Idaho Code § 41-5103 — Idaho Code / Title 41 / Chapter 51 / Section 41-5103
41-5103 LICENSURE.
Status: in_force

41-5103. Licensure. (1) No person, firm, association or corporation shall act as a RB in this state if the RB maintains an office either directly or as a member or employee of a firm or association, or an officer, director or employee of a corporation:

(a) In this state, unless such RB is a licensed producer in this state; or

(b) In another state, unless such RB is a licensed producer in this state or another state having a law substantially similar to this law or such RB is licensed in this state as a nonresident reinsurance intermediary.

(2) No person, firm, association or corporation shall act as a RM:

(a) For a reinsurer domiciled in this state, unless such RM is a licensed producer in this state;

(b) In this state, if the RM maintains an office either directly or as a member or employee of a firm or association, or an officer, director or employee of a corporation in this state, unless such RM is a licensed producer in this state;

(c) In another state for a nondomestic insurer, unless such RM is a licensed producer in this state or another state having a law substantially similar to this law or such person is licensed in this state as a nonresident reinsurance intermediary.

(3) The director may require a RM subject to subsection (2) of this section to:

(a) File a bond in an amount from an insurer acceptable to the director for the protection of the reinsurer; and

(b) Maintain an errors and omissions policy in an amount acceptable to the director.

(4) (a) The director may issue a reinsurance intermediary license to any person, firm, association or corporation who has complied with the requirements of this chapter. Any such license issued to a firm or association will authorize all the members of such firm or association and any designated employees to act as reinsurance intermediaries under the license, and all such persons shall be named in the application and any supplements thereto. Any such license issued to a corporation shall authorize all of the officers, and any designated employees and directors thereof to act as reinsurance intermediaries on behalf of such corporation, and all such persons shall be named in the application and any supplements thereto.

(b) If the applicant for a reinsurance intermediary license is a nonresident, such applicant, as a condition precedent to receiving or holding a license, shall designate the director as agent for service of process in the manner, and with the same legal effect, provided for in this title for designation of service of process upon unauthorized insurers, and shall also furnish the director with the name and address of a resident of this state upon whom notices or orders of the director or process affecting such nonresident reinsurance intermediary may be served. Such licensee shall promptly notify the director in writing of every change in its designated agent for service of process, and such change shall not become effective until acknowledged by the director.

(5) The director may refuse to issue a reinsurance intermediary license if, in his judgment, the applicant, anyone named on the application, or any member, principal, officer or director of the applicant, is not trustworthy, or that any controlling person of such applicant is not trustworthy to act as a reinsurance intermediary, or that any of the foregoing has given cause for revocation or suspension of such license, or has failed to comply with any prerequisite for the issuance of such license. Upon written request therefor, the director will furnish a summary of the basis for refusal to issue a license, which document shall be privileged and exempt from disclosure pursuant to exemptions provided in chapter 1, title 74, Idaho Code.

(6) Licensed attorneys at law of this state when acting in their professional capacity as such shall be exempt from the provisions of this section.

History:

[41-5103, added 1992, ch. 82, sec. 1, p. 250; am. 1999, ch. 30, sec. 12, p. 55; am. 2015, ch. 141, sec. 115, p. 464.]
Idaho Code § 41-3338 — Idaho Code / Title 41 / Chapter 33 / Section 41-3338
41-3338 SPECIAL PROVISIONS FOR THIRD PARTY CLAIMS.
Status: in_force

41-3338. Special provisions for third party claims. (1) Whenever any third party asserts a cause of action against an insured of an insured in liquidation, the third party may file a claim with the liquidator.

(2) Whether or not the third party files a claim, the insured may file a claim on his own behalf in the liquidation. If the insured fails to file a claim by the date for filing claims specified in the order of liquidation or within sixty (60) days after mailing of the notice required by section 41-3322, Idaho Code, whichever is later, he is an unexcused late filer.

(3) The liquidator shall make his recommendations to the court under section 41-3342, Idaho Code, for the allowance of an insured's claim under subsection (2) of this section after consideration of the probable outcome of any pending action against the insured on which the claim is based, the probable damages recoverable in the action and the probable costs and expenses of defense. After allowance by the court, the liquidator shall withhold any dividends payable on the claim, pending the outcome of litigation and negotiation with the insured. Whenever it seems appropriate, he shall reconsider the claim on the basis of additional information and amend his recommendations to the court. The insured shall be afforded the same notice and opportunity to be heard on all changes in the recommendation as in its initial determination. The court may amend its allowance as it thinks appropriate. As claims against the insured are settled or barred, the insured shall be paid from the amount withheld the same percentage dividend as was paid on other claims of like property, based on the lesser of:

(a) The amount actually recovered from the insured by action or paid by agreement plus the reasonable costs and expenses of defense; or

(b) The amount allowed on the claims by the court. After all claims are settled or barred, any sum remaining from the amount withheld shall revert to the undistributed assets of the insurer. Delay in final payment under this subsection shall not be a reason for unreasonable delay of final distribution and discharge of the liquidator.

(4) If several claims founded upon one (1) policy are filed, whether by third parties or as claims by the insured under this section, and the aggregate allowed amount of the claims to which the same limit of liability in the policy is applicable exceeds that limit, each claim as allowed shall be reduced in the same proportion so that the total equals the policy limit. Claims by the insured shall be evaluated as in subsection (3) of this section. If any insured's claim is subsequently reduced under subsection (3) of this section, the amount thus freed shall be apportioned ratably among the claims which have been reduced under this subsection.

(5) No claim may be presented under this section if it is or may be covered by any guaranty association or foreign guaranty association.

History:

[41-3338, added 1981, ch. 249, sec. 2, p. 531.]
Idaho Code § 41-6602 — Idaho Code / Title 41 / Chapter 66 / Section 41-6602
41-6602 PURPOSE AND APPLICABILITY.
Status: in_force

41-6602. purpose and applicability. (1) The purpose of this chapter is to establish minimum and uniform standards and criteria for the audit of pharmacies.

(2) The provisions of this chapter shall apply to any audit of a pharmacy conducted on or after July 1, 2023, unless:

(a) Contrary provisions for a specific type of audit are provided in federal or state law, rule, or procedure;

(b) The audit relates to medicaid payments;

(c) The audit is an investigative audit based on reasonable suspicion of willful misrepresentation, abuse, waste, or fraud; or

(d) The audit is a financial examination conducted by a certified public accountant according to generally accepted auditing standards.

History:

[41-6602, added 2023, ch. 233, sec. 1, p. 719.]
Idaho Code § 41-5912 — Idaho Code / Title 41 / Chapter 59 / Section 41-5912
41-5912 MINIMUM QUALIFICATIONS FOR INDEPENDENT REVIEW ORGANIZATIONS.
Status: in_force

41-5912. minimum qualifications for independent review organizations. (1) To be approved to conduct external reviews, an independent review organization shall have and maintain written policies and procedures that govern all aspects of both the standard external review process and the expedited external review process set forth in this chapter that include, at a minimum:

(a) A quality assurance mechanism in place that:

(i) Ensures that external reviews are conducted within the specified time frames and that required notices are provided in a timely manner;

(ii) Ensures the selection of qualified and impartial clinical reviewers to conduct external reviews on behalf of the independent review organization and suitable matching of reviewers to specific cases and that the independent review organization employs or contracts with an adequate number of clinical reviewers to meet this objective;

(iii) Ensures the confidentiality of medical and treatment records and clinical review criteria; and

(iv) Ensures that any person employed by or under contract with the independent review organization adheres to the requirements of this chapter;

(b) A toll free telephone service to receive information on a twenty-four (24) hour day, seven (7) day a week basis related to external reviews that is capable of accepting, recording or providing appropriate instruction to incoming telephone callers during other than normal business hours; and

(c) An agreement to maintain and provide to the director the information set out in section 41-5914, Idaho Code.

(2) All clinical reviewers assigned by an independent review organization to conduct external reviews shall be physicians or other appropriate health care providers who meet the following minimum qualifications:

(a) Be an expert in the treatment of the covered person's medical condition that is the subject of the external review;

(b) Be knowledgeable about the recommended health care service or treatment through recent or current actual clinical experience treating patients with the same or similar medical condition of the covered person;

(c) Hold a nonrestricted license in a state of the United States and, for physicians, a current certification by a recognized American medical specialty board in the area or areas appropriate to the subject of the external review; and

(d) Have no history of disciplinary actions or sanctions, including loss of staff privileges or participation restrictions, that have been taken or are pending by any hospital, governmental agency or unit or regulatory body that raise a substantial question as to the clinical reviewer's physical, mental or professional competence or moral character.

(3) In addition to the requirements set forth in subsection (1) of this section, an independent review organization may not own or control, be a subsidiary of or in any way be owned or controlled by, or exercise control with a health benefit plan, a national, state or local trade association of health benefit plans, or a national, state or local trade association of health care providers.

(4) In addition to any other requirements, to be approved to conduct an external review of a specified case, neither the independent review organization selected to conduct the external review, nor any clinical reviewer assigned by the independent organization to conduct the external review, may have a material professional, familial or financial conflict of interest with any of the following:

(a) The health carrier that is the subject of the external review;

(b) The covered person whose treatment is the subject of the external review;

(c) Any officer, director or management employee of the health carrier that is the subject of the external review;

(d) The health care provider, the health care provider's medical group or independent practice association recommending the health care service or treatment that is the subject of the external review;

(e) The facility at which the recommended health care service or treatment would be provided; or

(f) The developer or manufacturer of the principal drug, device, procedure or other therapy being recommended for the covered person whose treatment is the subject of the external review.

(5) In determining whether an independent review organization or a clinical reviewer of the independent review organization has a material professional, familial or financial conflict of interest for purposes of subsection (4) of this section, the director shall take into consideration situations where the independent review organization to be assigned to conduct an external review of a specified case, or a clinical reviewer to be assigned by the independent review organization to conduct an external review of a specified case, may have an apparent professional, familial or financial relationship or connection with a person described in subsection (4) of this section, but that the characteristics of that relationship or connection are such that they are not a material professional, familial or financial conflict of interest that results in the disapproval of the independent review organization or the clinical reviewer from conducting the external review.

(6) An independent review organization that is accredited by a nationally recognized private accrediting entity, which has independent review accreditation standards that the director has determined are equivalent to or exceed the minimum qualifications of this section, shall be presumed in compliance with this section to be eligible for approval under section 41-5911, Idaho Code.

(7) The director shall initially review and periodically review the independent review organization accreditation standards of a nationally recognized private accrediting entity to determine whether the entity's standards are, and continue to be, equivalent to or exceed the minimum qualifications established under this section.

(8) Upon request, a nationally recognized private accrediting entity shall make its current independent review organization accreditation standards available to the director in order for the director to determine whether the entity's standards are equivalent to or exceed the minimum qualifications established under this section.

(9) An independent review organization shall be unbiased. An independent review organization shall establish and maintain written procedures to ensure that it is unbiased in addition to any other procedures required under this section.

(10) Each independent review organization applying to the director to be approved shall include in its application its schedule of costs and fees for performing external reviews and shall file with the director any subsequent changes to its fee schedule. If the director finds that the proposed fees are excessive or unreasonable, the director shall disapprove the application or, if the review organization has already been approved, remove the organization from the list of eligible review organizations. An independent review organization may not impose charges for a review under this chapter that exceed those set forth on its schedule of fees filed with the director.

History:

[41-5912, added 2009, ch. 87, sec. 1, p. 253.]
Idaho Code § 41-804 — Idaho Code / Title 41 / Chapter 8 / Section 41-804
41-804 CUSTODIAL ARRANGEMENTS FOR DEPOSITS.
Status: in_force

41-804. Custodial arrangements for deposits. (1) All deposits of insurers made in this state under this code shall be made through the director.

(2) The deposits shall be made with and held by the trust department of an established bank located in Idaho, approved by the director for the purpose, and under custodial arrangements likewise approved by him. All such custodial arrangements shall comply in substance with the requirements of this code as to the amount, purposes, maintenance, initial amounts, release and withdrawal of such a deposit, and as to the rights of the insurer therein.

(3) The securities qualified for deposit under this chapter may be deposited with a clearing corporation or held in the federal reserve book-entry system. Securities deposited with a clearing corporation or held in the federal reserve book-entry system and used to meet the deposit requirements set forth in this chapter shall be under the control of the director of the department of insurance and shall not be withdrawn by the insurer without the approval of the director. Any insurer holding securities in such manner shall provide evidence satisfactory to the director, issued by its custodian or member bank through which such insurer has deposited such securities in a clearing corporation or through which such securities are held in the federal reserve book-entry system, respectively, in order to establish that the securities are actually recorded in an account in the name of the custodian or other direct participant or member bank, and that the records of the custodian, other participant or member bank reflect that such securities are held subject to the order of the director. Definitions contained in section 41-2870, Idaho Code, shall apply to this subsection (3).

(4) The cost of any such custodial arrangements shall be borne by the insurer. The state of Idaho shall have no responsibility for the safekeeping of the deposit.

History:

[41-804, added 1961, ch. 330, sec. 173, p. 645; am. 1969, ch. 214, sec. 28, p. 625; am. 1981, ch. 174, sec. 3, p. 308; am. 2004, ch. 90, sec. 6, p. 329.]
Idaho Code § 41-1090 — Idaho Code / Title 41 / Chapter 10 / Section 41-1090
41-1090 SHORT TITLE.
Status: in_force

41-1090. SHORT TITLE. Sections 41-1090 through 41-1096, Idaho Code, shall be known and may be cited as the "Limited Lines Travel Insurance Act."

History:

[41-1090, added 2017, ch. 198, sec. 2, p. 495.]
Idaho Code § 41-2210 — Idaho Code / Title 41 / Chapter 22 / Section 41-2210
41-2210 REQUIRED PROVISION IN GROUP AND BLANKET POLICIES.
Status: in_force

41-2210. Required provision in group and blanket policies. (1) Any group disability insurance contract or blanket disability insurance contract, delivered or issued for delivery in this state which provides coverage for injury or sickness for newborn dependent children of subscribers or other members of the covered group, shall provide coverage for such newborn children, including adopted newborn children that are placed with the adoptive subscriber or other member of the covered group within sixty (60) days of the adopted child's date of birth, from and after the moment of birth. Coverage under the contract for an adopted newborn child placed with the adoptive subscriber or other member of the covered group more than sixty (60) days after the birth of the adopted child shall be from and after the date the child is so placed. Coverage provided in accord with this section shall include, but not be limited to, coverage for congenital anomalies. For the purposes of this section, "child" means an individual who has not attained age eighteen (18) years as of the date of the adoption or placement for adoption. For the purposes of this section, "placed" shall mean physical placement in the care of the adoptive subscriber or other member of the covered group, or in those circumstances in which such physical placement is prevented due to the medical needs of the child requiring placement in a medical facility, it shall mean when the adoptive subscriber or other member of the covered group signs an agreement for adoption of such child and signs an agreement assuming financial responsibility for such child. Prior to legal finalization of adoption, the coverage required under the provisions of this subsection (1) as to a child placed for adoption with a subscriber or other member of the covered group continues in the same manner as it would with respect to a naturally born child of the subscriber or other member of the covered group until the first to occur of the following events:

(a) Date the child is removed permanently from that placement and the legal obligation terminates; or

(b) The date the subscriber or other member of the covered group rescinds, in writing, the agreement of adoption or agreement assuming financial responsibility.

(2) An insurer shall not restrict coverage under a group disability insurance contract or a blanket disability insurance contract of any dependent child adopted by a participant or beneficiary, or placed with a participant or beneficiary for adoption, solely on the basis of a preexisting condition of a child at the time the child would otherwise become eligible for coverage under the plan, if the adoption or placement for adoption occurs while the participant or beneficiary is eligible for coverage under the plan.

(3) Any new or renewing group disability insurance contract or blanket disability insurance contract delivered or issued for delivery in this state shall provide that an unmarried child under the age of twenty-five (25) years and who receives more than one-half (1/2) of his financial support from the parent shall be permitted to remain on the parent's or parents' contract. Further, any unmarried child of any age who is medically certified as disabled and financially dependent upon the parent is permitted to remain on the parent's or parents' contract.

(4) No policy of disability insurance which provides maternity benefits for a person covered continuously from conception shall be issued, amended, delivered, or renewed in this state on or after January 1, 1977, if it contains any exclusion, reduction, or other limitations as to coverage, deductibles, or coinsurance provisions, as to involuntary complications of pregnancy, unless such provisions apply generally to all benefits paid under the policy. If a fixed amount is specified in such policy for surgery, the fixed amounts for surgical procedures involving involuntary complications of pregnancy shall be commensurate with other fixed amounts payable for procedures of comparable difficulty and severity. In a case where a fixed amount is payable for maternity benefits, involuntary complications of pregnancy shall be deemed an illness and entitled to benefits otherwise provided by the policy. Where the policy contains a maternity deductible, the maternity deductible shall apply only to expenses resulting from normal delivery and cesarean section delivery; however, expenses for cesarean section delivery in excess of the deductible shall be treated as expenses for any other illness under the policy. This section shall apply to all disability policies except any group disability policy made subject to an applicable collective-bargaining agreement in effect before January 1, 1977.

For purposes of this section, involuntary complications of pregnancy shall include, but not be limited to, puerperal infection, eclampsia, cesarean section delivery, ectopic pregnancy, and toxemia.

All policies subject to this section and issued, amended, delivered, or renewed in this state on or after January 1, 1977, shall be construed to be in compliance with this section, and any provision in any such policy which is in conflict with this section shall be of no force or effect.

(5) From and after January 1, 1998, no policy of disability insurance which provides medical expense maternity benefits, shall restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child in a manner that would be in conflict with the newborns' and mothers' health protection act of 1996.

History:

[41-2210, as added by 1974, ch. 66, sec. 3, p. 1146; am. 1976, ch. 113, sec. 2, p. 444; am. 1993, ch. 305, sec. 2, p. 1130; am. 1994, ch. 365, sec. 4, p. 1151; am. 1997, ch. 321, sec. 2, p. 950; am. 2008, ch. 296, sec. 1, p. 825; am. 2009, ch. 125, sec. 2, p. 392.]
Idaho Code § 41-1039A — Idaho Code / Title 41 / Chapter 10 / Section 41-1039A
41-1039A NOTICE.
Status: in_force

41-1039A. notice. In the event that the director revokes or suspends a bail agent's license or a surety's certificate of authority, or lifts such revocation or suspension, the director shall immediately notify all judicial district trial court administrators and all sureties with whom the agent is appointed of the effective date of such revocation or suspension or of the lifting of such revocation or suspension.

History:

[41-1039A, added 2010, ch. 86, sec. 4, p. 167.]
Idaho Code § 41-1026 — Idaho Code / Title 41 / Chapter 10 / Section 41-1026
41-1026 PROCEDURE FOLLOWING SUSPENSION, REVOCATION, DENIAL — REINSTATEMENT.
Status: in_force

41-1026. Procedure following suspension, revocation, denial — Reinstatement. (1) Upon suspension, revocation, or refusal to continue any license, the director shall notify the licensee as provided in section 41-212(3), Idaho Code, and, in the case of a producer who holds appointments from insurers, shall give like notice to the insurers represented.

(2) Suspension, revocation, or refusal of any one (1) license held by the licensee under title 41, Idaho Code, shall automatically suspend, revoke or refuse continuation of all other licenses held by the licensee under title 41, Idaho Code.

(3) The director shall not issue a license under title 41, Idaho Code, to or as to any person whose license has been revoked or continuance refused until after the expiration of not less than one (1) year, to a maximum of five (5) years, from the date of such revocation or refusal, which time period shall be set forth in the final order, or, if judicial review of such revocation or refusal is sought, not less than one (1) year, to a maximum of five (5) years, from the date of a final court order or decree affirming the revocation or refusal. If no time period is specified in the final order or final court order or decree, the time period shall be one (1) year. In the event the former licensee again files an application for a license under title 41, Idaho Code, the director may require the applicant to show good cause why the prior revocation or refusal to continue his license shall not be deemed a bar to the issuance of a new license.

