A.R.S. § 20-1099 — Arizona Code / Title 20 / Chapter 4 / Article 15 / Section 1099
20-1099 Definitions
Status: in_force

20-1099. Definitions

In this article, unless the context otherwise requires:

1. "Administrator" means a third party other than the warrantor who is designated by the warrantor to be responsible for the administration of vehicle protection product warranties.

2. "Incidental costs" means expenses that are specified in the vehicle protection product warranty incurred by the warranty holder relating to the failure of the vehicle protection product to perform as provided in the warranty.  Incidental costs may include insurance policy deductibles, rental vehicle charges, the difference between the actual value of the stolen vehicle at the time of theft and the cost of a replacement vehicle, sales taxes, registration fees, transaction fees and mechanical inspection fees.

3. "Vehicle protection product" means a vehicle protection device, system or service that:

(a) Is installed on or applied to a vehicle.

(b) Is designed to prevent loss or damage to a vehicle from a specific cause.

(c) Includes a written warranty by a warrantor that provides if the vehicle protection product fails to prevent loss or damage to a vehicle from a specific cause, the warranty holder shall be paid specified incidental costs by the warrantor as a result of the failure of the vehicle protection product to perform pursuant to the terms of the warranty.

(d) Covers the warrantor's liability with a warranty reimbursement insurance policy.

Vehicle protection product includes alarm systems, body part marking products, steering locks, window etch products, pedal and ignition locks, fuel and ignition kill switches and electronic, radio and satellite tracking devices.

4. "Vehicle protection product warrantor" or "warrantor" means a person who is contractually obligated to the warranty holder under the terms of the vehicle protection product warranty agreement.  Warrantor does not include an authorized insurer.

5. "Warranty reimbursement insurance policy" means a policy of insurance issued to the vehicle protection product warrantor to pay on behalf of the warrantor all covered contractual obligations incurred by the warrantor under the terms and conditions of the vehicle protection product warranty.  An insurer authorized to do business in this state that has filed its policy form with the department shall issue the warranty reimbursement insurance policy.
A.R.S. § 20-1361 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1361
20-1361 Insurance with other insurers; provision of service or expense incurred basis
Status: in_force

20-1361. Insurance with other insurers; provision of service or expense incurred basis

A. There may be a provision as follows:

"Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on a provision of service basis or on an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss, the only liability under any expense incurred coverage of this policy shall be for such proportion of the loss as the amount which would otherwise have been payable hereunder plus the total of the like amounts under all such other valid coverages for the same loss of which this insurer had notice bears to the total like amounts under all valid coverages for such loss, and for the return of such portion of the premiums paid as shall exceed the pro rata portion for the amount so determined.  For the purpose of applying this provision when other coverage is on a provision of service basis, the 'like amount' of such other coverage shall be taken as the amount which the services rendered would have cost in the absence of such coverage."

B. If the policy provision set forth in subsection A of this section is included in a policy which also contains the policy provision set out in section 20-1362 there shall be added to the caption of the provision the phrase "--expense incurred benefits." The insurer may, at its option, include in this provision a definition of "other valid coverage," approved as to form by the director which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and by hospital or medical service organizations, and to any other coverage the inclusion of which may be approved by the director. In the absence of such definition the term shall not include group insurance, automobile medical payments insurance, or coverage provided by hospital or medical service organizations or by union welfare plans or employer or employee benefit organizations. For the purpose of applying the policy provision with respect to any insured, any amount of benefit provided for the insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, whether provided by a governmental agency or otherwise shall in all cases be deemed to be "other valid coverage" of which the insurer has had notice. In applying the policy provision no third party liability coverage shall be included as "other valid coverage."
A.R.S. § 20-143 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 143
20-143 Rule-making power
Status: in_force

20-143. Rule-making power

A. The director may make reasonable rules necessary for effectuating any provision of this title.

B. The director shall make rules concerning proxies, consents or authorizations in respect of securities issued by domestic stock insurance companies having a class of equity securities held of record by one hundred or more persons to conform with the requirements of section 12(g)(2)(G)(ii) of the securities exchange act of 1934, as amended, and as may be amended. Such rule shall not apply to any such company having a class of equity securities which are registered or are required to be registered pursuant to section 12 of the securities exchange act of 1934, as amended, or as may be amended. Whenever such equity securities of any such company are registered or are required to be registered pursuant to section 12 of the securities exchange act of 1934, as amended, or as may be amended, then, no person shall solicit or permit the use of his name to solicit, in any manner whatsoever, any proxy, consent or authorization in respect of any equity security of such company without having first complied with the rules prescribed by the securities and exchange commission pursuant to section 14 of the securities exchange act of 1934, as amended, or as may be amended.

C. All rules made pursuant to this section shall be subject to title 41, chapter 6.

D. In addition to any other penalty provided, wilful violation of any rule made by the director is a violation of this title.
A.R.S. § 20-1117 — Arizona Code / Title 20 / Chapter 5 / Article 1 / Section 1117
20-1117 Underwriters' and combination policies
Status: in_force

20-1117. Underwriters' and combination policies

A. Two or more authorized insurers may jointly issue, and shall be jointly and severally liable on, an underwriters' policy bearing their names. Any one insurer may issue policies in the name of an underwriter's department and such policy shall plainly show the true name of the insurer.

B. Two or more insurers may, with the approval of the director, issue a combination policy which shall contain provisions substantially as follows:

1. That the insurers executing the policy shall be severally liable for the full amount of any loss or damage, according to the terms of the policy, or for specified percentages or amounts thereof, aggregating the full amount of insurance under the policy.

2. That service of process, or of any notice or proof of loss required by such policy, upon any of the insurers executing the policy, shall constitute service upon all such insurers.

C. This section shall not apply to cosurety obligations.
A.R.S. § 20-374 — Arizona Code / Title 20 / Chapter 2 / Article 4 / Section 374
20-374 Revocation and suspension of licenses
Status: in_force

20-374. Revocation and suspension of licenses

The director may suspend the license of any rating organization or the certificate of authority of any insurer which fails to comply with an order of the director made pursuant to this article within the time limited by the order, or any extension thereof which may be granted by the director. The director shall not suspend the license of any rating organization or the certificate of authority of any insurer for failure to comply with an order until the time prescribed for a review thereof has expired, or if a review has been sought, until the order has been affirmed. The director may determine when a suspension of license or certificate shall become effective, and it shall remain in effect for the period fixed by him, unless he modifies or rescinds the suspension, or until the order upon which suspension is based is modified, rescinded or reversed. No license or certificate shall be suspended or revoked except upon the written order of the director stating his findings, made after a hearing held upon not less than ten days written notice to such person or organization, specifying the alleged violation.
A.R.S. § 20-665 — Arizona Code / Title 20 / Chapter 3 / Article 6 / Section 665
20-665 Plan of operation
Status: in_force

20-665. Plan of operation

A. The board shall submit to the director a fund plan of operation and any amendments necessary or suitable to assure the fair, reasonable and equitable administration of the fund. The plan of operation and any amendments shall become effective upon approval in writing by the director.

B. If the board fails to submit a suitable plan of operation or if at any time the board fails to submit suitable amendments to the plan, the director shall adopt any plan or amendment that is necessary or advisable to effectuate the provisions of this article and the plan or amendment shall continue in force until modified by the director or superseded by a plan submitted by the board and approved by the director. All member insurers shall comply with the plan of operation.

C. The plan of operation shall:

1. Establish the procedures for execution of all powers and duties of the board.

2. Establish procedures for handling assets of the fund.

3. Establish the amount and method of reimbursing members of the board pursuant to section 20-663.

4. Establish procedures by which claims may be filed with the fund and establish acceptable forms of proof of covered claims. Notice of claims to the receiver, conservator or liquidator of the insolvent insurer shall be deemed notice to the fund or its agents and a list of such claims shall be periodically submitted to the fund or similar organization in another state by the receiver or liquidator.

5. Establish regular places and times for meetings of the board.

6. Establish procedures for records to be kept of all financial transactions of the fund, the board and its agents.

7. Provide that any member insurer aggrieved by any final action or decision of the fund may appeal to the director within thirty days after the action or decision.

8. Establish the procedures for recommendations to the director for selections to the board.

9. Contain additional provisions that are necessary or proper for the execution of the powers and duties of the board.

D. In regard to the prevention and detection of insolvencies the board shall:

1. Notify the director of any information indicating that any member insurer may be insolvent or in a financial condition that is hazardous to the policyholders or to the public.

2. Notify the director of any information indicating that a member insurer may be unable to fulfill its contractual obligations and request a meeting with the director.

3. Upon request of the director, attend hearings before the director and meet with and advise the director or the receiver, conservator or liquidator appointed by the director on matters relating to the affairs of an insolvent insurer and relating to action which may be taken by the director, receiver, conservator or liquidator to best protect the interests of persons holding covered claims against the insolvent insurer and relating to the amount and timing of partial assessments and the marshalling of assets and the processing and handling of covered claims.

4. At the conclusion of any insurer insolvency in which the fund was obligated to pay covered claims, prepare a report on the history and causes of such insolvency, based on the information available to the board and submit such report to the director.

E. In regard to the prevention and detection of insolvencies the board may, on majority vote:

1. Request that the director make available to the board any information in the director's possession relative to the financial condition of any member insurer, including the power to pursue officially any operational records or activity of the member insurer wherever deemed necessary.

2. Request that the director order an examination of any member insurer which the board in good faith believes may be in a financial condition hazardous to the policyholders or to the public.

3. Make recommendations and reports to the director upon any matter germane to the solvency, liquidation, rehabilitation or conservation of any member insurer. Such reports and recommendations shall not be considered public documents.

4. Make recommendations to the director for the detection and prevention of insurer insolvencies.

F. The plan of operation may provide that any or all powers and duties of the board, except those pursuant to section 20-664, subsection A, paragraphs 3 and 4 and subsection B, are delegated to a corporation, association or other organization which performs or will perform functions similar to those of this fund, or its equivalent, in two or more states. Such a corporation, association or organization shall be reimbursed as a servicing facility and shall be paid for its performance of any other function of the fund. A delegation pursuant to this subsection shall take effect only with the approval of both the board and the director and may be made only to a corporation, association or organization which extends protection not substantially less favorable and effective than that provided by this article.
A.R.S. § 20-1602 — Arizona Code / Title 20 / Chapter 6 / Article 10 / Section 1602
20-1602 Scope and repeal
Status: repealed

20-1602. Scope and repeal

A. All consumer credit insurance issued, sold or made effective in connection with a loan or other credit transaction for personal, family or household purposes is subject to this article and to all other provisions of this title not inconsistent with this article. Any provision of other law, general or special, that is inconsistent with this article is repealed to the extent of the inconsistency. In addition, all consumer credit insurance issued or made effective relative to consumer lender loans under title 6, chapter 5 is subject to this article.

B. The following consumer credit insurance transactions are not subject to this article:

1. Insurance on credit transactions of more than fifteen years duration.

2. Insurance written in connection with a credit transaction that is secured by a first mortgage or deed of trust and made to finance the purchase of real property or the construction of a dwelling or to refinance a prior credit transaction made for such a purpose.

3. Insurance sold as an isolated transaction on the part of the insurer and not related to an agreement or a plan for insuring debtors of the creditor.

4. Insurance for which no identifiable charge is made to the debtor.
A.R.S. § 20-1089 — Arizona Code / Title 20 / Chapter 4 / Article 10 / Section 1089
20-1089 Certificates of authority
Status: in_force

20-1089. Certificates of authority

A. Any domestic limited stock insurer formed and existing pursuant to section 20-708 which does not come within the provisions of section 20-708, subsection B, and which holds a valid certificate of authority as such an insurer, shall become a domestic life and disability reinsurer on the effective date of this article. If such reinsurer meets the requirements for a renewal certificate of authority under the provisions of this article, it shall have its authority renewed under such provisions beginning with the first certificate of authority renewal following the effective date of this article.

B. Any domestic limited stock insurer formed and existing pursuant to section 20-708 which comes within the provisions of section 20-708, subsection B, which holds a valid certificate of authority as such an insurer, but which was transformed into a domestic life and disability reinsurer by operation of the provisions of subsection D of section 20-210 shall be a domestic life and disability reinsurer, but shall continue to have such right and privilege to issue life and disability policies direct to the public as is provided in section 20-708. If such reinsurer meets the requirements for a renewal certificate of authority under the provisions of this article, it shall have its authority renewed under such provisions beginning with the first certificate of authority renewal following the effective date of this article.
A.R.S. § 20-1304 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1304
20-1304 Application and policy as entire contract; statements of applicant as representations
Status: in_force

20-1304. Application and policy as entire contract; statements of applicant as representations

There shall be a provision that the policy shall constitute the entire contract between the parties, or, if a copy of the application is endorsed upon or attached to the policy when issued, a provision that the policy and the application therefor shall constitute the entire contract. If the application is so made a part of the contract, the policy shall also provide that all statements made by the applicant in such application shall, in the absence of fraud, be deemed to be representations and not warranties.
A.R.S. § 20-486.08 — Arizona Code / Title 20 / Chapter 2 / Article 10 / Section 486.08
20-486.08 Duties of reinsurers utilizing the services of a reinsurance intermediary manager
Status: in_force

20-486.08. Duties of reinsurers utilizing the services of a reinsurance intermediary manager

A. A reinsurer shall not engage the services of a person, firm, association or corporation to act as a reinsurance intermediary manager on its behalf unless the person is licensed as required by section 20-486.01.

B. The reinsurer annually shall obtain a copy of the statements on the financial condition of each reinsurance intermediary manager that the reinsurer has engaged. The statements shall be prepared by an independent certified accountant in a form acceptable to the director.

C. If a reinsurance intermediary manager establishes loss reserves, the reinsurer annually shall obtain the opinion of an actuary attesting to the adequacy of loss reserves that are established for losses incurred and outstanding on business produced by the reinsurance intermediary manager. The actuary's opinion is in addition to any other required loss reserve certification.

D. An officer of the reinsurer who is not affiliated with the reinsurance intermediary manager has binding authority for all retrocessional contracts or participation in reinsurance syndicates.

E. Within thirty days of termination of a contract with a reinsurance intermediary manager, the reinsurer shall provide written notification to the director of the termination.

F. A reinsurer shall not appoint to its board of directors an officer, director, employee, controlling shareholder or subproducer of its reinsurance intermediary manager. This subsection does not apply to relationships that are governed by the holding company act or, if applicable, the broker controlled insurer act.
A.R.S. § 20-1491 — Arizona Code / Title 20 / Chapter 6 / Article 6 / Section 1491
20-1491 Definitions
Status: in_force

20-1491. Definitions

In this article, unless the context otherwise requires:

1. "Certificate holder" means the individual named insured group member under a group excess liability insurance policy.

2. "Certificate of insurance" means the certificate of insurance, evidence of coverage or other summary of coverage that is issued to each certificate holder under a group excess liability insurance policy.

3. "Conditional renewal" means a renewal that is conditioned on any of the following:

(a) A change of limits.

(b) A change in the type of coverage.

(c) A reduction or elimination of coverage.

(d) Increased deductibles or the addition of exclusions.

(e) Increased premiums in excess of ten percent, except for premium increases that are generated as a result of increased exposure units or as a result of experience rating, loss rating, retrospective rating or audit.

4. "Excess liability insurance" means liability insurance, as prescribed in section 20-252, paragraph 1, that provides excess coverage after the certificate holder's primary liability insurance limits have been exhausted.

5. "Excess uninsured or underinsured liability" means damages for bodily injury, personal injury or property damage that the certificate holder or an immediate family member of the certificate holder is legally entitled to receive from an uninsured or underinsured negligent person.

6. "Group excess liability insurance" means excess liability insurance that is issued on a group basis and that covers groups of persons as prescribed in this article.

7. "Group policyholder" means those groups identified in section 20-1492, subsection D to which a group excess liability insurance policy may be issued.

8. "Immediate family member" includes any of the following:

(a) The certificate holder's spouse or domestic partner.

(b) Any relative of the certificate holder who lives with the certificate holder.

(c) Any person who is under twenty-five years of age and who is in the care of the certificate holder.

9. "Issued on a group basis" means the issuance of a master policy to a group policyholder, with certificates of insurance issued to certificate holders, solely for the benefit of persons other than the group policyholder.

10. "Negligent person" means a natural person who is identifiable by legal name, who is not an immediate family member of the certificate holder and who is legally responsible for any damages that were sustained by the certificate holder or the certificate holder's immediate family member and that were caused by an accident or offense to which the group excess liability insurance policy applies.
A.R.S. § 20-1057.15 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1057.15
20-1057.15 Prescriptions; cost sharing; refills; dispensing fees; definition
Status: in_force

20-1057.15. Prescriptions; cost sharing; refills; dispensing fees; definition

A. An evidence of coverage 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 evidence of coverage that is dispensed by a network pharmacy for less than the standard refill amount if the enrollee requests enrollment into a medication synchronization program and less than the standard refill amount for the purpose of synchronizing the enrollee'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. § 20-3210 — Arizona Code / Title 20 / Chapter 22 / Article 1 / Section 3210
20-3210 Annual statements; record retention
Status: in_force

20-3210. Annual statements; record retention

A. Each licensed provider shall file with the director on or before March 1 of each year an annual statement in a form prescribed by the director.  The annual statement shall be verified by the oath of at least two of its principal officers, showing its condition at the end of the preceding calendar year.  In addition to any other requirements, the annual statement shall include the total number, aggregate face amount and life settlement proceeds of policies settled during the immediately preceding calendar year, together with a breakdown of the information by policy issue year. The annual statement shall not include individual transaction data regarding the business of life settlements or information that there is a reasonable basis to believe could be used to identify the owner or the insured.

