S.C. Code Ann. § 38-21-95 — SC Code / Title 38 / Chapter 21 / Section 38-21-95
SECTION 38-21-95. Approval for acquisition of domestic insurer by controlling producer; conditions and requirements.
Status: in_force

(A) An acquisition of a domestic insurer, whether a member of a holding company system or not, by a controlling producer may not be approved by the director or his designee unless the acquiring party demonstrates, to the satisfaction of the director or his designee compliance with the requirements contained in subsection (B) of this section. For the purposes of this section, "controlling producer" means a broker that: (1) places business on behalf of an insured with a licensed insurer; (2) controls or seeks to control a domestic insurer as that term is defined in Section 38-21-10(2); and (3) places, in any calendar year, an aggregate amount of gross written premium with the controlled insurer which is equal to or greater than five percent of the admitted assets of the controlled insurer as reported in the insurer's quarterly statement filed as of September thirtieth of the prior year. (B) Approval of the acquisition of a domestic insurer, whether a member of a holding company system or not, by a controlling producer may not be approved unless the following requirements are met: (1) A controlled insurer may not accept business from a controlling producer and a controlling producer may not place business with a controlled insurer unless there is a written contract between the controlling producer and the controlled insurer specifying the responsibilities of each party, which contract has been approved by the board of directors of the controlled insurer and which contains a provision: (a) that the controlled insurer may terminate the contract for cause, upon written notice to the controlling producer. The controlled insurer shall suspend the authority of the controlling producer to write business during the pendency of any dispute regarding the cause for the termination; (b) that the controlling producer shall render accounts to the controlled insurer detailing all material transactions, including information necessary to support all commissions, charges, and other fees received by, or owing to, the controlling producer; (c) that the controlling producer shall remit all funds due under the terms of the contract to the controlled insurer on at least a monthly basis. The due date must be fixed so that premiums or installments of it collected must be remitted no later than ninety days after the effective date of any policy placed with the controlled insurer under this contract; (d) that all funds collected for the controlled insurer's account must be held by the controlling producer in a fiduciary capacity, in one or more appropriately identified bank accounts in banks that are members of the Federal Reserve System; (e) that the controlling producer shall maintain separately identifiable records of business written for the controlled insurer; (f) that the contract may not be assigned in whole or in part by the controlling producer; (g) that the controlled insurer shall provide the controlling producer with its underwriting standards, rules, procedures, manuals setting forth the rates to be charged, and the conditions for the acceptance or rejection of risks. The controlling producer shall adhere to the standards, rules, procedures, rates, and conditions. The standards, rules, procedures, rates, and conditions must be the same as those applicable to comparable business placed with the controlled insurer by a producer other than the controlling producer; (h) establishing the rates and terms of the controlling producer's commissions, charges, or other fees and the purposes for those charges or fees. The rates of the commissions, charges, and other fees must be no greater than those applicable to comparable business placed with the controlled insurer by producers other than controlling producers. For purposes of this subitem and subitem (g), examples of "comparable business" include the same lines of insurance, same kinds of insurance, same kinds of risks, similar policy limits, and similar quality of business; (i) that, if the contract provides that the controlling producer, on insurance business placed with the insurer, is to be compensated contingent upon the insurer's profits on that business, then that compensation must not be determined and paid until at least five years after the premiums on liability insurance are earned and at least one year after the premiums are earned on any other insurance. The commissions may not be paid until the adequacy of the controlled insurer's reserves on remaining claims has been independently verified pursuant to subsection (B)(3)(a); (j) limiting the controlling producer's writings in relation to the controlled insurer's surplus and total writings. The controlled insurer may establish a different limit for each line or subline of business. The controlled insurer shall notify the controlling producer when the applicable limit is approached and may not accept business from the controlling producer if the limit is reached. The controlling producer may not place business with the controlled insurer if it has been notified by the controlled insurer that the limit has been reached; and (k) that the controlling producer may negotiate but does not bind reinsurance on behalf of the controlled insurer on business the controlling producer places with the controlled insurer, except that the controlling producer may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the controlled insurer contains underwriting guidelines including, for both reinsurance assumed and ceded, a list of reinsurers with which these automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured, and commission schedules. (2) Each controlled insurer shall have an audit committee of the board of directors composed of independent directors. The audit committee shall meet annually with management, the controlled insurer's independent certified public accountants, and an independent casualty actuary, or other independent loss reserve specialist acceptable to the director or his designee to review the adequacy of the controlled insurer's loss reserves. (3)(a) In addition to another required loss reserve certification, the controlled insurer shall file annually, on April first of each year, with the director or his designee an opinion of an independent casualty actuary, or other independent loss reserve specialist acceptable to the director or his designee, reporting loss ratios for each line or subline of business written and attesting to the adequacy of loss reserves established for losses incurred and outstanding as of year-end, including incurred but not reported losses, on business placed by the controlling producer. (b) The controlled insurer shall report annually to the director or his designee the amount of commissions paid to the controlling producer, the percentage the amount represents of the net premiums written, and comparable amounts and percentages paid to noncontrolling producers for placements of the same kinds of insurance. (4) The controlling producer, before the effective date of the policy, shall deliver written notice to the prospective insured disclosing the relationship between the controlling producer and the controlled insurer, except that, if the business is placed through a subproducer who is not a controlling producer, the controlling producer shall retain in his records a signed commitment from the subproducer that the subproducer is aware of the relationship between the controlled insurer and the controlling producer and that the subproducer has or will notify the insured. (5)(a) If the director or his designee believes that the controlling producer or other person has not materially complied with this section, or regulation or order promulgated pursuant to the provisions of this section, after notice and opportunity to be heard, the director or his designee may order the controlling producer to cease placing business with the controlled insurer. (b) If it was found that because of the material noncompliance that the controlled insurer or any policyholder of it has suffered any loss or damage, the director or his designee may maintain a civil action or intervene in an action brought by or on behalf of the controlled insurer or policyholder for recovery of compensatory damages for the benefit of the controlled insurer or policyholder or other appropriate relief. (c) If an order for liquidation or rehabilitation of the controlled insurer has been entered pursuant to Chapter 27, Title 38, and the receiver appointed under that order believes that the controlling producer or another person has not materially complied with this section, or regulation or order promulgated under it, and the controlled insurer suffered any loss or damage from it, the receiver may maintain a civil action for recovery of damages or other appropriate sanctions for the benefit of the controlled insurer. (d) Nothing contained in this section affects the right of the director or his designee to impose other penalties provided for in the insurance law. (e) Nothing contained in this section is intended to or in any manner alters or affects the rights of policyholders, claimants, creditors, or other third parties.
S.C. Code Ann. § 38-43-107 — SC Code / Title 38 / Chapter 43 / Article 1 / Section 38-43-107
SECTION 38-43-107. Business, email, mailing and residential street addresses on application for insurance producer's license; notice of change of legal name or address; penalty.
Status: in_force

(A) If an individual applies for an insurance producer's license, he shall supply the department his business, email, mailing, and residential street addresses. The producer also shall notify the department within thirty days of any change in legal name or in these addresses. (B) Failure to inform the director or his designee of a change in legal name or address within this period is a violation of this title and the producer is subject to the penalties provided in Section 38-2-10. Effect of Amendment 2016 Act No. 194, SECTION 2, in (A), inserted "email," and substituted "residential street addresses" for "residence street address".
S.C. Code Ann. § 38-13-700 — SC Code / Title 38 / Chapter 13 / Article 7 / Section 38-13-700
SECTION 38-13-700. Periodic examination of unemployment compensation fund; duties of director.
Status: in_force

(A) At least every five years, or upon request pursuant to Section 38-13-710, the director must conduct an examination of the unemployment compensation fund administered by the Department of Employment and Workforce. Examinations scheduled by the director must include at least a detailed accounting of the revenue and expenditures of the fund and an analysis of the current and future solvency of the fund. (B) In scheduling and determining the nature, scope, and frequency of examinations, the director shall consider compliance with relevant federal and South Carolina laws and regulations, the results of previous examinations, changes in management, and reports of the audits performed by the Legislative Audit Council. (C) For purposes of completing an examination of an insurer under this article, the director may examine or investigate the Department of Employment and Workforce in a manner considered necessary or material by the director.
S.C. Code Ann. § 38-73-440 — SC Code / Title 38 / Chapter 73 / Article 5 / Section 38-73-440
SECTION 38-73-440. Certain factors may not be considered in determining automobile insurance rates.
Status: in_force

In determining the premium rates to be charged on automobile insurance, it is unlawful to consider race, religion, national origin, or economic status.
S.C. Code Ann. § 38-23-50 — SC Code / Title 38 / Chapter 23 / Section 38-23-50
SECTION 38-23-50. Profits realized from certain transactions by beneficial owners, directors, or officers inure to insurer; suit to recover these profits.
Status: in_force

For the purpose of preventing the unfair use of information which may have been obtained by a beneficial owner, director, or officer by reason of his relationship to the insurer, any profit realized by him from any purchase and sale, or any sale and purchase, of any equity security of the insurer within any period of less than six months, unless the security was acquired in good faith in connection with a debt previously contracted, inures to and is recoverable by the insurer, irrespective of any intention on the part of the beneficial owner, director, or officer in entering into the transaction of holding the security purchased or of not repurchasing the security sold for a period exceeding six months. Suit to recover this profit may be instituted at law or in equity in any court of competent jurisdiction by the insurer or by the owner of any security of the insurer in the name and in behalf of the insurer if the insurer fails or refuses to bring the suit within sixty days after request or fails diligently to prosecute it thereafter. This suit may not be brought more than two years after the date the profit was realized. This section may not be construed to cover any transaction where the beneficial owner was not a beneficial owner both at the time of the purchase and sale, or the sale and purchase, of the security involved, or any transaction or transactions which the department, by regulation, may exempt as not comprehended within the purpose of this section.
S.C. Code Ann. § 38-29-90 — SC Code / Title 38 / Chapter 29 / Section 38-29-90
SECTION 38-29-90. Plan of operation.
Status: in_force

(1) The association shall submit to the department a plan of operation and any amendments necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments become effective upon the written approval of the director or his designee or thirty days after submission if the plan of operation and any amendments have not been rejected by the director. If the association fails to submit suitable amendments to the plan, the director or his designee shall, after notice and hearing, adopt and promulgate reasonable amendments necessary or advisable to effectuate the provisions of this chapter. These amendments must continue in force until modified by the director or his designee or superseded by amendments submitted by the association and approved by the director or his designee. (2) All member insurers shall comply with the plan of operation. (3) The plan of operation shall, in addition to requirements enumerated elsewhere in this chapter: (a) establish procedures for handling the assets of the association; (b) establish the amount and method of reimbursing members of the board of directors under Section 38-29-60; (c) establish regular places and times for meetings of the board of directors; (d) establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors; (e) establish the procedure whereby selections for the board of directors must be made and submitted to the department director; (f) establish any additional procedures for assessments under Section 38-29-80; (g) contain additional provisions necessary or proper for the execution of the powers and duties of the association; (h) establish procedures whereby a member of the board of directors may be removed for cause including a case where a member insurer director becomes an impaired or insolvent insurer; (i) require the board of directors to establish a policy and procedures for addressing conflicts of interest. (4) The plan of operation may provide that any or all powers and duties of the association, except those under Section 38-29-70(13)(c) and Section 38-29-80, are delegated to a corporation, association, or other organization which performs or will perform functions similar to those of this association, or its equivalent, in two or more states. Such a corporation, association, or organization must be reimbursed for any payments made on behalf of the association and must be paid for its performance of any function of this association. A delegation under this subsection takes effect only with the approval of both the board of directors and the department director or his designee and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter. Editor's Note 2020 Act No. 121, SECTION 1.B, provides as follows: "[1.]B. The amendments made by this act do not apply to a member insurer that has been placed under an order of rehabilitation or liquidation before July 1, 2020." Effect of Amendment 2020 Act No. 121, SECTION 1.A, in (1), in the second sentence, inserted "or thirty days after submission if the plan of operation and any amendments have not been rejected by the director"; in (3), added (h) and (i) and made nonsubstantive changes; and in (4), in the first sentence, substituted "Section 38-29-70(13)(c)" for "Section 38-29-70(11)(c)".
S.C. Code Ann. § 38-63-620 — SC Code / Title 38 / Chapter 63 / Article 5 / Section 38-63-620
SECTION 38-63-620. Calculation of cash surrender values, paid-up nonforfeiture benefits, adjusted premiums, and present values; net value of paid-up additions.
Status: in_force

Any cash surrender value and any paid-up nonforfeiture benefit, available under the policy in the event of default in a premium payment due at any time other than on the policy anniversary, must be calculated with allowance for the lapse of time and the payment of fractional premiums beyond the last preceding policy anniversary. All values referred to in SECTIONS 38-63-530, 38-63-540, and 38-63-570 to 38-63-600 may be calculated upon the assumption that any death benefit is payable at the end of the policy year of death. The net value of any paid-up additions, other than paid-up term additions, may not be less than the amounts used to provide such additions.
S.C. Code Ann. § 38-21-250 — SC Code / Title 38 / Chapter 21 / Section 38-21-250
SECTION 38-21-250. Standards for transactions within insurance holding company system.
Status: in_force

(A) Transactions within an insurance holding company system to which an insurer subject to registration is a party are subject to the following standards: (1) The terms must be fair and reasonable. (2) Agreements for cost-sharing services and management must include provisions required by regulation promulgated by the department. (3) Charges or fees for services performed must be reasonable. (4) Expenses incurred and payment received must be allocated to the insurer in conformity with customary insurance accounting practices consistently applied. (5) The books, accounts, and records of each party to all transactions must be so maintained as to clearly and accurately disclose the nature and details of the transactions including such accounting information as is necessary to support the reasonableness of the charges or fees to the respective parties. (6) The insurer's surplus as regards policyholders following any dividends or distributions to shareholder affiliates must be reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs. (7) If an insurer subject to this act is deemed by the director to be in a hazardous financial condition as defined by Sections 38-5-120 and 38-9-330 or a condition that would be grounds for supervision, conservation, or a delinquency proceeding, then the director may require the insurer to secure and maintain either a deposit, held by the director, or a bond, as determined by the insurer at the insurer's discretion, for the protection of the insurer for the duration of the contracts or agreements, or the existence of the condition for which the director required the deposit or the bond. In determining whether a deposit or a bond is required, the director should consider whether concerns exist with respect to the affiliated person's ability to fulfill the contracts or agreements if the insurer were to be put into liquidation. Once the insurer is deemed to be in a hazardous financial condition or a condition that would be grounds for supervision, conservation, or a delinquency proceeding, and a deposit or bond is necessary, the director has discretion to determine the amount of the deposit or bond, not to exceed the value of the contracts or agreements in any one year, and whether such deposit or bond should be required for a single contract, multiple contracts, or a contract only with a specific person. (8) All records and data of the insurer held by an affiliate are and remain the property of the insurer, are subject to control of the insurer, are identifiable, and are segregated or readily capable of segregation, at no additional cost to the insurer, from all other persons' records and data. This includes all records and data that are otherwise the property of the insurer, in whatever form maintained including, but not limited to, claims and claim files, policyholder lists, application files, litigation files, premium records, rate books, underwriting manuals, personnel records, financial records, or similar records within the possession, custody, or control of the affiliate. At the request of the insurer, the affiliate must provide that the receiver can obtain a complete set of all records of any type that pertain to the insurer's business; obtain access to the operating systems on which the data is maintained; obtain the software that runs those systems either through assumption of licensing agreements or otherwise; and restrict the use of the data by the affiliate if it is not operating the insurer's business. The affiliate must provide a waiver of any landlord lien or other encumbrance to give the insurer access to all records and data in the event of the affiliate's default under a lease or other agreement. (9) Premiums or other funds belonging to the insurer that are collected by or held by an affiliate are the exclusive property of the insurer and are subject to the control of the insurer. Any right of offset in the event an insurer is placed into receivership must be subject to Chapter 27, Title 38. (B) The following transactions involving a domestic insurer and any person in its insurance holding company system, including amendments or modifications of affiliate agreements previously filed pursuant to this section, which are subject to any materiality standards contained in items (1) through (7) may not be entered into unless the insurer has notified the department in writing of its intention to enter into the transaction at least thirty days prior, or such shorter period as the director or his designee may permit, and the director or his designee has not disapproved it within such period. The notice for amendments or modifications must include the reasons for the charge and the financial impact on the domestic insurer. Informal notice must be reported within thirty days after termination of a previously filed agreement to the director or his designee for determination of the type of filing required, if any. (1) Sales, purchases, exchanges, loans, or extensions of credit, guarantees, or investments if the transactions are equal to or exceed: (a) with respect to nonlife insurers, the lesser of three percent of the insurer's admitted assets or twenty-five percent of surplus as regards policyholders as of the thirty-first day of December next preceding; (b) with respect to life insurers, three percent of the insurer's admitted assets, each as of the thirty-first day of December next preceding. (2) Loans or extensions of credit to any person who is not an affiliate, where the insurer makes the loans or extensions of credit with the agreement or understanding that the proceeds of the transactions, in whole or in substantial part, are to be used to make loans or extensions of credit to purchase assets of, or make investments in, any affiliate of the insurer making the loans or extensions of credit as long as such transactions are equal to or exceed: (a) with respect to nonlife insurers, the lesser of three percent of the insurer's admitted assets or twenty-five percent of surplus as regards policyholders; (b) with respect to life insurers, three percent of the insurer's admitted assets, each as of the thirty-first day of December next preceding. (3) Reinsurance agreements or modifications, including: (a) all reinsurance pooling agreements; and (b) agreements in which the reinsurance premium or a change in the insurer's liabilities, or the projected reinsurance premium or a change to the insurer's liabilities in any of the next three years, equals or exceeds five percent of the insurer's surplus as regards policyholders, as of the thirty-first day of December next preceding, including those agreements which may require as consideration the transfer of assets from an insurer to a nonaffiliate, if an agreement or understanding exists between the insurer and nonaffiliate that any portion of such assets will be transferred to one or more affiliates of the insurer. (4) All management agreements, service contracts, tax allocation agreements, and all cost-sharing arrangements. (5) Guarantees when made by a domestic insurer; provided, however, that a guarantee which is quantifiable as to amount is not subject to the notice requirements of this item unless it exceeds the lesser of one-half of one percent of the insurer's admitted assets or ten percent of surplus as regards policyholders as of the thirty-first day of December next preceding. Further, all guarantees which are not quantifiable as to amount are subject to the notice requirements of this item. (6) Direct or indirect acquisitions or investments in a person that controls the insurer or in an affiliate of the insurer in an amount which, together with its present holdings in such investments, exceeds two and one-half percent of the insurer's surplus to policyholders. Direct or indirect acquisitions or investments in subsidiaries acquired pursuant to Sections 38-21-20 through 38-21-50, or authorized under any other section of this chapter, or in nonsubsidiary insurance affiliates that are subject to the provisions of this chapter, are exempt from this requirement. (7) Any material transactions, specified by regulation of the department, which the director or his designee determines may adversely affect the interests of the insurer's policyholders. Nothing herein authorizes or permits any transactions which, in the case of an insurer, not a member of the same insurance holding company system, would be otherwise contrary to law. (C) A domestic insurer may not enter into transactions, which are part of a plan or series of like transactions with persons within the insurance holding company system, if the purpose of those separate transactions is to avoid the statutory threshold amount and thus avoid the review that would occur otherwise. If the director or his designee determines that such separate transactions were entered into over any twelve-month period for such purpose, he may exercise his authority under Section 38-21-340. (D) The director or his designee, in reviewing transactions pursuant to subsection (B), shall consider whether the transactions comply with the standards set forth in subsection (A) and whether they may adversely affect the interests of policyholders. (E) The department must be notified within thirty days of any investment of the domestic insurer in any one corporation if the total investment in the corporation by the insurance holding company system exceeds ten percent of the corporation's voting securities. (F) Any affiliate that is party to an agreement or contract with a domestic insurer that is subject to subsection (B)(4) is subject to the jurisdiction of any supervision, seizure, conservatorship, or receivership proceedings against the insurer and to the authority of any supervisor, conservator, rehabilitator, or liquidator for the insurer appointed pursuant to Chapters 26 and 27, Title 38 for the purpose of interpreting, enforcing, and overseeing the affiliate's obligations under the agreement or contract to perform services for the insurer that: (1) are an integral part of the insurer's operations including, but not limited to, management, administrative, accounting, data processing, marketing, underwriting, claims handling, investment, or any other similar functions; or (2) are essential to the insurer's ability to fulfill its obligations under insurance policies. (G) The director may require that an agreement or contract pursuant to subsection (B)(4) for the provision of services described in subsection (F)(1) and (2) specify that the affiliate consents to the jurisdiction as set forth in subsection (F). Effect of Amendment 2015 Act No. 2, SECTION 13, rewrote the section. 2025 Act No. 17, SECTION 7, rewrote the section.
S.C. Code Ann. § 38-9-350 — SC Code / Title 38 / Chapter 9 / Article 3 / Section 38-9-350
SECTION 38-9-350. Authorized Control Level Event defined; discretion, rights, powers and duties of director.
Status: in_force