(4) The director shall not issue a license under title 41, Idaho Code, to any person whose application for a license was previously denied until after the expiration of one (1) year from the date of such license denial or, if judicial review of such license denial is sought, one (1) year from the date of a final court order or decree affirming the license denial.

History:

[41-1026, added 2001, ch. 296, sec. 3, p. 1061; am. 2016, ch. 50, sec. 2, p. 146.]
Idaho Code § 41-2613 — Idaho Code / Title 41 / Chapter 26 / Section 41-2613
41-2613 SURETY COMPANIES AUTHORIZED TO BECOME SURETY UNDER ARREST BOND CERTIFICATE — CERTIFICATE AS CASH BAIL.
Status: in_force

41-2613. Surety companies authorized to become surety under arrest bond certificate — Certificate as cash bail. (A) Right of qualified surety company to become surety with respect to guaranteed arrest bond certificates.

(1) Any domestic or foreign surety company which has qualified to transact surety business in this state by complying with the provisions of title 41, Idaho Code, may, in any year, become surety in an amount not to exceed two hundred ($200) dollars with respect to any guaranteed arrest bond certificates issued in such year by an automobile club or association by filing with the department of insurance of this state an undertaking thus to become surety.

(2) Such undertaking shall be in form to be prescribed by the director of the department of insurance and shall state the following:

(a) The name and address of the automobile club or clubs or automobile association or associations with respect to the guaranteed arrest bond certificates of which the surety company undertakes to be surety.

(b) The unqualified obligation of the surety company to pay the fine or forfeiture in an amount not to exceed two hundred ($200) dollars of any person who, after posting a guaranteed arrest bond certificate with respect to which the surety company has undertaken to be surety, fails to make the appearance to guarantee which the guaranteed arrest bond certificate was posted.

(3) The term "guaranteed arrest bond certificate," as used herein, means any printed card or other certificate issued by an automobile club or association to any of its members, which said card or certificate is signed by such member and contains a printed statement that such automobile club or association and a surety company guarantee the appearance of the person whose signature appears on the card or certificate and that they will, in the event of failure of said person to appear in court at the time of trial, pay any fine or forfeiture imposed on such person in an amount not to exceed two hundred ($200) dollars.

(B) Guaranteed arrest bond certificates as cash bail. Any guaranteed arrest bond certificate with respect to which a surety company has become surety, as provided in section (A) hereof shall, when posted by the person whose signature appears thereon, be accepted in lieu of cash bail in an amount not to exceed two hundred ($200) dollars, as a bail bond, to guarantee the appearance of such person in any court, including municipal courts, in this state, at such time as may be required by the court, when such person is arrested for violation of any motor vehicle law of this state or ordinance of any municipality in this state (except for the offense of driving while intoxicated or for any felony) committed prior to the date of expiration shown on such guaranteed arrest bond certificates; provided, that any such guaranteed arrest bond certificate so posted as a bail bond in any court in this state shall be subject to the forfeiture and enforcement provisions with respect to bail bonds posted in criminal cases under the law as it now exists or may hereafter be amended, and that any such guaranteed arrest bond certificate posted as a bail bond in any municipal court in this state shall be subject to the forfeiture and enforcement provisions of the charter or ordinance of the particular municipality pertaining to bail bonds posted.

History:

[I.C., sec. 41-2613, as added by 1963, ch. 36, sec. 1, p. 183.]
Idaho Code § 41-916 — Idaho Code / Title 41 / Chapter 9 / Section 41-916
41-916 REPORTING OF ACTIONS.
Status: in_force

41-916. reporting of actions. (1) An administrator shall report to the director any administrative action taken against the administrator in another jurisdiction or by another governmental agency within thirty (30) days of the final disposition of the matter. The report shall include a copy of the order, consent order or other relevant legal documents.

(2) Within thirty (30) days of the initial pretrial hearing date, an administrator shall report to the director any criminal prosecution of the administrator or an individual responsible for the conduct of its affairs taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing and any other relevant legal documents.

History:

[41-916, added 2010, ch. 31, sec. 2, p. 59.]
Idaho Code § 41-4313 — Idaho Code / Title 41 / Chapter 43 / Section 41-4313
41-4313 CREDITS FOR ASSESSMENTS PAID.
Status: in_force

41-4313. credits for assessments paid. (1) A member insurer may offset against its premium tax liability to this state an assessment described in section 41-4309(8), Idaho Code, to the extent of twenty percent (20%) of the amount of the assessment for each of five (5) calendar years beginning with the premium tax due under section 41-402(4), Idaho Code, with respect to the year of payment of the assessment and thereafter with the premium tax due under section 41-402(4), Idaho Code, during each of the four (4) succeeding years. An allowable offset, or portion thereof, not used in any calendar year cannot be carried over or back to any other year.

(2) Any sums acquired by refund, pursuant to section 41-4309(6), Idaho Code, from the association which have theretofore been written off by contributing insurers and offset against premium taxes as provided in subsection (1) of this section, and are not then needed for purposes of this chapter, shall be paid by the association to the director and by him deposited with the state treasurer for credit to the general account of the state operating fund.

History:

[41-4313, added 2011, ch. 196, sec. 2, p. 575; am. 2013, ch. 265, sec. 2, p. 650.]
Idaho Code § 41-2873 — Idaho Code / Title 41 / Chapter 28 / Section 41-2873
41-2873 BEST PRICE — MOST FAVORED NATIONS CLAUSE PROHIBITED.
Status: in_force

41-2873. Best price — Most favored nations clause prohibited. (1) No stock or mutual insurance company (hereafter, insurance company) may require, as an element of any health care provider participation contract, that any provider agree:

(a) To the unnegotiated adjustment by the insurance company of the provider's contractual reimbursement rate to equal the lowest reimbursement rate the provider has agreed to charge any other payor;

(b) To a requirement that the provider adjust, or enter into negotiations to adjust, his or her charges to the insurance company if the provider agrees to charge another payor lower rates; or

(c) To a requirement that the provider disclose his or her contractual reimbursement rates from other payors.

(2) For the purposes of this section, "provider" means any physician, hospital, or other person licensed or otherwise authorized to furnish health care services in Idaho.

History:

[41-2873, added 1998, ch. 422, sec. 2, p. 1334.]
Idaho Code § 41-4017 — Idaho Code / Title 41 / Chapter 40 / Section 41-4017
41-4017 RECOVERY OF DEPLETED FUNDS.
Status: in_force

41-4017. Recovery of depleted funds. If after notice and the opportunity for a hearing the director finds that any self-funded plan trust fund has been depleted by reason of any wrongful or negligent act or omission of a trustee or any other person, he shall transmit a copy of his findings to the attorney general of this state, who may bring an action in the name of the people of this state, or intervene in any action brought by or on behalf of an employer or beneficiary, for the recovery of the amount of such depletion, for the benefit of the trust fund, and to impose any sanctions as authorized by law.

History:

[41-4017, added 1974, ch. 248, sec. 17, p. 1624; am. 2013, ch. 181, sec. 16, p. 431.]
Idaho Code § 41-3107 — Idaho Code / Title 41 / Chapter 31 / Section 41-3107
41-3107 REINSURANCE.
Status: in_force

41-3107. Reinsurance. A county mutual fire insurer may cede reinsurance to another county mutual fire insurer or to any insurer authorized in this state to transact the kind of insurance involved or approved by the director. A county mutual fire insurer shall accept reinsurance only from another county mutual fire insurer.

History:

[41-3107, added 1961, ch. 330, sec. 665, p. 645.]
Idaho Code § 41-2209 — Idaho Code / Title 41 / Chapter 22 / Section 41-2209
41-2209 PAYMENT OF BENEFITS UNDER BLANKET POLICY.
Status: in_force

41-2209. Payment of benefits under blanket policy. All benefits under any blanket disability policy shall be payable to the person insured, or to his designated beneficiary or beneficiaries, or to his estate; except, that if the person insured be a minor or mental incompetent, such benefits may be made payable to his parent, guardian, or other person actually supporting him; or if the entire cost of the insurance has been borne by the employer such benefits may be made payable to the employer. Provided, however, that the policy may provide that all or any portion of any indemnities provided by such policy on account of hospital, nursing, medical or surgical services may, at the insurer's option, be paid directly to the hospital or person rendering such services; but the policy may not require that the service be rendered by a particular hospital or person. Payment so made shall discharge the insurer's obligation with respect to the amount of insurance so paid.

History:

[41-2209, added 1961, ch. 330, sec. 535, p. 645.]
Idaho Code § 41-2906 — Idaho Code / Title 41 / Chapter 29 / Section 41-2906
41-2906 SURPLUS FUNDS REQUIRED.
Status: in_force

41-2906. Surplus funds required. (1) A domestic reciprocal insurer is governed, as to surplus required to be maintained, by section 41-313 or 41-313A, Idaho Code.

(2) A domestic reciprocal insurer may be authorized to transact additional kinds of insurance if it has otherwise complied with the provisions of this code therefor and possesses and maintains surplus funds as to such additional kinds of insurance as provided in section 41-313, Idaho Code.

(3) A domestic reciprocal insurer holding a valid certificate of authority to transact insurance in this state immediately prior to January 1, 1995, shall have a period of two (2) years from and after January 1, 1995, within which to comply with any increase in surplus requirements.

History:

[41-2906, added 1961, ch. 330, sec. 633, p. 645; am. 1969, ch. 214, sec. 69, p. 625; am. 1979, ch. 318, sec. 2, p. 855; am. 1995, ch. 96, sec. 5, p. 276.]
Idaho Code § 41-296 — Idaho Code / Title 41 / Chapter 2 / Section 41-296
41-296 CONFIDENTIALITY — COMPULSORY TESTIMONY.
Status: in_force

41-296. Confidentiality — Compulsory testimony. (1) The department of insurance, state fire marshal or authorized agency described in section 41-291, Idaho Code, which has received any information furnished pursuant to section 41-258, 41-290 or 41-292, Idaho Code, shall hold the information and the information shall be subject to disclosure according to chapter 1, title 74, Idaho Code.

(2) Any authorized agency referred to in section 41-291, Idaho Code, or their personnel, may be required to testify in any litigation in which the insurance company at interest is named as a party, if such testimony is not otherwise privileged by law.

History:

[41-296, added 1982, ch. 120, sec. 19, p. 346; am. 1990, ch. 213, sec. 53, p. 523; am. and redesig. 1994, ch. 219, sec. 8, p. 701; am. 2015, ch. 141, sec. 107, p. 456.]
Idaho Code § 41-4916 — Idaho Code / Title 41 / Chapter 49 / Section 41-4916
41-4916 ENROLLED SUBSCRIBERS' LIABILITY ON JUDGMENT.
Status: in_force

41-4916. Enrolled subscribers' liability on judgment. (1) No action shall lie against any owner or operator of a tank insured by the Idaho petroleum clean water trust fund upon any obligation claimed against this trust fund until a final judgment has been obtained against this trust fund and remains unsatisfied for thirty (30) days.

(2) Any such judgment shall be binding upon each owner or operator only in such proportion as his interests may appear and in an amount not exceeding his contingent liability, if any, in excess of the amount of insurance provided by the trust fund.

History:

[(41-4916) 41-4915, added 1990, ch. 119, sec. 1, p. 278; am. 1991, ch. 59, sec. 11, p. 128; am. & redesig. 2003, ch. 96, sec. 18, p. 297.]
Idaho Code § 41-2507 — Idaho Code / Title 41 / Chapter 25 / Section 41-2507
41-2507 CANCELLATION OF POLICIES — GROUNDS.
Status: in_force

41-2507. Cancellation of policies — Grounds. No notice of cancellation of a policy shall be effective and the insurer shall not refuse renewal of a policy, unless based on one (1) or more of the following reasons:

(1) Nonpayment of premium; or

(2) The policy was obtained through a material misrepresentation; or

(3) Any insured violated any of the terms and conditions of the policy; or

(4) The named insured failed to disclose fully his motor vehicle accidents and moving traffic violations, or his losses covered under any automobile physical damage or comprehensive coverage, for the preceding thirty-six (36) months if called for in the application; or

(5) As to renewal of the policy, if the insured at any time while the policy was in force failed to disclose fully to the insurer, upon request therefor, facts relative to accidents and losses incurred material to underwriting of the risk; or

(6) Any insured made a false or fraudulent claim or knowingly aided or abetted another in the presentation of such a claim; or

(7) The named insured or any other operator who either resides in the same household or customarily operates an automobile insured under such policy:

(a) Has, within the thirty-six (36) months prior to the notice of cancellation or nonrenewal, had his driver's license under suspension or revocation; or

(b) Has a history of and is subject to epilepsy or heart attacks and such individual cannot produce a certificate from a physician testifying to his unqualified ability to operate a motor vehicle safely; or

(c) Has an accident record, conviction record, either criminal or traffic, physical, mental or other condition which is such that his operation of an automobile might endanger the public safety; or

(d) Has, while the policy is in force, engaged in a prearranged competitive speed contest while operating or riding in an automobile insured under the policy; or

(e) Has, within the thirty-six (36) months prior to the notice of cancellation or nonrenewal, been addicted to the use of narcotics or other drugs; or

(f) Uses alcoholic beverages to excess; or

(g) Has been convicted, or forfeited bail, during the thirty-six (36) months immediately preceding the notice of cancellation or nonrenewal; for

(i) Any felony; or

(ii) Criminal negligence resulting in death, homicide or assault arising out of the operation of a motor vehicle; or

(iii) Operating a motor vehicle while in an intoxicated condition or while under the influence of drugs; or

(iv) Leaving the scene of an accident without stopping to report; or

(v) Theft or unlawful taking of a motor vehicle; or

(vi) Making fraudulent statements in an application for a driver's license; or

(h) Has been convicted of, has had a judgment entered against, or forfeited bail for, three (3) or more violations within the thirty-six (36) months immediately preceding the notice of cancellation or nonrenewal of any law, ordinance or regulation of any state for which a violation point is assessed by the Idaho transportation department under the provisions of section 49-326, Idaho Code, whether or not the violations were repetitions of the same offense or different offenses; or

(8) The insured automobile is:

(a) So mechanically defective that its operation might endanger public safety; or

(b) Used in carrying passengers for hire or compensation, except that the use of an automobile for a carpool shall not be considered use of an automobile for hire or compensation; or

(c) Used in the business of transportation of flammables or explosives; or

(d) An authorized emergency vehicle; or

(e) Modified or changed in condition during the policy period so as to increase the risk substantially; or

(f) Subject to an inspection law and has not been inspected or, if inspected, has failed to qualify; or

(9) As to the renewal of the policy only, the insured automobile is registered in a jurisdiction other than Idaho.

History:

[41-2507, added 1969, ch. 214, sec. 60, p. 625; am. 1992, ch. 250, sec. 1, p. 734; am. 2013, ch. 56, sec. 1, p. 130.]
Idaho Code § 41-106 — Idaho Code / Title 41 / Chapter 1 / Section 41-106
41-106 “DOMESTIC,” “FOREIGN,” “ALIEN” INSURER DEFINED.
Status: in_force

41-106. "Domestic," "foreign," "alien" insurer defined. (1) A "domestic" insurer is one formed under the laws of this state or an insurer which has transferred its domicile pursuant to section 41-342, Idaho Code, to this state.

(2) A "foreign" insurer is one formed under the laws of a jurisdiction other than this state.

(3) An "alien" insurer is one formed under the laws of any country other than the United States of America, its states, districts, territories, and commonwealths.

(4) Except where distinguished by context, "foreign" insurers includes also "alien" insurers.

History:

[41-106, added 1961, ch. 330, sec. 6, p. 645; am. 1987, ch. 302, sec. 4, p. 643.]
Idaho Code § 41-2138 — Idaho Code / Title 41 / Chapter 21 / Section 41-2138
41-2138 HEALTH INSURANCE — TEN-DAY FREE EXAMINATION.
Status: in_force

41-2138. Health insurance — Ten-day free examination. (1) Except as to nonrenewable accident policies and individual credit health insurance policies, every individual health insurance policy shall contain a provision therein or in a separate rider attached thereto when delivered, stating in substance that the person to whom the policy is issued shall be permitted to return the policy within ten (10) days of its delivery to such person and to have a refund of the premium paid if after examination of the policy the purchaser is not satisfied with it for any reason. The provision shall be set forth in the policy under appropriate caption, and if not so printed on the face page of the policy adequate notice of the provision shall be printed or stamped conspicuously on the face page.

(2) The policy may be so returned to the insurer at its home or branch office or to the agent through whom it was applied for, and thereupon shall be void as from the beginning and as if the policy had not been issued.

History:

[I.C., sec. 41-2138, as added by 1969, ch. 214, sec. 58, p. 625.]
Idaho Code § 41-4924 — Idaho Code / Title 41 / Chapter 49 / Section 41-4924
41-4924 QUALIFICATIONS FOR REGISTRATION.
Status: in_force

41-4924. Qualifications for registration. The director shall not register the trust fund if it is not qualified therefor. To be qualified, the trust fund:

(1) Shall require all application fees to be paid in advance and to be deposited in and disbursed from the trust fund duly created under this chapter.

(2) Shall have, or provide for, a trustworthy and responsible administrator for competent administration of the trust fund and plan.

(3) Shall provide that the administrator furnish to each insured owner or operator a contract of insurance adequately and clearly stating all rights and obligations of the insured owner or operator, together with all applicable restrictions, limitations and exclusions, and the procedure for filing a claim.

(4) Shall be actuarially sound; that is, assets, income and other financial resources of the trust fund must be adequate under reasonable estimates for payment of all claims, claims adjustment expenses, taxes, expenses and other obligations.

(5) Shall otherwise be in compliance with the provisions of this chapter.

History:

[(41-4924) 41-4923, added 1990, ch. 119, sec. 1, p. 279; am. 1991, ch. 59, sec. 16, p. 129; am. & redesig. 2003, ch. 96, sec. 26, p. 299.]
Idaho Code § 41-1503 — Idaho Code / Title 41 / Chapter 15 / Section 41-1503
41-1503 LICENSURE.
Status: in_force

41-1503. Licensure. (1) No person, firm, association or corporation shall act in the capacity of a MGA with respect to risks located in this state for an insurer licensed in this state unless such person is a licensed agent in this state pursuant to the provisions of chapter 10, title 41, Idaho Code.

(2) No person, firm, association or corporation shall act in the capacity of a MGA representing an insurer domiciled in this state with respect to risks located outside this state unless such person is licensed as an agent in this state pursuant to the provisions of chapter 10, title 41, Idaho Code.

(3) Every MGA as defined in section 41-1502(3), Idaho Code, shall be required to be bonded. The bond shall be in favor of the state to be held in trust for the benefit and protection of insureds and insurers whose money the MGA handles. The amount of the bond shall not be less than ten per cent (10%) of the amount of total funds handled, except that in no case shall such bond be less than five thousand dollars ($5,000). For purposes of fixing the amount of such bond, the amount of funds handled shall be determined by the total funds handled by the MGA in the preceding year, or if no funds were handled during the preceding year, the amount of funds reasonably estimated to be handled during the current calendar year by the MGA. Only one (1) such bond shall be required of the MGA for all insurers which utilize the services of the MGA, unless provided otherwise in the written agreement between the insurer and the MGA or otherwise required by the director.

(4) The director may require the MGA to maintain an errors and omissions policy.

History:

[41-1503, added 1991, ch. 293, sec. 1, p. 755.]
Idaho Code § 41-1205 — Idaho Code / Title 41 / Chapter 12 / Section 41-1205
41-1205 PURPOSE OF PROCESS ACT.
Status: in_force

41-1205. Purpose of process act. The purpose of the unauthorized insurers process act is to subject certain insurers to the jurisdiction of courts of this state in suits by or on behalf of insureds or beneficiaries under insurance contracts.

