reglab/housing_qa huggingface dataset:
V.I. Code tit. 22, § 1453 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1453. Standards for policy provisions and authority to promulgate regulations

 (a) No Medicare supplement insurance policy, contract or certificate in force in the Territory shall contain benefits that duplicate benefits provided by Medicare. (b) The Commissioner shall adopt reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies, and certificates, which shall be in addition to and in accordance with applicable laws of this Territory. No requirement of this title relating to minimum required policy benefits, other than the minimum standards contained in this chapter, shall apply to Medicare supplement policies and certificates. The Standards may cover, but shall not be limited to: (1) Terms of renewability; (2) Initial and subsequent conditions of eligibility; (3) Nonduplication of coverage; (4) Probationary periods; (5) Benefit limitations, exceptions and reductions; (6) Elimination periods; (7) Requirements for replacement; (8) Recurrent conditions; and (9) Definition of terms (c) The Commissioner may adopt from time to time, such reasonable regulations as are necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations promulgated thereunder, including but not limited to: (1) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements; (2) Establishing a uniform methodology for calculating and reporting loss ratios; (3) Assuring public access to policies, premiums and loss ratio information of issuers of Medicare supplement insurance; (4) Establishing a process for approving or disapproving policy forms and certificate form and proposed premium increases; (5) Establishing a policy for holding public hearings prior to approval of premium increases; and (6) Establishing standards for Medicare Select policies and certificates.
V.I. Code tit. 22, § 1454 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1454. Prohibited policy provisions

 The Commissioner may adopt regulations that specify prohibited policy provisions not otherwise specifically authorized by statute which, in the opinion of the Commissioner, are unjust, unfair or unfairly discriminatory to any person insured or proposed to be insured under a Medicare supplement policy or certificate.
V.I. Code tit. 22, § 1455 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1455. Preexisting condition: denial of claim for losses

 Notwithstanding any other provision of law to the contrary, a Medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than six months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.
V.I. Code tit. 22, § 1457 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1457. Loss ratio standards.

 Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The Commissioner shall issue reasonable regulations to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience, or incurred health care expenses where coverage is provided by a health maintenance organization on a service rather than reimbursement basis, and earned premiums in accordance with accepted actuarial principles and practices.
V.I. Code tit. 22, § 1458 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1458. Disclosure standards: outline of coverage

 (a) In order to provide for full and fair disclosure of Medicare supplement policies, no Medicare supplement policy shall be delivered or issued for delivery in the Territory, and no certificate shall be delivered pursuant to a group Medicare supplement policy delivered or issued for delivery in the Territory unless an outline of coverage is delivered to the applicant at the time application is made. (b) The Commissioner shall prescribe the format and content of the outline of coverage required by subsection (a) of this section. For the purposes of this section, “format” means style, arrangement and overall appearance, including such items as the size, color and prominence of type and the arrangement of text and captions. The outline of coverage shall include: (1) A description of the principal benefits and coverage provided in the policy or contract; (2) A statement of the renewal provisions, including any reservation by the issuer of a right to change premiums; and disclosure of the existence of any automatic renewal premium increases based on the policyholder's age. (3) A statement that the outline of coverage is a summary of the policy issued or applied for, and that the policy should be consulted to determine governing contractual provisions. (c) The Commissioner may prescribe by regulation a standard form and the contents of an informational brochure for persons eligible for Medicare, which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare. Except in the case of direct response solicitation insurance policies, the Commissioner may require by regulation that the informational brochure be provided to any prospective insureds or subscribers eligible for Medicare concurrently with delivery of the outline of coverage. With respect to direct response solicitation insurance policies, the Commissioner may require by regulation that the prescribed brochure be provided upon request to any prospective insureds or subscribers eligible for Medicare, but in no event later than the time of policy or contract delivery. (d) The Commissioner may adopt regulations for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages, for all accident and sickness insurance policies sold to persons eligible for Medicare by reason of age, other than: (1) Medicare supplement policies; (2) Disability income policies; (3) Basic, catastrophic, or major medical expense or policies; or (4) Single premium, nonrenewable policies. (e) The Commissioner may adopt regulations to govern the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, or certificates subscriber contracts by persons eligible for Medicare.
V.I. Code tit. 22, § 1459 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1459. Notice of free examination