(A) An "Authorized Control Level Event" includes any of the following events: (1) filing of an RBC Report which indicates that a licensee's Total Adjusted Capital is greater than, or equal to, its Mandatory Control Level RBC, but is less than its Authorized Control Level RBC; (2) issuance of an Adjusted RBC Report that indicates the event in Section 38-9-350(A)(1), provided that the licensee does not challenge that Adjusted RBC Report pursuant to Section 38-9-370. If the licensee challenges that Adjusted RBC Report, then the Authorized Control Level Event occurs upon notification that an administrative law judge has rejected the challenge; or (3) the failure of a licensee to respond to a Corrective Order in a manner satisfactory to the director, provided the licensee has not challenged the Corrective Order pursuant to Section 38-9-370. If the licensee has challenged a Corrective Order and an administrative law judge has rejected the challenge or has modified the Corrective Order, then the Authorized Control Level Event occurs upon the failure of the licensee to respond to that Corrective Order in a manner satisfactory to the director. (B) In the event of an Authorized Control Level Event, the director may take action pursuant to Section 38-9-340 or, if the director considers it to be in the best interests of the policyholders and creditors of the licensee and of the public, he may take action necessary to place the licensee under regulatory control pursuant to Section 38-26-10, et seq., or to Section 38-27-10, et seq. The Authorized Control Level Event is sufficient grounds for the director to take that action, and the director has the rights, powers, and duties detailed within those provisions of law. If the director takes action, then the licensee is entitled to the protections that are afforded under those provisions pertaining to summary proceedings. Effect of Amendment 2014 Act No. 164, SECTION 5, substituted "licensee" for "insurer" throughout; and made other nonsubstantive changes.
S.C. Code Ann. § 38-26-20 — SC Code / Title 38 / Chapter 26 / Section 38-26-20
SECTION 38-26-20. Definitions.
Status: in_force

As used in this chapter: (1) "Insurer" means a person who has done, purports to do, is going to do, or is licensed to do an insurance business and is or has been subject to the authority of, or to liquidation, rehabilitation, reorganization, supervision, or conservation by the department, or similar entity, of a state. For purposes of this chapter, other persons included under Section 38-27-40 are considered insurers. (2) "Exceed its powers" means the following conditions: (a) The insurer has refused to permit examination of its books, papers, accounts, records, or affairs by the director or his deputies, designees, employees, or commissioned examiners. (b) A domestic insurer unlawfully has removed from this State books, papers, accounts, or records necessary for an examination of the insurer. (c) The insurer has failed to comply promptly with the applicable financial reporting statutes or regulations and related departmental requests. (d) The insurer has neglected or refused to observe an order of the director or his designee to make good, within the time prescribed by law, prohibited deficiency in its capital, capital stock, or surplus. (e) The insurer is continuing to transact insurance or write business after its license has been revoked or suspended by the director or his designee. (f) The insurer, by contract or otherwise, unlawfully, in violation of an order of the director or his designee, or without first having obtained written approval of the director or his designee if approval is required by law has: (i) totally reinsured its entire outstanding business; or (ii) merged or consolidated substantially its entire property or business with another insurer. (g) The insurer engaged in a transaction in which it is not authorized to engage under the laws of this State. (h) The insurer refused to comply with a lawful order of the director or his designee. (3) "Consent" means agreement to administrative supervision by the insurer.
S.C. Code Ann. § 38-61-50 — SC Code / Title 38 / Chapter 61 / Section 38-61-50
SECTION 38-61-50. Standards for readability of certain contracts and policies; advice of other agencies concerning standards.
Status: in_force

The director or his designee shall consult with and call upon the expertise of other state agencies, as may be necessary, to determine the standards to be promulgated and, after promulgation, the effectiveness of these standards. This consultation shall include, but is not limited to, the State Department of Education or its successor entity.
S.C. Code Ann. § 38-61-40 — SC Code / Title 38 / Chapter 61 / Section 38-61-40
SECTION 38-61-40. Compliance with standards for readability of certain contracts and policies; withdrawal of approval or certification on noncomplying documents.
Status: in_force

All insurers licensed to transact insurance business in this State shall comply with the standards prescribed by regulation of the department. The director or his designee is empowered to withdraw approval or certification on all existing policies of commonly purchased insurance that do not comply with Section 38-61-30.
S.C. Code Ann. § 38-43-90 — SC Code / Title 38 / Chapter 43 / Article 1 / Section 38-43-90
SECTION 38-43-90. Medical examiners of insurers exempt from license fees.
Status: in_force

No license fee may be charged by the State or any county or municipality to a resident, practicing physician in this State, duly licensed to practice by the State Board of Medical Examiners, for making medical examinations for life insurers or fraternal orders.
S.C. Code Ann. § 38-101-10 — SC Code / Title 38 / Chapter 101 / Section 38-101-10
SECTION 38-101-10. Intent of chapter.
Status: in_force

It is the intent of this chapter to foster innovative flood insurance coverages providing insurers the ability to test products in the market and consumers greater choice for flood insurance coverage. Editor's Note 2020 Act No. 166, SECTION 3, provides as follows: "SECTION 3. This act becomes effective sixty days following approval by the Governor. Insurers that are writing private flood insurance at the time of enactment have an additional one hundred twenty days to come into compliance with the requirements of this act."
S.C. Code Ann. § 38-23-60 — SC Code / Title 38 / Chapter 23 / Section 38-23-60
SECTION 38-23-60. Certain sales of equity securities by beneficial owners, directors, or officers are unlawful.
Status: in_force

It is unlawful for a beneficial owner, director, or officer, directly or indirectly, to sell any equity security of the insurer if the person selling the security or his principal (a) does not own the security sold, or (b) if owning the security, does not deliver it against the sale within twenty days thereafter, or does not within five days after the sale deposit it in the mails or other usual channels of transportation. A person is not considered to have violated this section if he proves that, notwithstanding the exercise of good faith, he was unable to make the delivery or deposit within this time or that to do so would cause undue inconvenience or expense.
S.C. Code Ann. § 38-73-1540 — SC Code / Title 38 / Chapter 73 / Article 13 / Section 38-73-1540
SECTION 38-73-1540. Rate filings may not be supported by data from unauthorized advisory organization.
Status: in_force

No insurer which makes its own filings nor any rating organization may support its filings by statistics or adopt rate-making recommendations furnished to it by an advisory organization which has not complied with this article or with an order of the director or his designee involving statistics or recommendations issued under Section 38-73-1530. If the director or his designee finds an insurer or rating organization to be in violation of this section, he may issue an order requiring the discontinuance of the violation.
S.C. Code Ann. § 38-63-210 — SC Code / Title 38 / Chapter 63 / Article 3 / Section 38-63-210
SECTION 38-63-210. Whole contract, including application, must appear in policy; oral applications.
Status: in_force

Every insurer doing a life insurance business in the State shall deliver with each policy of insurance issued by it a copy of the application made by the insured so that the whole contract appears in the application and policy of insurance. If the insurer violates this requirement, no defense is allowed to the policy on account of anything contained in, or omitted from, the application. If the insurance policy is issued upon an oral application, no defense is allowed to the policy on account of anything contained in, or omitted from, the oral application.
S.C. Code Ann. § 38-101-30 — SC Code / Title 38 / Chapter 101 / Section 38-101-30
SECTION 38-101-30. Issuance of policies.
Status: in_force

An insurer may issue an insurance policy, contract, or endorsement providing commercial lines or personal lines coverage for the named peril of flood or excess coverage for the named peril of flood on any structure and on the contents of commercial or personal property contained therein, or to insure against indirect losses from the named peril of flood subject to the requirements of this chapter. Any reference to policy in this chapter also includes endorsements that provide private flood insurance coverage. Editor's Note 2020 Act No. 166, SECTION 3, provides as follows: "SECTION 3. This act becomes effective sixty days following approval by the Governor. Insurers that are writing private flood insurance at the time of enactment have an additional one hundred twenty days to come into compliance with the requirements of this act." Effect of Amendment 2022 Act No. 195, SECTION 12, in the first sentence, substituted "named peril" for "peril" in three places, and made a nonsubstantive change.
S.C. Code Ann. § 38-74-50 — SC Code / Title 38 / Chapter 74 / Section 38-74-50
SECTION 38-74-50. Insurer's assessment.
Status: in_force

(A) Each insurer's assessment is determined by multiplying the net loss of pool operation by a fraction, the numerator of which equals that insurer's total premium and subscriber contract charges for health insurance written in the State during the preceding calendar year, and the denominator of which equals the total of all health premiums and subscriber contract charges written by all insurers in the State during the preceding calendar year. Health insurance premiums that are less than an amount determined by the board to justify the cost of collection are not considered for purposes of determining assessments. (B) If assessments exceed the net loss of pool operation, the excess must be held at interest and used by the board to offset future losses or to reduce pool premiums. As used in this subsection, "future losses" includes reserves for incurred but not reported claims. (C)(1) Each member's proportion of participation in the pool is determined annually by the board based on annual statements and other reports considered necessary by the board and filed by the member with it. (2) Any deficit incurred by the pool may be recouped by assessments apportioned under subsection (A) of this section by the board among members. (D) The board may abate or defer, in whole or in part, the assessment of a member if, in the opinion of the board, payment of the assessment would endanger the ability of the member to fulfill its contractual obligations. In the event an assessment against a member is abated or deferred in whole or in part, the amount by which the assessment is abated or deferred may be assessed against the other members in a manner consistent with the basis for assessments set forth in subsection (A) of this section. The member receiving abatement or deferment shall remain liable to the pool for the deficiency for four years.
S.C. Code Ann. § 38-77-20 — SC Code / Title 38 / Chapter 77 / Article 1 / Section 38-77-20
SECTION 38-77-20. Construction.
Status: in_force

This chapter is to be liberally construed in order to achieve its purposes.
S.C. Code Ann. § 38-72-60 — SC Code / Title 38 / Chapter 72 / Section 38-72-60
SECTION 38-72-60. General assembly to approve regulations; terms and conditions applicable to long term care insurance policy and group policy; advertising restrictions.
Status: in_force

(A) The director or his designee shall submit to the General Assembly for approval regulations to carry out the purposes of this chapter. These regulations may include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long term care insurance policies, terms of renewal, initial and subsequent conditions of eligibility, nonduplication of coverage provision, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. (B) A long term care insurance policy may not: (1) be canceled, nonrenewed, or otherwise terminated except for nonpayment of the premium; (2) contain a provision establishing a new waiting period if existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or (3) provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care. (C) The following applies to preexisting conditions: (1) A long term care insurance policy or certificate, other than a policy or certificate issued to a group as defined in Section 38-72-40(5)(a), may not use a definition of "preexisting condition" that is more restrictive than the following: "Preexisting condition" means a condition for which medical advice or treatment was recommended by or received from a provider of health care services within six months preceding the effective date of coverage of an insured person. (2) A long term care insurance policy or certificate, other than a policy or certificate issued to a group as defined in Section 38-72-40(5)(a), may not exclude coverage for a loss or confinement that is the result of a preexisting condition unless loss or confinement begins within six months following the effective date of coverage of an insured person. (3) The director or his designee may extend the limitation periods provided in items (1) and (2) as to specific age group categories in specific policy forms upon findings that the extension is in the best interest of the public. (4) The definition of "preexisting condition" does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant and, on the basis of the answers on that application, from underwriting in accordance with that insurer's established underwriting standards. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in item (2) expires. A long term care insurance policy or certificate may not exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period in item (2). (D)(1) A long term care insurance policy may not be delivered or issued for delivery in this State if the policy conditions eligibility for benefits: (a) on a prior hospitalization requirement; (b) provided in an institutional care setting on the receipt of a higher level of institutional care; or (c) other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement. (2)(a) A long term care insurance policy containing post-confinement, post-acute care, or recuperative benefits clearly must label in a separate paragraph of the policy or certificate entitled "Limitations or Conditions on Eligibility for Benefits" limitations or conditions, including the required number of days of confinement. (b) A long term care insurance policy or rider that conditions eligibility of post-confinement, post-acute care, or recuperative benefits on the prior receipt of institutional care may not require a prior institutional stay of more than thirty days. (c) A long term care insurance policy or rider that provides benefits only following institutionalization may not condition these benefits upon admission to a facility for the same or related conditions within a period of less than thirty days after discharge from the institution. (E) The director may adopt regulations establishing loss ratio standards for long term care insurance policies provided that a specific reference to long term care insurance policies is contained in the regulation. (F) The following applies to the right of the policyholder to return the policy: (1) Long term care insurance applicants have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long term care insurance policies and certificates must have a notice prominently printed on the first page or attached to it stating in substance that the applicant has the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, other than a certificate issued pursuant to a policy issued to a group as defined in Section 38-72-40(5)(a), the applicant is not satisfied for any reason. (2) This subsection applies to denials of applications and any refund must be made within thirty days of the return or denial. (G)(1) An outline of coverage must be delivered to a prospective applicant for long term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its purpose. (a) The director or his designee shall prescribe a standard format, including style, arrangement, and overall appearance, and the content of an outline of coverage. (b) For agent solicitations, an agent shall deliver the outline of coverage before the presentation of an application or enrollment form. (c) For direct response solicitations, the outline of coverage must be presented in conjunction with an application or enrollment form. (d) In the case of a policy issued to a group defined in Section 38-72-40(5)(a), an outline of coverage is not required to be delivered, provided that the information described in this subsection is contained in other materials relating to enrollment. Upon request, these other materials must be made available to the director. (2) The outline of coverage must include a: (a) description of the principal benefits and coverage provided in the policy; (b) statement of the principal exclusions, reductions, and limitations contained in the policy; (c) statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including a reservation in the policy of a right to change the premium. Continuation or conversion provisions of group coverage must be described specifically; (d) statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions; (e) description of the terms under which the policy or certificate may be returned and premium refunded; (f) brief description of the relationship of cost of care and benefits; (g) statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long term care insurance contract under 7702B(b) of the Internal Revenue Code of 1986, as amended. (H) A certificate issued pursuant to a group long term care insurance policy delivered or issued for delivery in this State must include a: (1) description of the principal benefits and coverage provided in the policy; (2) statement of the principal exclusions, reductions, and limitations contained in the policy; and (3) statement that the group master policy determines governing contractual provisions. (I) If an application for a long term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than thirty days after the date of approval. (J) At the time of policy delivery, a policy summary must be delivered for an individual life insurance policy that provides long term care benefits within the policy or by rider. For direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request but, regardless of a request, shall make the delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the summary also must include: (1) an explanation of how the long term care benefit interacts with other components of the policy, including deductions from death benefits; (2) an illustration of the amount of benefits, the length of benefits, and the guaranteed lifetime benefits, if any, for each covered person; (3) exclusions, reductions, and limitations on benefits of long term care; (4) if applicable to the policy type: (a) a disclosure of the effects of exercising other rights under the policy; (b) a disclosure of guarantees related to long term care costs of insurance charges; and (c) current and projected maximum lifetime benefits; and (5) the provisions of the policy summary listed in this subsection may be incorporated into a basic illustration required to be delivered in accordance with regulation 69-40, Life Insurance Policy Illustration Regulation or into the life insurance summary which is required to be delivered in accordance with regulation 69-30, Solicitation of Life Insurance Regulation. (K) When a long term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report must be provided to the policyholder. The report must include: (1) long term care benefits paid out during the month; (2) an explanation of changes in the policy, such as death benefits or cash values, due to long term care benefits being paid out; (3) the amount of long term care benefits existing or remaining. (L) If a claim under a long term care insurance contract is denied, the issuer, within sixty days of the date of a written request by the policyholder or certificate holder, or a representative of the issuer, shall: (1) provide a written explanation of the reasons for the denial; and (2) make available all information directly related to the denial. (M) A policy or rider advertised, marketed, or offered as long term care or nursing home insurance must comply with the provisions of this chapter. (N) All insurers issuing long term care insurance policies must offer, at time of application, an optional benefit which provides that when an insured meets the requirements under the policy that care in a nursing home or community residential care facility is necessary, the insured shall have the option of receiving necessary care in the home or community, with daily benefits at the same level that would have been paid for care in a nursing home or community residential care facility. This optional coverage may be provided by rider to the policy or included as part of the policy. Notwithstanding the foregoing, insurers issuing long term care insurance policies may offer a home health care benefit which would provide benefits when care in the home only is necessary. This home health care benefit may provide lesser benefits than that provided by the policy for care in a nursing home or community residential care facility and may be provided either by rider to the policy or included as part of the policy.
S.C. Code Ann. § 38-77-190 — SC Code / Title 38 / Chapter 77 / Article 3 / Section 38-77-190
SECTION 38-77-190. Subrogation of insurer who pays claim under uninsured motorist provision to rights of insured.
Status: in_force