The legislature declares that it is a subject of concern that many residents of this state hold policies of insurance issued or delivered in this state by insurers while not authorized to do business in this state, thus presenting to such residents the often insuperable obstacle of resorting to distant forums for the purpose of asserting legal rights under such policies. In furtherance of such state interest, the legislature herein provides a method of substituted service of process upon such insurers and declares that in so doing it exercises its power to protect its residents and to define, for the purpose of this statute, what constitutes doing business in this state, and also exercises powers and privileges available to the state by virtue of Public Law 15, 79th Congress of the United States, chapter 20, 1st session, S. 340, which declares that the business of insurance and every person engaged therein shall be subject to the laws of the several states.

History:

[41-1205, added 1961, ch. 330, sec. 249, p. 645.]
Idaho Code § 41-1314 — Idaho Code / Title 41 / Chapter 13 / Section 41-1314
41-1314 REBATES — ILLEGAL INDUCEMENTS.
Status: in_force

41-1314. Rebates — Illegal inducements. (1) Except as otherwise expressly provided by law, no person shall knowingly make, permit to be made, or offer to make any contract of insurance, or of annuity, or agreement as to such contract, other than as plainly expressed in the contract issued thereon, or pay or allow, or give or offer to pay, allow, or give, directly or indirectly, as inducement to such insurance or annuity or in connection therewith, any rebate of premiums payable on the contract, or of any producer's commission related thereto, or any special favor or advantage in the dividends or other benefits thereon, or any paid employment or contract for services of any kind, or any valuable consideration or inducement whatever not specified in the contract; or directly or indirectly give, or sell, or purchase or offer or agree to give, sell, purchase, or allow as inducement to such insurance or annuity or in connection therewith, and whether or not specified or to be specified in the policy or contract, any agreement of any form or nature promising returns and profits, or any stocks, bonds, or other securities, or interest present or contingent therein or as measured thereby, of any insurer or other person, or any dividends or profits accrued or to accrue thereon; or offer, promise or give anything of value whatsoever not specified in the contract. Nor shall any insured, annuitant, or policyholder or employee thereof, or prospective insured, annuitant or policyholder, or employee thereof, knowingly accept or receive, directly or indirectly, any such prohibited contract, agreement, rebate, advantage, employment, or other inducement.

(2) Nothing in this section shall be construed as prohibiting the payment of commissions or other compensation to duly licensed producers, or as prohibiting any insurer from allowing or returning to its participating policyholders, members or subscribers, the usual and ordinary dividends, savings, or unabsorbed premium deposits.

(3) Nothing in this section shall be construed as prohibiting a life insurer, disability insurer, property insurer or casualty insurer, or producers who are marketing life insurance, disability insurance, property insurance or casualty insurance, from providing to a policyholder or prospective policyholder of life, disability, property or casualty insurance, any prizes, goods, wares, merchandise, articles or property of an aggregate value not to exceed two hundred dollars ($200) in a calendar year.

(4) Extension of credit for the payment of premium beyond the customary premium payment period without charging and collecting interest at a reasonable rate per annum on the amount of credit so extended and for the duration of such credit is prohibited under this section.

History:

[41-1314, added 1961, ch. 330, sec. 292, p. 645; am. 1969, ch. 214, sec. 46, p. 625; am. 2006, ch. 212, sec. 1, p. 643; am. 2011, ch. 259, sec. 1, p. 704.]
Idaho Code § 41-2914 — Idaho Code / Title 41 / Chapter 29 / Section 41-2914
41-2914 ACTION ON BOND.
Status: in_force

41-2914. Action on bond. Action on the attorney's bond or to recover against any such deposit made in lieu thereof may be brought at any time by one or more subscribers suffering loss through a violation of its conditions, or by a receiver or liquidator of the insurer. Amounts recovered on the bond shall be deposited in and become part of the insurer's funds. The total aggregate liability of the surety shall be limited to the amount of the penalty of such bond.

History:

[41-2914, added 1961, ch. 330, sec. 641, p. 645.]
Idaho Code § 41-3901 — Idaho Code / Title 41 / Chapter 39 / Section 41-3901
41-3901 SHORT TITLE.
Status: in_force

41-3901. Short title. This chapter may be cited as the Idaho "Managed Care Reform Act."

History:

[41-3901, added 1974, ch. 177, sec. 1, p. 1444; am. 1997, ch. 204, sec. 2, p. 582.]
Idaho Code § 41-1106 — Idaho Code / Title 41 / Chapter 11 / Section 41-1106
41-1106 SCOPE OF LICENSE.
Status: in_force

41-1106. Scope of license. Under his license an adjuster shall have authority to act as adjuster on behalf of the insurer only as to losses under insurance contracts.

History:

[41-1106, added 1961, ch. 330, sec. 242, p. 645.]
Idaho Code § 41-4116 — Idaho Code / Title 41 / Chapter 41 / Section 41-4116
41-4116 POLITICAL CONTRIBUTIONS PROHIBITED.
Status: in_force

41-4116. Political contributions prohibited. No board shall make or knowingly permit the making, directly or indirectly, of any political contribution by or from any joint public agency self-funded plan trust fund.

History:

[41-4116, added 2006, ch. 415, sec. 1, p. 1278.]
Idaho Code § 41-1934 — Idaho Code / Title 41 / Chapter 19 / Section 41-1934
41-1934 PROHIBITED POLICY PLANS.
Status: in_force

41-1934. Prohibited policy plans. (1) No life insurer shall hereafter deliver or issue for delivery in this state:

(a) As part of or in combination with any life insurance, endowment or annuity contract, any agreement or plan, additional to the rights, dividends, and benefits arising out of any such contract, which provides for the accumulation of profits over a period of years and for payment of all or any part of such accumulated profits only to members or policyholders of a designated group or class who continue as members or policyholders until the end of a specified or ascertainable period of years.

(b) Any individual life insurance policy which provides that on the death of anyone other than a beneficiary or a person insured thereunder, the owner or beneficiary of the policy shall receive the payment or granting of anything of value.

(c) Any "registered" policy; that is, any policy purporting to be "registered" or otherwise specially recorded, with any agency of the state of Idaho, or of any other state or with any bank, trust company, escrow company, or other institution other than the insurer; or purporting that any reserves, assets or deposits are held, or will be so held, for the special benefit or protection of the holder of such policy, by or through any such agency or institution.

(d) Any policy or contract under which any part of the premium or of funds or values arising from the policy or contract or from investment of reserves, or from mortality savings, lapses or surrenders, in excess of the normal reserves or amounts required to pay death, endowment, and nonforfeiture benefits in respective amounts as specified in or pursuant to the policy or contract, are on a basis not involving insurance or life contingency features, (i) to be placed in special funds or segregated accounts or specially designated places or (ii) to be invested in specially designated investments or types thereof, and the funds or earnings thereon to be divided among the holders of such policies or contracts, or their beneficiaries or assignees. This subdivision (d) does not apply as to variable life insurance or variable annuity contracts issued under section 41-1936, Idaho Code.

(e) Any profit sharing, charter, coupon or founders policy.

(f) For the purposes of subdivision (e) above, a "profit sharing" policy is:

(i) A life insurance policy which by its terms expressly provides that the policyholder will participate in the distribution of earnings or surplus other than earnings or surplus attributable, by reasonable and nondiscriminatory standards, to the participating policies of the insurer and allocated to the policyholder on reasonable and nondiscriminatory standards; or

(ii) A life insurance policy the provisions of which, through sales material or oral presentations, are interpreted by the insurer to prospective policyholders as entitling the policyholder to the benefits described in paragraph (i) of this subdivision (f).

(g) For the purposes of subdivision (e) above a "charter" or "founders" policy is:

(i) A life insurance policy which by its terms expressly provides that the policyholder will receive some preferential or discriminatory advantage or benefit not available to persons who purchase insurance from the insurer at future dates or under other circumstances; or

(ii) A life insurance policy the provisions of which, through sales material or oral presentations, are interpreted by the insurer to prospective policyholders as entitling the policyholders to the benefits described in subdivision (g)(i) of this section.

(h) For the purposes of subdivision (e) above, a "coupon" policy means a life insurance policy which provides a series of pure endowments maturing periodically in amounts not exceeding the gross annual policy premiums. The term "pure endowment" or "endowment" is used in its accepted actuarial sense, meaning a benefit becoming payable at a specific future date if the insured person is then living.

(2) This section shall not be deemed to prohibit the provision, payment, allowance or apportionment of regular annual dividends or "savings" under regular participating forms of policies or contracts.

History:

[41-1934, added 1961, ch. 330, sec. 465, p. 645; am. 1969, ch. 214, sec. 50, p. 625; am. 1972, ch. 369, sec. 10, p. 1072.]
Idaho Code § 41-1823 — Idaho Code / Title 41 / Chapter 18 / Section 41-1823
41-1823 BINDERS.
Status: in_force

41-1823. Binders. (1) Binders or other contracts for temporary insurance may be made orally or in writing and shall be deemed to include all the usual terms of the policy as to which the binder was given together with such supplemental information and applicable endorsements as are designated in the binder, except as superseded by the clear and express terms of the binder.

(2) No binder shall be valid beyond the issuance of the policy, or the endorsement, or the policy expiration, whichever is shortest, with respect to which it was given.

(3) This section shall not apply to life or disability insurances.

History:

[41-1823, added 1961, ch. 330, sec. 415, p. 645; am. 2012, ch. 314, sec. 2, p. 865.]
Idaho Code § 41-210 — Idaho Code / Title 41 / Chapter 2 / Section 41-210
41-210 GENERAL POWERS, DUTIES.
Status: in_force

41-210. General powers, duties. (1) The director shall enforce the provisions of this code, and shall execute the duties imposed upon him by this code.

(2) The director shall have the powers and authority expressly conferred upon him by or reasonably implied from the provisions of this code.

(3) The director may conduct such examinations and investigations of insurance matters, in addition to examinations and investigations expressly authorized, as he may deem proper to determine whether any person has violated any provision of this code or to secure information useful in the lawful administration of any such provision. The cost of such additional examinations and investigations shall be borne by the state.

(4) For any document required to be filed with the director or the department of insurance under the laws of this state, the director may specify the place and manner of filing of the document, including whether an electronic or paper filing is required or acceptable.

(5) The director shall have such additional powers and duties as may be provided by other laws of this state.

History:

[41-210, added 1961, ch. 330, sec. 27, p. 645; am. 2004, ch. 238, sec. 1, p. 701.]
Idaho Code § 41-1615 — Idaho Code / Title 41 / Chapter 16 / Section 41-1615
41-1615 RATING ORGANIZATION MEMBERSHIP REQUIRED.
Status: in_force

41-1615. Rating organization membership required. Every insurer, including the Idaho state insurance fund, writing workmen's compensation insurance in this state shall be a member of a workmen's compensation rating organization. No insurer may at the same time belong to more than one rating organization with respect to such insurance.

History:

[41-1615, added 1961, ch. 330, sec. 376, p. 645.]
Idaho Code § 41-1087 — Idaho Code / Title 41 / Chapter 10 / Section 41-1087
41-1087 SUSPENSION OR REVOCATION OF LICENSE.
Status: in_force

41-1087. SUSPENSION OR REVOCATION OF LICENSE. If a vendor of portable electronics or its employee or authorized representative violates any applicable provision of this chapter including, but not limited to, section 41-1016, Idaho Code, or applicable provisions of chapter 13, title 41, Idaho Code, or an applicable rule, the director may:

(1) Impose an administrative penalty pursuant to section 41-117, Idaho Code. However, penalties arising from the same or similar conduct shall not exceed fifty thousand dollars ($50,000) in the aggregate; and

(2) Impose other penalties that the director deems necessary and reasonable, including:

(a) Prohibiting such vendor from transacting portable electronics insurance pursuant to the provisions of this section at specific business locations where violations have occurred or from using specific employees or representatives in the transaction of portable electronics insurance; and

(b) Suspending, revoking or refusing to renew the license of such vendor.

History:

[41-1087, added 2012, ch. 226, sec. 9, p. 624.]
Idaho Code § 41-4906 — Idaho Code / Title 41 / Chapter 49 / Section 41-4906
41-4906 LIMITS OF LIABILITY FOR CONTRACTS OF INSURANCE ISSUED BY THE ADMINISTRATOR.
Status: in_force

41-4906. Limits of liability for contracts of insurance issued by the administrator. (1) Contracts of insurance issued by the administrator shall contain the following per occurrence and annual aggregate limits of liability for paying the costs of corrective action and compensating third parties who are legally entitled to receive compensation for bodily injury and property damage arising out of accidental releases from covered petroleum storage tanks:

(a) For owners or operators of heating tanks, farm tanks or residential tanks, no more than one hundred thousand dollars ($100,000) per occurrence and no more than one hundred thousand dollars ($100,000) annual aggregate;

(b) For nonmarketers of petroleum products who are owners or operators of above ground and underground storage tanks and who consume ten thousand (10,000) gallons or less of petroleum products each month, no more than five hundred thousand dollars ($500,000) per occurrence and no more than one million dollars ($1,000,000) annual aggregate;

(c) For owners or operators of one (1) to one hundred (100) covered underground petroleum storage tanks, no more than one million dollars ($1,000,000) per occurrence and no more than one million dollars ($1,000,000) annual aggregate;

(d) For owners or operators of one hundred and one (101) or more covered underground petroleum storage tanks, no more than one million dollars ($1,000,000) per occurrence and no more than two million dollars ($2,000,000) annual aggregate; and

(e) For owners or operators of covered above ground petroleum storage tanks, no more than one million dollars ($1,000,000) per occurrence and no more than one million dollars ($1,000,000) annual aggregate.

(2) Legal defense costs shall be disregarded for purposes of determining whether the limits specified in subsection (1) of this section have been reached.

(3) Benefits provided by the trust fund shall be primary and shall not be construed to be excess over and above any other valid and collectible insurance.

(4) If an owner or operator owns or operates more than one (1) of the types of petroleum storage tanks listed in subsection (1) of this section, then the limit of liability applicable to the type of petroleum storage tank from which the accidental release occurred shall apply. In no event shall any of the limits of liability in subsection (1) of this section be combined to exceed the highest per occurrence and annual aggregate limits of liability for any single category in subsections (1)(a) through (1)(e) of this section applicable to an insured owner or operator.

History:

[(41-4906) 41-4905, added 1990, ch. 119, sec. 1, p. 273; am. 1991, ch. 59, sec. 4, p. 122; am. & redesig. 2003, ch. 96, sec. 5, p. 290.]
Idaho Code § 41-4018 — Idaho Code / Title 41 / Chapter 40 / Section 41-4018
41-4018 TERMINATION OF REGISTRATION.
Status: in_force

41-4018. Termination of registration. (1) The director shall terminate the registration of a self-funded plan upon written request of the trustee, or if he finds, after an inquiry or an examination, that the trust fund is insolvent. For the purposes of this chapter, "insolvent" means the plan is unable to pay its obligations when they are due or that its assets do not exceed its liabilities. As used in this chapter, "assets" means all investments held in the name of the trust as permitted by section 41-4009, Idaho Code.

(2) The director may terminate the registration of a plan for violation of this chapter, or failure of the trustee to timely file with the director the annual statement or actuarial opinion and timely pay the tax required under sections 41-4011 and 41-4012, Idaho Code, or if he finds, after an inquiry or an examination of the trust fund and the plan or notice from the trustee:

(a) That the plan no longer meets the qualifications required by sections 41-4004 and 41-4005, Idaho Code, and that such deficiency will not or cannot be remedied within a reasonable time;

(b) That there is a pattern of benefits promised by the plan that are not being fairly and promptly paid;

(c) That the cost of administering the plan is excessive in relation to the character and volume of service being rendered in the administration;

(d) That the trust fund has been subject to fraudulent, incompetent or dishonest practices on the part of the trustee, administrator, consultant, any participating employer, any postsecondary educational institution, beneficiaries or others; or

(e) That the trust fund does not meet the minimum surplus requirements under this chapter.

(3) The director shall terminate the plan's registration by his written order provided to the trustee last of record with the department and to each employer or postsecondary educational institution last of record with the department. Such order shall state the grounds upon which it is based and its effective date. The order shall be subject to judicial review in the same manner as applies to official orders of the director in general.

History:

[41-4018, added 1974, ch. 248, sec. 18, p. 1624; am. 2006, ch. 414, sec. 15, p. 1267; am. 2013, ch. 181, sec. 17, p. 431.]
Idaho Code § 41-1030 — Idaho Code / Title 41 / Chapter 10 / Section 41-1030
41-1030 PRODUCER COMPENSATION.
Status: in_force

41-1030. Producer compensation. (1) For purposes of this section:

(a) "Consumer" means an insured, a prospective insured or an employer group.

(b) "Retail producer" means a producer who solicits, negotiates with or sells an insurance contract directly to a consumer.

(c) "Wholesale producer" means a producer who solicits, negotiates or sells an insurance contract directly with a retail producer, but not with a consumer.

(2) Notwithstanding any other provision of title 41, Idaho Code, and as provided in this subsection, retail producers and wholesale producers may charge a fee or be compensated by a combination of fees and commissions.

(a) Before charging a fee to a consumer, a retail producer shall provide to the consumer a written statement that describes the services the retail producer will perform and the fees the retail producer will receive. Acceptance by the consumer of a fee arrangement shall be evidenced by the consumer signing and dating the fee statement.

(b) Before charging a fee to a retail producer, a wholesale producer shall provide to the retail producer a written statement that describes the services the wholesale producer will perform and the fees the wholesale producer will receive. Information regarding the amount of the fees charged by the wholesale producer shall be disclosed in writing on the face of the policy as a separately itemized charge.

History:

[41-1030, added 2002, ch. 359, sec. 1, p. 1017.]
Idaho Code § 41-3444 — Idaho Code / Title 41 / Chapter 34 / Section 41-3444
41-3444 CONTRACTS WITH PROVIDERS OF DENTAL SERVICES.
Status: in_force

41-3444. contracts with providers of dental services. (1) No person contracting with dentists to provide coverage or reimbursement for dental services may require, as an element of any dental care provider participation contract, that the provider agree to adopt fees set by the person for dental care services that are not covered services under the contract. "Covered services" as used in this section means dental care services and procedures under the applicable dental plan, dental plan contract, or plan benefits for which payment is available to the covered person or dentist under the covered person's plan or contract or for which payment to the covered person or to the dentist would be available but for the application of contractual limitations on reimbursement, such as deductibles, copayments, coinsurance, and waiting periods. All services or procedures are no longer covered services, and the plan can no longer impose, contractually or otherwise, a fee schedule or other limitation when the following criteria have been met:

(a) When the third-party payer is no longer liable for paying for an individual service or a procedure, in part or in whole, due to calendar-year limitations or benefit-year limitations; and

(b) A patient has received dental services and procedures that equal an additional one hundred percent (100%) of the amount of the patient's capped annual maximum benefit for the calendar year or benefit year.

Once a patient's capped annual maximum benefit amount for a calendar year or benefit year has been exceeded by one hundred percent (100%), a dentist may choose to provide dental services or procedures according to a plan's fee schedule or to provide dental services or procedures at a fee agreed upon with the patient. The dentist must confer with and provide notice to the patient regarding the patient's change in fee status, and any agreed-upon fee shall not exceed the lowest fee available to the dentist's uninsured patients.

(2) A person contracting with dentists must provide one (1) or more methods of payment or reimbursement that:

(a) Provide the dentist one hundred percent (100%) of the contracted amount of the payment or reimbursement; and

(b) Do not require the dentist to incur a fee to access the payment or reimbursement.

(3) A person contracting with dentists may extend the provider network to other entities when:

(a) Full disclosure of the agreement has been provided to the dentist, including any variations in obligations and fee schedule from the original contract; and

(b) The dentist has been provided a timeframe of no less than two (2) weeks to decline participation.

This subsection shall not apply to a person operating in accordance with the same brand licensee program as the contracting person or to a person that is an affiliate, as long as the contractual terms, obligations, and fee schedule remain the same as the original agreement.

(4) Subsections (2) and (3) of this section shall apply to any contract with providers for dental services that is issued after December 31, 2021. Contracts that are in existence on December 31, 2021, shall be brought into compliance on the next anniversary date, renewal date, or the expiration date of the applicable collective bargaining contract, if any, whichever date is latest.

