TABLE OF CONTENTS
CHAPTER Ins 100 ORGANIZATIONAL RULES
PART Ins 101 DEFINITIONS
Section Ins 101.01
Commissioner
Section Ins 101.02
Department
PART Ins 102 DESCRIPTION OF
DEPARTMENT
Section Ins 102.01
Commissioner
Section Ins 102.02
Licensing Division
Section Ins 102.03
Consumer Services Division
Section Ins 102.04 Life,
Accident and Health Division
Section Ins 102.05
Property and Casualty Division
Section Ins 102.06
Examination Division
Section Ins 102.07
Administrative Division
Section Ins 102.08 Fraud
Division
PART Ins 103 REQUESTS FOR DEPARTMENT
DOCUMENT/RECORDS
Section Ins 103.01
Document Requests
Section Ins 103.02
Requests in Writing, Required Information
Section Ins 103.03
Department Response
CHAPTER Ins 200 PRACTICES
AND PROCEDURES
PART Ins 201 GENERAL INFORMATION
Section Ins 201.01 Scope
PART Ins 202 DEFINITIONS
Section Ins 202.01 Definitions
PART Ins 203 APPEARANCES BEFORE THE DEPARTMENT
Section Ins 203.01 Hearing Officer; Appointment; Authority
Section Ins 203.02 Withdrawal of Hearing Officer
Section Ins 203.03 Who May Appear
Section Ins 203.04 Representatives
Section Ins 203.05 Prohibited Conduct and Representation
Section Ins 203.06 Staff of Department
Section Ins 203.07 Ex Parte Communications
PART
Ins 204 PREHEARINGS, HEARINGS, APPEALS
TO THE COMMISSIONER OF DEPARTMENT DECISIONS, RATEMAKING, SHOW CAUSE HEARINGS
Section Ins 204.01 Prehearings, Hearings, Adjudicative
Proceedings, Contested Cases
Section Ins 204.02 Waiver or Suspension of Procedural Rules
Section Ins 204.03 Effect of Failure to Comply with the Rules
Section Ins 204.04 Summary Suspension of Department Issued
Licenses
Section Ins 204.05 Burden and Standard of Proof
Section Ins 204.06 Motions and Replies Thereto
Section Ins 204.07 Date of Issuance or Filing of Documents
Section Ins 204.08 Format of Documents
Section Ins 204.09 Delivery of Documents
Section Ins 204.10 Computation of Time
Section Ins 204.11 Role of Complainants in Enforcement or
Disciplinary Hearings
Section Ins 204.12 Right to Counsel
Section Ins 204.13 Continuances
Section Ins 204.14 Prehearing Conferences
Section Ins 204.15 Discovery and Disclosure
Section Ins 204.16 Subpoenas
Section Ins 204.17 Inquiry by Hearing Officer
Section Ins 204.18 Proposed Findings of Fact and Conclusions of
Law
Section Ins 204.19 Transcripts
Section Ins 204.20 Record
Section Ins 204.21 Reopening the Record
Section Ins 204.22 Reconsideration on the Department's Own
Motion
Section Ins 204.23 Stay of Department Orders
Section Ins 204.24 Consolidation
Section Ins 204.25 Severance
Section Ins 204.26 Limiting Number of Witnesses
Section Ins 204.27 Findings and Orders
Section Ins 204.28 Record Retention
PART Ins 205 PETITION FOR DECLARATORY RULING
Section Ins 205.01 Petitions
Section Ins 205.02 Action on Petitions
PART Ins 206 RULEMAKING
Section Ins 206.01 How Adopted
Section Ins 206.02 Manner for Adoption
Section Ins 206.03 Petitions to Department Rulemaking
Section Ins 206.04 Public Hearings
Section Ins 206.05
Request for Notice of Intended Department Rulemaking Action
PART Ins 207 EXPLANATION OF THE RULE
Section Ins 207.01 Explanation of the Rule
CHAPTER Ins 300 LIFE INSURANCE
PART Ins 301 LIFE INSURANCE
SOLICITATION
Section Ins 301.01
Purpose
Section Ins 301.02 Scope
Section Ins 301.03
Definitions
Section Ins 301.04 Life
Insurance Cost Indexes and Policy Summary
Section Ins 301.05
Disclosure Requirements
Section Ins 301.06
Solicitation of Life Insurance
Section Ins 301.07
Failure to Comply
PART Ins 302 LIFE INSURANCE AND
ANNUITIES REPLACEMENT
Section Ins 302.01
Purpose
Section Ins 302.02 Scope
Section Ins 302.03
Definitions
Section Ins 302.04
Duties of Producers
Section Ins 302.05
Duties of Insurers that Use Producers
Section Ins 302.06
Duties of Replacing Insurers that Use Producers
Section Ins 302.07
Duties of the Existing Insurer
Section Ins 302.08
Duties of Insurers with Respect to Direct Response Solicitations
Section Ins 302.09
Violations and Penalties
PART Ins 303 DEPOSIT TERM LIFE
INSURANCE
Section Ins 303.01
Purpose
Section Ins 303.02 Scope
Section Ins 303.03
Definitions
Section Ins 303.04
Advertising and Solicitation Requirements
Section Ins 303.05
Disclosure Requirements
Section Ins 303.06
Penalty
PART Ins 304 FINANCING OF LIFE
INSURANCE PREMIUMS
Section Ins 304.01 Premium
Financing Requirements
Section Ins 304.02
Exemption
PART
Ins 305 SUITABILITY IN ANNUITY
TRANSACTIONS
Section
Ins 305.01 Purpose
Section
Ins 305.02 Applicability and Scope
Section
Ins 305.03 Exemptions
Section
Ins 305.04 Definitions
Section
Ins 305.05 Duties of Insurers and of
Insurance Producers
Section
Ins 305.06 Mitigation of Responsibility
Section
Ins 305.07 Recordkeeping
PART Ins 306 ANNUITY AND DEPOSIT
FUND DISCLOSURE
Section Ins 306.01
RESERVED
Section Ins 306.02
Purpose
Section Ins 306.03 Scope
Section Ins 306.04
Definitions
Section Ins 306.05
Contract Summary
Section Ins 306.06
Disclosure Requirements
Section Ins 306.07
Solicitation of Annuity Contracts and Deposit Funds
Section Ins 306.08
Failure to Comply
Section Ins 306.09
Penalty
PART Ins 307 MORTALITY TABLES FOR USE
IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES
Section
Ins 307.01 Purpose
Section
Ins 307.02 Scope
Section
Ins 307.03 Definitions
Section
Ins 307.04 Individual Annuity or Pure
Endowment Contracts
Section
Ins 307.05 Group Annuity or Pure
Endowment Contracts
Section
Ins 307.06 Application of the 1994 GAR
Table
PART Ins 308 LIFE AND HEALTH
REINSURANCE AGREEMENTS
Section Ins 308.01
Purpose
Section Ins 308.02 Scope
Section Ins 308.03
Accounting Requirements
Section Ins 308.04
Written Agreements
Section Ins 308.05
Existing Agreements
PART Ins 309 LIFE INSURANCE
ILLUSTRATIONS
Section Ins 309.01
Purpose
Section Ins 309.02
Applicability and Scope
Section Ins 309.03
Definitions
Section Ins 309.04
Policies to be Illustrated
Section Ins 309.05
Illustration Requirements and Prohibitions
Section Ins 309.06
Standards for Basic Illustrations
Section Ins 309.07
Standards for Supplement Illustrations
Section Ins 309.08
Delivery of Illustration and Record Retention
Section Ins 309.09
Annual Report; Notice to Policy Owners
Section Ins 309.10
Annual Certifications