 Medicare supplement policies, certificates, shall have a notice prominently printed on the first page of the policy or certificate, or attached thereto, stating in substance that the applicant shall 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. Any refund made pursuant to this Section shall be paid directly to the applicant by the issuer in a timely manner.
V.I. Code tit. 22, § 1460 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1460. Filing requirements for advertising

 Every issuer of Medicare supplement insurance, policies or certificates in the Territory shall provide a copy of any Medicare supplement advertisement intended for use in the Territory, whether through written, radio or television medium, to the Commissioner for review or approval by the Commissioner.
V.I. Code tit. 22, § 1461 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 56 - Medicare Supplemental Insurance|§ 1461. Penalties

 In addition to any other applicable penalties for violations of this title, the Commissioner may require issuers violating any provision of this chapter, or regulations promulgated pursuant to this chapter, to cease marketing any Medicare supplement policy or certificate in the Territory which is related directly or indirectly to a violation or may require such issuer to take such actions as are necessary to comply with the provisions of this chapter, or both.
V.I. Code tit. 22, § 1480 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1480. Commercial self-insurance fund

 (a) Any group of persons may form a commercial self-insurance fund for the purpose of pooling and spreading liabilities of its group members in any commercial property or casualty risk or surety insurance. (b) As used in this chapter, “commercial self-insurance fund” or “fund” means a group of members, operating individually and collectively through an association, that must be: (1) Established by: (A) A not-for-profit trade association, industry association, or professional association of employers or professionals which has a constitution or bylaws, which is incorporated under the laws of the territory, and which has been organized and maintained in good faith for a continuous period of one year for purposes other than that of obtaining or providing insurance; or (B) A not-for-profit group comprised of a condominium association as defined in Title 28, chapter 33, Virgin Islands Code, which is incorporated under the laws of the territory, which restricts its membership to condominium associations only, and which has been organized and maintained in good faith for a continuous period of one year for purposes other than that of obtaining or providing insurance. (2) Operated pursuant to a trust agreement by a board of trustees which shall have complete fiscal control over the fund and which shall be responsible for all operations of the fund. The majority of the trustees shall be owners, partners, officers, directors, or employees of one or more members of the fund. The trustees shall have the authority to approve applications of members for participation in the fund and to contract with an authorized administrator or servicing company to administer the day-to-day affairs of the fund. (c) Each member of a commercial self-insurance trust fund established pursuant to this chapter must maintain membership in an association as set forth in subsection (b)(1)(A) and (B) of this section. (d) Any financial institution may participate as a member in a commercial self-insurance fund. A financial institution may not require as a condition precedent to making a loan that the prospective borrower insure with any commercial self-insurance fund. Any financial institution participating in a commercial self-insurance fund may participate only for the purpose of providing coverage on the financial institution's direct commercial property and commercial casualty or surety insurance exposures. The financial institution may not participate for the purpose of covering the direct or indirect exposures of its customers. (e) A commercial self-insurance fund shall not participate in the Virgin Islands Insurance Guaranty Association.
V.I. Code tit. 22, § 1481 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1481. Certificate of authority; violations

