reglab/housing_qa huggingface dataset:
LA Rev Stat § 22:2346 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2346. Annual report

RS 2346 - Annual report The governing committee of the plan shall file in the office of the commissioner of insurance each year a statement which shall summarize the transactions, conditions, operations, and affairs of the plan during the preceding fiscal year ending September thirtieth. Acts 2004, No. 761, §1, eff. July 6, 2004; Acts 2007, No. 459, §4, eff. Jan. 1, 2008; Redesignated from R.S. 22:1441.25 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2347 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2347. Examination of plan

RS 2347 - Examination of plan The commissioner of insurance may from time to time make an examination into the affairs of the plan when he deems it to be prudent and, in undertaking such examination, he may hold a public hearing. The expense of such examination shall be borne and paid by plan participants who shall share the expense ratably in accordance with their respective participation for the year under examination. Acts 2004, No. 761, §1, eff. July 6, 2004; Redesignated from R.S. 22:1441.26 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2361 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2361. Short title

RS 2361 - Short title This Chapter shall be known as the "Insure Louisiana Incentive Program", hereinafter referred to as the "program". Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3301 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2363 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2363. Cooperative endeavors; grants; regulations

RS 2363 - Cooperative endeavors; grants; regulations A. The commissioner of insurance is authorized to implement the essential public purpose of this Chapter through public-private partnerships executed through cooperative endeavors with authorized insurers. Such endeavors may include matching capital fund grants under the provisions of this Chapter. B. The commissioner of insurance may grant matching capital funds to qualified property insurers in accordance with the requirements of this Chapter from the fund. The commissioner shall adopt and promulgate rules and regulations in accordance with the Administrative Procedure Act, R.S. 49:950 et seq., governing the application process and award of grants, use of grant funds, reporting requirements and other regulations to assure compliance with and to carry out the purposes of the program. Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3303 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2012, No. 271, §1.
LA Rev Stat § 22:2365 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2365. Minimum capital requirements

RS 2365 - Minimum capital requirements A. Grants shall be made only to insurers who satisfy minimum capital requirements as specified in the rules and regulations adopted and promulgated by the commissioner of insurance, which shall include capital and surplus exceeding twenty-five million dollars, stable financial condition as shown by a satisfactory risk-based capital level, and an adequate risk-based reinsurance program. B. In no event shall matching fund grants exceed twenty percent of an insurer's capital and surplus. Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3305 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2366 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2366. Satisfactory prior experience

RS 2366 - Satisfactory prior experience As determined by the commissioner of insurance, grants shall be made only to insurers with satisfactory prior experience in writing property insurance or to new insurers whose management has satisfactory prior experience in property insurance. Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3306 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2367 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2367. Authorized insurers

RS 2367 - Authorized insurers Although a non-admitted insurer, including an approved unauthorized insurer, may apply for a grant, the insurer must become admitted and licensed to do business in Louisiana before it may actually receive the grant funding. The commissioner of insurance may reallocate funds allocated to such non-admitted insurer if that insurer does not apply on a timely basis, as specified in the regulations, or is not approved as an admitted and licensed insurer. Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3307 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2368 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2368. Matching capital fund grants

RS 2368 - Matching capital fund grants A. The insurer shall make a commitment of capital of not less than two million dollars to write property insurance in Louisiana that complies with the requirements of R.S. 22:2369. B. Matching capital fund grants authorized under this Chapter shall match such newly allocated insurer capital funds at a ratio of one dollar of state capital grant funds to one dollar of allocated insurer capital funds. Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3308 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2370 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2370. Earned capital