History:

[41-3444, added 2010, ch. 126, sec. 2, p. 272; am. 2019, ch. 153, sec. 2, p. 506; am. 2021, ch. 184, sec. 2, p. 506.]
Idaho Code § 41-1304 — Idaho Code / Title 41 / Chapter 13 / Section 41-1304
41-1304 FALSE INFORMATION AND ADVERTISING WITH RESPECT TO INSURANCE BUSINESS.
Status: in_force

41-1304. False information and advertising with respect to insurance business. No person shall make, publish, disseminate, circulate, or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in a newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station, or in any other way, any advertisement, announcement, or statement containing any assertion, representation or statement with respect to the business of insurance or with respect to any person in the conduct of his insurance business, which is untrue, deceptive or misleading.

History:

[41-1304, added 1961, ch. 330, sec. 282, p. 645.]
Idaho Code § 41-1039 — Idaho Code / Title 41 / Chapter 10 / Section 41-1039
41-1039 LICENSE REQUIRED.
Status: in_force

41-1039. License required. (1) No person shall hold himself out to be a bail agent or sell, solicit, negotiate, advise or consult regarding the terms of bail bond contracts in this state unless that person is licensed as a producer in the line of surety insurance. The director is vested with the exclusive authority to license bail agents and the authority to regulate the solicitation, negotiation and transaction of bail with retail consumers of bail bonds, provided however, that a court retains the authority to refuse to accept bail bonds from a surety or a bail agent pursuant to its inherent authority, pursuant to Idaho Code, or as provided by supreme court rules, guidelines or appellate decisions.

(2) A bail agent is authorized to execute and countersign undertakings of bail, including bail bonds, in connection with any judicial proceedings in each of the judicial districts of the state. Any sheriff or clerk of the district court shall accept bail bonds only from a bail agent, unless otherwise ordered by the court pursuant to subsection (1) of this section.

(3) In addition to the authority to revoke, suspend or refuse to issue a bail agent's license pursuant to section 41-1016, Idaho Code, the director shall suspend a license for a period not to exceed six (6) months, after mailing notice to the last known address of the bail agent but prior to a hearing, if such bail agent:

(a) Has been convicted or has entered a guilty plea to any felony or to a misdemeanor evidencing theft, dishonesty, intimidation, threats, or violence; or

(b) Intentionally and fraudulently makes a false statement to a court in connection with a bail transaction.

(4) In addition to the provisions of subsection (3) of this section, the director may also suspend a license for a period not to exceed six (6) months, after mailing notice to the last known address of the bail agent but prior to a hearing, for reasons set forth in the rules of the department.

History:

[41-1039, added 2003, ch. 104, sec. 3, p. 329; am. 2010, ch. 86, sec. 3, p. 166; am. 2013, ch. 36, sec. 1, p. 77; am. 2019, ch. 266, sec. 3, p. 780.]
Idaho Code § 41-5505 — Idaho Code / Title 41 / Chapter 55 / Section 41-5505
41-5505 REINSURANCE.
Status: in_force

41-5505. Reinsurance. (1) Any individual carrier issuing a health benefit plan shall be liable to the pool for the reinsurance premium and shall be reinsured by the pool for each eligible individual ceded in accordance with section 41-5509, Idaho Code, and the plan of operation.

(2) The pool shall reimburse a reinsuring carrier with respect to the claims of a ceded eligible individual incurred during the calendar year and paid by the reinsuring carrier for benefits covered by the health benefit plan, in accordance with the reinsurance parameters set forth in the plan of operation.

(a) The board may annually adjust the reinsurance parameters by submitting an amendment to the plan of operation in accordance with section 41-5503(1), Idaho Code. The adjustments may reflect increases in costs and utilization within the individual market for health benefit plans but must consider the availability of pool funding and the stability of the individual health insurance market, as well as any objectives stated in the plan of operation.

(b) The board shall not submit for approval by the director a plan of operation or an amendment thereto with an initial level of less than twenty-five thousand dollars ($25,000) or a reinsuring carrier coinsurance percentage of less than twenty percent (20%).

(3) A reinsuring carrier shall apply all managed care and claims handling techniques, including utilization review, individual case management, preferred provider provisions, and other managed care provisions or methods of operation consistently with respect to reinsured and nonreinsured business.

(4) Each carrier shall make a filing with the director containing the carrier's earned health insurance premium derived from health benefit plans delivered or issued for delivery in this state in the previous calendar year.

(5) Each carrier shall file with the director, in a form and manner to be prescribed by the director, an annual report. The report shall state the number of resident persons insured under the carrier's health benefit plan, or through excess or stop loss coverage.

(6) Carriers shall permit individuals and their dependents covered by a high risk pool plan to remain on the high risk pool plan as long as the individual continues to meet the conditions of section 41-5501(6)(a), Idaho Code.

History:

[41-5505, added 2000, ch. 472, sec. 17, p. 1637; am. 2003, ch. 267, sec. 4, p. 717; am. 2005, ch. 353, sec. 5, p. 1119; am. 2017, ch. 281, sec. 4, p. 737.]
Idaho Code § 41-1333 — Idaho Code / Title 41 / Chapter 13 / Section 41-1333
41-1333 REFUND OF UNEARNED HEALTH INSURANCE PREMIUMS.
Status: in_force

41-1333. Refund of unearned health insurance premiums. If an insured person, insured person's estate or entity cancels a health insurance policy for any reason, the insurer or other entity regulated pursuant to the provisions of this title shall refund the pro rata portion of the unused collected premium to the beginning of the next monthly billing cycle. As used in this section the term "health insurance policy" shall refer to a contract entered into pursuant to the provisions of this title for which payment or reimbursement is rendered to a claimant or health care provider for the claimant's utilization of health care services which is any service rendered to an individual for diagnosis, relief or treatment of any injury, ailment or bodily condition. As used in this section "unused collected premium" shall mean that portion of any premium collected which is not used, on a pro rata basis to the beginning of the next monthly billing cycle at the time of cancellation, by the insurer or other entity regulated pursuant to this title to insure against loss as there is no risk of loss from the insured individual, or that portion of any collected premium which would have not been collected had the insured paid monthly.

History:

[41-1333, added 1993, ch. 339, sec. 1, p. 1271.]
Idaho Code § 41-315 — Idaho Code / Title 41 / Chapter 3 / Section 41-315
41-315 PERMISSIBLE INSURING COMBINATIONS WITHOUT ADDITIONAL CAPITAL FUNDS.
Status: in_force

41-315. Permissible insuring combinations without additional capital funds. (1) A life insurer may also grant annuities without additional capital or additional surplus.

(2) A disability insurer may also issue insurance against congenital defects, as defined in section 41-506(1) (l), without additional capital or additional surplus.

(3) A casualty insurer may be authorized to transact also disability insurance without additional capital or additional surplus.

(4) A property insurer may without additional capital or additional surplus include such amount and kind of insurance against legal liability or injury, damage, or loss to the person or property of others, and for medical, hospital, and surgical expense related to such injury, as the director deems to be reasonably incidental to insurance of real property against fire and other perils under policies covering farm properties, or residential properties designated for occupancy by not more than four (4) families, with or without incidental office, professional, private school or studio occupancy by an insured whether or not the premium or rate charged for certain perils so covered is specified in the policy. Any provision of section 41-509 (limit of risk) to the contrary notwithstanding, no insurer authorized as to property insurance only shall pursuant to this subsection retain risk as to any one (1) subject of insurance as to hazards other than property insurance hazards, in an amount exceeding five per cent (5%) of its surplus to policyholders.

History:

[41-315, added 1961, ch. 330, sec. 78, p. 645; am. 1969, ch. 214, sec. 7, p. 625.]
Idaho Code § 41-5412 — Idaho Code / Title 41 / Chapter 54 / Section 41-5412
41-5412 NOTICES.
Status: in_force

41-5412. Notices. All notices by the director to an insurer which may result in regulatory action hereunder shall be effective upon dispatch if transmitted by registered or certified mail, or in the case of any other transmission shall be effective upon the insurer's receipt of such notice.

History:

[41-5412, added 1996, ch. 96, sec. 1, p. 293.]
Idaho Code § 41-3343 — Idaho Code / Title 41 / Chapter 33 / Section 41-3343
41-3343 LIQUIDATOR'S RECOMMENDATIONS TO THE COURT.
Status: in_force

41-3343. Liquidator's recommendations to the court. (1) The liquidator shall review all claims duly filed in the liquidation and shall make such further investigation as he shall deem necessary. He may compound, compromise or in any other manner negotiate the amount for which claims will be recommended to the court except where the liquidator is required by law to accept claims as settled by any person or organization, including any guaranty association or foreign guaranty association. Unresolved disputes shall be determined under section 41-3339, Idaho Code. As soon as practicable, he shall present to the court a report of the claims against the insurer with his recommendations. The report shall include the name and address of each claimant and the amount of the claim finally recommended, if any. If the insurer has issued annuities or life insurance policies, the liquidator shall report the persons to whom, according to the records of the insurer, amounts are owed as cash surrender values or other investment value and the amounts owed.

(2) The court may approve, disapprove, or modify, the report on claims by the liquidator. Such reports as are not modified by the court within a period of sixty (60) days following submission by the liquidator shall be treated by the liquidator as allowed claims, subject thereafter to later modification or to rulings made by the court pursuant to section 41-3339, Idaho Code. No claim under a policy of insurance shall be allowed for an amount in excess of the applicable policy limits.

History:

[41-3343, added 1981, ch. 249, sec. 2, p. 534.]
Idaho Code § 41-247 — Idaho Code / Title 41 / Chapter 2 / Section 41-247
41-247 INQUIRY POWERS OF DIRECTOR.
Status: in_force

41-247. Inquiry powers of director. The director shall have power to direct an inquiry in writing to any person subject to his jurisdiction with respect to any insurance transaction or matter relative to a subject of insurance resident, located, or to be performed in this state. The person to whom such an inquiry is addressed shall upon receipt thereof promptly furnish to the director all requested information which is in his possession or subject to his control.

History:

[I.C., sec. 41-247, as added by 1969, ch. 214, sec. 5, p. 625.]
Idaho Code § 41-4934 — Idaho Code / Title 41 / Chapter 49 / Section 41-4934
41-4934 PROHIBITED PECUNIARY INTERESTS IN PLAN MANAGEMENT.
Status: in_force

41-4934. Prohibited pecuniary interests in plan management. (1) Neither the administrator nor any other person having responsibility for the management of the trust fund or the investment or other handling of the trust fund moneys or assets shall:

(a) Receive directly or indirectly or be pecuniarily interested in any fee, commission, compensation or emolument, other than salary or other similar compensation regularly fixed and allowed for services regularly rendered to the trust fund, arising out of any transaction to which the trust fund is or is to be a party;

(b) Receive compensation as a consultant to the trust fund while also acting as a trustee or administrator, or as an employee of either;

(c) Have any direct or indirect material pecuniary interest in any loan or investment of the trust fund.

(2) The director may, after reasonable notice and a hearing, prohibit the administrator from employing or retaining or continuing to employ or retain any person in the administration of the trust fund upon finding that such employment or retention involves a conflict of interest not in the best interests of the trust fund or adversely affecting the interests of the owners or operators insured by the trust fund.

(3) Any conflict of interest or prohibited pecuniary interest involving the members of the board of trustees of the trust fund shall be governed solely by the conflict of interest provisions of the Idaho nonprofit corporation act as set forth in section 30-30-619, Idaho Code.

History:

[(41-4934) 41-4937, added 1990, ch. 119, sec. 1, p. 285; am. 1991, ch. 59, sec. 24, p. 133; am. and redesig. 2003, ch. 96, sec. 38, p. 305; am. 2004, ch. 175, sec. 2, p. 554; am. 2017, ch. 58, sec. 27, p. 122.]
Idaho Code § 41-2866 — Idaho Code / Title 41 / Chapter 28 / Section 41-2866
41-2866 CONDITIONS EXEMPTING EQUITY SECURITIES.
Status: in_force

41-2866. Conditions exempting equity securities. The provisions of sections 41-2860—41-2862 shall not apply to equity securities of a domestic stock insurance company if:

(a) Such securities shall be registered, or shall be required to be registered, pursuant to section 12 of the Securities Exchange Act of 1934, as amended; or

(b) Such domestic stock insurance company shall not have any class of its equity securities held of record by one hundred (100) or more persons on the last business day of the year next preceding the year in which equity securities of the company would be subject to the provisions of sections 41-2860—41-2862 except for the provisions of this subsection (b).

History:

[41-2866, added 1965, ch. 294, sec. 7, p. 782.]
Idaho Code § 41-2112 — Idaho Code / Title 41 / Chapter 21 / Section 41-2112
41-2112 TIME OF PAYMENT OF CLAIMS.
Status: in_force

41-2112. Time of payment of claims. There shall be a provision as follows:

"Time of Payment of Claims: Indemnities payable under this policy for any loss other than loss for which this policy provides any periodic payment, will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid …. (insert period for payment which must not be less frequently than monthly) and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof."

History:

[41-2112, added 1961, ch. 330, sec. 501, p. 645.]
Idaho Code § 41-4010 — Idaho Code / Title 41 / Chapter 40 / Section 41-4010
41-4010 RESERVES AND SURPLUS.
Status: in_force

41-4010. Reserves and surplus. (1) The trustee of a self-funded plan shall establish and maintain in the trust fund the following reserves:

(a) A reserve in an amount as certified by a qualified actuary as being necessary for payment of claims liability. The reserve shall be reasonably adjusted on a quarterly basis in an amount as determined by a qualified actuary or other qualified person if authorized by the director.

(b) If, under the plan, periodic contributions to the trust fund have been paid in advance or are payable less frequently than monthly, there shall be a reserve for unearned contributions as computed pro rata on the basis of the unexpired portion of the period for which the contribution has been paid.

(c) If future claims payments plus future costs of operation are greater than future contributions plus current reserves, there shall be a reserve in an amount equal to future claims payments plus future costs of operation, less future contributions, less current reserves.

(2) In any determination of the financial condition of the trust fund, the claims reserve, reserve for unearned contributions and contribution deficiency reserve shall constitute liabilities.

(3)(a) In addition to reserves required by this section, a self-funded plan shall establish and maintain in its trust fund surplus equal to at least:

(i) The equivalence of three (3) months of contributions for the current plan year; or

(ii) One hundred ten percent (110%) of the difference between the total dollar aggregate stop-loss attachment point plus costs of operation and the total dollar expected contributions for the current plan year.

(b) Paragraph (a) of this subsection notwithstanding, a public postsecondary educational institution shall instead be required to establish and maintain in its trust fund surplus an amount equal to at least thirty percent (30%) of the unpaid claims liability of the plan.

(c) Upon request of a self-funded plan, the director may annually waive the surplus requirement provided in paragraph (a) or (b) of this subsection if:

(i) The plan or trust carries insurance providing aggregate coverage and specific coverage;

(ii) The plan, in its first year of operation, receives periodic contributions, at minimum on a monthly basis, at an amount at least equal to the point at which the insurance providing aggregate coverage must cover at least one hundred percent (100%) of the plan's liability, as certified by a qualified actuary; and

(iii) In its second and each subsequent year of operation, the plan:

1. Continues to provide stop-loss coverage as described in subparagraph (i) of this paragraph; or

2. Is funded, at minimum on a monthly basis, at an amount equal to at least one hundred percent (100%) of the self-funded plan's liability, less any surplus as defined in section 41-4002, Idaho Code, from previous years.

The director may also waive any or all requirements provided in subparagraphs (i) through (iii) of this paragraph, provided that the plan maintains reserves and surplus, as defined in section 41-4002, Idaho Code, of at least the amount certified annually by a qualified actuary as sufficient without aggregate coverage.

(4) A surplus note that has been approved by the director in a form and as defined in section 41-2841, Idaho Code, may be used to fund surplus and shall not be accounted as a liability.

(5) Up to one-third (1/3) of the surplus required by this section may be funded by a clean, irrevocable letter of credit, in a form acceptable to the director, issued in favor of the trust fund by a federally or state-chartered bank having a branch office in Idaho. Such irrevocable letter of credit cannot be guaranteed by pledge of any of the plan assets. The funding cannot be in the form of prepaid contributions or other loan or associated with an offsetting liability.

(6) A newly formed plan with no prior operating history shall meet the minimum surplus requirements no later than twelve (12) months after the date of initial operation. The director may extend for a reasonable period not to exceed twelve (12) additional months, provided that the plan is meeting all other provisions of this chapter. For plans registered with the department and in existence on the effective date of this law, such plans shall have twenty-four (24) months from the effective date of this law in which to increase their surplus level to comply with the requirements of subsection (3) of this section.

(7) The trust fund shall maintain the minimum surplus requirements at all times throughout the year.

History:

[41-4010, added 1974, ch. 248, sec. 10, p. 1624; am. 2006, ch. 414, sec. 9, p. 1264; am. 2013, ch. 181, sec. 10, p. 427; am. 2015, ch. 49, sec. 2, p. 109; am. 2017, ch. 179, sec. 1, p. 410; am. 2019, ch. 306, sec. 3, p. 917.]
Idaho Code § 41-1942 — Idaho Code / Title 41 / Chapter 19 / Section 41-1942
41-1942 ADVERTISEMENT OF INTEREST-INDEXED ANNUITIES.
Status: in_force

41-1942. advertisement of interest-indexed annuities. No issuer of interest-indexed annuity contracts shall advertise interest-indexed annuity contracts, regardless of the advertising medium, without prior approval of such advertisement from the director. For purposes of this section, "interest-indexed annuity" means a type of annuity whose credited interest is linked to an external reference at any time during the term of the contract and shall include contracts, application forms where written application is required and is to be made a part of the contract, printed riders, endorsements, and renewal certificates.

History:

[41-1942, added 2020, ch. 290, sec. 2, p. 839; am. 2021, ch. 41, sec. 9, p. 123.]
Idaho Code § 41-3221 — Idaho Code / Title 41 / Chapter 32 / Section 41-3221
41-3221 INVESTMENTS.
Status: in_force

41-3221. Investments. A society shall invest its funds only in such investments as are authorized by the laws of this state for the investment of assets of life insurers and subject to the limitations thereon. Any foreign or alien society permitted or seeking to do business in this state 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.

History:

[41-3221, added 1995, ch. 213, sec. 2, p. 734.]
Idaho Code § 41-1094 — Idaho Code / Title 41 / Chapter 10 / Section 41-1094
41-1094 TYPE OF POLICY.
Status: in_force

41-1094. type of POLICY. Travel insurance may be provided under an individual policy or under a group or master policy.

History:

[41-1094, added 2017, ch. 198, sec. 6, p. 497.]
Idaho Code § 41-6005 — Idaho Code / Title 41 / Chapter 60 / Section 41-6005
41-6005 POWER AND LIABILITY OF THE BOARD.
Status: in_force

41-6005. Power and liability of the board. [effective until july 1, 2029] (1) The board shall have the power to:

(a) Enter into contracts as are necessary or proper to carry out the provisions and purposes of this chapter, including contracts for administrative services;

(b) Determine the method of assessment and assess carriers in accordance with the provisions of section 41-6006, Idaho Code;

(c) Require carriers to provide to the board such statements and reports the board deems necessary to fulfill its duties under this chapter;

(d) Establish policies and procedures as may be necessary or convenient for the implementation of this chapter and the operation of the assessments authorized by this chapter; and

(e) Consult with the Idaho department of health and welfare and other experts as the board may deem appropriate as necessary or proper to carry out the provisions and purposes of this chapter.

(2) Neither the board nor its members shall be liable for any obligations of the vaccine assessments. No member or employee of the board shall be liable, and no cause of action of any nature may arise against them, for any act or omission related to the performance of their powers and duties under this chapter, unless such act or omission constitutes willful or wanton misconduct. Participation by a carrier in the assessments authorized by this chapter or on the board under the provisions of this chapter shall not be grounds for any legal action, criminal or civil liability, or penalty against the fund or any of its carriers or board members, either jointly or separately.

