D.C. Code § 31-3311.02 — DC Code / Title 31 / Chapter 33A / § 31-3311.02
§ 31-3311.02. Aggregate medical loss ratios; dividend; and rating bands.
Status: in_force

(a) For each calendar year, an insurer shall maintain an aggregate minimum medical loss ratio, as defined by rule, of 80% for individual policies, as defined by rule, 80% for small group policies, as defined by rule, and 85% for large group policies, as defined by rule. The medical loss ratio shall be defined by the Commissioner and shall be determined by rule in a manner and  generally consistent with the same standards as the medical loss ratio defined in section 2718(b) of the Public Health Service Act, approved March 23, 2010 (124 Stat. 136; 42 U.S.C. § 300gg-18(b)). No later than May 31st of each year, insurers shall file an annual report with the Commissioner, in a manner and on a form prescribed by Commissioner, indicating the medical loss ratio calculated for all policies and contracts written for the previous calendar year.
(b) All filings of rates and rating schedules shall demonstrate that actual expected claims in relation to premiums comply with the requirements of this chapter when combined with actual experience to date.
(c) In each case where the insurer fails to substantially comply with the medical loss ratio requirements set forth in subsection (a) of this section, the insurer shall issue a rebate for all policyholders in an amount determined in accordance with section 2718(b)(1)(B) of the Public Health Service Act, approved March 23, 2010 (124 Stat. 136; 42 U.S.C. § 300gg-18(b)(1)(B). The annual  report required by this section shall include the insurer’s calculation of the rebates and an explanation of the insurer’s plan to issue rebates. The instructions and format for calculating and reporting medical loss ratios and issuing rebates shall be  prescribed by the Commissioner by rule. The Commissioner shall establish, by rule, procedures for the distribution of a rebate in  the event of cancellation or termination by a policyholder.
(d) A plan of individual or small group health insurance rates shall not include a standard rate for any age that is more than 300% of the standard rate for the age with the lowest rate in the same plan and the standard rate for any age shall not be more than 104% of the standard rate for the previous age.
(e) An insurer’s failure to comply with the rebate requirements in subsection (c) of this section or rating band requirements set forth in subsection (d) of this section shall constitute an unfair or deceptive act or practice and shall be subject to the penalties in Chapter 22A of this title [ § 31-2231.01 et seq.].
(f) The Commissioner may audit any insurer to assure compliance with this section. Insurers shall retain at their principal place of business information necessary for the Commissioner to perform compliance audits.
D.C. Code § 31-5506 — DC Code / Title 31 / Chapter 55 / § 31-5506
§ 31-5506. Plan of operation.
Status: in_force

(a) (1) The Association shall submit to the Mayor a plan of operations, and any amendments thereto, necessary or suitable to assure the fair, reasonable, and equitable administration of the Association. The plan of operation and any amendments thereto shall become effective upon approval in writing by the Mayor.
  (2) If the Association fails to submit a suitable plan of operation within 90 days following October 21, 1993, or if at any time thereafter the Association fails to submit suitable amendments to the plan, the Mayor shall, after notice and hearing, issue those reasonable rules necessary or advisable to effectuate the provisions of this chapter. These rules shall continue in force until modified by the Mayor or superseded by a plan submitted by the Association and approved by the Mayor.
(b) All member insurers shall comply with the plan of operation.
(c) The plan of operation shall:
  (1) Establish the procedures whereby all the powers and duties of the Association under § 31-5505 will be performed;
  (2) Establish procedures for handling assets of the Association;
  (3) Establish the amount and method of reimbursing members of the board of directors under § 31-5504 ;
  (4) Establish procedures by which claims may be filed with the Association and establish acceptable forms of proof of covered claims. Notice of claims to the receiver or liquidator of the insolvent insurer shall be deemed notice to the Association or its agent and a list of claims shall be periodically submitted to the Association or similar organization in another jurisdiction by the receiver or liquidator;
  (5) Establish regular places and times for meetings of the board of directors;
  (6) Establish procedures for records to be kept of all financial transactions of the Association, its agents, and the board of directors;
  (7) Provide that any member insurer aggrieved by any final action or decision of the Association may appeal to the Mayor within 30 days after the action or decision;
  (8) Establish the procedures whereby selections for the board of directors will be submitted to the Mayor; and
  (9) Contain additional provisions necessary and proper for the execution of the powers and duties of the Association.
(d) The plan of operation may provide that any or all powers and duties of the Association, except those under § 31-5505(a)(3) and (b)(2), are delegated to a corporation, association, or other organization which performs, or will perform, functions similar to those of this Association or its equivalent in 2 or more states. Such a corporation, association, or organization shall be reimbursed as a servicing facility would be reimbursed and shall be paid for its performance of any other functions of the Association. A delegation under this subsection shall take effect only with the approval of both the board of directors and the Mayor, 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 chapter.
D.C. Code § 31-3863 — DC Code / Title 31 / Chapter 38D / § 31-3863
§ 31-3863. Medicaid reimbursement.
Status: in_force

Medicaid shall cover and reimburse for healthcare services appropriately delivered through telehealth if the same services would be covered when delivered in person.
D.C. Code § 31-736 — DC Code / Title 31 / Chapter 7 / § 31-736
§ 31-736. Failure to give notice.
Status: in_force

If the mutual company complies substantially and in good faith with the notice requirements of this subchapter, the mutual company’s failure to give any member or members any required notice does not impair the validity of any action taken under this subchapter.
D.C. Code § 31-5331 — DC Code / Title 31 / Chapter 53 / § 31-5331
§ 31-5331. Unfair methods of competition; unfair and deceptive acts and practices.
Status: in_force

Every society authorized to do business in the District and its agents shall be subject to the provisions of law applicable to life, accident, and health insurers relating to unfair and deceptive practices; provided, however, that nothing in such provisions shall be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership, or be construed as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society.
D.C. Code § 31-5511 — DC Code / Title 31 / Chapter 55 / § 31-5511
§ 31-5511. Examination of the Association.
Status: in_force

The Association shall be subject to examination and regulation by the Mayor. The board of directors shall submit, not later than March 30th of each year, a financial report for the preceding calendar year in a form approved by the Mayor.
D.C. Code § 31-3111 — DC Code / Title 31 / Chapter 31 / § 31-3111
§ 31-3111. Duties of Mayor.
Status: in_force

(a) The Mayor shall, within 120 days from February 28, 1987, issue rules to implement all sections of this chapter except § 31-3110 . The Mayor shall issue rules to implement § 31-3110 no later than 5 years from February 28, 1987.
(b) The Mayor shall provide the coverage and benefits set forth in this chapter to employees of the District and their dependents who are insured through the District of Columbia Employees’ Health Benefits Program. For District employees and their dependents who are insured through the Federal Employees’ Health Benefits Program, the Mayor shall provide supplemental coverage and benefits that comply with the requirements of this chapter no later than February 28, 1994.
D.C. Code § 31-1372.03 — DC Code / Title 31 / Chapter 13A / § 31-1372.03
§ 31-1372.03. Rated credit instruments.
Status: in_force

(a) Subject to the limitations of § 31-1372.02(b) and subsection (f) of this section, but not to the limitations of § 31-1372.02(a) , an insurer may acquire rated credit instruments issued, assumed, guaranteed, or insured by:
  (1) The United States; or
  (2) A government-sponsored enterprise of the United States if the instruments of the government-sponsored enterprise are assumed, guaranteed, or insured by the United States or are otherwise backed or supported by the full faith and credit of the United States.
(b) (1) Subject to the limitations of § 31-1372.02(b) and paragraph (2) of this subsection, but not the limitations of § 31-1372.02(a) , an insurer may acquire rated credit instruments issued, assumed, guaranteed, or insured by:
    (A) Canada; or
    (B) A government-sponsored enterprise of Canada if the instruments of the government-sponsored enterprise are assumed, guaranteed, or insured by Canada or are otherwise backed or supported by the full faith and credit of Canada.
  (2) An insurer shall not acquire an instrument under this subsection if, as a result of and after giving effect to the investment, the aggregate amount of investments then held by the insurer under this subsection would exceed 40% of its admitted assets.
(c) (1) Subject to the limitations of § 31-1372.02(b) and paragraph (2) of this subsection, but not to the limitations of § 31-1372.02(a) , an insurer may acquire rated credit instruments, excluding asset-backed securities:
    (A) Issued by a government money market mutual fund, a class one money market mutual fund, or a class one bond mutual fund;
    (B) Issued, assumed, guaranteed, or insured by a government-sponsored enterprise of the United States other than those eligible under subsection (a) of this section;
    (C) Issued, assumed, guaranteed, or insured by a state if the instruments are general obligations of the state; or
    (D) Issued by a multilateral development bank.
  (2) An insurer shall not acquire an instrument of any fund, enterprise or entity, or state under this subsection if, as a result of and after giving effect to the investment, the aggregate amount of investments then held in any one fund, enterprise or entity, or state under this subsection would exceed 10% of its admitted assets.
(d) Subject to the limitations of § 31-1372.02 , an insurer may acquire preferred stocks that are not foreign investments and that meet the requirements of rated credit instruments if, as a result of and after giving effect to the investment:
  (1) The aggregate amount of preferred stock then held by the insurer under this subsection does not exceed 20% of its admitted assets; and
  (2) The aggregate amount of preferred stock then held by the insurer under this subsection which are not sinking fund stocks or rated P1 or P2 by the SVO does not exceed 10% of its admitted assets.
(e) Subject to the limitations of § 31-1372.02 , in addition to those investments eligible under subsections (a), (b), (c), and (d) of this section, an insurer may acquire rated credit instruments that are not foreign investments.
(f) Notwithstanding any other provision of this section, an insurer shall not acquire special rated credit instruments under this section if, as a result of and after giving effect to the investment, the aggregate amount of special rated credit instruments held by the insurer would exceed 5% of its admitted assets.
(g) For purposes of this section, obligations of the Federal National Mortgage Association, Federal Home Loan Mortgage Corporation, or other mortgage-backed or mortgage-related securities as defined in section 106 of the Secondary Mortgage Market Enhancement Act of 1984, approved October 3, 1984 (98 Stat. 1691; 15 U.S.C. § 77r-1 ), may be acquired to the same extent as allowed under subsection (a) of this section, whether or not they are rated credit instruments authorized in subsection (a) of this section.
D.C. Code § 31-1204 — DC Code / Title 31 / Chapter 12 / § 31-1204
§ 31-1204. Failure to pay share of assessment.
Status: in_force

(a) Any insurer or health maintenance organization that fails to pay an assessment on or before the date set forth in § 31-1203 shall be subject to a penalty imposed by the Mayor, which shall be 10% of the assessment plus interest at one-half of 1% per month for the period between the due date and the date of full payment. If a payment is made in an amount later found to be in error, the Mayor shall do one of the following:
  (1) If an additional amount is due, notify the insurer of the additional amount which shall be due within 15 days of the date of mailing of the notice; or
  (2) If overpayment is made, order a refund.
(b) If an insurer or health maintenance organization fails to pay the amount of the assessment in a timely manner, the Mayor shall send the insurer or health maintenance organization a notice of deficiency, and 10 days after serving the deficiency notice may take whatever action, in the Mayor’s discretion, the Mayor deems appropriate, including suspending or revoking the insurer’s or health maintenance organization’s certificate of authority or license to transact business, or any other appropriate action or sanction authorized under the insurance laws for failure to comply with District laws, including referring the matter to the Corporation Counsel for legal action to collect the assessment.
(c) In the event that any insurer or health maintenance organization fails, by reason of insolvency, impairment of capital and surplus, or other reason approved by the Mayor, to pay its assessment in full, the unpaid amounts shall be assessed against the remaining insurers or health maintenance organizations respectively, on a proportionate basis in comparison to their direct gross receipts. Any insurer or health maintenance organization paying this additional assessment shall have a claim against the defaulting insurer or health maintenance organization for the amount paid.
D.C. Code § 31-1111 — DC Code / Title 31 / Chapter 11 / § 31-1111
§ 31-1111. Cancellation of insurance contracts.
Status: in_force

(a) When a premium finance agreement contains a power of attorney enabling the premium finance company to cancel any insurance contract or contracts listed in the agreement, the insurance contract or contracts shall not be canceled by the premium finance company unless such cancellation is effectuated in accordance with this section.
(b) Not less than 10 days written notice shall be mailed to the insured of the intent of the premium finance company to cancel the insurance contract unless the default is cured within such 10-day period.
(c) After expiration of such 10-day period, the premium finance company may thereafter request, in the name of the insured, cancellation of such insurance contract or contracts by mailing to the insurer a notice of cancellation, and the insurance contract shall be canceled as if such notice of cancellation had been submitted by the insured himself, but without requiring the return of the insurance contract or contracts. The premium finance company shall also mail a notice of cancellation to the insured at his last known address.
(d) All statutory, regulatory, and contractual restrictions providing that the insurance contract may not be canceled unless notice is given to a governmental agency, mortgagee, or other third party shall apply where cancellation is effected under the provisions of this section. The insurer shall give the prescribed notice in behalf of itself or the insured to any governmental agency, mortgagee, or other third party on or before the 2nd business day after the day it receives the notice of cancellation from the premium finance company and shall determine the effective date of cancellation taking into consideration the number of days notice required to complete the cancellation.
(e) Whenever an insurance contract is cancelled in accordance with this section, the insurer shall return whatever gross unearned premiums are due under the insurance contract to the premium finance company affecting the cancellation for the account of the insured or insureds.
(f) In the event that the crediting of return premiums to the account of the insured results in a surplus over the amount due from the insured, the premium finance company shall refund such excess to the insured provided that no such refund shall be required if it amounts to less than $1.
(g) When a default results in the cancellation of an insurance contract listed in the premium finance agreement, the premium finance agreement may provide for the payment by the insured of a cancellation charge equal to the difference between any delinquent charge imposed in respect of the installment or installments in default and $10; provided, however, that should the cancellation notice be withdrawn prior to its effective date and the insurance coverage reinstated, the agreement may provide for payment by the insured of a reinstatement charge equal to the cancellation charge herein provided.
D.C. Code § 31-5405 — DC Code / Title 31 / Chapter 54 / § 31-5405
§ 31-5405. Powers and duties of the Association.
Status: in_force