B. The provider shall maintain records of all consummated transactions and life settlement contracts for three years after the death of the insured. The director may inspect these records during reasonable business hours.
A.R.S. § 20-390 — Arizona Code / Title 20 / Chapter 2 / Article 4.1 / Section 390
20-390 Advisory organizations; filing with director
Status: in_force

20-390. Advisory organizations; filing with director

A. An advisory organization shall not conduct its operations in this state until it files with the director:

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

2. A list of its members and subscribers.

3. The name and address of one or more residents of this state upon whom notices, process affecting it or orders of the director may be served.

B. An advisory organization shall promptly file any amendments to a document required to be filed pursuant to this section.

C. It is unlawful for an advisory organization to engage in any unfair or unreasonable practice.
A.R.S. § 20-1801 — Arizona Code / Title 20 / Chapter 8 / Article 1 / Section 1801
20-1801 Definitions
Status: in_force

20-1801. Definitions

In this chapter, unless the context otherwise requires:

1. "Assets of a life care facility" means those assets held in the name of the life care facility only.

2. "Contract holder" means a person who enters into a life care contract with a provider or who is designated, in a life care contract, to be a person provided with services in the person's private residence with the right to future access to services, board and lodging in a facility.

3. "Entrance fee" means an initial or deferred transfer to a provider of a sum of money or property, made or promised to be made by a person entering into a life care contract, which assures a resident or contract holder of services pursuant to a life care contract.

4. "Facility":

(a) Means a place or places in which a provider undertakes to provide a resident with nursing services, medical services or health-related services, in addition to board and lodging, for a term in excess of one year or for life pursuant to a life care contract.

(b) Does not include a contract holder's private residence.

5. "Life care contract" means a contract to provide to a person for the duration of the person's life or for a term in excess of one year nursing services, medical services or health-related services, as defined in section 36-401, in addition to board and lodging for the person in a facility or services in the person's private residence with the right to future access to services, board and lodging in a facility, conditioned on the transfer of an entrance fee to the provider of such services in addition to or in lieu of the payment of regular periodic charges for the care and services involved.

6. "Living unit" means an apartment, room or other area within a facility set aside for the exclusive use of one or more identified residents.

7. "Manager" means a corporation, partnership, association, joint stock company, trust, or any other unincorporated organization that is contracted with to manage the residential section or health-related section, or both, of a life care facility.

8. "Permit" means a permit to enter into life care contracts issued by the department.

9. "Promoter" means the primary person who is employed to consult or to promote the establishment of a life care facility.

10. "Provider" means a person who provides services pursuant to a life care contract.

11. "Resident" means a person who enters into a life care contract with a provider or who is designated, in a life care contract, to be a person provided with services, board and lodging in a living unit or at a facility.
A.R.S. § 20-1264 — Arizona Code / Title 20 / Chapter 6 / Article 2 / Section 1264
20-1264 Beneficiary
Status: reserved

20-1264. Beneficiary

In group life policies there shall be a provision that any sum becoming due by reason of the death of the person insured shall be payable to the beneficiary designated by the person insured, subject to the provisions of the policy in the event there is no designated beneficiary, as to all or any part of such sum, living at the death of the person insured, and subject to any right reserved by the insurer in the policy and set forth in the certificate to pay at its option a part of such sum not exceeding two hundred fifty dollars to any person appearing to the insurer to be equitably entitled thereto by reason of having incurred funeral or other expenses incident to the last illness or death of the person insured.
A.R.S. § 20-3651 — Arizona Code / Title 20 / Chapter 31 / Article 1 / Section 3651
20-3651 Definitions
Status: in_force

20-3651. Definitions

In this article, unless the context otherwise requires:

1. "Clinical practice guidelines" means a systematically developed statement to assist health care providers and patients in making decisions about appropriate health care for specific clinical circumstances and conditions.

2. "Clinical review criteria" means the written screening procedures, decision abstracts, clinical protocols and practice guidelines that are used by a health care insurer, pharmacy benefit manager or utilization review agent to determine the medical necessity and appropriateness of health care services.

3. "Exigent circumstance" means the action of a health care insurer, pharmacy benefit manager or utilization review agent on a step therapy protocol exception request within the application of the time periods for making a nonexpedited decision, as determined and documented by the prescribing provider, could seriously jeopardize the insured's, enrollee's or subscriber's life, health or ability to regain maximum function or cause a significant negative change in the patient's medical condition.

4. "Health care insurer" has the same meaning prescribed in section 20-2501.

5. "Health care plan" means a policy, contract or evidence of coverage that a health care insurer issues to an insured, enrollee or subscriber.

6. "Medically necessary" means, with respect to a prescription drug, appropriate under the applicable standard of care:

(a) To improve or preserve health, life or function.

(b) To slow the deterioration of health, life or function.

(c) For the early screening, prevention, evaluation, diagnosis or treatment of a disease, condition, illness or injury.

7. "Methodologist" means a person that manages research design for the purpose of accurate and unbiased data collection and that has experience testing questions that are germane to the subject of the research.

8. "Pharmaceutical sample" means a unit of a prescription drug that is not intended to be sold but is intended to promote the sale of the prescription drug.

9. "Pharmacy benefit manager" has the same meaning prescribed in section 20-3321.

10. "Serious adverse reaction":

(a) Means an adverse event or suspected adverse reaction if, in the view of either the investigator or sponsor, the event or reaction results in any of the following outcomes:

(i) Death.

(ii) A life-threatening adverse event.

(iii) Inpatient hospitalization or prolonging existing hospitalization.

(iv) A persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions.

(v) A congenital anomaly or birth defect.

(b) Includes an event or reaction that might not result in death, be life threatening or require hospitalization but, based on appropriate medical judgment, could jeopardize the patient's health or medical situation by requiring medical or surgical intervention to prevent at least one of the outcomes listed in subdivision (a) of this paragraph.

11. "Step therapy exception" means a step therapy protocol that is overridden in favor of immediate coverage of a health care provider's selected prescription drug.

12. "Step therapy protocol" means a protocol or program that establishes the specific sequence in which prescription drugs that are for a specified medical condition and that are medically necessary for a particular patient are covered by a health care insurer under a health care plan.

13. "Utilization review" has the same meaning prescribed in section 20-2501.

14. "Utilization review agent" has the same meaning prescribed in section 20-2530.
A.R.S. § 20-366 — Arizona Code / Title 20 / Chapter 2 / Article 4 / Section 366
20-366 Appeal by member or subscriber from action relating to filings
Status: in_force

20-366. Appeal by member or subscriber from action relating to filings

A. Any member of or subscriber to a rating organization may appeal to the director from the action or decision of the rating organization in approving or rejecting any proposed change in or addition to the filings of the rating organization, and the director shall, after a hearing held upon not less than ten days' written notice to the applicant and to the rating organization, issue an order approving the action or decision of the rating organization or directing it to give further consideration to the proposal, or if the appeal is from the action or decision of the rating organization in rejecting a proposed addition to its filings, the director may, in the event that he shall find that such action or decision was unreasonable, issue an order directing the rating organization to make an addition to its filings, on behalf of its members and subscribers, in a manner consistent with the findings of the director, within a reasonable time after the issuance of the order.

B. In the case of insurance to which this article applies, if the appeal is based upon the failure of the rating organization to make a filing on behalf of such member or subscriber which is based on a system of expense provisions which differs from the system of expense provisions included in a filing made by the rating organization, the director shall, if he grants the appeal, order the rating organization to make the requested filing for use by the applicant. In deciding the appeal the director shall apply the standards set forth in section 20-356.

C. In the case of title insurance, if the appeal is from the action or decision of the rating organization with regard to a rate or a proposed change in or addition to its filings relating to the character and extent of coverage, the director may, in the event that he shall find that such action or decision was unreasonable, issue an order directing the rating organization to proceed in a manner consistent with his findings, within a reasonable time after the issuance of the order. The failure of a title insurance rating organization to take action or make a decision within thirty days after submission to it of a proposal under this article shall constitute a rejection of such proposal within the meaning of this section.  If such appeal is based upon the failure of the rating organization to make a filing on behalf of such members or subscriber which is based on a system of expense allocation which differs from the system of expense allocation included in a filing made by the rating organization, the director shall, if he grants the appeal, order the rating organization to make the requested filing for use by the applicant. In deciding such appeal, the director shall apply the standards set forth in section 20-375.
A.R.S. § 20-841.02 — Arizona Code / Title 20 / Chapter 4 / Article 3 / Section 841.02
20-841.02 Prohibiting denial of psychologist contract benefits
Status: in_force

20-841.02. Prohibiting denial of psychologist contract benefits

If a subscription contract of a hospital and medical service corporation provides for or offers reimbursement for any service which is within the lawful scope of the practice of a psychologist holding a certificate or license issued by the state in which the services are rendered, a subscriber covered under such contract may select either a physician or duly certified or licensed psychologist to provide the examination, care or treatment for which the subscriber is eligible and which falls within the scope of practice of the psychologist or physician.
A.R.S. § 20-549 — Arizona Code / Title 20 / Chapter 3 / Article 2 / Section 549
20-549 Investments not otherwise authorized; limitations; appraisal; cost
Status: in_force

20-549. Investments not otherwise authorized; limitations; appraisal; cost

A. An insurer may make loans or investments not otherwise qualifying or permitted under this article in an amount not exceeding in the aggregate ten per cent of the insurer's assets, and not exceeding two per cent of such assets as to any one such loan, investment or category of investment, except that such loan or investment shall not be represented by any item described in section 20-503.

B. The insurer shall fulfill the requirements of section 20-534 and shall maintain sufficient information so that the director can reasonably ascertain the market value of the loan or investment. The director may employ appraisers or other experts to assist in determining the value of the loans or investments. The insurer shall pay the cost incurred for any appraisal.
A.R.S. § 20-1203 — Arizona Code / Title 20 / Chapter 6 / Article 1 / Section 1203
20-1203 Grace period
Status: in_force

20-1203. Grace period

There shall be a provision that a grace period of thirty days, or, at the option of the insurer, of one month of not less than thirty days, shall be allowed within which the payment of any premium after the first may be made, during which period of grace the policy shall continue in full force. If a claim arises under the policy during the period of grace before the overdue premium is paid, the amount of the premium may be deducted from the policy proceeds.
A.R.S. § 20-2322 — Arizona Code / Title 20 / Chapter 13 / Article 1 / Section 2322
20-2322 Mental health services and benefits; definitions
Status: in_force

20-2322. Mental health services and benefits; definitions

A. Beginning on January 1, 1998, any health benefits plan that is offered by an accountable health plan and that provides services or health benefits that include mental health services or mental health benefits shall comply with this section.

B. If the health benefits plan does not include an aggregate lifetime limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall not impose any aggregate lifetime limit on mental health services or mental health benefits. If the health benefits plan includes an aggregate lifetime limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall either:

1. Apply the applicable lifetime limit to both the health services or health benefits that are not related to mental health services or mental health benefits and to the mental health services or mental health benefits.

2. Not include an aggregate lifetime limit on mental health services or mental health benefits that is less than the applicable lifetime limit for health services or health benefits that are not related to mental health services or mental health benefits.

C. If the health benefits plan does not include an aggregate annual limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall not impose any aggregate annual limit on mental health services or mental health benefits. If the health benefits plan includes an aggregate annual limit on substantially all health services or health benefits that are not related to mental health services or mental health benefits, the health benefits plan shall either:

1. Apply the applicable annual limit to both the health services or health benefits that are not related to mental health services or mental health benefits and to the mental health services or mental health benefits.

2. Not include any aggregate annual limit on mental health services or mental health benefits that is less than the applicable annual limit for health services or health benefits that are not related to mental health services or mental health benefits.

D. Except as provided in subsections A, B and C, this section does not prevent an accountable health plan that offers a health benefits plan that provides mental health services or mental health benefits from imposing terms and conditions, including cost sharing, limits on the number of visits or days of coverage or requirements relating to medical necessity in relation to the amount, duration or scope of coverage for mental health services or mental health benefits under the health benefits plan. Nothing in this section requires an accountable health plan to:

1. Offer a health benefits plan that provides mental health services or mental health benefits.

2. Comply with this section in connection with any health benefits plan offered to a small employer.

3. Comply with this section if that compliance under the health benefits plan offered by the accountable health plan would result in an increase in the cost to the health benefits plan of at least one per cent.

E. The requirements of this section apply separately to each health benefits plan offered by an accountable health plan and shall be consistent with title VII of the health insurance portability and accountability act of 1996 (P.L. 104-204; 110 Stat. 2944) and 45 Code of Federal Regulations part 146.

F. Mental health services or mental health benefits do not include benefits for the treatment of substance abuse or chemical dependency.

G. For the purposes of this section:

1. "Aggregate annual limit" means a dollar limitation on the total amount that may be paid in a twelve month period for benefits or services under a health benefits plan for an individual who is covered under a health benefits plan.

2. "Aggregate lifetime limit" means a dollar limitation on the total amount that may be paid for benefits or services under a health benefits plan for an individual who is covered under a health benefits plan.
A.R.S. § 20-2120 — Arizona Code / Title 20 / Chapter 11 / Article 1 / Section 2120
20-2120 No limitation of common law right
Status: in_force

20-2120. No limitation of common law right

Nothing in this article shall limit any common law right of any person.
A.R.S. § 20-1266 — Arizona Code / Title 20 / Chapter 6 / Article 2 / Section 1266
20-1266 Conversion on termination of eligibility
Status: in_force

20-1266. Conversion on termination of eligibility

In group life policies there shall be a provision that if the insurance, or any portion of it, on a person covered under the policy ceases because of termination of employment or of membership in the class or classes eligible for coverage under the policy, such person shall be entitled to have issued to him by the insurer, without evidence of insurability, an individual policy of life insurance without disability or other supplementary benefits, provided that application for the individual policy has been made, and the first premium paid to the insurer, within thirty-one days after the termination, and provided further that:

1. The individual policy, at the option of such person, is on any one of the forms, except term insurance, then customarily issued by the insurer at the age and for the amount applied for.

2. The individual policy is in an amount not in excess of the amount of life insurance which ceases because of the termination, less, in the case of a person whose membership in the class or classes eligible for coverage terminates but who continues in employment in another class, the amount of any life insurance for which the person is or becomes eligible under any other group policy within thirty-one days after the termination, provided that any amount of insurance which has matured on or before the date of the termination as an endowment payable to the person insured, whether in one sum or in installments or in the form of an annuity, shall not, for the purposes of this provision, be included in the amount which is considered to cease because of the termination.

3. The premium on the individual policy is at the insurer's then customary rate applicable to the form and amount of the individual policy, to the class of risk to which the person then belongs, and to his age attained on the effective date of the individual policy.
A.R.S. § 20-1404.02 — Arizona Code / Title 20 / Chapter 6 / Article 5 / Section 1404.02
20-1404.02 Eosinophilic gastrointestinal disorder; formula
Status: in_force

20-1404.02. Eosinophilic gastrointestinal disorder; formula

A. Any policy or contract that is offered by a blanket disability insurer and that contains a prescription drug benefit shall cover amino acid-based formula that is ordered by a physician or a registered nurse practitioner if:

1. The insured has been diagnosed with an eosinophilic gastrointestinal disorder.

2. The insured is under the continuous supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15.

3. There is risk of a mental or physical impairment without the use of the formula.

B. A blanket disability insurer shall cover at least seventy-five per cent of the cost of the formula.  The blanket disability insurer may limit the maximum annual benefit for formula under this section to twenty thousand dollars.

C. This section does not apply to limited benefit coverage as defined in section 20-1137.
A.R.S. § 20-892 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 892
20-892 Violation; classification
Status: in_force

20-892. Violation; classification

A. A person who knowingly or wilfully makes a false or fraudulent statement or representation in or relating to an application for membership or for the purpose of obtaining money from or a benefit in a society is guilty of a class 6 felony.

B. A person who wilfully makes a false or fraudulent statement in a verified report or declaration under oath required by this article or who makes a false or fraudulent statement of a material fact that is contained in a sworn statement concerning the death or disability of an insured for the purpose of procuring the payment of a benefit named in the certificate is guilty of perjury and is subject to section 13-2702.

C. A person who solicits membership for or who in any manner assists in procuring membership in a society that is not licensed to do business in this state is guilty of a violation and is subject to section 20-114.

D. A person who wilfully violates, neglects or refuses to comply with this article is guilty of a violation and is subject to section 20-114.
A.R.S. § 20-728 — Arizona Code / Title 20 / Chapter 4 / Article 1 / Section 728
20-728 Impairment of capital or assets
Status: in_force

20-728. Impairment of capital or assets

A. If the capital stock of a stock insurer becomes impaired, or the assets of a mutual insurer are less than its liabilities and the minimum amount of surplus required of it by this title for authority to transact the kinds of insurance being transacted, the director shall at once determine the amount of the deficiency and serve notice upon the insurer to make good the deficiency within ninety days after service of such notice.

