A. The provider or broker shall provide in writing the following information, in a separate document that is signed by the owner and provider, to the owner no later than the date of application for the life settlement contract:

1. 1. That there are possible alternatives to life settlements, including accelerated benefits options that may be offered by the life insurer or policy loans.
2. 2. That some or all of the proceeds of a life settlement may be taxable and that assistance should be sought from a professional tax adviser.
3. 3. That the proceeds from a life settlement could be subject to the claims of creditors.
4. 4. That receipt of proceeds from a life settlement contract may adversely affect the recipient's eligibility for public assistance or other government benefits or entitlements and that advice should be obtained from the appropriate agencies.
5. 5. That entering into a life settlement contract may cause other rights or benefits, including conversion rights and waiver of premium benefits that may exist under the policy or certificate of a group policy, to be forfeited by the owner and that assistance should be sought from a professional financial adviser.
6. 6. That the owner has a right to rescind a life settlement contract within fifteen days after the date it is executed by all parties and the owner has received all required disclosures. Rescission, if exercised by the owner, is effective only if both notice of rescission is given and the owner repays all proceeds and any premiums, loans and loan interest paid on account of the provider within the rescission period. If the insured dies during the rescission period, the contract is deemed to have been rescinded subject to repayment by the owner or the owner's estate of all proceeds and any premiums, loans and loan interest to the provider.
7. 7. That proceeds will be sent to the owner within three business days after the provider has received the insurer or group administrator's acknowledgment that ownership of the policy or the interest in the certificate has been transferred and the beneficiary has been designated according to the terms of the life settlement contract.
8. 8. The date by which the monies will be available to the owner and the transmitter of the monies.
9. 9. That the insured may be contacted by either the provider or the broker or its authorized representative for the purpose of determining the insured's health status or to verify the insured's address. This contact is limited to once every three months if the insured has a life expectancy of more than one year and not more than once per month if the insured has a life expectancy of one year or less.
10. 10. Any affiliations or contractual relations between the provider and the broker and the affiliation, if any, between the provider and the issuer of the policy to be settled.
11. 11. That a broker represents exclusively the owner and not the insurer or the provider or any other person and owes a fiduciary duty to the owner, including a duty to act according to the owner's instructions and in the best interest of the owner.
12. 12. The name, business address and telephone number of the broker.

B. The disclosure required under subsection A shall also include the following statements:

All medical, financial or personal information solicited or obtained by a provider or broker about an insured, including the insured's identity or the identity of family members, a spouse or a significant other, may be disclosed as necessary to effect the life settlement contract between the owner and provider. If you are asked to provide this information, you will be asked to consent to the disclosure. The information may be provided to someone who buys the policy or provides monies for the purchase. You may be asked to renew your permission to share information every two years.

Any person who knowingly presents false information in an application for insurance or life settlement contract is guilty of a class 1 misdemeanor and may be subject to fines and confinement in jail.

C. The broker shall provide the owner and the provider with at least all of the following disclosures in writing before all parties sign the life settlement contract. The disclosures shall be clearly displayed in the life settlement contract or in a separate document signed by the owner:

1. 1. The name, business address and telephone number of the broker.
2. 2. A full, complete and accurate description of all of the offers, counteroffers, acceptances and rejections relating to the proposed life settlement contract.
3. 3. A disclosure of any affiliations or contractual arrangements between the broker and any person making an offer in connection with the proposed life settlement contract.
4. 4. The name of each broker who receives compensation and the amount of compensation received by that broker including anything of value paid or given to the broker in connection with the life settlement contract.
5. 5. A complete reconciliation of the gross offer or bid by the provider to the net amount of proceeds or value to be received by the owner. For the purposes of this paragraph, "gross offer or bid" means the total amount or value offered by the provider for the purchase of one or more life insurance policies including commissions and fees.