Section Ins 309.11
Effective Date and Policy Sales
Section Ins 309.12
Penalties
PART Ins 310 MILITARY SALES PRACTICE
Section Ins 310.01 Purpose
Section Ins 310.02 Scope
Section Ins 310.03 Exemptions
Section Ins 310.04 Definitions
Section Ins 310.05 Practices Declared False, Misleading,
Deceptive or Unfair on a Military Installation
Section Ins 310.06 Practices Declared False, Misleading,
Deceptive or Unfair Regardless of Location
CHAPTER Ins 400 FILINGS FOR LIFE, ACCIDENT AND HEALTH
INSURANCE
PART Ins 401 FORM AND RATE FILINGS
Section Ins 401.01 Purpose and Scope
Section Ins 401.02 Definitions
Section Ins 401.03 Rules Applicable to All Forms
Section Ins 401.04 Individual Life and Annuity Contracts
Section Ins 401.05 Individual Accident and Health
Section Ins 401.06 Group Life Policies
Section Ins 401.07 Group and Blanket Accident and Health
Section Ins 401.08 Group Annuity Contracts
Section Ins 401.09 Variable Contracts
Section Ins 401.10 Computation of Cash Values for Variable
Annuities
Section Ins 401.11 Applications
Section Ins 401.12 Forms Filing, Review and Inventory Procedures
Section Ins 401.13 Penalty; Generally
PART
Ins 402 STANDARDS FOR FILINGS PROVIDING
A RETURN OF PREMIUM OR CASH BENEFITS
Section Ins 402.01 Scope
Section Ins 402.02 Standards Required
Section Ins 402.03 Rate Filings
Section Ins 402.04 Nonconforming Forms Subject to This Part
Section Ins 402.05 Penalties
Section Ins 402.06 Separability
PART
Ins 403 STANDARD WELLNESS PLAN RATE AND
FORM FILING STANDARDS
Section
Ins 403.01 Purpose
Section
Ins 403.02 Applicability and Scope
Section
Ins 403.03 Definitions
Section
Ins 403.04 Standard Wellness Plan
Section
Ins 403.05 Wellness Incentive Plan
Section
Ins 403.06 Hospital Tiering
Section
Ins 403.07 Application for
Section
Ins 403.08 Standard for Approval of Tier
Change
Section
Ins 403.09 Applications for Tier Changes
Section
Ins 403.10 Required Reporting
CHAPTER
Ins 500 DOMESTIC STOCK INSURERS - EXPIRED
CHAPTER Ins 600 CREDIT FOR REINSURANCE
PART Ins 601 CREDIT FOR REINSURANCE
Section Ins 601.01 Purpose
Section Ins 601.02 Reinsurer Licensed in This State
Section Ins 601.03 Accredited Reinsurers
Section
Ins 601.04 Reinsurer Domiciled and
Licensed in Another State
Section Ins 601.05 Reinsurers Maintaining Trust Funds
Section Ins 601.06 Credit for Reinsurance Required by Law
Section
Ins 601.07 Asset or Reduction From
Liability for Reinsurance Ceded to an Unauthorized Assuming Insurer Not Meeting
the Requirements of Ins 601.02 through Ins 601.06
Section Ins 601.08 Trust Agreements Qualified Under Ins 601.07
Section Ins 601.09 Letters of Credit Qualified Under Ins 601.07
Section Ins 601.10 Other Security
Section Ins 601.11 Reinsurance Contract
Section Ins 601.12 Contracts Affected
CHAPTER
Ins 700 REQUIREMENTS FOR FOREIGN INSURANCE COMPANIES APPLYING FOR A LICENSE TO
DO BUSINESS IN THE STATE OF
CHAPTER Ins 800
REPORTING OF STATISTICAL DATA BY PROPERTY AND CASUALTY INSURANCE
COMPANIES
PART Ins 801 REPORTING REQUIREMENTS
Section Ins 801.01 Purpose
Section Ins 801.02 Scope
Section Ins 801.03 Definitions
Section Ins 801.04 Examination of Statistical Agents
Section Ins 801.05 Filing of Statistical Plans by Statistical
Agents
Section Ins 801.06 Statistical Plans and Reporting by Insurers
Section Ins 801.07 Statistical Agents’ Compliance with the
Statistical handbook
Section Ins 801.08 Multiple Statistical Agents for the Same Line
of Insurance
Section Ins 801.09 Edit and Control Procedures for Statistical
Agents
Section Ins 801.10 Insurer Edit and Audit Procedures
Section Ins 801.11 Disclosure of Complying and Non-Complying
Insurers
Section Ins 801.12 Access to Data
Section Ins 801.13 Disclosure of Data
Section Ins 801.14 Exemption
Section Ins 801.15 Lines of Insurance Without a Statistical
Agent
Section Ins 801.16 Penalty
CHAPTER Ins 900 ACTUARIES
PART Ins 901 QUALIFICATION OF ACTUARIES
Section Ins 901.01 Scope
Section Ins 901.02 Definitions
Section Ins 901.03 Restriction on Use of Terms “Actuary” or
“Actuarial”
PART Ins 902 ACTUARIAL REVIEW OF RATE FILINGS
Section Ins 902.01 Scope
Section Ins 902.02 Review of Rate Filings
Section Ins 902.03 Expense
PART Ins 903 OTHER REQUISITE REPORTS AND DOCUMENTS
Section Ins 903.01 Signature of Actuary Required for Annual
Statements
Section Ins 903.02 Actuarial Certification
PART Ins 904 LIMITATIONS
Section Ins 904.01 Limitations
CHAPTER Ins 1000 CLAIM SETTLEMENT
PART Ins 1001 CLAIM SETTLEMENT
Section
Ins 1001.01 Communications Time Limit
Section
Ins 1001.02 Claims Settlement Time
Limits
Section
Ins 1001.03 Additional Information
Required in Accepting or Rejecting Claims
Section
Ins 1001.04 Undisputed Amounts
Section
Ins 1001.05 Notice of Insurance Department
Section
Ins 1001.06 Advance Payments
Section
Ins 1001.07 Physician's Examination
Section
Ins 1001.08 Insurers Use of Unlicensed
Adjusters Prohibited
Section
Ins 1001.09 Telephone Communications
With Claims Department
Section
Ins 1001.10 Other Insurer
Responsibilities
Section
Ins 1001.11 Penalty
PART
Ins 1002 CLAIM SETTLEMENT FOR PROPERTY
& CASUALTY INSURANCE
Section
Ins 1002.01 Purpose and Scope
Section
Ins 1002.02 Definitions
Section
Ins 1002.03 Computation of Time
Section
Ins 1002.04 Communications Time Limit
Section
Ins 1002.05 Claims Settlement Time
Limits
Section
Ins 1002.06 Additional Information
Required in Accepting or Denying Claims
Section
Ins 1002.07 Undisputed Amounts
Section
Ins 1002.08 Advance Payments
Section
Ins 1002.09 Value of Total Losses –
(Other than Motor Vehicle)
Section
Ins 1002.10 Insurers Use of Unlicensed
Adjusters Prohibited
Section
Ins 1002.11 Communications With Claims
Department
Section
Ins 1002.12 Other Insurer Responsibilities
Section
Ins 1002.13 Loss of Use
Section
Ins 1002.14 Estimates
Section
Ins 1002.15 Determining Amount of Motor
Vehicle Total Loss Claims
Section
Ins 1002.16 Willing and Able Contractors
and Repairers; Other Than Motor Vehicle
Section
Ins 1002.17 Willing and Able Repair
Facilities; Motor Vehicle Insurance
Section
Ins 1002.18 Additional Requirements,
Settlement of Jewelry Claims
Section
Ins 1002.19 Miscellaneous Provisions
Section
Ins 1002.20 Insurer Documentation
Section
