A.R.S. § 20-2310 — Arizona Code / Title 20 / Chapter 13 / Article 1 / Section 2310
20-2310 Discrimination prohibited; preexisting conditions; wellness programs
Status: in_force

20-2310. Discrimination prohibited; preexisting conditions; wellness programs

A. Except as provided in subsection B of this section, a health benefits plan may not deny, limit or condition the coverage or benefits based on a person's health status-related factors or a lack of evidence of insurability.

B. A health benefits plan shall not exclude coverage for preexisting conditions, except that:

1. A health benefits plan may exclude coverage for preexisting conditions for a period of not more than twelve months or, in the case of a late enrollee, eighteen months. The exclusion of coverage does not apply to services that are furnished to newborns who were otherwise covered from the time of their birth or to persons who satisfy the portability requirements under section 20-2308.

2. The accountable health plan shall reduce the period of any applicable preexisting condition exclusion by the aggregate of the periods of creditable coverage that apply to the individual.

C. A health benefits plan shall not include an affiliation period in a policy unless the affiliation period satisfies the requirements prescribed in 45 Code of Federal Regulations section 146.119(b).

D. On request of a health benefits plan, a person who provides coverage during a period of continuous coverage with respect to a covered individual shall promptly disclose the coverage provided to the covered individual, the period of the coverage and the benefits provided under the coverage.

E. The accountable health plan shall calculate creditable coverage according to the following rules:

1. The accountable health plan shall give an individual credit for each day the individual was covered by creditable coverage.

2. The accountable health plan shall not count a period of creditable coverage for an individual enrolled in a health benefits plan if after the period of coverage and before the enrollment date there were sixty-three consecutive days during which the individual was not covered under any creditable coverage.

3. The accountable health plan shall give credit in the calculation of creditable coverage for any period that an individual is in a waiting period or an affiliation period for any health coverage.

4. The accountable health plan shall not count a period of creditable coverage with respect to enrollment of an individual if, after the most recent period of creditable coverage and before the enrollment date, sixty-three consecutive days lapse during all of which the individual was not covered under any creditable coverage.  The accountable health plan shall not include in the determination of the period of continuous coverage described in this section any period that an individual is in a waiting period for health insurance coverage offered by a health care insurer, is in a waiting period for benefits under a health benefits plan offered by an accountable health plan or is in an affiliation period.

5. In determining the extent to which an individual has satisfied any portion of any applicable preexisting condition period the accountable health plan shall count a period of creditable coverage without regard to the specific benefits covered during that period.

6. An accountable health plan shall not impose any preexisting condition exclusion in the case of an individual who is covered under creditable coverage thirty-one days after the individual's date of birth.

7. An accountable health plan shall not impose any preexisting condition exclusion in the case of a child who is adopted or placed for adoption before age eighteen and who is covered under creditable coverage thirty-one days after the adoption or placement for adoption.

F. An accountable health plan shall provide the certificate of creditable coverage described in subsection G of this section without charge for creditable coverage occurring after June 30, 1996 if the individual:

1. Ceases to be covered under a health benefits plan offered by an accountable health plan or otherwise becomes covered under a COBRA continuation provision.  An individual who is covered by a health benefits plan that is offered by an accountable health plan, that is terminated or not renewed at the choice of the employer and where the replacement of the health benefits plan is without a break in coverage is not entitled to receive the certification prescribed in this paragraph but is instead entitled to receive the certifications prescribed in paragraphs 2 and 3 of this subsection.

2. Who was covered under a COBRA continuation provision ceases to be covered under the COBRA continuation provision.

3. Requests certification from the accountable health plan within twenty-four months after the coverage under a health benefits plan offered by an accountable health plan ceases.

G. The certificate of creditable coverage provided by an accountable health plan is a written certification of:

1. The period of creditable coverage of the individual under the accountable health plan and any applicable coverage under a COBRA continuation provision.

2. Any applicable waiting period or affiliation period imposed on an individual for any coverage under the accountable health plan.

H. Any accountable health plan that issues health benefits plans in this state, as applicable, shall issue and accept a written certificate of creditable coverage of the individual that contains at least the following information:

1. The date that the certificate is issued.

2. The name of the individual or dependent for whom the certificate applies and any other information that is necessary to allow the issuer providing the coverage specified in the certificate to identify the individual, including the individual's identification number under the policy and the name of the policyholder if the certificate is for or includes a dependent.

3. The name, address and telephone number of the issuer providing the certificate.

4. The telephone number to call for further information regarding the certificate.

5. One of the following:

(a) A statement that the individual has at least eighteen months of creditable coverage. For the purposes of this subdivision, "eighteen months" means five hundred forty-six days.

(b) Both the date that the individual first sought coverage, as evidenced by a substantially complete application, and the date that creditable coverage began.

6. The date creditable coverage ended, unless the certificate indicates that creditable coverage is continuing from the date of the certificate.

7. The consumer assistance telephone number for the department.

8. The following statement in at least fourteen-point type:

Important notice!

Keep this certificate with your important personal records to protect your rights under the health insurance portability and accountability act of 1996 ("HIPAA").  This certificate is proof of your prior health insurance coverage.  You may need to show this certificate to have a guaranteed right to buy new health insurance ("Guaranteed issue"). This certificate may also help you avoid waiting periods or exclusions for preexisting conditions. Under HIPAA, these rights are guaranteed only for a very short time period.  After your group coverage ends, you must apply for new coverage within 63 days to be protected by HIPAA. If you have questions, call the Arizona department of insurance and financial institutions.

I. An accountable health plan may provide any certification pursuant to subsection F, paragraph 1 of this section at the same time the accountable health plan sends the notice required by the applicable COBRA continuation provision.

J. An accountable health plan has satisfied the certification requirement under this section if the accountable health plan offering the health benefits plan provides the prescribed certificate in accordance with this section within thirty days after the event that triggered the issuance of the certification.

K. If an accountable health plan imposes a waiting period for coverage of preexisting conditions, within a reasonable period of time after receiving an individual's proof of creditable coverage and not later than the date by which the individual must select an insurance plan, the accountable health plan shall give the individual written disclosure of the accountable health plan's determination regarding any preexisting condition exclusion period that applies to that individual. The disclosure shall include all of the following information:

1. The period of creditable coverage allowed toward the waiting period for coverage of preexisting conditions.

2. The basis for the accountable health plan's determination and the source and substance of any information on which the accountable health plan has relied.

3. A statement of any right the individual may have to present additional evidence of creditable coverage and to appeal the accountable health plan's determination, including an explanation of any procedures for submission and appeal.

L. Periods of creditable coverage for an individual are established by presentation of the written certifications described in this section and section 20-1379.  In addition to written certification of the period of creditable coverage as described in this section, individuals may establish creditable coverage through the presentation of documents or other means.  In order to make a determination that is based on the relevant facts and circumstances of the amount of creditable coverage that an individual has, an accountable health plan shall take into account all information that the plan obtains or that is presented to the plan on behalf of the individual.

M. The department may enforce and monitor the issuance and delivery of the notices and certificates by accountable health plans and insurers as required by this section, the health insurance portability and accountability act of 1996 (P.L. 104-191; 110 Stat. 1936) and any federal regulations adopted to implement the health insurance portability and accountability act of 1996.

N. This section does not prohibit any health benefits plan from providing or offering to provide rewards or incentives under a wellness program that satisfies the requirements for an exception from the general prohibition against discrimination based on a health factor under the health insurance portability and accountability act of 1996 (P.L. 104-191; 110 stat. 1936), including any federal regulations that are adopted pursuant to that act.

O. Notwithstanding any other law, an insurer is not required to provide a certificate of creditable coverage if the federal laws that require providing a certificate of creditable coverage are superseded by the prohibition on preexisting condition exclusions.
A.R.S. § 20-3453 — Arizona Code / Title 20 / Chapter 27 / Article 1 / Section 3453
20-3453 Credentialing; loading; timelines; exception
Status: in_force

20-3453. Credentialing; loading; timelines; exception

A. Except as provided in subsection C of this section, the health insurer shall conclude the process of credentialing within sixty calendar days and loading the applicant's information into the health insurer's billing system within thirty calendar days after the date the health insurer receives a complete credentialing application.

B. A health insurer shall provide written or electronic notice of the approval or denial of a credentialing application to an applicant within seven calendar days after the conclusion of the credentialing process.

C. If a licensed health care facility has a delegated credentialing agreement with a health insurer, the health insurer is not responsible for compliance with the timeline prescribed in subsection A of this section for an applicant who works for that facility, but shall conclude the loading process for that applicant within ten calendar days after the health insurer receives a roster of demographic changes related to newly credentialed, terminated or suspended participating providers.
A.R.S. § 20-3153 — Arizona Code / Title 20 / Chapter 21 / Article 1 / Section 3153
20-3153 Health care insurer liability
Status: in_force

20-3153. Health care insurer liability

A. A health care insurer is liable for any damages caused to the insurer's enrollee by the insurer's delay in authorizing or failure to authorize a request for medically necessary health care services covered under the health care plan or by the insurer's denial of payment of benefits covered under the health care plan if both:

1. The health care insurer delayed authorizing or failed to authorize the requested health care services or denied payment of the covered benefits without a reasonable basis for that action.

2. The health care insurer knew that it acted without a reasonable basis or failed to perform an investigation or evaluation adequate to determine whether its action was supported by a reasonable basis.

B. A health care insurer:

1. Is liable under this section if the insurer's conduct was a cause of the enrollee's damages and if the damages would not have occurred without that conduct.

2. Is not liable under this section if the insurer's conduct under this section was inadvertent or unintentional.
A.R.S. § 20-1242.04 — Arizona Code / Title 20 / Chapter 6 / Article 1.2 / Section 1242.04
20-1242.04 Penalties
Status: in_force

20-1242.04. Penalties

An insurer or insurance producer that violates this article is subject to penalties prescribed under sections 20-220, 20-295 and 20-456.
A.R.S. § 20-1024 — Arizona Code / Title 20 / Chapter 4 / Article 8 / Section 1024
20-1024 Application for license; contents
Status: in_force

20-1024. Application for license; contents

The attorney shall file with the director a verified application for a certificate of authority setting forth and accompanied by:

1. The name of the attorney or attorneys and the title under which the business is to be conducted, which title shall contain the name Lloyd's and the name of the country or state under which it is organized, and shall not be so similar to any name or title in use in this state as to be likely to confuse or deceive.

2. The location of the principal office.

3. The kind or combination of kinds of insurance to be written, as defined in article 2 of chapter 2 of this title.

4. A copy of the form of power of attorney by virtue of which the attorney is to act for and bind the several underwriters, and a copy of the articles of agreement entered into between the underwriters themselves and the attorney.

5. The names and addresses of all underwriters, whose number shall not be smaller than three.

6. A financial statement showing in detail the assets contributed or accumulated in the hands of the attorneys-in-fact, committee of underwriters, trustees, or other officers of such Lloyd's association, together with the liabilities incurred and outstanding and the income received and disbursements made by the attorney for the underwriters.

7. An instrument executed by each and all of the underwriters specially empowering the attorney to accept service of process for each underwriter in any action on any policy or contract of insurance, and an instrument from the attorney to the director delegating the attorney's powers in this respect to the director.
A.R.S. § 20-3451 — Arizona Code / Title 20 / Chapter 27 / Article 1 / Section 3451
20-3451 Definitions
Status: in_force

20-3451. Definitions

In this chapter, unless the context otherwise requires:

1. "Applicant" means a provider that submits a credentialing application to a health insurer to become a participating provider in the health insurer's network.

2. "Application" means an applicant's initial application to be credentialed as a participating provider.

3. "Complete credentialing application":

(a) Means an application that includes all the information, any required supporting documentation and a current authorization to access electronic documentation that a health insurer needs in order to process the credentialing request through a credentialing system that is developed by a nationally recognized, nonprofit alliance of health plans and trade associations, including a nonprofit organization that is incorporated as a mutual health corporation and that is working to streamline the business of health care.

(b) Includes a credentialing system that is operated by a dental services corporation.

4. "Designee" means a third party to whom the health insurer has delegated credentialing activities or responsibilities.

5. "Health insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital, medical, dental and optometric service corporation and includes the health insurer's designee.  Health insurer does not include a pharmacy benefits manager as defined in section 20-3321.

6. "Loading" means to input a participating provider's information into a health insurer's billing system for the purpose of processing claims and submitting reimbursement for covered services.

7. "Participating provider" means a provider that has been credentialed and contracted by a health insurer to provide health care items or services to subscribers in at least one of the health insurer's provider networks.

8. "Provider" means a physician, hospital or other person that is licensed in this state or that is otherwise authorized to furnish health care services in this state.

9. "Recredential" means to confirm that a participating provider is in good standing by a health insurer and does not require submitting an application or going through a contracting and loading process.

10. "Subscriber" means a person who is eligible to receive health care benefits pursuant to a health insurance policy or coverage issued or provided by a health insurer.
A.R.S. § 20-282 — Arizona Code / Title 20 / Chapter 2 / Article 3 / Section 282
20-282 License required
Status: in_force

20-282. License required

A person shall not sell, solicit or negotiate insurance in this state for any class or classes of insurance unless the person is licensed for that line of authority in accordance with this article.
A.R.S. § 20-1402.01 — Arizona Code / Title 20 / Chapter 6 / Article 5 / Section 1402.01
20-1402.01 Group disability insurance; clinical trials; cancer; definitions
Status: in_force

20-1402.01. Group disability insurance; clinical trials; cancer; definitions

A. A group disability insurer is not obligated to pay any costs, other than covered patient costs, that are directly associated with a cancer clinical trial that is offered in this state and in which the insured participates voluntarily.  A cancer clinical trial is a course of treatment in which all of the following apply:

1. The treatment is part of a scientific study of a new therapy or intervention that is being conducted at an institution in this state, that is for the treatment, palliation or prevention of cancer in humans and in which the scientific study includes all of the following:

(a) Specific goals.

(b) A rationale and background for the study.

(c) Criteria for patient selection.

(d) Specific directions for administering the therapy and monitoring patients.

(e) A definition of quantitative measures for determining treatment response.

(f) Methods for documenting and treating adverse reactions.

2. The treatment is being provided as part of a study being conducted in a phase I, phase II, phase III or phase IV cancer clinical trial.

3. The treatment is being provided as part of a study being conducted in accordance with a clinical trial approved by at least one of the following:

(a) One of the national institutes of health.

(b) A national institutes of health cooperative group or center.

(c) The United States food and drug administration in the form of an investigational new drug application.

(d) The United States department of defense.

(e) The United States department of veterans affairs.

(f) A qualified research entity that meets the criteria established by the national institutes of health for grant eligibility.

(g) A panel of qualified recognized experts in clinical research within academic health institutions in this state.

4. The proposed treatment or study has been reviewed and approved by an institutional review board of an institution in this state.

5. The personnel providing the treatment or conducting the study:

(a) Are providing the treatment or conducting the study within their scope of practice, experience and training and are capable of providing the treatment because of their experience, training and volume of patients treated to maintain expertise.

(b) Agree to accept reimbursement as payment in full from the insurer at the rates that are established by the insurer and that are not more than the level of reimbursement applicable to other similar services provided by health care providers with the insurer's provider network.

6. There is no clearly superior, noninvestigational treatment alternative.

7. The available clinical or preclinical data provide a reasonable expectation that the treatment will be at least as efficacious as any noninvestigational alternative.

B. Pursuant to the patient informed consent document, no party is liable for damages associated with the treatment provided during any phase of a cancer clinical trial.

C. Each contract delivered or issued for delivery in this state shall provide benefits under the contract, and those benefits shall not supplant any portion of the clinical trial that is customarily paid for by government, biotechnical, pharmaceutical or medical device industry sources.

D. This section does not create any private right or cause of action for or on behalf of any patient against the insurer.  This section provides solely an administrative remedy to the director for any violation of this section or any related rule.

E. Nothing in this section prohibits the insurer from imposing deductibles, coinsurance or other cost sharing measures in relation to benefits provided pursuant to this section.

F. For the purposes of this section:

1. "Cooperative group" means a formal network of facilities that collaborates on research projects and that has an established national institutes of health approved peer review program operating within the group, including the national cancer institute clinical cooperative group and the national cancer institute community clinical oncology program.

2. "Institutional review board" means any board, committee or other group that is both:

(a) Formally designated by an institution to approve the initiation of and to conduct periodic review of biomedical research involving human subjects and in which the primary purpose of such review is to assure the protection of the rights and welfare of the human subjects and not to review a clinical trial for scientific merit.

(b) Approved by the national institutes of health office for protection from research risks.

3. "Multiple project assurance contract" means a contract between an institution and the United States department of health and human services that defines the relationship of the institution to the United States department of health and human services and that sets out the responsibilities of the institution and the procedures that will be used by the institution to protect human subjects.

4. "Patient" means the insured or the insured's covered dependent.

5. "Patient cost" means any fee or expense that is covered under the contract and that is for a service or treatment that would be required if the patient were receiving usual and customary care.  Patient cost does not include the cost:

(a) Of any drug or device provided in a phase I cancer clinical trial.

(b) Of any investigational drug or  device.

(c) Of nonhealth services that might be required for a person to receive treatment or intervention.

(d) Of managing the research of the clinical trial.

(e) That would not be covered under the patient's contract.

(f) Of treatment or services provided outside this state.
A.R.S. § 20-474 — Arizona Code / Title 20 / Chapter 2 / Article 7 / Section 474
20-474 Service charges in connection with insurance on collateral security prohibited when mortgagee procures insurance
Status: in_force

20-474. Service charges in connection with insurance on collateral security prohibited when mortgagee procures insurance

When a mortgagee or his agent at the inception of the mortgage procures the issuance of insurance for the mortgagor then the mortgagor may substitute a replacement policy within one year after the inception of the original policy procured by the mortgagee and it shall be unlawful for the mortgagee to charge an insurance service charge for services performed in changing the mortgagee's records and accounts.
A.R.S. § 20-162 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 162
20-162 Demand for hearing; stay of order
Status: in_force

20-162. Demand for hearing; stay of order

A. A request for a hearing pursuant to title 41, chapter 6, article 10 that is received by the director before the effective date of any order issued by the director or within ten days after the order is delivered shall stay the effectiveness of the order pending the hearing and an order made thereon, except as to action taken or proposed pursuant to section 41-1092.11, subsection B or under an order on hearing, an order pursuant to an order on hearing or an order to make good an impairment of the assets of an insurer.