(a) If a member insurer is an impaired domestic insurer, the Association may, in its discretion and subject to any conditions imposed by the Association that do not impair the contractual obligations of the impaired insurer that are approved by the Mayor, and that are, except in cases of court-ordered conservation or rehabilitation, also approved by the impaired insurer:
  (1) Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, any or all of the policies, contracts, or certificates of the impaired insurer;
  (2) Provide monies, pledges, notes, guarantees, or other proper means to effectuate paragraph (1) of this subsection and assure payment of the contractual obligations of the impaired insurer pending action under paragraph (1) of this subsection; or
  (3) Loan money to the impaired insurer.
(b) (1) If a member insurer is an impaired insurer, whether domestic, foreign, or alien, and the insurer is not paying claims timely, then subject to the preconditions specified in paragraph (2) of this subsection, the Association shall, in its discretion, either:
    (A) Take any of the actions specified in subsection (a) of this section, subject to the conditions therein; or
    (B) Provide substitute benefits in lieu of the contractual obligations of the impaired insurer solely for health claims, periodic annuity benefit payments, death benefits, supplemental benefits, and cash withdrawals for policy or contract owners who petition for them under claims of emergency or hardship in accordance with standards proposed by the Association and approved by the Mayor.
  (2) The Association shall be subject to the requirements of paragraph (1) of this subsection only:
    (A) If the laws of the member insurer’s state of domicile provide that until all payments of or on account of the impaired insurer’s contractual obligation by all guaranty associations, along with all expenses and interest on all payments and expenses, shall have been repaid to the guaranty associations or a plan of repayment by the impaired insurer shall have been approved by the guaranty associations:
      (i) The delinquency proceeding shall not be dismissed;
      (ii) Neither the impaired insurer nor its assets shall be returned to the control of its shareholders or private management; and
      (iii) It shall not be permitted to solicit or accept new business or have any suspended or revoked license restored; and
    (B) If the impaired insurer is a domestic insurer, it has been placed under an order of rehabilitation by a court of competent jurisdiction in the District of Columbia; or
    (C) If the impaired insurer is a foreign or alien insurer:
      (i) It has been prohibited from soliciting or accepting new business in the District of Columbia;
      (ii) Its certificate of authority has been suspended or revoked in the District of Columbia; and
      (iii) A petition for rehabilitation or liquidation has been filed in a court of competent jurisdiction in its state of domicile by the commissioner of insurance of the state.
(c) If a member insurer is an insolvent insurer, the Association shall, in its discretion:
  (1) (A) Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, the policies, contracts, and certificates of the insolvent insurer; or
    (B) Assure payment of the contractual obligations of the insolvent insurer; and
    (C) Provide the monies, pledges, guarantees, or other means as are reasonably necessary to discharge the duties; or
  (2) With respect only to life and health insurance policies and certificates, provide benefits and coverages in accordance with subsection (d) of this section.
(d) When proceeding under subsection (b)(1)(B) or (c)(2) of this section, the Association shall, with respect only to life and health insurance policies and certificates:
  (1) Assure payment of benefits for premiums identical to the premiums and benefits, except for terms of conversion and renewability, that would have been payable under the policies of the insolvent insurer for claims incurred. The payment of benefits required by this paragraph shall be made:
    (A) With respect to group policies, not later than the earlier of the next renewal date under the policies or 45 days, but in no event less than 30 days after the date on which the Association becomes obligated with respect to the policies; or
    (B) With respect to individual policies, not later than the earlier of the next renewal date, if any, under the policies or 1 year, but in no event less than 30 days from the date on which the Association becomes obligated with respect to the policies;
  (2) Make diligent efforts to provide all known insureds group policy and certificate holders with respect to group policies 30-days notice of the termination of the benefits provided; and
  (3) Make available, with respect to individual policies, to each known insured, or owner if other than the insured; with respect to an individual formerly insured under a group policy who is not eligible for replacement group coverage, make available substitute coverage on an individual basis in accordance with the provisions of subsection (e) of this section, if the insureds had a right under law or the terminated policy to convert coverage to individual coverage or to continue an individual policy in force until a specified age or for a specified time during which the insurer had no right unilaterally to make changes in any provision of the policy or had a right only to make changes in premium by class.
(e) (1) In providing the substitute coverage required under subsection (d)(3) of this section, the Association may offer to reissue the terminated coverage or to issue an alternative policy.
  (2) Alternative or reissued policies shall be offered without requiring evidence of insurability, and shall not provide for any waiting period or exclusion that would not have applied under the terminated policies.
  (3) The Association may reinsure any alternative or reissued policy.
(f) (1) Alternative policies adopted by the Association shall be subject to the approval of the Mayor. The Association may adopt alternative policies of various types for future issuance without regard to any particular impairment or insolvency.
  (2) Alternative policies shall contain at least the minimum statutory provisions required in the District of Columbia and provide benefits that shall not be unreasonable in relation to the premium charged. The Association shall set the premium in accordance with a table of rates which it shall adopt. The premium shall reflect the amount of insurance to be provided and the age and class of risk of each insured, but shall not reflect any changes in the health of the insured after the original policy was last underwritten.
  (3) Alternative policies issued and delivered by the Association shall provide coverage of a type similar to that of the policies issued and delivered by the impaired or insolvent insurer, as determined by the Association.
(g) If the Association elects to reissue terminated coverage at a premium rate different from that charged under the terminated policy, the premium shall be set by the Association in accordance with the amount of insurance provided and the age and class of risk, subject to prior approval of the Mayor or by a court of competent jurisdiction.
(h) The Association’s obligations with respect to coverage under policies of the impaired or insolvent insurer or under any reissued or alternative policies shall cease on the date the policies are replaced by other similar policies by either the policyholder, the insured, or the Association.
(i) When proceeding under subsection (b)(1)(B) or (c) of this section with respect to any policy or contract carrying guaranteed minimum interest rates, the Association shall assure the payment or crediting of a rate of interest consistent with § 31-5402(b)(2)(C) .
(j) Nonpayment of premiums within 31 days after the date required under the terms of any guaranteed, assumed, alternative, or reissued policy or contract or substitute coverage shall terminate the Association’s obligations under the policy or coverage, except with respect to any claims incurred or any net cash surrender value which may be due in accordance with the provisions of this chapter.
(k) Premiums due for coverage after entry of an order of liquidation of an insolvent insurer shall belong to and be payable at the direction of the Association, and the Association shall be liable for unearned premiums due to policy or contract owners arising after the entry of the order.
(l) The protection provided by this chapter shall not apply where any guaranty protection is provided to residents of the District of Columbia by the laws of the domiciliary state or jurisdiction of the impaired or insolvent insurer, other than the District of Columbia.
(m) In carrying out its duties under subsections (b) and (c) of this section, the Association may, subject to approval by the court:
  (1) Impose permanent policy or contract liens in connection with any guarantee, assumption, or reinsurance agreement, if the Association finds that the amounts which can be assessed under this chapter are less than the amount needed to assure full and prompt performance of the Association’s duties under this chapter, or that the economic or financial conditions as they affect member insurers are sufficiently adverse to render the imposition of a permanent policy or contract lien, to be in the public interest; or
  (2) Impose temporary moratoriums on liens on payments of cash values and policy loans, or any other right to withdraw funds held in conjunction with policies or contracts, in addition to any contractual provisions for deferral of cash or policy loan value. In the event of a temporary moratorium or moratorium charge imposed by the receivership court on payment of cash values or policy loans, or on any other right to withdraw funds held in conjunction with policies or contracts, out of the assets of the impaired or insolvent insurer, the Association may defer the payment of cash values, policy loans or other rights by the Association for the period of the moratorium or moratorium charge imposed by the receivership court, except for claims covered by the Association to be paid in accordance with a hardship procedure established by the liquidator or rehabilitator and approved by the receivership court.
(m-1) A deposit in the District held pursuant to law or required by the Commissioner for the benefit of creditors, including policy owners, not turned over to the domiciliary liquidator upon the entry of a final order of liquidation or order approving a rehabilitation plan of an insurer domiciled in the District or in a reciprocal state, pursuant to Chapter 13 of this title [ §  31-1301 et seq.], shall be promptly paid to the Association. The Association shall be entitled to retain a portion of any amount so paid to it equal to the percentage determined by dividing the aggregate amount of policy owners claims related to that insolvency for which the Association has provided statutory benefits by the aggregate amount of all policy owners’ claims in this state related to that insolvency and shall remit to the domiciliary receiver the amount so paid to the Association less the amount retained pursuant to this subsection. Any amount so paid to the Association and retained by it shall be treated as a distribution of the liquidator’s assets pursuant to Chapter 13 of this title [ §  31-1301 et seq.], dealing with early access disbursements.
(n) If the Association fails to act within a reasonable period of time under subsections (b)(1)(B), (c), and (d) of this section, the Mayor shall assume the powers and duties of the Association under this chapter with respect to impaired or insolvent insurers.
(o) The Association may render assistance and advice to the Mayor, upon request, concerning rehabilitation, payment of claims, continuance of coverage, or the performance of other contractual obligations of any impaired or insolvent insurer.
(p) The Association shall have standing to appear or intervene before any court in the District of Columbia with jurisdiction over an impaired or insolvent insurer for which the Association is or may become obligated under this chapter or with jurisdiction over any person or property against which the Association may have rights through subrogation or otherwise. Standing shall extend to all matters germane to the powers and duties of the Association, including, but not limited to, proposals for reinsuring, modifying, or guaranteeing the policies or contracts of the impaired or insolvent insurer and the determination of the policies or contracts and contractual obligations. The Association shall also have the right to appear or intervene before a court in another state with jurisdiction over an impaired or insolvent insurer for which the Association is or may become obligated or a court with jurisdiction over any person or property against whom the Association may have rights through subrogation or otherwise of the insurer’s policyholders.
(q) (1) Any person receiving benefits under this chapter shall be deemed to have assigned the rights under, and any causes of action against any person for losses arising under, resulting from, or otherwise relating to, the covered policy or contract to the Association, whether the benefits are payments of, or on account of, contractual obligations, continuation of coverage, or provision of substitute or alternative coverages. The Association may require an assignment to it of the rights and causes of action by any payee, policy or contract owner, beneficiary, insured, or annuitant as a condition precedent to the receipt of any rights or benefits conferred by this chapter upon such a person.
  (2) The subrogation rights of the Association under this subsection shall have the same priority against the assets of the impaired or insolvent insurer as that possessed by the person entitled to receive benefits under this chapter.
  (3) In addition to paragraphs (1) and (2) of this subsection, the Association shall have all common law rights of subrogation and any other equitable or legal remedy which would have been available to the impaired or insolvent insurer or holder of a policy or contract with respect to the policy or contracts.
  (4) If the preceding provisions of this subsection are invalid or ineffective with respect to any person or claim for any reason, the amount payable by the Association with respect to the related covered obligations shall be reduced by the amount realized by any other person with respect to the person or claim that is attributable to the policies (or portion thereof) covered by the Association.
  (5) If the Association has provided benefits with respect to a covered obligation and a person recovers amounts as to which the Association has rights as described in the preceding paragraphs of this subsection, the person shall pay to the Association the portion of the recovery attributable to the policies (or portion thereof) covered by the Association.
(r) The Association may:
  (1) Enter into contracts necessary or proper to carry out the provisions and purposes of this chapter;
  (2) Sue or be sued, including taking any legal actions necessary or proper to recover any unpaid assessments under § 31-5406 and to settle claims or potential claims against it;
  (3) Borrow money to carry out the purposes of this chapter; any notes or other evidence of indebtedness of the Association not in default shall be legal investments for domestic insurers and may be carried as admitted assets;
  (4) Employ or retain persons necessary to handle the financial transactions of the Association, and to perform other functions necessary or proper under this chapter;
  (5) Take legal action necessary to avoid payment of improper claims;
  (6) Exercise, for the purposes of this chapter and to the extent approved by the Mayor, the powers of a domestic life or health insurer, but in no case may the Association issue insurance policies or annuity contracts other than those issued to perform its obligations under this chapter;
  (6A) Unless prohibited by law, in accordance with the terms and conditions of the policy or contract, file for actuarily justified rate or premium increases for any policy or contract for which it provides coverage under this chapter ; and
  (7) Take other necessary or appropriate action to discharge its duties and obligations under this chapter or to exercise its powers under this chapter.
(s) The Association may join an organization of 1 or more other state associations of similar purposes to further the purposes and administration of the powers and duties of the Association.
(t) (1) (A) At any time within 180 days of the date of the order of liquidation, the Association may elect to succeed to the rights and obligations of the ceding member insurer that relate to policies or annuities covered, in whole or in part, by the Association, in each case under any one or more reinsurance contracts entered into by the insolvent insurer and its reinsurers and selected by the Association. Any such assumption shall be effective as of the date of the order of liquidation. The election shall be effected by the Association or the National Organization of Life and Health Insurance Guaranty Associations (“NOLHGA”) on its behalf sending written notice, return receipt requested, to the affected reinsurers.
    (B) To facilitate the earliest practicable decision about whether to assume any of the contracts of reinsurance, and in order to protect the financial position of the estate, the receiver and each reinsurer of the ceding member insurer shall make available upon request to the Association or to NOLHGA on its behalf as soon as possible after commencement of formal delinquency proceedings:
      (i) Copies of in-force contracts of reinsurance and all related files and records relevant to the determination of whether such contracts should be assumed; and
      (ii) Notices of any defaults under the reinsurance contracts or any known event or condition which with the passage of time could become a default under the reinsurance contracts.
    (C) The following provisions shall apply to reinsurance contracts so assumed by the Association:
      (i) The Association shall be responsible for all unpaid premiums due under the reinsurance contracts for periods both before and after the date of the order of liquidation, and shall be responsible for the performance of all other obligations to be performed after the date of the order of liquidation, which relate to policies or annuities covered, in whole or in part, by the Association. The Association may charge policies or annuities covered in part by the Association, through reasonable allocation methods, the costs for reinsurance in excess of the obligations of the Association and shall provide notice and an accounting of these charges to the liquidator.
      (ii) The Association shall be entitled to any amounts payable by the reinsurer under the reinsurance contracts with respect to losses or events that occur in periods after the date of the order of liquidation and that relate to policies or annuities covered, in whole or in part, by the Association; provided, that upon receipt of any such amounts, the Association shall be obliged to pay to the beneficiary under the policy or annuity on account of which the amounts were paid a portion of the amount equal to the lesser of:
        (I) The amount received by the Association; and
        (II) The excess of the amount received by the Association over the amount equal to the benefits paid by the Association on account of the policy or annuity, less the retention of the insurer applicable to the loss or event.
      (iii) Within 30 days following the Association’s election (“election date”), the Association and each reinsurer under contracts assumed by the Association shall calculate the net balance due to or from the Association under each reinsurance contract as of the election date with respect to policies or annuities covered, in whole or in part, by the Association, which calculation shall give full credit to all items paid by either the insurer or its receiver or the reinsurer before the election date. The reinsurer shall pay the receiver any amounts due for losses or events before the date of the order of liquidation, subject to any set-off for premiums unpaid for periods before the date, and the Association or reinsurer shall pay any remaining balance due the other, within 5 days of the completion of the aforementioned calculation. Any disputes over the amounts due to either the Association or the reinsurer shall be resolved by arbitration pursuant to the terms of the affected reinsurance contracts or, if the contract contains no arbitration clause, as otherwise provided by law. If the receiver has received any amounts due the Association pursuant to sub-subparagraph (ii) of this subparagraph, the receiver shall remit the same to the Association as promptly as practicable.
      (iv) If the Association or receiver, on the Association’s behalf, within 60 days of the election date, pays the unpaid premiums due for periods both before and after the election date that relate to policies or annuities covered, in whole or in part, by the Association, the reinsurer shall not be entitled to terminate the reinsurance contracts for failure to pay the premium insofar as the reinsurance contracts relate to policies or annuities covered, in whole or in part, by the Association, and shall not be entitled to set off any unpaid amounts due under other contracts, or unpaid amounts due from parties other than the Association, against amounts due the Association.
  (2) During the period from the date of the order of liquidation until the election date or, if the election date does not occur, until 180 days after the date of the order of liquidation:
    (A) Neither the Association nor the reinsurer shall have any rights or obligations under reinsurance contracts that the Association has the right to assume under paragraph (1) of this subsection, whether for periods before or after the date of the order of liquidation; provided, that once the Association has elected to assume a reinsurance contract, the parties’ rights and obligations shall be governed by paragraph (1) of this subsection; and
    (B) The reinsurer, the receiver, and the Association shall, to the extent practicable, provide each other data and records reasonably requested.
  (3) If the Association does not elect to assume a reinsurance contract by the election date pursuant to paragraph (1) of this subsection, the Association shall have no rights or obligations, in each case for periods both before and after the date of the order of liquidation, with respect to the reinsurance contract.
  (4) When policies or annuities, or covered obligations with respect thereto, are transferred to an assuming insurer, reinsurance on the policies or annuities may also be transferred by the Association, in the case of contracts assumed under paragraph (1) of this subsection, subject to the following:
    (A) Unless the reinsurer and the assuming insurer agree otherwise, the reinsurance contract transferred shall not cover any new policies of insurance or annuities in addition to those transferred;
    (B) The obligations described in paragraph (1) of this subsection shall no longer apply with respect to matters arising after the effective date of the transfer; and
    (C) Notice shall be given in writing, return receipt requested, by the transferring party to the affected reinsurer not less than 30 days before the effective date of the transfer.
  (5) The provisions of subsection (t) of this section shall supersede the provisions of any District law and any affected reinsurance contract that provides for or requires any payment of reinsurance proceeds, on account of losses or events that occur in periods after the date of the order of liquidation, to the receiver of the insolvent insurer or any other person. The receiver shall remain entitled to any amounts payable by the reinsurer under the reinsurance contracts with respect to losses or events that occur in periods before the date of the order of liquidation, subject to applicable setoff provisions.
  (6) Except as otherwise provided, nothing in this subsection shall:
    (A) Alter or modify the terms and conditions of any reinsurance contract;
    (B) Abrogate or limit any rights of any reinsurer to claim that it is entitled to rescind a reinsurance contract;
    (C) Give a policyholder or beneficiary an independent cause of action against a reinsurer that is not otherwise set forth in the reinsurance contract;
    (D) Limit or affect the Association’s rights as a creditor of the estate against the assets of the estate; or
    (E) Apply to reinsurance agreements covering property or casualty risks.
(u) The Board of Directors of the Association shall have discretion and may exercise reasonable business judgment to determine the means by which the Association is to provide the benefits of this chapter in an economical and efficient manner.
(v) Where the Association has arranged or offered to provide the benefits of this chapter to a covered person under a plan or arrangement that fulfills the Association’s obligations under this chapter, the person shall not be entitled to benefits from the Association in addition to or other than those provided under the plan or arrangement.
(w) Venue in a suit against the Association arising under the chapter shall be in the District. The Association shall not be required to give an appeal bond in an appeal that relates to a cause of action arising under this chapter.
D.C. Code § 31-5509 — DC Code / Title 31 / Chapter 55 / § 31-5509
§ 31-5509. Nonduplication of recovery.
Status: in_force

(a) Any person having a claim against an insurer under any provision in an insurance policy, other than a policy of an insolvent insurer which is also a covered claim, shall be required to exhaust first his or her right under such a policy. Any amount payable on a covered claim under this chapter shall be reduced by the amount of any recovery under such an insurance policy.
(b) Any person having a claim which may be recovered under more than one insurance guaranty association or its equivalent shall seek recovery first from the Association of the place of residence of the insured, except that if it is a first-party claim for damage to property with a permanent location, he or she shall seek recovery first from the Association of the location of the property, and if it is a workers’ compensation claim, he or she shall seek recovery first from the Association of the residence of the claimant. Any recovery under this chapter shall be reduced by the amount of recovery from any other insurance guaranty association or its equivalent.
D.C. Code § 31-202 — DC Code / Title 31 / Chapter 2 / § 31-202
§ 31-202. General duties of Commissioner; companies or associations to file certain information; service of legal process; rules and regulations.
Status: in_force

(a) It shall be the duty of the Commissioner to see that all laws of the United States relating to insurance or insurance companies, benefit orders, associations, and others doing insurance business in the District are faithfully executed, to keep on file in the Insurance Administration office copies of the charters, declarations of organizations, or articles of incorporation of every company, association, or order doing business in the District.
(b) Before any such insurance company, association, or order shall be licensed to do business in the District it shall file with the Commissioner a copy of its charter, declaration of organization, or articles of incorporation duly certified in accordance with the law by the Commissioner of Insurance and Securities [Commissioner of the Department of Insurance, Securities, and Banking], Insurance Commissioner, or other proper officers of the state, territory, or nation where the company, association, group, or organization was organized, a certificate setting forth that it is entitled to transact business and assume risks and issue policies of insurance therein and any other information required by the Commissioner; and a duly executed instrument appointing some suitable person in the District of Columbia, or not 10 miles beyond the territorial limits of the District of Columbia, as the agent for such company, upon whom all lawful process in any action or legal proceeding against it in the District may be served and shall register with the Commissioner the address of its principal office and the name and address of its agent for service of process in the District, including any changes in address.
(c) Should said company refuse to appoint such agent, or should any person, after making reasonable efforts to do so (which efforts shall be documented), be unable to serve such agent, said legal process shall be served upon the Commissioner and shall be deemed service upon the company. The Commissioner may by regulation establish fees to be paid when legal process is served upon the Commissioner pursuant to this section. Whenever the Commissioner is served pursuant to this section, he or she shall forward forthwith such process by certified mail to the company named therein, and shall maintain a log showing when such process was served upon the Commissioner and when it was forwarded to the person named therein. The Commissioner shall provide to any person, upon request, the name and address of the agent for any company, or in the alternative, a list of all such agents.
(d) Any company, association, group, or organization that fails to comply with the requirements of subsection (b) of this section shall be guilty of a misdemeanor and shall be fined not more than $500 a day for each violation. Civil fines, penalties, and fees may be imposed as alternative sanctions on any company, association, group, or organization that fails to comply with the requirements of subsection (b) of this section, or any rules or regulations issued pursuant to this section. Any company, association, group, or organization against which a fine, penalty, or fee has been imposed may, within 30 days after notice of the penalty is sent, contest the imposition or the amount of the civil fine, penalty, or fee. The hearing shall commence not less than 10 days nor more than 30 days from the date the request for the hearing is received by the Commissioner. The hearing shall be conducted according to the rules for contested cases enumerated in Title 26 (Insurance) of the District of Columbia Municipal Regulations (26 DCMR).
(e) The Commissioner shall maintain as confidential any documents or information received from the National Association of Insurance Commissioners or insurance departments of other states which is confidential in such other jurisdictions. The Commissioner may share information, including otherwise confidential information, with the National Association of Insurance Commissioners or insurance departments of other states so long as such other jurisdictions agree to maintain the same level of confidentiality as is available under District of Columbia law.
D.C. Code § 31-1316 — DC Code / Title 31 / Chapter 13 / § 31-1316
§ 31-1316. Liquidation orders.
Status: in_force