An insurer paying a claim under the uninsured motorist provision required by Section 38-77-150 is subrogated to the rights of the insured to whom the claim was paid against any and every person causing the injury, death, or damage to the extent that payment was made. However, the insurer shall pay its proportionate part of any reasonable costs and expenses incurred in connection with any recovery, including reasonable attorneys' fees.
S.C. Code Ann. § 38-71-2340 — SC Code / Title 38 / Chapter 71 / Article 23 / Section 38-71-2340
SECTION 38-71-2340. Enforcement of article; examination or audit of books and records; penalties for violations.
Status: in_force

(A) The director shall enforce this article. (B)(1) As often as the director deems appropriate, but not less frequently than once every five years, the director may examine or audit the books and records of a pharmacy services administrative organization providing prescription drug coverage or benefits on behalf of pharmacies or pharmacy benefits managers that are relevant to determining if the pharmacy services administrative organization is in compliance with this act. The pharmacy services administrative organization must pay the charges incurred in the examination, including the expenses of the director or his designee and the expenses and compensation of his examiners and assistants. The director or his designee promptly must institute a civil action to recover the expenses of examination against a pharmacy services administrative organization which refuses or fails to pay. (2) The information or data acquired during an examination pursuant to this section is considered proprietary and confidential and is not subject to the South Carolina Freedom of Information Act. (C) Violations of this article are subject to the penalties provided in Sections 38-2-10 through 38-2-30. (D) The director may promulgate regulations regarding pharmacy services administrative organizations that are not inconsistent with this article. Editor's Note 2023 Act No. 30, SECTION 7, provides as follows: "SECTION 7. This act takes effect January 1, 2024, but the recurring examinations by the Department of Insurance provided for in Sections 38-71-2250(B)(1) and 38-71-2340(B)(1) must not begin before January 1, 2025."
S.C. Code Ann. § 38-9-430 — SC Code / Title 38 / Chapter 9 / Article 3 / Section 38-9-430
SECTION 38-9-430. Exemptions from application of article.
Status: in_force

The director may exempt from the application of this article: (1) a domestic property and casualty insurer that: (a) writes direct business only in this State; (b) writes direct annual written premiums of two million dollars or less; and (c) assumes no reinsurance in excess of five percent of its direct written premium; and (2) a domestic health organization that: (a) writes direct business only in this State; (b) assumes no reinsurance in excess of five percent of direct premium written; and (c) writes direct annual premiums of one million dollars or less. Effect of Amendment 2014 Act No. 164, SECTION 12, rewrote the section.
S.C. Code Ann. § 38-90-215 — SC Code / Title 38 / Chapter 90 / Article 1 / Section 38-90-215
SECTION 38-90-215. Protected cells.
Status: in_force

(A) A protected cell may be either unincorporated or incorporated. (B) With regard to unincorporated protected cells: (1) The unincorporated protected cell shall have its own distinct name or designation, which shall include the words "Protected Cell" or the abbreviation "PC". Any captive insurance company or protected cell formed prior to the effective date of this section may not be required to change its name to comply with the provisions of this paragraph. (2) An unincorporated protected cell has the free and unimpaired paid-in capital and surplus in an amount determined by the director after giving due consideration to the protected cell's business plan, feasibility study, and pro formas, including the nature, scale, and complexity of the risks to be insured, and either: (a) establish loss and loss expense reserves for business written through the unincorporated protected cell; or (b) the business written through the unincorporated protected cell must be: (i) fronted by an insurance company licensed pursuant to the laws of: (A) any state; or (B) any jurisdiction if the insurance company is a wholly owned subsidiary of an insurance company licensed pursuant to the laws of any state; (ii) reinsured by a reinsurer authorized or approved by this State; or (iii) secured by a trust fund in the United States for the benefit of policyholders and claimants funded by an irrevocable letter of credit or other asset acceptable to the director. The amount of security provided by the trust fund may not be less than the reserves associated with those liabilities, including reserves for losses, allocated loss adjustment expenses, incurred but unreported losses, and unearned premiums for business written through the participant's protected cell. The director may require the sponsored captive to increase the funding of a trust established pursuant to this item. If the form of security in the trust is a letter of credit, the letter of credit must be established, issued, or confirmed by a bank chartered in this State, a member of the federal reserve system, or a bank chartered by another state if that state-chartered bank is acceptable to the director. A trust and trust instrument maintained pursuant to this item must be in a form and upon terms approved by the director. (3) The creation of an unincorporated protected cell does not create, with respect to that protected cell, a legal person separate from the sponsored captive insurance company. Amounts attributed to a protected cell, including assets transferred to a protected cell account, are owned by the sponsored captive insurance company of which the protected cell is a part, and the sponsored captive insurance company may not be, or may not hold itself out to be, a trustee with respect to those protected cell assets of that protected cell account. Notwithstanding the provisions of this subsection, the sponsored captive insurance company may allow for a security interest to attach to protected cell assets or a protected cell account when in favor of a creditor of the protected cell and otherwise allowed under applicable law. (4) This subsection may not be construed to prohibit the sponsored captive insurance company from: (a) entering into contracts of insurance on behalf of the protected cell; or (b) contracting with or arranging for third-party managers or advisors to manage the protected cell to manage the assets of a protected cell, if all remuneration, expenses, and other compensation of the third-party manager or advisor is payable from the protected cell assets of that protected cell and not from the protected cell assets of other protected cells or the assets of the sponsored captive insurance company's general account. (C) Incorporated protected cells shall be subject to all of the following: (1) An incorporated protected cell may be organized and operated in any form of business organization set forth in Section 38-90-60(A). (2) Except as specifically set forth in this chapter, each incorporated protected cell of a sponsored captive insurance company shall have free and unimpaired paid-in capital and surplus in an amount determined by the director after giving due consideration to the protected cell's business plan, feasibility study, and pro formas, including the nature, scale, and complexity of the risks to be insured. (3) A participant in an incorporated protected cell need not be a shareholder of the protected cell or of the sponsored captive insurance company or any affiliate thereof. (D) The name of an incorporated protected cell must include the words "Incorporated Cell" or the abbreviation "IC". (E) Any captive insurance company or protected cell formed prior to July 31, 2013, shall not be required to change its name to comply with the provisions of subsection (D). Effect of Amendment 2018 Act No. 251, SECTION 1, in (B)(2), substituted "free and unimpaired paid-in capital and surplus requirements" for "paid-in capital and free surplus requirements", and made a nonsubstantive change. 2025 Act No. 62, SECTION 12, rewrote (B)(2) and (C)(2).
S.C. Code Ann. § 38-57-90 — SC Code / Title 38 / Chapter 57 / Section 38-57-90
SECTION 38-57-90. Defamation prohibited.
Status: in_force

No person may make, publish, circulate, or disseminate, directly or indirectly, or aid, abet, or encourage the making, publishing, circulating, or disseminating 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 calculated to injure any person engaged or proposing to engage in the business of insurance.
S.C. Code Ann. § 38-51-70 — SC Code / Title 38 / Chapter 51 / Section 38-51-70
SECTION 38-51-70. Advertising.
Status: in_force

An administrator may use only the advertising pertaining to the business underwritten by an insurer as has been approved by the insurer in advance of its use.
S.C. Code Ann. § 38-83-140 — SC Code / Title 38 / Chapter 83 / Section 38-83-140
SECTION 38-83-140. Binding nature of plan of operation and rules of the board of directors.
Status: in_force

Every member of the association is bound by the approved plan of operation of the association and the rules of the board of directors of the association.
S.C. Code Ann. § 38-71-2350 — SC Code / Title 38 / Chapter 71 / Article 23 / Section 38-71-2350
SECTION 38-71-2350. Construction with relevant federal law; application exceptions.
Status: in_force

(A) Nothing in this act is intended or may be construed to be in conflict with existing relevant federal law. (B) This article does not apply to the South Carolina Department of Health and Human Services in the performance of its duties in administering Medicaid under Titles XIX and XXI of the Social Security Act or to the Medicaid-managed care organizations under contract with the South Carolina Department of Health and Human Services. Editor's Note 2023 Act No. 30, SECTION 7, provides as follows: "SECTION 7. This act takes effect January 1, 2024, but the recurring examinations by the Department of Insurance provided for in Sections 38-71-2250(B)(1) and 38-71-2340(B)(1) must not begin before January 1, 2025."
S.C. Code Ann. § 38-71-238 — SC Code / Title 38 / Chapter 71 / Article 1 / Section 38-71-238
SECTION 38-71-238. Abortion coverage prohibitions; exceptions.
Status: in_force

(A) Abortion coverage may not be provided by a qualified health plan offered by a health insurer, including a group health plan as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974 or health maintenance organization as defined in Section 38-33-20, through a health insurance exchange created pursuant to the federal "Patient Protection and Affordable Care Act". (B) This limitation shall not apply to an abortion performed when the life of the mother is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused or arising from the pregnancy, or when the pregnancy is the result of rape or incest.
S.C. Code Ann. § 38-103-10 — SC Code / Title 38 / Chapter 103 / Section 38-103-10
SECTION 38-103-10. Definitions.
Status: in_force

For purposes of this section: (1) "Child" means a biological, adopted, or foster son or daughter; a stepson or stepdaughter; a legal ward; a son or daughter of a domestic partner; or a son or daughter of a person to whom the employee stands in loco parentis who is either: (a) under eighteen years of age; or (b) eighteen years of age or older and incapable of self-care because of a mental or physical disability. (2) "Department" means the Department of Insurance. (3) "Director" means the director of the Department of Insurance. (4) "Employee" means an individual for whom an employer must complete a Form I-9 pursuant to federal law and regulations and does not include an independent contractor. (5) "Family leave" means any leave taken by an employee from work pursuant to Section 38-103-20. (6) "Family leave insurance" means an insurance policy issued to an employer related to a benefit program provided to an employee to pay for a percentage or portion of the employee's income loss due to: (a) the birth of a child or adoption of a child by the employee; (b) the placement of a child with the employee for foster care; (c) care of a family member of the employee who has a serious health condition; or (d) the status of a family member of the employee who is a service member on active duty or who has been notified of an impending call or order to active duty. (7) "Family member" means a child, spouse, or parent, or another person defined as a family member in a policy of insurance issued under this chapter. (8) "Health care provider" means a person licensed to provide health care services under Title 40. (9) "Parent" means a biological, foster, or adoptive parent, a stepparent, a legal guardian, or other person who stands in loco parentis to the employee when the employee was a child. (10) "Serious health condition" means an illness, injury, impairment, or physical or mental condition, including transplantation preparation and recovery from surgery related to organ or tissue donation, that involves in-patient care in a hospital, hospice, or residential health care facility, continuing treatment or continuing supervision by a health care provider as defined in the insurance policy. Continuing supervision by a health care provider includes a period of incapacity which is permanent or long term due to a condition for which treatment may not be effective and where the family member need not be receiving active treatment by a health care provider. (11) "Service member" means a member of the United States Armed Forces in active military service.
S.C. Code Ann. § 38-71-2000 — SC Code / Title 38 / Chapter 71 / Article 19 / Section 38-71-2000
SECTION 38-71-2000. Approval of independent review organizations.
Status: in_force

(A) The director or his designee shall approve independent review organizations eligible to be assigned to conduct external reviews to ensure that an independent review organization satisfies the minimum qualifications established under Section 38-71-2010. (B) The director or his designee shall develop an application form for initially approving and for reapproving independent review organizations to conduct external reviews and may establish an advisory committee with appropriate representation to review the applications. No member of the advisory committee may be liable to any person for any acts or omissions arising out of or related to the approval or reapproval of independent review organizations pursuant to this act. (C)(1) An independent review organization wishing to be approved to conduct external reviews under this article shall submit the application form and include with the form all documentation and information necessary for the director or his designee to determine if the independent review organization satisfies the minimum qualifications established under Section 38-71-2010. (2) The director or his designee may charge an application fee that independent review organizations shall submit to the director or his designee with an application for approval and reapproval. (D)(1) Except as provided in item (2), an approval is effective for two years. (2) The independent review organization must notify the director or his designee of any material changes in qualifications, including removal or loss of accreditation by a nationally recognized private accrediting entity, approved by the director or his designee pursuant to subsection (E). Whenever the director or his designee determines that an independent review organization no longer satisfies the minimum requirements established under Section 38-71-2010 or has violated a provision of this article, the director or his designee shall terminate the approval of the independent review organization and remove the independent review organization from the list of independent review organizations approved to conduct external reviews under this article that is maintained by the director or his designee pursuant to subsection (F). (E) An independent review organization accredited by a nationally recognized private accrediting entity with established and maintained standards for independent review organizations that meet the minimum qualifications established pursuant to Section 38-71-2010, which accrediting entity has been approved by the director or his designee, may be deemed to meet the minimum qualification requirements set forth in Section 38-71-2010. (F) The director or his designee shall maintain and periodically update a list of approved independent review organizations and approved nationally recognized private accrediting entities. (G) The director or his designee may promulgate regulations or bulletins to carry out the provisions of this section.
S.C. Code Ann. § 38-75-230 — SC Code / Title 38 / Chapter 75 / Article 3 / Section 38-75-230
SECTION 38-75-230. Information required on contracts for purchase of mobile homes.
Status: in_force

Any contract to purchase a mobile home shall on its face: (1) clearly include the provisions of Section 38-75-210; and (2) clearly inform the purchaser that it is a violation of the law of this State for the seller of a mobile home or for any person lending money upon the security thereof to require or to attempt to require that hazard insurance be purchased from any particular insurer or agent and shall include the address of the office of the Department of the Insurance with instructions to report any violation or attempted violation to his office.
S.C. Code Ann. § 38-71-350 — SC Code / Title 38 / Chapter 71 / Article 3 / Section 38-71-350
SECTION 38-71-350. Required provision for continuation of coverage for handicapped and dependent children of policyholder.
Status: in_force

An individual hospital or medical expense insurance policy, hospital service plan contract, or medical service plan contract delivered or issued for delivery in this State which provides that coverage of a dependent child terminates upon attainment of the limiting age for dependent children specified in the policy or contract shall also provide in substance that attainment of the limiting age does not operate to terminate the coverage of the child while the child is and continues to be both (a) incapable of self-sustaining employment by reason of intellectual disability or physical handicap and (b) chiefly dependent upon the policyholder or subscriber for support and maintenance, so long as proof of the incapacity and dependency is furnished to the insurer by the policyholder or subscriber within thirty-one days of the child's attainment of the limiting age and subsequently as may be required by the insurer but not more frequently than annually after the two-year period following the child's attainment of the limiting age.
S.C. Code Ann. § 38-75-1140 — SC Code / Title 38 / Chapter 75 / Article 13 / Section 38-75-1140
SECTION 38-75-1140. Evaluation of natural hazard catastrophe models; requirements for modeling organizations.
Status: in_force

(A) In recognition of the use of natural hazard catastrophe computer models and other recently developed or improved actuarial methodologies for projecting natural hazard losses, the director or his designee may make or cause to be made an evaluation of any natural hazard catastrophe model used in property rate filings in this State. Natural hazard catastrophe models are computer programs that estimate losses from potential natural hazard disasters, combining data on property exposures with information on natural hazards, such as storms or earthquakes, to generate estimates of potential losses. (B) If required to do so by the director, a modeling organization that prepares catastrophe models used by insurers in rate filings in this State shall submit an initial report to the director or his designee consisting of but not limited to: (1) a statement of its qualification as a modeling organization; (2) an outline of the background and experience of the staff of the modeling organization engaged in the development and preparation of the catastrophe models used by insurers in rate filings; and (3) one or more statements describing and attesting to the validity of the model for use in predicting losses associated with natural hazard catastrophes in this State. A separate statement must be made by an individual possessing expertise appropriate to the hazard being modeled in fields such as meteorology, engineering, building codes, geology, and actuarial science as they apply to natural hazard catastrophes faced by this State. (C) The modeling organization shall submit a supplemental report to the director or his designee following any substantially material revision of the model if the revision is used by insurers in determining rates for this State. The supplemental report must specify the changes made to the catastrophe model, specify a list of variables that are subject to insurer input, and contain one or more statements by experts attesting to the continuing validity of the model for use in predicting losses associated with natural hazard catastrophes in this State. (D) If the director or his designee determines the expert statements provided to be insufficient, he may reject the report. (E) In conducting his evaluation of a model, the director or his designee may rely on the report of an official of another state who has made such an evaluation pursuant to the laws of that state. (F) Proprietary or trade secret information that is submitted in a report, or is obtained, developed, or compiled in the course of any evaluation must be kept confidential by the director. (G)(1) To recover the costs associated with the review and evaluation of catastrophe models, the director or his designee may impose a filing fee on: (a) all insurers who use catastrophe or other computer simulated models; and (b) modelers or modeling organizations that submit a model to the department for its review, evaluation, or approval. This fee must be retained by the department to defray the costs of retaining actuaries and other experts to evaluate such models. (2) The fees collected pursuant to this section must be used only to offset expenses associated with the review of catastrophe models.
S.C. Code Ann. § 38-71-1340 — SC Code / Title 38 / Chapter 71 / Article 13 / Section 38-71-1340
SECTION 38-71-1340. Application of article; group size for health group cooperative.
Status: in_force