B. The deficiency may be made good in cash or in assets eligible under this title for the investment of the insurer's funds, or if a stock insurer, by reduction of the insurer's capital to an amount not below the minimum required for the kinds of insurance thereafter to be transacted, or if a mutual insurer, by amendment of its certificate of authority to cover only such kind or kinds of insurance for which the insurer has on deposit sufficient surplus.

C. If the deficiency is not made good and proof thereof filed with the director within the ninety day period, the insurer shall be deemed insolvent and the director shall institute delinquency proceedings against it as authorized by this title. If the deficiency exists because of increased loss reserves required by the director, or because of disallowance by the director of certain assets or reduction of the value at which carried in the insurer's accounts, the director may in his discretion and upon application and good cause shown, extend for not more than an additional ninety days the period within which the deficiency may be so made good and proof thereof so filed.
A.R.S. § 20-1130 — Arizona Code / Title 20 / Chapter 5 / Article 1 / Section 1130
20-1130 Administration of claim against insurer not deemed waiver of defense
Status: in_force

20-1130. Administration of claim against insurer not deemed waiver of defense

Without limitation of any right or defense of an insurer otherwise, none of the following acts by or on behalf of an insurer shall be deemed to constitute a waiver of any provision of a policy or of any defense of the insurer thereunder:

1. Acknowledgement of the receipt of notice of loss or claim under the policy.

2. Furnishing forms for reporting a loss or claim, for giving information relative thereto, or for making proof of loss, or receiving or acknowledging receipt of any such forms or proofs completed or uncompleted.

3. Investigating any loss or claim under any policy or engaging in negotiations looking toward a possible settlement of any such loss or claim.
A.R.S. § 20-3208 — Arizona Code / Title 20 / Chapter 22 / Article 1 / Section 3208
20-3208 Conflict of interest; examiners
Status: in_force

20-3208. Conflict of interest; examiners

A. The director may not appoint an examiner if the examiner, either directly or indirectly, has a conflict of interest or is affiliated with the management of or owns a pecuniary interest in any person subject to examination under this chapter.  This section does not automatically preclude an examiner from being an owner, an insured in a life settlement contract or insurance policy or a beneficiary in an insurance policy that is proposed for a life settlement contract.

B. Notwithstanding subsection A, the director may retain on an individual basis qualified actuaries, certified public accountants or other similar individuals who are independently practicing their professions even though these persons may from time to time be similarly employed or retained by persons subject to examination under this chapter.
A.R.S. § 20-1242.02 — Arizona Code / Title 20 / Chapter 6 / Article 1.2 / Section 1242.02
20-1242.02 Standards for the disclosure document and buyer's guide
Status: in_force

20-1242.02. Standards for the disclosure document and buyer's guide

A. If the application for an annuity contract is taken in a face-to-face meeting, the applicant, at or before the time of application, shall be given both the disclosure document and the buyer's guide in the form prescribed by the director.

B. If the application for an annuity contract is taken by means other than in a face-to-face meeting, the applicant shall be sent both the disclosure document and the buyer's guide no later than five business days after the completed application is received by the insurer.

C. With respect to an application received as a result of a direct solicitation through the mail:

1. Providing a buyer's guide in a mailing that invites prospective applicants to apply for an annuity contract is deemed to satisfy the requirement that the buyer's guide be provided no later than five business days after receipt of the application.

2. Providing a disclosure document in a mailing that invites a prospective applicant to apply for an annuity contract is deemed to satisfy the requirement that the disclosure document be provided no later than five business days after receipt of the application.

D. With respect to an application received through the internet:

1. Taking reasonable steps to make the buyer's guide available for viewing and printing on the insurer's web site is deemed to satisfy the requirement that the buyer's guide be provided not later than five business days after receipt of the application.

2. Taking reasonable steps to make the disclosure document available for viewing and printing on the insurer's web site is deemed to satisfy the requirement that the disclosure document be provided not later than five business days after receipt of the application.

E. A solicitation for an annuity contract provided in other than a face-to-face meeting shall include a statement that the proposed applicant may contact the insurer for a free annuity buyer's guide.

F. If the buyer's guide and disclosure document are not provided at or before the time of application, a free look period of not less than fifteen days shall be provided for the applicant to return the annuity contract without penalty.  This free look period shall run concurrently with any other free look period provided under statute.

G. At a minimum, the following information shall be included in the disclosure document required to be provided under this article:

1. The generic name of the contract, the company product name, if different, the form number and the fact that it is an annuity.

2. The insurer's name and address.

3. A description of the contract and its benefits, emphasizing its long-term nature and including examples where appropriate.

4. The guaranteed, nonguaranteed and determinable elements of the contract, their limitations, if any, and an explanation of how they operate.

5. An explanation of the initial crediting rate, specifying any bonus or introductory portion, the duration of the rate and the fact that rates may change from time to time and are not guaranteed.

6. The periodic income options both on a guaranteed and nonguaranteed basis.

7. Any value reductions caused by withdrawals from or surrender of the contract.

8. How values in the contract can be accessed.

9. The death benefit, if available, and how it will be calculated.

10. A summary of the federal tax status of the contract and any penalties applicable on withdrawal of values from the contract.

11. The impact of any rider, such as a long-term care rider.

12. The specific dollar amount or percentage charges.  Fees shall be listed with an explanation of how they apply.

13. Information about the current guaranteed rate for new contracts that contains a clear notice that the rate is subject to change.
A.R.S. § 20-406 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 406
20-406 Attorneys' fees in action against insurer
Status: in_force

20-406. Attorneys' fees in action against insurer

In any action against an unauthorized insurer pursuant to section 20-403, if the insurer has failed for thirty days after demand prior to the commencement of the action to make payment in accordance with the terms of the contract of insurance, and it appears to the court that the refusal was vexatious and without reasonable cause, the court may allow to the plaintiff a reasonable attorney's fee and include such fee in any judgment that may be rendered in the action. The attorney's fee shall not exceed one third of the amount which the court or jury finds the plaintiff is entitled to recover against the insurer, but in no event shall such a fee be less than one hundred dollars. Failure of an insurer to defend any such action shall be deemed prima facie evidence that its failure to make payment was vexatious and without reasonable cause.
A.R.S. § 20-1224 — Arizona Code / Title 20 / Chapter 6 / Article 1 / Section 1224
20-1224 Reinstatement of annuities
Status: in_force

20-1224. Reinstatement of annuities

In an annuity or pure endowment contract, other than a reversionary, survivorship or group annuity, there shall be a provision that the contract may be reinstated at any time within one year from the default in making stipulated payments to the insurer, unless the cash surrender value has been paid, but all overdue stipulated payments and any indebtedness to the insurer on the contract shall be paid or reinstated with interest thereon at a rate to be specified in the contract but not exceeding six per cent per annum payable annually, and in cases where applicable the insurer may also include a requirement of evidence of insurability satisfactory to the insurer.
A.R.S. § 20-1096.07 — Arizona Code / Title 20 / Chapter 4 / Article 12 / Section 1096.07
20-1096.07 Reserves
Status: in_force

20-1096.07. Reserves

Each mechanical reimbursement reinsurer shall maintain policy and loss reserves in those amounts as the director deems sufficient.
A.R.S. § 20-412 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 412
20-412 Acceptance of surplus lines business by broker
Status: in_force

20-412. Acceptance of surplus lines business by broker

A licensed surplus lines broker may accept or place surplus lines business from any insurance producer licensed in this state for the kind of insurance involved and may compensate the insurance producer therefor. The broker shall have the right to receive from the insurer the customary commission.
A.R.S. § 20-340.02 — Arizona Code / Title 20 / Chapter 2 / Article 3.5 / Section 340.02
20-340.02 Bond of bail bond agents
Status: in_force

20-340.02. Bond of bail bond agents

A. Each applicant for a bail bond agent's license or license renewal shall file with the application and shall maintain in force while licensed a bond in favor of this state executed by a surety insurer authorized to do business in this state. The bond may be continuous in form, and total aggregate liability on the bond shall be at least ten thousand dollars. The applicant shall place the bond on deposit with the state treasurer through the director's office. The bond shall be conditioned on full accounting and due payment to the person entitled to the bond of monies coming into the bail bond agent's possession as an incident to bail bond transactions under the license.

B. The bond remains in force until released by the director or until cancelled by the surety. Without prejudice to any liability previously incurred, the surety may cancel the bond on thirty days' advance written notice filed with the director.
A.R.S. § 20-666 — Arizona Code / Title 20 / Chapter 3 / Article 6 / Section 666
20-666 Assessments; notification; exemptions; setoffs; refunds
Status: in_force

20-666. Assessments; notification; exemptions; setoffs; refunds

A. The board shall assess each member insurer, as a condition of such insurer's authority to transact insurance in this state, in such amounts as are necessary to pay the obligations of the fund pursuant to section 20-667 subsequent to an insolvency, the expenses of handling covered claims subsequent to an insolvency, the cost of examinations and other expenses authorized pursuant to this article.

B. The assessment of each member insurer shall be in the proportion that the net direct written premiums of the member insurer for the preceding calendar year on the kinds of insurance in the account bears to the net direct written premiums of all member insurers for the preceding calendar year on the kinds of insurance in the account. The board shall notify each member insurer of the assessment not later than thirty days before it is due. No member insurer may be assessed in any year on any account an amount greater than one per cent of such member insurer's net direct written premiums for the preceding calendar year on the kinds of insurance in the account.

C. Except for the workers' compensation insurance account, if the maximum assessment, together with the other assets of the fund in any account, does not provide in any one year in any account an amount sufficient to make all necessary payments from such account, the funds available may be prorated and the unpaid portion shall be paid as soon as funds become available. The board shall pay claims in any order which it may deem reasonable, including the payment of claims as such claims are received from the claimants or in groups or categories of claims.

D. The board may exempt or defer, in whole or in part, the assessment of any member insurer, if the assessment would cause the member insurer's financial statement to reflect amounts of capital or surplus less than the minimum amounts required for a certificate of authority by any jurisdiction in which the member insurer is authorized to transact insurance.

E. Each member insurer serving as a servicing facility may set off against any assessment, authorized payments made on covered claims and expenses incurred in the payment of such claims by the member insurer if they are chargeable to the account for which the assessment is made.

F. In addition to all other assessments, the board may assess each member insurer in an amount not to exceed two hundred dollars per year for the purpose of paying for operating expenses of the board and employees of the board.

G. If, at the end of any calendar year, the board finds that the assets of the fund in any account exceed the liabilities of such account as estimated by the board for the coming year, the board may refund to the member insurers in proportion to the contribution of each member insurer to such account the amount by which the assets of the account exceed the liabilities. All refunds will be contingent upon the return of a member insurer's certificate(s) of contribution and will be in an amount equal to the premium tax offset value of the relinquished certificate.
A.R.S. § 20-705 — Arizona Code / Title 20 / Chapter 4 / Article 1 / Section 705
20-705 Articles of incorporation
Status: in_force

20-705. Articles of incorporation

A. The articles of incorporation shall state:

1. The name of the corporation. If a mutual, the word "mutual" shall be a part of the name.

2. The duration of its existence, which may be perpetual.

3. The kinds of insurance the corporation is formed to transact, according to the definitions thereof in this title. If the corporation is to be a limited stock insurer, the articles shall provide for limitations on the insuring powers of the corporation consistent with section 20-708.

4. If a stock corporation, its authorized capital, the classes and number of shares into which divided, the par value of each such share and the respective rights of each such class. Shares without par value shall not be authorized.

5. If a mutual corporation, the maximum contingent liability of its members, other than as to nonassessible policies, for payment of losses and expenses incurred, which liability shall be as stated in the articles of incorporation but not less than one nor more than six times the premium for the member's policy at the annual premium rate for a term of one year.

6. The number of directors, not less than five nor more than fifteen, who shall conduct the affairs of the corporation, and the names and addresses of the corporation's first directors and officers for stated terms of office of not less than two months or more than one year.

7. The time of the annual meeting of stockholders or members.

8. The city or town in this state in which the principal place of business is to be located, and the counties, states and countries in which business may be transacted.

9. The limitations, if any, on the corporation's indebtedness.

10. If a stock corporation, the extent, if any, to which stock of the corporation shall be liable to assessment.

11. Such other provisions, not inconsistent with law, as deemed appropriate by the incorporators.

12. The names and addresses of the incorporators.

B. This section applies to stock and mutual insurers incorporated in this state after January 1, 1955.
A.R.S. § 20-1406.04 — Arizona Code / Title 20 / Chapter 6 / Article 5 / Section 1406.04
20-1406.04 Prohibiting denial of occupational or physical therapist contract benefits
Status: in_force

20-1406.04. Prohibiting denial of occupational or physical therapist contract benefits

If a group disability or blanket disability insurance contract provides coverage for occupational or physical therapy services, and provides both an in-network and out-of-network benefit, an insurer shall not deny a claim for covered occupational or physical therapy services obtained out-of-network solely on the basis that a physician did not refer the insured to the occupational or physical therapist or prescribe specific occupational or physical therapy services.  An insurer may impose coinsurance, copayments, deductibles, dollar caps, limitations on the number of visits, provider network restrictions or other cost containment measures as a condition of coverage of occupational and physical therapy services for both in-network and out-of-network benefits.
A.R.S. § 20-1303 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1303
20-1303 Grace period
Status: in_force

20-1303. Grace period

There shall be a provision that the insured is entitled to a grace period of four weeks within which the payment of any premiums after the first may be made, except that in policies the premiums for which are payable monthly, the period of grace shall be one month, but not less than thirty days, and that during the period of grace the policy shall continue in full force, but if during the grace period the policy becomes a claim, then any overdue and unpaid premiums may be deducted from any settlement under the policy.
A.R.S. § 20-157 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 157
20-157 Access and powers relating to insurers' records
Status: in_force

20-157. Access and powers relating to insurers' records

A. Every person being examined and its officers, employees, agents and representatives shall produce and make freely accessible to the director or the director's examiners the accounts, records, documents, files, assets and matters in the person's possession or control relating to the subject of the examination.

B. If the director finds accounts to be inadequate, or improperly kept or posted, the director may employ experts to rewrite, post or balance them at the expense of the person being examined if the person fails to complete or correct the accounting after the director has given the person notice and a reasonable opportunity to do so.

C. If the director deems it necessary to value any real estate involved in any examination, the director may employ one or more competent appraisers for the purpose.  The reasonable expense of the appraisal is a part of the cost of examination to be borne by the person being examined.

D. Any insurer or other person licensed under this title may cause its accounts, records, documents and files described in subsection A of this section to be created, recorded, copied or reproduced by any photographic, photostatic, microfilm, microcard, miniature photographic, optical disk, electronic imaging, electronic data processing, electronically transmitted facsimile, printout or reproduction of electronically stored data or other process that accurately reproduces or forms a durable medium for storing the account, record, document or file. If the items so stored are not the original, the original may be destroyed unless held in a custodial or fiduciary capacity, but only if the data is easily accessible to the department in readable form and readable reproduced copies are obtainable. A record so stored is admissible in evidence as the original in any judicial or administrative proceeding whether the original is in existence or not. The introduction of a reproduced record does not preclude admission of the original. This shall not be construed to exclude from evidence any document or copy that is otherwise admissible under the rules of evidence.
A.R.S. § 20-880 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 880
20-880 Investments
Status: in_force

20-880. Investments

A society shall invest its funds only in those investments that are authorized by this title. A foreign or alien society that is permitted or seeking to do business in this state and that invests its funds in accordance with the laws of the state, district, territory, country or province in which it is incorporated is deemed to meet the requirements of this section for the investment of funds.
A.R.S. § 20-224.01 — Arizona Code / Title 20 / Chapter 2 / Article 1 / Section 224.01
20-224.01 Additional premium tax; civil penalty
Status: in_force

20-224.01. Additional premium tax; civil penalty

A. Coincident with the filing of the tax report as required in section 20-224, each insurer shall pay to the director, for deposit, pursuant to sections 35-146 and 35-147, a tax of .4312 percent of such net premiums received from all insurance carried for or on vehicles as defined in section 28-101, in addition to other applicable taxes.

B. The tax of .4312 percent of such net premiums received by the director and paid by an insurer on account of premiums received for insurance on certain vehicles as defined in section 28-101 shall be separately specified in the insurer's report required in section 20-224 and is appropriated to the public safety personnel retirement system and shall be transferred by the state treasurer to the board of trustees of the public safety personnel retirement system for deposit in the highway patrol account. If the tax received is greater than the amount necessary to fund the highway patrol account, beginning in the 1991-1992 fiscal year the state treasurer shall deposit the excess in the Arizona highway patrol fund established by section 41-1752 in any amount required by legislative appropriation.

C. An insurer shall report and pay the taxes required by this section in the manner prescribed by section 20-224. An insurer who fails to pay the tax on or before the prescribed payment dates is subject to a civil penalty determined pursuant to section 20-225.