B. If an automatic stay pursuant to subsection A of this section is not applicable, any party may apply to the director for a stay for cause.  If the director fails to grant the stay, the party may appeal the director's decision to the superior court in Maricopa county.
A.R.S. § 20-3557 — Arizona Code / Title 20 / Chapter 29 / Article 1 / Section 3557
20-3557 Travel administrators
Status: in_force

20-3557. Travel administrators

A. Notwithstanding any other provision of this title, a person may not act or represent itself as travel administrator for travel insurance in this state unless that person either:

1. Is a licensed property and casualty insurance producer in this state for activities allowed under that producer license.

2. Holds a valid managing general agent license in this state.

B. A travel administrator and its employees are exempt from the licensing requirements of chapter 2, article 3.2 of this title for travel insurance it administers.

C. An insurer that underwrites travel insurance is responsible for the acts of the travel administrator administering that travel insurance, ensuring that the travel administrator maintains all books and records relevant to the insurer and ensuring that the travel administrator makes the books and records available to the director on request.
A.R.S. § 20-448.01 — Arizona Code / Title 20 / Chapter 2 / Article 6 / Section 448.01
20-448.01 Required insurance procedures relating to HIV information; confidentiality; violations; penalties; definitions
Status: in_force

20-448.01. Required insurance procedures relating to HIV information; confidentiality; violations; penalties; definitions

A. In this section unless the context otherwise requires:

1. "Confidential HIV-related information" means information concerning whether a person has had an HIV-related test or has HIV infection, HIV-related illness or acquired immune deficiency syndrome and includes information which identifies or reasonably permits identification of that person or the person's contacts.

2. "HIV" means the human immunodeficiency virus.

3. "HIV-related test" means a laboratory test or series of tests for the virus, components of the virus or antibodies to the virus thought to indicate the presence of HIV infection.

4. "Protected person" means a person who takes an HIV-related test or who has been diagnosed as having HIV infection, acquired immune deficiency syndrome or HIV-related illness.

5. "Person" includes all entities subject to regulation under title 20, the employees, contractors and agents thereof, and anyone performing insurance related tasks for such entities, employees, contractors or agents.

B. Except as otherwise specifically authorized or required by this state or by federal law, no person may require the performance of, or perform an HIV-related test without first receiving the specific written informed consent of the subject of the test who has capacity to consent or, if the subject lacks capacity to consent, of a person authorized pursuant to law to consent for that person. Written consent shall be in a form as prescribed by the director.

C. No person who obtains confidential HIV-related information in the course of processing insurance information or insurance applications or pursuant to a release of confidential HIV-related information may disclose or be compelled to disclose that information except to the following:

1. The protected person or, if the protected person lacks capacity to consent, a person authorized pursuant to law to consent for the protected person.

2. A person to whom disclosure is authorized in writing pursuant to a release as set forth in subsection E of this section, including but not limited to a physician designated by the insured or a medical information exchange for insurers operated under procedures intended to ensure confidentiality, provided that in the case of a medical information exchange:

(a) The insurer will not report that blood tests of an applicant showed the presence of the AIDS virus antibodies, but only that unspecified blood test results were abnormal.

(b) Reports must use a general code that also covers results of tests for many diseases or conditions, such as abnormal blood counts that are not related to HIV, AIDS, AIDS related complex or similar diseases.

3. A government agency specifically authorized by law to receive the information. The agency is authorized to redisclose the information only pursuant to this section or as otherwise permitted by law.

4. A person regulated by this title to which disclosure is ordered by a court or administrative body pursuant to section 36-665.

5. The industrial commission or parties to an industrial commission claim pursuant to the provisions of section 23-908, subsection D and section 23-1043.02.

D. Test results and application responses may be shared with the underwriting departments of the insurer and reinsurers, or to those contractually retained medical personnel, laboratories, and insurance affiliates, excluding agents and brokers, which are involved in underwriting decisions regarding the individual's application if disclosure is reasonably necessary to make the underwriting decision regarding such application, and claims information may be shared with claims personnel and attorneys reviewing claims if disclosure is reasonably necessary to process and resolve claims.

E. A release of confidential HIV-related information pursuant to subsection C, paragraph 2 of this section shall be signed by the protected person or, if the protected person lacks capacity to consent, a person authorized pursuant to law to consent for the protected person. A release shall be dated and shall specify to whom disclosure is authorized, the purpose for disclosure and the time period during which the release is effective. A general authorization for the release of medical or other information is not a release of confidential HIV-related information unless the authorization specifically indicates its purpose as a general authorization and an authorization for the release of confidential HIV-related information and complies with the requirements of this section.

F. A person to whom confidential HIV-related information is disclosed pursuant to this section shall not disclose the information to another person except as authorized by this section. This subsection does not apply to the protected person or a person who is authorized pursuant to law to consent for the protected person.

G. If a disclosure of confidential HIV-related information is made pursuant to the provisions of a written release as permitted by subsection C, paragraph 2 of this section, the disclosure shall be accompanied by a statement in writing which warns that the information is from confidential records which are protected by state law that prohibits further disclosure of the information without the specific written consent of the person to whom it pertains or as otherwise permitted by law.

H. The person making a disclosure in accordance with subsection C, paragraphs 3, 4 and 5, and subsection G of this section shall keep a record of all disclosures for the time period prescribed by the director. On request, a protected person or his legal representative shall have access to the record.

I. Except as otherwise provided pursuant to this section or subject to an order or search warrant issued pursuant to section 36-665, no person who receives confidential HIV-related information pursuant to a release of confidential HIV-related information may disclose that information to another person or legal entity or be compelled by subpoena, order, search warrant or other judicial process to disclose that information to another person or legal entity.

J. The director shall adopt rules to implement the allowable tests and testing procedures, written consent to perform a human immunodeficiency virus related test, procedures for confidentiality and disclosure of medical information and procedures for gathering underwriting information and may adopt additional rules reasonable and necessary to implement this section.

K. Notwithstanding any other provision of law to the contrary, nothing in this section shall be interpreted to restrict the director's authority to full access to records of any entity subject to regulation under title 20, including but not limited to all records containing confidential HIV-related information. The director may only redisclose confidential HIV-related information in accordance with this section.

L. A protected person, whose rights provided in this section have been violated by a person or entity described in subsection A, paragraph 5 of this section, has those individual remedies specified in section 20-2118 against such a person or entity.
A.R.S. § 20-1057.18 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1057.18
20-1057.18 Contracts; optometrists; covered services; definition
Status: in_force

20-1057.18. Contracts; optometrists; covered services; definition

A. Except as provided in subsection C of this section, a contract, entered into or renewed on or after January 1, 2022, between a health care services organization and an optometrist who is licensed to practice in this state shall not:

1. Require the optometrist to provide a service to an individual covered under an evidence of coverage based on a fee set by the health care services organization unless the service for which the fee applies is a covered service under the individual's evidence of coverage.

2. Prohibit an optometrist from offering or providing a vision service that is not a covered service to a covered individual at a fee determined by the optometrist or by the optometrist and the covered individual.

3. Require an optometrist to use one or more specific vendors to replenish the optometrist's inventory of spectacle lenses after the optometrist dispenses the optometrist's inventory to eligible members of the vision plan as a covered vision service.

B. This section applies to an administrator providing third-party administration services or a provider network for a vision plan.

C. This section does not restrict the ability of a health care services organization to enter into a contract for an optometrist to participate in a discount program sponsored by the health care services organization for services that are not covered if:

1. Participation in the health care services organization network is not contingent on participation in the sponsored discount program.

2. The health care services organization offers equal treatment to an optometrist who does not participate in a sponsored discount program, regarding:

(a) Promotional treatment.

(b) Marketing benefits.

(c) Materials.

(d) Contract terms for providing a covered service.

D. Notwithstanding subsection C, paragraph 2, subdivision (d) of this section, a health care services organization, when providing a typically formatted list of optometrists in the health care services organization network, may identify whether an optometrist participates in a discount program for services not covered by the health care services organization if all lists state that other discounts may be available with individual optometrists.

E. All contracts shall be in compliance with this section by the first renewal period on or after January 1, 2022, but not later than December 31, 2022.

F. For the purposes of this section, "covered service" means a service for which any reimbursement is available under an evidence of coverage without regard to contractual limitations by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, exclusion or other limitation.
A.R.S. § 20-3459 — Arizona Code / Title 20 / Chapter 27 / Article 1 / Section 3459
20-3459 Civil immunity; enforcement; civil penalty
Status: in_force

20-3459. Civil immunity; enforcement; civil penalty

A. A health insurer that complies in good faith with the requirements of this chapter is immune from civil liability for the purposes of reviewing and approving a credentialing application.

B. A health insurer that does not credential a provider is not subject to civil liability for any act or omission of the provider in rendering services to a health insurer's member.

C. The director shall enforce this chapter.  A health insurer that fails to comply with this chapter or with any rules adopted pursuant to this chapter is subject to the civil penalties prescribed in section 20-456.

D. On receipt of multiple complaints of violations of this chapter by a health insurer from applicants or participating providers, the director shall conduct an examination of the health insurer pursuant to section 20-156, 20-831 or 20-1058, as applicable to the specific insurer.
A.R.S. § 20-1096.10 — Arizona Code / Title 20 / Chapter 4 / Article 12 / Section 1096.10
20-1096.10 Rules and regulations
Status: in_force

20-1096.10. Rules and regulations

The director may adopt those rules as are necessary to implement the provisions of this article.
A.R.S. § 20-581 — Arizona Code / Title 20 / Chapter 3 / Article 3 / Section 581
20-581 Deposits of insurers
Status: in_force

20-581. Deposits of insurers

The state treasurer shall accept and hold in trust, when made through the director, deposits of securities or funds by insurers as follows:

1. Deposits required for authority to transact insurance in this state.

2. Deposits of domestic, foreign or alien insurers when made pursuant to the laws of other states, provinces and countries as prerequisite for authority to transact insurance in such state, province or country.

3. Deposits in such additional amounts as are permitted to be made by section 20-587.
A.R.S. § 20-623 — Arizona Code / Title 20 / Chapter 3 / Article 4 / Section 623
20-623 Order of conservation or ancillary liquidation of foreign or alien insurers
Status: in_force

20-623. Order of conservation or ancillary liquidation of foreign or alien insurers

A. An order to conserve the assets of a foreign or alien insurer shall require the director as ancillary receiver to take immediate possession of the property of the insurer within this state and to conserve it, subject to the further direction of the court.

B. An order to liquidate the assets in this state of a foreign insurer shall require the director as ancillary receiver to take immediate possession of the property of the insurer within this state and to liquidate it subject to the orders of the court and with due regard to the rights and powers of the domiciliary receiver, as provided in this article.
A.R.S. § 20-154 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 154
20-154 Annual report; list of authorized insurers
Status: in_force

20-154. Annual report; list of authorized insurers

A. As early in the calendar year as possible the director shall annually prepare a report for delivery to the commission, the governor and the legislature, showing, with respect to the preceding calendar year:

1. List of authorized insurers transacting insurance in this state, with such report of their financial condition as he deems appropriate.

2. Names of insurers whose businesses were closed during the year, the cause thereof, and amount of assets and liabilities as ascertainable.

3. Names of insurers against which delinquency or similar proceedings were instituted, and a concise statement of the facts with reference to each such proceeding.

4. Name and compensation of each officer, deputy, examiner, assistant and employee of the office of director, and the whole amount, with reasonable itemization, of the expenses of the office of director.

5. Recommendations of the director as to amendment of laws affecting insurance, and as to matters affecting the office of director.

6. Such other pertinent information and matters as the director deems proper.

B. As early as possible in, and with respect to, the current calendar year, the director shall annually make available to the public a list of authorized insurers transacting insurance in this state and offering individual health insurance plans.

C. The director shall cause the report to be printed and delivered for the purpose intended.
A.R.S. § 20-3505 — Arizona Code / Title 20 / Chapter 28 / Article 1 / Section 3505
20-3505 Mental health parity advisory committee; members
Status: in_force

20-3505. Mental health parity advisory committee; members

A. The mental health parity advisory committee is established to advise the directors of the department of insurance and financial institutions and department of health services relating to matters pertinent to mental health parity, including recommendations related to case management, discharge planning and expedited review and appeals processes for cases involving suicidal ideation. The director of the department of insurance and financial institutions shall appoint the following members to the committee:

1. Four members who represent health care insurers.

2. One member who is a licensed behavioral health services provider.

3. One member who represents a behavioral health advocacy organization.

4. At least three members or family members who are not employed by or contracted with the state and who have been affected by suicide, substance use or a mental health disorder.

5. At least one member who represents a hospital that provides inpatient behavioral health services.

B. The director of the Arizona health care cost containment system may serve in an advisory capacity at the request of the director of the department of insurance and financial institutions or the director of the department of health services.
A.R.S. § 20-3209 — Arizona Code / Title 20 / Chapter 22 / Article 1 / Section 3209
20-3209 Immunity from liability
Status: in_force

20-3209. Immunity from liability

A. The director, the director's authorized representatives or any examiner appointed by the director is not liable for any statements made or conduct performed in good faith while carrying out the provisions of this chapter.

B. A person who communicates or delivers information or data to the director, the director's authorized representative or an examiner pursuant to an examination made under this chapter is not liable for the communication or delivery if the communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive.

C. A person listed in subsection A or B is entitled to attorney fees and costs if the person is the prevailing party in a civil cause of action for libel, slander or other relevant tort arising out of activities in carrying out the provisions of this chapter and the party bringing the action was not substantially justified in doing so.  For the purposes of this subsection, a proceeding is substantially justified if it had a reasonable basis in law or fact at the time that it was initiated.
A.R.S. § 20-1098.20 — Arizona Code / Title 20 / Chapter 4 / Article 14 / Section 1098.20
20-1098.20 Security for branch business and branch operations
Status: in_force

20-1098.20. Security for branch business and branch operations

A. In the case of a branch captive insurer, as security for the payment of liabilities attributable to the branch operations, the director shall require that either a trust fund that is funded by assets acceptable to the director or an irrevocable letter of credit be established and maintained in the United States for the benefit of United States policyholders and United States ceding insurers under insurance policies issued or reinsurance contracts issued or assumed by the branch captive insurer through its branch operations.

B. The amount of each security shall be at least the amount prescribed in section 20-1098.03 and the reserves on such insurance policies or such reinsurance contracts, including reserves for losses, allocated loss adjustment expenses, incurred but not reported losses and unearned premiums with regard to business written through the branch operations.  Notwithstanding this section the director may permit a branch captive insurer that is required to post security for loss reserves on branch business by its reinsurer to reduce the monies in the trust account or the amount payable under the irrevocable letter of credit required by this section by the same amount if the security remains posted with the reinsurer.

C. If the form of security selected is a letter of credit, the letter of credit must be established by, or issued or confirmed by, a qualified United States financial institution.
A.R.S. § 20-1243.05 — Arizona Code / Title 20 / Chapter 6 / Article 1.3 / Section 1243.05
20-1243.05 Compliance; enforcement; penalties
Status: in_force

20-1243.05. Compliance; enforcement; penalties

A. An insurer is responsible for compliance with this article.  If a violation occurs, either because of the action or inaction of the insurer or its producer, the director may order:

1. The insurer to take reasonably appropriate corrective action for any consumer who is harmed by a failure to comply with this article by the insurer, an entity contracted to perform the insurer's supervisory duties or the producer.

2. A general agency, independent agency or the producer to take reasonably appropriate corrective action for any consumer who is harmed by the producer's violation of this article.

3. Appropriate penalties and sanctions.

B. The director may reduce or eliminate any applicable penalty under sections 20-220, 20-295 and 20-456 for a violation of this article if corrective action for the consumer was taken promptly after a violation was discovered or the violation was not part of a pattern or practice.

C. The authority to enforce compliance with article is vested exclusively with the director.
A.R.S. § 20-3558 — Arizona Code / Title 20 / Chapter 29 / Article 1 / Section 3558
20-3558 Travel insurance classification and filing
Status: in_force

20-3558. Travel insurance classification and filing

A. Notwithstanding any other provision of this title, travel insurance is classified and filed for purposes of rates and forms under an inland marine line of insurance, except that travel insurance that provides coverage for sickness, accident, disability or death occurring during travel, either exclusively or in conjunction with related coverages of emergency evacuation or repatriation of remains, may be filed under either an accident and health line of insurance or an inland marine line of insurance.

B. Travel insurance may be in the form of an individual, group or blanket policy.

C. Eligibility and underwriting standards for travel insurance may be developed and provided based on travel protection plans that are designed for individual or identified marketing or distribution channels, if those standards also meet this state's underwriting standards for inland marine.
A.R.S. § 20-629 — Arizona Code / Title 20 / Chapter 3 / Article 4 / Section 629
20-629 Priority of distribution; definition
Status: reserved

20-629. Priority of distribution; definition

A. In a delinquency proceeding against an insurer domiciled in this state, the priority of distribution of claims from the general assets of the insurer shall be determined pursuant to this section. Every claim in each class shall be paid in full or adequate funds shall be reserved for the payment before the members of the next class may receive any payment.  Subclasses may not be established within any class. The order of distribution is as follows:

1. The costs and expenses of administration incurred in connection with the delinquency proceedings.

2. Claims of the Arizona property and casualty insurance guaranty fund established pursuant to section 20-662 and the life and disability insurance guaranty fund established pursuant to section 20-683 or a similar organization in another state to the extent the organization provides substantially similar protection with respect to the same kinds of insurance, including claims for unallocated loss adjustment expenses and general administrative costs and expenses.

3. Claims under insurance policies and contracts and guaranteed investment contracts except reinsurance, including claims under nonassessable policies for unearned premiums, claims under annuity contracts, third-party claims against insureds who are covered under liability insurance policies and, in a delinquency proceeding of a health care services organization that is domiciled in this state, claims of enrollees and enrollees' beneficiaries and any claim of a provider for services that are provided pursuant to and covered by a health care plan.

4. Claims of the federal government, except those claims under paragraph 3 of this subsection and claims that are treated as secured claims.

5. Claims for compensation actually owing to employees of the insurer, other than its officers, for services rendered to the insurer.  This priority is in lieu of any other similar priority authorized by law as to wages or compensation of employees.

