature in
enacting this chapter to ensure that illustrations do not mislead
purchasers of life insurance and to make illustrations more
understandable by providing illustration formats, prescribing
standards to be followed when illustrations are used, and specifying
the disclosures that are required in connection with illustrations.
Insurers should, as far as possible, eliminate the use of footnotes
and caveats and define terms used in the illustration in language
that is understandable by a typical person within the segment of the
public to which the illustration is directed.
10509.952. This chapter shall apply to all group and individual
life insurance policies and certificates except as follows:
(a) Variable life insurance.
(b) Individual and group annuity contracts.
(c) Credit life insurance.
(d) Life insurance policies with no illustrated death benefits on
any individual exceeding ten thousand dollars ($10,000).
10509.953. As used in this chapter:
(a) "Actuarial Standards Board" means the board established by the
American Academy of Actuaries to develop and promulgate standards of
actuarial practice.
(b) "Contract premium" means the gross premium that is required to
be paid under a fixed premium policy, including the premium for a
rider for which benefits are shown in the illustration.
(c) "Currently payable scale" means a scale of nonguaranteed
elements in effect for a policy form as of the preparation date of
the illustration or declared to become effective within the next 95
days.
(d) "Disciplined current scale" means a scale of nonguaranteed
elements constituting a limit on illustrations currently being
illustrated by an insurer that is reasonably based on actual recent
historical experience, as certified annually by an illustration
actuary designated by the insurer. Further guidance in determining
the disciplined current scale as contained in standards established
by the Actuarial Standards Board may be relied upon if the standards
meet all of the following:
(1) Have not been found to be inconsistent with the provisions of
this chapter by the commissioner after a hearing held in accordance
with Sections 11500 to 11530, inclusive, of the Government Code.
(2) Limit a disciplined current scale to reflect only actions that
have already been taken or events that have already occurred.
(3) Do not permit a disciplined current scale to include any
projected trends of improvements in experience or any assumed
improvements in experience beyond the illustration date.
(4) Do not permit assumed expenses to be less than minimum assumed
expenses.
(e) "Generic name" means a short title descriptive of the policy
being illustrated such as whole life, "term life" or "flexible
premium adjustable life."
(f) "Guaranteed elements" means the premiums, benefits, values,
credits or charges under a policy of life insurance that are
guaranteed and determined at issue.
(g) "Illustrated scale" means a scale of nonguaranteed elements
currently being illustrated that is not more favorable to the policy
owner than the lesser of either of the following:
(1) The disciplined current scale.
(2) The currently payable scale.
(h) "Illustration" means a presentation or depiction that includes
nonguaranteed elements of a policy of life insurance over a period
of years and that is one of the three types defined below:
(1) "Basic illustration" means a ledger or proposal used in the
sale of a life insurance policy that shows both guaranteed and
nonguaranteed elements.
(2) "Supplemental illustration" means an illustration furnished in
addition to a basic illustration that meets the applicable
requirements of this regulation, and that may be presented in a
format differing from the basic illustration, but may only depict a
scale of nonguaranteed elements that is permitted in a basic
illustration.
(3) "In force illustration" means an illustration furnished at any
time after the policy that it depicts has been in force for one year
or more.
(i) "Illustration actuary" means an actuary meeting the
requirements of Section 10509.960 who certifies to illustrations
based on the standard of practice promulgated by the Actuarial
Standards Board.
(j) "Lapse-supported illustration" means an illustration of a
policy form failing the test of self-supporting as defined in this
chapter, under a modified persistency rate assumption using
persistency rates underlying the disciplined current scale for the
first five years and 100 percent policy persistency thereafter.
(k) "Life insurance" means insurance upon the lives of persons or
appertaining thereto.
(l) (1) "Minimum assumed expenses" means the minimum expenses that
may be used in the calculation of the disciplined current scale for
a policy form. The insurer may choose to designate each year the
method of determining assumed expenses for all policy forms from all
of the following:
(A) Fully allocated expenses.
(B) Marginal expenses.
(C) A generally recognized expense table based on fully allocated
expenses representing a significant portion of insurance companies
and approved by the commissioner.
