reglab/statecodes huggingface dataset:
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 27 - GROUP LIFE INSURANCE (§§ 33-27-1 — 33-27-9) › Section 33-27-2 - Extension of policy coverage to dependents of employees or members

(a)
Any policy issued pursuant to paragraphs (1), (4), and (5) of Code Section
33-27-1
may be extended to insure the employees or members against loss due to the death of their spouses and dependent or minor children or any class or classes thereof, subject to the following requirements:
(1)
The premium for the insurance shall be paid by the policyholder either from the employer's or union's funds or funds contributed by the insured employees or members, or from both. If no part of the premium is to be derived from funds contributed by the employees or members, all eligible employees or members, excluding any as to whose family members' evidence of insurability is not satisfactory to the insurer, must be insured with respect to their spouses and children;
(2)
The insurance must be based on some plan precluding individual selection by the employees or members or by the policyholder, employer, or union;
(3)
Upon termination of the insurance with respect to the members of the family of any employee or member by reason of the employee's or member's termination of employment, termination of membership in the class or classes eligible for coverage under the policy, or death, the spouse shall be entitled to have issued by the insurer without evidence of insurability an individual policy of life insurance without disability or other supplementary benefits, providing application for the individual policy shall be made and the first premium paid to the insurer within 31 days after such termination, subject to the requirements of paragraph (8) of subsection (a) of Code Section
33-27-3
. If the group policy terminates or is amended so as to terminate the insurance of any class of employees or members and the employee or member is entitled to have issued an individual policy under paragraph (9) of subsection (a) of Code Section
33-27-3
, the spouse shall also be entitled to have issued by the insurer an individual policy, subject to the conditions and limitations provided in this Code section. If the spouse dies within the period during which the spouse would have been entitled to have an individual policy issued in accordance with this provision, the amount of life insurance which the spouse would have been entitled to have issued under such individual policy shall be payable as a claim under the group policy, whether or not application for the individual policy or the payment of the first premium therefor has been made.
(b)
Notwithstanding paragraph (7) of subsection (a) of Code Section
33-27-3
, only one certificate need be issued for delivery to an insured person if a statement concerning any dependent's coverage is included in the certificate.
Amended by 2013 Ga. Laws 243,§ 2, eff. 7/1/2013.
Amended by 2013 Ga. Laws 33,§ 33, eff. 4/24/2013.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 27 - GROUP LIFE INSURANCE (§§ 33-27-1 — 33-27-9) › Section 33-27-4 - Payment of interest on proceeds or payments under policies of group life insurance

Each insurer admitted to transact life insurance in this state shall pay interest on proceeds or payments under any policy of group life insurance payable to a beneficiary residing in this state, to a beneficiary under a policy issued in this state, or to a beneficiary under a policy insuring a person resident in this state at the time of death, in accordance with Code Section
33-25-10
.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 27 - GROUP LIFE INSURANCE (§§ 33-27-1 — 33-27-9) › Section 33-27-5 - Notification of policyholder of right to convert group policy to individual life insurance policy

(a)
If any individual insured under a group insurance policy delivered in this state becomes entitled under the terms of the policy to have an individual policy of life insurance issued to him or her without evidence of insurability, subject to making of application therefor and payment of the first premium within the period specified in such policy and, if such individual is not given notice of the existence of the right at least 15 days prior to the expiration date of the period, in such event the individual shall have an additional period within which to exercise the right, but nothing contained in this Code section shall be construed to continue any insurance beyond the period provided in the policy. This additional period shall expire 15 days after such individual is given notice, but in no event shall the additional period extend beyond 60 days after the expiration date of the period provided in the policy.
(b)
Written notice presented to the individual or mailed by the policyholders to the last known address of the individual or mailed by the insurer to the last known address of the individual as furnished by the policyholder shall constitute notice for the purpose of this Code section.
(c)
Nothing in this Code section shall have the effect of extending the time within which a death claim shall be paid under the policy as provided in paragraph (10) of subsection (a) of Code Section
33-27-3
.
(d)
Inclusion of a statement of this conversion privilege in the insurance certificate issued to the individual insured shall constitute a notice of conversion privileges to the individual insured as required by this Code section.
Amended by 2019 Ga. Laws 140,§ 81, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 27 - GROUP LIFE INSURANCE (§§ 33-27-1 — 33-27-9) › Section 33-27-6 - Assignment of incidents of ownership in group life insurance policies