6. Claims of any state or local government, except those claims under paragraph 3 of this subsection and claims that are treated as secured claims.

7. Claims of other general creditors that do not fall within any other priority under this section.

8. Claims that are filed after the date specified for filing proofs of claim pursuant to section 20-640.

9. Claims of surplus note or certificate of contribution holders or other similar obligations and for premium refunds on assessable policies.

10. Claims of shareholders, members or other owners in that capacity.

B. In a delinquency proceeding against an insurer domiciled in this state, the priority of claims against the general assets of the insurer shall be determined pursuant to this section regardless of where the claimant resides or where the assets are located.

C. In a delinquency proceeding against an insurer domiciled in a reciprocal state, claims owing to residents of this state shall be preferred if like claims are preferred by the laws of that state.

D. The owners of special deposit claims against an insurer for which a receiver is appointed in this or any other state shall be given priority against their several special deposits, including without limitation assets comprising the applicable separate account, in accordance with the provisions of the statutes governing the creation and maintenance of such deposits. If there is a deficiency in any such deposit so that the claims secured are not fully discharged, the claimants may share in the general assets, but such sharing shall be deferred until general creditors, all other persons who are entitled to priority under subsection A, paragraph 3 of this section, and also claimants against other special deposits who have received smaller percentages from their respective special deposits have been paid percentages of their claims equal to the percentage paid from the special deposit, subject to the applicable terms of any variable life contract, variable annuity contract or guaranteed investment contract that is supported by a separate account to the extent it is guaranteed by the general account. This subsection shall not be applied in a manner that would reduce the value of any general account guaranty.

E. The owner of a secured claim against an insurer for which a receiver has been appointed in this or any other state may surrender the owner's security and file the owner's claim as a general creditor, or the claim may be discharged by resort to the security, in which case the deficiency, if any, shall be treated as a claim against the general assets of the insurer on the same basis as claims of unsecured creditors. If the amount of the deficiency has been adjudicated in ancillary proceedings as provided in this article or if it has been adjudicated by a court of competent jurisdiction in proceedings in which the domiciliary receiver has had notice and opportunity to be heard, such amounts shall be conclusive.  Otherwise the amount shall be determined in the delinquency proceeding in the domiciliary state.

F. For the purposes of this section, "health care plan" has the same meaning prescribed in section 20-1051.
A.R.S. § 20-867 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 867
20-867 Exemption from liability
Status: in_force

20-867. Exemption from liability

A. The officers and members of the supreme governing body or a subordinate body of a society are not personally liable for any benefits that are provided by the society.

B. A society may indemnify and reimburse any person who is or was a director, officer, employee or agent of a society or who is or was serving at the request of the society as a director, officer, employee or agent of any other firm, corporation or organization for expenses reasonably incurred by and liabilities imposed on the person in connection with or arising out of any action, suit or proceeding or the threat of an action, suit or proceeding in which the person may be involved. In a civil action a person shall not be indemnified or reimbursed if a court of competent jurisdiction finds that the person breached a duty owed as a director, officer, employee or agent of the society or the matter is the subject of a settlement, unless the person acted in good faith for a purpose the person reasonably believed to be in or not opposed to the best interests of the society. In a criminal action a person shall not be indemnified or reimbursed if the person negotiates a plea bargain or is found guilty in a court of competent jurisdiction of an offense relating to his position of director, officer, employee or agent of the society unless the person had no reasonable cause to believe that his conduct was unlawful. The supreme governing body or board of directors by a majority vote of a quorum consisting of persons who were not parties to the action, suit or proceeding or a court of competent jurisdiction shall determine if the person acted in good faith. The termination of an action, suit or proceeding or a plea of no contest does not create a conclusive presumption that the person failed to act in good faith. The right of indemnification and reimbursement does not abrogate any other right to which the person is entitled as a matter of law and inures to the benefit of the heirs, executors and administrators of the person.

C. A society may purchase and maintain insurance on behalf of a person who is or was a director, officer, employee or agent of the society or who is or was serving at the request of the society as a director, officer, employee or agent of any other firm, corporation or organization against any liability that is asserted against the person and that the person incurred in his capacity as a director, officer, employee or agent. A society may purchase and maintain insurance pursuant to this subsection regardless of the society's ability to indemnify the person.

D. A director, officer, employee, member or volunteer of a society who serves without compensation is not personally liable and no action may be maintained against him in his individual capacity for damages resulting from an act or omission within the scope of his duties and responsibilities unless the act or omission was caused by wanton or wilful misconduct.
A.R.S. § 20-411 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 411
20-411 Licensing of surplus lines broker; examination
Status: in_force

20-411. Licensing of surplus lines broker; examination

A. A person shall not act as a surplus lines broker in this state on behalf of an insured whose home state is Arizona unless the person has a current surplus lines broker license issued by the director.

B. Any individual who is a resident of this state and who is licensed as a resident insurance producer authorized for property or casualty insurance in this state may also be licensed as a resident surplus lines broker if the director determines that the insurance producer is competent. The director shall prescribe and furnish application forms.

C. Each individual applicant for an original license as a resident surplus lines broker or for renewal of a resident surplus lines broker license who has not previously taken and passed a surplus lines broker license examination in this state shall take and pass to the director's satisfaction a written examination given by or under the supervision of the director. The examination shall reasonably test the applicant's knowledge of surplus lines insurance and the legal responsibilities of a surplus lines broker.

D. The director may issue a resident surplus lines broker license to any business entity that is licensed as a resident property or casualty insurance producer in this state and that satisfies all of the requirements prescribed by section 20-285, subsections C and D.

E. At least one individual in each office or place where surplus lines insurance is transacted in this state shall be licensed pursuant to this title as an insurance producer authorized for property or casualty insurance and shall be licensed pursuant to this article as a surplus lines broker.

F. The license prescribed in this section shall expire and be subject to renewal coincidental to, and in the same manner as, other insurance license authority as prescribed in section 20-289.  The director shall charge the surplus lines broker license fee prescribed in section 20-167, except that, from and after June 30, 2005, a licensee adding surplus lines broker authority to an existing insurance license shall be charged one-half the surplus lines broker license fee if less than two years remain in the term of the existing insurance license as of the date the director receives the application to add surplus lines broker authority to the existing insurance license.

G. To the extent not inconsistent with this article, section 20-281, section 20-283, subsection B, paragraph 6, section 20-286, subsection C and sections 20-287, 20-289, 20-291, 20-292, 20-295, 20-296, 20-297, 20-298, 20-299, 20-300, 20-301 and 20-302 apply to surplus lines brokers.

H. For the purposes of implementing the nonadmitted and reinsurance reform act of 2010 (15 United States Code section 8201), the director shall participate in the national insurance producer database of the national association of insurance commissioners or any other equivalent national database for the licensure and license renewal of surplus lines brokers on and after July 21, 2012.
A.R.S. § 20-1006 — Arizona Code / Title 20 / Chapter 4 / Article 7 / Section 1006
20-1006 Reserve requirement; exception
Status: in_force

20-1006. Reserve requirement; exception

A. A prepaid dental plan organization at all times shall maintain for protection of members a financial reserve consisting of two per cent of prepaid charges collected from members for the plan, until such reserve totals five hundred thousand dollars. Such reserve shall be in addition to the deposit prescribed by section 20-1005.

B. The reserve prescribed by subsection A of this section shall not apply with respect to a prepaid dental plan organization which is funded by the federal, state or a municipal government or any political subdivision or body and meets the requirements of section 20-1005, subsection F.
A.R.S. § 20-1691.08 — Arizona Code / Title 20 / Chapter 6 / Article 15 / Section 1691.08
20-1691.08 Rate and form review; disapproval
Status: in_force

20-1691.08. Rate and form review; disapproval

A. A person shall not deliver or issue for delivery in this state any long-term care insurance policy or rate unless the person has first filed the form or rate with the director and the director has approved the form or rate.  Unless the director issues an order affirmatively approving or disapproving the form or rate within sixty days after filing, the form or rate is deemed approved.  On written notice given to the insurer within the sixty-day period, the director may extend the sixty-day review period for up to fifteen additional days.

B. The director shall disapprove a rate or form if either:

1. The rate does not comply with this article or any rules adopted pursuant to this article.

2. The form contains provisions that are ambiguous, misleading or deceptive, that encourage misrepresentation of the coverage or that are contrary to this title or of any rule adopted pursuant to this title.

C. If the director disapproves a rate or form, the director shall send the insurer a written notice specifying the reason for the disapproval.  The insurer may request a hearing pursuant to title 41, chapter 6, article 10 to contest the disapproval.  It is unlawful for the insurer to issue or use a rate or form that has been disapproved.

D. At any time after notice and for cause shown, the director may issue an order withdrawing approval of any form or rate for any reason listed in subsection B of this section.  The insurer may request a hearing pursuant to title 41, chapter 6, article 10 to contest the director's order.

E. An insurer shall not issue or use a rate or form after the effective date of an order withdrawing approval.

F. The director, by order, may exempt from the requirements of this section for as long as the director deems proper any insurance rate or form specified in the order, to which, in the director's opinion, this section may not practicably be applied or the filing and approval of which are, in the director's opinion, not desirable or necessary for the protection of the public.
A.R.S. § 20-464 — Arizona Code / Title 20 / Chapter 2 / Article 6 / Section 464
20-464 Prohibiting payment for services to persons other than the assignee
Status: in_force

20-464. Prohibiting payment for services to persons other than the assignee

A. If an insured assigns to a health care provider performing services covered by the contract payment for benefits under a disability insurance contract, a group disability insurance contract or a blanket disability insurance contract, the contract does not prohibit assignments and the assignment is delivered to the insurer, payment may be made only to the health care provider to whom payment has been assigned.

B. Notwithstanding chapter 4, article 3 of this title, this section applies to a service corporation.

C. This section applies to an insurer whether acting as an insurer or performing administrative services.
A.R.S. § 20-769 — Arizona Code / Title 20 / Chapter 4 / Article 2 / Section 769
20-769 Organization of reciprocal insurer
Status: in_force

20-769. Organization of reciprocal insurer

A. Twenty-five or more persons domiciled in this state may organize a domestic reciprocal insurer and make application to the director for a certificate of authority to transact insurance.

B. The proposed attorney shall fulfill the requirements of and shall execute and file with the director, when applying for a certificate of authority, a declaration setting forth:

1. The name of the insurer.

2. The location of the insurer's principal office, which shall be the same as that of the attorney and shall be maintained within this state.

3. The kinds of insurance proposed to be transacted.

4. The names and addresses of the original subscribers.

5. The designation and appointment of the proposed attorney and a copy of the power of attorney.

6. The names and addresses of the officers and directors of the attorney, if a corporation, or its members, if a firm.

7. The powers of the subscribers' advisory committee, and the names and terms of office of the members thereof.

8. That all monies paid to the reciprocal shall, after deducting therefrom any sum payable to the attorney, be held in the name of the insurer and for the purposes specified in the subscribers' agreement.

9. A copy of the subscribers' agreement.

10. A statement that each of the original subscribers has in good faith applied for insurance of a kind proposed to be transacted, and that the insurer has received from each such subscriber the full premium or premium deposit required for the policy applied for, for a term of not less than six months at an adequate rate theretofore filed with and approved by the director.

11. A statement of the financial condition of the insurer, a schedule of its assets and a statement that the surplus as required by section 20-768 is on hand.

12. A copy of each policy, endorsement and application form it then proposes to issue or use.

C. The declaration shall be acknowledged by the attorney in the manner required for the acknowledgement of deeds.
A.R.S. § 20-2413 — Arizona Code / Title 20 / Chapter 14 / Article 1 / Section 2413
20-2413 Rules
Status: in_force

20-2413. Rules

The director may adopt rules relating to risk retention groups as may be necessary or desirable to carry out the provisions of this chapter.
A.R.S. § 20-125 — Arizona Code / Title 20 / Chapter 1 / Article 1 / Section 125
20-125 Sending notices and correspondence
Status: in_force

20-125. Sending notices and correspondence

For the purposes of this title, if a notice or correspondence is sent by:

1. Mail, the sender must send the notice or correspondence to the recipient's last known mailing address on file with the insurer.

2. Electronic means, the sender must send the notice or correspondence to the recipient's last known email address as provided by the recipient to the insurer.
A.R.S. § 20-253 — Arizona Code / Title 20 / Chapter 2 / Article 2 / Section 253
20-253 "Disability insurance" defined
Status: in_force

20-253. "Disability insurance" defined

"Disability insurance" is insurance against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto.
A.R.S. § 20-582 — Arizona Code / Title 20 / Chapter 3 / Article 3 / Section 582
20-582 Purpose of deposits
Status: in_force

20-582. Purpose of deposits

Deposits made under the provisions of section 20-581, shall be held for purposes as follows:

1. When the deposit is required for authority to transact insurance in this state the deposit shall be held for the protection of all the insurer's policyholders within the United States.

2. When the deposit is required pursuant to the laws of another state, province or country, the deposit shall be held for such purposes as are required by such laws, and as specified by the director at the time the deposit is made.

3. When the deposit is required pursuant to the retaliatory provision set forth in section 20-230, the deposit shall be held for purposes as specified in the director's order requiring the deposit.
A.R.S. § 20-1376.07 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1376.07
20-1376.07 Prescriptions; cost sharing; refills; dispensing fees; definition
Status: in_force

20-1376.07. Prescriptions; cost sharing; refills; dispensing fees; definition

A. A disability insurance policy that is issued or renewed on or after January 1, 2017 and that provides coverage for prescription drugs:

1. May not deny coverage and shall prorate the cost sharing rate for a prescription drug covered by the policy that is dispensed by a network pharmacy for less than the standard refill amount if the insured requests enrollment into a medication synchronization program and less than the standard refill amount for the purpose of synchronizing the insured's medications.

2. Shall accept early refill and short fill requests for prescription drugs using the submission clarification and message codes as adopted by the national council for prescription drug plans or alternative codes provided by the plan upon July 3, 2015.

B. For the purposes of this section, "medication synchronization" means the coordination of medication refills for a patient taking two or more medications for a chronic condition that are being dispensed by a single contracted pharmacy to facilitate the synchronization of the patient's medications for the purpose of improving medication adherence.
A.R.S. § 20-1225 — Arizona Code / Title 20 / Chapter 6 / Article 1 / Section 1225
20-1225 Standard provisions required in reversionary annuities
Status: in_force

20-1225. Standard provisions required in reversionary annuities

A. Except as stated herein, no contract for a reversionary annuity shall be delivered or issued for delivery in this state unless it contains in substance each of the following provisions:

1. The reversionary annuity contract shall contain the provisions specified in sections 20-1219, 20-1220, 20-1221, 20-1222 and 20-1223, except that under section 20-1219 the insurer may at its option provide for an equitable reduction of the amount of the annuity payments in settlement of an overdue or deferred payment in lieu of providing for deduction of such payments from an amount payable upon settlement under the contract.

2. In reversionary annuity contracts there shall be a provision that the contract may be reinstated at any time within three years from the date of default in making stipulated payments to the insurer, upon production of evidence of insurability satisfactory to the insurer, and upon condition that all overdue payments and any indebtedness to the insurer on account of the contract be paid, or, within the limits permitted by the then cash values of the contract, reinstated, with interest as to both payments and indebtedness at a rate to be specified in the contract but not exceeding six per cent per annum compounded annually.

B. This section shall not apply to group annuities or to annuities included in life insurance policies, and any such provisions not applicable to single premium annuities shall not to that extent be incorporated therein.
A.R.S. § 20-111 — Arizona Code / Title 20 / Chapter 1 / Article 1 / Section 111
20-111 Health insurers; savings incentive programs; definitions
Status: in_force

20-111. Health insurers; savings incentive programs; definitions

A. A health insurer may establish a program that provides a savings incentive for enrollees for medically necessary covered health care services that health care providers and health care facilities provide at a price that is below the health insurer's usual reimbursement.

B. The program may enable an eligible enrollee who receives covered health care services from a health care provider or health care facility at a price below the health insurer's usual reimbursement to have the amount the enrollee pays applied toward the enrollee's deductible and out-of-pocket maximum and be reimbursed for a portion of the amount of the difference between the price the enrollee paid and the health insurer's usual reimbursement.

C. For the purposes of this section:

1. "Health care facility" means a hospital, outpatient surgical center, health care laboratory, diagnostic imaging center or urgent care center.

2. "Health care provider" has the same meaning prescribed in section 32-3216.

3. "Health insurer" has the same meaning prescribed in section 32-3216.

4. "Usual reimbursement" means the amount the health insurer would ordinarily pay an in-network health care provider or an in-network health care facility for the service.
A.R.S. § 20-3331 — Arizona Code / Title 20 / Chapter 25 / Article 2 / Section 3331
20-3331 Pharmacy benefit managers; requirements; applicability
Status: in_force

20-3331. Pharmacy benefit managers; requirements; applicability

A. A pharmacy benefit manager shall do all of the following:

1. Update the price and drug information for each list that the pharmacy benefit manager maintains every seven business days.

2. At the beginning of the term of a contract, on renewal of a contract and at least once annually during the term of a contract, make available to each network pharmacy the sources used to determine maximum allowable cost pricing.

3. Establish a process by which a network pharmacy may appeal its reimbursement for a drug subject to maximum allowable cost pricing.

4. Allow a pharmacy services administrative organization that is contracted with the pharmacy benefit manager to file an appeal of a drug on behalf of the organization's contracted pharmacies.

B. Beginning on January 1, 2020, this section applies to all new and existing contracts between a pharmacy benefit manager and a licensed pharmacy.
A.R.S. § 20-1252 — Arizona Code / Title 20 / Chapter 6 / Article 2 / Section 1252
20-1252 Employee groups
Status: in_force

20-1252. Employee groups

The lives of a group of individuals may be insured under a policy issued to an employer, or to the trustees of a fund established by an employer, which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements:

1. The employees eligible for insurance under the policy shall be all of the employees of the employer, or all of any class or classes thereof determined by conditions pertaining to their employment.  The policy may provide that the term "employees" shall include the employees of one or more subsidiary corporations, and the employees, individual proprietors and partners of one or more affiliated corporations, proprietors or partnerships if the business of the employer and of such affiliated corporations, proprietors or partnerships is under common control through stock ownership, contract or otherwise.  The policy may provide that the term "employees" shall include the individual proprietor or partners if the employer is an individual proprietor or a partnership.  The policy may provide that the term "employees" shall include retired employees. No director of a corporate employer shall be eligible for insurance under the policy unless such person is otherwise eligible as a bona fide employee of the corporation by performing services other than the usual duties of a director. No individual proprietor or partner shall be eligible for insurance under the policy unless he is actively engaged in and devotes a substantial part of his time to the conduct of the business of the proprietor or partnership.  A policy issued to insure the employees of a public body may provide that the term "employees" shall include elected or appointed officials.