History:

[41-6005, added 2010, ch. 32, sec. 1, p. 62; am. 2011, ch. 121, sec. 1, p. 331.]
Idaho Code § 41-1936 — Idaho Code / Title 41 / Chapter 19 / Section 41-1936
41-1936 SEPARATE ACCOUNTS — OPERATION AND MANAGEMENT.
Status: in_force

41-1936. Separate accounts — Operation and management. (1) A domestic life insurer may, by or pursuant to resolution of its board of directors, establish one or more separate accounts, and may allocate thereto amounts to provide for life insurance or annuities (and benefits incidental thereto), payable in fixed or in variable amounts or in both.

(2) The amounts allocated to each such account and accumulations thereon may be invested as provided in section 41-734 of this act (special investments of separate account funds).

(3) The income, if any, and gains and losses, realized or unrealized, from assets allocated to a separate account shall be credited to or charged against the account without regard to other income, gains or losses of the insurer.

(4) Unless otherwise approved by the director, assets allocated to a separate account shall be valued at their market value on the date of valuation, or if there is no readily available market, then as provided under the terms of the contract or the rules or other written agreement applicable to such separate account; except, that unless otherwise approved by the director, a portion of the assets of such separate account equal to the insurer's reserve liability with regard to the guaranteed benefits and funds, if any, referred to in section 41-734, Idaho Code, (special investments of separate account funds), shall be valued in accordance with the rules otherwise applicable to the insurer's assets.

(5) Amounts allocated to a separate account in the exercise of the power granted by this section shall be owned by the insurer, and the insurer shall not be, nor hold itself out to be, a trustee with respect to such amounts. If and to the extent so provided under the applicable contracts, that portion of the assets of any such separate account equal to the reserves and other contract liabilities with respect to such account shall not be chargeable with liabilities arising out of any other business the insurer may conduct.

(6) No sale, exchange or other transfer of assets may be made by an insurer between any of its separate accounts or between any other investment account and one or more of its separate accounts unless, in case of a transfer into a separate account, such transfer is made solely to establish the account or to support the operation of the contracts with respect to the separate account to which the transfer is made, and unless such transfer, whether into or from a separate account, is made (a) by a transfer of cash, or (b) by a transfer of securities having a readily determinable market value, provided that such transfer of securities is approved by the director. The director may approve other transfers among such accounts if, in his opinion, such transfers would not be inequitable.

(7) To the extent that the insurer deems it necessary to comply with any applicable federal or state laws, the insurer, with respect to any separate account, including without limitation any separate account which is a management investment company or a unit investment trust, may provide for persons having an interest therein, appropriate voting and other rights and special procedures for the conduct of the business of such account, including without limitation special rights and procedures relating to investment policy, investment advisory services, selection of independent public accountants, and the selection of a committee, the members of which need not be otherwise affiliated with the insurer, to manage the business of such account.

History:

[I.C., sec. 41-1936, as added by 1969, ch. 214, sec. 51, p. 625; am. 1971, ch. 272, sec. 2, p. 1078.]
Idaho Code § 41-3805 — Idaho Code / Title 41 / Chapter 38 / Section 41-3805
41-3805 TENDER OFFER MATERIAL.
Status: in_force

41-3805. Tender offer material. All requests or invitations for tenders or advertisements making a tender offer or requesting or inviting tenders of such voting securities for control of a domestic insurer made by or on behalf of any person shall contain the information specified in section 41-3804, Idaho Code, as the director may prescribe and shall be filed with the director at least ten (10) days prior to the time such material is first published or sent or provided to security holders. Copies of any additional material soliciting or requesting such tender offers subsequent to the initial solicitation or request shall contain information as the director may prescribe as necessary or appropriate in the public interest or for the protection of policyholders and stockholders and shall be filed with the director at least ten (10) days prior to the time copies of the material are first published or sent or provided to security holders.

History:

[41-3805, added 2013, ch. 266, sec. 2, p. 657.]
Idaho Code § 41-2713 — Idaho Code / Title 41 / Chapter 27 / Section 41-2713
41-2713 ADMINISTRATION — EXAMINATION COSTS.
Status: in_force

41-2713. Administration — Examination costs. In the exercise of the powers of the director of the department of insurance to supervise and regulate title insurers, title insurance agents and title insurance rating organizations as provided in this chapter, as well as the powers of examination set forth in sections 41-219 and 41-220, Idaho Code, each title insurer, title insurance agent or rating organization regulated or examined shall, at the direction of the director, pay directly to such person charged with enforcing the law or regulations and making the examinations, actual travel expenses, a reasonable expense allowance, and compensation, at reasonable rates as approved by the director of the department of insurance, necessarily incurred in such matters on the presentation of a detailed account of such charges and expenses. A title insurer shall be charged for the original examination of a title insurance agent which the insurer desires to represent it, and a title insurer or rating organization shall be charged directly for hearings upon any hearing originated by filings made by it. The regulation and examination direct charges herein provided may include both field work and work in the office of the director necessary thereto.

Separately from the direct charges herein provided, the director may levy a general charge upon each title insurer in proportion to the gross premiums from title insurance written by it to defray the costs of regulation required by this chapter. Provided, nevertheless, a title insurer shall not be charged in any one (1) year, separately from the direct charges for examination under section 41-219, Idaho Code, said plant examination and said hearings, in excess of one per cent (1%) of the gross premiums as defined in section 41-402, Idaho Code, for title insurance written on Idaho real property in said year, provided the director in the first year after the effective date hereof may charge not in excess of two per cent (2%) of the gross premiums and may levy said charge after July 1, 1973, in advance based on the prior year's premiums. The director from year to year may carry forward any unexpended balance of general charges made in a rotating fund for said expenses to be incurred thereafter.

History:

[I.C., sec. 41-2713, as added by 1973, ch. 135, sec. 10, p. 252.]
Idaho Code § 41-710 — Idaho Code / Title 41 / Chapter 7 / Section 41-710
41-710 INTERNATIONAL BANK.
Status: in_force

41-710. International bank. An insurer may invest in obligations issued, assumed or guaranteed by the International Bank for Reconstruction and Development or the African Development Bank.

History:

[41-710, added 1961, ch. 330, sec. 147, p. 645; am. 1988, ch. 240, sec. 1, p. 469.]
Idaho Code § 41-265 — Idaho Code / Title 41 / Chapter 2 / Section 41-265
41-265 WITNESS FEES — CHARGE FOR SERVICE OF PROCESS.
Status: in_force

41-265. Witness fees — Charge for service of process. Each person summoned and testifying before the state fire marshal, his deputies or assistants, shall on the certification of the fire marshal and upon audit of the proper officer of the state, receive such sum or sums for witness fees and mileage as are provided for witnesses testifying in the district courts of this state; and officers serving subpoena and rendering other services to the state fire marshal shall be paid in like manner and amounts as they would be entitled for like service in such courts.

History:

[(41-265) 1970, ch. 190, sec. 16, p. 547; am. and redesig. 1982, ch. 120, sec. 13, p. 343.]
Idaho Code § 41-1421 — Idaho Code / Title 41 / Chapter 14 / Section 41-1421
41-1421 TECHNICAL SERVICES.
Status: in_force

41-1421. Technical services. Any rating organization may subscribe for or purchase actuarial, technical or other services, and such services shall be available to all members and subscribers without discrimination.

History:

[41-1421, added 1961, ch. 330, sec. 326, p. 645.]
Idaho Code § 41-6102 — Idaho Code / Title 41 / Chapter 61 / Section 41-6102
41-6102 PURPOSE AND INTENT.
Status: in_force

41-6102. purpose and intent. It is the public policy of the state of Idaho to actively resist federal actions that would limit or override state sovereignty under the 10th amendment of the United States constitution. Through this legislation, the state of Idaho asserts its sovereignty by refusing to surrender decision-making authority over health care issues, which are matters appropriately left to states and individual citizens. The purpose of this chapter is to establish a state-created, market-driven health insurance exchange that will facilitate the selection and purchase of individual and employer health benefit plans. The creation of a state-based health insurance exchange will provide an Idaho-specific solution that fits the unique needs of the state of Idaho. Participation in the exchange is voluntary in that no person or employer shall be required by this chapter to purchase a health benefit plan through the exchange. Creation of the exchange and its operation is deemed a public purpose intended to enhance Idaho residents' choice regarding options and access to health insurance.

History:

[41-6102, added 2013, ch. 170, sec. 1, p. 390.]
Idaho Code § 41-6207 — Idaho Code / Title 41 / Chapter 62 / Section 41-6207
41-6207 PROHIBITED ACTS.
Status: in_force

41-6207. Prohibited acts. (1) A motor vehicle service contract provider may not use in its name, contracts or literature:

(a) Any of the words "insurance," "casualty," "surety," "mutual" or any other words descriptive of the insurance, casualty or surety business; or

(b) A name deceptively similar to the name or description of any insurance or surety corporation, or any other motor vehicle service contract provider.

(2) A motor vehicle service contract provider, its representative or any other person may not make, permit or allow to be made any false, deceptive or misleading statement, or may not deliberately omit any material statement that would be considered misleading if omitted, in connection with the sale, offer to sell or advertisement of a motor vehicle service contract.

(3) It shall be unlawful for any company to directly or indirectly represent in any manner, whether by written solicitation, advertisement or telemarketing, a false, deceptive or misleading statement with regard to:

(a) Such company's affiliation with a motor vehicle manufacturer, recreational vehicle manufacturer or dealer;

(b) Such company's possession of information regarding a motor vehicle owner's current motor vehicle manufacturer's or recreational vehicle manufacturer's original equipment warranty;

(c) All indications that such company's records show that a motor vehicle or recreational vehicle owner's current motor vehicle manufacturer's or recreational vehicle manufacturer's original equipment warranty is nearing or past expiration;

(d) A requirement that such motor vehicle or recreational vehicle owner register for a new motor vehicle service contract with such company to maintain coverage under the motor vehicle or recreational vehicle owner's current service contract or manufacturer's original equipment warranty.

History:

[41-6207, added 2018, ch. 116, sec. 2, p. 245.]
Idaho Code § 41-1308 — Idaho Code / Title 41 / Chapter 13 / Section 41-1308
41-1308 DEFAMATION.
Status: in_force

41-1308. Defamation. No person shall make, publish, disseminate, or circulate, directly or indirectly, or aid, abet or encourage the making, publishing, disseminating or circulating of any oral or written statement or any pamphlet, circular, article or literature which is false, or maliciously critical of or derogatory to the financial condition of an insurer, or of an organization proposing to become an insurer, and which is circulated to injure any person engaged or proposing to engage in the business of insurance.

History:

[41-1308, added 1961, ch. 330, sec. 286, p. 645.]
Idaho Code § 41-606 — Idaho Code / Title 41 / Chapter 6 / Section 41-606
41-606 UNEARNED PREMIUM RESERVE.
Status: in_force

41-606. Unearned premium reserve. (1) As to insurance against loss or damage to property (except as provided in section 41-607), and as to all general casualty insurance and surety insurance, every insurer shall maintain an unearned premium reserve on all policies in force.

(2) The director may require that such reserves shall be equal to the unearned portions of the gross premiums in force after deducting applicable reinsurance in solvent insurers as computed on each respective risk from the policy's date of issue. If the director does not so require, the portions of the gross premium in force, less applicable reinsurance in solvent insurers, to be held as an unearned premium reserve, shall be computed according to the following table:

Term for which policy was written Reserve for unearned premium 1 year or less 1/2 2 years 1st year 3/4 2nd year 1/4 3 years 1st year 5/6 2nd year 1/2 3rd year 1/6 4 years 1st year 7/8 2nd year 5/8 3rd year 3/8 4th year 1/8 5 years 1st year 9/10 2nd year 7/10 3rd year 1/2 4th year 3/10 5th year 1/10 Over 5 years pro rata

(3) In lieu of computation according to the foregoing table, the insurer at its option may compute all of such reserves on a monthly or more frequent pro rata basis.

(4) After adopting a method for computing such reserve, an insurer shall not change methods without approval of the insurance supervisory official of the insurer's domicile.

(5) This section does not apply to title insurance.

History:

[41-606, added 1961, ch. 330, sec. 127, p. 645.]
Idaho Code § 41-203 — Idaho Code / Title 41 / Chapter 2 / Section 41-203
41-203 TERMS CONSTRUED.
Status: in_force

41-203. Terms construed. Wherever the words "commissioner of insurance" or "insurance commissioner" appear in title 41, Idaho Code, or elsewhere in the Idaho Code, they shall be understood and construed to mean the director of the department of insurance.

History:

[41-203, added 1961, ch. 330, sec. 20, p. 645; am. 1974, ch. 11, sec. 3, p. 60.]
Idaho Code § 41-326 — Idaho Code / Title 41 / Chapter 3 / Section 41-326
41-326 SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY — MANDATORY GROUNDS.
Status: in_force

41-326. Suspension or revocation of certificate of authority — Mandatory grounds. (1) The director shall refuse to continue, or shall suspend or revoke, an insurer's certificate of authority:

(a) If such action is required by any provision of this code; or

(b) If a foreign insurer, it no longer meets the requirements for the authority, on account of deficiency of assets or otherwise; or if a domestic insurer, it has failed to cure an impairment of capital or surplus within the time allowed therefor by the director under this code; or

(c) If the insurer knowingly exceeds its charter powers or powers granted under its certificate of authority; or

(d) If the insurer's certificate of authority to transact insurance therein is suspended or revoked by its state of domicile, or state of entry into the United States if an alien insurer.

(2) Except in cases of insolvency or impairment of required capital or surplus, or suspension or revocation by another state as referred to in subdivision (d) above, the director shall so refuse, suspend, or revoke the certificate of authority only after a hearing granted to the insurer thereon, unless the insurer waives such hearing in writing.

History:

[41-326, added 1961, ch. 330, sec. 89, p. 645.]
Idaho Code § 41-3608 — Idaho Code / Title 41 / Chapter 36 / Section 41-3608
41-3608 OBLIGATIONS AND POWERS OF ASSOCIATION.
Status: in_force

41-3608. Obligations and powers of association. (1) The association shall:

(a) Be obligated to pay covered claims existing prior to the order of liquidation arising within thirty (30) days after the order of liquidation, or before the policy expiration date if less than thirty (30) days after the order of liquidation, or before the insured replaces the policy or causes its cancellation, if he does so within thirty (30) days of the order of liquidation. Such obligation shall be satisfied by paying to the claimant an amount as follows:

(i) The full amount of a covered claim for benefits under a worker's compensation insurance coverage;

(ii) An amount not exceeding ten thousand dollars ($10,000) per policy for covered claim for the return of unearned premium;

(iii) An amount not exceeding three hundred thousand dollars ($300,000) per claim for all other covered claims.

(b) In no event shall the association be obligated to pay a claimant an amount in excess of the obligation of the insolvent insurer under the policy or coverage from which the claim arises.

Notwithstanding any other provision of this chapter, a covered claim shall not include any claim filed with the association after the earlier of: (i) eighteen (18) months after the date of the order of liquidation, or (ii) the final date set by the court for the filing of claims against the liquidator or receiver of an insolvent insurer and shall not include any claim filed with the association or a liquidator for protection afforded under the insured policy for incurred-but-not-reported losses. Any obligation of the association to defend an insured shall cease upon the association's payment by settlement releasing the insured or on a judgment of an amount equal to the lesser of the association's covered claim obligation limit or the applicable policy limit.

(c) Be deemed the insurer to the extent of its obligation on the covered claims and to such extent shall have all rights, duties, and obligations of the insolvent insurer as if the insurer had not become insolvent including, but not limited to, the right to pursue and retain salvage and subrogation recoverable on paid covered claim obligations.

(d) Assess member insurers separately for amounts necessary to pay the obligations of the association under paragraph (a) of this subsection subsequent to an insolvency, the expenses of handling covered claims subsequent to an insolvency and other expenses authorized by this chapter. The assessments of each member insurer shall be in the proportion that the net direct written premiums of the member insurer for the calendar year preceding the assessment on the kinds of insurance covered by the account bears to the net direct written premiums of all member insurers for the calendar year preceding the assessment on the kinds of insurance covered by the account. Each member insurer shall be notified of the assessment not later than thirty (30) days before it is due. No member insurer may be assessed in any one (1) year an amount greater than one percent (1%) of that member insurer's net direct written premiums for the calendar year preceding the assessment. If the maximum assessment, together with the other assets of the association in the account, does not provide in any one (1) year an amount sufficient to make all necessary payments, the funds available shall be prorated and the unpaid portion shall be paid as soon thereafter as funds become available. The association shall pay claims in any order that it deems reasonable, including the payment of claims as such are received from the claimants or in groups or categories of claims. The association may exempt or defer, in whole or in part, the assessment of any member insurer, if the assessment would cause the member insurer's financial statement to reflect amounts of capital or surplus less than the minimum amounts required for a certificate of authority by any jurisdiction in which the member insurer is authorized to transact insurance; provided, however, that during the period of deferment, no dividends shall be paid to shareholders or policyholders. Deferred assessments shall be paid when such payment will not reduce capital or surplus below required minimums. Such payments shall be refunded to those companies receiving larger assessments by virtue of such deferment, or at the election of any such company, credited against future assessments. Each member insurer may set off against any assessment authorized payments made on covered claims and expenses incurred in the payment of such claims by the member insurer if they are chargeable to the account.

(e) Investigate claims brought against the association and adjust, compromise, settle, and pay covered claims to the extent of the association's obligation and deny all other claims and may review settlements, releases and judgments to which the insolvent insurer or its insureds were parties to determine the extent to which such settlements, releases and judgments may be properly contested. The association shall have the right to appoint or substitute and to direct legal counsel retained under liability insurance policies for the defense of covered claims.

(f) Handle claims through its employees or through one (1) or more insurers or other persons designated as servicing facilities. Designation of a servicing facility is subject to the approval of the director, but such designation may be declined by a member insurer.

(g) Reimburse each servicing facility for obligations of the association paid by the facility and for expenses incurred by the facility while handling claims on behalf of the association and shall pay the other expenses of the association authorized by this chapter.

(2) The association may:

(a) Employ or retain such persons as are necessary to handle claims and perform other duties of the association.

(b) Borrow funds necessary to effect the purposes of this chapter in accord with the plan of operation.

(c) Sue or be sued, and such power to sue includes the power and right to intervene as a party before any court that has jurisdiction over the insolvent insurer as defined by this chapter.

(d) Negotiate and become a party to such contracts as are necessary to carry out the purpose of this chapter.

(e) Perform such other acts as are necessary or proper to effectuate the purpose of this chapter.

(f) Refund to the member insurers in proportion to the contribution of each member insurer the amount that, in the opinion of the board of directors, will not be needed for the purposes of this chapter within two (2) years from the date the association receives the refund from the receivership.

(g) Subject to approval by the director, provide claims handling services to any runoff insurer, provided the association expenses related to such services are fully reimbursed. Normal defenses applicable to guaranty fund handling of covered claims shall not apply to runoff claim handling and no guaranty fund assets shall be used for runoff claim or expense payment. There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member insurer, the association or its agents or employees, the board of directors or any person serving as a representative of any director for any action taken or any failure to act by them in the performance of their activities under the provisions of this paragraph. For purposes of this paragraph, "runoff insurer" means a property and casualty insurer that has:

(i) Total adjusted capital under risk-based capital requirements in an amount less than the authorized control level risk-based capital as defined in section 41-5401(13)(a), Idaho Code, and has indicated that it will cease writing new insurance policies, either as part of its corrective action plan or pursuant to being placed under regulatory control; or

(ii) Total adjusted capital under risk-based capital requirements in an amount less than the mandatory control level risk-based capital as defined in section 41-5401(13)(c), Idaho Code, and that has not been placed into liquidation pursuant to sections 41-3317 and 41-3318, Idaho Code.

