Frequently Asked Question's for Filing Life And Accident & Health Forms
We are happy to assist you in complying with these filing requirements. If you have any questions about the proper way to submit filings, please contact us at 512/322-4245.
- What is A Resubmission?
- What Is "File And Use?"
- When is Certification Required?
- Why Is "Highlighting" Prohibited?
- Will The Company Be Notified on an Exempt Filing?
- When Is An Application Form Exempt?
- What Is An "Exact Copy" Submission?
- How Should Corrections To A Pending Form Be Submitted?
- Common Problems
- Frequently Asked Questions Regarding Fees
- Common Questions
- Where Do We Send Our Filing?
Return to Index A "resubmission" is a form that has been previously formally disapproved that is now being filed for reconsideration.
A resubmission is NOT a form that has been returned to you "Not Accepted for Review." A resubmission also does NOT include corrections to a pending form.
A resubmission is NOT a form that has been officially withdrawn from the review process.
Chapter 1701.052, Texas Insurance Code allows a company to file a form and use it while it is pending approval. Under this provision, a company can start issuing forms immediately without waiting for the Texas Department of Insurance to take formal action. The form will be reviewed by the Texas Department of Insurance and must comply with all applicable statutes and rules.
The transmittal checklists include a place for you to indicate this election by checking Chapter 1701.052 "File & Use" (Pg. 2, #3). You must also complete the certification part (Pg. 3, #5) of the transmittal checklist by initialing "File and Use" if you file under this provision.
NOTE: Certain forms are exempt from the review and approval process under the provisions of Article 3.42(h). When filing an exempt form, a company may also begin using the form once it as been filed with the Department.
When is Certification Required?
You MUST always initial either "General" or "Specific" with a filing. The only time you initial "Specific" is if you file "File & Use" - Chapter 1701.052.
You MUST use the "Certification" part (Pg. 3, #5) of the transmittal checklist for filings that qualify as:
- "File & Use" - Chapter 1701.052, TIC and 28 TAC §3.5(a)(2) - when filing "file & use" as explained above. This is the only time you initial the "Specific" item in lieu of "General".
- "Exempt"- Chapter 1701.005, TIC and §3.5(a)(3) - filings that meet the criteria specified in §3.4004.
- "Substantially Similar To Previously Approved Form" - 28 TAC §3.5(b)(2) - filings that are similar to a previously "approved" form.
- "Exact Copy of a Previously Approved Form" - 28 TAC §3.5(b)(3) - filings that are an "exact" copy of a previously "approved" form.
- "Substitution of a Previously Approved or Exempted Form" - 28 TAC §3.5(b)(4) - the substitution of a form (approved or exempted) that has not been issued or the form number has not changed.
- "Corrections to a pending form" - 28 TAC §3.5(b)(5) - corrections to a form filing that is pending review and no action yet has been taken.
- "Resubmission of a Previously Disapproved form" - submission of a form that has been previously "disapproved".
- "Supplemental Coverage's" - 28 TAC §3.4(j)
- "Supplemental Coverage's" - 28 TAC §3.3080
- "Matrix or Insert Pages" - 28 TAC §3.4(f)
- "Readability" - 28 TAC §3.6(b)
ONLY INITIAL THE BOX/ITEM THAT PERTAINS TO YOUR FILING.
Example: If you are submitting a filing that is similar to a previously "approved" form under the "file & use" provisions of Chapter 1701.052, you should initial the box related to "Specific", "File & Use" and to "Similar To".
ALL BOXES MAY NOT APPLY. For example, if you are submitting an individual product, there will not be any information to complete related to group filings (type of group; etc).
Why Is "Highlighting" Prohibited?
Highlighting any portion of the form is strictly prohibited. Highlighted portions of forms are not legible. PLEASE UNDERLINE ALL CHANGES.
Will The Company Be Notified on an Exempt Filing?
Companies should refer to TAC §3.4004 to determine if the form is exempt before submitting it. We will notify the company if a form filed for review is eligible to be exempt via telephone, fax, or written correspondence. If your form is returned to you, we will enclose a letter describing any changes to filing fees and/or necessary documentation.
When Is An Application Form Exempt?
Exempt - when used with an exempt form exclusively.
Not Exempt - when an application is being used with a non-exempt policy or is being submitted for general use.
If an application was previously filed only with an exempt form and a company now wishes to use that application with a form that requires approval, the application that is being submitted must have a different form number. A new form number will be necessary to facilitate the tracking of this form.
What Is An "Exact Copy" Submission?
If you are submitting a filing as an "exact copy" of a previously approved form, all language and provisions must be exact (except for company identification information such as name, address, and telephone number). If you are submitting a group filing, all information including the type of group must be exact.
If the type of group is different but remaining language and provisions are identical, the forms should be filed as "similar to" previously approved forms and "similar to" checked off on the "certification" part of the checklist.
How Should Corrections To A Pending Form Be Submitted?
In order to expedite the review of corrections submitted for a pending form, TDI rules require companies to identify the modified text by underlining. In addition to underlining modified or new text and describing any deleted text, companies must submit the Transmittal Checklist referencing "corrections" - 28 TAC, §3.5(b)(5) with the certification of the checklist.
Please do not initial several blanks on the certification. The company representative should only initial what applies to the filing being submitted, such as resubmission, exempt, or substitution, etc.
Some companies use underlining as a mechanism for identifying variable language in a policy form. Since underlining of language has a new meaning under the new filing requirement rules, underlining should only be used to designate or identify changes to a form. Brackets should be used to indicate variable language.
Confusion with "Exempt" filings and "File & Use" filings. You cannot submit a filing and reference it as "Exempt" filings and "File & Use" together - see definition of both below:
- Exempt filings - are exempt from review/approval, but still have to be filed.
- File & Use filings - are filings that need review/approval, but the company can issue the form before TDI has taken action on it.
Frequently Asked Questions Regarding Fees
- What is the fee for a Resubmission with more than one policy?
There is a $50.00 filing fee per policy.
- Is there a filing fee for Substitutions?
No, unless the form has been issued in Texas and/or the form number has changed.
- Is there a filing fee for Corrections?
No, if the form for which the corrections are being submitted is still pending review.
- Is there a filing fee for a form submission that has been previously withdrawn from the review process?
Yes, $50.00 filing fee is required according to TAC§3.3(h)(2).
Can a form be submitted as an "Exact Copy" of a previously "exempted" form?
NO - any form that is being submitted as an "Exact Copy" has to be an exact copy of a "previously approved" form.
When submitting exact form filings, do you need to submit the Actuarial?
YES - the filing must be exact – all the forms, with actuarial and rates.
How often do companies need to submit the "provider list"?
The provider list is submitted on a quarterly basis.
Send form filings to the:
Texas Department of Insurance
Life/Health Group - MC 106-1E
Attention: Filings Intake Division
P. O. Box 149104
Austin, Texas 78714-9104
Life/Health Group's Physical Address:
Hobby Tower I - Sixth Floor
333 Guadalupe
Austin, Texas 78701
For more information contact:
Last updated: 01/26/2012