Ins 1002.21 Penalty
CHAPTER Ins 1100 CONFIDENTIALITY OF HIV TESTS
PART Ins 1101 PURPOSE AND SCOPE
Section Ins 1101.01
Purpose
Section Ins 1101.02
Scope
PART Ins 1102 DEFINITIONS
Section Ins 1102.01
Definitions
PART
Ins 1103 MAINTAINING THE CONFIDENTIALITY OF AND PROTECTING THE PRIVACY OF HUMAN
IMMUNODEFICIENCY VIRUS TEST RESULTS
Section Ins 1103.01
Informed Consent and Forms Pertaining Thereto
Section Ins 1103.02
Confidentiality and Disclosure of Test Results
Section Ins 1103.03
Penalties
Section Ins 1103.04
Disclosure to the Department of Health and Human Services
CHAPTER Ins 1200 CREDIT INSURANCE
PART Ins 1201 CREDIT LIFE AND CREDIT
ACCIDENT AND HEALTH INSURANCE
Section Ins 1201.01
Purpose
Section Ins 1201.02
Scope
Section Ins 1201.03
Definitions
Section Ins 1201.04
Rights and Treatment of Debtors
Section Ins 1201.05
Premium Refunds
Section Ins 1201.06
Policy Forms and Related Material
Section Ins 1201.07
Determination of Reasonableness of Premiums in Relation to Benefits
Section Ins 1201.08
Nominal Rates for Credit Life Insurance
Section Ins 1201.09
Nominal Rates for Credit Accident and Health Insurance
Section Ins 1201.10
Actual Premium Rates for Credit Insurance
Section Ins 1202.11
Annual Experience Reports
Section Ins 1202.12
Description of Forms A and B
Section Ins 1201.13 Rate
Deviation Procedures
Section Ins 1201.14
Supervision of Credit Insurance Operations
Section Ins 1201.15
Prohibited Transactions
Section Ins 1201.16
Special Rules for Open-End Credit Transactions
Section Ins 1201.17
Statutory Requirements
Section Ins 1201.18
Severability
Section Ins 1201.19
Actual Premium Rates
CHAPTER Ins 1300 PRODUCERS AND ADJUSTERS
PART Ins 1301 CONTINUING EDUCATION GENERAL INFORMATION
Section Ins 1301.01 Purpose and Applicability
Section Ins 1301.02 Definitions
PART Ins 1302 CONTINUING EDUCATIONAL REQUIREMENTS FOR
PRODUCERS AND ADJUSTERS
Section Ins 1302.01 Purpose
Section Ins 1302.02 Applicability
Section Ins 1302.03 Educational Requirements for Producers
Section Ins 1302.04 Educational Requirements for Insurance Claims
Adjusters and Public Adjusters
Section Ins 1302.05 Penalty
PART Ins 1303 CONTINUING EDUCATION COUNCILS, COURSES AND
APPROVALS
Section Ins 1303.01 Purpose and Applicability
Section Ins 1303.02 Continuing Education Advisory Councils
Section Ins 1303.03 Criteria
Section Ins 1303.04 Compliance
Section Ins 1303.05 Course Approval
Section Ins 1303.06 Course Completion Certificate
Section Ins 1303.07 Continuing Education Course List
PART Ins 1304 ONE TIME FLOOD INSURANCE TRAINING REQUIREMENT
Section Ins 1304.01 Purpose
Section Ins 1304.02 Applicability
Section Ins 1304.03 Educational Requirements
Section Ins 1304.04 Penalty
CHAPTER Ins 1400 AUTOMOBILE INSURANCE
PART
Ins 1400 PURPOSE AND SCOPE FOR THE
VOLUNTARY MARKET AND THE
Section Ins 1401.01 Purpose
Section Ins 1401.02 Scope
PART Ins 1402 THE WRITING OF AUTOMOBILE INSURANCE IN THE
VOLUNTARY MARKET
Section Ins 1402.01 Purpose
Section Ins 1402.02 Definitions Applicable to the Voluntary
Market
Section Ins 1402.03 Voluntary Market Refusal to Write; Refusal to
Renew; Cancellation
Section Ins 1402.04 Movement/Placement of a Policy in the
Voluntary Market
PART
Ins 1403 VOLUNTARY MARKET REGULATION PERTAINING
TO RATES, RATING PLANS AND PRACTICES
Section Ins 1403.01 Rating and Rating Plans
Section Ins 1403.02 Rating Practices
Section Ins 1403.03 Reflecting Driver Performance
PART
Ins 1404 RECORD RETENTION PROCEDURES IN
THE VOLUNTARY MARKET AND THE
Section Ins 1404.01 Record Retention Procedures
PART
Ins 1405 PLAN OF OPERATION FOR THE
Section Ins 1405.01 Purpose
Section Ins 1405.02 Definitions
Section Ins 1405.03 Insurers Required to Participate
Section Ins 1405.04 Basis of Participation
Section Ins 1405.05 Service
Section Ins 1405.06 Obligation of Members
Section Ins 1405.07 Board of Governors
Section Ins 1405.08 Meetings
Section Ins 1405.09 Statistical Data
Section Ins 1405.10 Cessions
Section Ins 1405.11 Facility Charges, Premium, and Allowance
Section
Ins 1405.12 Safe Driver Incentive Plan
and SDIP Points for the New Hampshire Automobile Reinsurance Facility
Section Ins 1405.13 Assessments and Participation
Section Ins 1405.14 Audits
Section Ins 1405.15 Indemnification
Section Ins 1405.16 Hearings and Review
Section Ins 1405.17 Amendments
Section Ins 1405.18 Claim Reserves
Section Ins 1405.19 Reinsurance Facility Rates
Section Ins 1405.20 Nonrenewal and Cancellation Protection
PART
Ins 1406 RESIDENCY REQUIREMENTS FOR
AUTOMOBILE INSURANCE IN THE VOLUNTARY MARKET AND THE
Section Ins 1406.01 Statement of Residency Including Applicable
Exemptions
CHAPTER Ins 1500 INSURANCE HOLDING COMPANIES
PART Ins 1501 FILINGS
Section Ins 1501.01 Purpose
Section Ins 1501.02 Definitions
Section Ins 1501.03 Forms - General Requirements
Section Ins 1501.04 Forms - Incorporation by Reference, Summaries
and Omissions
Section Ins 1501.05 Forms - Information Unknown or Unavailable
and Extension of Time to Furnish
Section Ins 1501.06 Forms - Additional Information and Exhibits
Section Ins 1501.07 Forms – Subsidiaries of Domestic Insurers
Section Ins 1501.08 Acquisition of Control – Statement Filing
Section Ins 1501.09 Amendments to Form A
Section Ins 1501.10 Acquisition of Persons Controlling a Domestic
Insurer
Section Ins 1501.11 Pre-Acquisition Notification
Section Ins 1501.12 Annual Registration of Insurers - Statement
Filing
Section Ins 1501.13 Summary of Registration – Statement Filing
Section Ins 1501.14 Amendments to Form B
Section Ins 1501.15 Alternative and Consolidated Registrations
Section Ins 1501.16 Disclaimers and Termination of Registration
Section Ins 1501.17 Transactions Subject to Prior Notice – Notice
Filing
Section Ins 1501.18 Extraordinary Dividends and Other
Distributions
Section Ins 1501.19 Adequacy of Surplus
CHAPTER
Ins 1600 SUBSIDIARIES OF INSURANCE COMPANIES - EXPIRED
CHAPTER Ins 1700
MEDICAL MALPRACTICE LIABILITY INSURANCE
PART
Ins 1701
Section
Ins 1701.01 Purpose
IPART
Ins 1702 PLAN PARTICIPATION
Section
Ins 1702.01 Persons Required to
Participate
Section
Ins 1702.02 Termination of Participation
Section
Ins 1702.03 Basis of Participation
Section
Ins 1702.04 Service
PART
