An outline of coverage, in the form prescribed in this section, shall be issued in connection with policies meeting the standards of § 88.171 (relating to supplemental insurance coverage). The coverage shall be identified by the appropriate bracketed title. The items included must appear in the sequence prescribed:

(COMPANY NAME)
(HOME OFFICE ADDRESS)
SUPPLEMENTAL INSURANCE COVERAGE
REQUIRED OUTLINE OF CONTRACT

1. (1) Read Your Policy Carefully—This outline of coverage provides a very brief description of the important features of your policy. This is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth in detail the rights and obligations of both you and your insurance company. It is, therefore, important that you READ YOUR POLICY CAREFULLY!
2. (2) (Supplemental Insurance Coverage)—Policies of this category are designed to provide, to persons insured, limited or supplemental coverage.

3. (3) (A brief specific description of the benefits, including dollar amounts contained in this policy:

   *NOTE: The above description of benefits shall be stated clearly and concisely, and shall include a description of benefit amounts, durations or limits, elimination periods, inner limits, deductible or co-payment provisions and any other items appropriate to the coverage provided. Proper disclosure of benefits which vary according to accidental cause shall be made.)

4. (4) (A description of any policy provisions which exclude, eliminate, restrict, reduce, limit, delay, or in any other manner operate to qualify payment of the benefits described in (3) above.)
5. (5) (A description of policy provisions respecting renewability or continuation of coverage, including age restrictions or any reservation of right to change premiums.)

Cross References

This section cited in 31 Pa. Code § 88.171 (relating to supplemental insurance coverage).