Nothing in this title or in any other law shall be construed to prohibit any person insured under a group life insurance policy from making an assignment of all or any part of his or her incidents of ownership under the policy, including, but not limited to, the privilege to have issued to him or her an individual policy of life insurance pursuant and subject to paragraphs (8) and (9) of subsection (a) of Code Section
33-27-3
and Code Section
33-27-5
and the right to name a beneficiary. Subject to the terms of the policy or agreement between the insured, the group policyholder and the insurer relating to assignment of incidents of ownership under the policy, an assignment made by an insured is valid for the purpose of vesting in the assignee, in accordance with any provisions included in the policy as to the time at which it is to be effective, all of the incidents of ownership so assigned without prejudice to the insurer on account of any payment it may make or individual policy it may issue in accordance with paragraphs (8) and (9) of subsection (a) of Code Section
33-27-3
prior to receipt of notice of the assignment.
Amended by 2019 Ga. Laws 140,§ 82, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 27 - GROUP LIFE INSURANCE (§§ 33-27-1 — 33-27-9) › Section 33-27-7 - Right of beneficiaries and assignees of insurance policies to proceeds as against creditors and representatives of insured

(a)
The proceeds and avails of any group life insurance policy shall be free from the claims of creditors and representatives of the insured and of the person effecting the same to the same extent and under the same conditions as provided for in the case of other life insurance policies under Code Section
33-25-11
.
(b)
This Code section shall not apply to group life insurance issued to a creditor covering his debtors to the extent that the proceeds are applied to payment of the obligation for the purpose of which the insurance was issued.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 27 - GROUP LIFE INSURANCE (§§ 33-27-1 — 33-27-9) › Section 33-27-9 - Notices of life insurance premium increases to be mailed or delivered to group life insurance policyholder

Notice of the maximum amount of a group life insurance premium increase shall be mailed or delivered to the group policyholder and to each employer group or subgroup insured under the group policy not less than 60 days prior to the effective date of the premium increase.
Amended by 2019 Ga. Laws 140,§ 83, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 28 - ANNUITY AND PURE ENDOWMENT CONTRACTS (§§ 33-28-1 — 33-28-7) › Section 33-28-1 - Definitions

As used in this chapter, the term:
(1)
"Annuity" means a contract by which one party in return for a stipulated payment or payments promises to pay periodic installments for a stated certain period of time or for the life or lives of the person or persons specified in the contract. The term does not cover the proceeds of life insurance no matter how payable.
(2)
"Pure endowment" means a contract under which one party in return for stipulated payment is obligated to pay a fixed sum if and only if the person designated in the contract survives a certain period specified in the contract.
(3)
"Reversionary annuity" means an annuity contract under which the person otherwise entitled to the proceeds is not to receive any payments unless that person survives another person or persons specified in the contract.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 28 - ANNUITY AND PURE ENDOWMENT CONTRACTS (§§ 33-28-1 — 33-28-7) › Section 33-28-4 - Scope of incontestable clause

A clause in any annuity contract providing that the contract shall be incontestable after a specified period shall preclude only a contest of the validity of the contract and shall not preclude the assertion at any time of defenses based upon provisions in the contract which exclude or restrict coverage, whether or not the restrictions or exclusions are excepted in the clause.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 28 - ANNUITY AND PURE ENDOWMENT CONTRACTS (§§ 33-28-1 — 33-28-7) › Section 33-28-5 - Contesting of contract after reinstatement

A reinstated annuity contract may be contested on account of fraud or misrepresentation of facts material to the reinstatement only for the same period following reinstatement and with the same conditions and exceptions as the contract provides with respect to contestability after original issuance.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 28 - ANNUITY AND PURE ENDOWMENT CONTRACTS (§§ 33-28-1 — 33-28-7) › Section 33-28-6 - Right of person to whom contract issued to return contract and receive premium refund; effect of return; proof of return