RS 2370 - Earned capital A. An insurer who has received a matching capital fund grant under the provisions of this Chapter is entitled to earn the grant at the rate of twenty percent per year for each year in which the insurer maintains the net written premiums in compliance with the requirements of this Chapter, so that the insurer can earn the entire grant in five years. B. If any insurer fails to comply with the requirements of this Chapter at the end of any year of the grant, the commissioner of insurance shall have the option of granting an extension if the insurer shows promise of future compliance. C. If the commissioner of insurance finds that an insurer has failed to comply with the statutory or regulatory requirements for the grant, the commissioner may declare the insurer in default. The insurer in default shall repay any matching capital fund grant funds that have not been earned under Subsection A of this Section, plus legal interest from the date of the commissioner's default declaration. D. In the event of insolvency of an insurer, the obligation to repay matching capital fund grants shall not be a liability of the Louisiana Insurance Guaranty Association. Acts 2007, No. 447, §1, eff. July 11, 2007; Redesignated from R.S. 22:3310 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
LA Rev Stat § 22:2371 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2371. Repealed by Acts 2009, No. 226, §3, eff. July 1, 2009.

RS 2371 - Repealed by Acts 2009, No. 226, §3, eff. July 1, 2009.
LA Rev Stat § 22:2372 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2372. Repealed by Acts 2009, No. 404, §1, eff. July 7, 2009.

RS 2372 - Repealed by Acts 2009, No. 404, §1, eff. July 7, 2009.
LA Rev Stat § 22:2382 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2382. Louisiana compact commission official

RS 2382 - Louisiana compact commission official Pursuant to the terms and conditions of this Part, the state of Louisiana seeks to join with other states and establish the Interstate Insurance Product Regulation Compact, and thus become a member of the Interstate Insurance Product Regulation Commission. The commissioner of insurance is hereby designated to serve as the representative of this state to the commission. Acts 2008, No. 353, §1.
LA Rev Stat § 22:2391 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2391. Purpose; short title

RS 2391 - Purpose; short title A. This Chapter shall be known and may be cited as the "Internal Claims and Appeals Process and External Review Act". B. The purpose of this Chapter is the following: (1) To establish standards and criteria for the structure and operation of utilization review and benefit determination processes designed to facilitate ongoing assessment and management of health care services. (2) To provide standards for the establishment and maintenance of procedures by health insurance issuers to assure that covered persons have the opportunity for the appropriate resolution of internal and external appeals, as defined in this Chapter. (3) To provide uniform standards for the establishment and maintenance of an internal claims and appeals process and external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination, as defined in this Chapter. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2393 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2393. Applicability and scope

RS 2393 - Applicability and scope  A. This Chapter shall apply to any health insurance issuer that offers a health benefit plan as defined in this Chapter.  B. For purposes of claims related to a dental insurance policy, this Chapter shall apply only to external review or adverse determinations involving individual claims in excess of two hundred fifty dollars.  Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2021, No. 89, §1, eff. June 4, 2021.
LA Rev Stat § 22:2394 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2394. Licensure as a utilization review organization

RS 2394 - Licensure as a utilization review organization A. No health insurance issuer, or entity acting on behalf of, or agent of a health insurance issuer shall act as a utilization review organization unless authorized as such by the commissioner as provided in this Chapter. B. Any other entity may apply for and be issued a license pursuant to this Chapter to act as a utilization review organization on behalf of a health insurance issuer. C. An entity licensed as a utilization review organization shall notify the commissioner of any material change in fact or circumstance affecting its qualification for a license in this state within sixty days of the effective date of the change. The notice shall include any documentation that the commissioner may require. Changes in fact or circumstances shall include the following items: (1) Changes in control as defined in R.S. 22:691.2. (2) Amendments to the articles of incorporation. (3) Changes in officers and directors. (4) Merger or consolidation of the utilization or independent review organization with any other person or entity. (5) Use of a trade name in this state. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2401 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2401. Requirements of federal laws and regulations; minimum requirements