2. The premium for the policy shall be paid by the policyholder, either from the employer's funds or funds contributed by him, or from funds contributed by the insured employees, or from both.  A policy on which no part of the premium is to be derived from funds contributed by the insured employees shall insure all eligible employees, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

3. The policy must cover at least two employees at date of issue.

4. The amounts of insurance under the policy must be based upon some plan precluding individual selection either by the employees or by the employer or trustees.
A.R.S. § 20-1098.12 — Arizona Code / Title 20 / Chapter 4 / Article 14 / Section 1098.12
20-1098.12 Rating organization; exemption
Status: in_force

20-1098.12. Rating organization; exemption

A captive insurer is not required to join a rating organization.
A.R.S. § 20-486.06 — Arizona Code / Title 20 / Chapter 2 / Article 10 / Section 486.06
20-486.06 Books and records; reinsurance intermediary managers
Status: in_force

20-486.06. Books and records; reinsurance intermediary managers

A. For at least ten years after a contract of reinsurance transacted by the reinsurance intermediary manager expires, the reinsurance intermediary manager shall maintain a complete record for each transaction that shows:

1. The type of contract, limits, underwriting restrictions, classes or risks and territory.

2. The period of coverage, including effective and expiration dates, cancellation provisions, notice required of cancellation and disposition of outstanding reserves on covered risks.

3. The reporting and settlement requirements of balances.

4. The rate used to compute the reinsurance premium.

5. The names and addresses of reinsurers.

6. The rates of all reinsurance commissions, including the commissions on any retrocessions that are handled by the reinsurance intermediary manager.

7. Related correspondence and memoranda.

8. Proof of placement.

9. Details regarding retrocessions that are handled by the reinsurance intermediary manager pursuant to section 20-486.08, subsection D including the identity of persons who receive retrocessions and the percentage of each contract that is assumed or ceded.

10. The financial records, including premium and loss accounts.

11. If the reinsurance intermediary manager procures directly from any assuming reinsurer a reinsurance contract on behalf of a licensed ceding insurer, written evidence that the assuming reinsurer has agreed to assume the risk.

12. If the reinsurance intermediary broker procures through a representative of the assuming reinsurer, other than an employee, a reinsurance contract on behalf of a licensed ceding insurer, written evidence that the reinsurer has delegated binding authority to the representative.

B. The reinsurer shall have access to and the right to copy all accounts and records related to its business that are maintained by the reinsurance intermediary manager in a form usable by the reinsurer.
A.R.S. § 20-2329 — Arizona Code / Title 20 / Chapter 13 / Article 1 / Section 2329
20-2329 Prescription contraceptive drugs and devices; definition
Status: in_force

20-2329. Prescription contraceptive drugs and devices; definition

A. An accountable health plan that provides a health benefits plan that provides coverage for:

1. Prescription drugs shall also provide coverage for any prescribed drug or device that is approved by the United States food and drug administration for use as a contraceptive.  An accountable health plan may use a drug formulary, multitiered drug formulary or list but that formulary or list shall include oral, implant and injectable contraceptive drugs, intrauterine devices and prescription barrier methods if the accountable health plan does not impose deductibles, coinsurance, copayments or other cost containment measures for contraceptive drugs that are greater than the deductibles, coinsurance, copayments or other cost containment measures for other drugs on the same level of the formulary or list.

2. Outpatient health care services shall also provide coverage for outpatient contraceptive services.  For the purposes of this paragraph, "outpatient contraceptive services" means consultations, examinations, procedures and medical services provided on an outpatient basis and related to the use of United States food and drug prescription contraceptive methods to prevent unintended pregnancies.

B. Notwithstanding subsection A of this section, a religiously affiliated employer may require that the accountable health plan provide a health benefits plan without coverage for specific items or services required under subsection A of this section because providing or paying for coverage of the specific items or services is contrary to the religious beliefs of the religiously affiliated employer offering the plan. If a religiously affiliated employer objects to providing coverage for specific items or services required under subsection A of this section, a written affidavit shall be filed with the accountable health plan stating the objection.  On receipt of the affidavit, the accountable health plan shall issue to the religiously affiliated employer a health benefits plan that excludes coverage for specific items or services required under subsection A of this section.  The accountable health plan shall retain the affidavit for the duration of the health benefits plan and any renewals of the plan.

C. Subsection B of this section shall not exclude coverage for prescription contraceptive methods ordered by a health care provider with prescriptive authority for medical indications other than for contraceptive, abortifacient, abortion or sterilization purposes.  A religiously affiliated employer offering the plan may state religious beliefs in its affidavit and may require the enrollee to first pay for the prescription and then submit a claim to the accountable health plan along with evidence that the prescription is not for a purpose covered by the objection.  An accountable health plan may charge an administrative fee for handling claims under this subsection.

D. Subsections B and C of this section do not authorize a religiously affiliated employer to obtain an employee's protected health information or to violate the health insurance portability and accountability act of 1996 (P.L. 104-191; 110 Stat. 1936) or any federal regulations adopted pursuant to that act.

E. Subsections B and C of this section shall not be construed to restrict or limit any protections against employment discrimination that are prescribed in federal or state law.

F. For the purposes of this section, "religiously affiliated employer" means either:

1. An entity for which all of the following apply:

(a) The entity primarily employs persons who share the religious tenets of the entity.

(b) The entity serves primarily persons who share the religious tenets of the entity.

(c) The entity is a nonprofit organization as described in section 6033(a)(3)(A)(i) or (iii) of the internal revenue code of 1986, as amended.

2. An entity whose articles of incorporation clearly state that it is a religiously motivated organization and whose religious beliefs are central to the organization's operating principles.
A.R.S. § 20-1691 — Arizona Code / Title 20 / Chapter 6 / Article 15 / Section 1691
20-1691 Definitions
Status: in_force

20-1691. Definitions

In this article, unless the context otherwise requires:

1. "Applicant" means:

(a) In the case of an individual long-term care insurance policy, the person who seeks to contract for such benefits.

(b) In the case of a group long-term care insurance policy, the proposed certificate holder.

2. "Certificate" means a certificate issued under a group long-term care insurance policy, which has been delivered or issued for delivery in this state.

3. "Chronically ill individual" means any individual who has been certified by a licensed health care practitioner as meeting the definition of illness established by title III of the health insurance portability and accountability act of 1996 (P.L. 104-191; 110 Stat. 1936).

4. "Group" means any of the following:

(a) One or more employers or labor organizations, or a trust or the trustees of a fund established by one or more employers or labor organizations for employees or former employees or members or former members of the labor organization.

(b) A professional, trade or occupational association for its members or former or retired members if the association is composed of individuals who were all actively engaged in the same profession, trade or occupation and the association has been maintained in good faith for purposes other than obtaining insurance.

(c) An association or a trust or the trustees of a fund established, created or maintained for the benefit of members of one or more associations, subject to compliance with the requirements of section 20-1691.04, subsection A.

(d) A group other than that described in subdivision (a), (b) or (c) of this paragraph if a policy issued to the group satisfies the criteria under section 20-1691.04, subsection C.

5. "Group long-term care insurance" means a long-term care insurance policy that is delivered or issued for delivery in this state to a group.

6. "Licensed health care practitioner" means any physician licensed pursuant to title 32, chapter 13 or 17, any registered nurse or registered nurse practitioner licensed pursuant to title 32, chapter 15 or any other individual who meets the requirements prescribed by the United States secretary of the treasury.

7. "Long-term care insurance" means an individual or group insurance policy or rider issued by insurers, fraternal benefit societies, nonprofit health, hospital and medical service corporations, prepaid health plans, health care services organizations or any similar organization and advertised, marketed, offered or designed to provide coverage for each covered person on an expense-incurred, indemnity, prepaid or other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, personal or custodial care services provided in a setting other than an acute care unit of a hospital. Long-term care insurance includes group and individual annuities, life insurance policies or riders that provide or supplement long-term care insurance and qualified long-term care insurance contracts.  Long-term care insurance also includes a policy or rider that provides for payment of benefits based on cognitive impairment or loss of functional capacity. Long-term care insurance does not include any insurance policy that is offered primarily to provide basic medicare supplement coverage, basic hospital expense coverage, basic medical and surgical expense coverage, major medical expense coverage, disability income or related asset protection coverage, hospital confinement indemnity coverage, accident only coverage, specified disease coverage, specified accident coverage or limited benefit health coverage or riders to the insurance policy or a life insurance policy that accelerates the death benefit for terminal illness, medical conditions requiring extraordinary medical intervention or permanent institutional confinement, that provides the option of a lump sum payment for those benefits and in which the benefits or the eligibility for the benefits is not conditioned on the receipt of long-term care.

8. "Long-term care partnership program" means a qualified state long-term care insurance partnership as defined in section 1917(b) of the social security act (42 United States Code section 1396p).

9. "Maintenance or personal care services" means any care the primary purpose of which is to provide assistance needed with any disability that results in the individual being a chronically ill individual, including the protection from threats to health and safety due to severe cognitive impairment.

10. "Policy" means an individual or group policy, contract, subscriber agreement, rider or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, nonprofit health, hospital or medical service corporation, prepaid health plan or health care services organization or any similar organization.

11. "Preexisting condition" means a condition for which medical advice or treatment was recommended by or received from a health care services provider within six months before the effective date of coverage of an insured person.

12. "Qualified long-term care insurance contract" means:

(a) Any insurance policy that meets the requirements of section 7702B(b) of the internal revenue code of 1986, as amended.

(b) The portion of a life insurance policy that provides long-term care insurance coverage by rider or as a part of the policy and that satisfies the requirements of section 7702B(b) and (e) of the internal revenue code of 1986, as amended.

13. "Qualified long-term care services" means necessary diagnostic, preventive, therapeutic, curing, treating, mitigating and rehabilitative services and maintenance or personal care services to which the insured is eligible under a qualified long-term care insurance contract and that are provided pursuant to a plan of care prescribed by a licensed health care practitioner.

14. "Severe cognitive impairment" means an impairment determined by a licensed health care practitioner as meeting the definition of an impairment as established by title III of the health insurance portability and accountability act of 1996 (P.L. 104-191; 110 Stat. 1936).
A.R.S. § 20-465 — Arizona Code / Title 20 / Chapter 2 / Article 6 / Section 465
20-465 Fees; insurance producers; definition
Status: in_force

20-465. Fees; insurance producers; definition

A. An insurance producer shall not charge or receive any fee or service charge in addition to the premium in connection with the transaction of insurance, unless both of the following apply:

1. The fee or service charge and the specific services for which it is charged are disclosed and agreed to in writing by the insured.

2. The amount of the fee or service charge is reasonably related to the cost of the service rendered and does not duplicate or increase any fee or service charge included in the insurer's rate filing pursuant to this title.

B. If after an examination and a hearing the director determines that an insurance producer has failed to comply with this section, the director may order the insurance producer to refund all or part of the fee or service charge and may impose civil penalties as set forth in section 20-295. The insurance producer shall pay the costs of the examination from monies deposited with the director pursuant to section 20-159 regardless of the findings of the examination.

C. This section does not restrict or prohibit insurance producers from charging and collecting fees included in the insurer's rate filing pursuant to this title.

D. Notwithstanding subsection A of this section, an insurance producer shall not charge or receive any fee or service charge in connection with the transaction of medicare supplement insurance.

E. This section does not apply to insurance producers transacting commercial insurance.

F. This section does not apply to surplus lines brokers transacting surplus lines insurance as set forth in article 5 of this chapter.

G. For the purposes of this section, "commercial insurance" means insurance that insures against the risks arising from business and commercial activity other than insurance maintained by a transportation network company driver under a private passenger automobile insurance policy.
A.R.S. § 20-1612 — Arizona Code / Title 20 / Chapter 6 / Article 10 / Section 1612
20-1612 Authorization for issuance of policies
Status: in_force

20-1612. Authorization for issuance of policies

A. Each policy, certificate of insurance, application for insurance, endorsement and rider of consumer credit insurance delivered or issued for delivery in this state shall be by an insurer authorized by the director to transact insurance in this state.

B. In any transaction where a premium is collected from, or a payment made by, a debtor for consumer credit insurance, each policy, certificate of insurance, application for insurance, endorsement and rider shall be solicited by and placed through a holder of a license issued by the director in accordance with chapter 2, article 3 of this title. Nothing in this section requires a creditor to be licensed as an insurance producer solely because the creditor enrolls individuals in or administers a subsisting contract of group insurance.
A.R.S. § 20-879 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 879
20-879 Nonforfeiture benefits, cash surrender value, certificate loans and other options
Status: in_force

20-879. Nonforfeiture benefits, cash surrender value, certificate loans and other options

A. For certificates that are issued before January 1, 1996, the value of every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall comply with the applicable provisions of law that were in effect before January 1, 1995.

B. For certificates that are issued on or after January 1, 1996 and for which reserves are computed pursuant to the commissioner's 1941 standard ordinary mortality table, the commissioner's 1941 standard industrial table, the commissioner's 1958 standard ordinary mortality table, the commissioner's 1980 standard mortality table or any other more recent table that is applicable to life insurers, every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall not be less than the corresponding amount that is ascertained and based on those tables for life insurance policies containing like benefits.
A.R.S. § 20-822 — Arizona Code / Title 20 / Chapter 4 / Article 3 / Section 822
20-822 Definitions
Status: in_force

20-822. Definitions

In this article, unless the context otherwise requires, "hospital service corporations", "medical service corporations", "dental service corporations", "optometric service corporations" and "hospital, medical, dental and optometric service corporations" mean corporations organized under the laws of this state for the purpose of establishing, maintaining and operating nonprofit hospital service or medical or dental or optometric service plans,  or a combination of such plans, whereby hospital, medical or dental or optometric service may be provided by hospitals, which within the meaning of this article may include extended care facilities and home health agencies, or by physicians, which within the meaning of this article may include professional and technical personnel under the direction of a physician, or by podiatrists, or by dentists which may include those engaged in the general practice of dentistry as well as the specialized or restricted practice of dentistry, or by optometrists which may include those engaged in the general practice of optometry as well as the specialized or restricted practice of optometry, with which the corporations have contracted for such purpose, to such of the public as become subscribers to the corporations under contracts that entitle each subscriber to certain hospital, medical, dental or optometric service, or in the case of hospital service corporations or medical service corporations, all such services, or whereby as operating expense or refunds, payments may be made to subscribers with respect to any such service that is rendered by a hospital, physician, podiatrist, dentist or optometrist with which the corporations have not so contracted.
A.R.S. § 20-481.11 — Arizona Code / Title 20 / Chapter 2 / Article 8 / Section 481.11
20-481.11 Exemption for nonmaterial items
Status: in_force

20-481.11. Exemption for nonmaterial items

A. No information need be disclosed on the registration statement filed under section 20-481.10 if such information is not material.

B. Unless otherwise prescribed by the director, sales, purchases, exchanges, loans or extensions of credit, or investments, involving one-half of one percent or less of an insurer's admitted assets as of December 31 next preceding shall not be deemed material.  For the purposes of this subsection, what is considered material does not apply to the group capital calculation or to the liquidity stress test framework.
A.R.S. § 20-1085 — Arizona Code / Title 20 / Chapter 4 / Article 10 / Section 1085
20-1085 Capital
Status: in_force

20-1085. Capital

A. To qualify for initial authority to transact business a domestic life and disability reinsurer shall possess and thereafter maintain minimum required capital stock in the amount of $100,000.

B. To qualify for initial authority to transact business, an unaffiliated credit life and disability reinsurer shall possess and thereafter maintain unimpaired capital stock in the amount of $75,000. An unaffiliated credit life and disability reinsurer may comply with this subsection with a clean, irrevocable and unconditional letter of credit that contains an evergreen clause and that is payable to the director in trust for the protection of all ceding insurers, affected policyholders and related expenses and that is issued or confirmed by a qualified United States financial institution as defined in section 20-3601, subsection A. For the purposes of this subsection, an evergreen clause provides for automatic renewal.
A.R.S. § 20-101 — Arizona Code / Title 20 / Chapter 1 / Article 1 / Section 101
20-101 Department of insurance and financial institutions; definition
Status: in_force

20-101. Department of insurance and financial institutions; definition

A. The department of insurance and financial institutions is established and shall be administered by the director of the department of insurance and financial institutions.

B. The department shall be known as "DIFI".

C. In this title, unless the context otherwise requires, "commission" or "department" means the department of insurance and financial institutions.
A.R.S. § 20-662 — Arizona Code / Title 20 / Chapter 3 / Article 6 / Section 662
20-662 Arizona property and casualty insurance guaranty fund
Status: in_force

20-662. Arizona property and casualty insurance guaranty fund

A. The Arizona property and casualty insurance guaranty fund is established within the department. The fund shall be deposited in a depository designated by the director and shall exercise its powers through a board established pursuant to section 20-663.

B. For the purpose of assessment, the fund shall be divided into three separate accounts:

1. The automobile insurance account.

2. The workers' compensation insurance account.

3. The account for all other insurance to which this article applies.

C. All costs, expenses and liabilities of the fund shall be paid by the fund and shall not be a general obligation of this state.

D. All monies placed in the accounts of the fund may be expended only for the purposes of this article and only for the purposes of the account into which the monies were placed. Monies placed in one of the three separate accounts established by this section may not be used directly or indirectly for any other purpose, including to satisfy an obligation attributable to another account.
A.R.S. § 20-661 — Arizona Code / Title 20 / Chapter 3 / Article 6 / Section 661
20-661 Definitions
Status: in_force

20-661. Definitions

In this article, unless the context otherwise requires:

1. "Account" means any one of the three accounts within the Arizona property and casualty insurance guaranty fund.

2. "Board" means the guaranty fund board.

