Form LAC005 "Group Life Insurance Checklist" - Texas

What Is Form LAC005?

This is a legal form that was released by the Texas Department of Insurance - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2020;
  • The latest edition provided by the Texas Department of Insurance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form LAC005 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance.

ADVERTISEMENT
ADVERTISEMENT

Download Form LAC005 "Group Life Insurance Checklist" - Texas

Download PDF

Fill PDF online

Rate (4.4 / 5) 28 votes
LAC005 | 0620
GROUP LIFE INSURANCE CHECKLIST
Every effort has been made to ensure the accuracy of the information in this document. All
parties should consult the Texas Insurance Code, the Texas Administrative Code, and other
applicable laws.
Important Notes
Use in addition to, not in lieu of, appropriate product checklist, i.e., Term and Whole Life
Checklist, Universal Life Checklist, Variable Life Checklist, Individual Deferred Annuities, Group
Annuities, etc.
Revisions to the
Texas Life and Health Insurance Guaranty Association Summary Document
became effective November 21, 2019. The Summary Document is not required to be filed with
the Texas Department of Insurance.
Revisions to the
Notice of Toll-Free Telephone Numbers and Information and Complaint
Procedures
became effective November 4, 2019. The Toll-Free notice must be provided in
accordance with
28 TAC
§1.601. The form is not required to be filed with the Texas Department
of Insurance. Insurers and HMOs must begin using the notice form described in subsection (a)
(2) of this section no later than May 1, 2020.
Eligible Groups -
TIC
§1131.002;
28 TAC
§3.3(b)(2)(K), and
§3.6(c)
The transmittal must define the eligible group. Use of forms for more than one group
Page
type is prohibited.
Employers -
TIC §1131.051
The policyholder is the employer or trustee of a fund established by an employer
Page
to insure the employer's employees for the benefit of persons other than the
employer. The insured is the employee.
The eligible employees shall be all of the employees of the employer, or all of any
Page
class or classes of employees determined by conditions relating to their
employment.
§1131.202
1/16
LAC005 | 0620
GROUP LIFE INSURANCE CHECKLIST
Every effort has been made to ensure the accuracy of the information in this document. All
parties should consult the Texas Insurance Code, the Texas Administrative Code, and other
applicable laws.
Important Notes
Use in addition to, not in lieu of, appropriate product checklist, i.e., Term and Whole Life
Checklist, Universal Life Checklist, Variable Life Checklist, Individual Deferred Annuities, Group
Annuities, etc.
Revisions to the
Texas Life and Health Insurance Guaranty Association Summary Document
became effective November 21, 2019. The Summary Document is not required to be filed with
the Texas Department of Insurance.
Revisions to the
Notice of Toll-Free Telephone Numbers and Information and Complaint
Procedures
became effective November 4, 2019. The Toll-Free notice must be provided in
accordance with
28 TAC
§1.601. The form is not required to be filed with the Texas Department
of Insurance. Insurers and HMOs must begin using the notice form described in subsection (a)
(2) of this section no later than May 1, 2020.
Eligible Groups -
TIC
§1131.002;
28 TAC
§3.3(b)(2)(K), and
§3.6(c)
The transmittal must define the eligible group. Use of forms for more than one group
Page
type is prohibited.
Employers -
TIC §1131.051
The policyholder is the employer or trustee of a fund established by an employer
Page
to insure the employer's employees for the benefit of persons other than the
employer. The insured is the employee.
The eligible employees shall be all of the employees of the employer, or all of any
Page
class or classes of employees determined by conditions relating to their
employment.
§1131.202
1/16
LAC005 | 0620
The premium must be paid by the policyholder wholly from the employers fund or
Page
funds contributed by the employer; partly from the employers fund and partly
from funds contributed by the insured employees, or wholly from funds
contributed by the insured employees.
§1131.203
The policy must cover at least 2 employees on the date of issue.
§1131.204(a)
Page
TIC §1131.052
Labor Unions -
The policyholder is the labor union. For purposes of TIC
Chapter
1131, the labor
Page
union is considered to be an employer and a member of a labor union is
considered to be an employee of the union. The insureds are the members of the
labor union who are actively engaged in the same occupation.
Funds Established by Employers or Labor Unions -
TIC §1131.053
The policyholder is the trustee of the fund and the insureds are the employees of
Page
the employers or the members of the union.
A group life insurance policy under TIC
§1131.053
may be issued to the trustees of
Page
a fund established or adopted by:
two or more employers in the same industry;
one or more labor unions;