(2) Marginal expenses may be used only if greater than a generally
recognized expense table. If no generally recognized expense table
is approved, fully allocated expenses must be used.
(m) "Non-guaranteed elements" means the premiums, benefits,
values, credits or charges under a policy of life insurance that are
not guaranteed or not determined at issue.
(n) "Non-term group life" means a group policy or individual
policies of life insurance issued to members of an employer group or
other permitted group that includes all of the following:
(1) Every plan of coverage was selected by the employer or other
group representative.
(2) Some portion of the premium is paid by the group or through
payroll deduction.
(3) Group underwriting or simplified underwriting is used.
(o) "Policy owner" means the owner named in the policy or the
certificate holder in the case of a group policy.
(p) "Premium outlay" means the amount of premium assumed to be
paid by the policy owner or other premium payer out-of-pocket.
(q) "Self-supporting illustration" means an illustration of a
policy form for which it can be demonstrated that, when using
experience assumptions underlying the disciplined current scale, for
all illustrated points in time on or after the 15th policy
anniversary or the 20th policy anniversary for second-or-later-to-die
policies (or upon policy expiration if sooner), the accumulated
value of all policy cash-flows equals or exceeds the total policy
owner value available. For this purpose, policy owner value will
include cash surrender values and any other illustrated benefit
amounts available at the policy owner's election.
10509.954. (a) Each insurer marketing policies to which this
chapter is applicable shall notify the commissioner whether a policy
form is to be marketed with or without an illustration. For all
policy forms being actively marketed on the effective date of this
chapter, the insurer shall identify in writing those forms and
whether or not an illustration will be used with them. For policy
forms filed after the effective date of this chapter, the
identification shall be made at the time of filing. Any previous
identification may be changed by notice to the commissioner.
(b) If the insurer identifies a policy form as one to be marketed
without an illustration, any use of an illustration for any policy
using that form prior to the first policy anniversary is prohibited.
(c) If a policy form is identified by the insurer as one to be
marketed with an illustration, a basic illustration prepared and
delivered in accordance with this chapter is required, except that a
basic illustration need not be provided to individual members of a
group or to individuals insured under multiple lives coverage issued
to a single applicant unless the coverage is marketed to these
individuals. The illustration furnished an applicant for a group life
insurance policy or policies issued to a single applicant on
multiple lives may be either an individual or composite illustration
representative of the coverage on the lives of members of the group
or the multiple lives covered.
(d) Potential enrollees of nonterm group life subject to this
chapter shall be furnished a quotation with the enrollment materials.
The quotation shall show potential policy values for sample ages and
policy years on a guaranteed and nonguaranteed basis appropriate to
the group and the coverage. This quotation shall not be considered an
illustration for purposes of this chapter, but all information
provided shall be consistent with the illustrated scale. A basic
illustration shall be provided at delivery of the certificate to
enrollees for nonterm group life who enroll for more than the minimum
premium necessary to provide pure death benefit protection. In
addition, the insurer shall make a basic illustration available to
any nonterm group life enrollee who requests it.
10509.955. (a) An illustration used in the sale of a life insurance
policy shall satisfy the applicable requirements of this chapter, be
clearly labeled "life insurance illustration," and include, but not
be limited to, the following information:
(1) Name of insurer.
(2) Name and business address of producer or insurer's authorized
representative, if any.
(3) Name, age and sex of proposed insured, except where a
composite illustration is permitted under this chapter.
(4) Underwriting or rating classification upon which the
illustration is based.
(5) Generic name of the policy, the company product name, if
different, and form number.
(6) Initial death benefit.
(7) Dividend option election or application of nonguaranteed
elements, if applicable.
(b) When using an illustration in the sale of a life insurance
policy, an insurer or its producers or other authorized
representatives shall not do any of the following:
(1) Represent the policy as anything other than a life insurance
policy.
(2) Use or describe nonguaranteed elements in a manner that is
misleading or has the capacity or tendency to mislead.
(3) State or imply that the payment or amount of nonguaranteed
elements is guaranteed.
(4) Use an illustration that does not comply with the requirements
of this chapter.
(5) Use an illustration that at any policy duration depicts policy
performance more favorable to the policy owner than that produced by
the illustrated scale of the insurer whose policy is being
illustrated.
