28 Tex. Admin. Code § 4.1114

Current through Reg. 49, No. 49; December 6, 2024
Section 4.1114 - Requirements for Acceleration-of-Life-Insurance Benefits That Fund Long-Term Care Expenses

When a life insurance contract provides for payment of long-term care expenses funded through an acceleration-of-life-insurance benefit provision, the long-term care provisions of the contract must meet the following requirements of Chapter 3, Subchapter Y of this title (relating to Standards for Long-Term Care Insurance, Non-Partnership and Partnership Long-Term Care Insurance Coverage Under Individual and Group Policies and Annuity Contracts, and Life Insurance Policies that Provide Long-Term Care Benefits Within the Policy):

(1) terms must be defined consistently with § 3.3804 of this title (relating to Definitions);
(2) definitions and descriptions of providers must be consistent with the requirements of § 3.3812 of this title (relating to Policy Standards for Provider);
(3) to the extent that the acceleration-of-life-insurance provisions provide for payment of home health or adult day care expenses, such provisions must meet applicable standards contained in § 3.3815 of this title (relating to Standards for Home Health and Adult Day Care Benefits);
(4) conditions triggering eligibility for benefits must comply with § 3.3818 of this title (relating to Standards for Eligibility for Benefits); and
(5) to the extent that the acceleration-of-life-insurance benefit is intended to fund long-term care expenses that will qualify for favorable tax treatment under federal law, the long-term care provisions of the contract must further comply with the provisions of § 4.1115 of this title (relating to Requirements for Benefits Represented to Be Qualified for Favorable Federal Tax Treatment) that are applicable to expenses paid for a "qualified long-term care illness," as defined in §4.1115, and any additional federal requirements for favorable tax treatment.

28 Tex. Admin. Code § 4.1114

Adopted by Texas Register, Volume 49, Number 03, January 19, 2024, TexReg 0258, eff. 1/24/2024