(a) An order to liquidate the business of a domestic insurer shall appoint the Commissioner and his or her successors in office liquidator and shall direct the liquidator to take possession of the assets of the insurer and to administer them under the general supervision of the court. The liquidator shall be vested by operation of law with the title to all of the property, contracts, and rights of action, and all of the books and records of the insurer ordered liquidated, wherever located, as of the entry of the final order of liquidation. The filing or recording of the order with the Clerk of the Superior Court of the District of Columbia, or, in the case of real estate, with the recorder of deeds of the county where the property is located, shall impart the same notice as a deed, bill of sale, or other evidence of title duly filed or recorded with that recorder of deeds would have imparted.
(b) Upon issuance of the order, the rights and liabilities of any insurer and of its creditors, policyholders, shareholders, members, and all other persons interested in its estate shall become fixed as of the date of entry of the order of liquidation, except as provided in §§ 31-1317 and 31-1335 .
(c) An order to liquidate the business of an alien insurer domiciled in the District shall be in the same terms and have the same legal effect as an order to liquidate a domestic insurer, except that the assets and the business in the United States shall be the only assets and business included therein.
(d) At the time of petitioning for an order of liquidation, or at any time thereafter, the Commissioner, after making appropriate findings of an insurer’s insolvency, may petition the court for a judicial declaration of insolvency. After providing notice and hearing it deems proper, the court may make the declaration.
(e) Any order issued under this section shall require financial reports to the court by the liquidator. Financial reports shall include, at a minimum, the assets and liabilities of the insurer and all funds received or disbursed by the liquidator during the current period. Financial reports shall be filed within 1 year of the liquidation order and at least annually thereafter.
(f) (1) Within 5 days of October 15, 1993, or, if later, within 5 days after the initiation of an appeal of an order of liquidation, which order has not been stayed, the Commissioner shall present for the court’s approval a plan for the continued performance of the defendant company’s policy claims obligations, including the duty to defend insureds under liability insurance policies, during the pendency of an appeal. Such a plan shall provide for the continued performance and payment of policy claims obligations in the normal course of events, notwithstanding the grounds alleged in support of the order of liquidation including the ground of insolvency. In the event the defendant company’s financial condition will not, in the judgment of the Commissioner, support the full performance of all policy claims obligations during the appeal pendency period, the plan may prefer the claims of certain policyholders and claimants over creditors and interested parties as well as other policyholders and claimants, as the Commissioner finds to be fair and equitable considering the relative circumstances of the policyholders and claimants. The court shall examine the plan submitted by the Commissioner, and, if it finds the plan to be in the best interests of the parties, the court shall approve the plan. No action shall lie against the Commissioner or any of his deputies, agents, clerks, assistants, or attorneys by any party based on preference in an appeal pendency plan approved by the court.
  (2) The appeal pendency plan shall not supersede or affect the obligations of any insurance guaranty association.
  (3) Any plans shall provide for equitable adjustments to be made by the liquidator to any distributions of assets to guaranty associations, in the event that the liquidator pays claims from assets of the estate, which would otherwise be the obligations of any particular guaranty association but for the appeal of the order of liquidation, so that all guaranty associations equally benefit on a pro rata basis from the assets of the estate. Further, in the event an order of liquidation is set aside upon any appeal, the company shall not be released from delinquency proceedings unless and until all funds advanced by any guaranty association, including reasonable administrative expenses in connection therewith relating to obligations of the company, shall be repaid in full, together with interest at the judgment rate of interest, or unless an arrangement for repayment has been made with the consent of all applicable guaranty associations.
D.C. Code § 31-3603 — DC Code / Title 31 / Chapter 36 / § 31-3603
§ 31-3603. Long-term insurance; who may issue.
Status: in_force

Long-term care insurance may be issued by insurers, fraternal benefits societies, nonprofit health, hospital, and medical service corporations, prepaid health plans, and health maintenance organizations, and any similar organization to the extent they are otherwise authorized to issue life or health insurance. Any product advertised, marketed, or offered as long-term care insurance shall be subject to the provisions of this chapter.
D.C. Code § 31-311 — DC Code / Title 31 / Chapter 3 / § 31-311
§ 31-311. Definition, availability, and maintenance of independent certified public accountant workpapers.
Status: in_force

(a) For purposes of this section, the term “workpapers” are the records kept by the independent certified public accountant of the procedures followed, the tests performed, the information obtained, and the conclusions reached pertinent to his or her audit of the financial statements of an insurer. Workpapers, accordingly, may include audit planning documentation, work programs, analyses, memoranda, letters of confirmation and representation, abstracts of company documents, and schedules or commentaries prepared or obtained by the independent certified public accountant in the course of his or her audit of the financial statements of an insurer and which support his or her opinion thereof.
(b) Every insurer required to file an audited financial report pursuant to this chapter shall require the accountant to make available for review by the Mayor’s examiners all workpapers prepared in the conduct of his or her audit and any communications related to the audit between the accountant and the insurer, at the offices of the insurer, or at any other reasonable place designated by the Mayor. The insurer shall require that the accountant retain the audit workpapers and communications until the Mayor has filed a report on examination covering the period of the audit but no longer than 7 years from the date of the audit report.
(c) The Mayor may make and retain photocopies of pertinent audit workpapers. The review by the Mayor’s examiners shall be considered investigations and all working papers and communications obtained during the course of the investigations shall be afforded the same confidentiality as other examination workpapers generated by the Mayor.
D.C. Code § 31-4708 — DC Code / Title 31 / Chapter 47 / § 31-4708
§ 31-4708. Filing and approval of life policy forms.
Status: in_force

A policy of life insurance shall not be issued or delivered in the District until the form of the same has been filed with the Commissioner, nor if the Commissioner gives written notice, within 30 days of such filing, to the company proposing to issue it, showing wherein the form of such policy does not comply with the requirements of the laws of the District, provided that such action of the Commissioner shall be subject to review by a court of competent jurisdiction.
D.C. Code § 31-2403.01 — DC Code / Title 31 / Chapter 24 / § 31-2403.01
§ 31-2403.01. Pre-litigation discovery of insurance.
Status: in_force

(a) After a claimant makes a written claim for compensation or damages concerning a vehicle accident, and provides the documents described in subsection (b) or (c) of this section to an insurer, the claimant shall be entitled to obtain from the insurer documentation of the applicable limits of coverage in any insurance agreement under which the insurer may be liable to:
  (1) Satisfy all or part of the claim; or
  (2) Indemnify or reimburse for payments made to satisfy the claim.
(b) For a claimant to obtain the documentation described in subsection (a) of this section from the insurer, the claimant shall provide the following, in writing, to the insurer:
  (1) The date of the vehicle accident;
  (2) The name and last known address of the alleged tortfeasor;
  (3) A copy of the vehicle accident report, if any;
  (4) The insurer’s claim number, if available;
  (5) The claimant’s health care bills and documentation of the claimant’s loss of income, if any, resulting from the vehicle accident; and
  (6) The records of health care treatment for the claimant’s injuries caused by the vehicle accident.
(c) If the claim is brought by the estate of an individual or a beneficiary of the individual, whose death resulted from a vehicle accident, the insurer must provide the documentation described in subsection (a) of this section if the claimant provides the following, in writing, to the insurer:
  (1) The date of the vehicle accident;
  (2) The name and last known address of the alleged tortfeasor;
  (3) A copy of the vehicle accident report, if any;
  (4) The insurer’s claim number, if available;
  (5) A copy of the decedent’s death certificate issued in the District of Columbia or another jurisdiction;
  (6) A copy of the letters of administration issued to appoint the personal representative of the decedent’s estate in the District of Columbia or a substantially similar document issued by another jurisdiction;
  (7) The name of each beneficiary of the decedent, if known;
  (8) The relationship to the decedent of each known beneficiary of the decedent;
  (9) The health care bills for health care treatment, if any, of the decedent resulting from the vehicle accident; and
  (10) The records of health care treatment for injuries to the decedent caused by the vehicle accident.
(d) After receipt of the documents pursuant to either subsection (b) or (c) of this section, the insurer shall respond in writing within 30 days of receipt of the request issued pursuant to subsection (a) of this section and shall disclose the limits of coverage, of all policies, regardless of whether the insurer contests the applicability of the policy to the claim.
(e) Disclosure of documentation required under this section shall not constitute:
  (1) An admission that the asserted claim is subject to the applicable agreement between the insurer and the alleged tortfeasor; or
  (2) A waiver of any term or condition of the applicable agreement between the insurer and the alleged tortfeasor or any right of the insurer, including any potential defense concerning coverage or liability.
(f) An insurer, and the employees and agents of an insurer, may not be civilly or criminally liable for disclosure of the required documentation.
(g) Information concerning the insurance policy is not, by reason of disclosure pursuant to this section, admissible as evidence at trial.
(h) For the purposes of this section, the term “vehicle accident” includes accidents involving bicyclists.
D.C. Code § 31-2991 — DC Code / Title 31 / Chapter 29A / § 31-2991
§ 31-2991. Closed claim analysis.
Status: in_force

(a) Within 180 days of march 14, 2007, the Mayor shall submit legislation to the Council for the establishment of a database of closed obstetrician/gynecologist malpractice claims reports to be submitted by providers of medical malpractice insurance.
(b) The legislation shall include a plan which shall:
  (A) Contain provisions to identify trends and develop recommendations for preventative action for adverse Obstetrician/Gynecologist events;
  (B) Ensure dissemination of best practices among Obstetrician/Gynecologist practitioners and facilities and shall include provisions for ensuring the implementation of these practices; and
  (C) Include provisions to study recommendations based on closed Obstetrician/Gynecologist malpractice claims in other jurisdictions.
D.C. Code § 31-4710 — DC Code / Title 31 / Chapter 47 / § 31-4710
§ 31-4710. Group policies — General requirements.
Status: repealed

Repealed.
D.C. Code § 31-2302 — DC Code / Title 31 / Chapter 23 / § 31-2302
§ 31-2302. Domestication permitted.
Status: in_force

(a) (1) Upon compliance with this chapter, a Non-U.S. insurer which is authorized to use the District of Columbia (“District”) as a state of entry to transact insurance business through its United States branch and which owns beneficially, directly or indirectly, all outstanding shares of a domestic insurer or of a foreign insurer qualified and licensed in the District to write all the kinds of insurance for which the United States branch is qualified and licensed, may domesticate its United States branch by entering into a written domestication agreement with such domestic or foreign insurer providing for the acquisition of the business and assets, and the assumption of all liabilities, of the United States branch, by the domestic or foreign insurer for no consideration, except for (A) such assumption of liabilities, and (B) additional consideration payable by the issuance of shares of the acquiring insurer.
  (2) The domestication shall be subject to prior written approval by the Commissioner if the acquiring insurer is a domestic insurer or by the chief insurance regulatory official of the state of organization if it is a foreign insurer.
  (3) The domestication shall be subject to final approval by the Commissioner if the acquiring insurer is a domestic insurer or by the chief insurance regulatory official of the state of organization if it is a foreign insurer.
(b) Any shares of the acquiring insurer, or voting trust certificates therefor, held among the trusteed assets of the United States branch or held in a trust created by the Non-U.S. insurer of which the Non-U.S. insurer is a beneficiary shall be deemed to be shares held beneficially, but indirectly, by the Non-U.S. insurer.
(c) The acquiring insurer may be licensed to engage in the insurance business in the District either before entering into the domestication agreement or, if the Commissioner approves, effective with consummation of the domestication agreement in accordance with § 31-2306 .
(d) This chapter shall not be construed to (1) authorize an insurance company to do any kind of insurance business not authorized by its charter, or (2) authorize a foreign or Non-U.S. insurer to do any kind of insurance business in the District not authorized by its license or certificate of authority to do business in the District.
D.C. Code § 31-3875.05 — DC Code / Title 31 / Chapter 38F / § 31-3875.05
§ 31-3875.05. Appeals.
Status: in_force

(a) A utilization review entity shall provide an enrollee with at least 15 calendar days from the date the enrollee receives notice of an adverse determination to appeal the decision via the utilization review entity's website, facsimile, or mail; provided, that an appeal submitted by mail shall be considered timely if postmarked within 15 calendar days of the enrollee receiving notice.
(b) In reviewing an appeal, the utilization review entity shall consider all known clinical aspects of the health care service under review, including a review of all pertinent medical records, other relevant records, and any medical literature provided by the enrollee, representative, or the enrollee's health care provider.
(c) The enrollee, representative, and the enrollee's health care provider shall be notified within 24 hours of the utilization review entity making a decision on the appeal, which shall include the following information:
  (1) The qualifications of the physician reviewing the appeal including:
    (A) States in which the physician is licensed;
    (B) Status of their medical licenses;
    (C) Their medical specialty; and
    (D) Years of practice in that specialty; and
  (2) The grounds for the physician's decision under the utilization review entity's prior authorization requirements.
D.C. Code § 31-1347 — DC Code / Title 31 / Chapter 13 / § 31-1347
§ 31-1347. External audit of the receiver’s books.
Status: in_force

The Superior Court of the District of Columbia may, as it deems desirable, order audits to be made of the books of the Commissioner relating to any receivership established under this chapter, and a report of each audit shall be filed with the Commissioner and with the court. The books, records, and other documents of the receivership shall be made available to the auditor at any time without notice. The expense of each audit shall be considered a cost of administration of the receivership.
D.C. Code § 31-1631.07 — DC Code / Title 31 / Chapter 16A / § 31-1631.07
§ 31-1631.07. License denial, suspension, revocation, and refusal to renew; civil penalties.
Status: in_force

(a) The Commissioner may deny a license to an applicant or suspend, revoke, or refuse to renew a license if the applicant or licensee:
  (1) Violates the provisions of this chapter or any standard of conduct prescribed by the Commissioner in regulations;
  (2) Makes a material misstatement in the application for the license;
  (3) Engages in fraudulent or dishonest practices; or
  (4) Demonstrates incompetency or untrustworthiness to act as a public insurance adjuster.
(b) Upon a finding by the Commissioner of a violation of subsection (a)(1) or (3) of this section, the Commissioner may impose a civil penalty not to exceed $1,000 for each violation.
(c) This chapter shall not be applied or interpreted to bar a borrower from bringing an action pursuant to any District or federal law for damages, injunctive relief, or any other relief.
D.C. Code § 31-404 — DC Code / Title 31 / Chapter 4 / § 31-404
§ 31-404. Required contract provisions.
Status: in_force

A controlled insurer shall not accept business from a controlling producer and a controlling producer shall not place business with a controlled insurer unless there is a written contract between the controlling producer and the controlled insurer specifying the responsibilities of each party, which contract has been approved by the board of directors of the controlled insurer, and contains the following minimum provisions:
(1) The controlled insurer may terminate the contract for cause, upon written notice to the controlling producer. The controlled insurer shall suspend the authority of the controlling producer to write business during the pendency of any dispute regarding the cause for termination.
(2) The controlling producer shall render accounts to the controlled insurer detailing all material transactions, including information necessary to support all commissions, charges, and other fees received by, or owing to, the controlling producer.
(3) The controlling producer shall remit all funds due under the terms of the contract to the controlled insurer on at least a monthly basis. The due date shall be fixed so that premiums or installments collected shall be remitted no later than 90 days after the effective date of any policy placed with the controlled insurer under this contract.
(4) All funds collected for the controlled insurer’s account shall be held by the controlling producer in a fiduciary capacity, in one or more appropriately identified bank accounts in banks that are members of the Federal Reserve System, in accordance with applicable provisions of insurance law of the District of Columbia. Funds of a controlling producer not required to be licensed in the District of Columbia shall be maintained in compliance with the requirements of the controlling producer’s domiciliary jurisdiction.
(5) The controlling producer shall maintain separately identifiable records of business written for the controlled insurer.
(6) The contract shall not be assigned in whole or in part by the controlling producer.
(7) The controlled insurer shall provide the controlling producer with its underwriting standards, rules and procedures, manuals setting forth the rates to be charged, and the conditions for the acceptance or rejection of risks. The controlling producer shall adhere to the standards, rules, procedures, rates, and conditions. The standards, rules, procedures, rates, and conditions shall be the same as those applicable to comparable business placed with the controlled insurer by a producer other than the controlling producer.
(8) The rates and terms of the controlling producer’s commissions, charges, or other fees and the purposes for those charges or fees shall be included. The rates of the commissions, charges, and other fees shall be no greater than those applicable to comparable business placed with the controlled insurer by producers other than controlling producers. For purposes of this paragraph and paragraph (7) of this section, examples of “comparable business” include the same lines of insurance, same kinds of insurance, same kinds of risks, similar policy limits, and similar quality of business.
(9) If the contract provides that the controlling producer, on insurance business placed with the insurer, is to be compensated contingent upon the insurer’s profits on that business, then the compensation shall not be determined and paid until at least 5 years after the premiums on liability insurance are earned and at least 1 year after the premiums are earned on any other insurance. In no event shall the commissions be paid until the adequacy of the controlled insurer’s reserves on remaining claims has been independently verified pursuant to paragraphs (1) and (6) of this section.
(10) The contract provides a limit on the controlling producer’s writings in relation to the controlled insurer’s surplus and total writings. The insurer may establish a different limit for each line or subline of business. The controlled insurer shall notify the controlling producer when the applicable limit is approached and shall not accept business from the controlling producer if the limit is reached. The controlling producer shall not place business with the controlled insurer if it has been notified by the controlled insurer that the limit has been reached.
(11) The controlling producer may negotiate, but shall not bind, reinsurance on behalf of the controlled insurer on business the controlling producer places with the controlled insurer, except that the controlling producer may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the controlled insurer contains underwriting guidelines, including, for both reinsurance assumed and ceded, a list of reinsurers with which automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured, and commission schedules.
D.C. Code § 31-3506 — DC Code / Title 31 / Chapter 35 / § 31-3506
§ 31-3506. Surplus requirements.
Status: in_force

(a) At the time of issuance of a certificate of authority under this chapter and at all times thereafter until risk-based capital regulations for hospital and medical services corporations are promulgated, a corporation must possess surplus in an amount which is the greater of $5,000,000 or 8.0% of the total amount of premiums for insured risk received by the corporation in the preceding calendar year. The total amount of premiums for insured risk shall not include premiums collected for federal health benefit programs that have a separate reserve fund held by the federal government.
(b) The surplus requirement of 8.0% shall be phased-in following April 9, 1997 as follows:
  (1) Year one — 40% of the surplus requirement in subsection (a) of this section;
  (2) Year two — 60% of the surplus requirement in subsection (a) of this section;
  (3) Year three — 80% of the surplus requirement in subsection (a) of this section; and
  (4) Year four — 100% of the surplus requirement in subsection (a) of this section.
(c) The Mayor shall have the authority to require the differentiation of the corporation’s activities into risk and nonrisk business for the purpose of determining the corporation’s income that is derived from premiums for insured risk and from other sources.
(d) Notwithstanding the provisions of subsection (a) of this section, at the time of issuance of a certificate of authority under this chapter and at all times thereafter, a corporation shall be subject to the provisions of any risk-based capital regulations for hospital and medical services corporations promulgated by the Mayor, and must maintain at all times such surplus as is determined to be necessary under those regulations.
(e) The Commissioner may, on an annual basis, and shall, on a basis no less frequently than every 3 years, review the portion of the surplus of the corporation that is attributable to the District and may issue a determination as to whether the surplus is excessive. Any such review shall be undertaken in coordination with the other jurisdictions in which the corporation conducts business. The surplus may be considered excessive only if:
  (1) The surplus is greater than the appropriate risk-based capital requirements as determined by the Commissioner for the immediately preceding calendar year; and
  (2) After a hearing, the Commissioner determines that the surplus is unreasonably large and inconsistent with the corporation’s obligation under § 31-3505.01 .
(f) In determining whether the surplus of the corporation that is attributable to the District is excessive, the Commissioner shall take into account all of the corporation’s financial obligations arising in connection with the conduct of the corporation’s insurance business, including premium tax paid and the corporation’s contribution to the open enrollment program required by § 31-3514 and payments and expenditures pursuant to a public-private partnership.
(g) (1) If the Commissioner determines that the surplus of the corporation is excessive, the Commissioner shall order the corporation to submit a plan for dedication of the excess to community health reinvestment in a fair and equitable manner.
  (2) A plan submitted pursuant to paragraph (1) of this subsection may consist entirely of expenditures for the benefit of current subscribers of the corporation.
(h) When determining what surplus is attributable to the District and whether the surplus is excessive, the Commissioner may retain attorneys, appraisers, independent actuaries, independent certified public accountants, or other professionals, the cost of which shall be borne by the corporation.
(i) If the Commissioner determines that the corporation failed to submit a plan as ordered under subsection (g) of this section within a reasonable period or failed to execute within a reasonable period a plan already submitted under subsection (g) of this section, the Commissioner shall deny for 12 months all premium rate increases for subscriber policies written in the District sought by the corporation pursuant to § 31-3508 and may issue such orders as are necessary to enforce the purposes of this chapter.
(j) The existence of a public-private partnership shall not preclude the Commissioner’s surplus evaluation of the corporation or diminish the Commissioner’s authority to issue directives to the corporation pursuant to the evaluation.
D.C. Code § 31-2502.24 — DC Code / Title 31 / Chapter 25 / § 31-2502.24
§ 31-2502.24. Names or designations used by mutual companies and reciprocal or interinsurance exchanges.
Status: in_force