D. An insurer shall not claim a premium tax credit pursuant to section 20-224.03 for the premium taxes paid pursuant to this section.
A.R.S. § 20-632 — Arizona Code / Title 20 / Chapter 3 / Article 4 / Section 632
20-632 Deposit of monies collected
Status: in_force

20-632. Deposit of monies collected

The monies collected by the receiver in a proceeding under this article shall be from time to time deposited in one or more state or national banks, savings banks or trust companies, and in the case of the insolvency or voluntary or involuntary liquidation of any such depositary which is an institution organized and supervised under the laws of this state, such deposits shall be entitled to priority of payment on an equality with any other priority given by the banking laws of this state. The receiver may deposit such monies or any part thereof in a national bank or trust company as a trust fund.
A.R.S. § 20-512 — Arizona Code / Title 20 / Chapter 3 / Article 1 / Section 512
20-512 Valuation of other securities
Status: in_force

20-512. Valuation of other securities

A. Securities, other than those referred to in section 20-511, held by an insurer shall be valued, in the discretion of the director, at their market value, or at their appraised value, at prices determined by the director as representing their fair market value but shall not be valued in a manner that is inconsistent with the standards promulgated by the securities valuation office of the national association of insurance commissioners.

B. Preferred or guaranteed stocks or shares while paying full dividends may be carried at a fixed value in lieu of market value, at the discretion of the director and in accordance with such method of computation as the director may approve but shall not be valued in a manner that is inconsistent with the standards promulgated by the securities valuation office of the national association of insurance commissioners.
A.R.S. § 20-2635 — Arizona Code / Title 20 / Chapter 16 / Article 2 / Section 2635
20-2635 Variable annuity contracts
Status: in_force

20-2635. Variable annuity contracts

A. A variable annuity that provides benefits payable in variable amounts and that is delivered or issued for delivery in this state shall contain a statement of the essential features of the procedures the insurance company must follow in determining the dollar amount of the variable benefits. The contract, including a group contract and any certificate in evidence of variable benefits that is issued under the contract, shall state that the dollar amount will vary to reflect investment experience and shall contain on its first page a clear statement that the benefits under the contract are on a variable basis.

B. Illustrations of benefits that are payable under a variable annuity shall not include projections of past investment experience into the future or attempted predictions of future investment experience. This subsection does not prohibit the use of hypothetical assumed rates of return to illustrate possible benefit levels.

C. An insurer shall not deliver or issue for delivery in this state an individual variable annuity contract that calls for the payment of periodic stipulated payments unless the contract contains in substance the following provision or provisions:

1. A grace period provision of thirty days or of one month, within which any stipulated payment to the insurer that falls due after the first day may be made and during which the contract shall continue in force. The contract may state the basis for determining the date as of which any payment that is received during the grace period shall be applied to produce the values under the contract arising from the contract.

2. A reinstatement provision that unless the cash surrender value has been paid the contract may be reinstated on the payment to the insurer of the overdue payments as required by contract and all indebtedness on the contract, including interest, at any time after the date of the default in making periodic stipulated payments to the insurer during the life of the annuitant. The contract may state the basis for determining the date as of which the amount to cover the overdue payments and indebtedness shall be applied to produce the values under the contract arising from the contract.

D. A variable annuity contract that is delivered or issued for delivery in this state shall stipulate the investment increment factors the insurer will use in computing the dollar amount of variable benefits or other variable contractual payments or values under the variable annuity contract. The contract may guarantee that expense or mortality results, or both, do not adversely affect the dollar amounts. If the expense and mortality results may adversely affect the dollar amount of benefits, the insurer shall stipulate the expense and mortality factors in the contract. For the purposes of this subsection, the contract may stipulate that expense excludes some or all taxes.

E. In computing the dollar amount of variable benefits or other contractual payments or values under an individual variable annuity contract:

1. Unless the director otherwise approves, the annual net investment increment assumption shall not exceed five per cent.

2. To the extent that the level of benefits may be affected by future mortality results, unless the director approves the use of another table the mortality factor shall be determined from the annuity mortality table for 1949, ultimate, or any modification of that table not having a lower life expectancy at any age.

F. The reserve liability for variable annuities shall be established pursuant to the requirements of section 20-510 in accordance with actuarial procedures that recognize the variable nature of the benefits provided and any mortality guarantees.
A.R.S. § 20-226 — Arizona Code / Title 20 / Chapter 2 / Article 1 / Section 226
20-226 Exclusive character of premium tax; exception
Status: in_force

20-226. Exclusive character of premium tax; exception

A. With respect to authorized insurers the premium tax provided by section 20-224 shall be payment in full and in lieu of all other demands for any and all state, county, district, municipal and school taxes, licenses and excises of whatever kind or character, excepting only:

1. The fees prescribed by this title.

2. Taxes on real and tangible personal property located within this state.

3. The transaction privilege tax and the use tax imposed as provided in title 42, chapter 5, articles 1 and 4.

4. The transaction privilege taxes and use taxes imposed by any county, city or town.

B. Except as provided in subsection A of this section, the state preempts the field of imposing excise, privilege, franchise, income, license and similar taxes upon insurers and their general agents and agents as such and on the intangible property of insurers or such agents. Except as provided in subsection A of this section, no county, municipality, district, school district or other political subdivision or agency in this state shall levy upon insurers, or upon their general agents and agents as such, any tax additional to such as are levied in this title. Nothing in this section allows a county, city or town to impose a transaction privilege tax or use tax on insurance policies, premiums, brokers or agents.
A.R.S. § 20-501 — Arizona Code / Title 20 / Chapter 3 / Article 1 / Section 501
20-501 Eligible assets
Status: in_force

20-501. Eligible assets

In any determination of the financial condition of an insurer, the department shall allow only those assets that are owned by the insurer and that consist of:

1. Cash in the possession of the insurer, or in transit under its control, including the true balance of any deposit in a solvent bank or trust company.

2. Investments, securities, properties and loans acquired or held in accordance with this title, and the following related items:

(a) Interest due or accrued on any bond or evidence of indebtedness that is not in default and that is not valued on a basis including accrued interest.

(b) Declared and unpaid dividends on stock and shares, unless the amount has otherwise been allowed as an asset.

(c) Interest due or accrued on a collateral loan in an amount that is not more than one year's interest.

(d) Interest due or accrued on deposits in solvent banks and trust companies, and interest due or accrued on other assets, if the director determines that the interest is a collectible asset.

(e) Interest due or accrued on a mortgage loan, in an amount that is not more than the amount, if any, of the excess of the value of the property less delinquent taxes on the property over the unpaid principal, but in no event shall interest accrued for a period of more than one hundred eighty days be allowed as an asset.

(f) Rent due or accrued on real property if the rent is not in arrears for more than three months, and rent more than three months in arrears if the payment of the rent is adequately secured by property held in the name of the tenant and conveyed to the insurer as collateral.

(g) The unaccrued portion of taxes paid before the due date on real property.

3. Premium notes, policy loans and other policy assets and liens on policies and certificates of life insurance and annuity contracts and accrued interest, in an amount that is not more than the legal reserve and other policy liabilities carried on each individual policy.

4. For a life insurer, the net amount of uncollected and deferred premiums and annuity considerations.

5. Premiums in the course of collection not more than three months past due, less commissions payable on the premiums. Premiums payable directly or indirectly by the United States or by any of its instrumentalities are not subject to the three months past due limitation.

6. Installment premiums allowed pursuant to the accounting practices and procedures manual adopted by the national association of insurance commissioners.

7. Notes and like written obligations not past due, taken for premiums other than life insurance premiums on policies permitted to be issued on such basis, to the extent of the unearned premium reserves carried on the policies.

8. The full amount of reinsurance that is recoverable by a ceding insurer from a solvent reinsurer and that is authorized under section 20-261.

9. Amounts receivable by an assuming insurer representing funds withheld by a solvent ceding insurer under a reinsurance treaty.

10. Deposits or equities recoverable from underwriting associations, syndicates and reinsurance funds, or from any suspended banking institution, to the extent the director deems those funds are available for the payment of losses and claims and at values determined by the director.

11. Deferred tax assets as allowed pursuant to the accounting practices and procedures manual adopted by the national association of insurance commissioners.

12. Electronic data processing equipment, including operating system software, net of accumulated depreciation, that is necessary for use in the business of the insurer.  The insurer shall depreciate the equipment over a period of not more than three years.  The admitted value of the equipment shall not be more than the amount allowed pursuant to the accounting practices and procedures manual adopted by the national association of insurance commissioners.

13. Goodwill as allowed pursuant to the accounting practices and procedures manual adopted by the national association of insurance commissioners.

14. Other assets that are not inconsistent with this section and that the director deems are available for the payment of losses and claims, at values determined by the director.
A.R.S. § 20-481.15 — Arizona Code / Title 20 / Chapter 2 / Article 8 / Section 481.15
20-481.15 Consolidated registration by affiliates
Status: in_force

20-481.15. Consolidated registration by affiliates

The director may require or allow two or more affiliated insurers subject to registration to file a consolidated registration statement or consolidated reports amending their consolidated registration statement or their individual registration statements.
A.R.S. § 20-843 — Arizona Code / Title 20 / Chapter 4 / Article 3 / Section 843
20-843 Eligibility; prohibiting cancellation because of eligibility for certain benefits
Status: in_force

20-843. 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 hospital and medical service corporation shall not consider the availability of or a person's eligibility for medical assistance 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 a plan for eligible subscribers.

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 that are 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 hospital and medical service corporation shall pay the state program pursuant to title XIX of the social security act according to the coverage provided in the contract.

C. A hospital and medical service corporation 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 hospital or medical service corporation 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. § 20-460 — Arizona Code / Title 20 / Chapter 2 / Article 6 / Section 460
20-460 Free choice of insurance producer
Status: in_force

20-460. Free choice of insurance producer

No casualty or property insurance company, including any subsidiary of any such company, may offer any insurance program in this state to exclusive insurance producers without offering the same insurance program through all of its other authorized insurance producers authorized for similar types of insurance coverage with the exception of employer-employee programs making use of central premium collection.
A.R.S. § 20-1673 — Arizona Code / Title 20 / Chapter 6 / Article 14 / Section 1673
20-1673 Grounds for valid cancellation
Status: in_force

20-1673. Grounds for valid cancellation

A. No insurer may cancel an insurance policy before the expiration of the agreed term or one year from the effective date of the policy or renewal, whichever is less, if one of the following is true:

1. The policy has been in effect for sixty days.

2. The policy is a renewal, effective immediately.

B. Notwithstanding subsection A of this section, an insurer may cancel a policy for either of the following:

1. Nonpayment of a premium.

2. One of the following grounds, which must be stated in the policy:

(a) Conviction of the named insured of a crime arising out of acts increasing the hazard insured against.

(b) Acts or omissions by the insured or the insured's representative constituting fraud or material misrepresentation in obtaining the policy, in continuing the policy or in presenting a claim under the policy.

(c) A substantial change in the risk assumed, except to the extent that the insurer should reasonably have foreseen the change or contemplated the risk in writing the contract.

(d) A substantial breach of contractual duties or conditions.

(e) Loss of reinsurance applicable to the risk insured against, but only if the absence of reinsurance has resulted from termination of treaty or facultative reinsurance initiated or implemented by the reinsurer or reinsurers of the company issuing the policy.

(f) A determination by the director that the continuation of the policy would place the insurer in violation of the insurance laws of this state or would jeopardize the solvency of the insurer.

(g) Acts or omissions by the insured or the insured's representative that materially increase the hazard insured against.
A.R.S. § 20-1055 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1055
20-1055 Deposit requirement
Status: in_force

20-1055. Deposit requirement

A. A health care services organization at all times shall maintain on deposit with the state treasurer through the director's office cash, or securities eligible for the investment of capital funds of domestic insurers under this title, or other financial security approved by the director in an amount of not less than five hundred thousand dollars.

B. The deposit prescribed by subsection A shall be held by the state treasurer in trust for the benefit and protection of persons covered by a health care plan and for the satisfaction of all debts and liabilities of the health care services organization.

C. Any securities within the description of subsection A, with the approval of the director, may be exchanged for similar securities or cash of equal amount. Interest on securities so deposited shall be payable to the health care services organization depositing them.

D. An unsettled final judgment arising upon an evidence of coverage shall be a lien on the deposit prescribed by subsection A, subject to execution after thirty days from the entry of final judgment. If the deposit is reduced, it shall be replenished within ninety days by the health care services organization.

E. Upon liquidation, dissolution or withdrawal of a health care services organization and the satisfaction of all of its debts and liabilities, any balance remaining of the cash or securities deposit prescribed in subsection A together with any other assets of the health care services organization shall be returned by the director to the health care services organization.

F. Unless preempted under federal law or unless federal law imposes greater requirements than this section, this section applies to a provider sponsored health care services organization.
A.R.S. § 20-1568 — Arizona Code / Title 20 / Chapter 6 / Article 9 / Section 1568
20-1568 Unearned premium reserve
Status: in_force

20-1568. Unearned premium reserve

A. Every title insurer shall, in addition to other reserves, establish and maintain a reserve to be known as the "unearned premium reserve" for title insurance on real estate, which shall, at all times and for all purposes, be deemed and shall constitute the unearned portions of premiums due or received on account of such insurance and shall be charged as a reserve liability of such title insurer in determining its financial condition. A foreign title insurer doing business in this state may establish an unearned premium reserve for title insurance on real estate in accordance with the laws of its domiciliary state, provided an unearned premium reserve is mandatory under the law of its domiciliary state and such law is substantially equivalent to the requirements of this title.

B. The unearned premium reserve for title insurance on real estate shall be retained and held by such title insurer for the protection of the policyholders' interest in policies on real estate which have not expired. Except as provided in section 20-1571, assets equal to the amount of such reserve shall not be subject to distribution among other creditors or stockholders of such title insurer until all claims of policyholders or holders of title insurance contracts or agreements of such title insurer have been paid in full and all liability on the policies or title insurance contracts or agreements, whether contingent or actual, has been discharged or lawfully reinsured. Income from the investment of the amount of such reserve shall be the unrestricted property of the title insurer.
A.R.S. § 20-1611 — Arizona Code / Title 20 / Chapter 6 / Article 10 / Section 1611
20-1611 Refunds
Status: in_force

20-1611. Refunds

A. Each individual policy or group certificate of consumer credit insurance shall provide that, in the event of termination of insurance prior to the scheduled maturity date of the debt, any refund of an amount paid by the debtor for insurance shall be remitted or credited promptly to the person entitled to the refund or credit.  The director shall prescribe a minimum refund, which shall be not less than five dollars.  An insurer is not required to refund any amount that is less than the minimum. The formula to be used in computing refunds shall be filed with the director and shall be subject to the director's approval.

B. If a creditor requires a debtor to make any payment for consumer credit insurance and an individual policy or group certificate is not issued, the creditor shall immediately give written notice to the debtor and shall promptly make an appropriate refund to the debtor or credit the debtor's account.
A.R.S. § 20-1307 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1307
20-1307 Dividends
Status: in_force

20-1307. Dividends

If a participating policy, there shall be a provision that the insurer shall annually ascertain and apportion any divisible surplus accruing on the policy, except that at the option of the insurer such participation may be deferred to the end of the fifth policy year. This provision shall not prohibit the payment of additional dividends on default of payment of premiums or termination of the policy.
A.R.S. § 20-1380 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1380
20-1380 Guaranteed renewability of individual health coverage
Status: in_force

20-1380. Guaranteed renewability of individual health coverage

A. Except as provided in this section, on request of the insured individual, a health care insurer that provides individual health coverage to the individual shall renew or continue that coverage.

B. A health care insurer may nonrenew or discontinue the health insurance coverage of an individual in the individual market only for one or more of the following reasons:

1. The individual has failed to pay premiums or contributions pursuant to the terms of the health insurance coverage or the health care insurer has not received premium payments in a timely manner.

2. The individual has performed an act or practice that constitutes fraud or has made an intentional misrepresentation of material fact under the terms of the coverage.

3. The health care insurer has ceased to offer new coverage and has discontinued all in-force coverage in the individual market pursuant to subsection D of this section.

4. If the health care insurer offers health care coverage through a network plan in this state, the individual no longer resides, lives or works in the service area or in an area served by the network plan for which the health care insurer is authorized to do business but only if the coverage is terminated uniformly without regard to any health status-related factor of any covered individual.

5. If the health care insurer offers health coverage in the individual market only through one or more bona fide associations, the membership of an individual in the association has ceased but only if that coverage is terminated uniformly without regard to any health status-related factor of any covered individual.

C. If a health care insurer decides to discontinue offering a particular policy form offered in the individual market, the health care insurer may discontinue that policy form only if:

1. The health care insurer provides notice to the director at least five business days before the health care insurer gives notice to each individual covered under that policy form of the intention to discontinue offering that policy form in this state.

2. The health care insurer provides notice to each individual who is covered by that policy form in the individual market at least ninety days before the date of the discontinuation of that policy form.

3. The health care insurer offers to each individual in the individual market whose coverage is discontinued pursuant to this subsection the option to purchase all other individual health insurance coverage currently offered by the health care insurer for individuals in that market.

4. In exercising the option to discontinue that type of coverage and in offering the option of coverage prescribed in paragraph 3 of this subsection, the health care insurer acts uniformly without regard to any health status-related factor of enrolled individuals or individuals who may become eligible for that coverage.

D. If a health care insurer elects to discontinue offering all health insurance coverage in the individual market in this state, the health care insurer may discontinue that coverage only if all of the following occur:

1. The health care insurer gives notice to the director at least five business days before the health care insurer gives notice to each individual of the intention to discontinue offering health insurance coverage in the individual market in this state.

2. The health care insurer provides notice to each individual of that discontinuation at least one hundred eighty days before the date of the expiration of that coverage.