Ins 1703 PLAN OF OPERATION
Section
Ins 1703.01 Definitions
Section
Ins 1703.02 Obligation of Members
Section
Ins 1703.03 Meetings of the Members
Section
Ins 1703.04 Board of Directors
Section
Ins 1703.05 Service Carriers
Section
Ins 1703.06 Servicing Carrier Allowance
Section Ins 1703.07 Assessment of Members for Deficits Incurred
as a Result of Policies Issued on or After January 1, 1986
Section Ins 1703.08 Assessment of Members for Deficits Incurred
as a Result of Policies Issued Prior to January 1, 1986
Section
Ins 1703.09 Stabilization Reserve Fund
Trust
Section
Ins 1703.10 Collection and Remitting of
the Stabilization Reserve Fund Charges
Section
Ins 1703.11 Coverage, Rates and Forms
Section
Ins 1703.12 Records and Reports
Section
Ins 1703.13 Joint Liability for Association
Business
Section
Ins 1703.14 Indemnification
Section
Ins 1703.15 Hearing Review
CHAPTER Ins 1800 CONTINUING CARE RETIREMENT COMMUNITIES
PART Ins 1801 PURPOSE AND SCOPE
Section Ins 1801.01 Purpose
Section Ins 1801.02 Scope
PART Ins 1802 DEFINITIONS
Section Ins 1802.01 Definitions
PART Ins 1803 CERTIFICATE OF AUTHORITY
Section Ins 1803.01 Application Procedures
Section Ins 1803.02 Revocation or Suspension
PART ins 1804 ANNUAL REPORTS
Section Ins 1804.01 Annual Reports
PART Ins 1805 LIQUID RESERVES
Section Ins 1805.01 Liquid Reserves
PART Ins 1806 PROCEDURES FOR OBTAINING AND EXTENDING LIENS
Section Ins 1806.01 Procedures for Obtaining and Extending Liens
PART Ins 1807 ENTRANCE FEE ESCROW ACCOUNTS
Section Ins 1807.01 Entrance Fee Escrow Accounts
PART Ins 1808 STANDARDS FOR RESIDENT CONTRACT AND
DISCLOSURE STATEMENTS
Section Ins 1808.01 Requirements for Documents
Section Ins 1808.02 Resident Contract Standards
Section Ins 1808.03 Disclosure Statements
PART Ins 1809 FEES
Section Ins 1809.01 Fees
PART Ins 1810 AUDITS AND INVESTIGATIONS
Section Ins 1810.01 Audits and Investigations
PART Ins 1811 TRANSFER OR
Section Ins 1811.01 Transfer or
PART Ins 1812 ENFORCEMENT
Section Ins 1812.01 Violations
CHAPTER Ins 1900 ACCIDENT AND HEALTH INSURANCE
PART Ins 1901 MINIMUM STANDARDS FOR ACCIDENT AND HEALTH
INSURANCE
Section Ins 1901.01 Purpose
Section Ins 1901.02 Applicability and Scope
Section Ins 1901.03 Definition of Group Supplemental Health
Insurance
Section Ins 1901.04 Policy Definitions
Section Ins 1901.05 Prohibited Policy Provisions
Section Ins 1901.06 Accident and Health Minimum Standards for
Benefits
Section Ins 1901.07 Required Disclosure Provisions
Section Ins 1901.08 Requirements for Replacement of Individual
Accident and Health Insurance
Section
Ins 1901.09 Member Identification Card
PART
Ins 1902 MINIMUM STANDARDS FOR MEDICARE
SUPPLEMENT POLICIES ISSUED PRIOR TO ADOPTION OF INSURANCE REGULATION 1975
Section Ins 1902.01 Purpose
Section Ins 1902.02 Applicability and Scope
Section Ins 1902.03 Definitions
Section Ins 1902.04 Policy Definitions and Terms
Section Ins 1902.05 Prohibited Policy Provisions
Section Ins 1902.06 Minimum Standards for Medicare Supplement
Policies
Section Ins 1902.07 Required Disclosure Provisions
Section Ins 1902.08 Requirements for Application Forms and
Replacement Coverage
Section Ins 1902.09 Loss Ratio Standards and Refund or Credit of
Premiums
Section Ins 1902.10 Standard for Claims Payment
Section Ins 1902.11 Permitted Compensation Arrangements
Section Ins 1902.12 Appropriations of Recommended Purchase and
Excessive Insurance
Section Ins 1902.13 Reporting of Multiple Policies
Section
Ins 1902.14 Prohibition Against
Pre-existing Conditions, Waiting Periods, Elimination Periods and Probationary
Periods in Replacement Policies or Certificates
Section Ins 1902.15 Benefit Conversion Requirements During
Transition
PART Ins 1903 MEDICARE SUPPLEMENT INSURANCE
Section Ins 1903.01 Purpose
Section Ins 1903.02 Applicability and Scope
Section Ins 1903.03 Definitions
Section Ins 1903.04 Benefit Conversion Requirements
Section Ins 1903.05 Requirements for New Policies and
Certificates
Section Ins 1903.06 Separability
PART Ins 1904 GROUP COORDINATION OF BENEFITS
Section Ins 1904.01 Scope
Section Ins 1904.02 Purpose
Section Ins 1904.03 Definitions
Section Ins 1904.04 Use of Model COB Contract Provision
Section Ins 1904.05 Rules for Coordination of Benefits
Section Ins 1904.06 Procedure to be Followed by Secondary Plan to
Calculate Benefits and Pay a Claim
Section Ins 1904.07 Notice to Covered Persons
Section Ins 1904.08 Miscellaneous Provisions
Section Ins 1904.09 Effective Date for Existing Contracts
Section Ins 1904.10 Penalties
PART
Ins 1905 MINIMUM STANDARDS FOR MEDICARE
SUPPLEMENT POLICIES
Section
Ins 1905.01 Purpose
Section
Ins 1905.02 Applicability and Scope
Section
Ins 1905.03 Definitions
Section
Ins 1905.04 Policy Definitions and Terms
Section
Ins 1905.05 Policy Provisions
Section
Ins 1905.06 Minimum Benefit Standards
for Pre-Standardized Medicare Supplement Benefit Plan Policies or Certificates
Issued for Delivery Prior To July 1, 1992
Section
Ins 1905.07 Benefit Standards for 1990
Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued
or Delivered on or after July 1, 1992 and Prior to June 1, 2010
Section
Ins 1905.08 Benefit Standards for 2010
Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued
for Delivery on or After June 1, 2010
Section
Ins 1905.09 Standard Medicare Supplement
Benefit Plans for 1990 Standardized Medicare Supplement Benefit Plan Policies
or Certificates Issued for Delivery on or After July 1, 1992 and Prior to June
1, 2010
Section
Ins 1905.10 Standard Medicare Supplement
Benefit Plans for 2010 Standardized Medicare Supplement Benefit Plan Policies
or Certificates Issued for Delivery on or After June 1, 2010
Section
Ins 1905.11 Medicare Select Policies and
Certificates
Section
Ins 1905.12 Open Enrollment
Section
Ins 1905.13 Guaranteed Issue for
Eligible Persons
Section
Ins 1905.14 Standards for Claims Payment
Section
Ins 1905.15 Loss Ratio Standards and
Refund or Credit of Premium
Section
Ins 1905.16 Filing and Approval of Policies
and Certificates and Premium Rates
Section
Ins 1905.17 Permitted Compensation
Arrangements
Section
Ins 1905.18 Required Disclosure
Provisions
Section
Ins 1905.19 Requirements for Application