RS 2401 - Requirements of federal laws and regulations; minimum requirements  Health insurance issuers shall implement effective processes for appeals of coverage determinations and claims. The processes shall comply with any applicable federal law or regulation. Under such processes, a health insurance issuer shall, at a minimum:  (1) Have in effect an internal claims appeal process.  (2) Provide notice to covered persons, in a culturally and linguistically appropriate manner, of available internal and external appeals processes and the availability of the office of consumer advocacy of the Department of Insurance to assist such persons with the appeals process.  (3) Allow covered persons, upon request and free of charge, to review and have copies of all documents relevant to the claim for benefits and to submit comments and documents relating to the claim, without regard to whether that information was submitted or considered in the initial benefit determination, and to receive continued coverage pending the outcome of the appeals process where required by applicable law or the plan document or policy.  Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2020, No. 36, §1.
LA Rev Stat § 22:2431 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2431. Short title

RS 2431 - Short title This Part shall be known and may be cited as the "Health Insurance Issuer External Review Act". Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2432 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2432. Purpose and intent

RS 2432 - Purpose and intent The purpose of this Part is to provide uniform standards for the establishment and maintenance of external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination, as defined in this Chapter. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2434 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2434. Request for external review

RS 2434 - Request for external review A.(1) Except for a request for an expedited external review, all requests for external review shall be made in writing to the health insurance issuer. (2) The commissioner may prescribe by regulation the form and content of external review requests required to be submitted pursuant to this Section. B. A covered person or his authorized representative may make a request for an external review of an adverse determination or final adverse determination when such determination involves an issue of medical necessity, appropriateness, health care setting, level of care, effectiveness, or a rescission. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2439 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2439. Binding nature of external review decision

RS 2439 - Binding nature of external review decision A. A standard or an expedited external review decision shall be binding on the health insurance issuer except to the extent the health insurance issuer has other remedies available under applicable federal or state law. B. A standard or an expedited external review decision shall be binding on the covered person except to the extent the covered person has other remedies available under applicable federal or state law. C. A covered person or his authorized representative may not file a subsequent request for a standard or expedited external review involving the same adverse determination or final adverse determination for which the covered person has already received a standard or expedited external review decision pursuant to this Part. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2440 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2440. Approval of independent review organizations

RS 2440 - Approval of independent review organizations  A. The commissioner shall approve independent review organizations eligible to be assigned to conduct external reviews under this Part.  B. In order to be eligible for approval by the commissioner under this Section to conduct external reviews under this Part, an independent review organization shall:  (1) Except as otherwise provided in this Section, be accredited by a nationally recognized private accrediting entity that the commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum qualifications for independent review organizations provided for pursuant to R.S. 22:2441.  (2) Submit an application for approval in accordance with Subsection D of this Section along with the application fee specified in R.S. 22:821(B)(37). Such application shall also include a specified e-mail address to which external review information may be submitted.  C. The commissioner shall develop an application form for approving independent review organizations to conduct external reviews.  D.(1) Any independent review organization wishing to be approved to conduct external reviews under this Part shall submit the application form and include with the form all documentation and information necessary for the commissioner to determine if the independent review organization satisfies the minimum qualifications provided for by R.S. 22:2441.  (2)(a) Subject to Subparagraph (b) of this Paragraph, an independent review organization shall be eligible for approval under this Section only if it is accredited by a nationally recognized private accrediting entity that the commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum qualifications for independent review organizations provided for by R.S. 22:2441.  (b) The commissioner may approve independent review organizations that are not accredited by a nationally recognized private accrediting entity if there are no acceptable nationally recognized private accrediting entities providing independent review organization accreditation.  (3) The commissioner shall charge an application fee as specified in R.S. 22:821(B)(37) that independent review organizations shall submit to the commissioner with an application for approval.  E.(1) An approval shall remain effective unless the commissioner determines that the independent review organization is not satisfying the minimum qualifications provided for by R.S. 22:2441, or if the independent review organization gives notice of intent to cease operations.  (2) Whenever the commissioner determines that an independent review organization has lost its accreditation or no longer satisfies the minimum requirements established under R.S. 22:2441, the commissioner shall terminate the approval of the independent review organization.  F. Repealed by Acts 2017, No. 14, §2.  Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 14, §§1,2.
LA Rev Stat § 22:2442 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2442. Hold harmless for external review procedures

