State RegulationsTX specificDifficulty 1/5
Which of the following must an Outline of Coverage contain when a long-term care insurance policy is delivered in Texas?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
28 TAC 3.3832 requires long-term care insurance to be accompanied by a standard-format Outline of Coverage that spells out the benefits, the exclusions, reductions and limitations, and the terms on which the policy may be continued in force or discontinued, in the prescribed order and wording. Because the outline is standardized, an applicant can compare two companies' forms side by side, and an agent who delivers a policy without it has failed a delivery requirement and created a misrepresentation risk.
Why the other options are wrong
- A) Loss ratio data is a rate-filing matter, not a required element of the Outline of Coverage under 28 TAC 3.3832.
- C) Agent compensation is not part of the standard-format Outline of Coverage required for long-term care insurance.
- D) No such consent belongs in the outline; the document is a consumer disclosure of benefits, limits and continuation terms.
Memory hook
Outline means benefits, exclusions, limits and how the policy ends.