(a)
Every annuity, reversionary annuity, or pure endowment contract issued for delivery in this state, except group annuities, shall have printed on or attached to the contract a notice stating in substance that the person to whom the annuity or contract is issued shall be permitted to return the annuity or contract within ten days after receipt thereof and to have the premium paid refunded if, after examination of the annuity or contract, the purchaser is not satisfied with it for any reason.
(b)
If the purchaser, pursuant to such notice, returns the annuity or contract to the insurer at its home or branch office or to the agent through whom it was purchased, it shall be void from the beginning and the parties shall be in the same position as if no annuity or contract had been issued.
(c)
Without limiting any other method of returning an annuity or contract under this Code section, it shall be prima-facie evidence of the fact and date of return of an annuity or contract if the annuity or contract is dispatched by certified mail or statutory overnight delivery to the insurer or agent, as provided in this Code section, and a return receipt provided by the United States Postal Service or the commercial delivery company is obtained.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 28 - ANNUITY AND PURE ENDOWMENT CONTRACTS (§§ 33-28-1 — 33-28-7) › Section 33-28-7 - Proceeds of annuity, reversionary annuity, or pure endowment contracts not liable to attachment, garnishment, or legal process in favor of creditors of beneficiary

The proceeds of annuity, reversionary annuity, or pure endowment contracts issued to citizens or residents of this state, upon whatever form, shall not in any case be liable to attachment, garnishment, or legal process in favor of any creditor of the person who is the beneficiary of such annuity contract unless the annuity contract was assigned to or was effected for the benefit of such creditor or unless the purchase, sale, or transfer of the policy is made with the intent to defraud creditors.
Amended by 2006 Ga. Laws 868,§ 2, eff. 5/5/2006.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-1 - "Accident and sickness policy" defined; applicability of chapter

(a)
As used in this chapter, the term "accident and sickness policy" means any policy insuring against loss resulting from sickness or from bodily injury or death by accident, or both, or any contract to furnish ambulance service in the future.
(b)
Nothing in this chapter shall apply to or affect:
(1)
Any policy of workers' compensation insurance or any policy of workers' insurance or any policy of liability insurance with or without supplementary expense coverage on the policy;
(2)
Any policy or contract of reinsurance;
(3)
Any policy, the renewal of which is subject to continuation of employment with a specified employer, or any blanket or group policy of insurance, or any policy issued pursuant to the exercise of conversion privileges provided for in group insurance policies; or
(4)
Life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and sickness insurance which provide additional benefits in case of death or dismemberment or loss of sight by accident, or which operate to safeguard such contracts against lapse or give a special surrender value or special benefit or an annuity in the event that the insured or annuitant becomes totally and permanently disabled as defined by the contract or supplemental contract.
Amended by 2019 Ga. Laws 140,§ 85, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-3.1 - Coverage for human heart transplants; optional endorsement; requirements; guidelines

(a)
Every insurer authorized to issue individual accident and sickness insurance plans, policies, or contracts shall be required to make available, either as a part of or as an optional endorsement to all such policies providing major medical insurance coverage which are issued, delivered, issued for delivery, or renewed coverage for human heart transplants, including any charges for acquisition, transportation, or donation of a human heart when a human heart transplant is performed. Such coverage shall be at least as extensive and provide at least the same degree of coverage as that provided by the respective plan, policy, or contract for the treatment of other types of physical illnesses. Such an optional endorsement shall also provide that the coverage required to be made available pursuant to this Code section shall also cover the spouse and the dependents of the insured if the insured's spouse and dependents are covered under such benefit plan, policy, or contract.
(b)
The optional endorsement required to be made available under subsection (a) of this Code section shall not contain any exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance provisions which apply to human heart transplants unless such provisions apply generally to other similar benefits provided or paid for under the accident and sickness insurance benefit plan, policy, or contract; provided, however, the optional endorsement may contain a waiting period for the coverage or a delayed eligibility date of not more than 12 months from the effective date of the endorsement.
(c)
Nothing in this Code section shall be construed to prohibit an insurer, nonprofit corporation, health care plan, health maintenance organization, or other person issuing any similar individual accident and sickness insurance benefit plan, policy, or contract from issuing or continuing to issue an individual accident and sickness insurance benefit plan, policy, or contract which provides benefits greater than the minimum benefits required to be made available under this Code section or from issuing any such plans, policies, or contracts which provide benefits which are generally more favorable to the insured than those required to be made available under this Code section.
(d)
Nothing in this Code section shall be construed to prohibit the inclusion of coverage for human heart transplants that differs from the coverage provided in the same insurance plan, policy, or contract for physical illnesses if the policyholder does not purchase the optional coverage made available pursuant to this Code section.
Amended by 2019 Ga. Laws 140,§ 87, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-3.3 - Coverage for bone marrow transplants for the treatment of breast cancer and Hodgkin's disease; optional endorsement; requirements; guidelines; applicability