(A) Except as provided in subsection (B), the provisions of this article apply to any health insurance plan that provides group coverage to groups of two to fifty. (B) The provisions of this article do not apply to individual health insurance policies that are subject to policy form and premium rate approval as may be provided in this title. (C) For health group cooperatives, the applicable group size is two to fifty. Health group cooperatives are permitted to attempt to obtain coverage for small employer groups that contain fewer than two eligible employees; however, such attempt to obtain coverage is subject to the medical underwriting requirements and policies of the small employer insurer.
S.C. Code Ann. § 38-71-2220 — SC Code / Title 38 / Chapter 71 / Article 21 / Section 38-71-2220
SECTION 38-71-2220. No restrictions or penalties against pharmacy for disclosing certain information.
Status: in_force

(A) In any participation contracts between pharmacy benefits managers and pharmacists or pharmacies providing prescription drug coverage for health benefit plans, no pharmacy or pharmacist may be prohibited, restricted, or penalized in any way from disclosing to any covered person any health care information that the pharmacy or pharmacist deems appropriate within their scope of practice. (B) A pharmacy or pharmacist must not be proscribed by a pharmacy benefits manager from discussing information regarding the total cost for pharmacist services for a prescription drug or from selling a more affordable alternative to the insured if a more affordable alternative is available, but a pharmacy benefits manager may proscribe a pharmacy or pharmacist from sharing proprietary or confidential information. (C) A pharmacy benefits manager contract with a participating pharmacist or pharmacy may not prohibit, restrict, or limit disclosure of information to the director investigating or examining a complaint or conducting a review of a pharmacy benefits manager's compliance with the requirements pursuant to this act. The information or data acquired during an examination or review pursuant to this section is considered proprietary and confidential and is not subject to the South Carolina Freedom of Information Act. Editor's Note 2023 Act No. 30, SECTION 7, provides as follows: "SECTION 7. This act takes effect January 1, 2024, but the recurring examinations by the Department of Insurance provided for in Sections 38-71-2250(B)(1) and 38-71-2340(B)(1) must not begin before January 1, 2025." Effect of Amendment 2023 Act No. 30, SECTION 2, reenacted the section with no apparent change.
S.C. Code Ann. § 38-39-30 — SC Code / Title 38 / Chapter 39 / Section 38-39-30
SECTION 38-39-30. Investigation of applicant; issuance of license; bond.
Status: in_force

(a) Upon the filing of an application and the payment of the license fee the director or his designee shall make an investigation of the applicant and shall issue a license if the applicant is qualified. If the director or his designee does not find the applicant qualified, he shall, within thirty days after he has received the application, at the request of the applicant, give the applicant a full hearing. (b) The director or his designee shall issue a license when he is satisfied that the person to be licensed: (1) is competent and trustworthy and intends to act in good faith in the capacity involved by the license applied for; (2) has a good business reputation and has had experience, training, or education so as to be qualified in the business for which the license is applied for; (3) if a corporation, is a corporation incorporated under the laws of this State or a foreign corporation authorized to transact business in this State; (4) has on deposit with the department a surety bond of fifty thousand dollars or has proven financial responsibility by depositing with the department acceptable securities of fifty thousand dollars. The bond or the deposit of securities must be held for the reimbursement of parties damaged through the acts, neglects, defaults, or insolvency of the premium service company; (5) if directly or indirectly owned or controlled by, or affiliated with, an insurer, will not use the license to restrain trade or to secure an unfair competitive advantage or to falsify the insurer's financial condition or to render deceptive or misleading a financial statement of the insurer or, in any other way, to aid or assist the insurer in evading insurance laws or regulations; (6) if a foreign corporation is regulated and examined by the appropriate department in its state of domicile. (c) Each license is for an indefinite term, unless sooner revoked or suspended, if the annual license fee is paid by March first.
S.C. Code Ann. § 38-9-370 — SC Code / Title 38 / Chapter 9 / Article 3 / Section 38-9-370
SECTION 38-9-370. Confidential hearing; notification; time of hearing.
Status: in_force

(A) A licensee has the right to a confidential hearing, on a record before the director, at which the licensee may challenge a determination or action by the director, upon notification to a licensee by the director: (1) of an Adjusted RBC Report; (2) that the licensee's RBC Plan or Revised RBC Plan is unsatisfactory, and that this notification constitutes a Regulatory Action Level Event with respect to the licensee; (3) that the licensee has failed to adhere to its RBC Plan or Revised RBC Plan and that this failure has a substantial adverse effect on the ability of the licensee to eliminate the Company Action Level Event with respect to the licensee in accordance with its RBC Plan or Revised RBC Plan; or (4) of a corrective order with respect to the licensee. (B) The licensee shall notify the director of its request for a hearing within five days after the notification by the director pursuant to subsection (A). Upon receipt of the licensee's request for a hearing, the director shall set a date for the hearing, which must be no less than ten days nor more than thirty days after the date of the licensee's request. Effect of Amendment 2014 Act No. 164, SECTION 8, rewrote the section.
S.C. Code Ann. § 38-27-630 — SC Code / Title 38 / Chapter 27 / Article 5 / Section 38-27-630
SECTION 38-27-630. Distribution of assets.
Status: in_force

Under the direction of the court, the liquidator shall pay distributions in a manner that will assure the proper recognition of priorities and a reasonable balance between the expeditious completion of the liquidation and the protection of unliquidated and undetermined claims, including third party claims. Distribution of assets in kind may be made at valuations set by agreement between the liquidator and the creditor and approved by the court.
S.C. Code Ann. § 38-73-950 — SC Code / Title 38 / Chapter 73 / Article 9 / Section 38-73-950
SECTION 38-73-950. Additional information may be required.
Status: in_force

When a filing is not accompanied by the information upon which the insurer supports the filing and the director or his designee does not have sufficient information to determine whether the filing meets the requirements of this chapter, he shall require the insurer to furnish the information upon which it supports the filing, and in this event the waiting period commences as of the date the information is furnished.
S.C. Code Ann. § 38-65-360 — SC Code / Title 38 / Chapter 65 / Article 5 / Section 38-65-360
SECTION 38-65-360. Promulgation of regulations.
Status: in_force

The Director of the Department of Insurance or his designee shall promulgate regulations to implement the provisions of this chapter.
S.C. Code Ann. § 38-101-130 — SC Code / Title 38 / Chapter 101 / Section 38-101-130
SECTION 38-101-130. Renewal of policy.
Status: in_force

(A) If an insurer intends to renew a policy, the insurer shall furnish renewal terms and a statement of the amount of premium or estimated premium due for the renewal policy period in the manner required by this section. (B) If the policy being renewed (original policy) is written for a term of one year or less, the renewal terms and statement of premium or estimated premium due must be furnished to the insured no less than forty-five days prior to the expiration date of the original policy. (C) If the original policy is written for a term of more than one year or for an indefinite term, the renewal terms and statement of premium or estimated premium due must be furnished to the insured no less than forty-five days prior to the anniversary date of the original policy. (D) The insurer may satisfy its obligation to furnish renewal terms and statement of premium or estimated premium due by either of the following methods: (1) mailing or delivering renewal terms and statement to the insured via electronic delivery in accordance with South Carolina law, at the address shown in the policy or, if not reflected, at the last known address, no less than forty-five days prior to expiration or anniversary; or (2) mailing or delivering renewal terms and statement to the producer or broker of record, if any, no less than sixty days prior to expiration or anniversary, along with instructions that the agent or broker furnish the renewal terms and statement to the insured no less than forty-five days prior to expiration or anniversary. (E) If the insurer fails to furnish the renewal terms and statement of premium or estimated premium due in the manner required by this section, the insured may elect to cancel the renewal policy within the forty-five-day period following receipt of the renewal terms and statement of premium or estimated premium due. Earned premium for any period of coverage must be calculated pro rata based upon the premium applicable to the original policy and not the premium applicable to the renewal policy. Editor's Note 2020 Act No. 166, SECTION 3, provides as follows: "SECTION 3. This act becomes effective sixty days following approval by the Governor. Insurers that are writing private flood insurance at the time of enactment have an additional one hundred twenty days to come into compliance with the requirements of this act."
S.C. Code Ann. § 38-73-990 — SC Code / Title 38 / Chapter 73 / Article 9 / Section 38-73-990
SECTION 38-73-990. Disapproval of filings generally.
Status: in_force

Except as provided in Section 38-73-995, if within the waiting period or any extension thereof as provided in Section 38-73-960 the director or his or her designee finds that a filing or a part of a filing does not meet the requirements of this chapter, he or she must send to the insurer or rating organization which made the filing written notice of disapproval of the filing or part of a filing specifying therein in what respects he or she finds the filing or part thereof fails to meet the requirements of this chapter and stating that the filing or the part may not become effective.
S.C. Code Ann. § 38-79-190 — SC Code / Title 38 / Chapter 79 / Article 3 / Section 38-79-190
SECTION 38-79-190. Policy forms and rate structure; claims-made or occurrence basis; forbidden provisions; rates charged.
Status: in_force

(1) The board of directors shall specify whether policy forms and the rate structure must be on a "claims-made" or "occurrence" basis and coverage may be provided by the association only on the basis specified by the board of directors. The board of directors shall specify the "claims-made" basis only if the contract makes provision for residual "occurrence" coverage upon the retirement, death, disability, or removal from the State of the insured. Provision may be made for a premium charge allocable to any such residual "occurrence" coverage and the premium charges for the residual coverage must be segregated and separately maintained for such purpose which may include the reinsurance of all or a part of that portion of the risk. (2) The policy may not contain any limitation in relation to the existing law in tort as provided by the statute of limitations of the State of South Carolina. (3) The policy form whether on a "claims-made" or "occurrence" basis may not require as a condition precedent to settlement or compromise of any claim the consent or acquiescence of the insured. However, such settlement or compromise may never be held or considered to be an admission of fault or wrongdoing by the insured. (4) The premium rate charged for either or both "claims-made" or "occurrence" coverage must be at rates established on an actuarially sound basis, including consideration of trends in the frequency and severity of losses. After the accumulated deficit has been eliminated, the association must function as a residual market mechanism. After that time, the association may not offer rates competitive with the admitted market but the rates for policies issued by the association must be adequate and established at a level that permits the association to operate as a self-sustaining mechanism. Effect of Amendment 2019 Act No. 67, SECTION 1, in (4), in the first sentence, deleted ", and must be calculated to be self-supporting" following "severity of losses", and added the second and third sentences.
S.C. Code Ann. § 38-71-1740 — SC Code / Title 38 / Chapter 71 / Article 17 / Section 38-71-1740
SECTION 38-71-1740. Responsibility for errors and omissions by parties to managed care participating provider agreements; limitations on network providers to discuss treatments, risks and legal obligations with an insured or member prohibited; permissible limitations.
Status: in_force

(A) For purposes of any health insurance plan, health maintenance organization, or any other health benefits plan offered in this State under the jurisdiction of South Carolina law: (1) Each party to a managed care participating provider agreement is responsible for the legal consequences and costs of his own acts or omissions, or both, and is not responsible for the acts or omissions, or both, of the other party. A clause in a participating provider agreement to the contrary is unlawful in this State, as a matter of public policy, whether entered into before or after January 1, 1999. (2) To the extent that a network plan requires an insured or a member to receive health benefits through a network of providers, the provisions of participating provider agreements may not limit the network provider's: (a) ability to discuss with an insured or a member, the treatment options available to the insured or member, risks associated with treatments, utilization management decisions, and recommended course of treatment; (b) legal obligations to an insured or a member as specified under the provider's professional license. (B) Nothing in this section: (1) prevents a network plan from prohibiting disclosure by network providers of trade secrets; (2) subjects a network plan to liability for clinical decisions made solely by the network provider; and (3) limits the ability of the network plan otherwise prudently to administer its provider contracts.
S.C. Code Ann. § 38-43-245 — SC Code / Title 38 / Chapter 43 / Article 1 / Section 38-43-245
SECTION 38-43-245. Fraudulent insurance application.
Status: in_force

A licensed insurance producer who, with the intent to injure, defraud, or deceive any insurance company or applicant for insurance: (1) presents or causes to be presented to any insurance company an application for insurance, knowing that the application contains any false or misleading information or omissions concerning any fact or thing material to the underwriting of the insurance for which the application is submitted, or (2) assists, abets, solicits, or conspires with another to prepare or make an application for insurance, knowing that the application contains any false or misleading information or omissions concerning any fact or thing material to the underwriting of the insurance for which the applicant is submitted, is guilty of a felony and, upon conviction, must be punished by imprisonment for not more than five years or a fine not to exceed five thousand dollars, or both.
S.C. Code Ann. § 38-13-190 — SC Code / Title 38 / Chapter 13 / Article 1 / Section 38-13-190
SECTION 38-13-190. Commissioner to examine affairs and methods of operations of insurance reserve fund; reports of findings.
Status: in_force

(1) At the end of each three years of operation, and at any other time considered prudent, the director or his designee shall examine the affairs of the insurance reserve funds and make findings and recommendations as provided by this section. For purposes of examination, the director or person making the examination has free access to all relevant records, books, and papers in the possession of any person or entity and may summon, administer oaths to, and examine as witnesses any persons in relation to matters relevant to the examination. (2) The director or his designee shall examine all methods of operation of the insurance reserve funds to determine whether the funds are being administered in accordance with sound insurance practices and in the best interest of the State. Following the examination, the director or his designee shall prepare a report for submission, through the State Fiscal Accountability Authority, to the Office of the Governor, the Speaker of the House of Representatives, and the President of the Senate containing his findings and conclusions and any recommendations to improve the efficiency, effectiveness, and overall operation of the funds. Code Commissioner's Note At the direction of the Code Commissioner, references in this section to the offices of the former State Budget and Control Board, Office of the Governor, or other agencies, were changed to reflect the transfer of them to the Department of Administration or other entities, pursuant to the directive of the South Carolina Restructuring Act, 2014 Act No. 121, SECTION 5(D)(1), effective July 1, 2015.
S.C. Code Ann. § 38-71-255 — SC Code / Title 38 / Chapter 71 / Article 1 / Section 38-71-255
SECTION 38-71-255. Health insurer may not impose different requirements on state agency.
Status: in_force

A health insurer, including a group health plan as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974 or health maintenance organization as defined in Section 38-33-20, may not impose requirements on a state agency, which has been assigned the rights of an individual eligible for medical assistance under Medicaid who is also covered under a plan issued by the health insurer, that are different from requirements applicable to an agent or assignee of any other individual so covered.
S.C. Code Ann. § 38-101-90 — SC Code / Title 38 / Chapter 101 / Section 38-101-90
SECTION 38-101-90. Written notice to applicants of consequences of discontinuing coverage under NFIP.
Status: in_force

(A) Before placing a personal lines private flood insurance policy with an admitted or surplus lines insurer, an insurance producer, broker, or the insurer shall provide a written notice to the applicant advising that if the applicant discontinues coverage under the NFIP, which is provided at a subsidized rate, the full risk rate for flood insurance may apply to the property if the applicant later seeks to reinstate coverage under the program. (B) This section only applies if the applicant lives in a special flood hazard area. The producer, broker, or insurer shall retain this notice for three years. This section automatically sunsets if there is federal legislation that allows the insured to switch between private flood insurance and NFIP coverage without penalty. Editor's Note 2020 Act No. 166, SECTION 3, provides as follows: "SECTION 3. This act becomes effective sixty days following approval by the Governor. Insurers that are writing private flood insurance at the time of enactment have an additional one hundred twenty days to come into compliance with the requirements of this act."
S.C. Code Ann. § 38-73-70 — SC Code / Title 38 / Chapter 73 / Article 1 / Section 38-73-70
SECTION 38-73-70. Regulations.
Status: in_force

The department may make reasonable regulations necessary to effect the purposes of this chapter.
S.C. Code Ann. § 38-33-250 — SC Code / Title 38 / Chapter 33 / Section 38-33-250
SECTION 38-33-250. Records of organization as public documents; trade secrets, etc.
Status: in_force

All applications and filings required under Section 38-33-30 and any annual and quarterly financial reports required under Section 38-33-90 must be treated as public documents. Nothing herein may be construed to require disclosure of trade secrets, privileged or confidential commercial information, or replies to a specific request for information made by the director or his designee.
S.C. Code Ann. § 38-27-420 — SC Code / Title 38 / Chapter 27 / Article 5 / Section 38-27-420
SECTION 38-27-420. Duties of agents.
Status: in_force

(a) Every person who receives notice in the form prescribed in Section 38-27-410 that an insurer which he represents as an agent is the subject of a liquidation order shall within fifteen days of the notice give notice of the liquidation order. The notice must 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 is considered 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 38-27-380. Notice by a general agent satisfies the notice requirement for any agents under contract to him. Each agent obligated to give notice under this section shall file a report of compliance with the liquidator. (b) Any agent failing to give notice or file a report of compliance as required in subsection (a) of this section is subject to the penalty provisions of Section 38-2-10. (c) 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.
S.C. Code Ann. § 38-93-90 — SC Code / Title 38 / Chapter 93 / Section 38-93-90
SECTION 38-93-90. Violations.
Status: in_force

