| LAC010
|
Fraternal Filings Checklist
|
PDF |
English |
| LAC012
|
Private Placement Filings Checklist
|
PDF |
English |
| LAC014
|
Life and Annuity Riders, Endorsements, and Amendments Checklist
|
PDF |
English |
| LAC018
|
Index-Linked Crediting Features Checklist
|
PDF |
English |
| LAC020
|
Life Illustration Certification and Notification Checklist
|
PDF |
English |
| LAC022
|
Prepaid Funeral Filings Checklist
|
PDF |
English |
| LAC028
|
Replacement of Life Insurance or Annuities
|
PDF |
English |
| LAH301
|
Noninsurance Benefits Checklist
|
PDF |
English |
| LAH302
|
Total and Partial Assumptions, Mergers, Name Changes, Redomestication, and Demutualization Form Filings Checklist
|
PDF |
English |
| LAH303
|
Advertising Product Review Checklist
|
PDF |
English |
| LAH345
|
Mandated Benefits and Mandated Offers Reporting Form
|
PDF |
English |
| LAHR324
|
Notice and Consent for HIV-Related Testing
|
PDF |
English |
| LAHR339
|
CCP Figure 1 - Required Disclosure Statement For All Consumer Choice Health Benefit Plans
|
PDF |
English |
| LAHR339 - Example 1
|
Employer example of LAHR339 (Form CCP1)
|
WORD |
English |
| LAHR339 - Example 2
|
Healthcare.gov example of LAHR339 (Form CCP1)
|
WORD |
English |
| LHL050
|
Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010
This form must be used beginning July 1, 2019.
|
PDF |
English |
| LHL138
|
Patient Health Plan Coverage
|
PDF |
English |
| LHL139
|
Enrollee's Other Health Plan Coverage
|
PDF |
English |
| LHL560
|
Long-Term Care Insurance Personal Worksheet
|
PDF |
English |
| LHL561
|
Long-Term Care Insurance Potential Rate Increase Disclosure Form
|
PDF |
English |
| LHL562
|
Long-Term Care Insurance Replacement and Lapse Reporting Form
|
PDF |
English |
| LHL563
|
Long-Term Care Insurance Recission Reporting Form
|
PDF |
English |
| LHL564
|
Long-Term Care Insurance Claim Denials Reporting Form
|
PDF |
English |
| LHL565
|
Long-Term Care Insurance Policies Sold Reporting Form
|
PDF |
English |
| LHL566
|
Long-Term Care Insurance Suitability Reporting Form
|
PDF |
English |
| LHL567
|
Things To Know Before You Buy Long-Term Care Insurance
|
PDF |
English |
| LHL568
|
Long-Term Care Insurance Suitability Letter
|
PDF |
English |
| LHL569
|
Partnership Status Disclosure Notice for Long-Term Care Partnership Policies/Certificates
|
PDF |
English |
| LHL570
|
Long-Term Care Partnership Program Insurer Certification Form
|
PDF |
English |
| LHL572
|
Long-Term Care Partnership Agent Training Certification Form Annual Report
|
PDF |
English |
| LHL573
|
Insurer Certification of Association Compliance with Marketing Standards for Long-Term Care Partnership and Non-Partnership Policies and Certificates
|
PDF |
English |
| NOFR001
|
Prior Authorization of Health Care Services
|
PDF |
English |
| NOFR002
|
Texas Standard Prior Authorization Request Form for Prescription Drug Benefits
|
PDF |
English |
