23 CAR § 107-110. Disclosure and notice

(a) Insurers offering for approval a basic benefit policy shall provide, separate from the policy, a disclosure to the insured that contains the following information: (1) An outline of the extent of coverage; (2) A specific list of the mandated benefits not provided; (3) An explanation of any managed care and cost control features, including all necessary telephone numbers and addresses; and (4) An explanation of the primary and preventive care features of the policy. (b) All disclosure statements shall use terminology and language which is easily understood by the average consumer. (c) The type used on the statements shall be pica size and the disclosure statement shall contain the following statement in 12-point boldfaced type: THIS IS A BASIC BENEFIT POLICY AND CONTAINS COVERAGE WHICH IS STRICTLY LIMITED IN NATURE AND DOES NOT CONTAIN BENEFITS WHICH WOULD BE PROVIDED UNDER A COMPREHENSIVE MAJOR MEDICAL POLICY. READ YOUR POLICY CAREFULLY. (d) A place for the insured's signature shall be provided under the statement, and no policy shall be issued unless the: (1) Disclosure statement is properly signed by the insured; and (2) Original of such retained in the records of the insurer for the duration of coverage. (e) The insured shall be provided a copy of the statement so retained by the insurer. (f) All disclosure statements shall be filed along with the policy form for approval by the Insurance Commissioner.