Except as otherwise provided in § 31-2502.14 , no mutual company shall be authorized to transact business in the District unless the name of such company shall include the word “mutual,” and no reciprocal or interinsurance exchange shall be authorized to transact business in the District unless the name or designation under which reciprocal or interinsurance contracts are to be exchanged shall include the words “reciprocal” or “interinsurance exchange,” or be supplemented by the following words immediately below the name or designation under which such contracts are exchanged: “A reciprocal” or “an interinsurance exchange.”
D.C. Code § 31-1349 — DC Code / Title 31 / Chapter 13 / § 31-1349
§ 31-1349. Liquidation of property of foreign or alien insurers found in the District of Columbia.
Status: in_force

(a) If no domiciliary receiver has been appointed, the Commissioner may apply to the Superior Court of the District of Columbia by verified petition for an order directing him or her to liquidate the assets, found in the District, of a foreign insurer or an alien insurer not domiciled in the District, on any of the following grounds:
  (1) Any of the grounds in § 31-1310 or § 31-1315 ; or
  (2) Any of the grounds specified in § 31-1348(a)(2) through (4).
(b) When an order is sought under subsection (a) of this section, the court shall cause the insurer to be given notice and time to respond reasonable under the circumstances.
(c) If it appears to the court that the best interests of creditors, policyholders, and the public so require, the court may issue an order to liquidate in whatever terms it shall deem appropriate. The filing or recording of the order with the Clerk of the Superior Court of the District of Columbia or the recorder of deeds of the District of Columbia shall impart the same notice as a deed, bill of sale, or other evidence of title duly filed or recorded with that recorder of deeds would have imparted.
(d) If a domiciliary liquidator is appointed in a reciprocal state while a liquidation is proceeding under this section, the liquidator under this section shall thereafter act as ancillary receiver under § 31-1351 . If a domiciliary liquidator is appointed in a nonreciprocal state while a liquidation is proceeding under this section, the liquidator under this section may petition the court for permission to act as ancillary receiver under § 31-1351 .
(e) On the same grounds as are specified in subsection (a) of this section, the Commissioner may petition any appropriate federal district court to be appointed receiver to liquidate that portion of the insurer’s assets and business over which the court will exercise jurisdiction, or any lesser part thereof that the Commissioner deems desirable for the protection of the policyholders and creditors in the District.
(f) The court may order the Commissioner, when he or she has liquidated the assets of a foreign or alien insurer under this section, to pay claims of residents of the District against the insurer under rules concerning liquidation of insurers under this chapter as are otherwise compatible with the provisions of this section.
D.C. Code § 31-5701 — DC Code / Title 31 / Chapter 57 / § 31-5701
§ 31-5701. Definition; authorized benefits and funds; governing provisions.
Status: repealed

Repealed.
D.C. Code § 31-5311 — DC Code / Title 31 / Chapter 53 / § 31-5311
§ 31-5311. Consolidations and mergers.
Status: in_force

A domestic society may enter into agreements of consolidation or merger in accordance with § 31-4443 .
D.C. Code § 31-3867 — DC Code / Title 31 / Chapter 38D / § 31-3867
§ 31-3867. Federal authorization.
Status: repealed

Repealed.
D.C. Code § 31-2361.04 — DC Code / Title 31 / Chapter 23R / § 31-2361.04
§ 31-2361.04. Registration.
Status: in_force

(a) It shall be unlawful for a person to directly or indirectly engage or to attempt to engage in business as an appraisal management company in the District, or to advertise or hold itself out as engaging in or conducting business as an appraisal management company in the District without first obtaining a registration issued by the Department.
(b) An applicant for registration as an appraisal management company in the District shall submit to the Department an application on forms prescribed by the Department and pay a fee established by the Department.  The forms shall require information necessary to determine eligibility for registration.
(c) Upon registration of an appraisal management company in the District, the Department may require a surety bond of not more than $25,000.
D.C. Code § 31-855 — DC Code / Title 31 / Chapter 8A / § 31-855
§ 31-855. Criminal proceedings.
Status: in_force

A court may, after an in camera review, require disclosure of material for which the privilege is asserted, if the court determines:
(1) The privilege is asserted for a fraudulent purpose;
(2) The material is not subject to the privilege;
(3) Even if subject to the privilege, the material shows evidence of noncompliance with District or federal statutes, rules, or orders and the company failed to undertake reasonable corrective action or eliminate the noncompliance within a reasonable time; or
(4) The material contains evidence relevant to the commission of a criminal offense under District law, and:
  (A) The Commissioner, Corporation Counsel, or U.S. Attorney has a compelling need for the information;
  (B) The information is not otherwise available; and
  (C) The Commissioner, Corporation Counsel, or U.S. Attorney is unable to obtain the substantial equivalent of the information by any means without incurring unreasonable cost and delay.
D.C. Code § 31-3757 — DC Code / Title 31 / Chapter 37 / § 31-3757
§ 31-3757. Notice of free examination.
Status: repealed

Repealed.
D.C. Code § 31-2412 — DC Code / Title 31 / Chapter 24 / § 31-2412
§ 31-2412. Temporary Motor Vehicle Insurance Review Commission.
Status: repealed

Expired.
D.C. Code § 31-5603.05 — DC Code / Title 31 / Chapter 56 / § 31-5603.05
§ 31-5603.05. Offer and sale of an indefinite amount of securities.
Status: in_force

(a) A face-amount certificate company, an open-end management company, a closed-end management company that is not a federal covered security under section 18(b)(1) of the Securities Act of 1933, or a unit investment trust, as those terms are defined in the Investment Company Act of 1940, shall comply with the requirements of this section if the company or trust files:
  (1) A notice under § 31-5603.08 of the offer or sale in the District of an indefinite amount of federal covered securities specified in section 18(b)(2) of the Securities Act of 1933 [15 U.S.C. § 77r]; or
  (2) An application to register under § 31-5603.03 the offer or sale in the District of an indefinite amount of securities.
(b) (1) A face-amount certificate company or an open-end management company, at the time of filing, shall pay an initial fee established by the Commissioner.
  (2) Within 60 days after the issuer’s fiscal year end during which its registration statement is effective or notice required by § 31-5603.08 is filed, a face-amount certificate company or an open-end management company shall:
    (A) Pay a fee in an amount established by rule; or
    (B) File a report, on a form that the Commissioner, by rule, adopts for the reporting of all sales of securities to persons within the District during the fiscal year, and pay a fee based upon the maximum aggregate offering price at which the securities were sold in the District in accordance with a formula established by rule.
  (3) (A) To calculate the net amount due under paragraph (2)(B) of this subsection, the initial fee paid in accordance with paragraph (1) of this subsection shall be deducted from the aggregate fee.
    (B) Except as provided in subsection (d) of this section, the aggregate fee due under this subsection may not exceed the maximum aggregate fee established by rule.
    (C) If the aggregate fee due under paragraph (2)(B) of this subsection is less than the initial fee, no additional amount shall be payable and no credit or refund shall be allowed or returned.
(c) (1) At the time of the filing, a unit investment trust or a closed-end management company that is not a federal covered security under section 18(b)(1) of the Securities Act of 1933 [15 U.S.C. § 77r] shall pay an initial fee established by rule.
  (2) Within 60 days after the anniversary of the date on which the issuer’s offer became effective or its notice filed under § 31-5603.08 was accepted, a unit investment trust or closed-end management fund that is not a federal covered security under section 18(b)(1) of the Securities Act of 1933 [15 U.S.C. § 77r] shall:
    (A) Pay a fee in an amount established by rule; or
    (B) File a report, on a form that the Commissioner, by rule, adopts for the reporting of all sales of securities to persons within the District during the effective period of the registration statement or the acceptance period of the notice filed under § 31-5603.08 ; and pay a fee based upon the maximum aggregate offering price at which the securities were sold in the District in accordance with a formula established by rule.
  (3) (A) To calculate the net amount due under paragraph (2)(B) of this subsection, the initial fee paid in accordance with paragraph (2) of this subsection shall be deducted from the aggregate fee.
    (B) Except as provided in subsection (d) of this section, the aggregate fee due under paragraph (2)(B) of this subsection may not exceed the maximum aggregate fee established by rule.
    (C) If the aggregate fee under paragraph (2)(B) of this subsection is less than the initial fee, no additional amount shall be payable and no credit or refund shall be allowed or returned.
(d) (1) The Commissioner may, by rule or order, extend the length of the renewal period to a period not exceeding 2 years for the effectiveness of a registered offering or for a notice filed under § 31-5603.08 .
  (2) If the Commissioner extends a renewal period in excess of one year, the fee shall be prorated for the extended renewal period.
D.C. Code § 31-2411 — DC Code / Title 31 / Chapter 24 / § 31-2411
§ 31-2411. Miscellaneous provisions.
Status: in_force

(a) Statute of limitations. — (1) Except as otherwise provided in this subsection, a civil action for the recovery of any personal injury protection benefits payable under this chapter shall be commenced not later than 3 years after the date of the injury giving rise to entitlement to such benefits.
  (2) If an appropriate written notice setting forth the name and address of the victim and the time, place, and nature of the injury is given to the insurer or any of its authorized agents reasonably promptly after the date of the accident resulting in the injury, a civil action may be commenced at any time within 3 years after the date such a notice is given by a person claiming to be entitled to personal injury protection benefits or by a person acting on behalf of a victim. If the applicable insurer makes any payment of benefits for personal injury protection with respect to a particular victim and injury, then a civil action may be commenced at any time within 3 years after the most recent payment.
(b) Physical or mental examination of victim. — (1) If a person’s physical or mental condition is material to any claim that has been made or that may be made for personal injury protection benefits, the person involved shall submit to physical or mental examination by physicians, in accordance with provisions of the policy of insurance pursuant to which a claim has been or may be made. A policy of insurance providing for payment of the benefits required for personal injury protection may include reasonable provisions for physical and mental examination of persons claiming any such benefits.
  (2) (A) If requested by the person examined, a copy of every written report concerning an examination under this subsection which is made by an examining physician shall be delivered or mailed to such person without charge.
    (B) At least 1 report shall set forth in detail the findings and conclusions of the examining physicians.
    (C) Upon request and delivery or mailing, the party causing a person to be examined under this subsection may request the person examined to furnish its representative with a copy of every written report available to that person concerning any examination which is relevant to that person’s claim for personal injury protection benefits.
    (D) An applicable insurer may request a person claiming personal injury protection benefits to submit the name and address of each physician, medical-care facility, hospital, clinic, rehabilitation center, nursing facility, or other person or institution that has diagnosed or treated the victim for or with respect to the injury claimed and any relevant past injury, as a prerequisite to the payment of benefits under this chapter.
    (E) A person shall authorize an insurer to inspect and copy records relevant to such a claim which are prepared or maintained by any physician, hospital, clinic, rehabilitation center, nursing facility, or other person or institution.
  (3) A court may make any order which is just in case a person refuses to comply with any provision of paragraph (1) or (2) of this subsection, except that an order shall not be entered directing the arrest of a person for disobeying an order to submit to a physical or mental examination.
  (4) Nothing contained in this subsection shall preclude a victim from obtaining treatment by the victim’s own physician.
(c) Good-faith mistake. — (1) Payment of personal injury protection benefits by an insurer in good faith to or for the benefit of a person believed to be entitled thereto discharges the insurer from its obligation to the extent of the amount of such payment, unless such insurer has been notified in writing prior to the payment of the claim of some other person.
  (2) If there is doubt about the proper person to receive the benefits involved or the proper apportionment to be made among the persons entitled to benefits or about whether an item of medical or rehabilitation expense was reasonably necessary or whether the charge for an item is reasonable, the insurer, the claimant, or any other interested person may apply to the Superior Court of the District of Columbia for an appropriate order. If an application is made by an insurer before the benefit claimed is overdue, the provisions of § 31-2410(c) and (e) are not applicable with respect to the amount.
(d) Subrogation. — (1) An insurer shall have a right of reimbursement from any other insurer, based upon a determination of fault, for any personal injury protection benefits paid or obligated to be paid by that insurer as a result of an accident that involved 2 or more motor vehicles, at least 1 of which was of a type other than a passenger motor vehicle.
  (2) An insurer which has paid or become obligated to pay personal injury protection benefits in any case not covered by paragraph (1) of this subsection may agree to receive a right of reimbursement from any other insurer with respect to some or all of those benefits.
  (3) Entitlement to reimbursement and the amount of any reimbursement under this subsection shall be determined by agreement between any insurers who are involved under paragraph (1) of this subsection or who agree under paragraph (2) of this subsection. If the insurers fail to reach agreement as to entitlement or amount or both, these issues shall be determined by intercompany arbitration in accordance with any applicable agreement between the insurers involved under procedures established by the Commissioner. The determination of any right of reimbursement under this subsection shall not be affected by the provisions of § 31-2405 .
(e) Waiver for taxicabs. — (1) Taxicabs shall be waived from the mandatory minimum insurance requirements of § 31-2406 (except for the provisions of § 31-2409 ) for 2 years from March 4, 1986. The Mayor shall gradually increase minimum liability insurance requirements for taxicabs during the waiver period, after hearings held in accordance with § 2-509 .
  (2) The rate of increase will be determined by the Mayor based upon evidence submitted to the Mayor on the reasonableness of the insurance rate and liability limit increase in relation to the need to preserve the economic viability of the taxi industry.
  (3) The Mayor shall impose the liability limits and rate increases on an annual basis.
  (4) Two years from March 4, 1986, the owners and operators of taxis shall be required to obtain mandatory insurance as set forth in § 31-2406 .
  (5) Nothing in this section shall preclude the owner or operator of a taxi from carrying insurance greater than the required minimum or from carrying at his or her option personal injury protection benefits.
(f) Rulemaking. — The Mayor, the Director, or the Commissioner, or each of them, may, in accordance with § 2-509 , issue rules to expeditiously and economically administer this chapter.
D.C. Code § 31-1210 — DC Code / Title 31 / Chapter 12 / § 31-1210
§ 31-1210. Applicability.
Status: in_force

(a) All health maintenance organizations, life, health, property, marine, title, casualty, fidelity, surety, insurance companies and fraternal benefit associations now or hereafter incorporated or formed in the District of Columbia or authorized to do business in the District of Columbia, shall be subject to this chapter. This chapter shall also apply to Group Hospitalization and Medical Service, Incorporated, and any other company or organization whether for profit or nonprofit subject to regulation by the Insurance Administration.
(b) The provisions of this chapter shall not apply until October 1, 1993.
D.C. Code § 31-2010 — DC Code / Title 31 / Chapter 20 / § 31-2010
§ 31-2010. Foreign Insurers.
Status: in_force

(a) Any foreign insurer, upon the written request of the Commissioner, shall submit to the Commissioner an RBC Report as of the end of the calendar year just ended on the later of:
  (1) The date an RBC Report would be required to be filed by a domestic insurer under this chapter; or
  (2) Fifteen days after the request is received by the foreign insurer.
(b) Any foreign insurer shall, at the written request of the Commissioner, promptly submit to the Commissioner a copy of any RBC Plan that is filed with the commissioner of any other state.
(c) In the event of a Company Action Level Event, Regulatory Action Level Event or Authorized Control Level Event, with respect to any foreign insurer as determined under the RBC statute applicable in the state of domicile of the insurer (or, if no RBC statute is in force in that state under the provisions of this chapter), if the insurance commissioner or similar authority of the state of domicile of the foreign insurer fails to require the foreign insurer to file an RBC Plan in the manner specified under that state’s RBC statute (or, if no RBC statute is in force in that state, under § 31-2002 ), the Commissioner may require the foreign insurer to file an RBC Plan with the Commissioner. In such event, the failure of the foreign insurer to file an RBC Plan with the Commissioner shall be grounds to order the insurer to cease and desist from writing new insurance business in the District.
(d) In the event of a Mandatory Control Level Event with respect to any foreign insurer, if no domiciliary receiver has been appointed with respect to the foreign insurer under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign insurer, the Commissioner may make application to the Superior Court permitted under Chapter 13 of this title with respect to the liquidation of property of foreign insurers found in the District, and the occurrence of the Mandatory Control Level Event shall be considered adequate grounds for the application.
D.C. Code § 31-4441 — DC Code / Title 31 / Chapter 44 / § 31-4441
§ 31-4441. Acquisition of own capital stock.
Status: repealed

Repealed.
D.C. Code § 31-2502.35 — DC Code / Title 31 / Chapter 25 / § 31-2502.35
§ 31-2502.35. Renewal of licenses.
Status: repealed

Repealed.
D.C. Code § 31-1309 — DC Code / Title 31 / Chapter 13 / § 31-1309
§ 31-1309. Confidentiality of records.
Status: in_force

In all proceedings and judicial reviews under § 31-1308 , all records of the insurer, other documents, all Department of Insurance, Securities, and Banking files, court records, and papers, so far as they pertain to or are a part of the record of the proceedings, shall be and remain confidential except as is necessary to obtain compliance, unless and until the Superior Court of the District of Columbia, after hearing arguments from the parties in chambers, shall order otherwise, or unless the insurer requests that the matter be made public. Until such a court order, all papers filed with the clerk of the Superior Court of the District of Columbia shall be held in a confidential file. The Commissioner may share documents, materials, or other information in the possession or control of the Department of Insurance, Securities, and Banking pertaining to an insurer that is the subject of a proceeding under this chapter with other state, federal, and international regulatory agencies; with the National Association of Insurance Commissioners, including its affiliates and subsidiaries; and with state, federal, and international law enforcement authorities; provided, that the recipient agrees, and has the legal authority, to maintain the confidentiality of the documents, material, or other information. No waiver of an applicable privilege or claim of confidentiality shall occur as a result of disclosure to the Commissioner or of sharing documents, materials, or other information under this section. Nothing in this section shall require an insurer to disclose documents, materials, or other information that is not otherwise required by law to be disclosed.
D.C. Code § 31-5603.04 — DC Code / Title 31 / Chapter 56 / § 31-5603.04
§ 31-5603.04. Registration by qualification.
Status: in_force

