Group Term Life Insurance Uniform Standards for Waiver of Premium While the Certificateholder is Totally Disabled
Table of Contents
1. Date Adopted: October 24, 2024
2. Purpose and Scope: The Group Term Life Insurance Uniform Standards for Waiver of Premium While the Certificateholder is Totally Disabled apply to waiver of premium benefits that are built into group term life insurance certificates or added to such certificates by rider, endorsement or amendment that are issued to employer groups and non-employer groups, as described herein, provided the groups are authorized under the laws of the jurisdiction where the policy is delivered or issued for delivery. The waiver is for Premiums due for a Covered Person in the event that the Certificateholder becomes totally disabled under the terms of the certificate. These standards also accommodate a waiver of premium benefit that becomes available in the event that the Spouse becomes totally disabled.
With respect to non-employer groups, approval of a group policy and certificate by the Commission shall not be deemed as approval to use or issue the product to a non-employer group. A non-employer group must be approved or permitted by the Compacting State as required under the applicable state laws and procedures before a product filing approved by the Commission pursuant to the applicable group Uniform Standards may be issued to a non-employer group.
3. Rules Repealed, Amended or Suspended by the Rule: This rule amends the Group Term Life Insurance Uniform Standards for Waiver of Premium While the Certificateholder is Totally Disabled (“Waiver of Premium”) originally adopted by the Interstate Insurance Product Regulation Commission (“IIPRC”) on May 20, 2013, and amended on August 12, 2022. The amendments apply only to new filings received after the effective date of the amendments. It is not necessary to resubmit previously approved forms to comply with these amendments, or to suspend use of previously approved forms that do not comply with these amendments. See the Transmittal Memo under the Standards History on the Record for a more detailed description of the amendments.
The purpose of these amendments is to amend the Group Term Life Uniform Standards to allow for Other than Employer Groups.
4. Statutory Authority: Among the primary purposes and powers of the Interstate Insurance Product Regulation Commission (“IIPRC”) is to establish reasonable uniform standards for insurance products covered under the Interstate Insurance Product Regulation Compact (“Compact”), specifically pursuant to Article I §2, Article IV § 2 and Article VII § 1 of the Compact, as enacted into law by each IIPRC member state.
5. Required Findings: None
6. Effective Date: February 10, 2025
Scope: These standards apply to waiver of premium benefits that are built into group term life insurance certificates or added to such certificates by rider, endorsement or amendment that are issued to employer groups and non-employer groups, as described herein, provided the groups are authorized under the laws of the jurisdiction where the policy is delivered or issued for delivery. The waiver is for Premiums due for a Covered Person in the event that the Certificateholder becomes totally disabled under the terms of the certificate. These standards also accommodate a waiver of premium benefit that becomes available in the event that the Spouse becomes totally disabled.
With respect to non-employer groups, approval of a group policy and certificate by the Commission shall not be deemed as approval to use or issue the product to a non-employer group. A non-employer group must be approved or permitted by the Compacting State as required under the applicable state laws and procedures before a product filing approved by the Commission pursuant to the applicable group Uniform Standards may be issued to a non-employer group
Mix and Match: These standards are available to be used in combination with State Product Components as described in Section 111(b) of the Operating Procedure for the Filing and Approval of Product Filings. These standards are available to be used in combination with IIPRC-approved or state-approved group life insurance and annuity forms.
Self-Certification: These standards are not available to be filed using the Rule for the Self-Certification of Product Components Filed with the Interstate Insurance Product Regulation Commission.
As used in these standards, the following definitions apply:
“Waiver benefit” means the waiver of Premium due for a Covered Person under the certificate.
Terms not defined in these standards that are capitalized and italicized have the meanings specified in the Group Term Life Insurance Policy and Certificate Standards for Employer Groups.
§ 1 ADDITIONAL SUBMISSION REQUIREMENTS
(1) If the waiver benefit is filed as an attachment to a certificate and the certificate is not included in the submission, include a statement of whether the waiver benefit is intended for use with new issues and/or in force business.
(2) Include a description of the benefit, including any limitations or exclusions.
(1) The provision shall describe the eligibility requirements for the waiver benefit, what life insurance amounts are eligible, the requirements for proof that the Certificateholder has satisfied the conditions and requirements for the waiver benefit, and when the waiver benefit ends.
(2) The provisions may require that total disability begin before the Certificateholder attains a specified age, not less than age 60.
(3) The provisions shall define “total disability” or “totally disabled” on a basis not more restrictive than due to an injury or sickness the Certificateholder is unable to perform the material duties of the Certificateholder’s regular job and is unable to perform for remuneration or profit any other job for which the Certificateholder is fit by education, training or experience.