(A) A violation of this chapter, including a single instance of a prohibited practice, is an unfair trade practice pursuant to Chapter 57, Title 38 and is subject to the penalties as provided for in Chapter 57 and in Section 38-2-10. The director or his designee at any time may examine an issuer, producer, agency, or insurance support organization to enforce this chapter. The expense of examination must be paid by the issuer, producer, agency, or insurance support organization. If an issuer, producer, agency, or insurance support organization determines that the fees assessed are unreasonable in relation to the examination performed, the issuer, producer, agency, or insurance support organization may appeal the assessments to the Administrative Law Court. Examination fees must be retained by the department and are considered "other" funds. (B) In addition, a violation of this chapter is an unfair trade practice as defined in Section 39-5-20 and is subject to the provisions of Sections 39-5-110 to 39-5-160. (C) The penalties and enforcement provisions of subsections (A) and (B) are in addition to penalties and enforcement provisions of federal law, including those set forth in the Genetic Information Nondiscrimination Act of 2008, Public Law 110-233. (D) An individual who is injured by a person's violation of this chapter may recover in a court of competent jurisdiction the following remedies: (1) equitable relief, which may include a retroactive order, directing the person to provide health insurance appropriate to the injured individual under the same terms and conditions as would have applied had the violation not occurred; and (2) an amount equal to any actual damages suffered by the individual as a result of the violation. (E) The prevailing party in an action under this section may recover costs and reasonable attorney's fees. Editor's Note Prior laws: 1998 Act No. 369, SECTION 1; 1976 Code SECTION 38-93-60.
S.C. Code Ann. § 38-13-1000 — SC Code / Title 38 / Chapter 13 / Article 9 / Section 38-13-1000
SECTION 38-13-1000. Purpose; construction; application.
Status: in_force

(A) The purpose of this article is to: (1) provide the director a summary of an insurer's or insurance group's corporate governance structure, policies, and practices to permit the director to gain and maintain an understanding of the insurer's corporate governance framework; (2) outline the requirements for completing a corporate governance annual disclosure and submitting the disclosure to the director; and (3) provide for the confidential treatment of the corporate governance annual disclosure and related information that will contain confidential and sensitive information related to an insurer or insurance group's internal operations and proprietary and trade secret information which, if made public, could potentially cause the insurer or insurance group competitive harm or disadvantage. (B) Nothing in this article may be construed to prescribe or impose corporate governance standards and internal procedures beyond what is required under applicable state corporate law. Notwithstanding the foregoing, nothing in this article may be construed to limit the director's authority or the rights or obligations of third parties, pursuant to Section 38-13-10, et seq. (C) The requirements of this article apply to all insurers domiciled in this State and do not apply to risk retention groups or captive insurance companies.
S.C. Code Ann. § 38-41-100 — SC Code / Title 38 / Chapter 41 / Section 38-41-100
SECTION 38-41-100. Regulations.
Status: in_force

The department may promulgate regulations which are necessary to implement the provisions of this chapter and to ensure the safe and proper operation of multiple employer self-insured health plans in this State.
S.C. Code Ann. § 38-49-25 — SC Code / Title 38 / Chapter 49 / Section 38-49-25
SECTION 38-49-25. Applicant's business and residence address required; notice of change of address required.
Status: in_force

When an individual applies for a motor vehicle physical damage appraiser's license he shall supply the department his business, email, and residential addresses. The appraiser shall notify the department within thirty days of any change in these addresses. Effect of Amendment 2016 Act No. 194, SECTION 7, inserted ", email,", substituted "residential addresses" for "residence address", and twice substituted "department" for "Department".
S.C. Code Ann. § 38-33-180 — SC Code / Title 38 / Chapter 33 / Section 38-33-180
SECTION 38-33-180. Suspension or revocation of certificate of authority.
Status: in_force

(A) The director or his designee may suspend or revoke a certificate of authority issued to a health maintenance organization if he finds that one or more of the following conditions exist: (1) The health maintenance organization is operating significantly in contravention of its basic organizational document or in a manner contrary to that described in other information submitted under Section 38-33-30, unless amendments to the submissions have been filed with and approved by the director or his designee. (2) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of Section 38-33-80. (3) The health maintenance organization does not provide or arrange for basic health care services. (4) The health maintenance organization does not meet the requirements of Section 38-33-40 or is unable to fulfill its obligations to furnish health care services. (5) The health maintenance organization is financially unsound or reasonably may be expected to be unable to meet its obligations to enrollees or prospective enrollees. (6) The health maintenance organization has failed to implement a mechanism affording the enrollees an opportunity to participate in matters of policy and operation under Section 38-33-60. (7) The health maintenance organization has failed to implement the complaint system required by Section 38-33-110 in a reasonable manner to resolve valid complaints. (8) The health maintenance organization, or a person on its behalf, advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner. (9) The continued operation of the health maintenance organization is hazardous to its enrollees. (10) The health maintenance organization otherwise has failed to comply with this chapter or regulations promulgated under it by the department. (B) A certificate of authority is suspended or revoked only after compliance with the requirements of Section 38-33-210. (C) When the certificate of authority of a health maintenance organization is suspended, the health maintenance organization, during the suspension, may not enroll additional enrollees except newborn children or other newly acquired dependents of existing enrollees and may not engage in advertising or solicitation. (D) When the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and may conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It may not engage in further advertising or solicitation. The director or his designee, by written order, may permit further operation of the organization he finds to be in the best interest of enrollees, to the end that enrollees are afforded the greatest practical opportunity to obtain continuing health care coverage.
S.C. Code Ann. § 38-23-40 — SC Code / Title 38 / Chapter 23 / Section 38-23-40
SECTION 38-23-40. Beneficial owners, directors, and officers of domestic stock insurers shall file statements.
Status: in_force

Every beneficial owner, director, or officer of a domestic stock insurer shall file in the office of the department within ten days after he becomes a beneficial owner, director, or officer a statement, in a form the director or his designee may prescribe, of the amount of all equity securities of the insurer which he beneficially owns. Within ten days after the close of each calendar month thereafter, if there has been a change in his ownership during the month, he shall file in the office of the department a statement, in a form the director or his designee may prescribe, indicating his ownership at the close of the calendar month and the changes in his ownership which have occurred during the calendar month.
S.C. Code Ann. § 38-27-930 — SC Code / Title 38 / Chapter 27 / Article 7 / Section 38-27-930
SECTION 38-27-930. Domiciliary liquidators in other states.
Status: in_force

(a) The domiciliary liquidator of an insurer domiciled in a reciprocal state is, except as to special deposits and security on secured claims under Section 38-27-940(c), vested by operation of law with the title to all of the assets, property, contracts and rights of action, agents' balances, and all of the books, accounts, and other records of the insurer located in this State. The date of vesting is the date of the filing of the petition, if that date is specified by the domiciliary law for the vesting of property in the domiciliary state. Otherwise, the date of vesting is the date of entry of the order directing possession to be taken. The domiciliary liquidator has the immediate right to recover balances due from agents and to obtain possession of the books, accounts, and other records of the insurer located in this State. He also has the right to recover all other assets of the insurer located in this State, subject to Section 38-27-940. (b) If a domiciliary liquidator is appointed for an insurer not domiciled in a reciprocal state, the director of this State or his designee is vested by operation of law with the title to all of the property, contracts and rights of action, and all of the books, accounts, and other records of the insurer located in this State, at the same time that the domiciliary liquidator is vested with title in the domicile. The director of this State or his designee may petition for a conservation or liquidation order under Section 38-27-910 or 38-27-920, or for an ancillary receivership under Section 38-27-940 or, after approval by the circuit court, may transfer title to the domiciliary liquidator, as the interests of justice and the equitable distribution of the assets require. (c) Claimants residing in this State may file claims with the liquidator or ancillary receiver, if any, in this State or with the domiciliary liquidator, if the domiciliary law permits. The claims must be filed by the last date fixed for the filing of claims in the domiciliary liquidation proceedings.
S.C. Code Ann. § 38-51-50 — SC Code / Title 38 / Chapter 51 / Section 38-51-50
SECTION 38-51-50. Payment of premiums.
Status: in_force

Whenever an insurer utilizes the services of an administrator under the terms of a written agreement as required in Section 38-51-40, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured is considered to have been received by the insurer, and the payment of return premiums or claims by the insurer to the administrator is not considered payment to the insured or claimant until the payments are received by the insured or claimant. Nothing herein limits any right of the insurer against the administrator resulting from his failure to make payments to the insurer, insureds, or claimants.
S.C. Code Ann. § 38-9-110 — SC Code / Title 38 / Chapter 9 / Article 1 / Section 38-9-110
SECTION 38-9-110. Voluntary deposits for compliance with laws of other states.
Status: in_force

A domestic company, in order to comply with the laws of any other state or territory of the United States, may make a voluntary deposit with the director or his designee in excess of the amount required by Section 38-9-80. This excess deposit is subject to all other applicable provisions of the laws of this State relating to the deposits of insurers, except that the excess deposit must be for the protection of all the company's policy obligations, ratably and without preference, notwithstanding the provisions of Section 38-9-90. However, a domestic company making this voluntary deposit is relieved of making the deposit required by Section 38-9-80 if the company meets the definition of a qualified insurer as defined in Section 38-9-100 and if the voluntary deposit meets the requirements of Section 38-9-100.
S.C. Code Ann. § 38-38-30 — SC Code / Title 38 / Chapter 38 / Article 1 / Section 38-38-30
SECTION 38-38-30. Representative form of government requirements.
Status: in_force

A society has a representative form of government when: (1) it has a supreme governing body constituted in one of the following ways: (a) the supreme governing body is an assembly composed of delegates elected directly by the members or at intermediate assemblies or conventions of members or their representatives, together with other delegates as may be prescribed in the society's bylaws. A society may provide for election of delegates by mail. The elected delegates constitute a majority in number and may not have less than two-thirds of the votes and not less than the number of votes required to amend the society's bylaws. The assembly must be elected and shall meet at least once every four years and shall elect a board of directors to conduct the business of the society between meetings of the assembly. Vacancies on the board of directors between elections may be filled in the manner prescribed by the society's bylaws; or (b) the supreme governing body is a board composed of persons elected by the members, either directly or by the representatives in intermediate assemblies, and other persons prescribed in the society's bylaws. A society may provide for election of the board by mail. Each term of a board member may not exceed four years. Vacancies on the board between elections may be filled in the manner prescribed by the society's bylaws. Those persons elected to the board shall constitute a majority in number and not less than the number of votes required to amend the society's bylaws. A person filling the unexpired term of an elected board member is considered an elected member. The board shall meet at least quarterly to conduct the business of the society; (2) the officers of the society are elected either by the supreme governing body or by the board of directors; (3) only benefit members are eligible for election to the supreme governing body and the board of directors; and (4) each voting member has one vote; a vote may not be cast by proxy.
S.C. Code Ann. § 38-90-490 — SC Code / Title 38 / Chapter 90 / Article 3 / Section 38-90-490
SECTION 38-90-490. Issuance of securities.
Status: in_force

(A) A SPFC may issue securities, including surplus notes and other forms of financial instruments, subject to and in accordance with applicable law, its approved plan of operation, and its organizational documents. (B) A SPFC, in connection with the issuance of securities, may enter into and perform all of its obligations under any required contracts to facilitate the issuance of these securities. (C) Subject to the approval of the director, a SPFC may lawfully: (1) account for the proceeds of surplus notes as surplus and not as debt for purposes of statutory accounting; (2) submit for prior approval of the director periodic written requests for payments of interest on and repayments of principal of surplus notes. (D) Surplus notes issued by a SPFC constitutes surplus or contribution notes of the type described at Section 38-27-610(9). (E) The director, without otherwise prejudicing the director's authority, may approve formulas for an ongoing plan of interest payments or principal repayments, or both, to provide guidance in connection with his ongoing reviews of requests to approve the payments on and principal repayments of the surplus notes. (F) The obligation to repay principal or interest, or both, on the securities issued by the SPFC must reflect the risk associated with the obligations of the SPFC to the counterparty under the SPFC contract.
S.C. Code Ann. § 38-72-70 — SC Code / Title 38 / Chapter 72 / Section 38-72-70
SECTION 38-72-70. Regulations.
Status: in_force

(A) The director may issue reasonable regulations to promote premium adequacy and to protect the policyholder if there is a substantial rate increase, and to establish minimum standards for producer education, marketing practices, producer compensation, producer testing, penalties, and reporting practices for long term care. (B) Regulations adopted pursuant to this chapter must be in accordance with the provisions of Chapter 23, Title 1.
S.C. Code Ann. § 38-90-35 — SC Code / Title 38 / Chapter 90 / Article 1 / Section 38-90-35
SECTION 38-90-35. Discovery of confidential information in civil actions.
Status: in_force

(A) Information submitted pursuant to the provisions of this chapter is confidential and may not be made public by the director or an agent or employee of the director without the written consent of the company, except that information may be discoverable by a party in a civil action or contested case to which the submitting captive insurance company is a party, upon a showing by the party seeking to discover the information that: (1) the information sought is relevant to and necessary for the furtherance of the action or case and the information sought is unavailable from other nonconfidential sources; or (2) a subpoena applicable to the information is issued by a judicial or administrative law officer of competent jurisdiction has been submitted to the director. (B) The director may disclose the information to the public officer having jurisdiction over the regulation of insurance in another state if: (1) the public official agrees in writing to maintain the confidentiality of the information; and (2) the laws of the state in which the public official serves require the information to be confidential. Effect of Amendment 2014 Act No. 282, SECTION 6, rewrote the section. 2018 Act No. 251, SECTION 1, reenacted the section with no apparent change.
S.C. Code Ann. § 38-77-120 — SC Code / Title 38 / Chapter 77 / Article 3 / Section 38-77-120
SECTION 38-77-120. Requirements for notice of cancellation of or refusal to renew policy.
Status: in_force

(a) No cancellation or refusal to renew by an insurer of a policy of automobile insurance is effective unless the insurer delivers or mails to the named insured at the address shown in the policy a written notice of the cancellation or refusal to renew. This notice: (1) must be approved as to form by the director or his designee before use; (2) must state the date not less than fifteen days after the date of the mailing or delivering on which the cancellation or refusal to renew becomes effective; (3) must state the specific reason of the insurer for cancellation or refusal to renew and provide for the notification required by subsection (B) of Section 38-77-390. However, those notification requirements must not apply when the policy is being canceled or not renewed for the reason set forth in Section 38-77-123(B), (4) must inform the insured of his right to request in writing within fifteen days of the receipt of notice that the director review the action of the insurer. The notice of cancellation or refusal to renew must contain the following statement to inform the insured of such right: "IMPORTANT NOTICE Within fifteen days of receiving this notice, you or your attorney may request in writing that the director review this action to determine whether the insurer has complied with South Carolina laws in canceling or nonrenewing your policy. If this insurer has failed to comply with the cancellation or nonrenewal laws, the director may require that your policy be reinstated. However, the director is prohibited from making underwriting judgments. If this insurer has complied with the cancellation or nonrenewal laws, the director does not have the authority to overturn this action."; (5) must inform the insured of the possible availability of other insurance which may be obtained through his agent, through another insurer, or through the Associated Auto Insurers Plan. It must also state that the Department of Insurance has available an automobile insurance buyer's guide regarding automobile insurance shopping and availability, and provide applicable mailing addresses and telephone numbers, including a toll-free number, if available, for contacting the Department of Insurance. Nothing in this subsection prohibits any insurer or agent from including in the notice of cancellation or refusal to renew, any additional disclosure statements required by state or federal laws, or any additional information relating to the availability of other insurance. The insurer must disclose in writing whether the insured is ceded to the facility. (b) Subsection (a) does not apply if the: (1) insurer has manifested to the insured its willingness to renew or to renew with a reduction in coverage by actually issuing or offering to the insured to issue a renewal policy, certificate, or other evidence of renewal, or has manifested such intention to the insured by any other means; provided, however, that in the case of a reduction in coverage, the insurer provides notice of a reduction in coverage to the named insured in a separate document entitled the 'Notice of Reduction in Coverage' no less than fifteen days prior to the effective date of the renewal that includes the proposed reduction in coverage. This notice must: (i) inform the insured of the reduction or elimination by the coverage section in the renewal policy or certificate; and (ii) provide that it is a notice of coverage changes. The Notice of Reduction in Coverage does not amend, extend, or alter coverage provided in a policy. An insurer's Notice of Reduction in Coverage must be provided to the director or his designee upon request when investigating a consumer complaint or when otherwise requested. The director or his designee may direct the insurer to provide the renewal without the reduction in coverage if the insurer fails to meet the requirements of this section. The director or his designee may issue guidance to an insurer or to the industry regarding the form and contents of the Notice of Reduction in Coverage in response to consumer inquiries or complaints; (2) named insured has demonstrated by some overt action to the insurer or its agent that he expressly intends that the policy be canceled or that it not be renewed. Validity For the validity of the amendment by 2020 Act No. 174, see Mercury Funding, LLC v. Chesney, 433 S.C. 591, 861 S.E.2d 35 (2021). Effect of Amendment 2020 Act No. 174, SECTION 2, rewrote (b). 2021 Act No. 14, SECTION 2, in (b)(1), in the first sentence, substituted "other means; provided, however," for "other means provided".
S.C. Code Ann. § 38-71-1810 — SC Code / Title 38 / Chapter 71 / Article 18 / Section 38-71-1810
SECTION 38-71-1810. Pharmacy audit rights.
Status: in_force

