18 Del. Admin. Code § 1210
The purpose of this regulation is to provide rules for life insurance policy illustrations that will protect consumers and foster consumer education. The regulation provides illustration formats, prescribes standards to be followed when illustrations are used, and specifies the disclosures that are required in connection with illustrations. The goals of this regulation are to ensure that illustrations do not mislead purchasers of life insurance and to make illustrations more understandable. Insurers will, as far as possible, eliminate the use of footnotes and caveats and define terms used in the illustration in language that would be understood by a typical person within the segment of the public to which the illustration is directed.
This regulation is issued based upon the authority granted the commissioner under18 Del.C. §§311 and 2304.
3.1 This regulation applies to all group and individual life insurance policies and certificates except:
4.1 For Purpose of this Regulation:
"Actuarial Standards Board"means the board established by the American Academy of Actuaries to develop and promulgate standards of actuarial practice.
"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.
"Currently payable scale"means a scale of non-guaranteed elements in effect for a policy form as of the preparation date of the illustration or declared to become effective within the next ninety-five (95) days.
"Disciplined current scale"means a scale of non-guaranteed 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:
• Are consistent with all provisions of this regulation;
• Limit a disciplined current scale to reflect only actions that have already been taken or events that have already occurred;
• 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; and
• Do not permit assumed expenses to be less than minimum assumed expenses.
"Generic name"means a short title descriptive of the policy being illustrated such as "whole life," "term life," or "flexible premium adjustable life."
“Guaranteed elements"means the premiums, benefits, values, credits or charges under a policy of life insurance that are guaranteed and determined at issue.
"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.
"Illustrated scale"means a scale of non-guaranteed elements currently being illustrated that is not more favorable to the policy owner than the lesser of:
• The disciplined current scale; or
• The currently payable scale.
"Illustration"means a presentation or depiction that includes non-guaranteed elements of a policy of life insurance over a period of years and that is one of the three (3) types defined below:
• “Basic illustration" means a ledger or proposal used in the sale of a life insurance policy that shows both guaranteed and non-guaranteed elements.
• “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 non-guaranteed elements that is permitted in a basic illustration.
• "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.
"Illustration actuary"means an actuary meeting the requirements of Section~11 who certifies to illustrations based on the standard of practice promulgated by the Actuarial Standards Board.
"Lapse-supported illustration"means an illustration of a policy form failing the test of self-supporting as defined in this regulation, under a modified persistency rate assumption using persistency rates underlying the disciplined current scale for the first five~(5)~years and 100~percent policy persistency thereafter.
"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 the following:
• Fully allocated expenses;
• Marginal expenses; and
• A generally recognized expense table based on fully allocated expenses representing a significant portion of insurance companies and approved by the National Association of Insurance Commissioners.
• 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.
"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 where:
• Every plan of coverage was selected by the employer or other group representative;
• Some portion of the premium is paid by the group or through payroll deduction; and
• Group underwriting or simplified underwriting is used.
"Policy owner"means the owner named in the policy or the certificate holder in the case of a group policy.
“Premium outlay"means the amount of premium assumed to be paid by the policy owner or other premium payer out-of-pocket.
"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 fifteenth policy anniversary or the twentieth 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.
5.4 Potential enrollees of non-term group life subject to this regulation 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 non-guaranteed basis appropriate to the group and the coverage. This quotation shall not be considered an illustration for purposes of this regulation, but all information shall be consistent with the illustrated scale.
6.1 An illustration used in the sale of a life insurance policy shall satisfy the applicable requirements of this regulation, be clearly labeled "life insurance illustration" and contain the following basic information:
6.2 When using an illustration in the sale of a life insurance policy, an insurer or its producers or other authorized representatives shall not:
7.1 Format. A basic illustration shall conform with the following requirements:
7.1.12 Any illustration of non-guaranteed elements shall be accompanied by a statement indicating that:
7.2 Narrative Summary. A basic illustration shall include the following:
7.3 Numeric Summary.
7.3.1 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 five~(5), ten~(10) and twenty~(20) and at age~70, if applicable, on the three bases shown below.
7.3.1.3 Insurer's illustrated scale used, but with the non-guaranteed elements reduced as follows:
For multiple life policies the summary shall show policy years five~(5), ten~(10), twenty~(20) and thirty~(30).
7.4 Statements. 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 regulation.
7.5 Tabular Detail.
7.5.1 A basic illustration shall include the following for at least each policy year from one~(1) to ten~(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:
7.5.3 Non-guaranteed 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 non-guaranteed elements are shown, they must be shown at the same durations as the corresponding guaranteed elements, if any.
8.1 A supplemental illustration may be provided so long as:
9.1
9.2
9.3 If the basic illustration or revised illustration is sent to the applicant or policy owner by mail from the insurer, 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 subsection 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.
10.1 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 contain at least the following information:
10.1.1 For universal life policies, the report shall include the following:
10.1.1.7 For fixed premium policies:
10.1.1.8 For flexible premium policies:
10.1.2 For all other policies, where applicable:
11.3 The illustration actuary shall:
11.3.3 Not have been found by the commissioner, following appropriate notice and hearing to have:
11.3.5 Disclose in the annual certification whether, since the last certification, a currently payable scale applicable for business issued within the previous five (5) years and within the scope of the certification has been reduced for reasons other than changes in the experience factors underlying the disciplined current scale.
11.3.6 Disclose in the annual certification the method used to allocate overhead expenses for all illustrations:
11.4
11.4.1 The illustration actuary shall file a certification with the board and with the commissioner:
11.6 A responsible officer of the insurer, other than the illustration actuary, shall certify annually;
In addition to any other penalties provided by the laws of this state, an insurer or producer that violates a requirement of this regulation shall be guilty of a violation of18 Del.C. Section.
If any provision of this regulation or its application to any person or circumstance is for any reason held to be invalid by any court of law, the remainder of the regulation and its application to other persons or circumstances shall not be affected.
This regulation shall become effective July 1, 1997, and shall apply to policies sold on or after the effective date.