3. The health care insurer discontinues all individual insurance or coverage that was issued or delivered for issuance in this state and does not renew any coverage that was offered or sold in this state.

E. If the health care insurer discontinues offering health insurance coverage pursuant to subsection D of this section, the health care insurer shall not issue any health insurance coverage in this state in the individual market for five years after the date that the last individual health insurance coverage was not renewed.

F. Subsection C of this section does not apply if the health care insurer modifies the health coverage at the time of renewal and that modification is otherwise consistent with this title and effective on a uniform basis among all individuals covered by that policy form.

G. A health care insurer shall provide the certification described in section 20-2310, subsection G if the individual:

1. Ceases to be covered under a policy offered by a health care insurer or otherwise becomes covered under a COBRA continuation provision.

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

3. Requests certification from the health care insurer within twenty-four months after the coverage under a policy offered by a health care insurer ceases.

H. The director may use independent contractor examiners pursuant to sections 20-148 and 20-159 to review the higher level of coverage and lower level of coverage policy forms offered by a health care insurer in compliance with this section and section 20-1379. All examination and examination related expenses shall be borne by the insurer and shall be paid by the insurance examiners' revolving fund pursuant to section 20-159.
A.R.S. § 20-1306 — Arizona Code / Title 20 / Chapter 6 / Article 3 / Section 1306
20-1306 Misstatement of age
Status: in_force

20-1306. Misstatement of age

There shall be a provision that if it is found that the age of the individual insured, or the age of any other individual considered in determining the premium, has been misstated, any amount payable or benefit accruing under the policy shall be such as the premium would have purchased at the correct age or ages.
A.R.S. § 20-1098.17 — Arizona Code / Title 20 / Chapter 4 / Article 14 / Section 1098.17
20-1098.17 Effect of fees payment; premium tax
Status: in_force

20-1098.17. Effect of fees payment; premium tax

A. The fees paid by a captive insurer pursuant to section 20-167, subsection F are payment in full and in lieu of all other demands for all state, county, district, municipal and school taxes, licenses and excises of whatever kind or character, except for:

1. A tax on real and tangible personal property that is located within this state.

2. The transaction privilege tax and the use tax that is imposed pursuant to title 42, chapter 5, articles 1 and 4.

3. The transaction privilege tax and use tax that is imposed by any county, city or town.

B. Notwithstanding subsection A of this section, an agency captive insurer that insures risks on policies as specified in section 20-1098.01, subsection A, paragraph 3, subdivision (b) shall pay the premium tax prescribed in section 20-224 for such policies that is in excess of any fees paid pursuant to section 20-167.
A.R.S. § 20-400.02 — Arizona Code / Title 20 / Chapter 2 / Article 4.2 / Section 400.02
20-400.02 Submittal of data comparing premiums charged to filed rates
Status: in_force

20-400.02. Submittal of data comparing premiums charged to filed rates

On the request of the director, each insurer authorized to write any insurance in this state to which this article applies shall submit data to the director establishing the relationship of the aggregate premiums actually charged policyholders by the insurer for each line of insurance to the premiums produced by the insurer's filed unmodified rates for each line of insurance. A rate service organization may file the data on behalf of the insurer. Any insurer whose data indicates that the aggregate premiums actually charged policyholders for each line of insurance exceed the premiums produced by its filed unmodified rates by more than a percentage established by the director by rule, or fall below the premiums produced by its filed unmodified rates by more than a percentage established and published by the director by rule, shall be examined by the director to determine whether the rating plan or filed unmodified rates comply with sections 20-356 and 20-357 or 20-384 and 20-385. The director shall prescribe the time period the data are to cover and the form in which the data are to be submitted.
A.R.S. § 20-486.04 — Arizona Code / Title 20 / Chapter 2 / Article 10 / Section 486.04
20-486.04 Duties of insurers utilizing the services of a reinsurance intermediary broker
Status: in_force

20-486.04. Duties of insurers utilizing the services of a reinsurance intermediary broker

A. An insurer shall not engage the services of a person, firm, association or corporation to act as a reinsurance intermediary broker on its behalf unless the person is licensed as required by section 20-486.01.

B. An insurer may not employ an individual who is employed by the reinsurance intermediary broker with which it transacts business, unless the reinsurance intermediary broker is under common control with the insurer and is subject to the holding company act.

C. The insurer annually shall obtain a copy of the statements on the financial condition of each reinsurance intermediary broker with which it transacts business.
A.R.S. § 20-492.01 — Arizona Code / Title 20 / Chapter 2 / Article 16 / Section 492.01
20-492.01 Disclosure requirements
Status: in_force

20-492.01. Disclosure requirements

A. By June 1 of each calendar year, an insurer, or the insurance group of which the insurer is a member, shall submit to the director a corporate governance annual disclosure that contains the information described in section 20-492.03. Notwithstanding any request from the director made pursuant to subsection C of this section, if the insurer is a member of an insurance group, the insurer shall submit the report required by this section to the chief regulatory official of the lead state for the insurance group, in accordance with the laws of the lead state, as determined by the procedures outlined in the most recent financial analysis handbook that is adopted by the national association of insurance commissioners.

B. The CGAD must include a signature of the insurer or insurance group's chief executive officer or corporate secretary attesting to the best of that individual's belief and knowledge that the insurer has implemented the corporate governance practices and that a copy of the disclosure has been provided to the insurer's board of directors or the appropriate committee of the board.

C. An insurer that is not required to submit a CGAD under this section shall do so on the director's request.

D. For the purposes of completing the CGAD, the insurer or insurance group may provide information regarding corporate governance at the ultimate controlling parent level, an intermediate holding company level or the individual legal entity level, depending on how the insurer or insurance group has structured its system of corporate governance. The insurer or insurance group is encouraged to make the CGAD at the level at which the insurer's or insurance group's risk appetite is determined, the level at which the earnings, capital, liquidity, operations and reputation of the insurer are overseen collectively and at which the supervision of those factors are coordinated and exercised or the level at which legal liability for failure of general corporate governance duties would be placed.  If the insurer or insurance group determines the level of reporting based on these criteria, it shall indicate which of the three criterion was used to determine the level of reporting and explain any subsequent changes in level of reporting.

E. The review of the CGAD and any additional requests for information shall be made through the lead state as determined by the procedures within the most recent financial analysis handbook that is adopted by the national association of insurance commissioners.

F. Insurers that provide information that is substantially similar to the information required by this article in other documents that are provided to the director, including proxy statements that are filed in conjunction with form B requirements, or other state or federal filings that are provided to the department are not required to duplicate that information in the CGAD but are required to cross-reference the document in which the information is included.
A.R.S. § 20-841.12 — Arizona Code / Title 20 / Chapter 4 / Article 3 / Section 841.12
20-841.12 Coverage of health care services
Status: in_force

20-841.12. Coverage of health care services

All contracts issued, delivered or renewed on or after July 1, 2017 by a corporation in this state must provide coverage for lawful health care services that are provided by a health care provider to a subscriber regardless of the familial relationship of the health care provider to the subscriber if the health care service would be covered were it provided to a subscriber who was not related to the health care provider.  The contract may limit the coverage to those health care providers who are members of the corporation's provider network.
A.R.S. § 20-3342 — Arizona Code / Title 20 / Chapter 25 / Article 3 / Section 3342
20-3342 Applicability
Status: in_force

20-3342. Applicability

A. This article applies to third parties that provide or manage drug coverage under a health care plan in this state.

B. This article does not apply to any of the following:

1. The Arizona health care cost containment system administration and its contractors as defined in section 36-2901 to the extent the services are provided pursuant to title 36, chapter 29 or 34 or equivalent medicaid programs from other states.

2. The department of health services to the extent the services are provided under the AIDS drug assistance program.

3. Any individual or entity identified in section 36-2930.05.
A.R.S. § 20-1364 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1364
20-1364 Unpaid premium
Status: in_force

20-1364. Unpaid premium

There may be a provision as follows: "Unpaid premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom."
A.R.S. § 20-487.03 — Arizona Code / Title 20 / Chapter 2 / Article 11 / Section 487.03
20-487.03 Disclosure
Status: in_force

20-487.03. Disclosure

Before the effective date of the policy, the controlling producer shall deliver written notice to the prospective insured disclosing the relationship between the producer and the controlled insurer, except that if the business is placed through a subproducer who is not a controlling producer the controlling producer shall retain in his records a signed commitment from the subproducer that the subproducer is aware of the relationship between the insurer and the producer and that the subproducer has or will notify the insured.
A.R.S. § 20-1098.21 — Arizona Code / Title 20 / Chapter 4 / Article 14 / Section 1098.21
20-1098.21 Branch captive insurer reports
Status: in_force

20-1098.21. Branch captive insurer reports

Within sixty days after its fiscal year end, a branch captive insurer shall file with the director a copy of all reports and statements that are required to be filed under the laws of the jurisdiction in which the alien captive insurer or foreign captive insurer is formed and that are verified by oath of two of its executive officers.
A.R.S. § 20-1406.07 — Arizona Code / Title 20 / Chapter 6 / Article 5 / Section 1406.07
20-1406.07 Prescriptions; cost sharing; refills; dispensing fees; definition
Status: in_force

20-1406.07. Prescriptions; cost sharing; refills; dispensing fees; definition

A. A group or blanket disability insurance contract 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 contract 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. § 20-841.09 — Arizona Code / Title 20 / Chapter 4 / Article 3 / Section 841.09
20-841.09 Telehealth; coverage of health care services; definition
Status: in_force

20-841.09. Telehealth; coverage of health care services; definition

A. All contracts issued, delivered or renewed in this state must provide coverage for health care services that are provided through telehealth if the health care service would be covered were it provided through an in-person encounter between the subscriber and a health care provider and provided to a subscriber receiving the service in this state. The following requirements apply to coverage of telehealth services:

1. Except as otherwise provided in this subsection, a corporation may not limit or deny the coverage of health care services provided through telehealth, including ancillary services, and may apply only the same limits or exclusions on a health care service provided through telehealth that are applicable to an in-person encounter for the same health care service, except for procedures or services for which the weight of evidence, based on practice guidelines, peer-reviewed clinical publications or research or recommendations by the telehealth advisory committee on telehealth best practices established by section 36-3607, determines not to be appropriate to be provided through telehealth.

2. Except as otherwise provided in this paragraph, a corporation shall reimburse health care providers at the same level of payment for equivalent services as identified by the healthcare common procedure coding system, whether provided through telehealth using an audio-visual format or in-person care.  A corporation shall reimburse health care providers at the same level of payment for equivalent in-person behavioral health and substance use disorder services as identified by the healthcare common procedure coding system if provided through telehealth using an audio-only format. This paragraph does not apply to a telehealth encounter provided through a telehealth platform that is sponsored or provided by the corporation.  A corporation may not require a health care provider to use a telehealth platform that is sponsored or provided by the corporation as a condition of network participation.

3. Before January 1, 2022, a corporation shall cover services provided through an audio-only telehealth encounter if that service is covered by medicare or the Arizona health care cost containment system when provided through an audio-only telehealth encounter. Beginning January 1, 2022, a corporation shall cover services provided through an audio-only telehealth encounter if the telehealth advisory committee on telehealth best practices established by section 36-3607 recommends that the services may appropriately be provided through an audio-only telehealth encounter.

4. A health care provider shall bill for a telehealth encounter using the healthcare common procedure coding system and shall identify whether the telehealth encounter was provided in an audio-only or audio-video format.  To submit a claim for an audio-only service, the health care provider must make telehealth services generally available to patients through the interactive use of audio, video or other electronic media.

5. At the time of the telehealth encounter, the health care provider shall access clinical information and records, if available, that are appropriate to evaluate the patient's condition.  The health care provider shall inform the subscriber before the telehealth encounter if there is a charge for the encounter.

6. A corporation may establish reasonable requirements and parameters for telehealth services, including documentation, fraud prevention, identity verification and recordkeeping, but such requirements and parameters may not be more restrictive or less favorable to health care providers or subscribers than are required for health care services delivered in person.

7. Covered telehealth services may be provided regardless of where the subscriber is located or the type of site.

8. Except in an emergency as prescribed in section 20-2803, the contract may limit the coverage to those health care providers who are members of the corporation's provider network.

B. Subsection A of this section does not:

1. Limit the ability of corporations to provide incentives to subscribers that are designed to improve health outcomes, increase adherence to a course of treatment or reduce risk.

2. Prevent corporations from offering network contracts to health care providers who employ value-based purchasing or bundled payment methodologies if otherwise allowed by law or prevent health care providers from voluntarily agreeing to enter into such contracts with a corporation.

C. This section does not relieve a corporation from an obligation to provide adequate access to in-person health care services. Network adequacy standards required by federal or state law may not be met by a corporation through the use of contracted health care providers who provide only telehealth services and do not provide in-person health care services in this state or within fifty miles of the border of this state.

D. This section does not prevent a corporation from imposing deductibles or copayment or coinsurance requirements for a health care service provided through telehealth if the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to an in-person encounter for the same health care service.  If the corporation waives a deductible or copayment or coinsurance requirement that impacts a health care provider's contracted reimbursement rate, the corporation shall reimburse the health care provider for the cost of the deductible or copayment or coinsurance requirement to ensure that the health care provider receives the contracted reimbursement rate if the service is covered and the claim meets other requirements of the network participation agreement.

E. Services provided through telehealth or resulting from a telehealth encounter are subject to all of this state's laws and rules that govern prescribing, dispensing and administering prescription pharmaceuticals and devices and shall comply with Arizona licensure requirements and any practice guidelines of the telehealth advisory committee on telehealth best practices established by section 36-3607 or, if not addressed, the practice guidelines of a national association of medical professionals promoting access to medical care for consumers via telecommunications technology or other qualified medical professional societies to ensure quality of care.

F. This section does not apply to limited benefit coverage as defined in section 20-1137.

G. For the purposes of this section, "telehealth":

1. Means the interactive use of audio, video or other electronic media, including asynchronous store-and-forward technologies and remote patient monitoring technologies, for the purpose of diagnosis, consultation or treatment.

2. Includes:

(a) The use of an audio-only telephone encounter between a subscriber who has an existing relationship with a health care provider or provider group if both of the following apply:

(i) An audio-visual telehealth encounter is not reasonably available due to the subscriber's functional status, the subscriber's lack of technology or telecommunications infrastructure limits, as determined by the health care provider.

(ii) The telehealth encounter is initiated at the request of the subscriber or authorized by the subscriber before the telehealth encounter.

(b) The use of an audio-only encounter between the subscriber and a health care provider, regardless of whether there is an existing relationship with the health care provider or provider group, if the telehealth encounter is for a behavioral health or substance use disorder service and both items of subdivision (a) of this paragraph apply.

3. Does not include the sole use of a fax machine, instant messages, voice mail or email.
A.R.S. § 20-1098.13 — Arizona Code / Title 20 / Chapter 4 / Article 14 / Section 1098.13
20-1098.13 Associations; benefits; prohibitions
Status: in_force

20-1098.13. Associations; benefits; prohibitions

Except as otherwise provided in section 20-1098.01, subsection B for a self-insurance program approved under section 23-961, a captive insurer shall not join or contribute financially to any plan, pool, association or guaranty or insolvency fund in this state.  A captive insurer or its insured, a parent, an affiliate, group members, a member organization of an association or a claimant under any captive insurance shall not receive any benefit from the plan, pool, association or guaranty or insolvency fund for claims arising out of the operations of the captive insurer.
A.R.S. § 20-862 — Arizona Code / Title 20 / Chapter 4 / Article 4 / Section 862
20-862 Lodge system
Status: in_force

20-862. Lodge system

A. A society operates on the lodge system if the society has a supreme governing body and subordinate lodges into which members are elected, initiated or admitted according to the society's laws, rules and ritual. The laws of the society shall require subordinate lodges to hold meetings at least once in each month in furtherance of the purposes of the society.

B. A society may organize and operate lodges for children who are under the minimum age for adult membership. A local lodge shall not require membership or initiation for children, and children shall not have a voice or vote in the management of the society.
A.R.S. § 20-1125 — Arizona Code / Title 20 / Chapter 5 / Article 1 / Section 1125
20-1125 Discharge of payor by payment of benefits under employee benefit plan or life insurance policy
Status: in_force

20-1125. Discharge of payor by payment of benefits under employee benefit plan or life insurance policy

Notwithstanding the provisions of section 25-211, when payment or refund is made to an employee, former employee or his beneficiary or estate pursuant to a written retirement, death or other employee benefit plan or savings plan, or when the proceeds of, or payments under, a policy or contract issued by a life insurance company becomes payable, and the company makes payment in accordance with the terms thereof, or in accordance with the terms of a written assignment thereof if the policy or contract has been assigned, the payment or refund shall fully discharge the employer and any trustee or insurance company making the payment or refund from all adverse claims thereto unless, before payment or refund is made, the employer or former employer, where the payment is made by the employer or former employer, has received at its principal place of business within this state, written notice by or on behalf of some other person that such other person claims to be entitled to the payment or refund or some part thereof, or where a trustee or insurance company is making the payment, the notice has been received by the trustee or insurance company at its home office. Nothing in this section shall affect a claim or right to the payment or refund or part thereof as between all persons other than the employer and the trustee or insurance company making such payment or refund.
A.R.S. § 20-403 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 403
20-403 Service of process in an action by someone other than the director
Status: in_force

20-403. Service of process in an action by someone other than the director

A. The transaction of an insurance business in this state, as provided in section 20-106, by, or on behalf of, an unauthorized nonresident insurer shall be deemed to constitute an appointment by the insurer of the director and the director's successors in office as its attorney, on whom may be served all lawful process issued within this state in any action or proceeding against such insurer brought by someone other than the director and arising out of any such transaction.