3. "Covered claim" means an unpaid claim, including one for unearned premium, which arises out of and is within the coverage of an insurance policy to which this article applies issued by an insurer, if such insurer becomes an insolvent insurer after August 27, 1977 and the claimant or insured is a resident of this state at the time of the insured event or the property from which the claim arises is permanently located in this state. Covered claim does not include any amount due any reinsurer, insurer, insurance pool or underwriting association as subrogation recoveries or otherwise nor shall it include any obligations of the insolvent insurer arising out of any reinsurance contracts nor shall it include  attorney fees or adjustment expenses incurred prior to the determination of insolvency.

4. "Fund" means the Arizona property and casualty insurance guaranty fund.

5. "Insolvent insurer" means an insurer that is licensed to transact insurance in this state either at the time the policy was issued or when the insured event occurred and against whom an order of liquidation with a finding of insolvency has been entered after September 19, 2007 by a court of competent jurisdiction in the insurer's state of domicile or by this state pursuant to section 20-623, and the order of liquidation has not been stayed or been the subject of a writ of supersedeas or other comparable order.  For purposes of the workers' compensation insurance account, insolvent insurer includes any insolvent insurer against which an order of liquidation with a finding of insolvency has been entered on, before or after the effective date of this section.

6. "Member insurer" means any person who writes any kind of insurance, unless such writing is restricted solely to life, title, surety, disability, credit, mortgage guaranty, ocean-marine or surplus lines insurance, including the exchange of reciprocal or inter-insurance contracts, and is licensed to transact insurance in this state.

7. "Net direct written premiums" means direct gross premiums written in this state on insurance policies to which this article applies, less return premiums and dividends paid or credited to policyholders on such direct business. Net direct written premiums do not include premiums on contracts between insurers or reinsurers.
A.R.S. § 20-2208 — Arizona Code / Title 20 / Chapter 12 / Article 1 / Section 2208
20-2208 Policies issued by the association; claims-made basis
Status: in_force

20-2208. Policies issued by the association; claims-made basis

Except as otherwise provided in this chapter, a liability insurance policy issued by the association shall be on a claims-made basis. The policy form shall be filed with and approved by the director.
A.R.S. § 20-2801 — Arizona Code / Title 20 / Chapter 17 / Article 1 / Section 2801
20-2801 Definitions
Status: in_force

20-2801. Definitions

In this chapter, unless the context otherwise requires:

1. "Coverage" means the contractual obligation of a health care services plan to pay its enrollee or a contracted or noncontracted provider for medically necessary emergency services rendered by the provider to an enrollee, as specified in the governing agreement, contract or policy between the plan and the enrollee, subject to applicable copayments, coinsurance and deductibles.

2. "Emergency ambulance services" means services that are provided by an ambulance service authorized to operate pursuant to title 36, chapter 21.1 following the onset of a medical condition that manifests itself by symptoms of pain, illness or injury that the absence of accessing an ambulance or emergency response by calling 911 or a designated telephone number to reach a public safety answering point and receiving time sensitive medical attention could reasonably be expected to result in any of the following:

(a) Placing the health of the individual or, with respect to a pregnant woman, the health of her unborn child, in serious jeopardy.

(b) Serious impairment to bodily functions.

(c) Serious dysfunction of any bodily organ or part.

3. "Emergency services" means health care services that are provided to an enrollee in a licensed hospital emergency facility by a provider after the recent onset of a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in any of the following:

(a) Serious jeopardy to the patient's health, including mental health.

(b) Serious impairment to a bodily function of the patient.

(c) Serious dysfunction of any bodily organ or part of the patient.

(d) Harm to the patient or others.

4. "Enrollee" means an individual, or a dependent of that individual, who is currently enrolled with and covered by a health care services plan.

5. "Health care services plan":

(a) Means a plan that is offered by a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation or medical service corporation that contractually agrees to pay or make reimbursement for health care expenses for one or more individuals residing in Arizona.

(b) Does not apply to benefits that are provided under limited benefit coverage as defined in section 20-1137.

6. "Prior authorization":

(a) Means authorization by telephone or fax that is given in advance of the performance of an emergency service on an enrollee by a health care services plan after receiving necessary medical and enrollment information on the enrollee.

(b) Is not a guarantee of full payment.

7. "Provider" means any physician, hospital or other person that is licensed or otherwise authorized to furnish emergency services in this state.
A.R.S. § 20-401.01 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 401.01
20-401.01 Unlawful transaction of insurance business; exemptions
Status: in_force

20-401.01. Unlawful transaction of insurance business; exemptions

A. It is unlawful for any insurer to transact insurance business, as provided by section 20-106, in this state without a certificate of authority from the director.

B. The provisions of subsection A of this section do not apply to:

1. The lawful transaction of surplus lines insurance.

2. The lawful transaction of reinsurance by insurers.

3. Transactions in this state involving a policy lawfully solicited, written and delivered outside of this state covering only subjects of insurance not resident, located or expressly to be performed in this state at the time of issuance, and which transactions are subsequent to the issuance of such policy.

4. Attorneys acting in the ordinary relation of attorney and client in the adjustment of claims or losses.

5. Transactions in this state involving group annuities where the master policy of such groups was lawfully issued and delivered in and pursuant to the laws of a state in which the insurer was authorized to do an insurance business, to a group organized for purposes other than the procurement of insurance, and where the policyholder is domiciled or otherwise has a bona fide situs.

6. Transactions in this state involving any policy of insurance or annuity contract issued prior to August 13, 1972.

7. Transactions in this state relative to a policy issued or to be issued outside this state involving insurance on vessels, craft or hulls, cargoes, marine builder's risk, marine protection and indemnity or other risk, including strikes and war risks commonly insured under ocean or wet marine forms of policy.

8. Transactions in this state involving contracts of insurance not readily obtainable from insurers authorized to transact insurance in this state issued to one or more industrial insureds, as defined in section 20-401.07.
A.R.S. § 20-482.07 — Arizona Code / Title 20 / Chapter 2 / Article 8.1 / Section 482.07
20-482.07 Foreign mutual insurer reorganization; definition
Status: in_force

20-482.07. Foreign mutual insurer reorganization; definition

A. A foreign mutual insurer organized under the laws of any other state, that, if a domestic corporation, would be organized under section 20-709, may reorganize by merging its policyholders' membership interests into an existing domestic mutual holding company in accordance with the requirements of any other law or regulation that applies to the foreign mutual insurer. The reorganization shall continue the corporate existence of the converting mutual insurer as a foreign stock insurance company subsidiary of the existing domestic mutual holding company or as a foreign stock insurance company subsidiary of an intermediate stock holding company. The reorganizing foreign mutual insurer may remain a foreign insurer after the restructuring and may be admitted to do business in this state if it meets the applicable requirements of this title. A foreign mutual insurer that is a party to the reorganization may at the same time redomesticate to this state by complying with the applicable requirements of this state and the foreign mutual insurer's state of domicile.

B. For the purposes of this section, "existing domestic mutual holding company" means a mutual holding company formed under this article.
A.R.S. § 20-1251.01 — Arizona Code / Title 20 / Chapter 6 / Article 2 / Section 1251.01
20-1251.01 Credit union groups
Status: in_force

20-1251.01. Credit union groups

The lives of a group of individuals may be insured under a policy issued to a credit union organized under the laws of this state or the federal credit union act, which shall be considered the policyholder, to insure eligible members for amounts of insurance related to the share balance of each member, based upon some plan which will preclude individual selection, for the benefit of someone other than the credit union or its officials and subject to the following requirements:

1. The members eligible for insurance under the policy shall be all the members of the credit union who meet standard physical requirement conditions of the insurer, or all of any class or classes of them determined by conditions pertaining to their age or to membership in the credit union or both.

2. The premiums for the policy shall be paid by the policyholder, either from the credit union's funds, or from funds contributed by the insured members specifically for their insurance, or from both. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members or all except those whose evidence of individual insurability is not satisfactory to the insurer.

3. The policy must cover at least twenty-five members at the date of issue.
A.R.S. § 20-864 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 864
20-864 Purposes and powers
Status: in_force

20-864. Purposes and powers

A. A society shall operate for the benefit of its members and their beneficiaries and shall:

1. Provide benefits pursuant to section 20-875.

2. Operate for social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic or religious purposes. This benefit may also be extended to other persons.

B. The society may carry out its purposes directly or indirectly through subsidiary corporations or affiliated organizations.  A subsidiary corporation or affiliated organization shall not transact insurance business or engage in any other activity regulated under this title unless the subsidiary corporation or affiliated organization complies with all of the applicable provisions of law. A society or a subsidiary corporation or affiliated organization through which a society carries out its purposes shall not own or operate a funeral home or undertaking establishment.

C. A society may adopt laws and rules for the government of the society, admission of members and management of society affairs. The society may amend any law or rule and shall have any other powers that are necessary and incidental to carry out the purposes of the society.
A.R.S. § 20-1311 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1311
20-1311 Authority to alter contract
Status: in_force

20-1311. Authority to alter contract

There shall be a provision that no insurance producer shall have the power or authority to waive, change or alter any of the terms or conditions of any policy, except that at the option of the insurer the terms or conditions may be changed by an endorsement signed by a duly authorized officer of the insurer.
A.R.S. § 20-368 — Arizona Code / Title 20 / Chapter 2 / Article 4 / Section 368
20-368 Advisory organizations
Status: in_force

20-368. Advisory organizations

A. Every group, association or other organization of insurers, whether located within or outside this state, which assists insurers which make their own filings or rating organizations in rate making, by the collection and furnishing of loss or expense statistics, or by the submission of recommendations, but which does not make filings under this article, shall be known as an advisory organization.

B. Every advisory organization shall file with the director:

1. A copy of its constitution, its articles of agreement or association or its certificate of incorporation and a copy of its bylaws, rules and regulations governing its activities.

2. A list of its members.

3. The name and address of a resident of this state upon whom notices or orders of the director or process affecting the advisory organization may be served.

4. An agreement that the director may examine the advisory organization in accordance with the provisions of section 20-370.

C. If, after a hearing, the director finds that the furnishing of such information or assistance involves any act or practice which is unfair or unreasonable or otherwise inconsistent with the provisions of this article, he may issue a written order specifying in what respects such act or practice is unfair or unreasonable or otherwise inconsistent, and requiring the discontinuance of such act or practice.

D. No insurer which makes its own filings nor any rating organization shall support its filings by statistics or adopt rate making recommendations furnished to it by an advisory organization which has not complied with this section or with an order of the director involving such statistics or recommendations issued under subsection C of this section. If the director finds the insurer or rating organization to be in violation of this subsection, he may issue an order requiring the discontinuance of the violation.
A.R.S. § 20-379 — Arizona Code / Title 20 / Chapter 2 / Article 4 / Section 379
20-379 Deviations in title insurance rates
Status: in_force

20-379. Deviations in title insurance rates

A. No title insurer or title insurance agent may deviate from its rates that are in effect for the title insurer or title insurance agent pursuant to section 20-376.

B. If the director finds that a title insurer or title insurance agent has charged rates that deviate from its rates filed pursuant to section 20-376, the title insurer or title insurance agent who computed and initially collected the deviation is subject to a civil penalty for each deviation that is equal to the difference between the rate charged and the allowable rate pursuant to section 20-376. To the extent that the deviation results in an overcharge, the director in lieu of a civil penalty may require a refund of the overcharge.

C. If after a hearing the director finds that a title insurer or title insurance agent with such frequency as to indicate a general business practice violated the provisions of this section and section 20-376 with respect to a particular provision of the applicable title insurance rate, the director, in addition to the civil penalty imposed under subsection B of this section, may:

1. For each violation, impose an additional civil penalty of not more than two times the civil penalty imposed under subsection B of this section.

2. Order the title insurance agent to cease and desist from the act or practice.

3. Revoke the title insurance agent's license or suspend the title insurer's certificate of authority.

D. The civil penalties that are imposed under subsections B and C of this section may not in the aggregate exceed fifteen thousand dollars during any one year period for an individual title insurer or title insurance agent licensed pursuant to this title.
A.R.S. § 20-1215 — Arizona Code / Title 20 / Chapter 6 / Article 1 / Section 1215
20-1215 Payment of claims
Status: in_force

20-1215. Payment of claims

There shall be a provision that when a policy becomes a claim by the death of the insured settlement shall be made upon receipt of due proof of death and, at the insurer's option, surrender of the policy, proof of the interest of the claimant, or both. If an insurer specifies a particular period prior to the expiration of which settlement shall be made, the period shall not exceed two months from the receipt of such proofs.
A.R.S. § 20-393 — Arizona Code / Title 20 / Chapter 2 / Article 4.1 / Section 393
20-393 Recording and reporting of experience
Status: in_force

20-393. Recording and reporting of experience

The director shall promulgate reasonable rules, including rules providing statistical plans, for use by all insurers in the recording and reporting of loss and expense experience, in order that the experience of such insurers may be made available to the director. No insurer may be required to record or report its experience on a classification basis inconsistent with its own rating system. An insurer may report its experience to any rate service organization or advisory organization with which it affiliates.
A.R.S. § 20-254.01 — Arizona Code / Title 20 / Chapter 2 / Article 2 / Section 254.01
20-254.01 "Annuities" defined
Status: in_force

20-254.01. "Annuities" defined

"Annuities" encompass all agreements to make periodic payments, other than contracts defined by section 20-254 as "life insurance", where the making or continuance of all or of some of a series of such payments, or the amount of any such payment, is dependent upon the continuance of human life. Except as exemption or other provision is made, all provisions in this title applicable to life insurance shall be deemed applicable also to annuities.
A.R.S. § 20-407 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 407
20-407 Surplus lines; brokers
Status: in_force

20-407. Surplus lines; brokers

A. Any portion or all of an insurance coverage designated in this article as "surplus lines" may be procured from unauthorized insurers subject to the following conditions:

1. The insurance is procured through a surplus lines broker licensed in this state, referred to in this article as the "broker".

2. The insurance coverage is a recognized surplus line pursuant to section 20-409 or the insurance coverage is not procurable, after diligent effort has been made to procure coverage or the coverage has been procured to the full extent the insurers are willing to insure, and the placing of insurance with an unauthorized insurer is not for the purpose of securing advantages either as to premium rate or terms of the insurance contract.

B. Subsection A, paragraph 2 of this section does not apply to the sale of insurance coverage to an industrial insured as defined in section 20-401.07.  At the inception of each new policy and at the time of each renewal, but not less than annually during the term of the policy, each industrial insured that purchases a policy as provided in this section shall certify to the broker on a form prescribed by the director that the insured meets the definition of industrial insured prescribed in section 20-401.07. The broker shall maintain the certification in the broker's files.  The insurance is surplus lines insurance and is subject to the applicable provisions of this article that relate to surplus lines insurance.

C. This section does not prohibit a resident or nonresident insurance producer licensed in this state for property or casualty insurance from obtaining surplus lines insurance for policyholders through a surplus lines broker if the insurance producer uses a surplus lines broker licensed in this state for the transaction of the insurance with the surplus lines insurer.  The surplus lines broker is responsible for compliance with the applicable provisions of this article.  The insurance producer may pay a fee or share a commission with a surplus lines broker who procures the surplus coverage on behalf of the insurance producer.  For the purposes of this subsection, "transaction" means the acts listed in section 20-106, subsection A.

D. For the transaction of surplus lines insurance, a surplus lines broker licensed in this state shall not receive a fee, commission, brokerage or other valuable consideration from any person who is not licensed in this state as any of the following:

1. An insurance producer pursuant to article 3 of this chapter.

2. A managing general agent pursuant to article 3.1 of this chapter.

3. A surplus lines broker pursuant to section 20-411, 20-411.01 or 20-411.02.
A.R.S. § 20-885 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 885
20-885 Reports
Status: in_force

20-885. Reports

Each fraternal benefit society shall file reports as follows:

1. Unless the director extends the time for filing for good cause shown, on or before March 1, each society transacting business in this state shall annually file with the director a true statement of its financial condition, transactions and affairs for the preceding calendar year and shall pay the fee prescribed by section 20-167 for filing the statement.  The statement shall be in the general form and context that is approved by the national association of insurance commissioners for fraternal benefit societies, supplemented by any additional information that the director requires.

2. At the time of filing its annual statement pursuant to paragraph 1 of this section, each society shall also file with the director a valuation of its certificates in force as of the preceding December 31.  On a showing of good cause, the director may extend the time for filing the valuation for a period of not more than two calendar months. The valuation shall be conducted pursuant to section 20-884. A qualified actuary shall certify the valuation and underlying data or, at the expense of the society, an actuary of the insurance department in the domiciliary state of the society shall verify the valuation and underlying data.
A.R.S. § 20-2503 — Arizona Code / Title 20 / Chapter 15 / Article 1 / Section 2503
20-2503 Utilization review standards; applicability; definition
Status: in_force

20-2503. Utilization review standards; applicability; definition

A. The utilization review standards established in this chapter apply to prospective, concurrent and retrospective utilization review for:

1. Inpatient admissions to hospitals and other inpatient facilities.

2. Outpatient admissions to surgical facilities.

3. Outpatient surgical services provided in a health care provider's office.

4. Medical, surgical and health care services that may be covered by a health care insurer depending on determinable contingencies, including without limitation outpatient services, in-office consultations with medical specialists, specialized diagnostic testing, mental health services, emergency care and inpatient and outpatient hospital services.

B. For purposes of this section "inpatient admissions" includes inpatient admissions to all acute medical, surgical, obstetrical, psychiatric and chemical dependency inpatient services at a licensed hospital or other inpatient facility.
A.R.S. § 20-884 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 884
20-884 Valuation
Status: in_force

20-884. Valuation

A. The standards of valuation for certificates that are issued before January 1, 1996 are the standards of valuation that were in effect immediately before January 1, 1995.

B. The minimum standards of valuation for certificates that are issued on or after January 1, 1996 shall be based on the following tables:

1. For certificates of life insurance: the commissioner's 1941 standard ordinary mortality table, the commissioner's 1941 standard industrial mortality table, the commissioner's 1958 standard ordinary mortality table, the commissioner's 1980 standard ordinary mortality table or a more recent table that applies to life insurers.

2. For annuity and pure endowment certificates, total and permanent disability benefits, accidental death benefits and noncancellable accident and health benefits: the tables that are authorized for use by like insurers in this state.

C. The tables listed under subsection B of this section shall be under the valuation methods and standards, including interest assumptions, that are in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits.

