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State RegulationsTX specificDifficulty 2/5

At the time of application for a Medicare supplement policy in Texas, which of the following must be delivered to the applicant under the Texas Medicare supplement rules?

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Answer & full 3-part explanation (select an option above, or peek)

Why B is correct

28 TAC 3.3308(b)-(c) requires an Outline of Coverage describing the policy's benefits to be delivered to the applicant at the time of application, with a receipt obtained from the applicant except in direct response solicitations, and requires a substitute outline to accompany the policy where the policy as issued differs from the outline delivered. Failing to deliver it is a rule violation by the issuer and the agent. In practice, a Texas agent should document delivery of the outline in the application file, since that is the record TDI will look for on a market conduct examination.

Why the other options are wrong

  • A) A financial rating report is not a required solicitation or application document under these rules, however useful it may be in practice.
  • C) The rules do not require a county-by-county provider roster. That is not a Medicare supplement disclosure obligation.
  • D) Medicare Advantage plan comparison materials belong to the Medicare Advantage market, not to the required Medicare supplement application disclosures.

Memory hook

Med supp application: deliver the Outline of Coverage.

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