Forms and Replacement Coverage
Section
Ins 1905.20 Filing Requirement for
Advertising
Section
Ins 1905.21 Standards for Marketing
Section
Ins 1905.22 Appropriateness of
Recommended Purchase and Excessive Insurance
Section
Ins 1905.23 Reporting of Multiple
Policies
Section
Ins 1905.24 Prohibition Against
Preexisting Conditions, Waiting Periods, Elimination Periods and Probationary
Periods in Replacement Policies or Certificates
Section
Ins 1905.25 Prohibition Against Use of
Genetic Information and Requests for Genetic Testing
PART Ins
1906 DISCONTINUANCE AND REPLACEMENT OF
GROUP ACCIDENT AND HEALTH COVERAGE
Section Ins 1906.01 Scope
Section Ins 1906.02 Definitions
Section
Ins 1906.03 Effective Date of the
Discontinuance for Nonpayment of Premium or Subscription Charges
Section Ins 1906.04 Requirements for Notice of Discontinuance
Section Ins 1906.05 Extension of Benefits
Section
Ins 1906.06 Continuance of Coverage in
Situations Involving Replacement of One Carrier by Another
PART
Ins 1907 NONDISCRIMINATION IN HEALTH
INSURANCE COVERAGE IN THE GROUP MARKET
Section Ins 1907.01 Purpose and Scope
Section Ins 1907.02 Definitions
Section Ins 1907.03 Prohibited Discrimination in Rules for
Eligibility
Section Ins 1907.04 Prohibited Discrimination in Premium and
Contribution Rates
Section
Ins 1907.05 Application of Ins 1907.03
to Plan Benefits; Preexisting Condition Exclusions; Similarly Situated
Individuals
Section
Ins 1907.06 Application of Ins 1907.03
and Ins 1907.04 to Nonconfinement and Actively-at-Work Provisions
Section Ins 1907.07 Enforcement
CHAPTER Ins 2000 MEDICAL UTILIZATION REVIEW ENTITIES
PART Ins 2001 LICENSURE OF MEDICAL
UTILIZATION REVIEW ENTITIES
Section Ins 2001.01
Purpose
Section Ins 2001.02 Scope
of Rule
Section Ins 2001.03
Definitions
Section Ins 2001.04
Licensure Procedure
Section Ins 2001.05
Procedures for Licensure Renewal
Section Ins 2001.06
Privileged Information
Section Ins 2001.07
Forms Required
Section Ins 2001.08
Change in Name
Section Ins 2001.09 Fees
Section Ins 2001.10
Standards Relative to Time Periods for Notification of Determinations
Section Ins 2001.11
Manner and Intent of Notification
Section Ins 2001.12
Standards for Telephone Accessibility
Section Ins 2001.13
Reconsideration Procedures
Section Ins 2001.14
Confidentiality
Section Ins 2001.15
Scope of Review
Section Ins 2001.16
Reviewers
Section Ins 2001.17
Other Provisions
Section Ins 2001.18
Compliance
CHAPTER
Ins 2100 MUTUAL COMPANIES - EXPIRED
CHAPTER Ins 2200 HEALTH MAINTENANCE ORGANIZATIONS
PART Ins 2201 DOMESTIC HEALTH MAINTENANCE ORGANIZATIONS
Section 2201.01 Purpose
Section 2201.02 Applicability and Scope
Section 2201.03 Definitions
Section 2201.04 Certificate of Authority
Section 2201.05 Evidences of Coverage and Advertising
Section 2201.06 Periodic and Special Reporting
Section 2201.07 Annual Reports
Section 2201.08 Licensing of Producers
Section 2201.09 Federal Legislation and Regulation
Section 2201.10 Continuity of Benefits
Section 2201.11 Tax Exemptions
CHAPTER Ins 2300 THIRD PARTY ADMINISTRATORS
PART
Ins 2301 REGULATION OF THIRD PARTY
ADMINISTRATORS
Section
Ins 2301.01 Purpose
Section
Ins 2301.02 Definitions
Section
Ins 2301.03 Application
Section
Ins 2301.04 Disclosure of Information
Section
Ins 2301.05 Surety Bond
Section
Ins 2301.06 Audited Financial Statement
Section
Ins 2301.07 Written Agreement Necessary
Section
Ins 2301.08 Fiduciary Obligation
Section
Ins 2301.09 Establishment of Premium
Trust Account
Section
Ins 2301.10 Commingling of Funds
Prohibited
Section
Ins 2301.11 Interest-Bearing Accounts
Section
Ins 2301.12 Return Premiums
Section
Ins 2301.13 Recordkeeping Requirements
Section
Ins 2301.14 Periodic Audit
Section
Ins 2301.15 Responsibilities of the
Insurer
Section
Ins 2301.16 Approval of Advertising
Section Ins 2301.17 Grounds for Denial, Nonrenewal, Suspension or
Revocation of Certificate; Penalty
Section
Ins 2301.18 Inquiry by Commissioner
Section
Ins 2301.19 Hearing and Appeal
Section
Ins 2301.20 Violations and Penalties
CHAPTER Ins 2400 ACTUARIAL OPINION AND MEMORANDUM
PART Ins 2401 GUIDELINES AND
STANDARDS
Section Ins 2401.01 Purpose
Section Ins 2401.02 Applicability and Scope
Section Ins 2401.03 Definitions
Section Ins 2401.04 General Requirements
Section Ins 2401.05 Statement of Actuarial Opinion Based on an
Asset Adequacy Analysis
Section Ins 2401.06 Description of Actuarial Memorandum Including
an Asset Adequacy Analysis
Section
Ins 2401.07 Use of Assets Supporting the
Interest Maintenance Reserve and the Asset Valuation Reserve
CHAPTER
Ins 2500 HOME WARRANTY INSURANCE - REPEALED
CHAPTER Ins 2600 ADVERTISEMENTS
OF INSURANCE
PART Ins 2601 ADVERTISEMENTS OF ACCIDENT AND HEALTH
INSURANCE
Section Ins 2601.01 Purpose
Section Ins 2601.02 Applicability
Section Ins 2601.03 Definitions
Section Ins 2601.04 Method of Disclosure of Required Information
Section Ins 2601.05 Form and Content of Advertisements
Section Ins 2601.06 Advertisements of Benefits Payable, Losses
Covered or Premiums Payable
Section
Ins 2601.07 Necessity for Disclosing
Policy Provisions Relating to Renewability, Cancellability and Termination
Section Ins 2601.08 Standards for Marketing
Section Ins 2601.09 Testimonials or Endorsements by Third Parties
Section Ins 2601.10 Use of Statistics
Section Ins 2601.11 Identification of Plan or Number of Policies
Section Ins 2601.12 Disparaging Comparisons and Statements
Section Ins 2601.13 Jurisdictional Licensing and Status of
Insurer
Section Ins 2601.14 Identity of Insurer
Section Ins 2601.15 Group or Quasi-Group Implications
Section Ins 2601.16 Introductory, Initial or Special Offers
Section Ins 2601.17 Statements About an Insurer
Section Ins 2601.18 Enforcement Procedures
Section Ins 2601.19 Filing for Prior Review
Section Ins 2601.20 Penalties
PART Ins 2602 ADVERTISEMENTS OF LIFE INSURANCE AND
ANNUITIES
Section Ins 2602.01 Purpose
Section Ins 2602.02 Applicability
Section Ins 2602.03 Definitions
Section Ins 2602.04 Form and Content of Advertisements
Section Ins 2602.05 Disclosure Requirements
Section Ins 2602.06 Identity of Insurer
Section Ins 2602.07 Jurisdictional Licensing and Status of
