§ 89.102. Guidelines for approval of forms.
(a) General filing requirements. Fraternal benefit society filings shall comply with the requirements and procedures of Subchapters A—C (relating to requirements for all policies and forms; requirements for life insurance; and requirements for accident and health insurance) except where these requirements and procedures are not applicable.
(b) General conditions of approval. General conditions of approval shall conform with the following:
(1) An approved form may not be used to insure anyone who is not a member or a spouse or dependent of a member of the fraternal benefit society as required by section 301(b) of the Fraternal Benefit Society Code (40 P. S. § 1141-301(b)). Nor may an approved form be used to insure a juvenile except upon the application of an adult as required by section 302(a) of the Fraternal Benefit Society Code (40 P. S. § 1141-302(a)).
(2) [Reserved].
(3) Forms can contain words such as insurance, insured, premium, policy and other type words usually associated with commercial insurance. In lieu thereof, words such as benefit, member, dues, certificate and the like type may be used. However, the type of wording used in forms shall be consistent. This is not intended to prohibit the use of words to describe different things as long as the wording used in the form is consistent.
(4) Approvals are conditioned upon the forms being used lawfully, and in conformity with applicable rules and regulations of the Department.
(c) Specific guidelines for certificates. Specific guidelines for certificates shall conform with the following:
(1) The words ‘‘A Fraternal Benefit Society’’ will appear in conspicuous type on the first page and filing back under the name of the society, as required by section 403 of the Fraternal Benefit Society Code (40 P. S. § 1141-403).
(2) If a certificate is issued on the life of a nonmember as the principal insured, the following or similar terminology shall appear in the certificate:
(i) If a certificate is issued in connection with section 301(b) of the Fraternal Benefit Society Code (40 P. S. § 1141-301(b)) it shall contain the following:
Application Member
Insured
(ii) If a certificate is issued in connection with section 302(a) of the Fraternal Benefit Society Code (40 P. S. § 1141-302(a)) it shall contain the following:
Applicant Adult
Insured
(3) A certificate shall provide a suspended or expelled member with the opportunity to maintain his certificate or his spouse’s or dependent’s certificate in force, upon timely payment of premium.
(4) A certificate shall specify (except with respect to those excluded by section 903 of the Fraternal Benefit Society Code (40 P. S. § 1141-903) the amount of benefits furnished thereunder. A certificate shall provide that the certificate, charter or articles of incorporation or, if a voluntary association, the articles of the association, the constitution and bylaws of the society, the application for membership, medical examination or health certificates signed by the applicant and amendments to the documents, shall constitute the agreement between the society and the member. See section 306(a) of the Fraternal Benefit Society Code (40 P. S. § 1141-306(a)).
(5) In order that the membership may be fully aware of their responsibility, certificates shall provide, except with respect to those excluded by section 903 of the Fraternal Benefit Society Code (40 P. S. § 1141-903) for additional or increased contributions from members in the event of financial deficiencies to the extent required in the bylaws and shall provide for the consequences if the contributions are not made.
(6) A certificate providing an accidental death benefit may not contain a requirement that death must occur within a specific time period.
(d) Specific guidelines for applications. Specific guidelines for applications shall conform with the following:
(1) Membership and insurance applications may not be combined into one application. Questions relating to membership may not be included in an insurance application, except as provided in paragraph (5).
(2) If proposed insured is adult (18 or over), a member, and is the applicant, the application for insurance shall contain:
‘‘Proposed Insured’s Signature
’’(3) If proposed insured is an adult and not a member, the application for insurance shall contain:
‘‘Proposed Insured’s Signature
’’‘‘Member Applicant’s Signature
’’(4) If proposed insured is a child, the application for insurance shall contain:
‘‘Adult Applicant’s Signature
’’(5) Each application except exchange or conversion applications for insurance on the life of an adult shall contain the following:
‘‘Is the applicant a member of (
)?’’‘‘Yes
No
’’‘‘If not, apply for membership.’’
(6) The words ‘‘A Fraternal Benefit Society’’ shall appear in conspicuous type on the insurance application.
Source The provisions of this § 89.102 amended July 22, 1977, effective July 23, 1977, 7 Pa.B. 2060. Immediately preceding text appears at serial page (19984).
Cross References This section cited in 31 Pa. Code § 90c.23 (relating to applications of fraternal benefit societies); 31 Pa. Code § 90d.8 (relating to fraternal benefit society); 31 Pa. Code § 90e.10 (relating to fraternal benefit society); 31 Pa. Code § 90f.12 (relating to fraternal benefit society); 31 Pa. Code § 90g.12 (relating to fraternal benefit society); and 31 Pa. Code § 90h.10 (relating to fraternal benefit society).
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