B. Such service of process shall be made by delivering to and leaving with the director two copies thereof. At the time of service the plaintiff shall pay $5 to the director, taxable as costs in the action. The director shall immediately mail by registered or certified mail one of the copies of process to the defendant at its principal place of business as last known to the director and shall keep a record of all process so served.

C. Notice of service and a copy of process shall be sent by the plaintiff's attorney to the defendant insurer at its last known principal place of business by registered or certified mail. The defendant insurer's receipt, or registry receipt as to the mailing issued by the post office where registered or certified, showing the name of the sender and name and address of the addressee, and the affidavit of plaintiff's attorney showing compliance with this subsection, shall be filed in the court in which the action is pending on or before the date the defendant insurer is required to appear, or within such further time as the court may allow.  A judgment by default against the insurer may not be taken under this section until the expiration of thirty days after the date of filing of the affidavit of compliance.

D. Service of process in an action or proceeding against an unauthorized resident insurer shall be valid if served on any person within this state who transacts an insurance business in this state on behalf of such insurer. Subsection C of this section applies with respect to service of process.

E. Service of process on an insurer in accordance with this section shall be as valid and effective as if served on a defendant personally present in this state.

F. Means provided in this section for service of process on the insurer shall not be deemed to prevent service of process on the insurer by any other lawful means.

G. An insurer that has been so served with process, subject to section 20-405, shall have the right to appear in and defend the action and employ attorneys and other persons in this state to assist in the action's defense or settlement.
A.R.S. § 20-210 — Arizona Code / Title 20 / Chapter 2 / Article 1 / Section 210
20-210 Minimum required capital stock or basic surplus
Status: in_force

20-210. Minimum required capital stock or basic surplus

A. Except as provided in subsection B, to qualify for authority to transact any one kind of insurance or combinations of kinds of insurance as shown below, an insurer shall possess and thereafter maintain unimpaired minimum required capital stock, if a stock insurer, or unimpaired minimum required basic surplus, if a mutual or a reciprocal insurer, and free surplus not less than fifty per cent of the initial free surplus, and when first so authorized shall possess initial free surplus, all in amounts not less than as determined from the following table:

Stock Insurers      Mutual Insurers      Reciprocal Insurers

Minimum           Minimum           Minimum

Kind or     Required    Initial     Required    Initial     Required    Initial

Kinds of    Capital     Free  Basic Free  Basic Free

Insurance   Stock Surplus     Surplus     Surplus     Surplus     Surplus

Casualty          $600,000          $300,000    $600,000    $300,000    $600,000      $300,000

Disability         300,000           150,000     300,000     150,000     300,000     150,000

Life         300,000           150,000     300,000     150,000         Not Applicable

Disability

and life           400,000           200,000     400,000     200,000         Not Applicable

Marine and

Transporta-        600,000           300,000     600,000     300,000     600,000     300,000

tion

Property           600,000           300,000     600,000     300,000     600,000     300,000

Surety            1,000,000          500,000    1,000,000    500,000    1,000,000    500,000

Multiple Line     1,000,000          500,000    1,000,000    500,000    1,000,000    500,000

Vehicle            600,000           300,000     600,000     300,000     600,000     300,000

Title        500,000           250,000       Not Applicable      Not Applicable

B. A domestic insurer, including a domestic limited stock insurer subject to the capital and surplus requirements prescribed in subsection D of this section, holding a valid certificate of authority to transact insurance in this state of the kind or kinds as set forth in subsection A prior to the effective date of this section, may, if otherwise qualified, continue to be so authorized while possessing the amount of paid-in capital stock, if a stock insurer, or surplus, if a mutual insurer, required by the laws of this state for such authority immediately prior to the effective date of this section. The director shall not grant such an insurer authority to transact any other or additional kinds of insurance unless such insurer fully complies with the requirements as to capital and surplus, as applied to all kinds of insurance which the insurer proposes to transact, as provided by this section for like insurers applying for original certificates of authority under this title. Upon a change in the control of such an insurer, such insurer shall within one year from the effective date of such change in control meet the capital and surplus requirements for new insurers pursuant to subsection A of this section. For the purposes of this subsection "control" shall have the same meaning and be determined in the same manner as prescribed in section 20-481.

C. Capital and surplus requirements are based upon all kinds of insurance transacted by the insurer in all areas in which the insurer operates or proposes to operate whether or not only a portion of such kinds are to be transacted in this state.

D. Notwithstanding the limitation in the first sentence of subsection B of this section on increased capitalization for authorized insurers, any domestic limited stock insurer which on January 31, 1969 was the holder of a valid certificate of authority shall not be required to meet the capital and initial free surplus requirement of this section, but after January 31, 1980, any such domestic limited stock insurer shall possess and thereafter maintain:

1. Minimum paid-in capital stock of one hundred thousand dollars, and

2. Surplus funds in an amount of not less than one-half such minimum paid-in capital. On and after the effective date of this section any domestic limited stock insurer which holds a valid certificate of authority immediately prior to such effective date and which qualified under the provisions of subsection B of section 20-708 and whose premium income as a direct writer during calendar year 1976 did not exceed fifty per cent of its total premium income including reinsurance premiums from insurance policies and contracts for such year, shall be a domestic life and disability reinsurer and be subject to the provisions of article 10, of chapter 4 of this title.
A.R.S. § 20-400.05 — Arizona Code / Title 20 / Chapter 2 / Article 4.2 / Section 400.05
20-400.05 Examiners and examination related expenses
Status: in_force

20-400.05. Examiners and examination related expenses

A. The director shall utilize independent contractor examiners pursuant to section 20-148, subsection B and section 20-159 to perform the examinations required under sections 20-400.01 and 20-400.02.

B. All examination and examination related expenses shall be borne by the insurer and shall be paid by the insurance examiners' revolving fund in accordance with section 20-159.
A.R.S. § 20-1057.01 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1057.01
20-1057.01 Standing referrals to network health care professionals; definition
Status: in_force

20-1057.01. Standing referrals to network health care professionals; definition

A. A health care services organization shall establish a procedure by which an enrollee may apply for a standing referral to a network health care professional. The health care services organization shall provide an enrollee with a standing referral if all of the following conditions are met:

1. The enrollee is a covered member of that health care services organization.

2. The enrollee has a disease or condition that is life threatening, degenerative, chronic or disabling.

3. The enrollee's primary care physician or registered nurse practitioner in conjunction with a network health care professional determines that the enrollee's health care requires a network health care professional's expertise.

4. The enrollee's primary care physician or registered nurse practitioner determines that the enrollee's disease or condition will require ongoing medical care for an extended period of time.

5. The standing referral is made by the enrollee's primary care physician or registered nurse practitioner to a network health care professional who is responsible for providing and coordinating the enrollee's specialty care.

6. The network health care professional is authorized by the health care services organization to provide the services under the standing referral.

B. The health care services organization may limit the number of visits and time period for which an enrollee may receive a standing referral.

C. If the enrollee receives a standing referral or any other referral from the enrollee's primary care physician, that referral remains in effect even if the primary care physician leaves the health care services organization's network.

D. If the treating health care professional leaves the network or the enrollee ceases to be a covered member, the standing referral expires.

E. For the purposes of this section, "network health care professional" means a practitioner of a health profession as defined in section 32-3101 who is under written contract with the health care services organization to provide services in a specialty discipline that is recognized by an American medical specialty board.
A.R.S. § 20-1230 — Arizona Code / Title 20 / Chapter 6 / Article 1 / Section 1230
20-1230 Prohibition of dual or multiple pay policies
Status: in_force

20-1230. Prohibition of dual or multiple pay policies

No life insurance policy shall be issued or delivered in this state if it provides that on the death of anyone not specifically named therein, the owner or beneficiary of the policy shall receive the payment or granting of anything of value.
A.R.S. § 20-1902 — Arizona Code / Title 20 / Chapter 9 / Article 1 / Section 1902
20-1902 Disclosure of information
Status: in_force

20-1902. Disclosure of information

A. An authorized agency may, in writing, require an insurer to release to such other authorized agency any relevant information which the insurer has in its possession relating to a loss which such authorized agency is investigating including:

1. Application for an insurance policy.

2. Policy premium payment records.

3. History of previous claims made by the insured.

4. Material relating to the investigation of the loss, including statements of any person, proof of loss and any other evidence relevant to the investigation.

B. If an insurer has reason to believe that a loss in which it has an interest may be based on a false or fraudulent claim such insurer shall, in writing, notify an authorized agency and provide it with all material developed from the insurer's inquiry into the loss. Notice to any one of the authorized agencies listed in section 20-1901, paragraph 1, subdivisions (a) through (g) shall be sufficient notice for the purpose of this subsection.

C. Nothing in subsection B of this section shall abrogate or impair the rights or powers created under subsection A of this section.

D. The authorized agency provided with information pursuant to subsection A or B of this section shall upon request release or provide such information to any other authorized agency.

E. An insurer providing information to an authorized agency shall have the right to request in writing from such agency relevant information and receive, within a reasonable time, not to exceed thirty days, the information requested. The relevant information shall not include non-conviction criminal history record information nor any other information detrimental to another ongoing criminal investigation or that would reveal the identity of a confidential source of information.
A.R.S. § 20-1009 — Arizona Code / Title 20 / Chapter 4 / Article 7 / Section 1009
20-1009 Annual report to director
Status: in_force

20-1009. Annual report to director

A. Every prepaid dental plan organization annually on or before the first day of March shall file with the director a report of its financial condition, transactions and affairs as of the preceding December 31 as prescribed in sections 20-223 and 20-234 and shall pay the annual renewal fee prescribed in section 20-167.

B. The prepaid dental plan organization shall also submit any reports required by chapter 2, article 12 of this title.

C. A prepaid dental plan organization that fails to timely file the annual report required under subsection A of this section is subject to the penalties prescribed in section 20-223.
A.R.S. § 20-340.06 — Arizona Code / Title 20 / Chapter 2 / Article 3.5 / Section 340.06
20-340.06 Application of other laws
Status: in_force

20-340.06. Application of other laws

To the extent not inconsistent with this article, sections 20-281, 20-284 and 20-285, section 20-286, subsections B, C and D, section 20-288, subsection B and sections 20-289, 20-289.01, 20-292, 20-295, 20-296, 20-297, 20-298, 20-299, 20-301 and 20-302 apply to bail bond agents.
A.R.S. § 20-2533 — Arizona Code / Title 20 / Chapter 15 / Article 2 / Section 2533
20-2533 Denial; levels of review; disclosure; additional time after service by mail; review process
Status: in_force

20-2533. Denial; levels of review; disclosure; additional time after service by mail; review process

A. No minimum dollar amount may be imposed on any claim that is the subject of an adverse determination for a member to, and any member who receives an adverse determination may, pursue the applicable review process prescribed in this article. Except as provided in sections 20-2534 and 20-2535, health care insurers shall provide at least the following levels of review, as applicable:

1. An expedited medical review and expedited appeal pursuant to section 20-2534.

2. An initial appeal pursuant to section 20-2535.

3. An external independent review pursuant to section 20-2537.

B. For group plans, and for grandfathered individual plans, a health care insurer may elect to offer a voluntary internal appeal pursuant to section 20-2536 as an additional internal level of review after a determination of an initial appeal.

C. For individual plans and group plans for which the health care insurer does not elect to offer a voluntary internal appeal as an internal level of review, the health care insurer shall:

1. With the exception of a denial of a claim for service that has already been provided, send the member a written determination within thirty days after the health care insurer receives the appeal request.

2. For a denial of a claim for service that has already been provided, send the member a written determination within sixty days after the health care insurer receives the appeal request.

D. A health care insurer that elects to offer a voluntary internal appeal for the health care insurer's group plans shall:

1. With the exception of a denial of a claim for service that has already been provided, send the member a written determination within fifteen days after the health care insurer receives the initial appeal request and within fifteen days after the health care insurer receives the voluntary internal appeal request.

2. For a denial of a claim for a service that has already been provided, send the member its written determination within thirty days after the health care insurer receives the health care insurer receives the initial appeal request and within thirty days after the health care insurer receives the voluntary internal appeal request.

E. A health care insurer shall provide a written determination as required by this section and include the basis, criteria used, clinical reasons and rationale for the determination.

F. Except as provided in sections 20-2534 and 20-2537, a member shall be considered to have exhausted a health care insurer's internal levels of review if the health care insurer fails to comply with this article, except to the extent that the member requested or agreed to the delay, and the member may simultaneously initiate an expedited external independent review.

G. Notwithstanding subsection A, paragraph 2 of this section, a health care insurer may waive the internal appeal process.

H. At the time coverage is initiated, each health care insurer that operates in this state and 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 include a separate information packet that is approved by the director with the member's policy, evidence of coverage or similar document.  At the time coverage is renewed, each health care insurer shall include a separate statement with the member's policy, evidence of coverage or similar document that informs the member that the member can obtain a replacement packet that explains the appeal process by contacting a specific department and telephone number.  A health care insurer shall also provide a copy of the information packet to the member or the member's treating provider on request and shall prominently display a copy of the approved information packet on its website.  The information packet provided by the health care insurer shall include all of the following information:

1. A detailed description and explanation of each level of review prescribed in subsections A and B of this section and notice of the member's right to proceed to the next level of review if the prior review is unsuccessful.

2. An explanation of the procedures that the member must follow, including the applicable time periods, for each applicable level of review prescribed in subsections A, B, C and D of this section and an explanation of how the member may obtain the member's medical records pursuant to title 12, chapter 13, article 7.1.

3. The specific title and department of the person and the address, telephone number and fax number or email address of the person whom the member must notify at each applicable level of review prescribed in subsections A and B of this section in order to pursue that level of review.

4. The specific title and department of the person and the address, telephone number and fax number or email address of the person who will be responsible for processing that review.

5. A notice that if the member decides to pursue an appeal the member must provide the person who will be responsible for processing the appeal with any material justification or documentation for the appeal at the time that the member files the written appeal.

6. A description of the utilization review agent's and health care insurer's roles at each applicable level of review prescribed by subsections A, B, C and D of this section and an outline of the director's role during the external independent review process, if not already described in response to paragraph 1 of this subsection.

7. A notice that if the member participates in the process of review pursuant to this article the member waives any privilege of confidentiality of the member's medical records regarding any person who examined or will examine the member's medical records in connection with that review process for the medical condition under review.

8. A statement that the member is not responsible for the costs of any external independent review.

9. Standardized forms that are prescribed by the department and that a member may use to file and pursue an appeal.

10. The name and telephone number for the department of insurance and financial institutions consumer assistance office with a statement that the department of insurance and financial institutions consumer assistance office can assist consumers with questions about the health care appeals process.

I. At the time of issuing a denial, the health care insurer shall notify the member of the right to appeal under this article.  A health care insurer that issues an explanation of benefits document shall satisfy this obligation by prominently displaying in the document a statement about the right to appeal.  A health care insurer that does not issue an explanation of benefits document shall satisfy this obligation through some other reasonable means to assure that the member is apprised of the right to appeal at the time of a denial.  A reasonable means that includes giving the member's treating provider a form statement about the right to appeal shall require the treating provider to notify the member of the member's right to appeal.

J. Any written notice, acknowledgment, request, determination or other written document that is sent by mail is deemed received by the person to whom the document is properly addressed on the fifth business day after mailing.

K. The director shall require any member who files a complaint with the department relating to an adverse determination to pursue the review process prescribed in this article.  This subsection does not limit the director's authority pursuant to chapter 1, article 2 of this title.

L. If the member's complaint involves an issue of medical necessity or appropriateness, including health care setting, level of care or effectiveness of a covered benefit, or is experimental or investigational under the coverage document and not whether the claim or service is covered, the initial appeal process shall be performed as prescribed by section 20-2535 by a licensed health care professional.  If the member's complaint involves an issue of medical necessity or appropriateness, including health care setting, level of care or effectiveness of a covered benefit, or is experimental or investigational under the coverage document and not whether the claim or service is covered, the expedited review or voluntary internal appeal shall be decided by a physician, provider or other health care professional as prescribed by section 20-2534 or 20-2536.  Any external independent review shall be decided by a physician, provider or other health care professional as prescribed by section 20-2537.

M. Before a health care insurer makes a final internal adverse determination that relies on new or additional evidence generated directly or indirectly by the health care insurer, the health care insurer shall provide the new or additional information to the member free of charge sufficiently in advance of the final adverse determination to allow the member a reasonable opportunity to respond within the applicable time frames for the health care insurer to provide the member with a written determination prescribed in subsections C and D of this section.

N. Any person given access to a member's medical records or other medical information in connection with proceedings pursuant to this article shall maintain the confidentiality of the records or information in accordance with title 12, chapter 13, article 7.1.
A.R.S. § 20-1353 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1353
20-1353 Payment of claims
Status: in_force

20-1353. Payment of claims

A. There shall be a provision as follows:

"Payment of claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the insured."