(a) A security may be registered by qualification.
(b) In addition to the information specified in § 31-5603.06(c) and the consent to service of process required under § 31-5607.06 , a registration statement under this section shall contain the following information and be accompanied by the following documents:
  (1) With respect to the issuer and any significant subsidiary:
    (A) The name, address, and form of its organization;
    (B) The state or foreign jurisdiction and date of its organization;
    (C) The general character and location of its business;
    (D) A description of its physical properties and equipment;
    (E) A statement of the general competitive conditions in the industry or business in which it is or will be engaged; and
    (F) Certified copies of its articles of incorporation;
  (2) With respect to every director and officer of the issuer, or person occupying a similar status or performing similar functions:
    (A) The name, address, and principal occupation for the past 5 years;
    (B) The amount of securities of the issuer held by the person as of a specified date within 30 days of the filing of the registration statement;
    (C) The amount of the securities covered by the registration statement to which the person has indicated an intention to subscribe; and
    (D) A description of any material interest in any material transaction that the person has effected, or proposed to effect, with the issuer or any significant subsidiary of the issuer within the past 3 years;
  (3) With respect to persons covered under paragraph (2) of this subsection, the remuneration paid during the past 12 months and estimated to be paid during the next 12 months, directly or indirectly, by the issuer, including all its predecessors, parents, subsidiaries, and affiliates, to all these persons in the aggregate;
  (4) With respect to a person owning of record, or beneficially if known, 10% or more of the outstanding shares of any class of equity security of the issuer, the information specified in paragraph (2) of this subsection other than the person’s occupation;
  (5) With respect to every promoter if the issuer was organized within the past 3 years, the information specified in paragraph (2) of this subsection, any amount paid, or intended to be paid, to the promoter within the 3-year period or intended to be paid to the promoter and a description of the services or other consideration provided in return for the payment;
  (6) With respect to a person on whose behalf a part of the offering is to be made in a non-issuer distribution:
    (A) The person’s name and address;
    (B) The amount of securities of the issuer held by the person as of the date of the filing of the registration statement;
    (C) A description of any material interest in any material transaction that the person has effected, or proposed to effect, with the issuer or any significant subsidiary of the subsidiary within the past 3 years; and
    (D) A statement of the person’s reasons for making the offering;
  (7) (A) The capitalization and long-term debt, on both a current and pro forma basis, of the issuer and any significant subsidiary, including a description of each security outstanding or being registered or otherwise offered; and
    (B) A statement of the amount and kind of consideration, whether in the form of cash, physical assets, services, patents, goodwill, or anything else, for which the issuer or any subsidiary has issued any of its securities within the past 2 years or is obligated to issue any of its securities;
  (8) (A) The amount and kind of securities to be offered; the proposed offering price or method by which it shall be computed, and any variation from the offering price at which a proportion of the offering is to be made to a person or class of persons other than the underwriters, with a specification of the person or class; and the basis upon which the offering is to be made if otherwise than for cash;
    (B) The estimated aggregate underwriting and selling discounts or commissions and finders’ fees, separately stating the amount of cash, securities, contracts, or anything else of value to accrue to the underwriters or finders in connection with the offering, or, if the selling discounts or commissions are variable, the basis of determining them and their maximum and minimum amounts;
    (C) The estimated amounts of other selling expenses, including legal, engineering, and accounting charges, the name and address of every underwriter and every recipient of a finder’s fee, and a copy of any underwriting or selling group agreement under which the distribution is to be made or the proposed form of the agreement whose terms have not yet been determined; and
    (D) A description of the plan of distribution of securities which are to be offered otherwise than through an underwriter;
  (9) (A) The estimated cash proceeds to be received by the issuer from the offering, the purposes for which the proceeds are to be used by the issuer, and the amount to be used for each purpose;
    (B) The order or priority in which the proceeds will be used for the purposes stated, the amounts of any funds to be raised from other sources to achieve the purposes stated, and the sources of such funds; and
    (C) If any part of the proceeds is to be used to acquire property, including goodwill, otherwise than in the ordinary course of business:
      (i) The names and addresses of the vendors;
      (ii) The purchase price;
      (iii) The names of persons who have received commissions in connection with the acquisition; and
      (iv) The amount of the commissions and any other expense in connection with the acquisition, including the cost of borrowing money to finance the acquisition;
  (10) A description of stock options or other security options outstanding, or to be created in connection with the offering, and the amount of such options held, or to be held, by a person required to be named in paragraphs (2), (4), (5), (6), or (8) of this subsection and by a person who holds, or will hold, 10% or more, in the aggregate, of any such options;
  (11) (A) The dates of, parties to, and general effect, concisely stated of, every management or other material contract made, or to be made, otherwise than in the ordinary course of business if it is to be performed in whole or in part at or after the filing of the registration statement or was made within the past 2 years, together with a copy of the contract; and
    (B) A description of any pending litigation or proceeding to which the issuer is a party and which materially affects its business or assets, including any litigation or proceeding known to be contemplated by governmental authorities;
  (12) Two copies of any prospectus, pamphlet, circular, form letter, advertisement, or other sales literature intended, as of the effective date, to be used in connection with the offering;
  (13) A specimen, copy, or description of the security being registered; a certified copy of the issuer’s articles of incorporation and a certified copy of its bylaws, or their substantial equivalents, as currently in effect; and a copy of any indenture or other instrument covering the security to be registered;
  (14) A signed or conformed copy of an opinion of counsel as to the legality of the security being registered, with an English translation if it is in a foreign language, which opinion shall state whether the security when sold will be legally issued, fully paid, and non-assessable, and, if a debt security, a binding obligation of the issuer;
  (15) The written consent of an accountant, engineer, appraiser, or other person whose profession gives authority to a statement made by the person, if the person is named as having prepared or certified a report or valuation, other than a public and official document or statement, which is used in connection with the registration statement;
  (16) A certified statement of financial condition of the issuer as of a date within 4 months prior to the filing of the registration statement; a balance sheet, profit and loss statement, and analysis of surplus for each of the 3 calendar years preceding the date of the statement of financial condition and for any period between the close of the last calendar year and the date of the statement of financial condition, or for the period of the issuer’s and any predecessors existence if less than 3 years, and if any part of the proceeds of the offering is to be applied to the purchase of any business, the same financial statements which would be required if that business were the registrant; and
  (17) Any additional information the Commissioner may require by rule or order.
(c) A registration statement under this section shall become effective no later than 60 calendar days after the date of the registration statement or the last statement other than a price amendment is filed if:
  (1) No stop order is in effect and no proceeding is pending under § 31-5603.06 ;
  (2) The Commissioner has not ordered under subsection (d) of this section that effectiveness be delayed; and
  (3) The registrant has not requested that effectiveness be delayed.
(d) The Commissioner may delay effectiveness for a single period not to exceed 90 days if the Commissioner determines that the registration statement is not complete in all material respects and promptly notifies the registrant of the determination. The Commissioner may delay effectiveness for a single period not to exceed 30 days if the Commissioner determines that delay is necessary, whether or not the Commissioner previously delayed effectiveness under this subsection.
D.C. Code § 31-6105 — DC Code / Title 31 / Chapter 61 / § 31-6105
§ 31-6105. Notice of free examination.
Status: repealed

Repealed.
D.C. Code § 31-2502.31 — DC Code / Title 31 / Chapter 25 / § 31-2502.31
§ 31-2502.31. Compensation of unlicensed persons prohibited.
Status: in_force

No company, policy-writing agent, soliciting agent, broker, or salaried employee shall pay any money or commission or brokerage or give or allow any valuable consideration to any person for or because of service in the District in negotiating or effecting a policy on any person, property, business activity, or insurable interest in the District, unless said person is duly licensed in conformity with this chapter as a broker or as an agent or salaried employee of the company issuing the policy. This section shall not apply to contracts of reinsurance, and shall not apply to persons and kinds of insurance exempted under § 31-2502.38 .
D.C. Code § 31-2403 — DC Code / Title 31 / Chapter 24 / § 31-2403
§ 31-2403. Required insurance.
Status: in_force

(a) Residents of District. — Each owner of a motor vehicle which is required to be registered or for which a reciprocity sticker is required in the District shall maintain insurance required by § 31-2406 . This insurance shall be in effect continuously during the motor vehicle’s period of registration or reciprocity.
(b) Nonresidents of District owning or operating motor vehicles in District. — (1) A person who is not a resident of the District who owns a motor vehicle shall not operate the motor vehicle, or permit the motor vehicle to be operated in the District, unless insurance required by § 31-2406 is provided and maintained during the time that the motor vehicle is present in the District.
  (2) The Director shall require adequate proof of insurance as required by this section for nonresident owners or operators prior to the return of motor vehicles immobilized by the Department to the nonresident owners or operators.
(c) Form. — (1) Any policy of motor vehicle insurance which is represented or sold as providing, pursuant to this chapter or pursuant to the coverage required by Chapter 13 of Title 50 , security covering a motor vehicle or required insurance shall be deemed to provide insurance for payment of the benefits required by this chapter.
  (2) The insurance required by this section may be provided under a valid policy of insurance issued by an insurer authorized to transact business in the District or by any other method approved by the Commissioner.
(d) Administration of requirement. — (1) (A) Every person applying to register a motor vehicle in the District or applying for a reciprocity sticker for a motor vehicle in the District shall certify to the Director, on a form supplied by the Director, that the insurance required by this chapter is in effect with respect to that motor vehicle.
    (B) The Director may request an insurer to verify any information provided pursuant to subparagraph (A) of this paragraph. The insurer shall accurately respond to the Director’s request within 10 business days.
    (C) The Director may request that the person who has certified to the Director pursuant to subparagraph (A) of this paragraph submit proof, within 15 business days, that the required insurance is in effect.
  (2) (A) The Director shall suspend the reciprocity sticker or vehicle registration certificate issued to the owner of a motor vehicle if the required insurance is not in effect with respect to the motor vehicle. The suspension shall take effect 30 days after service by regular mail of a notice of proposed suspension, unless the person provides proof that he or she has an effective motor vehicle insurance policy and has paid all applicable fines. The person shall also be advised that the fine established pursuant to § 31-2413(b)(2) shall be imposed unless, within the 30 day period, the person proves that the required insurance was maintained during the registration or reciprocity period. The suspension shall remain in effect until the person appears at the Department with proof of an effective motor vehicle insurance policy and pays a reinstatement fee and the applicable fine.
    (i)-(iii) Repealed.
      (iv) If a person’s registration certificate has been suspended as provided for in this subsection, the registration certificate shall not be transferred and the motor vehicle with respect to which the registration certificate was issued shall not be registered in any other name until the Director is satisfied that the transfer of the registration certificate is in good faith and not for the purpose or with the effect of defeating the purposes of this chapter.
      (v) Nothing in this section shall affect the rights of any conditional vendor, chattel mortgagee or lessor of the motor vehicle.
      (vi) The Director shall suspend or revoke the registration certificate of any motor vehicle transferred in violation of the provisions of this section.
      (vii) Decisions of the Director shall be subject to review by the Mayor. Orders and decisions of the board of review shall be appealable pursuant to § 2-510 . For the purposes of this sub-subparagraph, the phrase “review by the Mayor” shall mean a review by any board of review established by the Mayor pursuant to this chapter to review the order or act of any agent of the Mayor.
    (B) A motor vehicle with respect to which the registration certificate or reciprocity sticker is suspended under this paragraph may be immobilized by the Department or the Metropolitan Police Department until the insurance required by this section is in effect.
    (C) The registration certificate or reciprocity sticker and the tags of any motor vehicle, the registration or reciprocity of which is suspended under this paragraph, shall be recovered whenever possible.
  (3) (A) The Director shall require all insurers authorized to sell motor vehicle insurance in the District to furnish to the Department notice of motor vehicle insurance cancellations within 30 days after the effective date of cancellation. Upon receipt of a notice of cancellation concerning a motor vehicle insurance policy on a vehicle registered in the District, the Director shall notify the person in whose name the vehicle is registered that the Director will revoke or cancel the registration of the vehicle pursuant to law.
    (B) The insurers shall provide information and cooperate in prosecutions under § 31-2413 .
    (C) The insurers shall cooperate with, assist, and advise the Director with respect to the detection of persons who have applied for or obtained registration certificate or reciprocity stickers for motor vehicles in the District without first obtaining the insurance, or who cancel or otherwise terminate insurance subsequent to the issuance of a registration certificate or reciprocity stickers.
  (4) (A) Repealed.
    (B) Payments from the Administration Fund shall be made for the benefit of the Commissioner and for the benefit of the Department but no payments shall be made for costs incurred by either the Department or the Commissioner prior to September 18, 1982, or which would probably have been incurred if this chapter had not been enacted.
  (5) (A) On the first day of each month, an insurer authorized to sell motor vehicle insurance in the District shall furnish to the Director the following records pertaining to each vehicle insured by it in the District:
      (i) The owner’s full name and address;
      (ii) The insurance policy number or binder number;
      (iii) The commencement date of the motor vehicle insurance policy;
      (iv) The expiration or termination date of the motor vehicle insurance policy;
      (v) The operator’s license number, if known;
      (vi) The corresponding vehicle identification number, if known; and
      (vii) Other relevant information the Director may require.
    (B) The records required by this paragraph shall be submitted or transmitted in electronic files and in compliance with procedures established by the Department.
    (C) In lieu of requiring insurers to satisfy the requirements of subparagraph (A) of this paragraph, the Director may allow insurers to verify insurance through an online insurance verification system.
D.C. Code § 31-3138 — DC Code / Title 31 / Chapter 31A / § 31-3138
§ 31-3138. Applicability.
Status: in_force

(a) This chapter shall apply to any individual and group health benefits plan issued or renewed in the District of Columbia. Health insurers shall comply with this chapter on the earlier of October 16, 2002, or the effective date of the claims payment standards in section 1173 of the Social Security Act, approved August 14, 1935 (110 Stat. 2024; 42 U.S.C. § 1320d-2 ).
(b) Section 31-3132 shall apply to claims received on or after October 16, 2002.
(c) Section 31-3133 shall apply to retroactive denials made on or after October 16, 2002.
(d) Section 31-3134 shall apply to any contract issued or renewed on or after October 16, 2002.
(e) Section 31-3135 shall apply to claims data collected beginning with the first full calendar year following July 23, 2002. A health insurer shall include this data in the annual report filed with the Commissioner beginning on March 15, 2004.
D.C. Code § 31-3834.06 — DC Code / Title 31 / Chapter 38B / § 31-3834.06
§ 31-3834.06. Coverage of fertility treatments.
Status: in_force

(a) (1) Beginning January 1, 2025, a health insurer offering a large group health benefit plan shall provide coverage for the diagnosis and treatment of infertility, including in vitro fertilization and standard fertility preservation services, as provided in paragraph (2) of this subsection; provided that the treatment would be consistent with a physician's or surgeon's overall plan of care.
  (2) The health benefit plan shall cover:
    (A) At least 3 complete oocyte retrievals with unlimited embryo transfers from those oocyte retrievals or from any oocyte retrieval performed prior to January 1, 2025, in accordance with the guidelines of ASRM, using single embryo transfer when recommended and medically appropriate; and
    (B) The medical costs related to an embryo transfer to be made from an enrollee to a third-party; except, that the enrollee's coverage shall not extend to any medical costs of the surrogate or gestational carrier after the embryo transfer procedure.
(b) (1) Beginning January 1, 2025, a health insurer offering an individual health benefit plan or small group health plan shall provide coverage for the diagnosis and treatment of infertility, including in vitro fertilization and standard fertility preservation services, as provided in paragraph (2) of this subsection; provided that the treatment would be consistent with a physician's or surgeon's overall plan of care.
  (2) The health benefit plan shall cover:
    (A) At least 3 complete oocyte retrievals with unlimited embryo transfers from those oocyte retrievals or from any oocyte retrieval performed prior to January 1, 2025, in accordance with the guidelines of ASRM, using single embryo transfer when recommended and medically appropriate; and
    (B) The medical costs related to an embryo transfer to be made from an enrollee to a third-party; except, that the enrollee's coverage shall not extend to any medical costs of the surrogate or gestational carrier after the embryo transfer procedure.
(c) (1) Beginning January 1, 2024, the DC Healthcare Alliance program shall provide health insurance coverage for the diagnosis of infertility and any medically necessary ovulation enhancing drugs and medical services related to prescribing and monitoring the use of such drugs, which shall include at least 3 cycles of ovulation-enhancing medication treatment over an enrollee's lifetime.
  (2) By January 1, 2024, the Department of Health Care Finance shall submit an amendment to the Medicaid state plan to the Centers for Medicare & Medicaid Services to authorize coverage through Medicaid for the diagnosis of infertility and any medically necessary ovulation enhancing drugs and medical services related to prescribing and monitoring the use of such drugs, which shall include at least 3 cycles of ovulation-enhancing medication treatment over an enrollee's lifetime.
(d) Within 180 days of September 6, 2023, the Department of Health Care Finance shall submit a report to the Council after consulting with the Centers for Medicare & Medicaid Services on whether in vitro fertilization and standard fertility preservation services are medically reasonable and necessary procedures under federal law, possible methods for covering in-vitro fertilization and standard fertility preservation services as a Medicaid covered benefit for both fee-for-service and managed care organizations, including any potentially applicable waiver authorities, and the amount of money that would need to be allocated to federal and local funds for such coverage.
(e) Coverage for the treatment of infertility shall be provided without discrimination on the basis of age, ancestry, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation.
(f) A health insurer shall not impose:
  (1) Deductibles, copayments, coinsurance, benefit maximums, waiting periods or any other limitations on coverage for the diagnosis and treatment of infertility, including the prescription of fertility medications, different from those imposed upon benefits for services not related to infertility;
  (2) Pre-existing condition exclusions or pre-existing condition waiting periods on coverage for the diagnosis and treatment of infertility or use any prior diagnosis of or prior treatment for infertility as a basis for excluding, limiting, or otherwise restricting the availability of coverage for required benefits; or
  (3) Limitations on coverage based solely on arbitrary factors, including number of attempts, dollar amounts, or age, or provide different benefits to, or impose different requirements upon, a class protected under Unit A of Chapter 14 of Title 2 than that provided to, or required of, other patients.
(g) Nothing in this section shall be construed to interfere with the clinical judgment of a physician or surgeon.
(h) The health insurer shall notify all policyholders and all prospective group policyholders with whom they are negotiating of the availability of coverage provided under this section.
(i) For the purposes of this section, the term:
  (1) "ASRM" means the American Society for Reproductive Medicine.
  (2) "Infertility" means a disease, condition, or status characterized by:
    (A) The failure to establish a pregnancy or to carry a pregnancy to live birth after regular, unprotected sexual intercourse in accordance with the guidelines of ASRM;
    (B) A person's inability to reproduce without medical intervention either as a single individual or with their partner; or
    (C) A licensed physician's findings based on a patient's medical, sexual, and reproductive history, age, physical findings, or diagnostic testing.
  (3) "Treatment for infertility" means procedures consistent with established medical practices in the treatment of infertility by licensed physicians and surgeons, including diagnosis, diagnostic tests, medication, surgery, or gamete intrafallopian transfer.
  (4) "Standard fertility preservation services" means procedures that are consistent with established medical practices or professional guidelines published by ASRM or the American Society of Clinical Oncology for a person who has a medical condition or is expected to undergo medication therapy, surgery, radiation, chemotherapy, or other medical treatment that is recognized by medical professionals to cause a risk of impairment to fertility.
(j) The Mayor, pursuant to subchapter I of Chapter 5 of Title 2 , shall issue rules to implement the provisions of this section.
D.C. Code § 31-2707 — DC Code / Title 31 / Chapter 27 / § 31-2707
§ 31-2707. Information to be furnished to insured or Commissioner; grievance procedure.
Status: in_force

