Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 8238 (December 30, 2023).

31 Pa. Code § 90g.2. General provisions.

§ 90g.2. General provisions.

 An individual health care facility benefit filing complying with the following is acceptable:

   (1)  The submission letter for a form complies with applicable requirements of §  89b.5 (relating to letter of submission). For a rider, the submission letter includes a list of the contracts to which the rider will be attached.

   (2)  The form is submitted in duplicate. This complies with §  89b.4(a) (relating to general filing procedure).

   (3)  The form is submitted in the final printed form intended for actual issue, unless the insurer requests tentative approval under §  89.4(d) (Reserved). A form submitted for tentative approval is in draft, printer’s-proof, photocopied, ‘‘filer’’ or some other legible form.

   (4)  The form number and the wording of the form are printed in easily readable type.

   (5)  Logos are or are not present and are more or less prominent than the company name.

   (6)  The full company name appears on a rider for filing purposes. The name is printed or added by rubber stamp or other appropriate means. This complies with §  89b.11(a) (relating to general contents of forms).

   (7)  An administrative office address or the home office address is or is not shown. If an address is captioned as ‘‘home office,’’ it is the official home office address of record.

   (8)  The form contains a caption:

     (i)   Disclosing the coverage provided—health care facilities, long term care or other descriptive disclosure.

     (ii)   For a rider, disclosing that the form is a rider, endorsement, agreement or amendment. An alternative caption may be used if the form provides that the form is ‘‘attached to and made a part of the policy.’’

   (9)  A rider contains an effective date disclosure, either in the rider or on the specifications page of the policy.

   (10)  A rider contains a disclosure of a premium, cost of insurance rates or other charges, either in the rider or on the specifications page of the policy. For a benefit built into a policy, the specifications page discloses that the cost of the benefit is included in the basic policy premium. If the benefit provides for other charges, the benefit or specifications page discloses the charges.

   (11)  The premium, maximum cost of insurance or another charge is guaranteed.



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