B. The following provisions, or either of them, may be included with the provision set forth in subsection A of this section at the option of the insurer: "If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give a valid release, the insurer may pay such indemnity, up to an amount not exceeding $ ____________________ (insert an amount which shall not exceed one thousand dollars), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment."

"Subject to any written direction of the insured in the application or otherwise all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical, or surgical services may, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proof of such loss, be paid directly to the hospital or person rendering such services, but it is not required that the service be rendered by a particular hospital or person."
A.R.S. § 20-230 — Arizona Code / Title 20 / Chapter 2 / Article 1 / Section 230
20-230 Retaliation
Status: in_force

20-230. Retaliation

A. When by or pursuant to the laws of any other state or foreign country any premium or income or other taxes, or any fees, fines, penalties, licenses, deposit requirements or other material obligations, prohibitions or restrictions are imposed on insurers domiciled in this state doing business, or that might seek to do business in such other state or country, or on the agents of such insurers, which in the aggregate are in excess of such taxes, fees, fines, penalties, licenses, deposit requirements or other obligations, prohibitions or restrictions directly imposed on similar insurers domiciled in such other state or foreign country under the statutes of this state, as long as such laws continue in force or are so applied, the same obligations, prohibitions and restrictions of whatever kind shall be imposed on similar insurers domiciled in such other state or foreign country doing business in this state. Any tax, license or other obligation imposed by any city, county or other political subdivision of a state or foreign country on insurers of this state or their agents shall be deemed to be imposed by such state or foreign country within the meaning of this section. For the purpose of this section, the director shall compute the burden of any tax, license or other obligation imposed by any city, county or other political subdivision of a state or foreign country on insurers of this state or their agents on an aggregate statewide or foreign countrywide basis as an addition to the rate of tax payable by Arizona insurers in such state or foreign country. The addition to the rate of tax payable by Arizona life insurers shall be calculated separately from the addition to the rate of tax payable by other Arizona insurers. In each case, the addition to the rate of tax payable by Arizona insurers shall be calculated by dividing the aggregate of the tax obligations paid by Arizona insurers to any such city, county or other political subdivision of such state or foreign country by the aggregate of their taxable premiums under the premium taxing statute of such state or foreign country. The director may issue rules to carry out the purpose of this section. This section does not apply to ad valorem taxes on real or personal property or to personal income taxes or to assessments on or credits to insurers for the payment of claims of policyholders of insolvent insurers. This subsection does not apply to insurers that do business in this state and that are domiciled in another state or foreign country that does not impose retaliatory taxes, or whose laws, on a reciprocal basis, exempt from retaliatory taxes similar insurers domiciled in this state doing business, or that might seek to do business in the other state or foreign country.

B. If an insurer domiciled in this state is refused authority to transact insurance in another state on a plan and in a manner that is permitted for domestic insurers of such other state, notwithstanding that the insurer of this state is fully qualified for such authority in accordance with the applicable laws of such other state, and if such refusal is not accompanied by a written statement of the grounds therefor, then and thereafter, and for as long as such refusal shall continue, the director may refuse to grant an initial certificate of authority, but not a renewal of an existing certificate of authority, to any insurer domiciled in such other state that may seek to transact in this state a like kind or kinds of insurance.
A.R.S. § 20-3554 — Arizona Code / Title 20 / Chapter 29 / Article 1 / Section 3554
20-3554 Premium tax; definitions
Status: in_force

20-3554. Premium tax; definitions

A. A travel insurer shall pay premium tax as provided in section 20-224 on travel insurance premiums paid by any of the following:

1. An individual primary policyholder who is a resident of this state.

2. A primary certificate holder who is a resident of this state and who elects coverage under a group travel insurance policy.

3. A blanket travel insurance policyholder that is a resident in this state, or has its principal place of business or the principal place of business of an affiliate or subsidiary that has purchased blanket travel insurance in this state for eligible blanket group members, subject to any apportionment rules that apply to the insurer across multiple taxing jurisdictions or that allow the insurer to allocate premium on an apportioned basis in a reasonable and equitable manner in those jurisdictions.

B. A travel insurer shall:

1. Document the state of residence or principal place of business of the policyholder or certificate holder as required in subsection A of this section.

2. Report as premium only the amount allocable to travel insurance and not any amounts received for travel assistance services or cancellation fee waivers.

C. For the purposes of this section:

1. "Primary certificate holder" means an individual who elects and who purchases travel insurance under a group policy.

2. "Primary policyholder" means an individual who elects and who purchases individual travel insurance.
A.R.S. § 20-3301 — Arizona Code / Title 20 / Chapter 24 / Article 1 / Section 3301
20-3301 Definitions; applicability
Status: in_force

20-3301. Definitions; applicability

A. In this article, unless the context otherwise requires:

1. "Insurance compliance audit" means a voluntary, internal evaluation, review, assessment, audit or investigation that follows adopted written standards and criteria for the purpose of identifying or preventing noncompliance with or promoting compliance with laws, regulations, orders or industry or professional standards that is conducted by or on behalf of a company licensed or regulated under this title and specified in subsection B of this section, or that involves an activity regulated under this title.  An audit shall establish a start and end date.

2. "Insurance compliance audit document":

(a) Means documents prepared as a result of or in connection with an insurance compliance audit and identified specifically as part of an insurance compliance audit.

(b) Includes any of the following:

(i) An insurance compliance audit report prepared by an auditor, who may be an employee of the company or an independent contractor, which may include the scope of the audit, the information gained in the audit and conclusions and recommendations, with exhibits and appendices.

(ii) Memoranda and documents analyzing portions or all of the insurance compliance audit report and discussing potential implementation issues.

(iii) An implementation plan that addresses correcting past noncompliance, improving current compliance and preventing future noncompliance.

(iv) Analytic data generated in the course of conducting the insurance compliance audit.

(c) May include a written response to the findings of an insurance compliance audit and field notes and records of observations, findings, opinions, suggestions, conclusions, drafts, memoranda, drawings, photographs, exhibits, computer-generated or electronically recorded information, phone records, maps, charts, graphs and surveys if this supporting information is collected or developed for the primary purpose and in the course of an insurance compliance audit.

B. This article applies to insurance compliance audit documents prepared and insurance compliance audits conducted by or on behalf of an insurer licensed or regulated under this title including any:

1. Stock, mutual, reciprocal or title insurer.

2. Fraternal benefit society.

3. Health care services organization.

4. Hospital service corporation, medical service corporation, dental service corporation, optometric service corporation or hospital, medical, dental and optometric service corporation.

5. Prepaid dental plan organization.

6. Mechanical reimbursement reinsurer.

7. Prepaid legal plan.

8. Lloyd's association.

9. Service company as defined in this title.
A.R.S. § 20-1548 — Arizona Code / Title 20 / Chapter 6 / Article 8.1 / Section 1548
20-1548 Underwriting discrimination
Status: in_force

20-1548. Underwriting discrimination

A. Nothing in this article shall be construed as limiting the right of any mortgage guaranty insurance company to impose reasonable requirements upon the lender with regard to the terms of any note or bond or other evidence of indebtedness secured by a mortgage or deed of trust, such as requiring a stipulated down payment by the borrower.

B. A mortgage guaranty insurance company shall not discriminate in the issuance or extension of mortgage guaranty insurance on the basis of the applicant's sex, marital status, race, color, creed or national origin.

C. No policy of mortgage guaranty insurance, excluding policies of reinsurance, shall be written unless the insurer shall have conducted a reasonable and thorough examination of:

1. The evidence supporting credit worthiness of the borrower.

2. The appraisal report reflecting market evaluation of the property and shall have determined that prudent underwriting standards have been met.
A.R.S. § 20-1406.02 — Arizona Code / Title 20 / Chapter 6 / Article 5 / Section 1406.02
20-1406.02 Prohibiting denial of psychologist contract benefits
Status: in_force

20-1406.02. Prohibiting denial of psychologist contract benefits

If a group disability insurance contract or blanket disability insurance contract provides for or offers reimbursement for any service which is within the lawful scope of the practice of a psychologist holding a certificate or license issued by the state in which the services are rendered, a subscriber covered under such contract may select either a physician or psychologist to provide the examination, care or treatment for which the subscriber is eligible and which falls within the scope of practice of the psychologist or physician.
A.R.S. § 20-208 — Arizona Code / Title 20 / Chapter 2 / Article 1 / Section 208
20-208 Definition of guaranteed investment contract
Status: in_force

20-208. Definition of guaranteed investment contract

In this title, unless the context otherwise requires, "guaranteed investment contract" means any unallocated group contract, investment contract, funding agreement, guaranteed interest contract or other similar instrument by whatever name in which an insurance company agrees to guarantee a fixed or variable rate of interest or a future payment that is based on an index or any other similar criteria, that is payable at a predetermined date on monies that are deposited with the insurance company and that is not dependent on the continuance of human life.
A.R.S. § 20-481.30 — Arizona Code / Title 20 / Chapter 2 / Article 8 / Section 481.30
20-481.30 Judicial review; special action
Status: in_force

20-481.30. Judicial review; special action

A. Notwithstanding section 20-166, any person aggrieved by any act, determination, rule, regulation or order or any other action of the director pursuant to this article may appeal to the superior court in Maricopa county. The court shall conduct its review without a jury and by trial de novo, except that if all parties, including the director, so stipulate, the review shall be confined to the record. Portions of the record may be introduced by stipulation into evidence in a trial de novo as to those parties so stipulating.

B. The filing of an appeal pursuant to this section shall stay the application of any such rule, regulation, order or other action of the director to the appealing party unless the court, after giving such party notice and an opportunity to be heard, determines that such a stay would be detrimental to the interest of policyholders, shareholders, creditors or the public.

C. Any person aggrieved by any failure of the director to act or make a determination required by this article may institute proceedings for a special action in the superior court in Maricopa county directing the director to act or make such determination.
A.R.S. § 20-1672 — Arizona Code / Title 20 / Chapter 6 / Article 14 / Section 1672
20-1672 Definitions
Status: in_force

20-1672. Definitions

In this article, unless the context otherwise requires:

1. "Cancellation" means termination of a policy at a date other than its expiration date.

2. "Expiration date" means the date on which coverage under a policy ends as set forth in the policy. For a policy written for a term longer than one year or with no fixed expiration date, each annual anniversary date of the policy is the expiration date.

3. "Nonpayment of premium" means the failure or inability of the named insured to discharge any obligation in connection with the payment of premiums on a policy of insurance subject to this article, whether the payments are payable directly to the insurer or its agent or payable through a premium finance plan or extension of credit.

4. "Nonrenewal" means termination of a policy at its expiration date.

5. "Renewal" or "to renew" means the issuance of or the offer to issue by an insurer a policy succeeding a policy previously issued and delivered by the same insurer or an insurer within the same group of insurers or the issuance of a certificate or notice extending the term of an existing policy for a specified period beyond its expiration date.
A.R.S. § 20-1095.06 — Arizona Code / Title 20 / Chapter 4 / Article 11 / Section 1095.06
20-1095.06 Required service contract disclosures
Status: in_force

20-1095.06. Required service contract disclosures

A. Each service company holding a service company permit shall submit all service contract forms to the director for approval at least thirty days before the proposed effective date of the form.  A form may not be used until it is approved by the director or has been on file with the director for more than thirty days.

B. The director may not approve a service contract if:

1. The service contract may be canceled or voided due to acts or omissions of the service company or its assignees or subcontractors for their failure to provide correct information or their failure to perform the services or repairs provided in a timely, competent and workmanlike manner.

2. Parts or components repaired or replaced under the service contract are excluded.

3. The service contract may be canceled by the service company or its representatives for any of the following reasons:

(a) The service contract fails to state the extent to which preexisting conditions will or will not be covered.

(b) Misrepresentation by either the service company or the person selling the service contract on the service company's behalf.

C. Service contracts may not be issued, sold or offered for sale in this state unless the service company has provided both:

1. A receipt for or other written evidence of the purchase of the service contract to the contract holder.

2. A copy of the service contract to the service contract holder within a reasonable period of time after the date of purchase.

D. Service contracts that are marketed, sold, offered for sale, issued, made, proposed to be made or administered in this state shall be written, printed or typed in clear, understandable language that is easy to read and shall disclose the following, as applicable:

1. Service contracts that are insured under a mechanical reimbursement insurance policy pursuant to section 20-1095.03, subsection A, paragraph 3, subdivision (b) shall state the name and address of the insurer and contain a statement in substantially the following form: "Obligations of the obligor under this service contract are insured under a mechanical service contract reimbursement insurance policy".

2. Service contracts that are not insured under a reimbursement insurance policy pursuant to section 20-1095.03, subsection A, paragraph 3, subdivision (b) shall contain a statement in substantially the following form:  "Obligations of the obligor under this service contract are backed by the full faith and credit of the obligor".

3. Service contracts shall state the name and address of the obligor and shall identify an administrator if different from the obligor, the service contract seller and the service contract holder to the extent that the name of the service contract holder has been furnished by the service contract holder.  The identities of these parties are not required to be preprinted on the service contract and may be added to the service contract at the time of sale.

4. Service contracts shall state the total purchase price of the service contract.  The purchase price is not required to be preprinted on the service contract and may be negotiated at the time of sale with the service contract holder.

5. Service contracts shall state the existence of a deductible amount, if applicable.

6. Service contracts shall specify the merchandise and services to be provided and any limits, exceptions or exclusions.  Exclusions from coverage shall be in bold-faced type. Service contracts may, but are not required to, cover damage resulting from rust, corrosion or damage caused by a noncovered part or system.

7. Service contracts covering motor vehicles shall state whether the use of nonoriginal manufacturers' parts is allowed.

8. Service contracts shall state any restrictions governing the transferability of the service contract, if applicable.

9. Service contracts shall state the terms, restrictions or conditions governing cancellation of the service contract before the termination or expiration date of the service contract by either the service company or the service contract holder.  At a minimum, a service contract shall provide for a pro rata refund after deducting for benefits paid and administrative expenses associated with the cancellation.  The administrative expenses may not exceed $75 or ten percent of the purchase price of the service contract, whichever is less. Any administrative expense assessed may not exceed the amount of the refund due to the service contract holder.

10. Service contracts shall set forth all of the obligations and duties of the service contract holder, including the duty to protect against any further damage and any requirement to follow the owner's manual.

11. Service contracts shall disclose the material acts or omissions of the contract holder that cancel or void coverage, if any, and may include:

(a) Fraudulent or unlawful acts by the contract holder arising out of or relating to the service contract.

(b) The contract holder's use of a covered consumer product in a manner other than as intended by the manufacturer that is likely to increase the likelihood that the consumer product will be damaged or require repairs.

12. Service contracts shall clearly indicate whether preexisting conditions are covered or excluded under the terms of the service contract.

E. Brochures and other advertising or marketing materials are not required to be filed with or approved by the director.
A.R.S. § 20-402 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 402
20-402 Validity of contracts
Status: in_force

20-402. Validity of contracts

A. The transaction of business in violation of section 20-401.01 by an insurer does not impair the validity of any act or contract of the insurer and does not prevent the insurer from defending any action at law or suit in equity in any court of this state, except that no insurer transacting insurance business in this state without a certificate of authority is permitted to maintain an action in any court of this state to enforce any right, claim or demand arising out of the transaction of the business until the insurer obtains a certificate of authority.

B. If an insurer transacting business in violation of section 20-401.01 fails to pay any claim or loss within the provisions of the insurance contract, any person who acted directly or indirectly as an insurance producer for or otherwise represented or aided the insurer in the solicitation, negotiation, procurement or effectuation of the insurance contract or renewal of the contract is liable to the insured for the full amount of the claim or loss in the manner provided by the provisions of the insurance contract.
A.R.S. § 20-160 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 160
20-160 Powers of examination; witnesses; subpoenas; perjury
Status: in_force

20-160. Powers of examination; witnesses; subpoenas; perjury

A. The director may take depositions, subpoena witnesses or documentary evidence, administer oaths and examine under oath any individual relative to the affairs of any person being examined or relative to the subject of any hearing or investigation.

B. Witness fees and mileage, if claimed, shall be allowed the same as for testimony in a superior court. Witness fees, mileage and the actual expense necessarily incurred in securing attendance of witnesses and their testimony shall be itemized, and shall be paid by the person being examined if such person is found to have been in violation of the law as to the matter with respect to which such witness was so subpoenaed, or by the person, if other than the director, at whose request the hearing is held.

C. The subpoena shall be served in the same manner as if issued from a superior court. If a person fails to obey a subpoena lawfully served, the director shall forthwith forward a report of such disobedience, together with a copy of the subpoena and proof of service thereof, to the superior court for the county in which the person was required to appear. The court shall forthwith cause such person to be produced and shall impose penalties as though he had disobeyed a subpoena issued out of such court.