(6) Provide an applicant with an incomplete illustration.
(7) Represent in any way that premium payments will not be
required for each year of the policy in order to maintain the
illustrated death benefits, unless that is the fact.
(8) Use the term "vanishing" or "vanishing premium," or a similar
term that implies the policy becomes paid up, to describe a plan for
using nonguaranteed elements to pay a portion of future premiums.
(9) Except for policies that can never develop nonforfeiture
values, use an illustration that is "lapse-supported."
(10) Use an illustration that is not "self-supporting."
(c) If an interest rate used to determine the illustrated
nonguaranteed elements is shown, it shall not be greater than the
earned interest rate underlying the disciplined current scale.
10509.956. (a) A basic illustration shall conform with the
following requirements:
(1) The illustration shall be labeled with the date on which it
was prepared.
(2) Each page, including any explanatory notes or pages, shall be
numbered and show its relationship to the total number of pages in
the illustration.
(3) The assumed dates of payment receipt and benefit payout within
a policy year shall be clearly identified.
(4) If the age of the proposed insured is shown as a component of
the tabular detail, it shall be issue age plus the numbers of years
the policy is assumed to have been in force.
(5) The assumed payments on which the illustrated benefits and
values are based shall be identified as premium outlay or contract
premium, as applicable. For policies that do not require a specific
contract premium, the illustrated payments shall be identified as
premiums outlay.
(6) Guaranteed death benefits and values available upon surrender,
if any, for the illustrated premium outlay or contract premium shall
be shown and clearly labeled guaranteed.
(7) If the illustration shows any nonguaranteed elements, they
cannot be based on a scale more favorable to the policy owner than
the insurer's illustrated scale at any duration. These elements shall
be clearly labeled nonguaranteed.
(8) The guaranteed elements, if any, shall be shown before
corresponding nonguaranteed elements and shall be specifically
referred to on any page of an illustration that shows or describes
only the nonguaranteed elements.
(9) The account or accumulation value of a policy, if shown, shall
be identified by the name this value is given in the policy being
illustrated and shown in close proximity to the corresponding value
available upon surrender.
(10) The value available upon surrender shall be identified by the
name this value is given in the policy being illustrated and shall
be the amount available to the policy owner in a lump sum after
deduction of surrender charges, policy loans, and policy loan
interest, as applicable.
(11) Illustrations may show policy benefits and values in graphic
or chart form in addition to the tabular form.
(12) Any illustration of nonguaranteed elements shall be
accompanied by a statement indicating that:
(A) The benefits and values are not guaranteed.
(B) The assumptions on which they are based are subject to change
by the insurer.
(C) Actual results may be more or less favorable.
(13) If the illustration shows that the premium payer may have the
option to allow policy charges to be paid using nonguaranteed
values, the illustration shall clearly disclose that a charge
continues to be required and that, depending on actual results, the
premium payer may need to continue or resume premium outlays. Similar
disclosure shall be made for premium outlay of lesser amounts or
shorter durations than the contract premium. If a contract premium is
due, the premium outlay display shall not be left blank or show zero
unless accompanied by an asterisk or similar mark to draw attention
to the fact that the policy is not paid up.
(14) If the applicant plans to use dividends or policy values,
guaranteed or nonguaranteed, to pay all or a portion of the contract
premium or policy charges, or for any other purpose, the illustration
may reflect those plans and the impact on future policy benefits and
values.
(b) A basic illustration shall include all of the following:
(1) A brief description of the policy being illustrated, including
a statement that it is a life insurance policy.
(2) A brief description of the premium outlay or contract premium,
as applicable, for the policy. For a policy that does not require
payment of a specific contract premium, the illustration shall show
the premium outlay that must be paid to guarantee coverage for the
term of the contract, subject to maximum premiums allowable to
qualify as a life insurance policy under the applicable provisions of
the Internal Revenue Code.
(3) A brief description of any policy features, riders or options,
guaranteed or nonguaranteed, shown in the basic illustration and the
impact they may have on the benefits and values of the policy.
(4) Identification and a brief definition of column headings and
key terms used in the illustration.
(5) A statement as follows: "This illustration assumes that the
currently illustrated nonguaranteed elements will continue unchanged
for all years shown. This is not likely to occur, and actual results
may be more or less favorable than those shown."