(4) If there is a specified period of time for which total disability must continue without interruption (the waiting period), the provisions shall specify such period and such period shall not be more than 12 months.
(5) The provisions shall state whether Premiums need to be paid during the waiting period and by whom.
(6) The provisions shall state whether or not the Certificateholder’s Dependent life insurance Premium will be waived while the Certificateholder is qualified for the waiver benefit. If the Certificateholder’s Dependent life insurance remains in effect only if the Premium is paid while the Certificateholder is qualified for the waiver benefit, the provision shall so state.
(7) The form shall state that the Premiums waived by the insurance company shall not be deducted from the certificate proceeds.
B. CLAIM PROCEDURES
(1) The provisions shall state to whom and when the Certificateholder must provide notice of the Certificateholder’s total disability. The provision shall also state that failure to give notice within the specified time shall not invalidate or reduce any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible.
(2) The provisions shall state that after the waiting period ends, the Certificateholder must send the insurance company, within a specified period not to exceed 12 months, required proof of the total disability and that it has continued without interruption until the end of the waiting period. The provisions shall also state that failure to furnish such proof within such time shall not invalidate or reduce any claim if it shall be shown not to have been reasonably possible to furnish such proof within such time, provided such proof was furnished as soon as reasonably possible.
(3) The provisions may state that the insurance company has the right to require a second or third medical opinion to confirm waiver benefit eligibility.
(a) If the provisions reserve the right to require a second or third medical opinion, the provisions shall state that the second and third medical opinions are at the insurance company’s expense.
(b) The second medical opinion may include a physical examination by a physician designated by the insurance company.
(c) In the case of conflicting opinions, eligibility for waiver benefits shall be determined by a third medical opinion that is provided by a physician that is mutually acceptable to the Certificateholder and the insurance company.
(4) The provisions shall state that the insurance company will send the Certificateholder written notice advising whether the Certificateholder is approved for the waiver benefit and, if approved, the amount of the Premium being waived.
(5) The provisions may state that, after the initial approval, the insurance company may periodically request additional proof of continuing total disability, but shall not do so more frequently than once every six months.
(6) The provisions shall state that if the Certificateholder dies during the waiver benefit period, Proof of Loss should be submitted to the insurance company after death. Proof of Loss includes supporting documentation that total disability continued without interruption from the date the waiver benefit started to the date of death. If the Certificateholder had converted the continued coverage to an individual life insurance policy, the insurance company will pay the continued life insurance if the individual policy is returned.
C. WHEN THE WAIVER BENEFIT ENDS
(1) The provisions may include the following conditions under which the waiver benefit shall end. The waiver benefit may end at the earliest of:
(a) The date of an Certificateholder’s death;
(b) The date an Certificateholder’s total disability ends;
(c) Upon the failure to provide Proof of Loss as requested;
(d) A Certificateholder’s refusal to be examined by a physician; or
(e) The expiration of a specified benefit period, such as 1 to 10 years, or an Certificateholder’s attainment of a specified age not less than age 65.
(2) The provisions may include the following conditions under which the waiver benefit for a Dependent shall end. The waiver benefit for a Dependent may end at the earliest of:
(a) The date the required Premium, if any, is not paid;
(b) The date an Certificateholder’s waiver benefit ends;
(c) The date an Certificateholder dies; or
(d) The date the Dependent ceases to be eligible under the policy.
(1) The provisions shall allow the Certificateholder to convert the Certificateholder’s life insurance in effect on the date that the waiver benefit ends, unless at such time the Certificateholder has returned to Active Work in an eligible class and becomes insured under the policy, or unless the Certificateholder has already converted the life insurance or portion thereof. The Conversion provision of the certificate shall describe the conversion right.
(2) The provisions shall allow conversion of the Dependent’s life insurance if such insurance was in effect on the date that the waiver benefit ends. The Conversion provision of the certificate shall describe the conversion right.
Effective on 02/10/2025
Purpose of Proposed New Rules: The purpose of these amendments is to amend the Group Term Life and Group Whole Life Uniform Standards to allow for Other than Employer Groups. See the link for the Transmittal Memo for a more detailed description of the proposed amendments.