(A) For the purposes of this article: (1) "Insurer" means an entity that provides health insurance coverage in this State as defined in Section 38-71-670(7) and Section 38-71-840(16). (2) "Responsible party" means the entity responsible for payment of claims for health care services other than: (a) the individual to whom the health care services were rendered; or (b) that individual's guardian or legal representative. (3) "Audit" means an evaluation, investigation, or review of claims paid to a pharmacy that takes place at the pharmacy location and does not include review of claims or claims payments that an insurer conducts as a normal course of business. Nothing in this definition limits the review of claims or claims payments through an electronic or algorithmic system designed to reduce fraud, waste, or abuse, provided that recoupments may not be calculated based on extrapolation pursuant to Section 38-71-1810(21). (4) "Abuse" means any practice that: (a)(i) is inconsistent with sound fiscal or business practices; or (ii) fails to meet professionally recognized standards for pharmacy services; and (b) directly or indirectly causes financial loss to a responsible party. (B) If a managed care organization, insurer, third-party payor, or any entity that represents a responsible party conducts an audit of the records of a pharmacy, then, with respect to this audit, the pharmacy has a right to: (1) not have an audit initiated or scheduled during the first five days of any month without the express consent of the pharmacy, which shall cooperate with the auditor to establish an alternate date if the audit would fall within the excluded days, and no audit may be performed during a state of emergency declared by the Governor that applies to the pharmacy location unless the state of emergency extends beyond ninety days or is agreed to by the pharmacy location; (2) have an audit that involves clinical judgment be conducted with a pharmacist who is licensed and employed by or working under contract with the auditing entity; (3) not have clerical or recordkeeping errors, including typographical errors, scrivener's errors, and computer errors, on a required document or record considered fraudulent in the absence of any other evidence or serve as the sole basis of rejection of a claim; however, the provisions of this item do not prohibit recoupment of fraudulent payments; (4) have the auditing entity to provide the pharmacy, upon request, all records related to the audit in an electronic format or contained in digital media; (5) have at least thirty days to respond to an audit notice and to submit records requested by the auditing entity related to the audit in electronic format or by certified mail. If a pharmacy requests an extension during this thirty-day period, it must be granted an additional thirty days to respond. The auditing entity must confirm receipt of all materials and documentation provided by the pharmacy to the auditing entity; (6) have the properly documented records of a hospital or of a person authorized to prescribe controlled substances for the purpose of providing medical or pharmaceutical care for their patients transmitted by any means of communication approved by the auditing entity in order to validate a pharmacy record with respect to a prescription or refill for a controlled substance or narcotic drug pursuant to federal and state regulations; (7) have a projection of an overpayment or underpayment based on either the number of patients served with a similar diagnosis or the number of similar prescription orders or refills for similar drugs; however, the provisions of this item do not prohibit recoupments of actual overpayments unless the projection for overpayment or underpayment is part of a settlement by the pharmacy; (8) prior to the initiation of an audit, if the audit is conducted for an identified problem, have the audit limited to claims that are identified by prescription number or by range of prescription numbers; (9) if an audit is conducted for a reason other than described in item (8), have the audit limited to one hundred selected prescriptions per pharmacy benefits manager; (10) if an audit reveals the necessity for a review of additional claims, the audit may be conducted on-site; (11) except for audits initiated for the reason described in items (8) or (10), be subject to no more than one audit in one calendar year, unless fraud or misrepresentation is reasonably suspected; (12) be free of recoupments based on either of the following subitems unless defined within the billing, submission, or audit requirements set forth in the pharmacy provider manual not inconsistent with current State Board of Pharmacy Regulations, except for cases of Food and Drug Administration regulation or drug manufacturer safety programs in accordance with federal or state regulations: (a) documentation requirements in addition to, or exceeding requirements for, creating or maintaining documentation prescribed by the State Board of Pharmacy; (b) a requirement that a pharmacy or pharmacist perform a professional duty in addition to, or exceeding, professional duties prescribed by the State Board of Pharmacy unless otherwise agreed to by contract with the auditing entity; (13) be subject, so long as a claim is made within the contractual claim submission time period, to recoupment only following the correction of a claim and to have recoupment limited to amounts paid in excess of amounts payable under the corrected claim unless a prescription error occurs. For purposes of this subsection, a prescription error includes, but is not limited to, wrong drug, wrong strength, wrong dose, or wrong patient; (14) be subject to reversals of approval, except for Medicare claims, for drug, prescriber, or patient eligibility upon adjudication of a claim only in cases in which the pharmacy obtained the adjudication by fraud or misrepresentation of claim elements; (15) be audited under the same standards and parameters as other similarly situated pharmacies audited by the same entity; (16) have at least thirty days following receipt of the preliminary audit report to produce documentation to address any discrepancy found during an audit; (17) have the option of providing documentation in electronic format or by certified mail; (18) have the period covered by an audit limited to twenty-four months from the date a claim was submitted to, or adjudicated by, a managed care organization, an insurer, a third-party payor, or an entity that represents responsible parties, unless a longer period is permitted by or under federal law; (19) have the preliminary audit report delivered to the pharmacy within one hundred twenty days after conclusion of the audit; (20) have a final audit report delivered to the pharmacy within ninety days after the end of the appeals period; (21) not have the accounting practice of extrapolation used in calculating recoupments or penalties for audits, unless otherwise required by federal requirements or federal plans; and (22) have the right to an external review pursuant to Section 38-71-2240 for any denied appeals of recoupment if the pharmacy believes the recoupment amounts were calculated in violation of this article. (C) Notwithstanding Section 38-71-1840, the auditing entity shall provide the pharmacy, if requested, a masked list that provides a prescription number range the auditing entity is seeking to audit. Editor's Note 2019 Act No. 48, SECTION 3.B, provides as follows: "B. The provisions of this section are effective upon approval by the Governor [May 16, 2019]." 2023 Act No. 30, SECTION 7, provides as follows: "SECTION 7. This act takes effect January 1, 2024, but the recurring examinations by the Department of Insurance provided for in Sections 38-71-2250(B)(1) and 38-71-2340(B)(1) must not begin before January 1, 2025." Effect of Amendment 2019 Act No. 48, SECTION 3.A, in (B), in (3), inserted "or serve as the sole basis of rejection of a claim" and made a nonsubstantive changed, in (4), deleted ", if required under the terms of the contract with the auditing entity," following "have", inserted (5) and redesignated (5) to (11) as (6) to (12), and inserted (13) and redesignated (12) to (15) as (14) to (17). 2023 Act No. 30, SECTION 1, in (A)(3), added the second sentence; and rewrote (B).
S.C. Code Ann. § 38-19-1230 — SC Code / Title 38 / Chapter 19 / Article 13 / Section 38-19-1230
SECTION 38-19-1230. Filing of annual statements; audit; notice of stock offering.
Status: in_force

(A) A mutual insurance holding company shall file with the Director of the Department of Insurance an annual income statement, balance sheet, and cash flow statement, and a statement regarding any encumbrances or plans to encumber the assets of the mutual insurance holding company. (B) A mutual insurance holding company shall have an annual audit by an independent certified public accountant and shall file an audited financial report with the Director of the Department of Insurance by June first of each year. (C) A mutual insurance holding company shall notify the director ninety days prior to any initial and subsequent subsidiary stock offering for review by the director for compliance with all applicable state law and the offering shall be deemed approved by the director within thirty days of submission to the director unless the director states otherwise in writing within thirty days of submission.
S.C. Code Ann. § 38-63-250 — SC Code / Title 38 / Chapter 63 / Article 3 / Section 38-63-250
SECTION 38-63-250. Alternative adjustable interest rate.
Status: in_force

(a) In the alternative life insurers may issue policies that permit an adjustable maximum interest rate established from time to time by the life insurer as permitted by law. These adjustable maximum interest rates may not exceed the higher of the following: (1) the Published Monthly Average for the calendar month ending two months before the date on which the rate is determined; or (2) the rate used to compute the cash surrender values under the policy during the applicable period plus one percent per annum. "Published Monthly Average" means Moody's Corporate Bond Yield Average - Monthly Average Corporates as published by Moody's Investors Service, Inc., or any successor thereto or, if Moody's Corporate Bond Yield Average - Monthly Average Corporates is no longer published, a substantially similar average, established by regulation issued by the department. (b) If the maximum rate of interest is determined pursuant to this section, the policy shall contain a provision setting forth the frequency at which the rate is to be determined for the policy. (c) The maximum rate for each policy must be determined at regular intervals but only once each twelve months. (d) At the intervals specified in the policy: (1) the rate being charged may be increased whenever the increase as determined under subsection (a) would increase the rate by one-half percent or more per annum, but not more than twice in any calendar year; (2) the rate being charged must be reduced whenever the reduction as determined under subsection (a) would decrease that rate by one-half percent or more per annum. (e) The life insurer shall: (1) notify the policyholder at the time a cash loan is made of the initial rate of interest on the loan; (2) notify the policyholder with respect to premium loans of the initial rate of interest on the loan as soon as it is reasonably practical to do so, but in no event later than sixty days after making the initial loan. Notice need not be given to the policyholder when a further premium loan is added, except as provided in item (3); (3) send to policyholders with loans at least thirty days' advance notice of any increase in the rate and within due course notify the policyholder of any decrease in the interest rate; (4) include in the notices required above the substance of the pertinent provisions of Section 38-63-240 or subsections (a) and (b). (f) The loan value of the policy must be determined in accordance with the provisions of this article but no policy may terminate in a policy year as the sole result of change in the interest rate during that policy year, and the life insurer shall maintain coverage during that policy year until the time at which it would otherwise have terminated if there had been no change during that policy year. (g) The substance of the pertinent provisions of SECTION 38-63-240 or subsections (a) and (b) must be set forth in the policies to which they apply. (h) For the purposes of this section: (1) the rate of interest on policy loans hereunder shall include the interest rate charged on reinstatement of policy loans for the period during and after any lapse of a policy; (2) policy loan includes any premium loan made under a policy to pay one or more premiums that were not paid to the life insurer as they fell due; (3) policyholder includes the owner of the policy or the person designated to pay premiums, if different, as shown on the records of the life insurer; (4) policy includes certificates issued by a fraternal benefit society and annuity contracts which provide for policy loans. However, before May 1, 1986, no life insurer may issue policies that permit such rates unless at the same time it also makes available policies providing for a rate of interest under SECTION 38-63-240.
S.C. Code Ann. § 38-85-80 — SC Code / Title 38 / Chapter 85 / Section 38-85-80
SECTION 38-85-80. Authorization to promulgate regulations.
Status: in_force

The department is authorized to promulgate regulations to implement this chapter.
S.C. Code Ann. § 38-3-10 — SC Code / Title 38 / Chapter 3 / Article 1 / Section 38-3-10
SECTION 38-3-10. Department of Insurance and Insurance Commission established.
Status: in_force

There is established a separate and distinct department of this State, known as the Department of Insurance. The department must be managed and operated by a director appointed by the Governor upon the advice and consent of the Senate. The director is subject to removal by the Governor as provided in Section 1-3-240(B). The director shall be selected with special reference to his training, experience, technical knowledge of the insurance industry, and demonstrated administrative ability. The director may appoint or designate the person or persons who shall serve at the pleasure of the director to carry out the objectives or duties of the department as provided by law. Furthermore, the director may bestow upon his designee or deputy director any duty or function required of him by law in managing or supervising the Department of Insurance.
S.C. Code Ann. § 38-9-220 — SC Code / Title 38 / Chapter 9 / Article 1 / Section 38-9-220
SECTION 38-9-220. "Qualified United States financial institution" defined.
Status: in_force

(A) For purposes of Section 38-9-210, a "qualified United States financial institution" means an institution that: (1) is organized or, for a United States office of a foreign banking organization, licensed under the laws of the United States or its state; (2) is regulated, supervised, and examined by federal or state authorities having regulatory authority over banks and trust companies; (3) has been determined by the director or designee or the Securities Valuation Office of the National Association of Insurance Commissioners to meet standards of financial condition and standing necessary and appropriate to regulate the quality of financial institutions whose letters of credit are acceptable to the director or designee. (B) For purposes of those provisions of this law specifying those institutions that are eligible to act as a fiduciary of a trust, a "qualified United States financial institution" means an institution that is: (1) organized or, for a United States branch or agency office of a foreign banking organization, licensed under the laws of the United States or its state and has been granted authority to operate with fiduciary powers; (2) regulated, supervised, and examined by federal or state authorities having regulatory authority over banks and trust companies.
S.C. Code Ann. § 38-90-160 — SC Code / Title 38 / Chapter 90 / Article 1 / Section 38-90-160
SECTION 38-90-160. Application of provisions of title; director discretion; exemption of special purpose captive insurance companies.
Status: in_force

(A) No provisions of this title or regulations, other than those contained in this chapter or contained in specific references contained in this chapter and regulations applicable to them, apply to captive insurance companies. The South Carolina Insurance Data Security Act set forth in Chapter 99, Title 38 applies to captive insurance companies unless the captive insurer qualifies for an exemption set forth in that chapter. (B) The director may exempt, by rule, regulation, or written approval, special purpose captive insurance companies, other than a risk retention group formed as a special purpose captive insurance company, on a case by case basis, from provisions of this chapter that he determines to be inappropriate given the nature, scale, and complexity of the risks to be insured. (C) The provisions of Sections 38-5-120(A)(5), 38-5-120(B), 38-5-120(D)(1), 38-5-120(D)(2), 38-9-225, 38-9-230, 38-21-10, 38-21-30, 38-21-60, 38-21-70, 38-21-80, 38-21-90, 38-21-95, 38-21-100, 38-21-110, 38-21-120, 38-21-130, 38-21-140, 38-21-150, 38-21-160, 38-21-170, 38-21-220, 38-21-225, 38-21-230, 38-21-250, 38-21-270, 38-21-280, 38-21-285, 38-21-290, 38-21-310, 38-21-320, 38-21-330, 38-21-360, 38-55-75 and Chapters 44, 46, and 99, Title 38 and applicable regulations apply in full to a risk retention group and, if a conflict occurs between those code sections and chapters referenced in this subsection and this chapter (Chapter 90, Title 38), then the code sections and chapters referenced in this subsection control. (D) Except as provided elsewhere in this chapter, the provisions of Chapter 87, Title 38 apply to a risk retention group. (E)(1) Except for Section 38-9-330(F) and Section 38-9-440, the provisions of Article 3 and Article 5, Chapter 9, Title 38 apply in full to a risk retention group, and if a conflict occurs between those provisions and this chapter, the provisions of this subsection control. (2) The director may elect not to take regulatory action as otherwise required by Sections 38-9-330, 38-9-340, 38-9-350, and 38-9-360 if any of the following conditions exist: (a) the director establishes that the risk retention group's members, sponsoring organizations, or both, are well-capitalized entities whose financial condition and support for the risk retention group is adequately documented. In making this determination, the director shall, at a minimum, require the filing of at least three years of historical, audited financial statements of the members, sponsor, or both, to assess the financial ability of the members', sponsor's, or both, support of the risk retention group. In addition, one year of projected financial information must be reviewed if available. The members, sponsor, or both, shall have: (i) an investment grade rating from a nationally recognized statistical rating organization or A.M. Best rating of A- or better; or (ii) equity equal to or greater than one hundred million dollars or equity equal to or greater than ten times the risk retention group's largest net retained per occurrence limit; (b) each policyholder qualifies as an industrial insured in their state or this State, depending on which has the greater requirements, provided that if the policyholder's home state does not have an industrial insured exemption or equivalent, the policyholder must qualify under the industrial insured requirement of this State; or (c) the risk retention group's certificate of authority date of issue was before January 1, 2011, and, based on a minimum five-year history of successful operations, is specifically exempted, in writing, from the requirements for mandatory risk-based capital action by the director. Editor's Note 2014 Act No. 164, SECTION 15, effective January 1, 2015, provides as follows: "SECTION 15. (A) Article 3, Chapter 9, Title 38, designated 'Risk Based Capital' is redesignated 'Risk-Based Capital'. "(B) Sections 38-9-400, 38-9-410, 38-9-420, 38-9-430, 38-9-440, 38-9-450, and 38-9-460 of the 1976 Code, which are designated as Article 5, Chapter 9, Title 38, are redesignated as part of Article 3, Chapter 9, Title 38, and Article 5, Chapter 9, Title 38 is deleted." Effect of Amendment 2014 Act No. 282, SECTION 17, in subsection (B), inserted "other than a special purpose captive insurance company formed as a risk retention group,"; in subsection (C), substituted "38-5-120(A)(5), 38-5-120(B), 38-5-120(D)(1), 38-5-120(D)(2)," for "38-5-120(A)(3), 38-5-120(C), 38-5-120(D),"; and in subsections (C), (D), (E)(1) substituted "a captive insurance company" for "an industrial insured a captive insurance company". 2015 Act No. 2, SECTION 17, in (C), inserted reference to the following sections: 38-21-80, 38-21-100, 38-21-110, 38-21-220, 38-21-225, 38-21-230, 38-21-285, and 38-21-290. 2016 Act No. 191, SECTION 4, in (D) added the second sentence. 2018 Act No. 251, SECTION 1, rewrote the section. 2019 Act No. 6, SECTION 10, in (A), added the second sentence, applying the South Carolina Insurance Data Security Act to captive insurance companies; and in (C), substituted "Chapters 44, 46, and 99" for "Chapters 44 and 46".
S.C. Code Ann. § 38-12-210 — SC Code / Title 38 / Chapter 12 / Article 2 / Section 38-12-210
SECTION 38-12-210. Scope of article.
Status: in_force

This article applies to the investments and investment practices of life and health insurers, and other companies whose investments and investment practices are regulated as if they were life and health insurers under this title, subject to the provisions of Section 38-12-20.
S.C. Code Ann. § 38-38-550 — SC Code / Title 38 / Chapter 38 / Article 11 / Section 38-38-550
SECTION 38-38-550. Authorization to transact business in State; what to file with director.
Status: in_force