D. The director may accept other standards for valuation if the director finds that the reserves produced by those standards will not be less in the aggregate than the reserves computed in accordance with the minimum valuation standards prescribed by this section. The director may vary the standards of mortality that apply to all benefit contracts on substandard lives or other extra hazardous lives issued by a society authorized to do business in this state.

E. With the consent of the insurance director in the domiciliary state of the society and under any conditions that the director of the department of insurance and financial institutions in this state may impose, a society may establish and maintain reserves on its certificates in excess of the reserves required by the standards of valuation, except that the contractual rights of a benefit member are not affected by the excess reserves.
A.R.S. § 20-1560 — Arizona Code / Title 20 / Chapter 6 / Article 8.1 / Section 1560
20-1560 Examinations; rules
Status: in_force

20-1560. Examinations; rules

A. The director may use independent contractor examiners pursuant to sections 20-148 and 20-159 to conduct examinations to review compliance with this article. All examination and examination related expenses shall be borne by the mortgage guaranty insurer and shall be paid by the insurance examiners' revolving fund pursuant to section 20-159.

B. The director may adopt rules to carry out this article.
A.R.S. § 20-1016 — Arizona Code / Title 20 / Chapter 4 / Article 7 / Section 1016
20-1016 Rehabilitation, liquidation or conservation of prepaid dental plan organization
Status: in_force

20-1016. Rehabilitation, liquidation or conservation of prepaid dental plan organization

Any rehabilitation, liquidation or conservation of a prepaid dental plan organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurer and shall be conducted pursuant to chapter 3, article 4 of this title.
A.R.S. § 20-2531 — Arizona Code / Title 20 / Chapter 15 / Article 2 / Section 2531
20-2531 Applicability; requirements; exception
Status: in_force

20-2531. Applicability; requirements; exception

A. Notwithstanding article 1 of this chapter and subject to subsection B of this section, this article applies to all utilization review decisions made by utilization review agents and health care insurers operating in this state.

B. Each utilization review agent and each health care insurer operating in this state whose utilization review system includes the power to affect the direct or indirect denial of requested medical or health care services or claims for medical or health care services shall adopt written utilization review standards and criteria and processes for the review, reconsideration and appeal of denials that do all of the following:

1. Meet the requirements of this article.

2. Are consistent with chapter 1 of this title.

3. Comply with section 20-2505, paragraphs 2 through 6.

C. This article does not apply to utilization review:

1. Performed under contract with the federal government for utilization review of patients eligible for all services under title XVIII of the social security act.

2. Performed by a self-insured or self-funded employee benefit plan or a multiemployer employee benefit plan created in accordance with and pursuant to 29 United States Code section 186(c) if the regulation of that plan is preempted by section 514(b) of the employee retirement income security act of 1974 (29 United States Code section 1144(b)), but this article does apply to a health care insurer that provides coverage for services as part of an employee benefit plan.

3. Of work related injuries and illnesses covered under the workers' compensation laws in title 23.

4. Performed under the terms of a policy that pays benefits based on the health status of the insured and does not reimburse the cost of or provide covered services.

5. Performed under the terms of a long-term care insurance policy as defined in section 20-1691.

6. Performed under the terms of a medicare supplement policy as defined by the department.

D. This article does not create any new private right or cause of action for or on behalf of any member. This article provides only an administrative process for a member to pursue an external independent review of a denial for a covered service or claim for a covered service.

E. Utilization review activities involving retrospective claims review are limited to the provisions of this article only as clearly and specifically provided in the provisions of this article.

F. The processes available under this article do not apply to a denial of a nonformulary exception request that was appealed pursuant to 45 Code of Federal Regulations section 156.122(c). A provider or enrollee may appeal a denial of a nonformulary exception for a plan covered by 45 Code of Federal Regulations section 156.122(c) through the process prescribed in the federal rule.
A.R.S. § 20-481.04 — Arizona Code / Title 20 / Chapter 2 / Article 8 / Section 481.04
20-481.04 Statement filed by partnership, corporation or other group
Status: in_force

20-481.04. Statement filed by partnership, corporation or other group

A. If the person required to file the statement referred to in section 20-481.02 is a partnership, limited partnership, syndicate or other group, the director may require that the information required pursuant to section 20-481.03 shall be given with respect to each partner of such partnership or limited partnership, each member of such syndicate or group and each person who controls such partner or member.

B. If any such partner, member or person is a corporation or the person required to file the statement referred to in section 20-481.02 is a corporation, the director may require that the information required pursuant to section 20-481.03 shall be given with respect to such corporation, each officer and director of such corporation and each person who is directly or indirectly the beneficial owner of more than ten per cent of the outstanding voting securities of such corporation.
A.R.S. § 20-1312 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1312
20-1312 Beneficiary; change of beneficiary; payment
Status: in_force

20-1312. Beneficiary; change of beneficiary; payment

A. Each policy shall have a space on the front or back page of the policy for the name of the beneficiary designated with a reservation of the right to designate or change the beneficiary after the issuance of the policy.

B. The policy may also provide that no designation or change of beneficiary shall be binding on the insurer unless endorsed on the policy by the insurer, and that the insurer may refuse to endorse the name of any proposed beneficiary who does not appear to the insurer to have an insurable interest in the life of the insured. Such a policy may also provide that if the beneficiary designated in the policy does not surrender the policy with due proof of death within the period stated in the policy, which shall be not less than thirty days after the death of the insured, or if the beneficiary is the estate of the insured or is a minor, or dies before the insured, or is not legally competent to give a valid release, then the insurer may make payment thereunder to the executor or administrator of the insured, or to any of the insured's relatives by blood or legal adoption or connection by marriage, or to any person appearing to the insurer to be equitably entitled thereto by reason of having been named beneficiary, or by reason of having incurred expense for the maintenance, medical attention or burial of the insured. The policy may also include a similar provision applicable to any other payment due under the policy.
A.R.S. § 20-1577 — Arizona Code / Title 20 / Chapter 6 / Article 9 / Section 1577
20-1577 Corporate acquisitions other than by merger or consolidation
Status: in_force

20-1577. Corporate acquisitions other than by merger or consolidation

A. A title insurer incorporated under the laws of this state may issue stock in exchange for all or any part of the assets or stock of a domestic or foreign title insurer, abstract company or title insurance agent if, in advance thereof, a plan or agreement of acquisition shall have been filed with the director. The director shall examine the terms and conditions of such plan or agreement of acquisition, and of any exchange of shares or securities pursuant thereto, after holding a hearing at which all persons or parties to whom it is proposed to issue shares or securities in such exchange shall have the right to appear. After such hearing, the director shall either approve or disapprove the fairness of such terms and conditions of such acquisition and exchange. The director shall give such approval within a reasonable time after filing of a plan or agreement unless he finds such plan or agreement either:

1. Is contrary to law.

2. Is inequitable to the stockholders of any title insurer or abstract company involved.

3. Would substantially reduce the security of and services to be rendered to policyholders of the domestic title insurer in this state or elsewhere.

B. No director, officer, agent or employee of any title insurer or abstract company party to such acquisition shall receive any fee, commission, compensation or other valuable consideration whatsoever for in any manner aiding, promoting or assisting therein except as set forth in such plan or agreement.

C. If the director does not approve any such plan or agreement, he shall notify the title insurer in writing specifying in detail his reasons therefor.

D. If the assets or stock to be acquired are held by a domestic corporation, such corporation shall comply with, and its stockholders shall have the rights set forth in title 10, chapter 13.
A.R.S. § 20-676 — Arizona Code / Title 20 / Chapter 3 / Article 6 / Section 676
20-676 Stay of proceedings
Status: in_force

20-676. Stay of proceedings

A. All proceedings in which the insolvent insurer or the insolvent insurer's insured is a party in any court of this state shall be stayed for six months from the date the insolvency is determined or an ancillary proceeding is instituted in this state, whichever is later, to permit proper defense by the fund of all pending causes of action as to any covered claim. At the request of any party and on a showing of good cause, the court may shorten or lengthen the stay prescribed in this section. This subsection does not apply to proceedings in which the insolvent insurer is a party to a proceeding before the industrial commission regarding an employee's entitlement to benefits under title 23, chapter 6, except that, on a showing of good cause, the industrial commission shall grant up to a ninety-day continuance of any scheduled hearing to allow the fund to assume the defense and investigate the claim.

B. On application of the fund, either on the fund's own behalf or on the insured's behalf, the court may set aside any judgment, order, decision, verdict, finding or award arising from the default of the insolvent insurer or the insurer's failure to defend the insured and the fund shall be allowed to defend the claim on the merits.

C. Notwithstanding any other provision of this chapter, a federal home loan bank may not be stayed, enjoined or prohibited from exercising or enforcing any right or cause of action against collateral pledged by an insurer member under any federal home loan bank security agreement or any pledge, security, collateral or guarantee agreement or other similar arrangement or credit enhancement relating to a security agreement to which that federal home loan bank is a party.
A.R.S. § 20-1534 — Arizona Code / Title 20 / Chapter 6 / Article 8 / Section 1534
20-1534 Guaranteed arrest bond certificate; cash bail or other bond; forfeiture
Status: in_force

20-1534. Guaranteed arrest bond certificate; cash bail or other bond; forfeiture

A. A guaranteed arrest bond certificate that conforms to section 20-1533 shall:

1. Be accepted as a bail bond in lieu of cash bail or any other bond if posted by the person whose signature appears on the certificate.

2. Be accepted to guarantee the appearance of the person whose signature appears on the certificate in any court in this state, including all municipal courts, at the time the court requires if the person is arrested or required to post a bond for a violation of a motor vehicle law of this state or a motor vehicle ordinance of a city or town.

3. Not be accepted as bail bonds for:

(a) The offense of driving under the influence of intoxicating liquor or of drugs.

(b) Any felony.

B. A guaranteed arrest bond certificate posted as bail bond in any court in this state shall be treated like a bail bond in any criminal case and:

1. Is subject to the same forfeiture and enforcement provisions that govern bail bonds in criminal cases.

2. If in any municipal court of this state, is subject to the forfeiture and enforcement provisions of the charter or ordinance of the particular city or town pertaining to bail bonds posted.
A.R.S. § 20-2211 — Arizona Code / Title 20 / Chapter 12 / Article 1 / Section 2211
20-2211 Rates; actuary
Status: in_force

20-2211. Rates; actuary

A. The rates, rating plans, rating rules, rating classifications and territories applicable to insurance written by the association, and the statistics relating thereto, are subject to the provisions of chapter 2, article 4.1 of this title, giving consideration to the past and prospective loss and expense experience for the designated class or classes of liability insurance, trends in the frequency and severity of losses, the investment income of the association and other relevant information. The premium rates for an occurrence policy and a claims-made policy for each year the association issues policies shall be established by the association. In determining whether the association's rates are not inadequate, excessive or unfairly discriminatory, the director shall consider recommendations made by the actuary. All rates shall be on an actuarially sound basis, giving consideration to the group retrospective rating plan, and shall be calculated to be self-supporting, except that the total initial expenses necessary to establish, commence and manage operations may be amortized over a period of at least five years. Such rates shall be deemed not inadequate if they are so constituted that the expenses and loss costs of the plan of operation are equal to or exceeded by the premium. Competition or lack of competition shall not be considered as a rating standard under this section.

B. All policies issued by the association are subject to a group retrospective rating plan under which the final premium for all policyholders of the association, as a group, shall be equal to administrative, servicing and contingency expenses, modified as applicable in accordance with subsection A, loss and loss adjustment expenses, and taxes. Policyholders shall be given full credit for all investment income, net of expenses and a reasonable management fee on policyholder supplied monies. The maximum final premium for all policyholders of the association, as a group, is limited as provided in this chapter.

C. The director shall examine the association as often as he deems appropriate to ensure that the group retrospective rating plan is being operated in a manner consistent with this section. If he finds that it is not being so operated, he shall issue an order to the association, specifying in what respect its operation is deficient and stating what corrective action shall be taken.
A.R.S. § 20-1316 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1316
20-1316 Title of policy
Status: in_force

20-1316. Title of policy

There shall be a title on the face of each such policy briefly describing its form.
A.R.S. § 20-183 — Arizona Code / Title 20 / Chapter 1 / Article 3 / Section 183
20-183 Report procedures and deadlines
Status: in_force

20-183. Report procedures and deadlines

A person or a legislator advocating a legislative proposal pursuant to section 20-181 shall submit a written report explaining the factors prescribed in section 20-182 to the joint legislative audit committee established by section 41-1279.  The report must be submitted on or before September 1 before the start of the legislative session for which the legislation is proposed. The joint legislative audit committee shall assign the written report to the appropriate legislative committee of reference established pursuant to section 41-2954. The legislative committee of reference shall hold at least one hearing and take public testimony after receiving the report. The legislative committee of reference shall study the written report and deliver a report of its recommendations to the joint legislative audit committee, the speaker of the house of representatives, the president of the senate, the governor and the director of the department of insurance and financial institutions on or before December 1 of the year in which the report is submitted.
A.R.S. § 20-3333 — Arizona Code / Title 20 / Chapter 25 / Article 2 / Section 3333
20-3333 Certificates of authority; issuance; revocation; renewal; civil penalties; rules
Status: in_force

20-3333. Certificates of authority; issuance; revocation; renewal; civil penalties; rules

A. A pharmacy benefit manager shall apply for, obtain and maintain a valid certificate of authority to operate as a pharmacy benefit manager in this state.  A certificate of authority is renewable biennially and is nontransferable.

B. A pharmacy benefit manager that applies for a certificate of authority shall submit to the director both of the following:

1. An application in a form and manner prescribed by the director. An officer or individual who is responsible for the conduct of the activities of the pharmacy benefit manager shall sign the application and verify that the contents of the application and any attachments are correct.  The application form shall include the following:

(a) The name, address and telephone number of the pharmacy benefit manager.

(b) A copy of all basic organizational documents of the pharmacy benefit manager, including the articles of incorporation, bylaws, articles of association and trade name certificate, any other similar documents and all amendments to the documents.

(c) The name and address of the pharmacy benefit manager's agent in this state for service of process.

(d) The names, addresses, official positions and professional qualifications of each individual who is responsible for the conduct of the activities of the pharmacy benefit manager.

(e) The name, address, telephone number, email address and official position of the employee who will serve as the primary contact for the department.

(f) A signed certificate of good standing.

(g) A description of the pharmacy benefit manager and its services, facilities and personnel.

(h) A document in which the pharmacy benefit manager confirms that its business practices and each ongoing Arizona contract comply with this article and all laws of this state.

2. An application fee prescribed by the director.

C. Within ninety days after receipt of a completed application and application fee, the director shall review the application and issue a certificate of authority if the applicant is deemed qualified under this section.  If the director determines that the applicant is not qualified, the director shall notify the applicant, shall specify the reason for the denial and shall allow the applicant sixty days to remedy the stated reasons for the denial.

D. Within thirty days after any material modification of the information submitted with the application for a certificate of authority, the pharmacy benefit manager shall file a notice of modification with the director.

E. The director may refuse to issue a certificate of authority if the director determines that the pharmacy benefit manager had a pharmacy benefit manager certificate of authority or license revoked for cause in another state.

F. The director may issue a cease and desist order if the pharmacy benefit manager does not hold a valid certificate of authority. The director may deny, suspend or revoke a pharmacy benefit manager's certificate of authority if the director finds, after notice and opportunity for hearing, that any of the following applies:

1. The pharmacy benefit manager violated any rule or order of the director or any law of this state applicable to a pharmacy benefit manager.

2. The pharmacy benefit manager refused to be examined or to produce its accounts, records and files for examination or that any individual responsible for the conduct of the activities in this state of the pharmacy benefit manager refused to provide information with respect to its activities or refused to perform any other legal obligation required by the director.

3. The pharmacy benefit manager is required under this section to have a certificate of authority and fails at any time to meet any qualification for which issuance of a certificate of authority could have been refused had the failure existed at the time of issuance and been known to the director, unless the director issued a certificate of authority with knowledge of the ground for disqualification and had the authority to waive it.

4. Any individual who is responsible for the management of the pharmacy benefit manager is convicted of or enters a plea of guilty or no contest to a felony related to the individual's activities on behalf of the pharmacy benefit manager.

5. The pharmacy benefit manager's certificate of authority or license has been revoked in another state.

G. If a pharmacy benefit manager's certificate of authority is suspended or restricted, the director may allow the operation of the pharmacy benefit manager for a limited time not to exceed one hundred twenty days.  The director may allow a pharmacy benefit manager whose certificate of authority has been suspended or restricted to operate for a period that exceeds one hundred twenty days if the director determines that the continued operation of the pharmacy benefit manager is in the beneficial interests of the covered persons by ensuring minimal disruptions to the continuity of care.  A pharmacy benefit manager whose certificate of authority has been suspended or restricted is subject to the following civil penalties each month, as determined by the director, until the pharmacy benefit manager remedies the violation:

1. For an unintentional violation, not more than $1,000 for each violation and not more than an aggregate of $10,000 in any six month period.

2. For an intentional violation, not more than $5,000 for each violation and not more than an aggregate of $50,000 in any six month period.

H. The director may revoke the certificate of authority if the pharmacy benefit manager has been operating under a suspended certificate of authority for a period of more than one hundred twenty days.

I. For the purposes of this section, a pharmacy benefit manager has the same rights to notice and a hearing prescribed in title 41, chapter 6, article 10.

J. The director may investigate officers, directors and owners of a pharmacy benefit manager to comply with this section.

K. To renew a certificate of authority, a pharmacy benefit manager shall submit to the director all of the following:

1. A renewal application in a form and manner prescribed by the director. An officer or authorized representative of the pharmacy benefit manager shall sign the application and verify that the contents of the renewal form are correct.

2. A renewal schedule and a fee prescribed by the director.

L. A pharmacy benefit manager's certificate of authority expires by operation of law if a complete renewal application and fee is not received by the due date as established in rule.

M. If a pharmacy benefit manager and an insurer enter into a contractual agreement, the pharmacy benefit manager shall comply with the laws and rules that govern the contractual agreement as of the date of issuance of the certificate of authority.

N. A pharmacy benefit manager shall comply with the records retention schedules as prescribed in rule and section 20-3334.

O. A pharmacy benefit manager shall comply with the duties and appeals processes of a utilization review agent as prescribed by rule and chapter 15 of this title.