 (a) No person shall establish a commercial self-insurance fund unless such fund is issued a certificate of authority by the Commissioner. (b)  (1) Any person failing to hold a certificate of authority from the Commissioner while operating or maintaining a commercial self-insurance fund shall be subject to a fine of not less than $5,000.00 or more than $10,000 for each violation. (2) Any person who operates or maintains a commercial self-insurance fund without a certificate of authority from the Commissioner shall be subject to the cease and desist penalty powers of the Commissioner. (3) In addition to the penalties and other enforcement provisions of this title, the Commissioner is vested with the power to seek both temporary and permanent injunctive relief when: (A) A commercial self-insurance fund is being operated by any person or entity without a certificate of authority. (B) Any person, entity, or commercial self-insurance fund has engaged in any activity prohibited by this title or by any regulation adopted pursuant thereto. (C) Any commercial self-insurance fund, person or entity is renewing, issuing, or delivering a policy, contract, certificate, summary plan description, or other evidence of the benefits and coverages provided to members without a certificate of authority. The Commissioner's authority to seek injunctive relief shall not be conditioned on having conducted any proceeding pursuant to chapter 7 of this title. The authority vested in the Commissioner by virtue of the operation of this section shall not act to reduce any other enforcement remedy or power to seek injunctive relief that may otherwise be available to the Commissioner.
V.I. Code tit. 22, § 1483 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1483. Maintaining certificate

 After issuance of its initial certificate of authority, a commercial self-insurance fund shall thereafter meet the following requirements as a condition of maintaining its certificate of authority: (1) Maintenance of competent and trustworthy persons to service the program. Written notice shall be provided to the Commissioner before changing the fund's method of fulfilling its servicing requirements. (2) Maintenance of a risk management program. (3) Maintenance of a deposit of cash or securities in the amount of $100,000, or a surety bond in lieu thereof. (4) Maintenance of excess insurance in accordance with sound actuarial principles, unless waived by the Commissioner. (5) Maintenance of a fidelity bond. (6) Maintenance of appropriate funded loss reserves determined in accordance with sound actuarial principles satisfactory to the Commissioner. (7) Maintenance of an aggregate net worth of at least $500,000 of all fund members. A fund shall not be required to provide financial statements of its members evidencing conformity to this requirement after its certificate of authority has been issued, unless required to do so by the Commissioner upon showing of good cause. (8) Each fund shall have and maintain its principal place of business in the territory and shall therein make available to the Commissioner, upon reasonable notice, complete records of its assets, transactions, and affairs in accordance with such methods and systems as are customary for, or suitable to, the kind or kinds of business transacted. (9) A fund shall file such reports with the Commissioner as required by section 1484 of this chapter. (10) A fund shall report to the Commissioner within fifteen days of a determination that the actual premiums written or liability assumed or any other factor which substantially contributes to the financial condition of the plan deviates by more than twenty-five percent from the projections used in the most recent annual report, or if the first annual report has not yet been filed, projections used in the initial plan of operation. (11) Payment of annual license fees and premium taxes.
V.I. Code tit. 22, § 1484 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1484. Financial statement

 (a) Every commercial self-insurance fund shall, annually within 3 months of the end of the fiscal year, file a financial statement of the fund, including its balance sheet and a statement of operations for the preceding year, verified by the oath of a member of the board of trustees or by an administrative executive appointed by the board. (b) Every fund shall, annually within six months of the end of the fiscal year, file a report with the Commissioner verified by the oath of a member of the board of trustees or by an administrative executive appointed by the board, containing the following information: (1) A financial statement of the fund, including its balance sheet and a statement of operations for the preceding year certified by an independent certified public accountant. (2) A report prepared by an actuary who is a member of the American Academy of Actuaries as to the actuarial soundness of the fund. The report shall consist of, but shall not be limited to, the following: (A) Adequacy of premiums or contributions in paying claims and changes, if any, needed in the contribution rates to achieve or preserve a level of funding deemed adequate, which shall include a valuation of present assets, based on statement value, and prospective assets and liabilities of the plan and the extent of any unfunded accrued liabilities. (B) A plan to amortize any unfunded liabilities and a description of actions taken to reduce unfunded liabilities. (C) A description and explanation of actuarial assumptions. (D) A schedule illustrating the amortization of any unfunded liabilities. (E) A comparative review illustrating the level of funds available to the commercial self-insurance fund from rates, investment income, and other sources realized over the period covered by the report, indicating the assumptions used. (F) A projection of the following year's plan of operation, including additional number of members, gross premiums to be written, and projected liabilities. (G) A statement by the actuary that the report is complete and accurate and that in his opinion the techniques and assumptions used are reasonable and meet the requirements of this section. (H) Other factors or statements as may be reasonably required by the Commissioner in order to determine the actuarial soundness of the plan. (3) Any changes in the constitution, bylaws, or trust agreement of the fund.
V.I. Code tit. 22, § 1485 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1485. Liability