History:

[41-3608, added 1970, ch. 152, sec. 8, p. 462; am. 1980, ch. 275, sec. 1, p. 718; am. 1984, ch. 66, sec. 1, p. 115; am. 1992, ch. 316, sec. 3, p. 944; am. 1993, ch. 279, sec. 1, p. 944; am. 1997, ch. 109, sec. 6, p. 259; am. 2001, ch. 155, sec. 3, p. 561; am. 2005, ch. 268, sec. 1, p. 829; am. 2014, ch. 89, sec. 1, p. 239; am. 2021, ch. 321, sec. 32, p. 972.]
Idaho Code § 41-2853 — Idaho Code / Title 41 / Chapter 28 / Section 41-2853
41-2853 ASSESSMENT OF STOCKHOLDERS OR MEMBERS.
Status: in_force

41-2853. Assessment of stockholders or members. (1) Any insurer receiving the director's notice required in section 41-2852(1):

(a) If a stock insurer and to the extent that stockholders are subject to assessment under the insurer's articles of incorporation, by resolution of its board of directors the insurer may assess its stockholders for amounts necessary to cure the deficiency and provide the insurer with a reasonable amount of surplus in addition. If any stockholder fails to pay a lawful assessment after notice given to him in person, or by mail addressed to him at his address last of record with the insurer, or in such other manner as may be approved by the director, the insurer may require the return of the certificates of stock theretofore held by the stockholder, and in cancellation and in lieu thereof issue new certificates for such number of shares as the stockholder may then be entitled to, upon the basis of the stockholder's proportionate interest in the amount of the insurer's capital stock as determined by the director to be remaining unimpaired at the time of the determination of the amount of impairment under section 41-2852, after deducting from such proportionate interest the amount of such unpaid assessment. The insurer may pay for or issue fractional shares under this subsection.

(b) If a mutual insurer, may levy an assessment upon members as is provided for under section 41-2847.

(2) Neither this section nor section 41-2852 shall be deemed to prohibit the insurer from curing any such deficiency through any lawful means other than those referred to in such sections.

History:

[41-2853, added 1961, ch. 330, sec. 621, p. 645.]
Idaho Code § 41-6403 — Idaho Code / Title 41 / Chapter 64 / Section 41-6403
41-6403 DISCLOSURE REQUIREMENT.
Status: in_force

41-6403. DISCLOSURE REQUIREMENT. (1) A domestic insurer, or the insurance group of which the domestic insurer is a member, shall, no later than June 1 of each calendar year, submit to the director a corporate governance annual disclosure (CGAD) that contains the information described in section 41-6404, Idaho Code. Absent a request from the director pursuant to subsection (3) of this section, an insurance group is not required to submit the CGAD if Idaho is not the lead state for the insurance group, as determined by the procedures outlined in the most recent national association of insurance commissioners' (NAIC) financial analysis handbook adopted by the director by rule, administrative order or bulletin.

(2) The CGAD must include a signature of the insurer or insurance group's chief executive officer or corporate secretary, attorney in fact, executive administrator, or other officer having responsibility for the insurer's or insurance group's compliance with governance structure, practices and policies attesting to the best of that individual's belief and knowledge that the insurer has implemented the corporate governance practices and that a copy of the disclosure has been provided to the insurer's board of directors or the appropriate committee thereof.

(3) An insurer or insurance group not required to submit a CGAD under subsection (1) of this section shall do so upon the director's request.

(4) For purposes of completing the CGAD, the insurer or insurance group may provide information regarding corporate governance at the ultimate controlling parent level, an intermediate holding company level and/or the individual legal entity level, depending upon how the insurer or insurance group has structured its system of corporate governance. The insurer or insurance group is encouraged to make the CGAD disclosures at the level at which the insurer's or insurance group's risk appetite is determined, or at which the earnings, capital, liquidity, operations and reputation of the insurer are overseen collectively and at which the supervision of those factors are coordinated and exercised, or the level at which legal liability for failure of general corporate governance duties would be placed. If the insurer or insurance group determines the level of reporting based on these criteria, it shall indicate which of the three (3) criteria was used to determine the level of reporting and explain any subsequent changes in the level of reporting.

(5) The review of the CGAD and any additional requests for information shall be made through the lead state as determined by the procedures within the most recent financial analysis handbook referenced in subsection (1) of this section.

(6) Insurers providing information substantially similar to the information required by this chapter in other documents provided to the director, including proxy statements filed in conjunction with form B requirements or other state or federal filings provided to the department, shall not be required to duplicate that information in the CGAD but shall only be required to cross-reference the document in which the information is included.

History:

[41-6403, added 2017, ch. 77, sec. 1, p. 210.]
Idaho Code § 41-2834 — Idaho Code / Title 41 / Chapter 28 / Section 41-2834
41-2834 VOTING RIGHTS OF MUTUAL MEMBERS.
Status: in_force

41-2834. Voting rights of mutual members. (1) Each member of a mutual insurer is entitled to one (1) vote upon each matter coming to a vote at meetings of members.

(2) A member shall have the right to vote in person or by his written proxy filed with the corporate secretary not less than five (5) days prior to the meeting. No such proxy shall be made irrevocable, nor be valid beyond the earlier of the following dates:

(a) The date of expiration set forth in the proxy; or

(b) The date of termination of membership; or

(c) Five (5) years from the date of execution of the proxy.

(3) No member's vote upon any proposal to divest the insurer of its business or assets, or the major part thereof, shall be registered or taken except in person or by proxy newly executed and specific as to the matter to be voted upon.

History:

[41-2834, added 1961, ch. 330, sec. 602, p. 645.]
Idaho Code § 41-236 — Idaho Code / Title 41 / Chapter 2 / Section 41-236
41-236 SHOW CAUSE NOTICE.
Status: in_force

41-236. Show cause notice. If any person is entitled to a hearing by any provision of the insurance code before any proposed action is taken, the notice of the proposed action may be in the form of a notice to show cause stating that the proposed action may be taken, unless such person shows cause at a hearing to be held as specified in the notice why the proposed action should not be taken, and stating the basis of the proposed action.

History:

[41-236, added 1961, ch. 330, sec. 53, p. 645.]
Idaho Code § 41-1613 — Idaho Code / Title 41 / Chapter 16 / Section 41-1613
41-1613 EXCESS RATES.
Status: in_force

41-1613. Excess rates. Upon the written application of the insured, stating his reasons therefor, filed with and approved by the director, a rate in excess of that provided by a filing otherwise applicable may be used on any specific risk.

History:

[41-1613, added 1961, ch. 330, sec. 374, p. 645.]
Idaho Code § 41-2516 — Idaho Code / Title 41 / Chapter 25 / Section 41-2516
41-2516 OPTIONAL SUSPENSION OF AUTOMOBILE INSURANCE COVERAGE.
Status: in_force

41-2516. Optional suspension of automobile insurance coverage. (1) If a person enters into a contract with an insurer for coverage under an automobile insurance policy as defined in section 41-2506, Idaho Code, the insurer may allow the person to suspend policy coverages. The suspension period may begin at any time, at the person's option. All requests for suspension of coverage shall be confirmed in writing by the insurer to the insured regardless of the method used by the insured to request suspension of coverage. The suspension of coverage shall not constitute a cancellation of the policy. For those coverages suspended, during the period of suspension, premiums shall not be charged to the person, and the insurer shall not be liable for any loss under such suspended coverages occurring during said suspension period. The period of suspension may be changed at any time upon written agreement by the parties. This shall not preclude the insurer's right to reinspect the previously insured motor vehicle regarding its insurability.

(2) Suspended premium may accrue on a pro rata basis as a credit for future premium.

(3) If a person drives a motor vehicle within the state of Idaho while the liability coverage of the policy is suspended, he shall be subject to the penalties set out for the violation of the provisions of section 49-1428, Idaho Code.

(4) The provisions of this section shall apply to a policy entered into or renewed after July 1, 1990.

History:

[41-2516, added 1990, ch. 57, sec. 1, p. 133; am. 1991, ch. 273, sec. 1, p. 710.]
Idaho Code § 41-5504 — Idaho Code / Title 41 / Chapter 55 / Section 41-5504
41-5504 POWERS AND AUTHORITY.
Status: in_force

41-5504. Powers and authority. (1) The pool shall have the general powers and authority granted under the laws of this state to insurance companies and managed care organizations licensed to transact business, except the power to issue health benefit plans directly to individuals. In addition thereto, the pool shall have the specific authority to:

(a) Enter into contracts as are necessary or proper to carry out the provisions and purposes of this chapter, including the authority, with the approval of the director, to enter into contracts with similar programs of other states for the joint performance of common functions or with persons or other organizations for the performance of administrative functions;

(b) Sue or be sued, including taking any legal actions necessary or proper to recover any assessments and penalties for, on behalf of, or against the pool or any carrier;

(c) Define the high risk medical conditions for which reinsurance will be provided, and to issue reinsurance policies, in accordance with the requirements of this chapter;

(d) Establish rules, conditions and procedures for reinsuring risks under the pool;

(e) Establish actuarial functions as appropriate for the operation of the pool;

(f) Assess carriers in accordance with the provisions of section 41-5508, Idaho Code, and make advance interim assessments of carriers as may be reasonable and necessary for organizational and interim operating expenses. Any interim assessments shall be credited as offsets against any regular assessments due following the close of the fiscal year;

(g) Appoint appropriate legal, actuarial and other committees as necessary to provide technical assistance in the operation of the pool, policy and other contract design, and any other function within the authority of the pool;

(h) Borrow money to effect the purposes of the pool. Any notes or other evidence of indebtedness of the pool not in default shall be legal investments for carriers and may be carried as admitted assets;

(i) Establish rules, policies and procedures as may be necessary or convenient for the implementation of this chapter and the operation of the pool.

(2) Neither the board nor its employees shall be liable for any obligations of the pool. No member or employee of the board shall be liable, and no cause of action of any nature may arise against them, for any act or omission related to the performance of their powers and duties under this chapter, unless such act or omission constitutes willful or wanton misconduct. The board may provide for indemnification of, and legal representation for, its members and employees.

(3) No participation of a reinsuring carrier in the pool, no establishment of rates, forms or procedures, and no other joint or collective action required under the provisions of this chapter shall be grounds for any legal action, criminal or civil liability, or penalty against the pool or any of its reinsuring carriers either jointly or separately.

(4) The pool shall have no authority to provide reinsurance for any claims incurred after December 31, 2022, unless the following conditions are met:

(a) The state develops an application for a waiver for state innovation pursuant to 42 U.S.C. 18052 of the federal patient protection and affordable care act that facilitates the resumption of operations of the pool in a manner that minimizes the loss of federal funding to support the affordability of health insurance in the state;

(b) After proper public comment periods and consultation with interested parties, including the pool board, and the approval of the governor, the waiver application is submitted to the secretary of the United States department of health and human services and to the secretary of the United States department of the treasury; and

(c) The waiver application is approved.

(5) The director shall have the authority as necessary or proper to develop, apply for, and upon approval implement an innovation waiver under 42 U.S.C. 18052 of the federal patient protection and affordable care act, including authorizing the pool to perform activities necessary for its implementation.

History:

[41-5504, added 2000, ch. 472, sec. 17, p. 1636; am. 2017, ch. 281, sec. 3, p. 736; am. 2022, ch. 160, sec. 1, p. 549.]
Idaho Code § 41-1930 — Idaho Code / Title 41 / Chapter 19 / Section 41-1930
41-1930 POLICY SETTLEMENTS.
Status: in_force

41-1930. Policy settlements. Any life insurer shall have the power to hold under agreement the proceeds of any policy issued by it, upon such terms and restrictions as to revocation by the policyholder and control by beneficiaries, and with such exemptions from the claims of creditors of beneficiaries other than the policyholder as set forth in the policy or as agreed to in writing by the insurer and the policyholder. Upon maturity of a policy, in the event the policyholder has made no such agreement, the insurer shall have the power to hold the proceeds of the policy under an agreement with the beneficiaries. The insurer shall not be required to segregate the funds so held but may hold them as part of its general assets.

History:

[41-1930, added 1961, ch. 330, sec. 461, p. 645.]
Idaho Code § 41-3358 — Idaho Code / Title 41 / Chapter 33 / Section 41-3358
41-3358 INTERSTATE PRIORITIES.
Status: in_force

41-3358. Interstate priorities. (1) In a liquidation proceeding in this state involving one or more reciprocal states, the order of distribution of the domiciliary state shall control as to all claims of residents of this and reciprocal states. All claims of residents of reciprocal states shall be given equal priority of payment from general assets regardless of where such assets are located.

(2) The owners of special deposit claims against an insurer for which a liquidator is appointed in this or any other state shall be given priority against the special deposits in accordance with the statutes governing the creation and maintenance of the deposits. If there is a deficiency in any deposit, so that the claims secured by it are not fully discharged from it, the claimants may share in the general assets, but the sharing shall be deferred until general creditors, and also claimants against other special deposits who have received smaller percentages from their respective special deposits, have been paid percentages of their claims equal to the percentage paid from the special deposit.

(3) The owner of a secured claim against an insurer for which a liquidator has been appointed in this or any other state may surrender his security and file his claim as a general creditor, or the claim may be discharged by resort to the security in accordance with section 41-3341, Idaho Code, in which case the deficiency, if any, shall be treated as a claim against the general assets of the insurer on the same basis as claims of unsecured creditors.

History:

[41-3358, added 1981, ch. 249, sec. 2, p. 539.]
Idaho Code § 41-3337 — Idaho Code / Title 41 / Chapter 33 / Section 41-3337
41-3337 SPECIAL CLAIMS.
Status: in_force

41-3337. Special claims. (1) The claim of a third party which is contingent only on his first obtaining a judgment against the insured shall be considered and allowed as if there were no such contingency.

(2) A claim may be allowed even if contingent, if it is filed in accordance with section 41-3335, Idaho Code. It may be allowed and may participate in all distributions declared after it is filed to the extent that it does not prejudice the orderly administration of the liquidation.

(3) Claims that are due except for the passage of time shall be treated as absolute claims are treated, except that such claims may be discounted at the legal rate of interest.

(4) Claims made under employment contracts by directors, principal officers, or persons in fact performing similar functions or having similar powers are limited to payment for services rendered prior to the issuance of any order of rehabilitation or liquidation under sections 41-3313 or 41-3318, Idaho Code.

History:

[41-3337, added 1981, ch. 249, sec. 2, p. 530.]
Idaho Code § 41-1902 — Idaho Code / Title 41 / Chapter 19 / Section 41-1902
41-1902 “INDUSTRIAL LIFE INSURANCE” DEFINED.
Status: in_force

41-1902. "Industrial life insurance" defined. For the purposes of this code "industrial life insurance" is that form of life insurance written under policies of face amount of one thousand dollars ($1,000) or less bearing the words "industrial policy" imprinted on the face thereof as part of the descriptive matter, and under which premiums are payable monthly or more often.

History:

[41-1902, added 1961, ch. 330, sec. 433, p. 645.]
Idaho Code § 41-3323 — Idaho Code / Title 41 / Chapter 33 / Section 41-3323
41-3323 DUTIES OF AGENTS.
Status: in_force

41-3323. Duties of agents. (1) Every person who receives notice in the form prescribed in section 41-3322, Idaho Code, that an insurer which he represents as an agent is the subject of a liquidation order, shall within fifteen (15) days of such notice give notice of the liquidation order. The notice shall be sent by first class mail to the last address contained in the agent's records to each policyholder or other person named in any policy issued through the agent by the insurer, if he has a record of the address of the policyholder or other person. A policy shall be deemed issued through an agent if the agent has a property interest in the expiration of the policy, or if the agent has had in his possession a copy of the declarations of the policy at any time during the life of the policy, except where the ownership of the expiration of the policy has been transferred to another. The written notice shall include the name and address of the insurer, the name and address of the agent, identification of the policy impaired and the nature of the impairment including termination of coverage, as described in section 41-3319, Idaho Code. Notice by a general agent satisfies the notice requirement for any agents under contract to him. Each agent obligated to give notice under the provisions of this section shall file a report of compliance with the liquidator.

(2) Any agent failing to give notice or file a report of compliance as required in subsection (1) of this section may be subject to payment of a penalty of not more than one thousand dollars ($1,000) and may have his license suspended, said penalty to be imposed after a hearing held by the director.

(3) The liquidator may waive the duties imposed by this section if he determines that other notice to the policyholders of the insurer under liquidation is adequate.

History:

[41-3323, added 1981, ch. 249, sec. 2, p. 519.]
Idaho Code § 41-1912 — Idaho Code / Title 41 / Chapter 19 / Section 41-1912
41-1912 PAYMENT OF PREMIUMS.
Status: in_force

41-1912. Payment of premiums. There shall be a provision relative to the payment of premiums.

History:

[41-1912, added 1961, ch. 330, sec. 443, p. 645.]
Idaho Code § 41-3112 — Idaho Code / Title 41 / Chapter 31 / Section 41-3112
41-3112 ASSESSMENTS.
Status: in_force

41-3112. Assessments. (1) A county mutual fire insurer may from time to time assess and collect from its members, and from the owners or trustees of churches or public halls insured by it, such sums of money as may be necessary to pay losses incurred under policies issued by the insurer, from time to time as such losses occur, and to pay such fire protection expenses and other expenses of the insurer as may have been approved by the board of directors consistent with section 41-3113.

(2) The insurer may classify its policies for assessment purposes in accordance with types and circumstances of properties and hazards insured, and may vary the amount of assessment as applied to the respective such classes, if the insurer maintains adequate records from which the loss experience of the respective classes can readily be determined.

(3) The levy and collection of assessments shall be regulated by the insurer's constitution and by-laws. But no assessment to cover insured losses incurred shall be levied in advance of the occurrence of the losses on account of which the assessment is made; except, that the insurer may, in its by-laws, provide for an emergency fund, which fund shall at no time exceed ten thousand dollars ($10,000) or one percent (1%) of the amount of insurance in force, whichever is the larger sum, out of which fund losses to the extent of the money therein may be immediately paid.

History:

[41-3112, added 1961, ch. 330, sec. 670, p. 645.]
Idaho Code § 41-731 — Idaho Code / Title 41 / Chapter 7 / Section 41-731
41-731 PROHIBITED INVESTMENTS AND INVESTMENT UNDERWRITING.
Status: in_force

41-731. Prohibited investments and investment underwriting. (1) In addition to investments excluded under other provisions of this code, an insurer shall not directly or indirectly invest in or loan its funds upon the security of:

(a) Issued shares of its own capital stock, except for the purpose of mutualization under section 41-2854, Idaho Code, or in connection with a plan approved by the director for purchase of such shares by the insurer's officers, employees, or agents, or for other reasonable purposes under a plan filed with and approved by the director. No such stock shall, however, constitute an asset of the insurer in any determination of its financial condition.

(b) Except with the director's consent, any security issued by any corporation or enterprise the controlling interest of which is, or will after such acquisition by the insurer be, held directly or indirectly by the insurer or any combination of the insurer and the insurer's directors, officers, parent corporation, subsidiaries, controlling stockholders, and the spouses and children of any of the foregoing individuals. Investments in subsidiaries under sections 41-706(2), 41-715 and 41-3803, Idaho Code, shall not be subject to this provision.

(c) Any note or other evidence of indebtedness of any director, officer, or controlling stockholder of the insurer, or the spouse or child of any of the foregoing individuals, except as to policy loans authorized under section 41-718, Idaho Code.

(d) Any investment or security which is found by the director to be designed to evade any prohibition of this chapter.

(2) No insurer shall underwrite or participate in the underwriting of an offering of securities or property by any other person.

History:

[41-731, added 1961, ch. 330, sec. 168, p. 645; am. 1969, ch. 214, sec. 25, p. 625; am. 1971, ch. 122, sec. 7, p. 408; am. 1993, ch. 194, sec. 10, p. 501; am. 2013, ch. 266, sec. 6, p. 680.]
Idaho Code § 41-311 — Idaho Code / Title 41 / Chapter 3 / Section 41-311
41-311 NAME OF INSURER.
Status: in_force

41-311. Name of insurer. (1) No insurer shall be formed, authorized or otherwise allowed to transact insurance in this state which has or uses a name or principal identifying name factor which is the same as or deceptively similar to that of another insurer earlier authorized or allowed to transact insurance in this state.

(2) No life insurer shall be authorized or otherwise allowed to transact insurance in this state which has or uses a name deceptively similar to that of another insurer authorized or otherwise allowed to transact insurance in this state within the preceding ten (10) years if life insurance policies originally issued by such other insurer are still outstanding in this state.