P. The director may examine or review the relevant books and records of a pharmacy benefit manager to determine if the pharmacy benefit manager is in compliance with this article. All of the following apply to the information or data that is obtained during an examination or review:

1. The information is considered and treated as proprietary and confidential.

2. The information is not a public record and is exempt from title 39, chapter 1.

3. The information is to be used only for the purpose of ensuring a pharmacy benefit manager's compliance with this article.

Q. The director may adopt rules to implement this section.

R. This section shall apply only to a pharmacy benefit manager performing services for a health plan subject to the jurisdiction of this state.

S. This section does not apply to a workers' compensation insurer performing services under title 23.
A.R.S. § 20-3202 — Arizona Code / Title 20 / Chapter 22 / Article 1 / Section 3202
20-3202 Licensure; requirements
Status: in_force

20-3202. Licensure; requirements

A. Except as otherwise provided in this section, a person shall not act as a provider or broker with any owner who is a resident of this state unless the person obtains a certificate of authority or license pursuant to this section.

B. An applicant for a provider certificate of authority shall submit an application to the director on a form prescribed by the director. The application shall be accompanied by a fee in an amount established by the director.

C. The applicant for a provider certificate of authority shall provide all of the information required by the director. The director, at any time, may require an applicant to fully disclose the identity of its partners, officers, employees and stockholders except for stockholders owning less than ten percent of the shares of an applicant whose shares are publicly traded. The director, at the director's sole discretion, may refuse to issue a certificate of authority in the name of any person if the director is not satisfied that any officer, employee, stockholder or partner who may materially influence the applicant's conduct meets the requirements of this chapter.

D. A provider certificate of authority issued to a partnership, corporation or other entity authorizes all members, officers and designated employees to act as a provider under the certificate of authority if those persons are named in the application and any supplements to the application.

E. The director shall require that:

1. A provider submit a detailed plan of operation.

2. If the applicant for a provider certificate of authority is a legal entity, it be formed or organized pursuant to the laws of this state or, if it is a foreign legal entity, it be authorized to transact business in this state or provide a certificate of good standing from the state of its domicile.

3. The applicant for a provider certificate of authority provide an antifraud plan that meets the requirements of section 20-3211 and that includes a description of:

(a) The procedures for detecting and investigating possible fraudulent acts and for resolving material inconsistencies between medical records and insurance applications.

(b) The procedures for reporting fraudulent insurance acts to the director.

(c) The plan for antifraud education and training of its underwriters and other personnel.

(d) A written description or organizational chart of the antifraud personnel who are responsible for the investigation and reporting of possible fraudulent insurance acts and the investigation of unresolved material inconsistencies between medical records and insurance applications.

F. A producer that is licensed in this state with a life line of authority shall:

1. Be deemed to meet the licensing requirements of this section and be permitted to operate as a broker.

2. Within the first thirty days of operating as a broker, notify the director, on a form prescribed by the director, that the producer is acting as a broker. Notification shall include an acknowledgement by the life insurance producer that the producer will operate as a broker pursuant to this chapter.

3. Pay any applicable fee as determined by the director.

G. A broker may renew a license by paying the renewal fee in an amount established by the director. The expiration date of the broker authority shall coincide with the expiration date of the life line of authority as set forth in section 20-289.

H. The director may not issue a license to any nonresident applicant unless a written designation of an agent in this state for service of process is filed and maintained with the director or unless the applicant has filed with the director the applicant's written irrevocable consent that any action against the applicant may be commenced against the applicant by service of process on the director.

I. A provider may not use any person to perform the function of a broker unless the person holds a valid license as a broker pursuant to this section.

J. A broker may not use any person to perform the functions of a provider unless the person holds a valid license as a provider pursuant to this section.

K. A provider or broker shall submit to the director any new or revised information concerning individuals required to be disclosed pursuant to subsection C of this section within thirty days of any change.

L. A person who is licensed as an attorney or a certified public accountant, who is retained to represent the owner and whose compensation is not paid directly or indirectly by the provider or purchaser may negotiate a life settlement contract on behalf of the owner without having to obtain a license as a broker.

M. The insurer that issued the policy and that is the subject of a life settlement contract is not responsible for any act or omission of a broker or provider or a purchaser arising out of or in connection with the life settlement transaction unless the insurer receives compensation for the placement of a life settlement contract from the provider, broker or purchaser in connection with the life settlement contract.
A.R.S. § 20-369 — Arizona Code / Title 20 / Chapter 2 / Article 4 / Section 369
20-369 Joint underwriting or joint reinsurance
Status: in_force

20-369. Joint underwriting or joint reinsurance

A. Every group, association or other organization of insurers which engages in joint underwriting or joint reinsurance shall be subject to regulation with respect thereto as provided by this article, subject, however, with respect to joint underwriting, to all other provisions of this article, and with respect to joint reinsurance, to the provisions of sections 20-370 and 20-374.

B. If, after a hearing the director finds that any activity or practice of any such group, association or other organization is unfair or unreasonable or otherwise inconsistent with the provisions of this article, he may issue a written order specifying in what respects the activity or practice is unfair or unreasonable or otherwise inconsistent and requiring the discontinuance of the activity or practice.
A.R.S. § 20-881 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 881
20-881 Funds
Status: in_force

20-881. Funds

A. Unless otherwise provided in the benefit contract, all assets shall be held, invested and disbursed for the use and benefit of the society, and no member or beneficiary has any individual rights in the assets and is not entitled to any apportionment on the surrender of any part of the assets.

B. A society may create, maintain, invest, disburse and apply any special fund or funds necessary to carry out any purpose permitted by the laws of the society.

C. Pursuant to a resolution of the supreme governing body, a society may establish and maintain one or more separate accounts and issue contracts on a variable basis, subject to the provisions of this title regulating life insurers. To the extent that the society deems it necessary in order to comply with any applicable federal or state law, the society may:

1. Adopt special procedures for the conduct of the business and affairs of a separate account.

2. For persons who have beneficial interests in a separate account, provide special voting and other rights, including, without limitation, special rights and procedures relating to investment policy, investment advisory services, selection of certified public accountants and selection of a committee to manage the business and affairs of the account.

3. Issue contracts on a variable basis. Section 20-878, subsections B and D do not apply to these contracts.
A.R.S. § 20-787 — Arizona Code / Title 20 / Chapter 4 / Article 2 / Section 787
20-787 Nonassessable policies
Status: in_force

20-787. Nonassessable policies

A. If a reciprocal insurer has a surplus of assets over all liabilities at least equal to the minimum capital stock generally required of a domestic stock insurer authorized to transact like kinds of insurance, upon application of the attorney and as approved by the subscribers' advisory committee the director shall issue his certificate authorizing the insurer to extinguish the contingent liability of subscribers under its policies then in force in this state, and to omit provisions imposing contingent liability in all policies delivered or issued for delivery in this state for so long as all such surplus remains unimpaired.

B. Upon impairment of the surplus, the director shall forthwith revoke the certificate. The revocation shall not render subject to contingent liability any policy then in force and for the remainder of the period for which the premium has theretofore been paid, but after such revocation no policy shall be issued or renewed without providing for contingent assessment liability of the subscriber.

C. The director shall not authorize a domestic reciprocal insurer so to extinguish the contingent liability of any of its subscribers or in any of its policies to be issued, unless it qualifies to and does extinguish such liability of all its subscribers and in all such policies for all kinds of insurance transacted by it, but if required by the laws of another state in which the insurer is transacting insurance as an authorized insurer, the insurer may issue policies providing for the contingent liability of such of its subscribers as may acquire such policies in such state, and need not extinguish the contingent liability applicable to policies theretofore in force in such state.
A.R.S. § 20-3503 — Arizona Code / Title 20 / Chapter 28 / Article 1 / Section 3503
20-3503 Enforcement and oversight
Status: in_force

20-3503. Enforcement and oversight

A. The department shall enforce this chapter.

B. On or before January 1, 2021, the department shall develop a web page that provides the following information in nontechnical and readily understandable language:

1. Consumer-friendly information concerning the scope and applicability of the mental health parity and addiction equity act and the mental health parity requirements that apply to health care insurers that issue health plans in this state.

2. A step-by-step guide with supporting information that explains how consumers can file an appeal or complaint with the department concerning an alleged violation of this chapter. The guide must also prominently display a link to the United States department of labor's website, or a related website, that provides information on appeals or complaints by consumers who are covered by self-insured plans that are regulated by the employee retirement income security act of 1974 (P.L. 93-406; 88 Stat. 829).

C. On or before January 1, 2023, the department shall post to the web page prescribed in subsection B of this section an aggregated summary of its analysis of the reports filed by health care insurers pursuant to section 20-3502, subsection B, including any conclusions regarding industry compliance with the mental health parity and addiction equity act.  The department may not post any information that:

1. Contains any proprietary or confidential information of a health care insurer.

2. Enables a person to determine the identity of a health care insurer.

D. Beginning in 2022, the department shall include in its annual report a summary of all stakeholder outreach and regulatory activity related to the implementation, oversight and enforcement of the mental health parity and addiction equity act and the requirements of this chapter.
A.R.S. § 20-1073 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1073
20-1073 Eligibility; prohibiting cancellation because of eligibility for certain benefits
Status: in_force

20-1073. Eligibility; prohibiting cancellation because of eligibility for certain benefits

A. Except as specifically provided in sections 20-1379 and 20-1380, with respect to the determination of whether a person is an eligible individual, a health care services organization shall not consider the availability of or a person's eligibility for medical assistance under a program pursuant to title XIX of the social security act (P.L. 89-97; 79 Stat. 344; 42 United States Code section 1396a (1980)) when considering eligibility for coverage or calculating payments under its plan for eligible enrollees.

B. To the extent that payment for covered expenses has been made under the state program pursuant to title XIX of the social security act for health care items or services furnished to an individual, the state is considered to have acquired the rights of the individual to payment by any other party for those health care items or services. On presentation of proof that the state program pursuant to title XIX of the social security act has paid for covered items or services, the health care services organization shall make payments to the state program pursuant to title XIX of the social security act according to the coverage provided in the evidence of coverage.

C. A health care services organization may not impose on a state agency that has been assigned the rights of an individual who is eligible for medical assistance and who is covered for health benefits from the insurer any requirements that are different from the requirements applicable to an agent or assignee of any other covered individual.

D. A health care services organization shall not cancel or fail to renew the contract of any person based on that person's eligibility for or enrollment in a program funded under title XIX of the social security act or title 36, chapter 29 or 34. Nothing in this section prohibits cancellation or failure to renew for nonpayment of monies due under the contract.
A.R.S. § 20-238 — Arizona Code / Title 20 / Chapter 2 / Article 1 / Section 238
20-238 Health insurance; state regulation; rating areas; definitions
Status: in_force

20-238. Health insurance; state regulation; rating areas; definitions

(Conditionally Rpld.)

A. The director, through the adoption of rules or other regulatory and administrative actions within the director's authority, shall ensure that this state retains its full authority to regulate policies, certificates, evidences of coverage and contracts of insurance that are issued or delivered by health insurers taking into consideration the enactment of the act.

B. Notwithstanding any other provision of this title, a health insurer subject to the act shall not issue a contract, policy, certificate or evidence of coverage or otherwise transact insurance if the coverage and benefits provided in the contract, policy, certificate or evidence of coverage are inconsistent with the applicable provisions of the act.

C. Except for coverage under individual and small group policies, certificates, evidences of coverage and contracts that are grandfathered as prescribed by 42 United States Code section 18011, the following rating areas are established and shall be used by all health insurers issuing individual and small group policies, certificates, evidences of coverage or contracts in this state:

1. Mohave, Coconino, Apache and Navajo counties.

2. Yavapai county.

3. La Paz and Yuma counties.

4. Maricopa county.

5. Pinal and Gila counties.

6. Pima and Santa Cruz counties.

7. Graham, Greenlee and Cochise counties.

D. For the purposes of this section:

1. "Act" means the patient protection and affordable care act (P.L. 111-148) as amended by the health care and education reconciliation act (P.L. 111-152) or any rules adopted pursuant to those acts.

2. "Health insurer" means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation, dental service corporation, prepaid dental plan organization or hospital, medical, dental and optometric service corporation.

3. "Rating area" means an area within which a health insurer shall not vary rates based on geography.
A.R.S. § 20-461 — Arizona Code / Title 20 / Chapter 2 / Article 6 / Section 461
20-461 Unfair claim settlement practices
Status: in_force

20-461. Unfair claim settlement practices

A. A person shall not commit or perform with such a frequency to indicate as a general business practice any of the following:

1. Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.

2. Failing to acknowledge and act reasonably and promptly upon communications with respect to claims arising under an insurance policy.

3. Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under an insurance policy.

4. Refusing to pay claims without conducting a reasonable investigation based upon all available information.

5. Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed.

6. Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear.

7. As a property or casualty insurer, failing to recognize a valid assignment of a claim.  The property or casualty insurer shall have the rights consistent with the provisions of its insurance policy to receive notice of loss or claim and to all defenses it may have to the loss or claim, but not otherwise to restrict an assignment of a loss or claim after a loss has occurred.

8. Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by the insureds.

9. Attempting to settle a claim for less than the amount to which a reasonable person would have believed he was entitled by reference to written or printed advertising material accompanying or made part of an application.

10. Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of, the insured.

11. Making claims payments to insureds or beneficiaries not accompanied by a statement setting forth the coverage under which the payments are being made.

12. Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration.

13. Delaying the investigation or payment of claims by requiring an insured, a claimant or the physician of either to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information.

14. Failing to promptly settle claims if liability has become reasonably clear under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.

15. Failing to promptly provide a reasonable explanation of the basis in the insurance policy relative to the facts or applicable law for denial of a claim or for the offer of a compromise settlement.

16. Attempting to settle claims for the replacement of any nonmechanical sheet metal or plastic part which generally constitutes the exterior of a motor vehicle, including inner and outer panels, with an aftermarket crash part which is not made by or for the manufacturer of an insured's motor vehicle unless the part meets the specifications of section 44-1292 and unless the consumer is advised in a written notice attached to or printed on a repair estimate which:

(a) Clearly identifies each part.

(b) Contains the following information in ten point or larger type:

This estimate has been prepared based on the use of replacement parts supplied by a source other than the manufacturer of your motor vehicle. Warranties applicable to these replacement parts are provided by the manufacturer or distributor of these parts rather than the manufacturer of your vehicle.

17. As an insurer subject to section 20-826, 20-1342, 20-1402 or 20-1404, or as an insurer of the same type as those subject to section 20-826, 20-1342, 20-1402 or 20-1404 that issues policies, contracts, plans, coverages or evidences of coverage for delivery in this state, failing to pay charges for reasonable and necessary services provided by any physician licensed pursuant to title 32, chapter 8, 13 or 17, if the services are within the lawful scope of practice of the physician and the insurance coverage includes diagnosis and treatment of the condition or complaint, regardless of the nomenclature used to describe the condition, complaint or service.

18. Failing to comply with chapter 15 of this title.

19. Denying liability for a claim under a motor vehicle liability policy in effect at the time of an accident without having substantial facts based on reasonable investigation to justify the denial for damages or injuries that are a result of the accident and that were caused by the insured if the denial is based solely on a medical condition that could affect the insured's driving ability.

B. Nothing in subsection A, paragraph 17 of this section shall be construed to prohibit the application of deductibles, coinsurance, preferred provider organization requirements, cost containment measures or quality assurance measures if they are equally applied to all types of physicians referred to in this section, and if any limitation or condition placed upon payment to or upon services, diagnosis or treatment by any physician covered by this section is equally applied to all physicians referred to in subsection A, paragraph 16 of this section, without discrimination to the usual and customary procedures of any type of physician.  A determination under this section of discrimination to the usual and customary procedures of any type of physician shall not be based on whether an insurer applies medical necessity review to a particular type of service or treatment.

C. In prescribing rules to implement this section, the director shall follow, to the extent appropriate, the national association of insurance commissioners unfair claims settlement practices model regulation.

D. Nothing contained in this section is intended to provide any private right or cause of action to or on behalf of any insured or uninsured resident or nonresident of this state. It is, however, the specific intent of this section to provide solely an administrative remedy to the director for any violation of this section or rule related to this section.

E. The director shall deposit, pursuant to sections 35-146 and 35-147, all civil penalties collected pursuant to this article in the state general fund.
A.R.S. § 20-167 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 167
20-167 Fees; definition
Status: in_force

20-167. Fees; definition

A. The director shall collect in advance the following fees, determined by the director, which are nonrefundable on payment:

Not Less Than:    Not More Than:

1. For filing charter documents:

(a) Original charter documents,

articles of incorporation,

bylaws, or record of

organization of insurers,

or certified copies thereof,

required to be filed with

the director and not also

subject to filing in the

office of the corporation

commission     $   40.00   $  115.00

(b) Amended charter documents                  15.00 45.00

(c) No charge or fee shall be

required for filing with

the director any of such

documents also required

by law to be filed in the

office of the corporation

commission

2. Certificate of authority:

(a) Issuance:

Fraternal benefit societies      $   15.00   $   45.00

Medical or hospital service

corporations, health care

services organizations or

prepaid dental plan

organizations     40.00 115.00

Mechanical reimbursement

reinsurers     150.00      450.00

All other insurers      100.00      295.00

(b) Renewal:

Fraternal benefit societies      15.00 45.00

Medical or hospital service

corporations, health care

services organizations or

prepaid dental plan

organizations     40.00 115.00

Domestic stock life insurers,

domestic stock disability

insurers or domestic stock

life and disability insurers  750.00      2,250.00

Domestic life reinsurers,

domestic disability

reinsurers or domestic

life and disability

reinsurers     2,250.00 5,500.00

Mechanical reimbursement

reinsurers  2,250.00    5,500.00

All other insurers   70.00 205.00

3. Certificate of registration as an

administrator or application for

renewal under section 20-485.12    $  100.00   $  295.00

4. Authority to solicit applications

for and issue policies by means

of mechanical vending machines   $   30.00   $   90.00

5. Service company permit    $  150.00   $  450.00

6. Application for motor vehicle

service contract program approval  $  150.00   $  450.00

7. Life care contract application

or annual report $  225.00   $  675.00

8. Filing annual statement   $  150.00   $  450.00

9. Annual statement filing for

exempt insurer transacting life

insurance, disability insurance

or annuity business pursuant to

section 20-401.05    $   65.00   $  100.00

10. Licenses and examinations:

(a) Licenses:

Surplus lines broker's license,

quadrennially      $  600.00   $1,000.00

All other licenses,

quadrennially      60.00 180.00

(b) Examinations for license:

Examination on laws and one kind

of insurance   8.00  25.00

Examination on laws and two or

more kinds of insurance    15.00 45.00

11. Miscellaneous:

Fee accompanying service of

process on director  $    8.00   $   25.00

Certificate of director,

under seal     0.00  5.00

Copy of document filed in

director's office, per page      0.50  0.75

B. Except as provided in section 20-1098.18, the director shall deposit, pursuant to sections 35-146 and 35-147, all fees collected pursuant to this section in the state general fund. A refund is not allowed for any unused portion of a fee, and the director shall not prorate fees.