(a) Every rating organization and every company which makes its own rates shall, within a reasonable time after receiving written request therefor and upon payment of such reasonable charge as it may make, furnish to any insured affected by a rate made by it, or to the authorized representative of such insured, all pertinent information as to such rate.
(b) Every rating organization and every company which makes its own rates shall provide within the District reasonable means whereby any person aggrieved by the application of its rating system may be heard, in person or by his authorized representative, on his written request to revise the manner in which such rating system has been applied in connection with the insurance afforded him. If the rating organization or company fails to grant or reject such request within 30 days after it is made, the applicant may proceed in the same manner as if his application had been rejected. Any party affected by the action of such rating organization or such company on such request may, within 30 days after written notice of such action, appeal to the Commissioner, who, after a hearing held upon not less than 10 days written notice to the appellant and to such rating organization or company, may affirm or reverse such action.
(c) No company, agent, broker, or rating organization may willfully withhold required information from or give false or misleading information to the Commissioner.
(d) No company, agent, or broker shall fail to furnish to an insured any policy or comparable evidence of insurance to which the insured is entitled.
D.C. Code § 31-1319 — DC Code / Title 31 / Chapter 13 / § 31-1319
§ 31-1319. Powers of liquidator.
Status: in_force

(a) The liquidator shall have the power:
  (1) To appoint a special deputy or deputies to act for him or her under this chapter, and to determine his or her reasonable compensation. The special deputy shall have all powers of the liquidator granted by this section. The special deputy shall serve at the pleasure of the liquidator;
  (2) To hire employees, agents, legal counsel, actuaries, accountants, appraisers, consultants, and other personnel he or she deems necessary to assist in the liquidation;
  (3) To appoint, with the approval of the court, an advisory committee of policyholders, claimants, or other creditors, including guaranty associations, should such a committee be deemed necessary. The committee shall serve at the pleasure of the Commissioner and shall serve without compensation other than reimbursement for reasonable travel and per diem living expenses. No other committee of any nature shall be appointed by the Commissioner or the court in liquidation proceedings conducted under this chapter;
  (4) To fix the reasonable compensation of employees and agents, legal counsel, actuaries, accountants, appraisers, and consultants with the approval of the court;
  (5) To pay reasonable compensation to persons appointed, and to defray from the funds or assets of the insurer all expenses of taking possession of, conserving, conducting, liquidating, disposing of, or otherwise dealing with the business and property of the insurer. In the event that the property of the insurer does not contain sufficient cash or liquid assets to defray the costs incurred, the Commissioner may advance the costs incurred out of any appropriation for the maintenance of the Department of Insurance, Securities, and Banking. Any amounts advanced for expenses of administration shall be repaid to the Commissioner for the use of the Department of Insurance, Securities, and Banking out of the first available monies of the insurer;
  (6) To hold hearings, subpoena witnesses to compel their attendance, administer oaths, examine any person under oath, and compel any person to subscribe to his or her testimony after it has been correctly reduced to writing; and in connection therewith to require the production of any books, papers, records, or other documents which the liquidator deems relevant to the inquiry;
  (7) To audit the books and records of all agents of the insurer insofar as those records relate to the business activities of the insurer;
  (8) To collect all debts and moneys due and claims belonging to the insurer, wherever located, and for this purpose:
    (A) To institute timely action in other jurisdictions, in order to forestall garnishment and attachment proceedings against the debts;
    (B) To do any other acts necessary or expedient to collect, conserve, or protect assets or property of the insurer, including the power to sell, compound, compromise, or assign debts for purposes of collection upon terms and conditions as he or she deems best; and
    (C) To pursue any creditor’s remedies available to enforce his or her claims;
  (9) To conduct public and private sales of the property of the insurer;
  (10) To use assets of the estate of an insurer under a liquidation order to transfer policy obligations to a solvent assuming insurer, if the transfer can be arranged without prejudice to applicable priorities under § 31-1340 ;
  (11) To acquire, hypothecate, encumber, lease, improve, sell, transfer, abandon, or otherwise dispose of or deal with, any property of the insurer at its market value or upon terms and conditions that are fair and reasonable. The liquidator shall also have power to execute, acknowledge, and deliver all deeds, assignments, releases, and other instruments necessary or proper to effectuate any sale of property or other transaction in connection with the liquidation;
  (12) To borrow money on the security of the insurer’s assets or without security and to execute and deliver all documents necessary to that transaction for the purpose of facilitating the liquidation. Any funds borrowed may be repaid as an administrative expense and have priority over any other claims in Class 1 under the priority of distribution;
  (13) To enter into any contracts necessary to carry out the order to liquidate, and to affirm or disavow any contracts to which the insurer is a party;
  (14) To continue to prosecute and to institute in the name of the insurer, or in his or her own name, any and all suits and other legal proceedings, in the District or elsewhere, and to abandon the prosecution of claims he or she deems unprofitable to pursue further. If the insurer is dissolved under § 31-1318 , the liquidator shall have the power to apply to any court in the District or elsewhere for leave to substitute himself or herself for the insurer as plaintiff;
  (15) To prosecute any action which may exist in behalf of the creditors, members, policyholders, or shareholders of the insurer against any officer of the insurer, or any other person;
  (16) To remove any or all records and property of the insurer to the offices of the Commissioner or to any other place convenient for the purposes of efficient and orderly execution of the liquidation. Guaranty associations and foreign guaranty associations shall have reasonable access to the records of the insurer necessary for them to carry out their statutory obligations;
  (17) To deposit in 1 or more banks in the District the sums required for meeting current administration expenses and dividend distributions;
  (18) To invest all sums not currently needed, subject to the same standards that would apply if those sums were invested by the insurer, unless the court orders otherwise;
  (19) To file any necessary documents for record in the office of any recorder of deeds or record office in the District or elsewhere where property of the insurer is located;
  (20) To assert all defenses available to the insurer against third persons, including statutes of limitation, statutes of frauds, and the defense of usury. A waiver of any defense by the insurer after a petition in liquidation has been filed shall not bind the liquidator. Whenever a guaranty association or foreign guaranty association has an obligation to defend any suit, the liquidator shall give precedence to such an obligation and may defend only in the absence of a defense by the guaranty associations;
  (21) To exercise and enforce all the rights, remedies, and powers of any creditor, shareholder, policyholder, or member, including any power to avoid any transfer or lien that may be given by the general law and that is not included within §§ 31-1324 through 31-1326 ;
  (22) To intervene in any proceeding wherever instituted that might lead to the appointment of a receiver or trustee, and to act as the receiver or trustee whenever the appointment is offered;
  (23) To enter into agreements with any receiver or superintendent or commissioner of insurance of any other state relating to the rehabilitation, liquidation, conservation, or dissolution of an insurer doing business in both states; and
  (24) To exercise all powers now held or hereafter conferred upon receivers by the laws of the District not inconsistent with the provisions of this chapter.
(b) (1) If a company placed in liquidation issued liability policies on a claims-made basis, which provided an option to purchase an extended period to report claims, the liquidator may make available to holders of the policies, for a charge, an extended period to report claims as stated herein. The extended reporting period shall be made available only to those insureds who have not secured substitute coverage. The extended period made available by the liquidator shall begin upon termination of any extended period to report claims in the basic policy and shall end at the earlier of the final date for filing of claims in the liquidation proceeding or 18 months from the order of liquidation.
  (2) The extended period to report claims made available by the liquidator shall be subject to the terms of the policy to which it relates. The liquidator shall make available such an extended period within 60 days after the order of liquidation at a charge to be determined by the liquidator subject to approval of the court. The offer shall be deemed rejected unless the offer is accepted in writing and the charge is paid within 90 days after the order of liquidation. No commissions, premium taxes, assessments, or other fees shall be due on the charge pertaining to the extended period to report claims.
(c) The enumeration, in this section, of the powers and authority of the liquidator shall not be construed as a limitation upon him or her, nor shall it exclude in any manner his or her right to do other acts not specifically enumerated or otherwise provided for, necessary or appropriate for the accomplishment of or in aid of the purpose of liquidation.
(d) Notwithstanding the powers of the liquidator stated in subsections (a) and (b) of this section, the liquidator shall have no obligation to defend claims or to continue to defend claims subsequent to the entry of a liquidation order.
D.C. Code § 31-3451.07 — DC Code / Title 31 / Chapter 34A / § 31-3451.07
§ 31-3451.07. Hearings.
Status: in_force

(a) A health organization may request a confidential department hearing, on a record, to challenge a determination or action if the Commissioner notifies it of the following:
  (1) An adjusted RBC report;
  (2) (A) The health organization’s RBC plan or revised RBC plan is unsatisfactory; and
    (B) The notification constitutes a Regulatory Action Level Event;
  (3) The health organization has failed to adhere to its RBC plan or revised RBC plan and that the failure has a substantial adverse effect on the ability of the health organization to eliminate the Company Action Level Event in accordance with its RBC plan or revised RBC plan; or
  (4) A corrective order.
(b) The health organization shall notify the Commissioner of its request for a hearing within 5 days after a notification described in subsection (a) of this section. Upon receipt of the health organization’s request for a hearing, the Commissioner shall set a date for the hearing, which shall be no less than 10, or more than 30, days after the date of the health organization’s request.
D.C. Code § 31-2602.12 — DC Code / Title 31 / Chapter 26 / § 31-2602.12
§ 31-2602.12. Taxation of companies—Computation and payment of taxes on earnings and investment income.
Status: repealed

Repealed.
D.C. Code § 31-5305 — DC Code / Title 31 / Chapter 53 / § 31-5305
§ 31-5305. Liability of officers and members.
Status: in_force

(a) The officers and members of the supreme governing body or any subordinate body of a society shall not be personally liable for any benefits provided by a society.
(b) Any person may be indemnified and reimbursed by any society for expenses reasonably incurred by, and liabilities imposed upon, such person in connection with or arising out of any action, lawsuit, or proceeding, whether civil, criminal, administrative, or investigative, or threat thereof, in which the person may be involved by reason of the fact that he or she is or was a director, officer, employee, or agent of the society or of any firm, corporation, or organization which he or she served in any capacity at the request of the society. A person shall not be so indemnified or reimbursed:
  (1) In relation to any matter in such action, lawsuit, or proceeding as to which he or she shall finally be adjudged to be, or have been guilty of, breach of a duty as a director, officer, employee or agent of the society; or
  (2) In relation to any matter in such action, lawsuit, or proceeding, or threat thereof, which has been made the subject of a compromise settlement.
(c) A society may indemnify or reimburse a person in relation to any matter specified in subsection (b)(1) and (2) of this section if the person acted in good faith for a purpose the person reasonably believed to be in or not opposed to the best interests of the society and, in a criminal action or proceeding, in addition, had no reasonable cause to believe that his or her conduct was unlawful.  The determination whether the conduct of the person met the standard required in order to justify indemnification and reimbursement in relation to any matter described in subsection (b)(1) and (2) of this section may only be made by the supreme governing body or board of directors by a majority vote of a quorum consisting of persons who were not parties to the action, lawsuit, or proceeding or by a court of competent jurisdiction. The termination of any action, lawsuit, or proceeding by judgment, order, settlement, conviction, or upon a plea of no contest, as to the person shall not in itself create a conclusive presumption that the person did not meet the standard of conduct required in order to justify indemnification and reimbursement.
(d) The right to indemnification and reimbursement shall not be exclusive of other rights to which such person may be entitled as a matter of law and shall inure to the benefit of his or her heirs, executors, and administrators.
(e) A society shall have power to purchase and maintain insurance on behalf of any person who is or was a director, officer, employee, or agent of the society, or who is or was serving at the request of the society as a director, officer, employee, or agent of any other firm, corporation, or organization against any liability asserted against such person and incurred by him or her in any such capacity or arising out of his or her status as such, whether or not the society would have the power to indemnify the person against such liability under this section.
(f) No director, officer, employee, member, or volunteer of a society serving without compensation, shall be liable, and no cause of action may be brought, for damages resulting from the exercise of judgment or discretion in connection with the duties or responsibilities of such person for the society unless such act or omission involved willful or wanton misconduct.
D.C. Code § 31-3709 — DC Code / Title 31 / Chapter 37 / § 31-3709
§ 31-3709. Remedies.
Status: in_force

In addition to any other applicable penalty for a violation of the insurance laws of the District, the Mayor may require an insurer who violates this subchapter, or rules issued pursuant to this subchapter, to cease marketing in the District any Medicare supplement policy or certificate that is related directly or indirectly to a violation, or may require the issuer to take any actions necessary to comply with the provisions of this subchapter, or both.
D.C. Code § 31-1405 — DC Code / Title 31 / Chapter 14 / § 31-1405
§ 31-1405. Conflict of interest.
Status: in_force

(a) No examiner may be appointed by the Mayor 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 shall not be construed to automatically preclude an examiner from being:
  (1) A policyholder or claimant under an insurance policy;
  (2) A grantor of a mortgage or similar instrument on the examiner’s residence to a regulated entity if done under customary terms and in the ordinary course of business;
  (3) An investment owner in shares of regulated diversified investment companies; or
  (4) A settlor or beneficiary of a blind trust into which any otherwise impermissible holdings have been placed.
(b) Notwithstanding the requirements of this section, the Mayor may retain from time to time, 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.
D.C. Code § 31-5051.03 — DC Code / Title 31 / Chapter 50C / § 31-5051.03
§ 31-5051.03. Billing and collection of premiums.
Status: in_force

(a) Charges for portable electronics insurance coverage may be billed and collected by the vendor of portable electronics. Any charge to the enrolled customer for coverage that is not included in the cost associated with the purchase or lease of portable electronics or related services shall be separately itemized on the enrolled customer’s bill. If the portable electronics insurance coverage is included with the purchase or lease of portable electronics or related services, the vendor shall clearly and conspicuously disclose to the enrolled customer that the portable electronics insurance coverage is included with the portable electronics or related services.
(b) Vendors billing and collecting charges for portable electronics insurance coverage shall not be required to maintain funds collected in a segregated account; provided, that the vendor is authorized by the insurer to hold the funds in an alternative manner and remits the amounts to the supervising entity within 60 days of receipt. All funds received by a vendor from an enrolled customer for the sale of portable electronics insurance shall be considered funds held in trust by the vendor in a fiduciary capacity for the benefit of the insurer.
(c) Vendors may receive compensation for billing and collection services.
D.C. Code § 31-2361.06 — DC Code / Title 31 / Chapter 23R / § 31-2361.06
§ 31-2361.06. Appraisal management company requirements.
Status: in_force

(a) An appraisal management company operating in the District shall meet the following requirements at all times:
  (1) At the time of applying for registration or renewing registration in the District, the appraisal management company shall designate one of its controlling persons to serve as the main contact for all communication between the Department and the company.  The designated controlling person shall:
    (A) Remain in good standing in the District and in any other state that has issued the controlling person an appraiser license or certification; except, that, nothing in this chapter shall require that a designated controlling person hold or continue to hold an appraiser license or certification in any jurisdiction;
    (B) Never have had an appraiser license or certification in the District or any other state refused, denied, canceled, revoked, or surrendered in lieu of a pending disciplinary proceeding in any jurisdiction and not subsequently reinstated or granted; and
    (C) Be of good moral character;
  (2) Before or at the time of placing an assignment to appraise real property in the District with an appraiser on the appraiser panel of the appraisal management company, the appraisal management company shall verify that the appraiser receiving the assignment holds an appraiser license or certification in good standing in the District;
  (3) Any employee of or independent contractor to the appraisal management company who performs an appraisal review for a property located in the District must be a certified or licensed appraiser in good standing in the District; and
  (4) An appraisal management company registered in the District shall place its registration number on engagement documents utilized by the appraisal management company to procure appraisal services in the District of Columbia.
(b) An appraisal management company that has a reasonable basis to believe an appraiser has materially failed to comply with applicable laws or rules or has materially violated the USPAP shall refer the matter to the Department in conformance with applicable federal laws and regulations.
D.C. Code § 31-4309 — DC Code / Title 31 / Chapter 43 / § 31-4309
§ 31-4309. Representation of financial standing—All companies or agents.
Status: repealed

Repealed.
D.C. Code § 31-1373.12 — DC Code / Title 31 / Chapter 13A / § 31-1373.12
§ 31-1373.12. Additional investment authority.
Status: in_force

(a) An insurer may acquire under this section investments, or engage in investment practices, of any kind that are not specifically prohibited by this chapter or engage in investment practices without regard to any limitation in §§ 31-1373.03 through 31-1373.10 ; provided, that an insurer shall not acquire an investment or engage in an investment practice under this section if, as a result of and after giving effect to the transaction, the aggregate amount of the investments held by the insurer under this section would exceed the greater of:
  (1) Its unrestricted surplus; or
  (2) The lesser of:
    (A) Ten percent of its admitted assets; or
    (B) Fifty percent of its surplus as regards policyholders.
(b) An insurer shall not acquire any investment or engage in any investment practice under subsection (a)(2) of this section if, as a result of and after giving effect to the transaction the aggregate amount of all investments in any one person held by the insurer under that subsection would exceed 5% of its admitted assets.
D.C. Code § 31-5329 — DC Code / Title 31 / Chapter 53 / § 31-5329
§ 31-5329. Injunction.
Status: in_force

No application or petition for injunction against any domestic, foreign or alien society, or lodge thereof, shall be recognized in any court of the District unless made by the Corporation Counsel upon request of the Commissioner.
D.C. Code § 31-5715 — DC Code / Title 31 / Chapter 57 / § 31-5715
§ 31-5715. Individual violations of provisions.
Status: repealed

Repealed.
D.C. Code § 31-334 — DC Code / Title 31 / Chapter 3A / § 31-334
§ 31-334. Contents of Corporate Governance Annual Disclosure.
Status: in_force