(3) No insurer shall hereafter be formed, newly authorized or otherwise allowed to transact insurance in this state which has or uses a name the same as or deceptively similar to the name of any foreign insurer doing business elsewhere than in this state if such foreign insurer has within the last preceding twelve (12) months signified its intention to secure incorporation in this state under such name, or do business as a foreign insurer in this state under such name by filing notice of such intention with the director, unless the written consent to the use of such name or deceptively similar name has been given by such foreign insurer.

(4) No insurer shall be authorized or otherwise allowed to transact insurance in this state which has or uses a name which tends to deceive or mislead as to the type of organization of the insurer.

(5) In case of conflict of names hereafter between two (2) insurers, or a conflict otherwise prohibited under this section, the director may permit, or shall require as a condition to the issuance of an original certificate of authority or other approval to transact insurance in this state to an applicant insurer, the insurer to use in this state such supplementation or modification of its name or such business name as may reasonably be necessary to avoid the conflict. No such name, supplementation or modification shall contain the principal identifying factor of the name of any other insurer already authorized or otherwise allowed to transact insurance in this state.

History:

[41-311, added 1961, ch. 330, sec. 74, p. 645; am. 2004, ch. 91, sec. 1, p. 331.]
Idaho Code § 41-1331 — Idaho Code / Title 41 / Chapter 13 / Section 41-1331
41-1331 CLAIMS FORMS STATEMENT.
Status: in_force

41-1331. Claims forms statement. (1) All claims forms may contain a statement that clearly states in substance the following: "Any person who knowingly, and with intent to defraud or deceive any insurance company, files a statement of claim containing any false, incomplete, or misleading information is guilty of a felony." The lack of such a statement shall not constitute a defense against prosecution under this section.

(2) For the purposes of this section, "statement" includes, but is not limited to, any notice, statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of property damages, bill for services, diagnosis, prescription, hospital or doctor records, x-ray test results, or other evidence of loss, injury, or expense.

History:

[41-1331, added 1981, ch. 23, sec. 4, p. 41; am. 1982, ch. 178, sec. 1, p. 466.]
Idaho Code § 41-1853 — Idaho Code / Title 41 / Chapter 18 / Section 41-1853
41-1853 PLANS COVERING CONTRACEPTION.
Status: in_force

41-1853. plans covering contraception. (1) As used in this section:

(a) "Health benefit plan" shall have the same meaning as provided in section 41-5501, Idaho Code.

(b) "Prescription contraception" means all drugs, devices, and products approved by the United States food and drug administration that are used to prevent pregnancy and that are prescribed by an enrollee's provider. The term "prescription contraception" does not include drugs, devices, or products intended to induce abortion as defined by section 18-604, Idaho Code.

(2) A health benefit plan or student health benefit plan issued or renewed on or after January 1, 2025, that includes coverage for prescription contraception must:

(a) Provide reimbursement for prescription contraception intended to last six (6) months obtained at one (1) time by the enrollee, unless:

(i) No prescription contraception has previously been prescribed to the enrollee, in which case the prescribing provider shall prescribe a smaller supply; or

(ii) The enrollee requests a smaller supply or the prescribing provider instructs that the enrollee must receive a smaller supply; and

(b) Allow enrollees to receive prescription contraception on-site at the prescribing provider's office, if available. Any dispensing practices required by the plan must follow clinical guidelines for appropriate prescribing and dispensing to ensure the health of the patient while maximizing access to effective prescription contraception.

(3) Nothing in this section shall be construed to require a health benefit plan or a student health benefit plan to provide reimbursement for drugs, devices, or products intended to induce abortion as defined in section 18-604, Idaho Code, or for any emergency contraception approved by the United States food and drug administration.

History:

[41-1853, added 2024, ch. 53, sec. 1, p. 267.]
Idaho Code § 41-2212 — Idaho Code / Title 41 / Chapter 22 / Section 41-2212
41-2212 DEFINITIONS.
Status: in_force

41-2212. Definitions. In this act, unless the context otherwise requires:

(1) "Carrier" shall mean the insurance company, nonprofit hospital and medical service corporation, or other entity responsible for the payment of benefits or provision of services under a policy.

(2) "Dependent" shall have the meaning set forth in a policy.

(3) "Discontinuance" shall mean the termination of a policy by action taken by the policyholder, including failure to pay premium within the period provided by the policy, or by the carrier pursuant to a provision of the policy permitting termination or by mutual agreement of the policyholder and carrier.

(4) "Employee" shall mean all agents, employees, and members of unions or associations to whom benefits are provided under a policy.

(5) "Extension of Benefits" means the continuation of coverage under a particular benefit provided under a policy following discontinuance with respect to an employee or dependent who is totally disabled on the date of discontinuance.

(6) "Policy" shall mean any group insurance policy, group hospital and medical service contract or other plan, contract or policy subject to the provisions of this act.

(7) "Policyholder" shall mean the entity to which a policy is issued as specified in section 41-2213.

(8) "Premium" shall mean the consideration payable to the carrier.

(9) "Replacement Coverage" shall mean the benefits which are substituted under one carrier's policy by similar benefits under a policy issued by another carrier.

(10) "Totally Disabled" shall have the meaning set forth in a policy and not be inconsistent with the definition of "disability insurance" in section 41-503, Idaho Code.

History:

[41-2212, added 1975, ch. 204, sec. 3, p. 565.]
Idaho Code § 41-2611 — Idaho Code / Title 41 / Chapter 26 / Section 41-2611
41-2611 DEDUCTION OF BOND PREMIUM FROM WAGES OF EMPLOYEES.
Status: in_force

41-2611. Deduction of bond premium from wages of employees. No firm, individual, railroad or other corporation doing business within this state shall collect or retain from the wages of the persons in their employ the cost of any guaranty or security furnished the said firm, individual or railroad or other corporation, covering the said employees, unless such employees shall have agreed to pay the premium on such guaranty or security.

History:

[41-2611, added 1961, ch. 330, sec. 564, p. 645.]
Idaho Code § 41-732 — Idaho Code / Title 41 / Chapter 7 / Section 41-732
41-732 DOMESTIC RECIPROCAL INSURER.
Status: in_force

41-732. Domestic reciprocal insurer. Notwithstanding the provisions of chapter 1, title 57, Idaho Code, and section 67-2328, Idaho Code, funds of a domestic reciprocal insurer which is comprised of and exclusively insures members who are political subdivisions of the state, as defined in section 6-902(2), Idaho Code, and which exclusively insures against risk pertaining to property and casualty claims, shall be invested, reinvested and used in the manner and subject to the conditions, restrictions and limitations set forth in this chapter.

History:

[41-732, added 2008, ch. 399, sec. 1, p. 1089.]
Idaho Code § 41-1402 — Idaho Code / Title 41 / Chapter 14 / Section 41-1402
41-1402 PURPOSE OF LAW — INTERPRETATION.
Status: in_force

41-1402. Purpose of law — Interpretation. (1) The purpose of this chapter is to promote the public welfare by regulating insurance rates as herein provided to the end that they shall not be excessive, inadequate or unfairly discriminatory, and to authorize and regulate cooperative action among insurers in rate making and in other matters within the scope of this chapter.

(2) It is the express intent of this chapter to permit and encourage competition between insurers on a sound financial basis, and nothing in this chapter is intended to give the director power to fix and determine a rate level by classification or otherwise.

(3) This chapter shall be liberally interpreted to carry into effect the provisions of this section.

History:

[41-1402, added 1961, ch. 330, sec. 307, p. 645; am. 1969, ch. 306, sec. 2, p. 917.]
Idaho Code § 41-1102 — Idaho Code / Title 41 / Chapter 11 / Section 41-1102
41-1102 “ADJUSTER” DEFINED.
Status: in_force

41-1102. "Adjuster" defined. (1) An "adjuster" is a person who, on behalf of the insurer, for compensation as an independent contractor or as the employee of such an independent contractor, or for fee or commission, investigates and negotiates settlement of claims arising under insurance contracts.

(2) None of the following is an "adjuster" for the purposes of this chapter:

(a) A licensed attorney at law who is qualified to practice law in this state.

(b) The salaried employee of an authorized insurer, or group of such insurers under common control or ownership, or of a managing general agent, who adjusts losses for such insurer or insurers or for the authorized insurers represented by the general agent.

(c) The licensed agent of an authorized insurer who, at the insurer's request, from time to time adjusts or assists in adjustment of losses arising under policies issued by such insurer.

(d) An individual who collects claim information from, or furnishes claim information to, claimants or those who are insured and who conducts data entry, including entering data into an automated claims adjudication system, provided that the individual is an employee of a licensed adjuster or its affiliate where no more than twenty-five (25) such persons are under the supervision of one (1) licensed adjuster or licensed agent. A licensed agent who acts as a supervisor or adjusts claims pursuant to the provisions of this paragraph is not required to also be licensed as an adjuster. For purposes of this section, "automated claims adjudication system" means a pre-programmed computer system designed for the collection, data entry, calculation and final resolution of portable electronics insurance claims that:

(i) May only be utilized by a licensed adjuster, licensed agent or supervised individuals operating pursuant to the provisions of this paragraph;

(ii) Must comply with all claims payment requirements of the insurance code; and

(iii) Must be certified as compliant with this section by a licensed adjuster who is an officer of a licensed business entity pursuant to the provisions of this chapter.

History:

[41-1102, added 1961, ch. 330, sec. 238, p. 645; am. 2012, ch. 226, sec. 12, p. 626.]
Idaho Code § 41-508 — Idaho Code / Title 41 / Chapter 5 / Section 41-508
41-508 “TITLE INSURANCE” DEFINED.
Status: in_force

41-508. "Title insurance" defined. (1) "Title insurance" is the certification or guarantee of title or ownership, or insurance of owners of property or others having an interest therein or liens or encumbrances thereon, against loss by encumbrance, or defective titles, or invalidity, or adverse claim to title. This definition shall not be deemed to apply as to the business of preparing and issuing abstracts of, but not certifying, guaranteeing, or insuring, title to or ownership of property or certifying to the validity of documents relative to such title.

(2) A title insurer may also insure:

(a) The identity, due execution, and validity of any note or bond secured by mortgage or deed of trust; and

(b) The identity, due execution, validity and recording of any such mortgage or deed of trust.

History:

[41-508, added 1961, ch. 330, sec. 117, p. 645.]
Idaho Code § 41-6305 — Idaho Code / Title 41 / Chapter 63 / Section 41-6305
41-6305 ORSA SUMMARY REPORT.
Status: in_force

41-6305. orsa summary report. (1) Upon the director's request, and no more than once each year, an insurer shall submit to the director an ORSA summary report or any combination of reports that together contain the information described in the ORSA guidance manual, applicable to the insurer and/or the insurance group of which the insurer is a member. If the insurer is a member of an insurance group, the insurer shall submit the report(s) required by this subsection if the director is the lead state director of the insurance group as determined by the procedures within the financial analysis handbook adopted by the NAIC and as adopted by the director by rule, administrative order or bulletin.

(2) The report(s) shall include a signature of the insurer's or the insurance group's chief risk officer or other executive having responsibility for the oversight of the insurer's enterprise risk management process attesting to the best of the officer's or executive's belief and knowledge that the insurer applies the enterprise risk management process described in the ORSA summary report and that a copy of the report has been provided to the insurer's board of directors or the appropriate committee thereof.

(3) An insurer may comply with subsection (1) of this section by providing the most recent and substantially similar report(s) provided by the insurer or another member of an insurance group of which the insurer is a member to the director or commissioner of another state or to a supervisor or regulator of a foreign jurisdiction if that report provides information that is comparable to the information described in the ORSA guidance manual. Any such report in a language other than English must be accompanied by a translation of that report into the English language.

History:

[41-6305, added 2017, ch. 75, sec. 1, p. 189.]
Idaho Code § 41-5805 — Idaho Code / Title 41 / Chapter 58 / Section 41-5805
41-5805 APPLICATION FOR LICENSE.
Status: in_force

41-5805. Application for license. [EFFECTIVE UPON A STATE'S PARTICIPATION IN NAIC'S CENTRAL REPOSITORY FOR CRIMINAL BACKGROUND INFORMATION] (1) A person applying for a public adjuster license shall make application to the department on an application form prescribed by the department.

(2) The applicant shall declare under penalty of perjury and under penalty of refusal, suspension or revocation of the license that the statements made in the application are true, correct and complete to the best of the applicant's knowledge and belief.

(3) In order to make a determination of license eligibility, the department is authorized to require fingerprints of applicants and submit the fingerprints and the fee required to perform the criminal history record checks to the Idaho state police and the federal bureau of investigation (FBI) for state and national criminal history record checks; the department shall require a criminal history record check on each applicant in accordance with this chapter. The department shall require each applicant to submit a full set of fingerprints in order for the department to obtain and receive national criminal history records from the FBI criminal justice information services division.

(a) The department may contract for the collection, transmission and resubmission of fingerprints required under this section. If the department does so, the fee for collecting, transmitting and retaining fingerprints shall be payable directly to the contractor by the person. The department may agree to a reasonable fingerprinting fee to be charged by the contractor.

(b) The department is authorized to receive criminal history record information in lieu of the Idaho state police that submitted the fingerprints to the FBI.

History:

[41-5805, added 2008, ch. 179, sec. 1, p. 533.]
Idaho Code § 41-3443 — Idaho Code / Title 41 / Chapter 34 / Section 41-3443
41-3443 BEST PRICE — MOST FAVORED NATIONS CLAUSE PROHIBITED.
Status: in_force

41-3443. Best price — Most favored nations clause prohibited. No service corporation may require, as an element of any service agreement, that any licensee or hospital agree:

(1) To the unnegotiated adjustment by the service corporation of the licensee's or hospital's contractual reimbursement rate to equal the lowest reimbursement rate the licensee or hospital has agreed to charge any other payor;

(2) To a requirement that the licensee or hospital adjust, or enter into negotiations to adjust, their charges to the service corporation if the licensee or hospital agrees to charge another payor lower rates; or

(3) To a requirement that the licensee or hospital disclose his, her or its contractual reimbursement rates from other payors.

History:

[41-3443, added 1998, ch. 422, sec. 3, p. 1334.]
Idaho Code § 41-6604 — Idaho Code / Title 41 / Chapter 66 / Section 41-6604
41-6604 APPEALS PROCESS.
Status: in_force

41-6604. Appeals process. (1) Each person or entity conducting an audit shall establish a written appeals process under which a pharmacy may appeal an unfavorable preliminary audit report or final audit report to the person or entity. The pharmacy must submit documentation or other evidence to support its appeal.

(2) Following an appeal, if the person or entity finds that an unfavorable audit report is unsubstantiated, the person or entity shall dismiss the unsubstantiated portion of the audit report.

(3) Any final audit report, following the final audit appeal period, with a finding of potential criminal conduct shall be referred to the prosecuting attorney having proper jurisdiction upon completion of the appeals process.

History:

[41-6604, added 2023, ch. 233, sec. 1, p. 722.]
Idaho Code § 41-105 — Idaho Code / Title 41 / Chapter 1 / Section 41-105
41-105 “DIRECTOR,” “DEPARTMENT” DEFINED.
Status: in_force

41-105. "Director," "department" defined. (1) "Director" means the director of the department of insurance of this state.

(2) "Department" means the department of insurance of this state.

History:

[41-105, added 1961, ch. 330, sec. 5, p. 645.]
Idaho Code § 41-1235 — Idaho Code / Title 41 / Chapter 12 / Section 41-1235
41-1235 FALSE ADVERTISING ACT.
Status: in_force

41-1235. False advertising act. Sections 41-1235 through 41-1237 of this act constitute and may be referred to as the unauthorized insurers false advertising process act.

History:

[I.C., sec. 41-1235, as added by 1969, ch. 214, sec. 42, p. 625.]
Idaho Code § 41-3305 — Idaho Code / Title 41 / Chapter 33 / Section 41-3305
41-3305 INJUNCTIONS AND ORDERS.
Status: in_force

41-3305. Injunctions and orders. (1) Any receiver appointed in a proceeding under this act, may at any time apply for and any court of general jurisdiction may grant, such restraining orders, preliminary and permanent injunctions, and other orders as may be deemed necessary and proper to prevent:

(a) The transaction of further business;

(b) The transfer of property;

(c) Interference with the receiver or with a proceeding under this act;

(d) Waste of the insurer's assets;

(e) Dissipation and transfer of bank accounts;

(f) The institution or further prosecution of any actions or proceedings;

(g) The obtaining of preferences, judgments, attachments, garnishments, or liens against the insurer, its assets or its policyholders;

(h) The levying of execution against the insurer, its assets, or its policyholders;

(i) The making of any sale or deed for nonpayment of taxes or assessments that would lessen the value of the assets of the insurer; or

(j) The withholding from the receiver of books, accounts, documents, or other records relating to the business of the insurer; or

(k) Any other threatened or contemplated action that might lessen the value of the insurer's assets or prejudice the rights of policyholders, creditors, or shareholders, or the administration of any proceeding under this act.

(2) The receiver may apply to any court outside of the state for the relief described in subsection (1) of this section.

History:

[41-3305, added 1981, ch. 249, sec. 2, p. 507.]
Idaho Code § 41-2612 — Idaho Code / Title 41 / Chapter 26 / Section 41-2612
41-2612 RELEASE OF SURETY ON BOND OF LICENSEE OR PERMITTEE.
Status: in_force

41-2612. Release of surety on bond of licensee or permittee. (1) The surety or the representative of any surety upon any bond given on behalf or for the use and benefit of any person, firm, copartnership, association or corporation as a licensee or permittee under any law of the state of Idaho, or any municipality thereof, desiring to be released from subsequent liability and responsibility on such bond, shall serve a written notice upon the principal of such bond that on and after twenty (20) days from the date of service of such notice, the surety will withdraw as surety on such bond, and a copy of such notice shall forthwith be served upon the official with whom such bond is filed.

(2) Such notice shall be served personally upon the principal if found within the state of Idaho, and if not, by registered mail directed to the principal at his last known address. If the principal cannot be served either personally or by registered mail, service shall be made by publication of the notice in a newspaper of general circulation in the county of the residence or principal place of business of the principal, once a week for a period of two consecutive weeks. Service upon the principal shall be complete one week from the date of the last publication. The affidavit of the persons so serving such notice, with the registered return receipt card attached thereto, if such service has been made by mail, or the affidavit of the publisher of the newspaper, shall be sufficient proof of service of such notice.

(3) Proof of such service shall be filed with the official having custody of the bond and the liability of the surety shall cease after a period of twenty (20) days from the date of the service of such notice on the principal. If the principal fails within such twenty (20) day period to file with the proper official a new bond the permit or license shall be canceled and terminated.

History:

[41-2612, added 1961, ch. 330, sec. 565, p. 645.]
Idaho Code § 41-4315 — Idaho Code / Title 41 / Chapter 43 / Section 41-4315
41-4315 EXAMINATION OF THE ASSOCIATION –- ANNUAL REPORT.
Status: in_force

41-4315. examination of the association –- annual report. The association shall be subject to examination and regulation by the director. The board of directors shall submit to the director each year, not later than May 1 of each year, a financial report in a form approved by the director and a report of its activities during the preceding fiscal year. Upon the request of a member insurer, the association shall provide the member insurer with a copy of the report.

History:

[41-4315, added 2011, ch. 196, sec. 2, p. 577.]
Idaho Code § 41-4112 — Idaho Code / Title 41 / Chapter 41 / Section 41-4112
41-4112 TAXES — EXEMPTION.
Status: in_force

41-4112. Taxes — Exemption. Any plan established under this chapter is not subject to any state tax, including a premium or maintenance tax.

History:

[41-4112, added 2006, ch. 415, sec. 1, p. 1277.]
Idaho Code § 41-5503 — Idaho Code / Title 41 / Chapter 55 / Section 41-5503
41-5503 PLAN OF OPERATION.
Status: in_force

41-5503. Plan of operation. (1) The board shall submit to the director a plan of operation and thereafter any amendments thereto necessary or suitable to assure the fair, reasonable and equitable administration of the pool. The director may, after notice and hearing, approve the plan of operation if the director determines it to be suitable to assure the fair, reasonable and equitable administration of the pool, and to provide for the sharing of pool gains or losses on an equitable and proportionate basis in accordance with the provisions of this chapter. The plan of operation shall become effective upon written approval by the director.