C. The license fees prescribed by this section shall be payment in full of all demands for all state, county, district and municipal license fees, license taxes, business privilege taxes and business privilege fees and charges of every kind.

D. The director may contract for the examination for licensing adjusters, insurance producers, bail bond agents, risk management consultants and surplus lines brokers. If the director does so, the fee for examinations for licenses pursuant to this section is payable directly to the contractor by the applicant for examination. The director may agree to a reasonable examination fee to be charged by the contractor.  The fee may exceed the amounts prescribed in this section.

E. The director may contract with a voluntary domestic organization of surplus lines brokers to perform any transaction prescribed in chapter 2, article 5 of this title, including the acceptance or maintenance of the reports required by section 20-408. The director may allow the contractor to charge a stamping fee. The surplus lines broker shall pay the stamping fee established pursuant to this section directly to the contractor.

F. Captive insurers shall pay certificate of authority issuance and renewal fees as prescribed by the director.

G. For the purposes of this section, "stamping fee" means a reasonable filing fee charged by a contractor for any transaction prescribed in chapter 2, article 5 of this title, including the acceptance or maintenance of the reports required by section 20-408.
A.R.S. § 20-481.32 — Arizona Code / Title 20 / Chapter 2 / Article 8 / Section 481.32
20-481.32 Management of domestic insurers subject to registration
Status: in_force

20-481.32. Management of domestic insurers subject to registration

A. Notwithstanding the control of a domestic insurer by any person, the officers and directors of an insurer may not be relieved of any obligation or liability to which they are subject by law and the insurer shall be managed so as to assure its separate operating identity consistent with this article.

B. This section does not preclude a domestic insurer from having or sharing a common management or the cooperative or joint use of personnel, property or services with one or more other persons under arrangements meeting the standards of section 20-481.12.

C. At least one-third of the directors of a domestic insurer and at least one-third of the members of each committee of the board of directors of any domestic insurer must be composed of persons who are not officers or employees of the insurer or of any entity controlling, controlled by or under common control with the insurer and who are not beneficial owners of a controlling interest in the voting stock of the insurer or entity.  At least one person must be included in any quorum for the transaction of business at any meeting of the board of directors or any committee.

D. The board of directors of a domestic insurer shall establish one or more committees composed solely of directors who are not officers or employees of the insurer or of any entity controlling, controlled by or under common control with the insurer and who are not beneficial owners of a controlling interest in the voting stock of the insurer or any such entity. The committee or committees shall have responsibility for nominating candidates for director for election by shareholders or policyholders, evaluating the performance of officers deemed to be principal officers of the insurer and recommending to the board of directors the selection and compensation of the principal officers.

E. Subsections C and D of this section do not apply to a domestic insurer if the person controlling the insurer, including an insurer, a mutual insurance holding company or a publicly held corporation, has a board of directors and committees that meet the requirements of subsections C and D of this section.

F. An insurer may make application to the director for a waiver from the requirements of this section if the insurer's annual direct written and assumed premium excluding premiums reinsured with the federal crop insurance corporation and federal flood program is less than three hundred million dollars.  An insurer may also make application to the director for a waiver from the requirements of this section based on unique circumstances. The director may consider various factors including the type of business entity, volume of business written, availability of qualified board members and the ownership or organizational structure of the entity.
A.R.S. § 20-1077 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1077
20-1077 Use of freestanding urgent care centers; policies
Status: in_force

20-1077. Use of freestanding urgent care centers; policies

A health care services organization that requires its enrollees to use a freestanding urgent care center as a condition of coverage or a reduction in copayment, coinsurance or deductible amounts for covered health care services shall:

1. Develop and maintain policies for the appropriate referral of its enrollees to freestanding urgent care centers. The health care services organization's medical director shall approve these policies.

2. Inform its enrollees through an appropriate means as to when to seek care at a freestanding urgent care center instead of using a higher level of care, such as a hospital emergency department.

3. At least every two years, review the performance of and recredential the freestanding urgent care centers under contract with the health care services organization.
A.R.S. § 20-623.01 — Arizona Code / Title 20 / Chapter 3 / Article 4 / Section 623.01
20-623.01 Conduct of all delinquency proceedings
Status: in_force

20-623.01. Conduct of all delinquency proceedings

A. In any delinquency proceeding, the receiver may appoint one or more special deputy receivers to act for the receiver and may employ, as the receiver deems necessary, counsel, clerks and assistants. Subject to the approval of the court, the receiver shall fix the compensation of the special deputies, counsel, clerks or assistants and all expenses of taking possession of the insurer and of conducting the proceeding and shall use the funds or assets of the insurer to pay the compensation and expenses. Subject to the limits of duties imposed on a special deputy, in any delinquency proceeding the special deputy possesses all of the powers given to the receiver and, in the exercise of those powers, is subject to all of the duties imposed on the receiver.

B. No person except the receiver may cancel or terminate an insurance policy under which another insurer who is the subject of a delinquency proceeding is included in the policy as an owner or insured, based on the director or receiver instituting the delinquency proceeding or any other action pursuant to this article.
A.R.S. § 20-1023 — Arizona Code / Title 20 / Chapter 4 / Article 8 / Section 1023
20-1023 "Attorney" defined; office
Status: in_force

20-1023. "Attorney" defined; office

Policies of insurance may be executed by an attorney or by an attorney-in-fact, or other representative, hereby designated "attorney", authorized by and acting for the underwriters who constitute the Lloyd's association. The principal office of such attorney shall be maintained at such place as may be designated by the underwriters in their articles of agreement.
A.R.S. § 20-488.11 — Arizona Code / Title 20 / Chapter 2 / Article 12 / Section 488.11
20-488.11 Immunity
Status: in_force

20-488.11. Immunity

In addition to any other immunity provided by law, the director, the department or the employees or agents of the department are not liable for any acts when acting in good faith within the scope of their authority under this article.
A.R.S. § 20-533 — Arizona Code / Title 20 / Chapter 3 / Article 2 / Section 533
20-533 Qualification of securities or property as eligible investments
Status: in_force

20-533. Qualification of securities or property as eligible investments

A. No security or investment, other than real and personal property acquired pursuant to section 20-556, shall be eligible for acquisition unless it is interest bearing or interest accruing or dividend or income paying, is not then in default as to principal or interest and the insurer is entitled to receive for its exclusive account and benefit the interest or income accruing on the security or investment, except as provided in subsection D of this section. Defaults in interest or income occurring subsequent to acquisition of an investment shall not affect allowance thereof as an asset.

B. No security or investment shall be eligible for purchase at a price above its market value.

C. No provision of this article shall prohibit the acquisition by an insurer of other or additional securities or property if received as a dividend or as a lawful distribution of assets, or if acquired pursuant to a lawful and bona fide agreement of bulk reinsurance, merger or consolidation. Any investment so acquired through bulk reinsurance, merger or consolidation, which is not otherwise eligible under this article, is subject to the following conditions:

1. The investment qualifies as an asset under the insurance laws of the jurisdiction of the insurer from which the investment was acquired.

2. The insurer shall dispose of the investment within three years after the date of acquisition unless within the period the security has attained the necessary standard of eligibility pursuant to this article.

D. An insurer may invest any of its monies in debt securities which are not interest bearing or interest accruing if, after giving effect to the acquisition of the debt security, the aggregate cost of the securities, other than investments acquired pursuant to subsection C of this section, does not exceed ten per cent of the insurer's total assets.
A.R.S. § 20-504 — Arizona Code / Title 20 / Chapter 3 / Article 1 / Section 504
20-504 Reporting assets not allowed
Status: in_force

20-504. Reporting assets not allowed

All assets not allowed and all other assets of doubtful value or character included as assets in any statement by an insurer to the director, or in any examiner's report to him, shall also be reported, to the extent of the value disallowed, as deductions from the gross assets of the insurer except where the director permits a reserve to be carried among the liabilities of the insurer in lieu of any such deduction.
A.R.S. § 20-126 — Arizona Code / Title 20 / Chapter 1 / Article 1 / Section 126
20-126 Annual dental loss ratio report; posting; definitions
Status: in_force

20-126. Annual dental loss ratio report; posting; definitions

A. Beginning July 1, 2024 and on or before July 1 of each year thereafter, each dental insurer doing business in this state shall file with the department on a standard form issued by the department an annual report on the dental loss ratio for the preceding calendar year. The dental loss ratio annual report shall include the following:

1. A combined dental loss ratio percentage for all individual dental policies.

2. A combined dental loss ratio percentage for all group dental policies issued to fully insured groups.

B. Not later than August 1 of each year, the department shall post the reported dental loss ratios for each dental insurer on the department's website in a manner that is easily located and identifiable to the public. The department may not post the underlying claims, premiums and other data used to calculate the dental loss ratios and shall treat all claims, premiums and other data as confidential.

C. For the purposes of this section:

1. "Adjusted incurred annual dental claims" means claims that were incurred for services rendered during the preceding calendar year and paid through March 31 of the following year and liability for claims incurred for services rendered during the preceding calendar year that have not been reported or paid through March 31 of the following calendar year.

2. "Dental insurer" means a dental service corporation pursuant to chapter 4, article 3 of this title, prepaid dental plan organization pursuant to chapter 4, article 7 of this title, health care services organization pursuant to chapter 4, article 9 of this title, disability insurer pursuant to chapter 6, article 4 of this title or group or blanket disability insurer pursuant to chapter 6, article 5 of this title that offers, issues or renews a contract, evidence of coverage or policy covering dental services.

3. "Dental loss ratio percentage" means the ratio, stated as a percentage, of the numerator as prescribed in subdivision (a) of this paragraph to the denominator as prescribed in subdivision (b) of this paragraph.

(a) The numerator is the sum of all of the following:

(i) The adjusted incurred annual dental claims in this state.

(ii) The amount spent by a dental insurer on activities that improve the quality of dental care but does not include expenses for advertising, promotions or donations to charitable foundations.

(iii) The amount of claims identified through fraud reduction efforts.

(b) The denominator is the sum of the annual dental insurance premiums earned in this state, excluding:

(i) The annual incurred federal and state taxes, licensing fees and regulatory fees on dental premiums in this state.

(ii) The annual federal income taxes attributed to the dental line of business for the reporting year.

4. "Dental policies" means a contract, evidence of coverage or policy covering dental services, excluding:

(a) A policy, subscription contract, group or blanket disability insurer contract or evidence of coverage that includes dental benefits that are included in the medical benefits of a policy and not administered as stand-alone dental benefits.

(b) A self-funded employer group health or dental plan.

(c) A plan or group of plans covering dental services for which a dental insurer does not have credible experience, as determined by the director.
A.R.S. § 20-400.04 — Arizona Code / Title 20 / Chapter 2 / Article 4.2 / Section 400.04
20-400.04 Examinations
Status: in_force

20-400.04. Examinations

The director may examine each insurer authorized to write any insurance to which this article applies to determine whether such insurer has complied with sections 20-400.01 and 20-400.02.
A.R.S. § 20-1031 — Arizona Code / Title 20 / Chapter 4 / Article 8 / Section 1031
20-1031 Deposit required of Lloyd's association
Status: in_force

20-1031. Deposit required of Lloyd's association

The deposit requirements of section 20-213 and section 20-583 shall in all respects apply to any Lloyd's association, foreign or domestic, provided that the director shall not issue a certificate of authority to any Lloyd's association unless it has deposited in trust with the state treasurer of Arizona or in public custody in any other state or states cash or securities eligible for the investment of capital funds of domestic insurers in an amount not less than four hundred thousand dollars.
A.R.S. § 20-3457 — Arizona Code / Title 20 / Chapter 27 / Article 1 / Section 3457
20-3457 Availability of credentialing information; policies
Status: in_force

20-3457. Availability of credentialing information; policies

A. A health insurer shall make the following nonproprietary information available to all applicants for credentialing and shall post the information on its website:

1. The applicable credentialing policies and procedures.

2. A list of all the information required to be included in an application.

3. A checklist of materials that must be submitted in the credentialing process.

4. Designated contact information, including a designated point of contact, an e-mail address and a telephone number to address any credentialing inquiries.

B. On completion of the credentialing process, a health insurer shall make all nonproprietary information pertaining to a provider's credentialing application and final decision available to the applicant on request, if allowed by law.
A.R.S. § 20-468 — Arizona Code / Title 20 / Chapter 2 / Article 6 / Section 468
20-468 Motor vehicle loss; policyholder choice of repair facility
Status: in_force

20-468. Motor vehicle loss; policyholder choice of repair facility

A. For repair facilities other than glass repair facilities and subject to the rights of an insurer to receive notice of loss or claim consistent with the provisions of its policy, a person in this state has the right to choose any repair facility for the repair of a motor vehicle loss. If an insurer provides information about a repair facility, the insurer shall inform the person of this right at the same time as making the recommendation or providing the information.  This section does not create a private right or cause of action to or on behalf of any person.

B. If an insured or claimant selects a repair facility to repair the insured's or claimant's motor vehicle in which the insurer owns an interest in that repair facility, the adjuster for the motor vehicle shall not be employed by the repair facility or have any direct authority over that facility's recommendations or decisions relating to the repair of the insured's or claimant's motor vehicle.
A.R.S. § 20-490.02 — Arizona Code / Title 20 / Chapter 2 / Article 14 / Section 490.02
20-490.02 Enforcement; civil penalty
Status: in_force

20-490.02. Enforcement; civil penalty

A. An insurer that fails to comply with a claim brought pursuant to this article by denying the claim on the grounds that the claim is not timely or by asserting a statute of limitations defense violates this article.

B. If the director considers it necessary, the director may initiate an examination under section 20-156.

C. If the director believes that an insurer has violated or is violating this article the director may:

1. Issue a cease and desist order.

2. Assess a civil penalty of not more than one thousand dollars for each act or violation but not to exceed an aggregate civil penalty of ten thousand dollars.

3. Refer the matter to the attorney general for appropriate enforcement.
A.R.S. § 20-1138 — Arizona Code / Title 20 / Chapter 5 / Article 1 / Section 1138
20-1138 Health insurance policies; member identification cards; applicability
Status: in_force

20-1138. Health insurance policies; member identification cards; applicability

A. An identification card that includes information facilitating a subscriber's, enrollee's or insured's access to services or coverage under an individual or group health insurance contract, evidence of coverage or policy issued or renewed in this state by a hospital and medical service corporation, health care services organization or disability insurer must prominently display the letters "AZDOI" in capital letters on the bottom front of the identification card and a telephone number that a subscriber, enrollee or insured may call for customer assistance.

B. This section applies to identification cards for any individual or group contract, evidence of coverage or policy issued or renewed from and after December 31, 2021.
A.R.S. § 20-585 — Arizona Code / Title 20 / Chapter 3 / Article 3 / Section 585
20-585 Responsibility of state for safekeeping of deposits
Status: in_force

20-585. Responsibility of state for safekeeping of deposits

The state shall be responsible for the safekeeping and return of all funds and securities deposited pursuant to this title with the state treasurer or in any depositary so designated by him.
A.R.S. § 20-724 — Arizona Code / Title 20 / Chapter 4 / Article 1 / Section 724
20-724 Illegal dividends; violation; classification
Status: in_force

20-724. Illegal dividends; violation; classification

A. Any director of a domestic stock or mutual insurer who knowingly votes for or concurs in declaration or payment of an illegal dividend to stockholders or members is guilty of a class 2 misdemeanor and is jointly and severally liable, together with other such directors, for any loss thereby sustained by the insurer.

B. The stockholders or members knowingly receiving such an illegal dividend shall be liable in the amount of the illegal dividend to the insurer.

C. The director of the department of insurance and financial institutions may revoke or suspend the certificate of authority of an insurer that has declared or paid an illegal dividend.
A.R.S. § 20-1543 — Arizona Code / Title 20 / Chapter 6 / Article 8.1 / Section 1543
20-1543 Limitation on geographic concentration
Status: in_force

20-1543. Limitation on geographic concentration

A. A mortgage guaranty insurance company shall not:

1. Insure loans secured by a single risk in excess of ten per cent of the company's aggregate capital, surplus and contingency reserve.

2. Have more than twenty per cent of its total insurance in force in any one standard metropolitan statistical area, as defined by the United States department of commerce.

B. The provisions of this section shall not apply to a mortgage guaranty insurance company until it has possessed a certificate of authority in this state for three years.
A.R.S. § 20-1347 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1347
20-1347 Grace period
Status: in_force

20-1347. Grace period

A. There shall be a provision as follows: "Grace period: A grace period of ______________ (insert a number not less than 'seven' for weekly premium policies, 'ten' for monthly premium policies and 'thirty-one' for all other policies) days will be granted for the payment of each premium falling due after the first premium, during which grace period the policy shall continue in force."

B. A policy which contains a cancellation provision may add, at the end of the provision set forth in subsection A of this section: "subject to the right of the insurer to cancel in accordance with the cancellation provision hereof."

C. A policy in which the insurer reserves the right to refuse any renewal shall have, at the beginning of the provision set forth in subsection A of this section: "Unless not less than five days prior to the premium due date the insurer has delivered to the insured or has mailed to his last address as shown by the records of the insurer written notice of its intention not to renew this policy beyond the period for which the premium has been accepted,".
A.R.S. § 20-2638 — Arizona Code / Title 20 / Chapter 16 / Article 2 / Section 2638
20-2638 Foreign companies
Status: in_force

20-2638. Foreign companies

If the law in a foreign company's domiciliary state provides a degree of protection to the policyholders and the public that is substantially equal to the degree of protection that is provided by this article, the director may determine that the foreign company has complied with this article.