 (a) The liability of each member for obligations of the commercial self-insurance fund shall be individual, several, and proportionate, but not joint, except as provided in this section and section 1487 of this chapter. (b) Each member shall have a contingent assessment liability for payment of actual losses and expenses incurred while his policy was in force. (c) Each policy issued by the fund shall contain a statement of the contingent liability. Both the application for insurance and the policy shall contain, in contrasting color and in not less than ten point type, the following statements: “This is a fully assessable policy. In the event the fund is unable to pay its obligations, policyholders will be required to contribute on a pro rata earned premium basis the money necessary to meet any unfilled obligations.”
V.I. Code tit. 22, § 1486 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1486. Dividends

 A commercial self-insurance fund shall obtain the approval of the Commissioner prior to paying any dividend or refund to its members. No such dividend or refund may be approved until twelve months after the last day of the fiscal year for which the dividend or refund is payable, or such later time as the Commissioner may require in accordance with sound actuarial principles.
V.I. Code tit. 22, § 1487 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1487. Assessment

 (a) The trustees may assess from time to time members of a commercial self-insurance fund liable therefor under the terms of their policies and pursuant to this section, or the Commissioner may assess the members in the event of liquidation of the fund. (b) Each member's share of a deficiency for which an assessment is made shall be computed by applying to the premium earned on the member's policy or policies during the period to be covered by the assessment the ratio of the total deficiency to the total premiums earned during such period upon all policies subject to the assessment. In the event one or more members fail to pay an assessment, the other members are liable on a proportionate basis for an additional assessment. The fund, acting on behalf of all members who paid the additional assessment, shall institute legal action when necessary and appropriate to recover the assessment from members who failed to pay it. (c) In computing the earned premiums for the purposes of this section, the gross premium received by the fund for the policy shall be used as a base, deducting therefrom charges not recurring upon the renewal or extension of the policy. (d) No member shall have an offset against any assessment for which he is liable on account of any claim for unearned premium or losses payable.
V.I. Code tit. 22, § 1488 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1488. Financial impairment

 (a) If the assets of a commercial self-insurance fund are at any time insufficient to comply with the requirements of law or to discharge its liabilities, other than any liability on account of funds contributed by the trustees or others, and to meet the required conditions of financial soundness, or if a judgment against the fund has remained unsatisfied for thirty days, its trustees shall forthwith make up the deficiency or levy an assessment upon the members for the amount needed to make up the deficiency, but subject to the limitation set forth in the trust agreement or the policy. (b) If the trustees fail to make an assessment as required by subsection (a) of this section, the Commissioner shall order the trustees to do so. If the deficiency is not sufficiently made up within sixty days after the date of the order, the fund shall be deemed insolvent and grounds shall exist to proceed against the fund as provided for in chapter 51 of this title. (c) Subject to the provisions of this section, any rehabilitation, liquidation, conservation, or dissolution of a commercial self-insurance fund shall be conducted under the supervision of the Commissioner, who shall have all power with respect thereto granted to him under chapter 51 of this title governing the rehabilitation, liquidation, conservation, or dissolution of insurers.
V.I. Code tit. 22, § 1489 (2019)
2019 US Virgin Islands Code|Title 22 - Insurance|Chapter 58 - Commercial Self-Insurance Fund|§ 1489. Agents

 A commercial self-insurance fund shall use an agent or agents licensed under chapter 31 of this title. A commercial self-insurance fund may petition the Commissioner to have agents licensed in accordance with chapter 31 of this title, and the fund and its licensed agents shall be subject to the requirements of such provisions.