(c) (1) Following the narrative summary, a basic illustration
shall include a numeric summary of the death benefits and values and
the premium outlay and contract premium, as applicable. For a policy
that provides for a contract premium, the guaranteed death benefits
and values shall be based on the contract premium. This summary shall
be shown for at least policy years 5, 10, and 20 and at age 70, if
applicable, on the three bases shown below. For multiple life
policies the summary shall show policy years 5, 10, 20, and 30.
(A) Policy guarantees.
(B) Insurer's illustrated scale.
(C) Insurer's illustrated scale used but with the nonguaranteed
elements reduced as follows:
(i) Dividends at 50 percent of the dividends contained in the
illustrated scale used.
(ii) Nonguaranteed credited interest at rates that are the average
of the guaranteed rates and the rates contained in the illustrated
scale used.
(iii) All nonguaranteed charges, including but not limited to,
term insurance charges, mortality and expense charges, at rates that
are the average of the guaranteed rates and the rates contained in
the illustrated scale used.
(2) In addition, if coverage would cease prior to policy maturity
or age 100, the year in which coverage ceases shall be identified for
each of the three bases.
(d) Statements substantially similar to the following shall be
included on the same page as the numeric summary and signed by the
applicant, or the policy owner in the case of an illustration
provided at time of delivery, as required in this chapter.
(1) A statement to be signed and dated by the applicant or policy
owner reading as follows: "I have received a copy of this
illustration and understand that any nonguaranteed elements
illustrated are subject to change and could be either higher or
lower. The agent has told me they are not guaranteed."
(2) A statement to be signed and dated by the insurance producer
or other authorized representative of the insurer reading as follows:
"I certify that this illustration has been presented to the
applicant and that I have explained that any nonguaranteed elements
illustrated are subject to change. I have made no statements that are
inconsistent with the illustration."
(e) (1) A basic illustration shall include the following
information for at least each policy year from 1 to 10 and for every
fifth policy year thereafter ending at age 100, policy maturity or
final expiration; and except for term insurance beyond the 20th year,
for any year in which the premium outlay and contract premium, if
applicable, is to change:
(A) The premium outlay and mode the applicant plans to pay and the
contract premium, as applicable.
(B) The corresponding guaranteed death benefit, as provided in the
policy.
(C) The corresponding guaranteed value available upon surrender,
as provided in the policy.
(2) For a policy that provides for a contract premium, the
guaranteed death benefit and value available upon surrender shall
correspond to the contract premium.
(3) Nonguaranteed elements may be shown if described in the
contract. In the case of an illustration for a policy on which the
insurer intends to credit terminal dividends, they may be shown if
the insurer's current practice is to pay terminal dividends. If any
nonguaranteed elements are shown they must be shown at the same
durations as the corresponding guaranteed elements, if any. If no
guaranteed benefit or value is available at any duration for which a
nonguaranteed benefit or value is shown, a zero shall be displayed in
the guaranteed column.
10509.957. (a) A supplemental illustration may be provided if it
meets all of the following requirements:
(1) It is appended to, accompanied by, or preceded by a basic
illustration that complies with this chapter.
(2) The nonguaranteed elements shown are not more favorable to the
policy owner than the corresponding elements based on the scale used
in the basic illustration.
(3) It contains the same statement as required of a basic
illustration under subdivision (d) of Section 10509.956 that
nonguaranteed elements are not guaranteed.
(4) For a policy that has a contract premium, the contract premium
underlying the supplemental illustration is equal to the contract
premium shown in the basic illustration. For policies that do not
require a contract premium, the premium outlay underlying the
supplemental illustration shall be equal to the premium outlay shown
in the basic illustration.
(b) The supplemental illustration shall include a notice referring
to the basic illustration for guaranteed elements and other
important information.
(c) If cost indices are required by Chapter 5.6 (commencing with
Section 10509.970), they may be provided by means of a supplemental
illustration or included in the basic illustration. Those indices
shall be based on nonguaranteed elements calculated according to the
standards required in this chapter.