Insurer
Section Ins 2602.08 Statements About the Insurer
Section Ins 2602.09 Enforcement Procedures
Section Ins 2602.10 Penalties
Section Ins 2602.11 Conflict with Other Laws or Rules
PART Ins 2603 ADVERTISEMENTS OF MEDICARE SUPPLEMENT
INSURANCE WITH INTERPRETIVE GUIDELINES
Section Ins 2603.01 Purpose
Section Ins 2603.02 Applicability
Section Ins 2603.03 Definitions
Section Ins 2603.04 Method of Disclosure of Required Information
Section Ins 2603.05 Form and Content of Advertisements
Section Ins 2603.06 Advertisements of benefits, Losses covered or
Premiums Payable
Section Ins 2603.07 Necessity for Disclosing Policy Provisions
Relating to Renewability, Cancellability and Termination
Section Ins 2603.08 Testimonials or Endorsements by Third Parties
Section Ins 2603.09 Use of Statistics
Section Ins 2603.10 Disparage Comparisons and Statements
Section Ins 2603.11 Jurisdictional Licensing and Status of
Insurer
Section Ins 2603.12 Identify of Insurer
Section Ins 2603.13 Group of Quasi-Group Implications
Section Ins 2603.14 Introductory, Initial or Special Offers
Section Ins 2603.15 Statements About an Insurer
Section Ins 2603.16 Enforcement Procedures
Section Ins 2603.17 Filing for Prior Review
PART Ins 2604 ALL OTHER ADVERTISEMENTS OF INSURANCE
Section Ins 2604.01 Purpose
Section Ins 2604.02 Applicability and Scope
Section Ins 2604.03 Definitions
Section Ins 2604.04 Reference to Policy Form Numbers
Section Ins 2604.05 Advertisements in General
Section Ins 2604.06 Advertisements of Benefits Payable, Losses Covered
or Premiums Payable
Section Ins 2604.07 Testimonials
Section Ins 2604.08 Use of Statistics
Section Ins 2604.09 Inspection of Policy
Section Ins 2604.10 Identification of Plan or Number of Policies
Section Ins 2604.11 Jurisdictional Licensing
Section Ins 2604.12 Identity of Insurer
Section Ins 2604.13 Introductory, Initial or Special Offers
Section Ins 2604.14 Third Party Approval and Endorsement
Section Ins 2604.15 Advertising File
Section Ins 2604.16 Soliciting Names of Prospective Insureds
Section Ins 2604.17 Penalty Provisions
CHAPTER Ins 2700 MANAGED CARE
PART Ins 2701 NETWORK ADEQUACY
Section Ins 2701.01
Definitions
Section Ins 2701.02
Basic Access Requirement
Section Ins 2701.03
Primary Care Providers
Section Ins 2701.04
Standards for Geographic Accessibility
Section Ins 2701.05
Standards for Waiting Times for Appointments and Access to After-Hours Care
Section Ins 2701.06
Choice of and Access to Providers of Specialty Care
Section Ins 2701.07
Reporting Requirement
Section Ins 2701.08
Enforcement
PART Ins 2702 Reserved
PART Ins 2703 EXTERNAL REVIEW
Section Ins 2703.01
Applicability and Scope
Section Ins 2703.02
Definitions
Section Ins 2703.03 The Right
to External Review
Section Ins 2703.04
Notice of Right to External Review
Section Ins 2703.05
Standard External Review
Section Ins 2703.06
Expedited External Review
Section Ins 2703.07
Certification of Independent Review Organizations
Section Ins 2703.08
External Review Reporting Requirements
Section Ins 2703.09
General Provisions Regarding External Review
CHAPTER Ins 2800 PROPERTY AND CASUALTY RATE AND
SUPPLEMENTARY INFORMATION FILINGS
PART Ins 2801 ADVISORY ORGANIZATION
Section Ins 2801.01
Purpose, Applicability and Scope
Section Ins 2801.02
Definitions
Section Ins 2801.03
Advisory Organization Reference Filing of Advisory Prospective Loss Costs
Section Ins 2801.04
Required Filing Documents
Section Ins 2801.05
Underwriting and Rating Documentation
Section Ins 2801.06
Instructions for the Completion of Form RFF-1
CHAPTER Ins 2900 HAZARDOUS FINANCIAL CONDITIONS,
LICENSED COMPANIES
PART
Ins 2901 REGULATION OF COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION
Section Ins 2901.01
Purpose
Section Ins 2901.02
Standards
Section Ins 2901.03
Commissioner’s Authority
Section Ins 2901.04
Judicial Review
CHAPTER Ins 3000 PRIVACY OF CONSUMER FINANCIAL AND
HEALTH INFORMATION
PART Ins 3001 NONPUBLIC PERSONAL
HEALTH AND FINANCIAL INFORMATION
Section Ins 3001.01
Purpose
Section Ins 3001.02
Scope
Section Ins 3001.03 Rule
of Construction
Section Ins 3001.04
Definitions
PART Ins 3002 PRIVACY, AND OPT OUT
NOTICES FOR FINANCIAL INFORMATION
Section Ins 3002.01
Initial Privacy Notice to Consumers Required
Section Ins 3002.02
Annual Privacy Notice to Customers Required
Section Ins 3002.03
Information to be Included in Privacy Notices
Section Ins 3002.04 Form
of Opt Out Notice to Consumers and Opt Out Methods
Section Ins 3002.05
Revised Privacy Notices for Nonpublic Personal Financial Information
Section Ins 3002.06
Delivery
PART Ins 3003 LIMITS ON DISCLOSURES
OF FINANCIAL INFORMATION
Section
Ins 3003.01 Limits on Disclosure of Nonpublic Personal Financial Information to
Nonaffiliated Third Parties
Section Ins 3003.02
Limits on Redisclosure and Reuse of Nonpublic Personal Financial Information
Section Ins 3003.03
Limits on Sharing Account Number Information for Marketing Purposes
PART Ins 3004 EXCEPTIONS TO LIMITS
ON DISCLOSURES OF FINANCIAL INFORMATION
Section
Ins 3004.01 Exception to Opt Out Requirements for Disclosure of Nonpublic
Personal Financial Information for Service Providers and Joint Marketing
Section
Ins 3004.02 Exceptions to Notice and Opt Out Requirements for Disclosure of
Nonpublic Personal Financial Information for Processing and Servicing
Transactions
Section
Ins 3004.03 Other Exceptions to Notice and Opt Out Requirements for Disclosure
of Nonpublic Personal Financial Information
PART Ins 3005 RULES FOR HEALTH
INFORMATION
Section Ins 3005.01 When
Authorization Required for Disclosure of Nonpublic Personal Health Information
Section Ins 3005.02
Authorizations
Section Ins 3005.03
Authorization Request Delivery
Section Ins 3005.04
Relationship to Federal Rules
Section Ins 3005.05
Relationship to State Laws
PART Ins 3006 ADDITIONAL PROVISIONS
Section Ins 3006.01
Protection of Fair Credit Reporting Act
Section Ins 3006.02
Nondiscrimination
Section Ins 3006.03
Violation
Section Ins 3006.04
Effective Date; Transition Rule
CHAPTER Ins 3100
ELECTRONIC FILINGS
PART Ins 3101 ELECTRONIC FILING STANDARDS
Section Ins 3101.01 Purpose
Section Ins 3101.02 Applicability and Scope