(a)
Every insurer authorized to issue individual accident and sickness insurance plans, policies, or contracts shall be required to make available, either as a part of or as an optional endorsement to all such policies providing major medical insurance coverage which are issued, delivered, issued for delivery, or renewed coverage for bone marrow transplants for the treatment of breast cancer and Hodgkin's disease. Such coverage shall be at least as extensive and provide at least the same degree of coverage as that provided by the respective plan, policy, or contract for the treatment of other types of physical illnesses. Such an optional endorsement shall also provide that the coverage required to be made available pursuant to this Code section shall also cover the spouse and the dependents of the insured if the insured's spouse and dependents are covered under such benefit plan, policy, or contract.
(b)
The optional endorsement required to be made available under subsection (a) of this Code section shall not contain any exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance provisions which apply to bone marrow transplants for the treatment of breast cancer and Hodgkin's disease unless such provisions apply generally to other similar benefits provided or paid for under the accident and sickness insurance benefit plan, policy, or contract.
(c)
Nothing in this Code section shall be construed to prohibit an insurer, nonprofit corporation, health care plan, health maintenance organization, or other person issuing any similar individual accident and sickness insurance benefit plan, policy, or contract from issuing or continuing to issue an individual accident and sickness insurance benefit plan, policy, or contract which provides benefits greater than the minimum benefits required to be made available under this Code section or from issuing any such plans, policies, or contracts which provide benefits which are generally more favorable to the insured than those required to be made available under this Code section.
(d)
Nothing in this Code section shall be construed to prohibit the inclusion of coverage for bone marrow transplants for the treatment of breast cancer and Hodgkin's disease that differs from the coverage provided in the same insurance plan, policy, or contract for physical illnesses if the policyholder does not purchase the optional coverage made available pursuant to this Code section.
(e)
The provisions of this Code section shall apply to individual accident and sickness insurance policies issued by a fraternal benefit society, a health care plan, a health maintenance organization, or any similar entity.
Amended by 2019 Ga. Laws 140,§ 89, eff. 7/1/2019.
Amended by 2017 Ga. Laws 52,§ 40, eff. 7/1/2017.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-5 - Order of printing of provisions

The provisions which are the subject of Code Sections
33-29-3
and
33-29-4
, or any corresponding provisions which are used in lieu thereof in accordance with such Code sections, shall be printed in consecutive order of the provisions in such Code sections or, at the option of the insurer, any such provisions may appear as a unit in any part of the policy, with other provisions to which they may be logically related, provided the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered, or issued.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-6 - Provision in policies for medical or surgical services

(a)
The benefits on account of medical or surgical services provided by an individual policy of accident and sickness insurance may be limited by its terms to services performed by specifically defined professions, provided that in the absence of such definitions the term "physician" or "surgeon," as used in such policy, shall not be deemed limited solely to medical practitioners licensed under Chapter 34 of Title 43.
(b)
When an individual policy of accident and sickness insurance, except policies providing special coverage for limited diseases, accident protection only, or dental policies, provides for hospital care, there may be included within the scope of coverage hospital care rendered on account of mental illnesses and hospital care rendered by any psychiatric hospital duly licensed by this state. If such coverage is not included in the policy, a statement that the policy does not cover mental illnesses shall be printed in the policy in boldface type or stamped on the face of the policy and printed or stamped on any identification card issued pursuant to any such policy.
(c)
Any other laws to the contrary notwithstanding, whenever the term "physician" or "surgeon" is used in any policy of health or accident and sickness insurance issued in this state or in any contract for health care, services, or benefits existing under, and by virtue of, any laws of this state, said term shall include, within its meaning, medical practitioners licensed under and in accordance with Chapter 11 of Title 43, relating to dentists, in respect to any care, services, procedures, or benefits covered by said policy of insurance or health care contract which the said persons are licensed to perform, any provisions in any such policy of insurance or health care contract to the contrary notwithstanding. This subsection shall be applicable to all policies in this state, regardless of date of issue.
Amended by 2019 Ga. Laws 140,§ 92, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-7 - Provision in policies for refusal of renewal generally