10509.958. (a) (1) If a basic illustration is used by an insurance
producer or other authorized representative of the insurer in the
sale of a life insurance policy and the policy is applied for as
illustrated, a copy of that illustration, signed in accordance with
this chapter, shall be submitted to the insurer at the time of the
policy application. A copy also shall be provided to the applicant.
(2) If the policy is issued other than as applied for, a revised
basic illustration conforming to the policy as issued shall be sent
with the policy. The revised illustration shall conform to the
requirements of this chapter, shall be labeled "Revised Illustration"
and shall be signed and dated by the applicant or policy owner and
producer or other authorized representative of the insurer no later
than the time the policy is delivered. A copy shall be provided to
the insurer and the policy owner.
(b) (1) If no illustration is used by an insurance producer or
other authorized representative in the sale of a life insurance
policy or if the policy is applied for other than as illustrated, the
producer or representative shall certify to that effect in writing
on a form provided by the insurer. On the same form the applicant
shall acknowledge that no illustration conforming to the policy
applied for was provided and shall further acknowledge an
understanding that an illustration conforming to the policy as issued
will be provided no later than at the time of policy delivery. This
form shall be submitted to the insurer at the time of policy
application.
(2) If the policy is issued, a basic illustration conforming to
the policy as issued shall be sent with the policy and signed by the
policy owner no later than the time the policy is delivered. A copy
shall be provided to the insurer and the policy owner.
(c) If the basic illustration or revised illustration is sent by
the insurer to the applicant or policy owner by mail, it shall
include instructions for the applicant or policy owner to sign the
duplicate copy of the numeric summary page of the illustration for
the policy issued and return the signed copy to the insurer. The
insurer's obligation under this subdivision shall be satisfied if it
can demonstrate that it has made a diligent effort to secure a signed
copy of the numeric summary page. The requirement to make a diligent
effort shall be deemed satisfied if the insurer includes in the
mailing a self-addressed postage prepaid envelope with instructions
for the return of the signed numeric summary page.
(d) A copy of the basic illustration and a revised basic
illustration, if any, signed as applicable, along with any
certification that either no illustration was used or that the policy
was applied for other than as illustrated, shall be retained by the
insurer until three years after the policy is no longer in force. A
copy need not be retained if no policy is issued.
10509.959. (a) In the case of a policy designated as one for which
illustrations will be used, the insurer shall provide each policy
owner with an annual report on the status of the policy that shall
include, but not be limited to, the following information:
(1) For universal life policies, the report shall include the
following:
(A) The beginning and end date of the current report period.
(B) The policy value at the end of the previous report period and
at the end of the current report period.
(C) The total amounts that have been credited or debited to the
policy value during the current report period, identifying each by
type, including, but not limited to, interest, mortality, expense and
riders.
(D) The current death benefit at the end of the current report
period on each life covered by the policy.
(E) The net cash surrender value of the policy as of the end of
the current report period.
(F) The amount of outstanding loans, if any, as of the end of the
current report period.
(G) For fixed premium policies:
If, assuming guaranteed interest, mortality and expense loads and
continued scheduled premium payments, the policy's net cash surrender
value is such that it would not maintain insurance in force until
the end of the next reporting period, a notice to this effect shall
be included in the report.
(H) For flexible premium policies:
If, assuming guaranteed interest, mortality and expense loads, the
policy's net cash surrender value will not maintain insurance in
force until the end of the next reporting period unless further
premium payments are made, a notice to this effect shall be included
in the report.
(2) For all other policies, the report shall include the
following, where applicable:
(A) Current death benefit.
(B) Annual contract premium.
(C) Current cash surrender value.
(D) Current dividend.
(E) Application of current dividend.
(F) Amount of outstanding loan.
(3) Insurers writing life insurance policies that do not build
nonforfeiture values shall only be required to provide an annual
report with respect to these policies for those years when a change
has been made to nonguaranteed policy elements by the insurer.
(b) If the annual report does not include an in force
illustration, it shall contain the following notice displayed
prominently: "IMPORTANT POLICY OWNER NOTICE: You should consider
requesting more detailed information about your policy to understand
how it may perform in the future. You should not consider replacement
of your policy or make changes in your coverage without requesting a
current illustration. You may annually request, without charge, such
an illustration by calling