one or more employers in the same industry and one or more labor unions; or
one or more employers and one or more labor unions whose members are in the
same or related trades or occupations.
§1131.053(a)
2/16
LAC005 | 0620
A policy to which TIC
§1131.053
applies may provide that “employee” includes:
Page
an individual proprietor or partner, if the employer is an individual proprietorship
or partnership that is actively engaged in and devotes a substantial part of their
time to conducting the business of the proprietorship or partnership.
(§1131.053(b)(1)
and §1131.252(c));
a trustees, an employee of the trustee, or both if the person's duties are
principally connected with the trusteeship (§1131.053(b)(2)); or a retired employee
(§1131.053(b)(3)).
The individuals eligible for insurance under the policy are:
Page
all employees of the employers and the employees of the trade association of
those employers (§1131.252(a)(1));
all members of the labor union (§1131.252(a)(2)); or
all of any class or classes of employees or members determined by conditions
relating to their
employment, to their membership in the unions, or both
(§1131.252(a)(3)).
Note: The director of a corporate employer is also eligible for insurance under this
section providing the director is otherwise eligible as a bona fide employee of the
corporation by performing services other than the usual duties of a director.
§1131.252(b)
The premiums are to be paid by the policyholder from funds contributed either
Page
(§1131.253):
entirely by the employer, union, or both (must insure 100% of all the eligible
employees that provide satisfactory evidence of insurability);
§1131.254(c)
or
partially by the employer, union, or both and partly by the insured (must insure at
least 75% of eligible employees that can provide satisfactory evidence of
insurability on the date the policy takes effect).
§1131.254(b)
Note: The insured person must not contribute more than $0.40 per month for
each $1,000 of insurance coverage.
§1131.253
3/16
LAC005 | 0620
The policy must cover at least 100 individuals at the date of issue unless the policy
Page
is issued to the trustees of a fund established by employers through a collective
bargaining agreement or one or more labor unions.
§1131.254
The policy may not be issued to insure employees of:
Page
an employer that becomes eligible because of a business relationship with another
employer (regardless of whether such other employer participates in the fund);
§1131.053(d)(1); or
an employer who is not located in Texas unless the majority of the employees are
located in Texas; or the policy is issued to the trustees of a fund established or
adopted by one or more labor unions.
§1131.053(d)(2)
Governmental Entities or Associations of Public Employees -
TIC §1131.054
The policyholder is one of the governmental entities or associations of public
Page
employees listed below. The insureds are the governmental entity's employees or
the association's members, as appropriate.
"employee" includes an elected or appointed officer of the state.
§1131.054(a)
§1131.054(b)
a municipality, independent school district, or common school district;
a department of state government;
a state college or university; or
an association of public employees, including an association of:
(A) employees of the United States government, if the majority of the members of
the association reside in this state;
(B) state employees; or
(C) any combination of state, county, and municipal employees.
The eligible insureds will be:
Page
all of the employees of the employers, or all of any class or classes of employees
determined by conditions relating to their employment. §1131.202; or
all of the members of the association.
§1131.302
4/16
LAC005 | 0620
Premiums may be paid wholly or partly from funds contributed by :
Page
the employer;
the individual insureds; or
the insured employees who are members of the association of employees.
§1131.303
Note: The policy may be placed in force only if 75% of the eligible insureds at the
date of issue elect to make the required premium contributions.
§1131.304
The policy must cover at least 10 employees or members at the date of issue.
Page
§1131.304
Spouses and Children of Employees of the United States Government -
TIC §1131.055
Group term life insurance may be extended to the spouse and minor children of
Page
insured employees of the United States government, providing that the policy
constitutes a part of the employee benefit program and the spouse or children of
other employees covered by the same employee benefit program in other states
may be covered.
The premiums must be paid by the policyholder from funds solely contributed by
Page
the insured employee.
§1131.352
The maximum amount of insurance is the lesser of $10,000 or 50% of the amount
Page
of the insured's insurance on the life of the insured employee.
Insurance on the life of an employee's minor child may not exceed $2,000.
Page
§1131.353
5/16