1. (1) Forms in General.

   1. (a) A form is a file and use filing.
   2. (b) A form shall be identified by a unique form number that may not be variable.
   3. (c) A form shall be in final printed form and may not be submitted as a draft.

   4. (d) Blank spaces within a form shall be completed to accurately represent the purpose and use.

      1. (i) If the intended market is for a senior age market, the form shall be completed with data representative of senior annuitants.
      2. (ii) Any data in a form, including the data page, shall be consistent with the actuarial memorandum, the application, and any marketing materials, as applicable.

2. (2) Application Filing.

   1. (a) An application or enrollment form may be submitted as a separate filing or filed with its related contract or certificate filing.
   2. (b) If an application was previously filed or is filed separately, an informational copy of the application shall be included with the contract or certificate filing.
   3. (c) The Utah filed date or SERFF tracking number for the application shall be included in the filing description.

3. (3) Contract Filing.

   1. (a) Each TOI shall be filed separately.
   2. (b) A contract filing consists of one contract form, including the application, data page, rider, endorsement, and actuarial memorandum.
   3. (c) A contract data page shall be included with each contract filing.
   4. (d) Only one contract filing for a single TOI may be filed.

4. (4) Rider or Endorsement Filing.

   1. (a) Related riders or endorsements may be filed together.
   2. (b) A single rider or endorsement that affects multiple forms may be filed if the filing description references each affected form.
   3. (c) A rider or endorsement that is based on morbidity risks, such as critical illness or long-term care, is accident and health insurance and shall be filed under Rule R590-220.

   4. (d) The filing description shall include:

      1. (i) a list of each contract form number, title, and Utah filed date or SERFF tracking number;
      2. (ii) a description of how each filed rider or endorsement affects the contract; and
      3. (iii) a data page with data for the submitted form.
   5. (e) Unrelated riders or endorsements may not be filed together.

KEY: annuity insurance filings

Date of Last Change: May 1, 2023

Notice of Continuation: March 7, 2024

Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-2-201.1; 31A-2-202