This rule would amend the following Uniform Standards:
GROUP TERM LIFE PRODUCT LINE
1. Group Term Life Insurance Policy and Certificate Standards
2. Uniform Standards for Group Term Life Insurance Enrollment Forms and Statement of Insurability Forms
3. Uniform Standards for Group Term Life Insurance Statement of Insurability Change Form
4. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Term Insurance Certificate Changes
5. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Term Life Insurance Policy Changes
6. Group Term Life Insurance Uniform Standards for Accelerated Death Benefits
7. Group Term Life Insurance Uniform Standards for Accidental Death Benefits
8. Group Term Life Insurance Uniform Standards for Accidental Death and Dismemberment Benefits
9. Group Term Life Insurance Uniform Standards for Waiver of Premium While the Certificateholder is Totally Disabled
GROUP WHOLE LIFE PRODUCT LINE
1. Group Whole Life Insurance Policy and Certificate Standards
2. Uniform Standards for Group Whole Life Insurance Enrollment Forms and Statement of Insurability Forms
3. Uniform Standards for Group Whole Life Insurance Statement of Insurability Change Form
4. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Whole Insurance Certificate Changes
5. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Whole Life Insurance Policy Changes
6. Group Whole Life Insurance Uniform Standards for Accelerated Death Benefits
7. Group Whole Life Insurance Uniform Standards for Accidental Death Benefits
8. Group Whole Life Insurance Uniform Standards for Accidental Death and Dismemberment Benefits
9. Additional Standards for Waiver of Premium Benefits for Total Disability and Other Qualifying Events for Whole Life Insurance Policies and Certificates
10. Additional Standards for Graded Death Benefits for Whole Life Insurance Policies and Certificate
Effective 2/10/2025
Active
Purpose of Proposed New Rules: The purpose of these amendments is to amend the Group Term Life and Group Whole Life Uniform Standards to allow for Other than Employer Groups. See the link for the Transmittal Memo for a more detailed description of the proposed amendments.
This rule would amend the following Uniform Standards:
GROUP TERM LIFE PRODUCT LINE
1. Group Term Life Insurance Policy and Certificate Standards
2. Uniform Standards for Group Term Life Insurance Enrollment Forms and Statement of Insurability Forms
3. Uniform Standards for Group Term Life Insurance Statement of Insurability Change Form
4. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Term Insurance Certificate Changes
5. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Term Life Insurance Policy Changes
6. Group Term Life Insurance Uniform Standards for Accelerated Death Benefits
7. Group Term Life Insurance Uniform Standards for Accidental Death Benefits
8. Group Term Life Insurance Uniform Standards for Accidental Death and Dismemberment Benefits
9. Group Term Life Insurance Uniform Standards for Waiver of Premium While the Certificateholder is Totally Disabled
GROUP WHOLE LIFE PRODUCT LINE
1. Group Whole Life Insurance Policy and Certificate Standards
2. Uniform Standards for Group Whole Life Insurance Enrollment Forms and Statement of Insurability Forms
3. Uniform Standards for Group Whole Life Insurance Statement of Insurability Change Form
4. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Whole Insurance Certificate Changes
5. Uniform Standards for Riders, Endorsements or Amendments Used to Effect Group Whole Life Insurance Policy Changes
6. Group Whole Life Insurance Uniform Standards for Accelerated Death Benefits
7. Group Whole Life Insurance Uniform Standards for Accidental Death Benefits
8. Group Whole Life Insurance Uniform Standards for Accidental Death and Dismemberment Benefits
9. Additional Standards for Waiver of Premium Benefits for Total Disability and Other Qualifying Events for Whole Life Insurance Policies and Certificates
10. Additional Standards for Graded Death Benefits for Whole Life Insurance Policies and Certificate
Effective 11/28/2022
to 2/9/2025
Inactive
The purpose of these amendments is to revise the Operating Procedures and Uniform Standards effective between January 1, 2013, and June 30, 2014, in accordance with the Five-Year Commission Review of Rules required by §119 of the Rule for the Adoption, Amendment and Repeal of Rules for the Interstate Insurance Product Regulation Commission. The procedures adopted by the Management Committee in March 2012 for implementing the Five-Year Review process limit the scope of review under §119 to identifying “the need for continuation, repeal or amendment of the rule based primarily on whether circumstances or underlying assumptions have changed since the last time the rule was adopted, amended or reviewed.” See the (link for Transmittal memo) for a more detailed description of the proposed amendments.
Effective 9/4/2013
to 11/27/2022
Inactive
The Group Term Life Insurance Uniform Standards for Waiver of Premium While the Employee is Totally Disabled (the "Proposed Standards") apply to waiver of premium benefits that are built into group term life insurance certificates or added to such certificates by rider, endorsement or amendment. The waiver is for premiums due for a covered person in the event that the employee becomes totally disabled under the terms of the certificate. These standards also accommodate a waiver of premium benefit in the event an employee's spouse becomes totally disabled.