(a) (1) The Corporate Governance Annual Disclosure shall be prepared in accordance with rules issued pursuant to this chapter and contain the material information necessary to permit the Commissioner to gain an understanding of the insurer's or group's corporate governance structure, policies, and practices.
  (2) The Commissioner may request any additional information considered material to providing the Commissioner with a clear understanding of the corporate governance policies and the reporting or information system or controls implementing those policies.
(b) Documentation and supporting information for the Corporate Governance Annual Disclosure shall be maintained by the insurer or insurance group and made available for examination or upon request of the Commissioner.
D.C. Code § 31-4308 — DC Code / Title 31 / Chapter 43 / § 31-4308
§ 31-4308. Companies or agents not to make or publish false statements.
Status: repealed

Repealed.
D.C. Code § 31-4121.07 — DC Code / Title 31 / Chapter 41A / § 31-4121.07
§ 31-4121.07. Confidentiality.
Status: in_force

(a) Documents, materials, or other information, including the ORSA Summary Report, ("ORSA-related information") in the possession or control of the Department that are obtained by, created by, or disclosed to the Commissioner or other person acting under the authority of the Commissioner shall be deemed by the District as proprietary, to contain trade secrets, confidential, and privileged, not subject to subchapter II of Chapter 5 of Title 2 , not subject to subpoena, and not subject to discovery or admissible in evidence in any private civil action.
(b) Notwithstanding subsection (a) of this section, the Commissioner may use the ORSA-related information in the furtherance of any regulatory or legal action brought as part of the Commissioner's official duties; provided, that the Commissioner shall not otherwise make the ORSA-related information public without the prior written consent of the insurer.
(c) Neither the Commissioner nor any other person acting under the authority of the Commissioner who has received ORSA-related information, through examination or otherwise, shall be permitted or required to testify in any private civil action concerning any ORSA-related information.
(d) (1) To assist in the performance of the Commissioner's regulatory duties, the Commissioner may:
    (A) Upon request, share ORSA-related information with other District, state, federal, or international financial regulatory agencies, including members of any supervisory college in accordance with the Holding Company System Act, with NAIC, or a third-party consultant designated by the Commissioner; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA-related information and verifies in writing that it has the legal authority to maintain the confidentiality and privileged status of the ORSA-related information under all applicable laws and regulations; and
    (B) Receive ORSA-related information, including otherwise confidential and privileged documents, materials or information, from state, federal, or international financial regulatory agencies, including members of any supervisory college in accordance with the Holding Company System Act and from NAIC, and shall maintain as confidential or privileged any documents, materials, or information received with notice that it is confidential or privileged under the laws of the jurisdiction that is the source of the ORSA-related information.
  (2) The Commissioner shall enter into a written agreement with NAIC or a third-party consultant ("recipient") governing the sharing and use of this information provided pursuant to this chapter , which shall:
    (A) Specify procedures and protocols to be used to protect the confidentiality and security of information, and, in the case of an agreement with NAIC, including procedures and protocols for sharing the information with other state regulators from states in which an insurance group has domiciled insurers;
    (B) Require the recipient to maintain the confidentiality and privileged status of the ORSA-related information or other information and to verify that the recipient has the legal authority to maintain confidentiality and privileged status of the ORSA-related information or other information under all applicable laws and regulations;
    (C) Specify that the Commissioner retains ownership of the information and that the use of the information is subject to the direction of the Commissioner;
    (D) Prohibit the recipient from storing the information in a permanent database after the underlying analysis is completed;
    (E) Require the Department to give prompt notice to an insurer whose confidential information is in the possession of the recipient and is subject to a request or subpoena for disclosure or production in a judicial or administrative action;
    (F) Require the recipient to consent to intervention by an insurer in a judicial or administrative action in which the recipient may be required to disclose confidential information about the insurer shared with the recipient; and
    (G) In the case of an agreement with a third-party consultant, provide for the insurer's written consent.
(e) The Commissioner is solely responsible for the administration and execution of this chapter and sharing ORSA-related information by the Commissioner with another regulatory authority shall not constitute a delegation of regulatory authority.
(f) No waiver of any applicable privilege or claim of confidentiality in the ORSA-related information shall occur as a result of disclosure of the ORSA-related information to the Commissioner under this section or as a result of sharing the ORSA-related information, as authorized in this chapter .  The ORSA-related information shall retain the confidential status specified in subsection (a) of this section notwithstanding its lawful disclosure to the Commissioner, NAIC, or a third-party consultant.
D.C. Code § 31-2602.16 — DC Code / Title 31 / Chapter 26 / § 31-2602.16
§ 31-2602.16. Exemption from District taxes or fees.
Status: repealed

Repealed.
D.C. Code § 31-3422 — DC Code / Title 31 / Chapter 34 / § 31-3422
§ 31-3422. Regulations.
Status: in_force

The Commissioner, within 120 days of April 9, 1997, shall issue rules and regulations necessary to implement the provisions of this chapter. To facilitate the timely issuance of rules and regulations, the Commissioner may contract out for the drafting of rules and regulations pursuant to emergency procurement provisions set forth in § 2-354.05 .
D.C. Code § 31-313 — DC Code / Title 31 / Chapter 3 / § 31-313
§ 31-313. Canadian and British companies.
Status: in_force

(a) In the case of Canadian and British insurers, the annual audited financial report shall be defined as the annual statement of total business on the form filed by these companies with their domiciliary supervision authority duly audited by an independent chartered accountant.
(b) For Canadian and British insurers, the letter required in § 31-304 shall state that the accountant is aware of the requirements relating to the annual audited statement filed with the Mayor pursuant to § 31-302 and shall affirm that the opinion expressed is in conformity with these requirements.
D.C. Code § 31-1903 — DC Code / Title 31 / Chapter 19 / § 31-1903
§ 31-1903. Confidentiality.
Status: in_force

All financial analysis ratios and examination synopses and related information concerning insurance companies that are submitted to the Mayor by the NAIC Insurance Regulatory Information System are confidential and may not be disclosed by the Mayor or any member of the Department of Insurance, Securities, and Banking. This information shall not be subject to disclosure under the District of Columbia Freedom of Information Act or any other District law relating to disclosure of information.
D.C. Code § 31-5607.04 — DC Code / Title 31 / Chapter 56 / § 31-5607.04
§ 31-5607.04. Cooperation with other agencies.
Status: in_force

(a) To encourage uniform interpretation and administration of this chapter and effective securities regulation and enforcement, the Commissioner may cooperate with the securities agencies or administrators of one or more states, Canadian provinces or territories, or another country, the Securities and Exchange Commission, the Commodity Futures Trading Commission, the Securities Investor Protection Corporation, any self-regulatory organization, any national or international organization of securities officials or agencies, and any governmental law enforcement or regulatory agency.
(b) The cooperation authorized by subsection (a) shall include the following actions:
  (1) Establishing a central depository for registration under this chapter and for documents or records required or allowed to be maintained under this chapter;
  (2) Making a joint registration examination or investigation;
  (3) Holding a joint administrative hearing;
  (4) Filing and prosecuting a joint civil or administrative proceeding;
  (5) Sharing and exchanging personnel;
  (6) Sharing and exchanging information and documents; and
  (7) Formulating rules or proposed rules, statements of policy, guidelines, and interpretative opinions and releases.
D.C. Code § 31-3932.13 — DC Code / Title 31 / Chapter 39A / § 31-3932.13
§ 31-3932.13. Discount on reserves; report on reserves.
Status: in_force

(a) An SPFC may discount its reserves at discount rates as approved by the Commissioner.
(b) An SPFC shall file annually an actuarial opinion on reserves provided by an approved independent actuary.
D.C. Code § 31-651.01 — DC Code / Title 31 / Chapter 6B / § 31-651.01
§ 31-651.01. Definitions.
Status: in_force

For the purposes of this chapter, the term:
(1) “Delivered by electronic means” means delivery to an electronic mail address at which a party has consented to receive notices or documents or the posting on an electronic network or site accessible via the Internet, mobile application, computer, mobile device, tablet, or any other electronic device, together with separate notice of the posting, which shall be provided by electronic mail to the address at which the party has consented to receive notice or by any other delivery method that has been consented to by the party.
(2) “Insurance document” means any notice or document required in an insurance transaction or that is evidence of insurance coverage.
(3) “Party” means a recipient of an insurance document, including an applicant, an insured, a policyholder, or an annuity contract holder.
D.C. Code § 31-1604 — DC Code / Title 31 / Chapter 16 / § 31-1604
§ 31-1604. AIDS testing standards, protocols, and appeals.
Status: in_force

(a) (1) Within 30 days of March 16, 1989, the District of Columbia Commissioner of Public Health (“Commissioner”) shall certify the testing protocol that is the most reliable and accurate in identifying exposure to the probable causative agent of AIDS, ARC, and the HIV infection. The notice of certification shall include an estimate based on scientific evidence of the proportion of false positive results expected in use of the testing protocol.
  (2) Within 12 months from the date of the initial certification and at least annually thereafter, the Commissioner shall publish a new or renewal certification based upon an ongoing review of scientific evidence regarding the accuracy and reliability of the testing protocol.
(b) (1) A named insured who tests positive under the testing protocol certified by the Commissioner may appeal to the Commissioner of Insurance and Securities [Commissioner of the Department of Insurance, Securities, and Banking] to review the testing procedures and results, and may present additional medical evidence, including the results of similar tests for exposure to the probable causative agent of AIDS that the named insured independently obtains, to rebut the positive test results. If the Commissioner of Insurance and Securities [Commissioner of the Department of Insurance, Securities, and Banking] determines that the result of the test of the proposed insured is not a true positive, the Commissioner of Insurance and Securities [Commissioner of the Department of Insurance, Securities, and Banking] shall order the insurer from which the applicant sought coverage to disregard the positive test result. The Commissioner of Insurance and Securities [Commissioner of the Department of Insurance, Securities, and Banking] shall, when necessary, request the advice of the Commissioner in making this determination.
  (2) Hearings related to the appeal provided for in paragraph (1) of this subsection shall be held in accordance with subchapter I of Chapter 5 of Title 2 .
  (3) An insurer shall apply standard underwriting practices, in accordance with applicable laws and rules of the District, to all life, health, or disability income insurance policies or contracts for individuals who test positive under the testing protocol certified by the Commissioner.
D.C. Code § 31-3805 — DC Code / Title 31 / Chapter 38 / § 31-3805
§ 31-3805. Exclusions.
Status: in_force

Specifically excluded from the coverage requirements of this chapter are Medicare Supplement insurance policies, accident only policies, dread disease policies, student accident policies, nursing home policies, and home health care policies.
D.C. Code § 31-4304 — DC Code / Title 31 / Chapter 43 / § 31-4304
§ 31-4304. Certificate of authority — Investigation of qualifications; effect; Issuance.
Status: in_force

(a) The Commissioner shall issue a certificate of authority to a company when it shall have complied with the requirements of the laws of the District so as to be entitled to do business therein. The Commissioner may, however, satisfy himself by such investigation as he may consider proper or necessary that the company is duly qualified under the laws of the District to transact business therein, and may refuse to issue or renew a certificate to a company if the issuance or renewal of the certificate would adversely affect the public interest. In each case, the certificate shall be issued under the seal of the Commissioner, authorizing and empowering the company to transact the kind of business specified in the certificate, and the certificate shall expire on the 30th day of April next succeeding the date of its issuance.
(b) Repealed.
(c) No company shall transact any business of insurance in or from the District until it shall have received a certificate of authority as authorized by this section, and no company shall transact any business of insurance not specified in such certificate of authority.
D.C. Code § 31-2231.21 — DC Code / Title 31 / Chapter 22A / § 31-2231.21
§ 31-2231.21. “Twisting” prohibited.
Status: in_force

No person shall make or issue, or cause to be made or issued, a written or oral statement misrepresenting or making incomplete comparisons as to the terms, conditions, or benefits contained in a policy for the purpose of inducing or attempting or tending to induce the policyholder to lapse, forfeit, surrender, retain, exchange, or convert an insurance policy.
D.C. Code § 31-3311.06 — DC Code / Title 31 / Chapter 33A / § 31-3311.06
§ 31-3311.06. Post-claims underwriting and prior approval for rescission, cancellation, or limitation.
Status: in_force

(a) An insurer shall not rescind an enrollee’s plan or coverage once the enrollee is covered under the plan or coverage involved; provided, that this section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage. The plan or coverage shall not be cancelled without prior notice to the Commissioner as required by subsection (b) of this section and prior notice to the consumer and an opportunity to appeal as required by the Patient Protection and Affordable Care Act, approved March 23, 2010 (124 Stat. 109; scattered sections of the United States Code).
(b) A health carrier shall provide at least 30 days advance written notice to each plan enrollee, or for individual health insurance coverage, primary subscriber, who would be affected by the proposed rescission of coverage before coverage under the plan may be rescinded in accordance with subsection (a) of this section regardless of, in the case of group or only to an individual within the group. The notice shall explain the reason for the rescission, procedures of appealing, and how to contact the Health Care Ombudsman and the Department of Insurance, Securities, and Banking for further information.
(c) Prior to rescinding the enrollee’s plan or coverage, the insurer shall provide to the Commissioner documentation to support the rescission and the Commissioner shall have 5 business days following receipt of the proposed rescission and supporting documentation to review the documentation to determine if the insurer is complying with the requirements of subsection (a) of this section. The insurer may rescind the plan or coverage after the end of the 5-day period of review unless the Commissioner objects or disapproves the proposed rescission within the 5-day period.
D.C. Code § 31-4314 — DC Code / Title 31 / Chapter 43 / § 31-4314
§ 31-4314. False statements in application for policy.
Status: in_force

The falsity of a statement in the application for any policy of insurance shall not bar the right to recovery thereunder unless such false statement was made with intent to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the company.
D.C. Code § 31-4711 — DC Code / Title 31 / Chapter 47 / § 31-4711
§ 31-4711. Group policies — Required provisions.
Status: in_force

No policy of group life insurance shall be delivered in the District unless it contains in substance the following provisions, or provisions which in the opinion of the Commissioner are more favorable to the persons insured, or at least as favorable to the persons insured and more favorable to the policyholder; provided, however: (1) that the standard provisions required for individual life insurance policies shall not apply to group life insurance policies; (2) that if the group life insurance policy is on a plan of insurance other than the term plan, it shall contain a nonforfeiture provision or provisions which in the opinion of the Commissioner is or are equitable to the insured persons and to the policyholder, but nothing herein shall be construed to require that group life insurance policies contain the same nonforfeiture provisions as are required for individual life insurance policies; and (3) that subject to the terms of the policy any person insured under a group life insurance contract, whether issued before or after August 14, 1973, may make to any person, other than his employer, an absolute or collateral assignment of any or all the rights and benefits conferred on him by any provision of such policy or by law, including specifically, but not by way of limitation, any right to designate a beneficiary or beneficiaries thereunder and any right to have an individual policy issued upon termination either of employment or of said policy of group life insurance; but nothing herein shall be construed to have prohibited an insured from making an assignment of all or any part of his rights and privileges under the policy before August 14, 1973, and, subject to the terms of the policy, an assignment by an insured before or after August 14, 1973, is valid for the purposes of vesting in the assignee all rights and privileges so assigned, but without prejudice to the insurer on account of any payment it may make or individual policy it may issue prior to receipt of notice of the assignment:
(1) A provision that the policyholder is entitled to a grace period of 31 days for the payment of any premium due except the first, during which grace period the death benefit coverage shall continue in force, unless the policyholder shall have given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during such grace period;
(2) A provision that the validity of the policy shall not be contested, except for nonpayment of premiums, after it has been in force for 2 years from its date of issue; and that no statement made by any person insured under the policy relating to his insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of 2 years during such person’s lifetime nor unless it is contained in a written instrument signed by him;
(3) A provision that a copy of the application, if any, of the policyholder shall be attached to the policy when issued, that all statements made by the policyholder or by the persons insured shall be deemed representations and not warranties, and that no statement made by any person insured shall be used in any contest unless a copy of the instrument containing the statement is or has been furnished to such person or to his beneficiary;
(4) A provision setting forth the conditions, if any, under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of his coverage;
(5) A provision specifying an equitable adjustment of premiums or of benefits or of both to be made in the event the age of a person insured has been misstated, such provision to contain a clear statement of the method of adjustment to be used;
(6) 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 $250 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;
(7) A provision that the insurer will issue to the policyholder for delivery to each person insured an individual certificate setting forth a statement as to the insurance protection to which he is entitled, to whom the insurance benefits are payable, and the rights and conditions set forth in paragraphs (8), (9), and (10) of this section;
(8) 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 application for the individual policy shall be made, and the 1st premium paid to the insurer, within 31 days after such termination: And provided further, that:
  (A) The individual policy shall, at the option of such person, be on any 1 of the forms, except term insurance, then customarily issued by the insurer at the age and for the amount applied for;
  (B) The individual policy shall be in an amount not in excess of the amount of life insurance which ceases because of such termination, provided that any amount of insurance which shall have matured on or before the date of such termination as an endowment payable to the person insured, whether in 1 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 such termination; and
  (C) The premium on the individual policy shall be at the insurer’s then customary rate applicable to the form and amount of the individual policy, to the class of risk to which such person then belongs, and to his age attained on the effective date of the individual policy;
(9) A provision that if the group policy terminates or is amended so as to terminate the insurance of any class of insured persons, every person insured thereunder at the date of such termination whose insurance terminates and who has been so insured for at least 5 years prior to such termination date shall be entitled to have issued to him by the insurer an individual policy of life insurance, subject to the same conditions and limitations as are provided by paragraph (8) of this section, except that the group policy may provide that the amount of such individual policy shall not exceed the smaller of:
  (A) The amount of the person’s life insurance protection ceasing because of the termination or amendment of the group policy, less the amount of any life insurance for which he is or becomes eligible under any group policy issued or reinstated by the same or another insurer within 31 days after such termination; and
  (B) $2,000; and
(10) A provision that if a person insured under the group policy dies during the period within which he would have been entitled to have an individual policy issued to him in accordance with subparagraph (8) or (9) of this section and before such an individual policy shall have become effective, the amount of life insurance which he would have been entitled to have issued to him under such individual policy shall be payable as a claim under the group policy, whether or not application for the individual policy or the payment of the 1st premium therefor has been made.
D.C. Code § 31-3311.11 — DC Code / Title 31 / Chapter 33A / § 31-3311.11
§ 31-3311.11. Definitions.
Status: in_force

For the purposes of this chapter, the term:
(a) (1) “Affordable Care Act” means the Patient Protection and Affordable Care Act approved March 23, 2010 (124 Stat. 111; 42 U.S.C. § 18001, note), as the law and its implementing regulations were in effect on December 15, 2017.
  (2) “Commissioner” means the Commissioner of the Department of Insurance, Securities, and Banking established by Chapter 1 of this title [ § 31-101 et seq. ].
D.C. Code § 31-737.01 — DC Code / Title 31 / Chapter 7 / § 31-737.01
§ 31-737.01. Mergers and acquisitions.
Status: in_force