Section Ins 3101.03 Definitions
Section Ins 3101.04 Procedural Requirements
CHAPTER Ins 3200 SALES OF INSURANCE BY FINANCIAL INSTITUTIONS
PART Ins 3201 GENERAL INFORMATION
Section Ins 3201.01
Purpose
PART Ins 3202 LICENSING REQUIREMENTS
Section Ins 3202.01
License Required
Section Ins 3202.02
Financial Institution License Application
Section Ins 3202.03 Authorized
or Approved Carriers
PART Ins 3203 PROCEDURES FOR
AUTHORITY TO SELL INSURANCE
Section Ins 3203.01
Insurance Sales Relationships
Section Ins 3203.02
Special Requirements for Depository Institutions
Section Ins 3203.03
Qualifications and Training
Section Ins 3203.04
Independent Agent or Agency
Section Ins 3203.05
Commissions
Section Ins 3203.06
Referral Fees
Section Ins 3203.07
Inducements or Rebating
PART Ins 3204 CONSUMER PROTECTION
Section Ins 3204.01
Statutory Requirements
Section
Ins 3204.02 Disclosures
Section Ins 3204.03
Disclosures When Insurance is Required as a Condition of Obtaining a Loan
Section Ins 3204.04
Tying of Non-Insurance Products with Insurance Products Prohibited
Section Ins 3204.05
Discrimination Against Nonaffiliated Companies or Agents Prohibited
Section Ins 3204.06
Affirmative Statement Signed by Insurance Customer
Section Ins 3204.07
Separation from Deposit and Loan Activities
Section Ins 3204.08
Customer Privacy
Section Ins 3204.09 Advertising
of Insurance by a Financial Institution
PART Ins 3205 COMPLIANCE,
ENFORCEMENT AND PENALTY PROVISIONS
Section Ins 3205.01
Compliance
Section Ins 3205.02
Penalties
CHAPTER Ins 3300 INSURANCE SCORES
PART Ins 3301 USE OF INSURANCE
SCORES
Section Ins 3301.01
Purpose
Section Ins 3301.02
Scope
Section Ins 3301.03
Definitions
PART Ins 3302 STANDARDS
Section Ins 3302.01
Written Standards
PART Ins 3303 NOTICE TO INSURED
Section Ins 3303.01 Notice
Requirements
PART Ins 3304 FILING OF UNDERWRITING
MODELS
Section Ins 3304.01
Underwriting Filing Required
PART Ins 3305 RATE FILINGS
Section Ins 3305.01
Rates Filing Required
PART Ins 3306 USE OF INSURANCE
SCORES IN UNDERWRITING
Section Ins 3306.01
Underwriting Use of Scores
PART Ins 3307 USE OF INSURANCE
SCORES IN RATEMAKING
Section Ins 3307.01
Ratemaking Insurance Score Use Standards
PART Ins 3308 ADVERSE ACTION
Section Ins 3308.01
Adverse Action
PART Ins 3309 ADDITIONAL CONSUMER PROTECTIONS
Section Ins 3309.01
Review of Action
PART Ins 3310 REVIEW OF INSURANCE
SCORING MODEL
Section Ins 3310.01
Submission of Basis for Insurance Score
Section Ins 3310.02
Confidentiality of Submission
CHAPTER Ins 3400 PURCHASING ALLIANCES
PART Ins 3401 PURCHASING ALLIANCE STANDARDS
Section Ins 3401.01 Purpose
Section Ins 3401.02 Definitions
Section Ins 3401.03 Jurisdiction of the Commissioner; Penalties
Section Ins 3401.04 Purchasing
Section Ins 3401.05 Powers and Duties of and Restrictions on
Purchasing Alliances
Section Ins 3401.06 Requirements for Participating Carriers
Section Ins 3401.07 Marketing Health Benefit Plans
Section Ins 3401.08 Risk Adjustment Mechanism
Section Ins 3401.09 Conflict of Interest
Section
Ins 3401.10 Purchasing
Section Ins 3401.11 Purchasing
CHAPTER Ins 3500 VALUATION OF LIFE INSURANCE POLICIES
PART Ins 3501 PURPOSE
Section Ins 3501.01 Purpose
PART Ins 3502 APPLICABILITY
Section Ins 3502.01 Applicability
PART Ins 3503 DEFINITIONS
Section Ins 3503.01 Definitions
PART Ins 3504 GENERAL CALCULATION REQUIREMENTS FOR BASIC
RESERVES AND PREMIUM DEFICIENCY RESERVES
Section Ins 3504.01 Basic Reserves Calculation Requirements
Section Ins 3504.02 Deficiency Reserves Calculation Requirements
Section Ins 3504.03 Other Calculation Requirements
PART
Ins 3505 CALCULATION OF MINIMUM
VALUATION STANDARD FOR POLICIES WITH GUARANTEED NONLEVEL GROSS PREMIUMS OR
GUARANTEED NONLEVEL BENEFITS (OTHER THAN UNIVERSAL LIFE POLICIES)
Section Ins 3505.01 Calculation of Basic Reserves
Section Ins 3505.02 Calculation of Deficiency Reserves
Section Ins 3505.03 Minimum Value
Section Ins 3505.04 Unusual Pattern of Guaranteed Cash Surrender
Values
Section Ins 3505.05 Optional Exemption for Yearly Renewable Term
Reinsurance
Section
Ins 3505.06 Optional Exemption for
Attained-Age-Based Yearly Renewal Term Life Insurance Polices
Section
Ins 3505.07 Exemption from Unitary
Reserves for Certain n-Year Renewable
Term Life Insurance Policies
Section Ins 3505.08 Exemption from Unitary Reserves for Certain
Juvenile Policies
PART
Ins 3506 CALCULATION OF MINIMUM
VALUATION STANDARD FOR FLEXIBLE PREMIUM AND FIXED PREMIUM UNIVERSAL LIFE
INSURANCE POLICIES THAT CONTAIN PROVISIONS RESULTING IN THE ABILITY OF A POLICYHOLDER
TO KEEP A POLICY IN FORCE OVER A SECONDARY GUARANTEE PERIOD
Section Ins 3506.01 General Provisions
Section Ins 3506.02 Basic Reserves for the Secondary Guarantees
Section Ins 3506.03 Deficiency Reserves for the Secondary
Guarantees
Section Ins 3506.04 Minimum Reserves
PART
Ins 3507 RECOGNITION OF THE 2001 CSO
MORTALITY TABLE FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND
NONFORFEITURE BENEFITS
Section Ins 3507.01 Purpose
Section Ins 3507.02 Definitions Used in This Section
Section Ins 3507.03 2001 CSO Mortality Table
Section Ins 3507.04 Conditions
Section Ins 3507.05 Applicability of the 2001 CSO Mortality Table
Section Ins 3507.06 Gender-Blended Tables
PART Ins 3508 PERMITTING THE RECOGNITION OF PREFERRED
MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES
Section
Ins 3508.01 Purpose
Section
Ins 3508.02 Definitions
Section
Ins 3508.03 2001 CSO Preferred Class
Structure Table
Section
Ins 3508.04 Conditions
PART Ins 3509 Preneed
Life Insurance Minimum Standards for Determining Reserve Liabilities and
Nonforfeiture Values
Section Ins 3509.01
Purpose
Section Ins 3509.02
Applicability and Scope
Section Ins 3509.03
Definitions
Section Ins 3509.04
Minimum Valuation Mortality Standards
Section Ins 3509.05
Minimum Valuation Interest Rate Standards
Section Ins 3509.06
Minimum Valuation Method Standards
Section Ins 3509.07
Transition Rules
CHAPTER Ins 3600 LONG-TERM CARE INSURANCE
PART Ins 3601 LONG-TERM CARE
INSURANCE
Section Ins 3601.01
Purpose
Section Ins 3601.02
Applicability and Scope
Section Ins 3601.03
Definitions
Section Ins 3601.04
Policy Definitions
Section Ins 3601.05