A society may not transact business in this State without a certificate of authority issued by the director or his designee. A society desiring admission to, or wishing to continue to transact business in this State, shall comply with the requirements and limitations of this chapter. A society may be authorized to transact, or continue to transact, business in this State upon filing with the director or his designee: (1) a certified copy of its articles of incorporation; (2) a copy of its bylaws, certified by its secretary or corresponding officer; (3) a power of attorney to the director or his designee as prescribed in Section 38-38-710; (4) a statement of its business under the oath of its president and secretary or corresponding officers in a form prescribed by the director or his designee, verified by an examination made by the supervising insurance official of its home state or other state, territory, province, or country, satisfactory to the director or his designee; (5) certification from the proper official of this State or its home state, territory, province, or country that the society is legally incorporated, and that, for a foreign or alien society, it is licensed to transact business there and to write the lines of business for which authority is being requested; (6) copies of its certificate forms; (7) evidence that its assets are invested in accordance with the provisions of this chapter; (8) evidence that its name is not substantially similar to another society authorized to do business in this State; (9) evidence that the society's surplus complies with the amount required by Section 38-9-20. A society, if possessed of surplus on December 31, 1998, that was in compliance with the law at that time but is less than the minimum required to be maintained by Section 38-9-20, shall maintain not less than the amount of surplus stated in its 1998 annual statement. If the surplus of the society is reduced to less than eighty percent of the amount shown in its 1998 annual statement, the society is considered delinquent, and the director or his designee may begin delinquency proceedings as provided by Chapter 27 of this title. If the surplus of the society is increased to an amount greater than the amount possessed on December 31, 1998, eighty percent of that greater amount of surplus, or the minimum amount required to be maintained by Section 38-9-20, whichever amount is the lesser, must be maintained after the increase, and if it is not maintained, the society is considered delinquent, and the director or his designee may begin delinquency proceedings as provided by Chapter 27 of this title; (10) evidence that the society's deposit complies with the amount required by Section 38-9-80 and Regulation 69-15, Section 38-9-100, or Section 38-9-110; (11) evidence that the society's reserves are adequate for the protection of certificate holders of this State; (12) evidence that the society's directors and officers are competent, trustworthy, and have a good business reputation and that none of the directors and officers has been convicted of a crime in any jurisdiction involving fraud, dishonesty, or like moral turpitude or convicted of violating an insurance statute of any jurisdiction; (13) evidence that the society has employed one or more persons residing in this State with adequate experience and training to manage properly its business and affairs; (14) evidence that the society has not entered into any management contract, agency agreement, or other agreement which may materially affect its financial condition so as to render its proceedings hazardous to the public or to its certificate holders; (15) evidence that the society has made adequate reinsurance arrangements if required; (16) evidence that the society's proposed method of operation, when considered in light of its financial condition and the absence of any prior operating experience, will not likely render its proceedings hazardous to the public or to its policyholders; (17) an affidavit of its president or other chief officer that it has not violated this title in the past year and that it accepts the terms and obligations of this title as part of the consideration for license; (18) evidence that the society is safe and solvent; (19) evidence that society's dealings are fair and equitable; (20) evidence that the society conducts its business in a manner not contrary to the public interest; and (21) any other information the director or his designee considers necessary. The above requirements are subject to retaliatory provisions, if applicable, pursuant to Section 38-7-90. If subsequently the director or his designee is of the opinion that a condition exists which would have prohibited him from issuing the original certificate of authority or license to the society, then that condition also constitutes a ground for license revocation under Section 38-5-120.
S.C. Code Ann. § 38-75-960 — SC Code / Title 38 / Chapter 75 / Article 11 / Section 38-75-960
SECTION 38-75-960. Financial interest in title insurer or agent.
Status: in_force

(A) No title insurer or title insurance agent may accept an order for, issue a title insurance policy to, or provide services to an applicant if it knows or has reason to believe that the applicant was referred to it by any producer of title business or by any associate of the producer where the producer, the associate, or both, have a financial interest in the title insurer or title agent to which business is referred unless the producer has disclosed to the buyer, seller, or lender the financial interest of the producer of title business or associate referring the title business. The disclosure must be made in writing on forms prescribed by the director or his designee. The title insurer or agent shall maintain the disclosure forms for a period of three years. (B) Each title insurer and title agent shall file with the department, on forms prescribed by the director or his designee, reports setting forth the names and addresses of those persons, if any, who have had a financial interest in the title insurer or title agent during the calendar year who are known or reasonably believed by the title insurer or title agent to be producers of title business or associates of producers. (1) Each title insurer shall file the report required under this subsection with its application for a license and at any time there is a change in the information provided in the last report. (2) Each title agent shall file the report required under this subsection with its application for license and at any time there is a change in the information provided in its last report. (3) Each title insurer or title agent licensed on the effective date of this act, shall file the report required under this subsection within ninety days after the effective date of this act.
S.C. Code Ann. § 38-43-800 — SC Code / Title 38 / Chapter 43 / Article 6 / Section 38-43-800
SECTION 38-43-800. Sales practices for travel insurers.
Status: in_force

(A) A person offering travel insurance to residents of this State is subject to the provisions of Chapter 57 of this title, except as otherwise provided in this article. In the event of a conflict between this article and other provisions of this title regarding the sale and marketing of travel insurance and travel protection plans, the provisions of this article control. (B) Offering or selling a travel insurance policy that could never result in payment of any claims for any insured under the policy is deemed an unfair trade practice. (C)(1) All documents provided to consumers prior to the purchase of travel insurance including, but not limited to, sales materials, advertising materials, and marketing materials must be consistent with the travel insurance policy itself including, but not limited to, forms, endorsements, policies, rate filings, and certificates of insurance. (2) For travel insurance policies or certificates that contain preexisting condition exclusions, information and an opportunity to learn more about the preexisting condition exclusions must be provided any time prior to the time of purchase and in the coverage's fulfillment materials. (3) The fulfillment materials and the information described in Section 38-43-730(A)(1) must be provided to a policyholder or certificate holder as soon as practicable following the purchase of a travel protection plan. Unless the insured has either started a covered trip or filed a claim under the travel insurance coverage, a policyholder or certificate holder may cancel a policy or certificate for a full refund of the travel protection plan price from the date of purchase of a travel protection plan until at least: (a) fifteen days following the date of delivery of the travel protection plan's fulfillment materials by postal mail; or (b) ten days following the date of delivery of the travel protection plan's fulfillment materials by means other than postal mail. For the purposes of this section, "delivery" means handing fulfillment materials to the policyholder or certificate holder or sending fulfillment materials by postal mail or electronic means to the policyholder or certificate holder. (4) The company must disclose in the policy documentation and fulfillment materials whether the travel insurance is primary or secondary to other applicable coverage. (5) Where travel insurance is marketed directly to a consumer through an insurer's website or by others through an aggregator site, it shall not be an unfair trade practice or other violation of law where an accurate summary or short description of coverage is provided on the web page, so long as the consumer has access to the full provisions of the policy through electronic means. (D) No person offering, soliciting, or negotiating travel insurance or travel protection plans on an individual or group basis may do so by using negative option or opt out, which would require a consumer to take an affirmative action to deselect coverage such as unchecking a box on an electronic form when the consumer purchases a trip. (E) It is an unfair trade practice to market blanket travel insurance coverage as free. (F) Where a consumer's destination jurisdiction requires insurance coverage, it shall not be an unfair trade practice to require that a consumer choose between the following options as a condition of purchasing a trip or travel package: (1) purchasing the coverage required by the destination jurisdiction through the travel retailer or limited lines travel insurance producer supplying the trip or travel package; or (2) agreeing to obtain and provide proof of coverage that meets the destination jurisdiction's requirements prior to departure.
S.C. Code Ann. § 38-69-110 — SC Code / Title 38 / Chapter 69 / Article 3 / Section 38-69-110
SECTION 38-69-110. No defenses allowed if application not attached to annuity contract; oral applications.
Status: in_force

If the insurer does not deliver with an annuity contract issued by it a copy of the application made by the insured, no defense is allowed to that annuity on account of anything contained in or omitted from the application. If the annuity is issued upon an oral application, no defense is allowed to the contract on account of anything contained in, or omitted from, the oral application.
S.C. Code Ann. § 38-90-440 — SC Code / Title 38 / Chapter 90 / Article 3 / Section 38-90-440
SECTION 38-90-440. License to transact business in State; contents of application; fees; foreign corporations.
Status: in_force

(A) A SPFC, when permitted by its organizational documents, may apply to the director for a license to transact insurance or reinsurance business as authorized by this article. A SPFC only may insure or reinsure the risks of its counterparty. Notwithstanding another provision of this article, a SPFC may purchase reinsurance to cede the risks assumed under the SPFC contract as approved by the director. (B) To transact business in this State a SPFC shall: (1) obtain from the director a license authorizing it to conduct insurance or reinsurance business, or both, in this State; (2) hold at least one management meeting each year in this State; (3) maintain its principal place of business in this State; (4) appoint a resident registered agent to accept service of process and to otherwise act on its behalf in this State. If the registered agent, with reasonable diligence, is not found at the registered office of the SPFC, the director must be an agent of the SPFC upon whom any process, notice, or demand may be served; (5) provide such documentation of the insurance securitization as requested by the director immediately upon closing of the transaction, including: (a) an opinion of legal counsel with respect to compliance with this article and any other applicable laws as of the effective date of the transaction; and (b) a statement under oath of its president and secretary showing its financial condition; and (6) provide a complete set of the documentation of the insurance securitization to the director shortly following closing of the transaction. (C) A complete SPFC application must include the following: (1) a certified copy of its organizational documents; and (2) evidence of: (a) the amount and liquidity of its assets relative to the risks to be assumed; (b) the adequacy of the expertise, experience, and character of the person or persons who manages it; (c) the overall soundness of its plan of operation; (d) other factors considered relevant by the director in ascertaining whether the proposed SPFC is able to meet its policy obligations; and (e) the applicant SPFC's financial condition, including the source and form of the minimum capitalization to be contributed to the SPFC. (3) A plan of operation, consisting of a description of or statement of intent with respect to the contemplated insurance securitization, the SPFC contract, and related transactions, which must include: (a) draft documentation or, at the discretion of the director, a written summary of all material agreements that are entered into to effectuate the SPFC contract and, before effecting such, the insurance securitization, to include the names of the counterparty, the nature of the risks being assumed, the proposed use of protected cells, if any, and the maximum amounts, purpose, and nature and the interrelationships of the various transactions required to effectuate the insurance securitization; (b) the source and form of additional capitalization to be contributed to the SPFC; (c) the proposed investment strategy of the SPFC; (d) a description of the underwriting, reporting, and claims payment methods by which losses covered by the SPFC contract are reported, accounted for, and settled; and (e) a pro forma balance sheet and income statement illustrating various stress case scenarios for the performance of SPFC under the SPFC contract. (4) Biographical affidavits in NAIC format of all of the prospective SPFC's officers and directors, providing their legal names, any names under which they have or are conducting their affairs, and any affiliations with other persons as defined in Chapter 21 of this title, together with other biographical information as the director may request. (5) An affidavit from the applicant SPFC verifying: (a) the applicant SPFC meets the provisions of this article; (b) the applicant SPFC operates only pursuant to the provisions in this article; (c) the applicant SPFC's investment strategy reflects and takes into account the liquidity of assets and the reasonable preservation, administration, and asset management of such assets relative to the risks associated with the SPFC contract and the insurance securitization transaction; (d) the securities proposed to be issued are valid legal obligations that are either properly registered with the Securities Commissioner or constitute an exempt security or form part of an exempt transaction pursuant to Section 35-1-310 or 35-1-320; and (e) unless otherwise exempted by the director, the trust agreement, the trusts holding assets that secure the obligations of the SPFC under the SPFC contract, and the SPFC contract with the counterparty in connection with the contemplated insurance securitization are structured pursuant to the provisions in this article. (6) Any other statements or documents required by the director to evaluate and complete the licensing of the SPFC. (D) In addition to the information required by subsection (C), and to the provisions of Section 38-90-480, if a protected cell is used, an applicant SPFC shall file with the director: (1) a business plan demonstrating how the applicant accounts for the loss and expense experience of each protected cell at a level of detail found to be sufficient by the director, and how it reports the experience to the director; (2) a statement acknowledging that all financial records of the SPFC, including records pertaining to any protected cells, must be made available for inspection or examination by the director; (3) all contracts or sample contracts between the SPFC and any counterparty, related to each protected cell; and (4) a description of the expenses allocated to each protected cell. (E) Information submitted pursuant to this subsection is confidential and is subject to Section 38-90-610. (F) Section 38-13-60 applies to examinations, investigations, and processing conducted pursuant to the authority of this article. (G) To transact insurance or reinsurance business in this State, a SPFC shall pay to the department: (1) a nonrefundable fee of two hundred dollars for processing its application for license. In addition, the director may retain legal, financial, and examination services from outside the department to examine and investigate the application, the reasonable cost of which may be charged against the applicant. The director also may use internal resources to examine and investigate the application based upon an hourly rate for the services performed or the usual and customary fee charged by the financial services industry for similar work subject to a minimum fee of twelve thousand dollars, six thousand dollars of which is payable upon filing of the application and the remainder upon licensure; (2) a license fee for the year of registration of three hundred dollars and an annual renewal fee of five hundred dollars; (3) an annual review fee of twenty-four hundred dollars or, if higher, the actual cost as determined by the director; and (4) premium taxes as required by this article. (H) The director may grant a license authorizing the SPFC to transact insurance or reinsurance business as a SPFC in this State until March first, at which time the license may be renewed, upon finding that the: (1) proposed plan of operation provides a reasonable and expected successful operation; (2) terms of the SPFC contract and related transactions comply with this article; (3) proposed plan of operation is not hazardous to any counterparty; (4) commissioner of the state of domicile of each counterparty has notified the director in writing or otherwise provided assurance satisfactory to the director that it has approved or nondisapproved the transaction; and (5) the certificate of authority authorizing the SPFC to transact business is limited only to the insurance or reinsurance activities that the SPFC is allowed to conduct pursuant to this article. (I) In evaluating the expectation of a successful operation, the director shall consider, among other factors, whether the proposed SPFC, and its management are of known good character and reasonably believed not to be affiliated, directly or indirectly, through ownership, control, management, reinsurance transactions, or other insurance or business relations, with a person known to have been involved in the improper manipulation of assets, accounts, or reinsurance. (J) A foreign or alien corporation or limited liability company, upon approval of the director, may become a domestic SPFC by complying with all of the provisions of this article and by filing with the Secretary of State its organizational documents, together with appropriate amendments to it, as may be adopted pursuant to the provisions of this article to bring these organizational documents into compliance with this article. After this is accomplished, the foreign or alien corporation or limited liability company is entitled to the necessary or appropriate certificates or licenses to transact business as a SPFC in this State and is subject to the authority and jurisdiction of this State. In connection with this redomestication, the director may waive any requirements for public hearings. It is not necessary for a corporation or limited liability company redomesticating into this State to merge, consolidate, transfer assets, or otherwise engage in another reorganization, other than as specified in this section.
S.C. Code Ann. § 38-3-130 — SC Code / Title 38 / Chapter 3 / Article 1 / Section 38-3-130
SECTION 38-3-130. Actuaries, examiners, clerks, and employees.
Status: in_force

The director shall appoint or employ actuaries, examiners, clerks, and other employees necessary for the proper execution of the work of the department.
S.C. Code Ann. § 38-90-590 — SC Code / Title 38 / Chapter 90 / Article 3 / Section 38-90-590
SECTION 38-90-590. Conditions for SPFC contract being granted credit for reinsurance treatment or otherwise qualifying as asset or reduction from liability for benefit of counterparty.
Status: in_force

A SPFC contract meeting the provisions of this article must be granted credit for reinsurance treatment or otherwise qualifies as an asset or a reduction from liability for reinsurance ceded by a domestic insurer to a SPFC as an assuming insurer pursuant to the provisions of Section 38-9-210 for the benefit of the counterparty, provided and only to the extent: (1) of the fair value of the assets held in trust for, or irrevocable letters of credit issued by a bank chartered by this State or a member bank of the Federal Reserve System or as approved by the director, for the benefit of the counterparty under the SPFC contract; (2) the assets are held in trust pursuant to the provisions of this article; (3) the assets are administered in the manner and pursuant to arrangements as provided in this article; and (4) the assets are held or invested in one or more of the forms allowed in Section 38-90-530.
S.C. Code Ann. § 38-69-300 — SC Code / Title 38 / Chapter 69 / Article 5 / Section 38-69-300
SECTION 38-69-300. Calculating benefits available other than on anniversary date.
Status: in_force

Any paid-up annuity, cash surrender, or death benefits available at any time, other than on the contract anniversary under any contract with fixed scheduled considerations, must be calculated with allowance for the lapse of time and the payment of any scheduled considerations beyond the beginning of the contract year in which cessation of payment of considerations under the contract occurs.
S.C. Code Ann. § 38-55-310 — SC Code / Title 38 / Chapter 55 / Article 3 / Section 38-55-310
SECTION 38-55-310. Life insurers may not operate undertaking business.
Status: in_force

It is unlawful for a life insurer, except a fraternal benefit association licensed to do business in this State, to own, manage, supervise, operate, or maintain a mortuary or undertaking establishment or to permit its officers, agents, or employees to own, operate, or maintain a funeral or undertaking business, except as may be authorized under Section 38-55-330.
S.C. Code Ann. § 38-71-2230 — SC Code / Title 38 / Chapter 71 / Article 21 / Section 38-71-2230
SECTION 38-71-2230. Pharmacy benefits manager prohibited from taking certain actions.
Status: reserved