(a) Subject to applicable requirements of this subchapter and subchapter I of this chapter , a mutual insurance holding company may:
  (1) Merge or consolidate with, or acquire the assets of, a mutual insurance holding company licensed pursuant to this subchapter or any similar entity organized pursuant to laws of any other state;
  (2) Either alone or together with one or more intermediate stock holding companies, or other subsidiaries, directly or indirectly acquire the stock of a stock insurance company or a mutual insurance company that reorganizes under this subchapter or the law of its state of organization;
  (3) Together with one or more of its stock insurance company subsidiaries, acquire the assets of a stock insurance company or a mutual insurance company;
  (4) Acquire a stock insurance company through the merger of such stock insurance company with a stock insurance company or interim stock insurance company subsidiary of the mutual insurance holding company; or
  (5) Acquire the stock or assets of any other person to the same extent as would be permitted for any District stock corporation or, if the mutual insurance holding company writes insurance, a mutual insurance company.
(b) A merger or acquisition pursuant to this section is subject to the applicable procedures prescribed by the District laws applying to mutual insurance companies, except as otherwise provided in this subsection. The Commissioner may retain, at the expense of the mutual insurance company, any attorneys, actuaries, accountants, and other experts not otherwise a part of the Commissioner’s staff as may be reasonably necessary to assist the Commissioner in reviewing the proposed merger or acquisition.
  (1) The plan and agreement for merger shall be submitted to and approved by vote of 2/3rds of those members of any domestic mutual insurance holding company involved in the merger who vote either in person or by proxy thereon at a lawful meeting called for the purpose pursuant to such reasonable notice and procedure as has been approved by the Commissioner.
  (2) No such merger shall be effectuated unless in advance thereof, the plan and agreement therefor have been filed with the Commissioner and approved by him. The Commissioner shall give such approval unless he finds such plan or agreement:
    (A) Is inequitable to the policyholders of any domestic insurer involved in the merger or the members of any domestic mutual insurance holding company involved in the merger; or
    (B) Would substantially reduce the security of and service to be rendered to policyholders of a domestic insurer in the District.
D.C. Code § 31-5602.09 — DC Code / Title 31 / Chapter 56 / § 31-5602.09
§ 31-5602.09. Withdrawal.
Status: in_force

(a) Withdrawal from licensing as a broker-dealer, agent, investment adviser, or investment adviser representative shall be effective 30 days after the receipt by the Commissioner of an application to withdraw or within any shorter period the Commissioner, by order, determines, unless:
  (1) A revocation or suspension proceeding is pending when the withdrawal application is filed; or
  (2) A proceeding to revoke or suspend or to impose conditions upon the withdrawal is instituted within 30 days after the withdrawal application is filed.
(b) If a proceeding is pending or instituted, the withdrawal shall be effective at the time and upon the conditions that the Commissioner, by order, determines. If no proceeding is pending or instituted and the withdrawal becomes effective, the Commissioner may institute a proceeding under § 31-5602.07 within one year after the withdrawal became effective and enter an order as of the last date on which the license was effective.
D.C. Code § 31-2351.10 — DC Code / Title 31 / Chapter 23M / § 31-2351.10
§ 31-2351.10. Enforcement provisions.
Status: in_force

(a) The Commissioner may conduct examinations of providers, administrators, insurers, or other persons to enforce the provisions of this chapter and protect service contract holders in the District. Upon request of the Commissioner, the provider shall make all accounts, books, and records concerning a service contract sold by the provider available to the Commissioner that the Commissioner considers necessary to enable the Commissioner to reasonably determine compliance or noncompliance with this chapter .
(b) (1) The Commissioner may take action that is necessary or appropriate to enforce the provisions of this chapter and regulations and orders issued pursuant to this chapter , and to protect service contract holders in the District.
  (2) If a provider has violated this chapter or a regulation or order issued pursuant to this chapter , the Commissioner may issue an order, or any combination of the following, that:
    (A) Orders the provider to cease and desist from committing the violation;
    (B) Prohibits the provider from selling or offering for sale service contracts in violation of this chapter or a regulation or order issued pursuant to this chapter ; or
    (C) Imposes a civil penalty on the provider.
(c) (1) A person aggrieved by a Commissioner's order issued pursuant to this subsection may request a hearing before the Commissioner; provided, that the request for a hearing shall be filed with the Commissioner within 20 days after the effective date of the Commissioner's order.
  (2) If a hearing is timely requested, the order at issue shall be suspended until completion of the hearing and a final decision of the Commissioner.
  (3) (A) At the hearing, the burden shall be on the Commissioner to show why the order issued pursuant to this subsection is justified.
    (B) The hearing shall be conducted according to the rules established in Subtitle A of Chapter 38 of Title 26 of the District of Columbia Municipal Rules (26 DCMR A3800 et seq. ).
(d) The Commissioner may bring an action in any court of competent jurisdiction for an injunction or other appropriate relief for a violation of this chapter or a regulation or order issued pursuant to this chapter . An action filed under this section may also seek restitution on behalf of a person aggrieved by a violation of this chapter or a regulation or order issued pursuant to this chapter .
(e) (1) A person who is found to have violated this chapter or a regulation or order issued pursuant to this chapter may be assessed a civil penalty in an amount determined by the Commissioner of not more than $500 per violation and no more than $10,000 in the aggregate for all violations of a similar nature.
  (2) For purposes of this subsection, violations are of a similar nature if the violation consists of the same or similar course of conduct, action, or practice.
D.C. Code § 31-2351.12 — DC Code / Title 31 / Chapter 23M / § 31-2351.12
§ 31-2351.12. Rules.
Status: in_force

The Mayor, pursuant to Chapter 5 of Title 2 , may issue rules to implement the provisions of this chapter .
D.C. Code § 31-2602.02 — DC Code / Title 31 / Chapter 26 / § 31-2602.02
§ 31-2602.02. Applicability of District insurance laws.
Status: repealed

Repealed.
D.C. Code § 31-3909 — DC Code / Title 31 / Chapter 39 / § 31-3909
§ 31-3909. Annual report.
Status: repealed

Repealed.
D.C. Code § 31-5604.05 — DC Code / Title 31 / Chapter 56 / § 31-5604.05
§ 31-5604.05. Filing of sales and advertising literature.
Status: in_force

The Commissioner may, by rule or order, require the filing of a prospectus, pamphlet, circular, form letter, advertisement, or other sales literature or advertising communication, whether communicated in printed form, by electronic means, or otherwise, addressed or intended for distribution to prospective investors, including clients or prospective clients of an investment adviser, unless the security or transaction is exempt under § 31-5604.01 or § 31-5604.02 , the security is a federal covered security, the transaction concerns a federal covered security or a federal covered adviser, or the transaction concerns a broker-dealer registered under the Securities Exchange Act of 1934.
D.C. Code § 31-5603.03 — DC Code / Title 31 / Chapter 56 / § 31-5603.03
§ 31-5603.03. Registration by coordination.
Status: in_force

(a) A security for which a registration statement has been filed under the Securities Act of 1933 in connection with the offering of the security may be registered by coordination.
(b) In addition to the information specified in § 31-5603.06(c) and the consent to service of process required under § 31-5607.06 , a registration statement under this section shall contain the following information and be accompanied by the following documents:
  (1) Two copies of the latest prospectus or offering circular filed under the Securities Act of 1933;
  (2) If the Commissioner, by rule or order, requires:
    (A) A copy of the articles of incorporation and by-laws, or their substantial equivalents, as currently in effect;
    (B) A copy of any agreement with or among underwriters;
    (C) A copy of any indenture or other instrument governing the issuance of the security to be registered; and
    (D) A specimen, copy, or description of the security;
  (3) If the Commissioner requests, any other information or copies of any document filed under the Securities Act of 1933; and
  (4) An undertaking to forward all future amendments to the federal prospectus, other than an amendment which merely delays the effective date of the registration statement, promptly and not later than the first business day after the day on which they are forwarded to or filed with the Securities and Exchange Commission, whichever occurs first.
(c) A registration statement under this section shall become effective at the time that the federal registration statement becomes effective if all of the following conditions are satisfied:
  (1) A stop order is not in effect and a proceeding is not pending under § 31-5603.06 ;
  (2) The registration statement has been on file with the Commissioner for at least 10 business days; and
  (3) A statement of the maximum and minimum proposed offering prices and the maximum underwriting discounts and commissions has been on file for 2 full business days, or any shorter period which the Commissioner permits by rule or otherwise, and the offering is made within those limitations.
(d) The registrant shall promptly notify the Commissioner, in writing, facsimile transmission, or other means considered acceptable by the Commissioner, of the date and time when the federal registration statement became effective and the content of the price amendment, if any, and shall promptly file a post-effective amendment containing the information and documents in the price amendment.
(e) Upon failure to receive the required notification and post-effective amendment with respect to the price amendment, the Commissioner may enter a stop order, without notice or hearing, retroactively the denying the effectiveness of the registration statement or suspending its effectiveness until there is compliance with subsection (d) of this section if the Commissioner promptly notifies the registrant by telephone or otherwise, and promptly confirms by letter, facsimile transmission, or otherwise if the Commissioner notifies by telephone, of the issuance of the order. If the registrant proves compliance with the requirements of subsection (d) of this section as to notice and post-effective amendment, the stop order shall be void as of the time of its entry.
(f) The Commissioner may, by rule or otherwise, waive either or both of the conditions specified in subsection (c)(2) or (3) of this section.
(g) If the federal registration statement becomes effective before all of the conditions in subsection (c) of this section are satisfied and they are not waived, the registration statement shall become effective when all the conditions are satisfied. If the registrant advises the Commissioner of the date when the federal registration statement is expected to become effective, the Commissioner shall promptly advise the registrant by telephone, facsimile, or otherwise, at the registrant’s expense, whether all of the conditions are satisfied and whether the Commissioner then contemplates the institution of a proceeding under § 31-5603.06 . This advice by the Commissioner shall not preclude the institution of a proceeding for a stop order suspending the effectiveness of the registration statement.
(h) The Commissioner may, by rule or order, waive or modify the application of a requirement of this section if a provision, or an amendment, repeal, or other alteration of the securities registration provisions, of the Securities Act of 1933, or the regulations adopted thereunder, render the waiver or modification appropriate for further coordination of District and federal law.
D.C. Code § 31-3501 — DC Code / Title 31 / Chapter 35 / § 31-3501
§ 31-3501. Definitions.
Status: in_force

For the purposes of this chapter, the term:
(1) “Commissioner” means the Commissioner of the Department of Insurance, Securities, and Banking.
(1A) “Community health reinvestment” means expenditures that promote and safeguard the public health or that benefit current or future subscribers, including premium rate reductions.
(1B) “Contractholder” means a person entering into a subscriber contract with a corporation.
(2) “Corporation” means a nonstock, nonprofit corporation which is subject to regulation and licensing under this chapter and which offers subscriber contracts as part of a hospital service plan, a medical service plan, or both.
(3) “Domestic corporation” means a corporation organized under the laws of the District, or formed or organized under an act of Congress.
(3A) “Healthy DC and Health Care Expansion Fund” means the Healthy DC and Health Care Expansion Fund established by § 31-3514.02 .
(4) “Hospital service plan” means a plan for providing hospital and related services by hospitals and others which entitles a subscriber to certain hospital and related services, or to benefits and indemnification for such services.
(4A) (A) (i) Except as provided in sub-subparagraph (ii) of this subparagraph, “large employer” means, in connection with a group health plan with respect to a calendar year and a plan year, a single employer that employed an average of at least 51 employees on business days during the preceding calendar year and at least 2 employees on the first day of the plan year.
      (ii) Beginning in calendar year 2016 and for each succeeding year, “large employer” means, in connection with a group health plan with respect to a calendar year and a plan year, a single employer that employed an average of at least 101 employees on business days during the preceding calendar year and at least 2 employees on the first day of the plan year.
  (B) For the purposes of this paragraph:
    (i) All persons treated as a single employer under section 414(b), (c), (m), or (o) of the Internal Revenue Code of 1986, October 22, 1986 (100 Stat. 2085; 26 U.S.C. § 414(b), (c), (m), or (o)), shall be treated as a single employer;
    (ii) An employer and any predecessor employer shall be treated as a single employer;
    (iii) All employees shall be counted, including part-time employees and employees who are not eligible for health benefit coverage through the employer; and
    (iv) If an employer was not in existence throughout the preceding calendar year, the determination of whether that employer is a large employer shall be based on the average number of employees that the employer is reasonably expected to employ in the current calendar year.
(5) “Mayor” means the Mayor of the District of Columbia or the Mayor’s designated agent.
(6) “Medical service plan” means a plan for providing medical services and related services by physicians and others which entitles a subscriber to certain medical and related services, or to benefits and indemnification for such services.
(7) “Plan” means a hospital service plan, a medical service plan, or a combination of the two.
(7A) “Public-private partnership” means a mutually acceptable written agreement between the Mayor and a hospital and medical services corporation that is certified by the Commissioner upon the execution and delivery of the agreement by the parties and which agreement:
  (A) Shall include the following provisions:
    (i) A $5 million annual payment to the Healthy DC Fund (or appropriate successor fund) by the hospital and medical services corporation to be used for subsidies that expand health insurance coverage for low-income District residents;
    (ii) A targeted city-wide health care initiative aimed at improving nutrition and increasing physical fitness among the District’s senior citizens, or another comparable health promotion program;
    (iii) A term not to exceed 5 years, subject to extension upon the mutual written agreement of the parties;
    (iv) (I) (aa) The maintenance and support of the existing District open enrollment program as it operated prior to the enactment of the Medical Insurance Empowerment Amendment Act of 2008, effective March 25, 2009 ( D.C. Law 17-369 ; 56 DCR 1346) (“open enrollment program”), which program has an estimated average premium of $357 per member per month, and the enhancement of the open enrollment program by offering a new health maintenance organization product that includes comprehensive benefits with an average initial premium currently estimated at about $300 per member per month, which average may vary based upon age and family status, and subject to other reasonable adjustments, but with no adjustments for gender or pre-existing conditions.
        (bb) The annual premium rate of the existing open enrollment program shall not exceed 125% of the comparable medically underwritten product and shall be determined once every 12 months. The benefit package shall include, at a minimum, primary care services, specialist services, temporomandibular joint problems chiropractic services, mental health and addiction treatment, organ transplantation, treatment for morbid obesity, open heart surgery, and pharmaceutical benefits.
        (cc) The medical loss ratio to be utilized in rate filings and determinations shall not exceed 150%;
      (II) Under the open enrollment program pursuant to sub-sub-subparagraph (I) of this sub-subparagraph:
        (aa) Current members shall be permitted to maintain the option to continue their current open enrollment program coverage or opt for the new health maintenance organization product;
        (bb) New open enrollment members shall only be offered the new health maintenance organization product; and
        (cc) Total enrollment under subparagraph (A)(iv)(I) of this paragraph shall be capped at 2,500;
    (v) Participation in the open enrollment program (including the health maintenance organization product) may be limited to District residents, which shall be subject to periodic confirmation; and
    (vi) (I) A corporation shall prominently advertise the availability of the new open enrollment health maintenance organization product continuously on the Internet and at least quarterly in a newspaper of general circulation throughout the District.
      (II) The content and format of the advertising shall be filed with the Commissioner no less than 30 days before its appearance in a newspaper or on the Internet;
  (B) May include the following provisions:
    (i) Authority for the Commissioner to grant a hospital and medical services corporation reasonable relief from the requirements of the agreement, such as if federal or state health care reforms make the requirements unnecessary or redundant or if the corporation does not meet a financial performance or similar test as specified in the agreement; provided, that any relief granted shall not affect the certification of the agreement by the Commissioner or the status of the agreement as a public-private partnership for all purposes under this chapter; and
    (ii) Reasonable expiration and termination provisions; and
  (C) Shall be effective upon the certification of the Commissioner.
(7B) “RS Fund” means the rate stabilization fund established by § 31-3514(j) .
(7C) (A) (i) Except as provided in sub-subparagraph (ii) of this subparagraph, “small employer” means a single employer that employed an average of not more than 50 employees during the preceding calendar year.
    (ii) Beginning in calendar year 2016 and for each succeeding year, “small employer” means a single employer that employed an average of not more than 100 employees during the preceding calendar year.
  (B) For the purposes of this paragraph:
    (i) All persons treated as a single employer under section 414(b), (c), (m), or (o) of the Internal Revenue Code of 1986, October 22, 1986 (100 Stat. 2085; 26 U.S.C. § 414(b), (c), (m), or (o)), shall be treated as a single employer;
    (ii) An employer and any predecessor employer shall be treated as a single employer;
    (iii) All employees shall be counted, including part-time employees and employees who are not eligible for health benefit coverage through the employer; and
    (iv) If an employer was not in existence throughout the preceding calendar year, the determination of whether that employer is a small employer shall be based on the average number of employees that the employer is reasonably expected to employ in the current calendar year.”
(8) “Subscriber” means any person entitled to benefits under the terms and conditions of a subscriber contract.
(9) “Subscriber contract” means a written group or individual contract which is issued to a contractholder by a corporation which provides for subscriber participation in a hospital service plan, a medical service plan, or a combination of the two.
(10) “Subsidiary” means an affiliate controlled by a corporation directly or indirectly through 1 or more intermediaries.
(11) “Surplus” means the amount by which all admitted assets of the corporation exceed its liabilities, inclusive of the reserves required pursuant to § 31-3509 .
(4A) (A) (i) Except as provided in sub-subparagraph (ii) of this subparagraph, “large employer” means, in connection with a group health plan with respect to a calendar year and a plan year, a single employer that employed an average of at least 51 employees on business days during the preceding calendar year and at least 2 employees on the first day of the plan year.
    (ii) Beginning in calendar year 2016 and for each succeeding year, “large employer” means, in connection with a group health plan with respect to a calendar year and a plan year, a single employer that employed an average of at least 101 employees on business days during the preceding calendar year and at least 2 employees on the first day of the plan year.
  (B) For the purposes of this paragraph:
    (i) All persons treated as a single employer under section 414(b), (c), (m), or (o) of the Internal Revenue Code of 1986, October 22, 1986 (100 Stat. 2085; 26 U.S.C. § 414(b), (c), (m), or (o)), shall be treated as a single employer;
    (ii) An employer and any predecessor employer shall be treated as a single employer;
    (iii) All employees shall be counted, including part-time employees and employees who are not eligible for health benefit coverage through the employer; and
    (iv) If an employer was not in existence throughout the preceding calendar year, the determination of whether that employer is a large employer shall be based on the average number of employees that the employer is reasonably expected to employ in the current calendar year.
D.C. Code § 31-5318 — DC Code / Title 31 / Chapter 53 / § 31-5318
§ 31-5318. Investments.
Status: in_force

A domestic society shall invest its funds only in investments authorized by the laws of the District for the investment of assets of life insurers and subject to the limitations therein. Any foreign or alien society permitted or seeking to do business in the District which invests its funds in accordance with the laws of the state, district, territory, country or province in which it is incorporated, shall be held to meet the requirements of this section for the investment of funds.