Policy Practices and Provisions
Section Ins 3601.06
Unintentional Lapse
Section Ins 3601.07
Required Disclosure Provisions
Section Ins 3601.08
Required Disclosure of Rating Practices to Consumers
Section Ins 3601.09
Initial Filing Requirements
Section Ins 3601.10 Prohibition
Against Post-Claims Underwriting
Section
Ins 3601.11 Minimum Standards for Home Health and Community Care Benefits in
Long-Term Care Insurance Policies
Section Ins 3601.12
Requirement to Offer Inflation Protection
Section Ins 3601.13 Requirements
for Application Forms and Replacement Coverage
Section Ins 3601.14
Reporting Requirements
Section Ins 3601.15
Licensing
Section Ins 3601.16
Discretionary Powers of Commissioner
Section Ins 3601.17
Reserve Standards
Section Ins 3601.18 Loss
Ratio
Section Ins 3601.19
Premium Rate Schedule Increases
Section Ins 3601.20
Filing Requirement
Section Ins 3601.21
Filing Requirement for Advertising
Section Ins 3601.22
Standards for Marketing
Section Ins 3601.23
Suitability
Section
Ins 3601.24 Prohibition Against Preexisting Conditions and Probationary Periods
in Replacement Policies or Certificates
Section Ins 3601.25
Nonforfeiture Benefit Requirement
Section Ins 3601.26
Standards for Benefit Triggers
Section
Ins 3601.27 Additional Standards for Benefit Triggers for Qualified Long-Term
Care Insurance Contracts
Section Ins 3601.28
Standards Format Outline of Coverage
Section Ins 3601.29
Requirement to Delivery Shopper's Guide
Section Ins 3601.30
Penalties
CHAPTER Ins 3700 STANDARDS FOR SAFEGUARDING CUSTOMER
INFORMATION
PART Ins 3701 STANDARDS
Section Ins 3701.01 Purpose and Scope
Section Ins 3701.02 Definitions
Section Ins 3701.03 Information Security Program
Section Ins 3701.04 Objectives of Information Security Program
Section Ins 3701.05 Examples of Methods of Development and
Implementation
Section Ins 3701.06 Assess Risk
Section Ins 3701.07 Manage and Control Risk
Section Ins 3701.08 Oversee Service Provider Arrangements
Section Ins 3701.09 Adjust the Program
Section Ins 3701.10 Violations
PART Ins 3702 CUSTOMER NOTICE
Section Ins 3702.01 Purpose and Scope
Section Ins 3702.02 Definitions
Section Ins 3702.03 Standards for Providing Notice
Section Ins 3702.04 Affected Customers
Section Ins 3702.05 Content of Customer Notice
Section Ins 3702.06 Delivery of Customer Notice
Section Ins 3702.07 Violations
CHAPTER Ins 3800
MEDICAL PROFESSIONAL LIABILITY INSURANCE
PART Ins 3801 MANDATORY REPORTING OF DETAILED CLAIM
INFORMATION
Section Ins 3801.01 Purpose
Section Ins 3801.02 Scope
Section Ins 3801.03 Definitions
Section Ins 3801.04 Detailed Reporting Requirements
Section Ins 3801.05 Report Dates
Section Ins 3801.06 Penalty
Section Ins 3801.07 Confidentiality
CHAPTER Ins 3900 DISABILITY INSURANCE
PART Ins 3901 DISABILITY INSURANCE
Section Ins 3901.01
Purpose and Scope
Section Ins 3901.02
Definitions
Section Ins 3901.03
Claims Procedures
Section Ins 3901.04
Failure to Establish and Follow Reasonable Claims Procedures
Section Ins 3901.05
Effective Date
CHAPTER Ins 4000 UNIFORM REPORTING SYSTEM FOR HEALTH CARE
CLAIMS DATA SETS
PART Ins 4001 PURPOSE AND SCOPE
Section Ins 4001.01 Purpose and Scope
PART Ins 4002 DEFINITIONS
Section Ins 4002.01 Definitions
PART Ins 4003 REPORTING REQUIREMENTS FOR ALL LICENSED CARRIERS
AND HEALTH CARE CLAIMS PROCESSORS
Section
Ins 4003.01 HEDIS Reporting Requirements
Section
Ins 4003.02 CAHPS Reporting Requirements
PART
Ins 4004 HEALTH CARE CLAIMS DATA SET
FILING
Section
Ins 4004.01 Data Set Filing Description
Section
Ins 4004.02 General Requirements for
Data Submission
PART
Ins 4005 SUBMISSIONS REQUIREMENTS
Section
Ins 4005.01 Registration Form
Section
Ins 4005.02 File Organization
Section
Ins 4005.03 Filing Media
Section
Ins 4005.04 Transmittal Sheet
Section
Ins 4005.05 Testing of Files
Section
Ins 4005.06 Rejection of Files
Section
Ins 4005.07 Filing Periods
Section
Ins 4005.08 Replacement of Data Files
PART
Ins 4006 COMPLIANCE WITH DATA STANDARDS
Section
Ins 4006.01 Compliance
PART
Ins 4007 DATA RELEASE
Section
Ins 4007.01 Data Release
CHAPTER Ins 4300
FIDUCIARY OBLIGATION OF PRODUCERS
PART Ins 4301 FIDUCIARY STANDARDS AND PROCEDURES
Section Ins 4301.01 Purpose and Scope
Section Ins 4301.02 Definitions
Section Ins 4301.03 Fiduciary Obligation
Section Ins 4301.04 Establishment of Premium Trust Account
Section Ins 4301.05 Commingling of Funds Prohibited
Section Ins 4301.06 Return Premiums
Section Ins 4301.07 Exchange Terms
Section
Ins 4301.08 Recordkeeping Requirements
Section Ins 4301.09 Penalty
CHAPTER Ins 4400
STOP LOSS INSURANCE
PART Ins 4401 ACTUARIAL CERTIFICATION
Section Ins 4401.01 Purpose and Scope
Section Ins 4401.02 Definitions
Section Ins 4401.03 Actuary Criteria; Change of Actuary
Section Ins 4401.04 Certification by Actuary
Section Ins 4401.05 Term of Certification and Annual Filing
CHAPTER Ins 4500
ANNUAL FINANCIAL REPORTING
PART Ins 4501 ANNUAL FINANCIAL REPORTING
Section Ins 4501.01 Purpose and Scope
Section Ins 4501.02 Definitions
Section
Ins 4501.03 General Requirements Related
to Filing and Extensions for Filing of Annual Audited Financial Reports and
Audit Committee Appointment
Section Ins 4501.04 Contents of Annual Audited Financial Report
Section Ins 4501.05 Designation of Independent Certified Public
Accountant
Section Ins 4501.06 Qualifications of Independent Certified
Public Accountant
Section Ins 4501.07 Consolidated or Combined Audits
Section Ins 4501.08 Scope of Audit and Report of Independent
Certified Public Accountant
Section Ins 4501.09 Notification of Adverse Financial Condition
Section Ins 4501.10 Communication of Internal Control Related
Matters Noted in an Audit
Section Ins 4501.11 Accountant’s Letter of Qualifications
Section
Ins 4501.12 Definition, Availability and
Maintenance of Independent Certified Public Accountant Workpapers
Section Ins 4501.13 Requirements for Audit Committees
Section
Ins 4501.14 Conduct of Insurer in
Connection with the Preparation of Required Reports and Documents
Section Ins 4501.15 Management’s Report of Internal Control Over
Financial Reporting
Section Ins 4501.16 Exemptions and Effective Dates
Section Ins 4501.17 Canadian and British Companies