(A) A pharmacy benefits manager or representative of a pharmacy benefits manager shall not: (1) cause or knowingly permit the use of any advertisement, promotion, solicitation, representation, proposal, or offer that is untrue, deceptive, or misleading; (2) charge a pharmacist or pharmacy a fee related to the adjudication of a claim unless the fee is: (a) agreed to by a Pharmacy Services Administrative Organization acting on behalf of a pharmacy that it represents; or (b) identified and agreed to in contract and identified and reported on the remittance advice; (3) engage in an anticompetitive pattern of reimbursing independent or unaffiliated pharmacies or pharmacists in this State consistently less than the amount that the pharmacy benefits manager reimburses a pharmacy benefits manager affiliate for providing the same pharmacist services or prescription drug unless the difference in reimbursement is justified according to uniform, defined standards that apply to each network provider; (4) collect or require a pharmacy or pharmacist to collect from an insured a copayment for a prescription drug at the point of sale in an amount that exceeds the lesser of: (a) the contracted copayment amount; (b) the amount an individual would pay for a prescription drug if that individual was paying cash; or (c) the contracted amount for the drug. (5) require the use of mail order for filling prescriptions unless required to do so by the health benefit plan or the health benefit plan design; (6) Reserved; (7) penalize or retaliate against a pharmacist or pharmacy for exercising rights provided pursuant to the provisions of this chapter; (8) prohibit a pharmacist or pharmacy from offering and providing direct and limited delivery services including incidental mailing services, to an insured as an ancillary service of the pharmacy; or (9) any combination thereof. (B) No pharmacy benefits manager shall, directly or indirectly, impose retroactive fees, reductions, or recoupments of the amount paid to a pharmacist or pharmacy for any claim for prescription drugs other than the Medicare Part D Program as set forth in 42 U.S.C. 1395w-102 and 42 C.F.R. 423 or as provided in this subsection. (C) Notwithstanding subsection (B), a pharmacy benefits manager may make or permit a reduction or recoupment of payment for pharmacist or pharmacy services for: (1) claims submitted fraudulently; (2) claims where the pharmacist or pharmacy was previously paid for the same pharmacy goods or services; (3) claims not properly rendered or billed by the pharmacy or pharmacist; or (4) otherwise in accordance with state pharmacy audit laws. (D) This section does not preclude a pharmacy benefits manager from engaging in claims reconciliation activities relating to brand effective rates and generic effective rates if: (1) such activities are agreed to by a Pharmacy Services Administrative Organization acting on behalf of a pharmacy it represents and identified in the contract; or (2) if a pharmacy is not represented by a Pharmacy Services Administrative Organization, such activities are permitted if: (a) they are agreed to by a pharmacy and identified in a contract; (b) they do not result in a retroactive reduction or recoupment of payment to a pharmacist or pharmacy for a previously adjudicated covered claim, unless the pharmacy or pharmacist has clearly consented to retroactive reductions as part of participation in the program and the reductions are explained in an annual reconciliation statement; and (c) a pharmacy is allowed to choose not to participate in programs that include the activities. A pharmacy benefits manager offering different terms and conditions including, but not limited to, differing reimbursement rates, for participation versus nonparticipation in the activities shall not constitute a violation of Section 38-71-2230(A)(7). (E) This subsection may not be construed to limit overpayment recovery efforts as set forth in Section 38-59-250. A pharmacy may not be subject to a charge-back or recoupment for a clerical or recordkeeping error in a required document or record, including a typographical or computer error, unless the error resulted in overpayment to the pharmacy. (F) Termination of a pharmacy or pharmacist from a pharmacy benefits manager network does not release the pharmacy benefits manager from the obligation to make any payment due to the pharmacy or pharmacist for pharmacist services properly rendered according to the contract. (G) A pharmacy benefits manager must not directly or indirectly engage in patient steering to a pharmacy that is a pharmacy benefits manager affiliate without first making a written disclosure to the patient informing such patient of the pharmacy benefits manager's relationship with the pharmacy and providing the patient with access to information about unaffiliated, in-network pharmacies that are located near the patient. A pharmacy benefits manager must not prohibit a patient from choosing to use an alternative in-network pharmacy. (H) Nothing in this article abridges the right of a pharmacist to refuse to fill or refill a prescription as referenced in Section 40-43-86(E)(6) of the South Carolina Pharmacy Practice Act. Editor's Note 2023 Act No. 30, SECTION 7, provides as follows: "SECTION 7. This act takes effect January 1, 2024, but the recurring examinations by the Department of Insurance provided for in Sections 38-71-2250(B)(1) and 38-71-2340(B)(1) must not begin before January 1, 2025." Effect of Amendment 2023 Act No. 30, SECTION 2, rewrote the section.
S.C. Code Ann. § 38-99-50 — SC Code / Title 38 / Chapter 99 / Section 38-99-50
SECTION 38-99-50. Violations of chapter.
Status: in_force

(A) The director has the power and authority to examine and investigate into the affairs of a licensee to determine whether the licensee is engaged in conduct in violation of this chapter. This power is in addition to the powers which the director has under this title. An investigation or examination must be conducted pursuant to Section 38-13-10, et seq. (B) When the director has reason to believe that a licensee is engaged in conduct in this State which violates the provisions of this chapter, the director may take necessary and appropriate action to enforce the provisions of this chapter. Editor's Note 2018 Act No. 171, SECTIONS 1 and 2, provide as follows: "SECTION 1. The purpose and intent of this act is to establish standards for data security and standards for the investigation of and notification to the director of a cybersecurity event applicable to licensees. This act may not be construed to create or imply a private cause of action for a violation of its provisions nor may it be construed to curtail a private cause of action which would otherwise exist in the absence of this act. "SECTION 2. This act is known and may be cited as the 'South Carolina Insurance Data Security Act'."
S.C. Code Ann. § 38-71-1530 — SC Code / Title 38 / Chapter 71 / Article 15 / Section 38-71-1530
SECTION 38-71-1530. Screening; initial intervention; role of managed care organization; payments to providers.
Status: in_force

(A) A patient who presents to an emergency department, by the Federal Social Security Act, must be screened to determine whether an emergency medical condition exists. This evaluation may include, but is not limited to, diagnostic testing to assess the extent of the condition, sickness, or injury and radiographic procedures and interpretation. (B) Appropriate intervention must be initiated by medical personnel to stabilize any emergency medical condition before requesting authorization for the treatment by a managed care organization. (C) A managed care organization shall inform its insureds, enrollees, patients, and affiliated providers about all policies related to emergency medical care access, coverage, payment, and grievance procedures. It is the ultimate responsibility of the managed care organization to inform any contracted third party administrator, independent contractor, or primary care provider about the emergency medical care provisions contained in this subsection. (D) A managed care organization which includes emergency medical care services as part of its policy or contract shall provide coverage and shall subsequently pay providers for emergency medical care services provided to an insured, enrollee, or patient who presents an emergency medical condition. This subsection must not be construed to require coverage for illnesses, diseases, equipment, supplies, or procedures or treatments which are not otherwise covered under the terms of the insured's policy or contract. (E) A managed care organization may not retrospectively deny or reduce payments to providers for emergency medical care of an insured, enrollee, or patient even if it is determined that the emergency medical condition initially presented is later identified through screening not to be an actual emergency, except in these cases: (1) material misrepresentation, fraud, omission, or clerical error; (2) a payment reduction due to applicable co-payments, coinsurance, or deductibles which may be the responsibility of the insured; (3) cases in which the insured does not meet the emergency medical condition definition, unless the insured has been referred to the emergency department by the insured's primary care physician or other agent acting on behalf of the insurer.
S.C. Code Ann. § 38-79-220 — SC Code / Title 38 / Chapter 79 / Article 3 / Section 38-79-220
SECTION 38-79-220. Elimination of accumulated deficit; uniform assessment; surcharges.
Status: in_force

(1) All members of the association, excluding companies who have withdrawn from the association pursuant to Section 38-79-125, must contribute to the elimination of the association's and fund's accumulated deficit. Beginning on January 1, 2020, a uniform assessment of not less than two percent and not more than six percent of the net-direct written premium must be assessed against each member of the association in order to eliminate the accumulated deficits of the association and the fund. Association members must be notified of the assessment at least sixty days prior to each year end. After each quarter during the year following notification of the assessment, each member of the association must remit an amount equal to the assessment percentage of the previous quarter's direct written premiums. Monies derived from this assessment and collected must be distributed by the association to the accumulated deficits of the association and fund as determined appropriate by the director. Every member must directly recover from each policyholder one percent of the assessment and is authorized to recoup up to the remaining amount if they so choose. Amounts recouped under this section are not premium and are not subject to premium taxes, fees, or commissions. If one deficit is eliminated before the other, all subsequent monies collected must be distributed to the remaining deficit until it is eliminated. Assessments must cease when both accumulated deficits have been fully eliminated or on December 31, 2035, or whichever occurs first. Funds received by the association under this section will not be considered revenue or considered part of their operating income and will only be used to reduce the accumulated deficit. (2) Beginning on January 1, 2020, a surcharge on premium shall be assessed on association policyholders equal to the assessment percentage amount on members in any given year pursuant to the provisions of Section 38-79-220. Association policyholders will be notified of the surcharge percentage at least sixty days prior to each year end. Surcharges levied under this section are not premiums and are not subject to premium tax, any fees, or any commissions. Monies derived from this assessment and collected under this section must be distributed by the association to the accumulated deficits of the association and fund as determined appropriate by the director. Should one deficit be eliminated before the other deficit, all subsequent monies collected shall be distributed to the remaining deficit until it is eliminated. This surcharge shall cease when the accumulated deficits of both the association and the fund have been fully eliminated or on December 31, 2035, whichever occurs first. Funds received by the association under this section will not be considered revenue or considered part of their operating income and will only be used to reduce the accumulated deficit. (3) Each member shall remit to the association payment in full of its assessed amount under this section within thirty days of the end of each quarter. If a member fails to remit its assessed amount by the deadline, the association shall report the failure to the director or designee who may immediately take action to suspend or revoke such insurer's certificate of authority to transact the business of insurance in the State of South Carolina or issue a fine on that member until such time as the association certifies to the director or his designee that such assessment has been paid in full. The issuance of a fine, suspension, or revocation of an insurer's certificate of authority to transact business in the State of South Carolina shall not affect the right of the association to proceed against such insurer in any court for any remedy provided by law or contract to the association, including the right to collect such insurer's assessment. In addition to any other remedy, the association may offset assessments due from an insurer against any amounts in any account of such delinquent insurer. By mailing payment of its allocated amount of assessment, as provided herein, a member shall not waive any right it may have to contest the computation of its allocated amount of assessment. Such contest shall not, however, toll the time within which assessments must be paid or the report to be made to the director or his designee or affect or impede any action to be taken by the director or his designee upon receipt of such report. (4) Beginning January 1, 2020, all surplus lines insurance producers or brokers placing insurance through nonadmitted insurers shall collect from the insured and remit to the department to be distributed to the association and fund a nonadmitted policy surcharge on all premiums for all insurance written by such surplus lines insurance producer or broker for a policy from a nonadmitted insurer for any and all medical malpractice risks in this State. By procuring or selling medical malpractice insurance in this State from a nonadmitted insurer, each surplus lines insurance producer or broker placing insurance through a nonadmitted insurer agrees to be bound by the provisions of this chapter and to collect and remit the nonadmitted policy surcharge provided for herein. (a) The nonadmitted policy surcharge must be a percentage of the total policy premium, but the nonadmitted policy surcharge shall not be considered premium and is not subject to premium taxes or commissions. However, failure to pay the nonadmitted policy surcharge must be treated the same as failure to pay premium. "Total policy premium" includes taxes and commissions. (b) The nonadmitted policy surcharge percentage must be the same percentage as the assessment that has been approved by the board and director as applied to the insurers writing medical malpractice insurance, medical professional liability insurance, hospital professional liability insurance, or any other type of professional liability insurance in this State covering the professional liability risks of licensed health care providers as described in Section 38-79-220. (5) Within thirty days of the end of the quarter, surplus lines insurance producers or brokers placing insurance through nonadmitted insurers shall remit to the department all nonadmitted policy surcharges collected in the preceding quarter. Surplus lines insurance producers or brokers placing insurance through nonadmitted insurers may designate another surplus lines insurance producer or broker that actually procured the insurance from the nonadmitted carrier to collect and remit the nonadmitted policy surcharges. (6) Each insured in this State who directly procures or renews insurance with a nonadmitted insurer on medical malpractice insurance other than insurance procured through a surplus lines licensee, must be subject to the nonadmitted policy surcharge which must be paid by the insured according to the procedures provided for premium taxes in Chapter 45 of this title. Monies derived from the nonadmitted policy surcharge collected under this section must exclusively be used to reduce the accumulated deficits of the association and fund by equal amounts unless the director or his designee determines that different proportions are appropriate. Once the accumulated deficit of the association or the fund is eliminated, whichever occurs first, all subsequent monies collected through the assessment shall exclusively be used to reduce the remaining deficit until it has also been eliminated. The nonadmitted policy surcharge must continue until the surcharge provided in subsection (1) is eliminated. (7) The accumulated deficits of the association and the fund have accrued and persisted over a period of decades and being partially attributable to state agencies or institutions or their employees, until the director determines that the accumulated deficits of the association and the fund have been eliminated, he may receive appropriations that are explicitly provided for purposes of reducing the accumulated deficits of the association and fund. Effect of Amendment 2019 Act No. 67, SECTION 1, rewrote the section.
S.C. Code Ann. § 38-90-140 — SC Code / Title 38 / Chapter 90 / Article 1 / Section 38-90-140
SECTION 38-90-140. Tax payment; rates; "common ownership and control" defined.
Status: in_force

(A) A captive insurance company shall pay to the department by March first of each year, a tax at the rate of four-tenths of one percent on the first twenty million dollars and three-tenths of one percent on each dollar after that, up to a maximum tax of one hundred thousand dollars. Taxes are based on the direct premiums written or contracted for on policies or contracts of insurance written by the captive insurance company during the year ending December thirty-first next preceding, after deducting from the direct premiums subject to the tax the amounts paid to policyholders as return premiums which must include dividends on unabsorbed premiums or premium deposits returned or credited to policyholders. (B) A captive insurance company shall pay to the department by March first of each year, a tax at the rate of two hundred and twenty-five thousandths of one percent on the first twenty million dollars of assumed reinsurance premium, and one hundred fifty thousandths of one percent on the next twenty million dollars and fifty thousandths of one percent on the next twenty million dollars and twenty-five thousandths of one percent of each dollar of assumed reinsurance premium after that up to a maximum tax of one hundred thousand dollars. However, reinsurance tax does not apply to premiums for risks or portions of risks which are subject to taxation on a direct basis pursuant to subsection (A). A premium tax is not payable in connection with the receipt of assets in exchange for the assumption of loss reserves and other liabilities of another insurer or other funding mechanism under common ownership and control if the transaction is part of a plan to discontinue the operations related to the loss reserves and other liabilities being assumed of the other insurer or funding mechanism and if the intent of the parties to the transaction is to renew or maintain business with the captive insurance company. (C)(1) If the aggregate taxes to be paid by a captive insurance company calculated under subsections (A) and (B) amount to less than five thousand dollars in any year, the captive insurance company shall pay a minimum tax of five thousand dollars for that year. However, in the calendar year in which a captive is first licensed, the minimum tax must be prorated on a quarterly basis. (2) For captives licensed in the: (a) first quarter, the prorated minimum tax is five thousand dollars; (b) second quarter, the prorated minimum tax is three thousand seven hundred fifty dollars; (c) third quarter, the prorated minimum tax is two thousand five hundred dollars; and (d) fourth quarter, the prorated minimum tax is one thousand two hundred fifty dollars. (3) In the calendar year in which a captive is first licensed, if the aggregate taxes to be paid by a captive insurance company calculated under subsections (A) and (B) amount to less than the minimum tax prorated on a quarterly basis, the captive insurance company shall pay the prorated minimum tax for that calendar year. (4) If the aggregate taxes to be paid by a captive insurance company calculated under subsections (A) and (B) amount to more than one hundred thousand dollars in any year, the captive insurance company shall pay a maximum tax of one hundred thousand dollars for that year. (D) A captive insurance company failing to make returns or to pay all taxes required by this section, is subject to the relevant sanctions of this title. (E) Two or more captive insurance companies under common ownership and control must be taxed, as separate captive insurance companies. (F) For the purposes of this section, "common ownership and control" means: (1) in the case of stock corporations or limited liability companies, the direct or indirect ownership of eighty percent or more of the outstanding voting stock or membership interests of two or more corporations or limited liability companies by the same person or entity; (2) in the case of nonprofit corporations, the direct or indirect ownership of eighty percent or more of the voting power of two or more nonprofit corporations by the same member or members; and (3) in the case of mutual corporations, the direct or indirect ownership of eighty percent or more of the capitalization and the voting power of two or more corporations by the same member or members. (G) In the case of a branch captive insurance company, the tax provided for in this section applies only to the branch business of the company. (H) In the case of a sponsored captive insurance company, the aggregate taxes to be paid with respect to the sponsored captive insurance company and its unincorporated protected cells and incorporated protected cells, as calculated under subsections (A) and (B), must be calculated and paid on a consolidated basis as one captive insurance company. (I) The tax provided for in this section constitutes all taxes collectible under the laws of this State from a captive insurance company, and no other occupation tax or other taxes may be levied or collected from a captive insurance company by the State or a county, city, or municipality within this State, except ad valorem taxes on real and personal property used in the production of income. Effect of Amendment 2018 Act No. 251, SECTION 1, in (F)(3), substituted "capitalization" for "surplus" following "eighty percent or more"; and inserted (H) and redesignated (H) as (I). 2025 Act No. 62, SECTION 9, rewrote (H).
S.C. Code Ann. § 38-19-410 — SC Code / Title 38 / Chapter 19 / Article 5 / Section 38-19-410
SECTION 38-19-410. Contingent liability of members.
Status: in_force

Each member of a domestic mutual insurer, except as otherwise provided in this chapter, has a contingent liability, prorata and not one for another, for the discharge of its obligations. The contingent liability is, at a maximum, the amount stated in the insurer's articles of incorporation but may not be less than one nor more than five additional premiums for the member's policy at the annual premium rate. Every policy issued by the insurer shall contain a statement of the contingent liability. Cancellation of the policy of a member does not relieve the member of contingent liability for his proportion of the obligations of the insurer which accrued while the policy was in force.
S.C. Code Ann. § 38-77-130 — SC Code / Title 38 / Chapter 77 / Article 3 / Section 38-77-130
SECTION 38-77-130. Group automobile insurance; rate.
Status: in_force

An automobile insurer may negotiate and contract for the sale of automobile insurance with any bona fide group of twenty or more persons who are employed by a common employer or who have been members for six months or more of a fraternal order, labor union, or employment association. The insurer may negotiate, enter a contractual relationship, and service the contract solely and directly with the bona fide representative of the group. An insurance contract sold on the basis of a group plan or contract shall have a rate not less than five percent less than the individual rate for which the insurer markets a substantially similar policy.
S.C. Code Ann. § 38-19-660 — SC Code / Title 38 / Chapter 19 / Article 7 / Section 38-19-660
SECTION 38-19-660. Rights of holders of loan upon dissolution.
Status: in_force

Upon dissolution and liquidation of the insurer the holders of such loan agreements remaining unpaid after the retirement of all the insurer's other outstanding obligations are entitled to payment before any distribution may be made to the insurer's members.
S.C. Code Ann. § 38-55-510 — SC Code / Title 38 / Chapter 55 / Article 5 / Section 38-55-510
SECTION 38-55-510. Short title.
Status: in_force

This article is known and may be cited as the "Omnibus Insurance Fraud and Reporting Immunity Act".