D. A person who being under oath testifies falsely or makes any false affidavit during the course of any examination, investigation or hearing, is guilty of perjury.
A.R.S. § 20-1376.01 — Arizona Code / Title 20 / Chapter 6 / Article 4 / Section 1376.01
20-1376.01 Prohibiting denial of chiropractic contract benefits; direct reimbursement
Status: in_force

20-1376.01. Prohibiting denial of chiropractic contract benefits; direct reimbursement

If a disability insurance contract provides for or offers reimbursement for any service which is within the lawful scope of the practice of a chiropractor holding a certificate or license issued by the state in which the services are rendered, a subscriber covered under such contract may select either a physician or chiropractor to provide the examination, care or treatment for which the subscriber is eligible and which falls within the scope of practice of the chiropractor or physician.  Reimbursement for the cost of the service may be made directly to the person licensed or certified pursuant to title 32, chapter 8 or 13 or to the subscriber if the cost of the service has not been reimbursed to another provider or health care institution.
A.R.S. § 20-1588 — Arizona Code / Title 20 / Chapter 6 / Article 9 / Section 1588
20-1588 Examination of records; order; notice
Status: in_force

20-1588. Examination of records; order; notice

A. If he has reason to believe that any title insurance agent has violated or is violating any of the provisions of this article, the director shall forthwith examine such title insurance agent's books of account, records and vouchers pertaining to the business of title insurance, and any title insurance agent so examined shall pay to the director the cost of such examination on demand.

B. The director's order after an examination of a title insurer and its authorized title insurance agents shall describe each violation found by the director, the name of the title insurer or title insurance agent that caused or committed the violation and the penalty, if any, imposed for each violation.

C. After an examination of a title insurer and its authorized title insurance agents, a copy of the director's order or notice to the title insurer under section 20-151 shall be provided to each title insurance agent of the title insurer affected by the order or notice.
A.R.S. § 20-1095.08 — Arizona Code / Title 20 / Chapter 4 / Article 11 / Section 1095.08
20-1095.08 Nonrenewal, revocation or suspension of permit
Status: in_force

20-1095.08. Nonrenewal, revocation or suspension of permit

The director may refuse to renew or may revoke or suspend any permit issued to a service company pursuant to this article if, after notice and a hearing, the director finds any of the following:

1. Any judgment in favor of a contract holder or his heir or assignees has become final and has not been paid in full within sixty days.

2. The service company has violated any provision of this article.

3. In the opinion of the director, the service company is insolvent.
A.R.S. § 20-702 — Arizona Code / Title 20 / Chapter 4 / Article 1 / Section 702
20-702 "Mutual" insurer defined
Status: in_force

20-702. "Mutual" insurer defined

A "mutual" insurer is an incorporated insurer without capital stock or shares, and which is owned by its policyholders.
A.R.S. § 20-1506 — Arizona Code / Title 20 / Chapter 6 / Article 7 / Section 1506
20-1506 Provisions required by charter or laws of other states
Status: in_force

20-1506. Provisions required by charter or laws of other states

A domestic insurer may print in the standard fire policy any provisions which it is authorized or required by law to insert therein. A foreign or alien insurer may print in the policy any provision required by its charter or deed of settlement, or by the laws of its own state or country, not contrary to the laws of this state.
A.R.S. § 20-1616 — Arizona Code / Title 20 / Chapter 6 / Article 10 / Section 1616
20-1616 Cease and desist order; hearing
Status: in_force

20-1616. Cease and desist order; hearing

On finding that a person has violated this article or a rule adopted pursuant to this article, the director may issue an order directing that the person cease and desist from committing the violation.  On the issuance of an order to cease and desist, the person may request a hearing pursuant to section 20-161 and title 41, chapter 6, article 10.
A.R.S. § 20-1097.03 — Arizona Code / Title 20 / Chapter 4 / Article 13 / Section 1097.03
20-1097.03 Deposit required
Status: in_force

20-1097.03. Deposit required

A. A prepaid legal insurance corporation shall maintain on deposit with the state treasurer through the director's office a surety bond, guaranteeing services under its contracts, or cash or securities eligible for investment of capital funds in the amount required by section 20-213.

B. The deposit prescribed by subsection A of this section shall be held by the state treasurer in trust for the benefit and protection of persons covered by a prepaid legal contract.

C. Any securities within the description of subsection A of this section, with the approval of the director, may be exchanged for similar securities or cash of equal value. Interest on securities deposited shall be payable to the prepaid legal insurance corporation depositing such securities.

D. An unpaid final judgment arising from a legal insurance contract shall be a lien on the deposit prescribed by subsection A of this section, subject to execution thirty days from the entry of final judgment. If the deposit is reduced, it shall be replenished within ninety days by the prepaid legal insurance corporation.

E. Upon liquidation or dissolution of a prepaid legal insurance corporation and satisfaction of all debts and liabilities, any balance remaining of the cash or securities deposit prescribed in subsection A of this section together with any other assets of the corporation shall be returned by the director to the corporation.

F. The director may at any time enter an order increasing the amount of the deposit required by this section if:

1. He finds there has been a substantial change in the facts, including an increase in the amount of premiums, membership fees or similar charges in force in this state, on which the original determination was based.

2. Other circumstances arise which lead the director to conclude that it is reasonably necessary in order to protect the purchasers of such contracts.
A.R.S. § 20-481.13 — Arizona Code / Title 20 / Chapter 2 / Article 8 / Section 481.13
20-481.13 Material changes; amended statement; time; reporting of dividends
Status: in_force

20-481.13. Material changes; amended statement; time; reporting of dividends

A. Each registered insurer shall keep current the information required to be disclosed in its registration statement by reporting all material changes or additions on amendment forms provided by the director within fifteen days after the end of each month in which it learns of each such change or addition.

B. Subject to section 20-481.19, each registered insurer shall report to the director all dividends and other distributions to shareholders within five business days following the declaration and at least ten business days before payment of the dividend or distribution.

C. The director may adopt rules that provide for an extension of the reporting times prescribed in subsections A and B of this section.
A.R.S. § 20-401.03 — Arizona Code / Title 20 / Chapter 2 / Article 5 / Section 401.03
20-401.03 Service of process in an action by the director
Status: in_force

20-401.03. Service of process in an action by the director

A. Any act of transacting an insurance business in violation of section 20-401.01 by any unauthorized insurer is equivalent to and constitutes an irrevocable appointment by such insurer, binding on the insurer, the insurer's executor or administrator, or successor in interest if a corporation, of the secretary of state or the secretary of state's successor in office to be the true and lawful attorney of such insurer on whom may be served all lawful process in any action, suit or proceeding in any court by the director, through the attorney general, and on whom may be served any notice, order, pleading or process in any proceeding before the director and which arises out of transacting an insurance business in this state by such insurer. Any act of transacting an insurance business in this state by any unauthorized insurer shall be signification of its agreement that any such lawful process in such court action, suit or proceedings and any such notice, order, pleading or process in such administrative proceeding before the director so served shall be of the same legal force and validity as personal service of process in this state on such insurer.

B. Service of process in an action prescribed by subsection A of this section shall be made by delivering to and leaving with the secretary of state, or some person in apparent charge of the secretary of state's office, two copies of such process. Service on the secretary of state as such attorney shall be service on the principal.

C. The secretary of state shall immediately forward, by registered or certified mail, one copy of such process or such notice, order, pleading or process in proceedings before the director to the defendant in such court proceeding to whom the notice, order, pleading or process in such administrative proceeding is addressed or directed at its last known principal place of business and shall keep a record of all process so served on the secretary of state which shall show the day and hour of service. Such service shall be sufficient, provided:

1. Notice of such service and a copy of the court process or the notice, order, pleading or process in such administrative proceeding are sent within ten days thereafter by registered or certified mail by the director or the attorney general in the court proceeding or by the director in the administrative proceeding to the defendant in the court proceeding or to whom the notice, order, pleading or process in such administrative proceeding is addressed or directed at the last known principal place of business of the defendant in the court or administrative proceeding.

2. The defendant's receipt or receipts, issued by the post office with which the letter is registered or certified, showing the name of the sender of the letter and the name and address of the person or insurer to whom the letter is addressed, and an affidavit of the director or the attorney general in court proceeding or of the director in administrative proceeding, showing compliance therewith, are filed with the clerk of the court in which such action, suit or proceeding is pending or with the director in administrative proceedings, on or before the date the defendant in the court or administrative proceeding is required to appear or respond thereto, or within such further time as the court or director may allow.

D. The director or the attorney general shall not be entitled to a judgment or a determination by default in any court or administrative proceeding in which court process or notice, order, pleading or process in proceedings before the director is served under this section until the expiration of thirty days from the date of filing of the affidavit of compliance.

E. This section does not limit or affect the right to serve any process, notice, order or demand on any person or insurer in any other manner now or hereafter allowed by law or rules of the courts.
A.R.S. § 20-1679 — Arizona Code / Title 20 / Chapter 6 / Article 14 / Section 1679
20-1679 Application and effective date
Status: in_force

20-1679. Application and effective date

This article applies only to policies with coverage effective dates that are after the effective date of this article.
A.R.S. § 20-1057.07 — Arizona Code / Title 20 / Chapter 4 / Article 9 / Section 1057.07
20-1057.07 Health care services organizations; clinical trials; cancer; definitions
Status: in_force

20-1057.07. Health care services organizations; clinical trials; cancer; definitions

A. A health care services organization 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 enrollee 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 health care services organization at the rates that are established by the organization and that are not more than the level of reimbursement applicable to other similar services provided by health care providers with the organization'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 or evidence of coverage delivered or issued for delivery in this state shall provide benefits under the contract or evidence coverage, 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. Unless preempted under federal law or unless federal law imposes greater requirements than this section, this section applies to a provider sponsored health care services organization.

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

F. Nothing in this section prohibits the health care services organization from imposing deductibles, coinsurance or other cost sharing measures in relation to benefits provided pursuant to this section.

G. A trade association that represents health care services organizations and hospital service corporations and medical service corporations as defined in section 20-822 may select a representative to voluntarily serve on the institutional review board of an institution in this state that reviews and approves the proposed treatment or study conducted during the cancer clinical trial.

H. 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 enrollee or the enrollee's covered dependent.

5. "Patient cost" means any fee or expense that is covered under the contract or evidence of coverage 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. § 20-708 — Arizona Code / Title 20 / Chapter 4 / Article 1 / Section 708
20-708 Limited stock insurers
Status: in_force

20-708. Limited stock insurers

A. Domestic limited stock insurers may be formed, with capital and surplus as specified in sections 20-210 and 20-211, to transact life and disability insurance only or both, except as provided in subsection B of this section, but such an insurer may not:

1. Issue any policy or policies or combination of policies of life or disability insurance whether individual or group as a direct writer.

2. Accept any risk as a reinsurer under which the maximum possible benefits payable on the death or on the disability of any one insured shall exceed five thousand dollars nor without reinsuring the excess over three thousand dollars by noncancellable reinsurance authorized under section 20-261. Any risk accepted as a reinsurer under this paragraph shall be a risk under which the ceding life or disability insurer remains liable for the payment of all policyholder claims.

B. Prior to, but not after January 31, 1980, any domestic limited stock insurer that on January 31, 1969 was the holder of a valid certificate of authority and that on or before such date had policy forms approved as provided by this title and had sold and issued any such policies shall continue to have the right and privilege to issue life and disability policies direct without regard to the prohibition prescribed in subsection A of this section, but such company shall not:

1. Issue any policy or combination of life insurance policies or accept any risk direct under which the maximum possible benefits payable on the death of any one insured shall exceed five thousand dollars nor without reinsuring the excess over three thousand dollars by noncancellable reinsurance authorized under section 20-261.

2. Issue any policy or combination of disability insurance policies, or accept any disability risk direct under which the maximum possible benefits payable to or on account of any one insured shall exceed five thousand dollars.

3. Issue pure endowment policies or annuity contracts, but this paragraph does not prohibit the insurer from issuing life insurance endowment policies, limited payment life and other standard plans of life insurance policies, nor from providing therein standard settlement options.

C. With appropriate powers in its articles of incorporation by increase of its authorized and paid-in capital and its surplus funds to the minimum amount required by this title as for an insurer newly formed and on application to the director, a domestic limited stock insurer may become a domestic stock insurer free from the restrictions otherwise imposed by this section.

D. A domestic limited stock insurer may accept reinsurance of risks of life or disability stock insurers or stock reinsurers, subject to limits as to amount of insurance as to anyone insured as set forth in this section.
A.R.S. § 20-3118 — Arizona Code / Title 20 / Chapter 20 / Article 2 / Section 3118
20-3118 Surprise out-of-network bills; annual report
Status: in_force

20-3118. Surprise out-of-network bills; annual report

A. On or before December 31, 2019 and each December 31 thereafter, the department shall report on the resolution of disputed surprise out-of-network bills.  The report shall include:

1. The total number of inquiries regarding dispute resolution of surprise out-of-network bills.

2. The total number of requests that did not qualify for dispute resolution and the reasons why the disputed bills did not qualify.

3. The number of requests that qualified for dispute resolution.

4. The most common requests for dispute resolution by health care provider specialty area.

5. The most common requests for dispute resolution by health care service.

6. The number of requests for dispute resolution by geographic area in this state.

7. The most common requests for dispute resolution based on the type of health care facility in which the health care services were provided.

8. The number of requests for dispute resolution that were settled during a settlement teleconference.

9. The number of requests for dispute resolution that were settled during arbitration.

10. The number of times a health insurer, a health care provider or the provider's representative or an enrollee failed to attend the settlement teleconference.

11. The average percentage by which disputed surprise out-of-network bills were reduced from the initially billed amount.

12. Any additional information that the department determines is relevant in evaluating the effectiveness of the dispute resolution process.

B. The department shall submit the report to the governor, the president of the senate and the speaker of the house of representatives and shall provide a copy of the report to the secretary of state.
A.R.S. § 20-336.02 — Arizona Code / Title 20 / Chapter 2 / Article 3.4 / Section 336.02
20-336.02 License required
Status: in_force

20-336.02. License required

A person may not act as or claim to be a navigator or certified application counselor unless the person is licensed pursuant to this article.
A.R.S. § 20-589 — Arizona Code / Title 20 / Chapter 3 / Article 3 / Section 589
20-589 Levy upon deposits prohibited; exception
Status: in_force

20-589. Levy upon deposits prohibited; exception

No judgment creditor or other claimant of an insurer shall levy upon any deposit held pursuant to this title, or upon any part thereof, but such levy may be permitted if so specified in the director's order requiring the deposit pursuant to the retaliatory provision set forth in section 20-230.
A.R.S. § 20-157.01 — Arizona Code / Title 20 / Chapter 1 / Article 2 / Section 157.01
20-157.01 Confidentiality of insurer's claim files and records; access by director; definition
Status: in_force

20-157.01. Confidentiality of insurer's claim files and records; access by director; definition

A. Pursuant to the director's authority under sections 20-156, 20-157, 20-160, 20-466 and 20-3502, an insurer shall comply with a request to produce any documents, reports or other materials, whether maintained in written or electronic format, from an insurer's claim file or an insurer's record that is required to comply with chapter 28, article 1 of this title.

B. Any documents, reports or other materials that are provided to the director pursuant to this section are confidential and are not subject to disclosure, including discovery or subpoena, unless the subpoena is issued by the attorney general or a county attorney or by a court at the request of the attorney general, a county attorney or any other law enforcement agency. The director may disclose the information only to a state or federal agency or officer pursuant to a lawful request, subpoena or formal discovery procedure. If the requesting party cannot warrant confidentiality pursuant to section 20-158, subsection I, the information that is provided pursuant to discovery, subpoena or lawful request as provided for in this subsection remains confidential. The director shall make reasonable efforts to notify an insurer of any request for a subpoena for documents, reports or other materials in an insurer's claim file or other record that are produced by the insurer pursuant to this section so that the insurer may assert, in a court of competent jurisdiction, any applicable privileges.

C. The director may use the documents, reports or other materials in the furtherance of any regulatory action brought by the director or in actions brought against the director.

D. Subject to the restrictions prescribed in section 20-299, the director shall provide an insurer with a copy of any document the director receives pursuant to this section that the director believes supports a violation of this title or that justifies any regulatory or other action against the insurer.  A disclosure pursuant to this subsection is not a waiver of any applicable privilege or claim of confidentiality in the disclosed document.

E. For the purposes of this section, "insurer claim file" includes medical records, repair estimates, adjuster notes, insurance policy provisions, recordings or transcripts of witness interviews and any other records regarding coverage, settlement, payment or denial or adjustment of a claim asserted under an insurance policy.
A.R.S. § 20-786 — Arizona Code / Title 20 / Chapter 4 / Article 2 / Section 786
20-786 Limitation on liability
Status: in_force

20-786. Limitation on liability

No one policy or subscriber as to such policy, shall be assessed or charged with an aggregate of contingent liability as to obligations incurred by a domestic reciprocal insurer in any one calendar year, in excess of the amount provided for in the power of attorney or in the subscribers' agreement, computed solely upon premium earned on such policy during that year.
A.R.S. § 20-3112 — Arizona Code / Title 20 / Chapter 20 / Article 2 / Section 3112
20-3112 Applicability
Status: in_force

20-3112. Applicability

This article does not apply to:

1. Health care services that are not covered by the enrollee's health plan.

2. Limited benefit coverage as defined in section 20-1137.

3. Charges for health care services that are subject to a direct payment agreement under section 32-3216 or 36-437.

4. Health plans that do not include coverage for out-of-network health care services, unless otherwise required by law.

5. State health and accident coverage for full-time officers and employees of this state and their dependents that is provided pursuant to title 38, chapter 4, article 4.

6. A self-funded or self-insured employee benefit plan if the regulation of that plan is preempted by the employee retirement income security act of 1974 (P.L. 93-406; 88 Stat. 829; 29 United States Code section 1144(b)).