RS 2442 - Hold harmless for external review procedures No independent review organization or clinical peer working on behalf of an independent review organization or an employee, agent, or contractor of an independent review organization shall be liable in damages to any person for any opinions rendered or acts or omissions performed within the scope of the organization's or person's duties under the law during or upon completion of an external review conducted pursuant to this Part, unless the opinion was rendered or act or omission was performed in bad faith or involved negligence or gross negligence. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2443 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2443. External review reporting requirements

RS 2443 - External review reporting requirements  A. An independent review organization assigned pursuant to R.S. 22:2436 through 2438 to conduct an external review shall maintain written records in the aggregate, by state, and by health insurance issuer on all requests for external review for which it conducted an external review during a calendar year and, upon request, submit an annual report to the commissioner.  B. The independent review organization shall retain the written records required pursuant to this Section for at least three years.  Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 14, §1.
LA Rev Stat § 22:2444 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2444. Funding of external review

RS 2444 - Funding of external review  A. The health insurance issuer against which a request for a standard external review or an expedited external review is filed shall pay the cost of the independent review organization for conducting the external review, and no fee or other charge may be levied upon a covered person for any costs of an external review.  B.(1) The amount charged by the independent review organization as the cost to be paid by the health insurance issuer shall be a reasonable amount for the actual review performed. The independent review organization shall provide adequate documentation to the health insurance issuer justifying the amount charged.  (2) A health insurance issuer that believes that the amount charged for a review by an independent review organization is not reasonable may appeal those charges to the commissioner. In conducting the appeal, the commissioner shall review the amount charged, make a determination regarding the reasonableness of the amount charged, and, if warranted, may order an appropriate reduction. The commissioner may request additional information from the independent review organization, the health insurance issuer, or other independent review organizations or healthcare providers in making his determination.  Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 35, §1.
LA Rev Stat § 22:2445 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2445. Disclosure requirements

RS 2445 - Disclosure requirements A.(1) Each health insurance issuer shall include a description of the external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage that it provides to covered persons. (2) The description required by Paragraph (1) of this Subsection shall be in a format prescribed by the commissioner. B. The description required by Subsection A of this Section shall include a statement that informs covered persons of their right to file a request for an external review of an adverse determination or final adverse determination with the health insurance issuer. The statement may explain that an external review is available when the adverse determination or final adverse determination involves an issue of medical necessity, appropriateness, health care setting, level of care, or effectiveness. The statement shall include the telephone number and address of the commissioner. C. In addition to the requirements of Subsection B of this Section, the statement shall inform covered persons that, when filing a request for an external review, they will be required to authorize the release of any of their medical records that may be required to be reviewed for the purpose of reaching a decision on the external review. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.
LA Rev Stat § 22:2451 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2451. Repealed by Acts 2017, No. 14, §2.

RS 2451 - Repealed by Acts 2017, No. 14, §2.  Acts 2013, No. 326, §1, eff. Jan. 1, 2015; Acts 2017, No. 14, §2.
LA Rev Stat § 22:2452 (2021)
2021 Louisiana Laws|Revised Statutes|Title 22 - Insurance|§2452. Regulations; preemption

RS 2452 - Regulations; preemption A. The commissioner may promulgate such rules and regulations as may be necessary or proper to carry out the provisions of this Chapter. Such rules and regulations shall be promulgated and adopted in accordance with the Administrative Procedure Act, R.S. 49:950 et seq. B. If at any time a provision of this Chapter is in conflict with federal law or regulations promulgated pursuant to federal law, such a provision shall be preempted only to the extent necessary to avoid direct conflict with such federal law or regulations. The commissioner shall, pursuant to rule or regulation promulgated and adopted in accordance with the Administrative Procedure Act, subsequently administer and enforce this Chapter in a manner that conforms to such federal law or regulations. Acts 2013, No. 326, §1, eff. Jan. 1, 2015.