General provisions.

An individual life accidental death benefit filing complying with the following is acceptable:

(1) The submission letter for a form complies with applicable requirements of § 89b.5 (relating to letter of submission).

(2) The form is submitted in duplicate. This complies with § 89b.4(a) (relating to general filing procedure).

(3) The form is submitted in the final printed form intended for actual issue, unless the company requests tentative approval under § 89.4(d) (Reserved). A form submitted for tentative approval is submitted in draft, printer’s-proof, photocopied, ‘‘filer’’ or other legible form.

(4) The form number and the wording in the form are printed in easily readable type.

(5) Logos are or are not present and are more or less prominent than the company name.

(6) The full company name appears on a rider for filing purposes only. The name is printed or added by rubber stamp or other appropriate means. This complies with § 89b.11(a) (relating to general contents of forms).

(7) An administrative office address or the home office address is or is not shown. If an address is captioned as ‘‘home office,’’ it is the official home office address of record.

(8) The form contains a caption:

(i) Disclosing the coverage provided—accidental death or accidental death and dismemberment, as appropriate.

(ii) For a rider, disclosing that the form is a rider, endorsement, agreement or amendment. An alternative caption if the form provides that it is ‘‘attached to and made a part of the policy.’’

(9) A rider contains an effective date disclosure, either in the rider or on the specifications page of the policy.

(10) A rider contains a disclosure of the premium or cost of insurance rates, either in the rider or on the specifications page of the policy. For a benefit built into a policy, the specifications page discloses that the cost of the benefit is included in the basic policy premium.