(2) If the board fails to submit a suitable plan of operation, the director shall, after notice and hearing, adopt and promulgate a temporary plan of operation. The director shall approve the plan of operation submitted by the board, or adopt a temporary plan of operation if the board fails to submit a suitable plan. The director shall amend or rescind any plan adopted under the provisions of this section at the time a plan of operation is submitted by the board and approved by the director.

(3) The plan of operation shall:

(a) Establish procedures for handling and accounting of pool assets and moneys and for an annual fiscal reporting to the director;

(b) Establish procedures for selecting an administrator, and setting forth the powers and duties of the administrator;

(c) Establish procedures for reinsuring risks in accordance with the provisions of this chapter;

(d) Establish procedures and conditions for a carrier to cede individuals with certain high risk medical conditions;

(e) Define the high risk medical conditions for which carriers are allowed to cede for reinsurance;

(f) Set forth the reinsurance parameters including, but not limited to, the initial level of claims for which the reinsuring carrier is responsible, the coinsurance percentage at which claims above the initial level are reinsured by the pool, and the maximum claims limit above which the pool no longer reimburses;

(g) Establish procedures for collecting assessments from carriers to fund claims and administrative expenses incurred or estimated to be incurred by the pool; and

(h) Provide for any additional matters necessary for the implementation and administration of the pool.

History:

[41-5503, added 2000, ch. 472, sec. 17, p. 1636; am. 2017, ch. 281, sec. 2, p. 735.]
Idaho Code § 41-3217 — Idaho Code / Title 41 / Chapter 32 / Section 41-3217
41-3217 BENEFICIARIES.
Status: in_force

41-3217. Beneficiaries. (1) The owner of a benefit contract shall have the right at all times to change the beneficiary or beneficiaries in accordance with the laws or rules of the society unless the owner waives this right by specifically requesting in writing that the beneficiary designation be irrevocable. A society may, through its laws or rules, limit the scope of beneficiary designations and shall provide that no revocable beneficiary shall have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the benefit contract.

(2) A society may make provision for the payment of funeral benefits to the extent of such portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled thereto by reason of having incurred expense occasioned by the burial of the member, provided the portion so paid shall not exceed the sum of five hundred dollars ($500).

(3) If, at the death of any person insured under a benefit contract, there is no lawful beneficiary to whom the proceeds shall be payable, the amount of such benefit, except to the extent that funeral benefits may be paid as hereinbefore provided, shall be payable to the personal representative of the deceased insured, provided that if the owner of the certificate is other than the insured, such proceeds shall be payable to such owner.

History:

[41-3217, added 1995, ch. 213, sec. 2, p. 732.]
Idaho Code § 41-4103 — Idaho Code / Title 41 / Chapter 41 / Section 41-4103
41-4103 REGISTRATION REQUIRED — EXEMPTIONS — NOT SUBJECT TO INSURANCE CODE.
Status: in_force

41-4103. Registration required — Exemptions — Not subject to insurance code. (1) No joint public agency self-funded plan shall operate in this state except while registered with the director as hereinafter provided. Joint public agency self-funded plans already in operation as of July 1, 2006, shall so register within ninety (90) days of the effective date of this act.

(2) No registration shall be required of:

(a) Any plan established and maintained for the purpose of complying with any worker's compensation law or unemployment compensation disability insurance law; or

(b) Any plan that is primarily for the purpose of providing first aid care and treatment, at a dispensary of an employer, for injury or sickness of employees while engaged in their employment.

(3) Plans while so registered shall not be deemed to be engaged in the business of insurance and shall not be subject to provisions of the Idaho insurance code except as expressly provided in this chapter.

(4) The plan shall provide to each employer participant and to each prospective employer participant a written notice stating that the plan is not insurance and does not participate in the state guaranty association.

History:

[41-4103, added 2006, ch. 415, sec. 1, p. 1272.]
Idaho Code § 41-1221 — Idaho Code / Title 41 / Chapter 12 / Section 41-1221
41-1221 SURPLUS LINE INSURANCE VALID.
Status: in_force

41-1221. Surplus line insurance valid. Insurance contracts procured as surplus line coverage from unauthorized insurers in accordance with this law shall be fully valid and enforceable as to all parties, and shall be given recognition in all matters and respects to the same effect as like contracts issued by authorized insurers.

History:

[41-1221, added 1961, ch. 330, sec. 265, p. 645.]
Idaho Code § 41-5906 — Idaho Code / Title 41 / Chapter 59 / Section 41-5906
41-5906 REQUEST FOR EXTERNAL REVIEW.
Status: in_force

41-5906. request for external review. A covered person may make a request for an external review of a final adverse benefit determination. Except for a request for an expedited external review as set forth in section 41-5909, Idaho Code, all requests for external review shall be made in writing to the director. The director may prescribe by rule the form and content of external review requests required to be submitted under this section.

History:

[41-5906, added 2009, ch. 87, sec. 1, p. 246; am. 2011, ch. 122, sec. 4, p. 339.]
Idaho Code § 41-4404 — Idaho Code / Title 41 / Chapter 44 / Section 41-4404
41-4404 STANDARDS FOR POLICY PROVISIONS AND AUTHORITY TO PROMULGATE RULES.
Status: in_force

41-4404. Standards for policy provisions and authority to promulgate rules. (1) No medicare supplement policy or certificate in force in this state shall contain benefits that duplicate benefits provided by medicare.

(2) Notwithstanding any other provision of law of this state, a medicare supplement policy or certificate shall not exclude or limit benefits for loss incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.

(3) The director may adopt reasonable rules to establish specific standards for policy provisions of medicare supplement policies and certificates. The standards shall be in addition to and in accordance with applicable laws of this state, including chapter 21, title 41, Idaho Code, disability insurance policies. No requirement of the insurance code relating to minimum required policy benefits, other than the minimum standards contained in this chapter, shall apply to medicare supplement policies and certificates. The standards may cover but not be limited to:

(a) Terms of renewability;

(b) Initial and subsequent conditions of eligibility, including an annual period during which a policyholder may terminate an existing medicare supplement policy and be eligible to purchase any other comparable or lesser medicare supplement policy on a guaranteed issue basis;

(c) Nonduplication of coverage;

(d) Probationary periods;

(e) Benefit limitations, exceptions and reductions;

(f) Elimination periods;

(g) Requirements for replacement;

(h) Recurrent conditions;

(i) Definition of terms;

(j) Open enrollment; and

(k) Attained age rating prohibited; issue age rating prohibited for policies issued after February 28, 2022; and community rating permitted.

(4) The director may adopt reasonable rules to establish minimum standards for benefits, claims payment, marketing practices and compensation arrangements, and reporting practices for medicare supplement policies and certificates.

(5) The director may adopt from time to time reasonable rules necessary to conform medicare supplement policies and certificates to the requirements of federal law and regulations promulgated thereunder, including but not limited to:

(a) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;

(b) Establishing a uniform methodology for calculating and reporting loss ratios;

(c) Assuring public access to all policies, premiums and loss ratio information of issuers of medicare supplement insurance;

(d) Establishing a process for approving or disapproving policy forms and certificate forms and proposed premium increases;

(e) Establishing a policy for holding public hearings prior to approval of premium increases; and

(f) Establishing standards for medicare select policies and certificates.

(6) The director may adopt reasonable rules that specify prohibited policy provisions not otherwise specifically authorized by statute that, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed to be insured under a medicare supplement policy or certificate.

History:

[41-4404, added 1999, ch. 102, sec. 2, p. 324; am. 2021, ch. 274, sec. 1, p. 826.]
Idaho Code § 41-1016 — Idaho Code / Title 41 / Chapter 10 / Section 41-1016
41-1016 ADMINISTRATIVE PENALTY — SUSPENSION, REVOCATION, REFUSAL OF LICENSE.
Status: in_force

41-1016. Administrative penalty — Suspension, revocation, refusal of license. (1) The director may impose an administrative penalty not to exceed one thousand dollars ($1,000), for deposit in the general fund of the state of Idaho, and may suspend for not more than twelve (12) months or may revoke or refuse to issue or continue any license issued under this chapter, chapter 27, title 41, Idaho Code (title insurance), chapter 11, title 41, Idaho Code (adjusters), or chapter 12, title 41, Idaho Code (surplus lines brokers), if the director finds that as to the licensee or applicant any one (1) or more of the following causes or violations exist:

(a) Providing incorrect, misleading, incomplete or materially untrue information in the license application;

(b) Violating any provision of title 41, Idaho Code, department rule, subpoena or order of the director or of another state's insurance director;

(c) Obtaining or attempting to obtain a license through misrepresentation or fraud;

(d) Improperly withholding, misappropriating or converting any moneys or properties received in the course of doing insurance business;

(e) Misrepresenting the terms of an actual or proposed insurance contract or application for insurance or misrepresenting any fact material to any insurance transaction or proposed transaction;

(f) Being convicted of or pleading guilty to a crime that is deemed relevant in accordance with section 67-9411(1), Idaho Code, or that evidences dishonesty, a lack of integrity and financial responsibility, or an unfitness and inability to provide acceptable service to the consuming public;

(g) Admitting or being found to have committed any insurance unfair trade practice or fraud;

(h) Using fraudulent, coercive or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility, or being a source of injury and loss to the public or others, in the conduct of business in this state or elsewhere;

(i) Having an insurance license denied, suspended or revoked in any other state, province, district or territory;

(j) Forging another's name on an application for insurance or on any document related to an insurance transaction;

(k) Improperly using notes or any other reference material to complete an examination for an insurance license;

(l) Knowingly accepting insurance business from an individual who is not licensed;

(m) Failing to comply with an administrative or court order imposing a child support obligation, provided however, that nothing in this provision shall be deemed to abrogate or modify chapter 14, title 7, Idaho Code;

(n) Failing to pay state income tax or to comply with any administrative or court order directing payment of state income tax; or

(o) In the case of a bail agent, compensating or agreeing to compensate any incarcerated person to influence or encourage another incarcerated person or other incarcerated persons to engage the bail agent's services or the services of the bail agent's company or of other bail agents employed by such bail company. For purposes of this subsection, compensating any incarcerated person shall include providing payment in any form to any person, organization or entity designated by the incarcerated person to receive such payment.

(2) The director shall, without hearing, suspend for not more than twelve (12) months, or shall revoke or refuse to continue any license issued under this chapter to a nonresident where:

(a) The director has received a final order of suspension, revocation or refusal to continue from the insurance regulatory official or court of jurisdiction of the licensee's home state; or

(b) A nonresident no longer has a license in the licensee's home state because the home state license was:

(i) Voluntarily surrendered for any reason except relicensing as a resident in another state; or

(ii) Otherwise nonrenewed by the nonresident and remains nonrenewed for a period greater than ninety (90) days beyond its expiration date, and without notice to the director of relicensing as a resident in another state.

If cause under this provision exists after the expiration of the twelve (12) months, successive suspensions may be imposed by the director without hearing.

(3) The license of a business entity may be suspended, revoked or refused if the director finds that the violation of an individual licensee, who is registered to or acting on behalf of the business entity, was known or should have been known by one (1) or more of the owners, officers or managers acting on behalf of the business entity and that the violation was not reported to the director and no corrective action was taken.

(4) In addition to or in lieu of any applicable denial, suspension or revocation of a license, a person may, after hearing, be subject to a civil fine or administrative penalty pursuant to subsection (1) of this section or any other applicable section.

(5) The director shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by title 41, Idaho Code, against any person who is under investigation for or charged with a violation of title 41, Idaho Code, or department rule, even if the person's license or registration has been surrendered or has lapsed by operation of law, or if the person has never been licensed.

History:

[41-1016, added 2001, ch. 296, sec. 3, p. 1056; am. 2005, ch. 77, sec. 5, p. 259; am. 2006, ch. 49, sec. 3, p. 142; am. 2016, ch. 50, sec. 1, p. 144; am. 2017, ch. 258, sec. 1, p. 634; am. 2020, ch. 175, sec. 8, p. 511.]
Idaho Code § 41-4927 — Idaho Code / Title 41 / Chapter 49 / Section 41-4927
41-4927 BYLAWS OF THE FUND.
Status: in_force

41-4927. Bylaws of the fund. The board shall adopt bylaws subject to the approval of the director, who shall grant his approval only after his determination that the provisions in the bylaws are not inconsistent nor contrary to the applicable provisions of title 41, Idaho Code, as amended in this chapter. These bylaws shall outline the organizational structure of the trust fund, its operational methods of complying with the provisions of this chapter, including the deposit, custody, disbursement and accounting for the moneys in the trust fund, fidelity bonds, if any, required of the administrator, the essential elements of the managerial contract with the administrator, the powers and duties of the administrator of the trust fund, the rights, privileges and responsibilities of insured owners or operators of storage tanks, the manner in which annual and special meetings of the board shall be conducted, and such other matters as may be customary, necessary or convenient for the management and operation of the trust fund.

History:

[(41-4927) 41-4930, added 1990, ch. 119, sec. 1, p. 282; am. 1991, ch. 59, sec. 21, p. 131; am. & redesig. 2003, ch. 96, sec. 31, p. 301.]
Idaho Code § 41-5408 — Idaho Code / Title 41 / Chapter 54 / Section 41-5408
41-5408 CONFIDENTIALITY — PROHIBITION ON ANNOUNCEMENTS, PROHIBITION ON USE IN RATEMAKING.
Status: in_force

41-5408. Confidentiality — Prohibition on announcements, prohibition on use in ratemaking. (1) All RBC reports, to the extent the information therein is not required to be set forth in a publicly available annual statement schedule, and RBC plans, including the results or report of any examination or analysis of an insurer performed pursuant hereto and any corrective order issued by the director pursuant to examination or analysis, with respect to any domestic insurer or foreign insurer which are filed with the director, constitute information that might be damaging to the insurer if made available to its competitors, and therefore shall be kept confidential by the director and shall be considered privileged. Notwithstanding the provisions of chapter 1, title 74, Idaho Code, this information shall not be made public or be subject to subpoena and shall not be subject to discovery or admissible in evidence in any private civil action. However, the director is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the director's official duties.

(2) Neither the director nor any person who received documents, materials or other information while acting under the authority of the director shall be permitted or required to testify in any private civil action concerning any confidential documents, materials or information obtained or provided pursuant to subsection (1) of this section.

(3) In order to assist in the performance of his duties under this chapter, the director may:

(a) Share documents, materials or other information, including the confidential and privileged documents, materials or information subject to subsection (1) of this section, with other states, federal and international regulatory agencies, with the NAIC and its affiliates and subsidiaries and with state, federal and international law enforcement authorities, provided that the recipient agrees to maintain the confidentiality and privileged status of the document, material or other information;

(b) Receive documents, materials or information, including otherwise confidential and privileged documents, materials or information, from the NAIC and its affiliates and subsidiaries and from regulatory and law enforcement officials of other foreign or domestic jurisdictions and shall maintain as confidential or privileged any document, material or information received with notice of or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and

(c) Enter into agreements governing the sharing and use of information consistent with the provisions of this subsection.

(4) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information referenced in this section shall occur as a result of disclosure to the director under this section or as a result of sharing as authorized in subsection (3) of this section.

(5) It is the judgment of the legislature that the comparison of an insurer's total adjusted capital to any of its RBC levels is a regulatory tool which may indicate the need for possible corrective action with respect to the insurer, and is not intended as a means to rank insurers generally. Therefore, except as otherwise required under the provisions of this chapter, the making, publishing, disseminating, circulating or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated or placed before the public in a newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station, or in any other way, an advertisement, announcement or statement containing an assertion, representation or statement with regard to the RBC levels of any insurer, or of any component derived in the calculation, by any insurer, agent, broker or other person engaged in any manner in the insurance business would be misleading and is therefore prohibited; provided however, that if any materially false statement with respect to the comparison regarding an insurer's total adjusted capital to its RBC levels, or any of them, or an inappropriate comparison of any other amount to the insurers' RBC levels is published in any written publication and the insurer is able to demonstrate to the director with substantial proof the falsity of such statement, or the inappropriateness, as the case may be, then the insurer may publish an announcement in a written publication if the sole purpose of the announcement is to rebut the materially false statement.

(6) It is the further judgment of the legislature that the RBC instructions, RBC reports, adjusted RBC reports, RBC plans and revised RBC plans are intended solely for use by the director in monitoring the solvency of insurers and the need for possible corrective action with respect to insurers and shall not be used by the director for ratemaking nor considered or introduced as evidence in any rate proceeding nor used by the director to calculate or derive any elements of an appropriate premium level or rate of return for any line of insurance which an insurer or any affiliate is authorized to write.

History:

[41-5408, added 1996, ch. 96, sec. 1, p. 291; am. 2014, ch. 319, sec. 5, p. 789; am. 2015, ch. 141, sec. 116, p. 465.]
Idaho Code § 41-1916 — Idaho Code / Title 41 / Chapter 19 / Section 41-1916
41-1916 EXCLUDED OR RESTRICTED COVERAGE.
Status: in_force

41-1916. Excluded or restricted coverage. A clause in any policy of life insurance providing that such policy shall be incontestable after a specified period shall preclude only a contest of the validity of the policy, and shall not preclude the assertion at any time of defenses based upon provisions in the policy which exclude or restrict coverage, whether or not such restrictions or exclusions are excepted in such clause.

History:

[41-1916, added 1961, ch. 330, sec. 447, p. 645.]
Idaho Code § 41-3439 — Idaho Code / Title 41 / Chapter 34 / Section 41-3439
41-3439 LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.
Status: in_force

41-3439. Limitation of benefits for elective abortions. All individual nongroup or subscriber's policies, contracts, plans or certificates delivered, issued for delivery or renewed in this state after the effective date of this section shall exclude coverage for elective abortions except. Such exclusion may be waived by endorsement and the payment of a premium therefor. Availability of such coverage shall be at the option of the service corporation. For purposes of this section, an "elective abortion" means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.

History:

[41-3439, added 1983, ch. 94, sec. 3, p. 207.]
Idaho Code § 41-2206 — Idaho Code / Title 41 / Chapter 22 / Section 41-2206
41-2206 “BLANKET DISABILITY INSURANCE” DEFINED.
Status: in_force

41-2206. "Blanket disability insurance" defined. "Blanket disability insurance" is hereby declared to be that form of disability insurance covering groups of persons as enumerated in one of the following subdivisions.

(1) Under a policy or contract issued to any common carrier or to any operator, owner or lessee of a means of transportation, who or which shall be deemed the policyholder, covering a group defined as all persons or all persons of a class who may become passengers on such common carrier or such means of transportation.

(2) Under a policy or contract issued to an employer, who shall be deemed the policyholder, covering the employer and all employees, dependents or guests, defined by reference to specified hazards incident to the activities or operations of the employer or any class of employees, dependents or guests similarly defined.

(3) Under a policy or contract issued to a school, or other institution of learning, camp or sponsor thereof; or to the head or principal thereof, who or which shall be deemed the policyholder, covering students or campers. Supervisors and employees may be included.

(4) Under a policy or contract issued in the name of any religious, charitable, recreational, educational, or civic organization, which shall be deemed the policyholder, covering participants in activities sponsored by the organization.

(5) Under a policy or contract issued to a sports team or sponsors thereof which shall be deemed the policyholder, covering members, officials and supervisors.

(6) Under a policy or contract issued in the name of any volunteer fire department, first aid, or other such volunteer group, or agency having jurisdiction thereof, which shall be deemed the policyholder, covering all of the members of such fire department or group.

(7) Under a policy or contract issued to cover any other risk or class of risks which, in the discretion of the director may be properly eligible for blanket disability insurance. The discretion of the director may be exercised on an individual risk basis or class of risks, or both.

History:

[41-2206, added 1961, ch. 330, sec. 532, p. 645.]