(a)
Subject to Code Section
33-29-21
, each policy, covered by this chapter, except accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, shall provide, in substance, in a provision of the policy entitled "renewability," that, subject to the right to terminate the policy upon nonpayment of premiums when due, the right to refuse renewal shall not be exercised before the renewal date occurring on, or after and nearest, each anniversary or, in the case of lapse and reinstatement, at the renewal date occurring on, or after and nearest, each anniversary of the last reinstatement, and that any refusal or renewal shall be without prejudice to any claim originating while the policy is in force.
(b)
The insurer shall not amend or endorse the policy prior to the anniversary date in a manner tending to restrict or lower the benefits, add exclusions, or increase the premium.
Amended by 2005 Ga. Laws 82,§ 7, eff. 7/1/2005.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-8 - Provision in policies renewable or cancelable at option of insurer for refund of premiums

(a)
Except as provided in subsection (b) of this Code section, every insurer delivering or issuing for delivery in this state policies of accident and sickness insurance which are renewable at the option of the insurer or cancelable at the option of the insurer shall provide in said policies a provision as follows:
"If the company cancels or refuses to renew this policy except for nonpayment of premiums prior to age __________________ (insert age which shall not be less than 60), it will refund 75 percent of the premiums paid in excess of the benefits received. The requirements of this provision shall not apply to cancellation or refusal to accept renewal premiums because of change in occupation of the insured to an occupation generally classified by the insurer as to all applicants as uninsurable."
(b)
This Code section shall not apply to and the provision prescribed in subsection (a) of this Code section need not be included in any major medical policy which provides that the insurer may cancel or refuse to renew the policy as of an anniversary date when also canceling or refusing to renew all policies with the same provisions and premium rate basis in the jurisdiction in which the insured resides, and then only if either or both of the following conditions are applicable:
(1)
The insured is or could be covered by benefits, substantially similar in both kind and amount to those of the policy, in accordance with any federal or state governmental health insurance program; or
(2)
The insurer is prevented by any law or any regulation or ruling of a governmental agency from applying to the policy a table of premium rates which the insurer certifies, based on its experience, is reasonable in relation to the benefits provided.
(c)
For the purpose of this chapter, a major medical policy is any policy which provides benefits of at least 75 percent of necessary, reasonable, and customary charges for medical care, including hospitalization in semiprivate accommodations, with maximum lifetime benefit of at least $100,000.00, subject only to such exceptions, restrictions, limitations, and deductible as the Commissioner may deem reasonable.
Amended by 2005 Ga. Laws 82,§ 8, eff. 7/1/2005.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-9 - Requirements as to references in policies to noncancelable nature or guaranteed renewability nature; exception for certain matters concerning renewability of individual accident and sickness policies; rules and regulations

(a)
No policy of accident or sickness insurance shall refer to its noncancelable nature without at the same time disclosing all options the insurer may have in regard to renewability; and the guaranteed renewable nature of any such policy shall not be referred to unless the reference at the same time discloses the qualifications on the guarantee of renewability, including any age limits, any right to change premium rates by class, any aggregate provisions, and any other limitations on the right to renewal in a manner which shall not minimize or render obscure the qualifying conditions.
(b)
An insurer operating in the major medical or comprehensive, guaranteed renewable business in this state shall permit an insured to change his or her major medical or comprehensive coverage, upon election at any renewal, to a comparable product offered by that insurer or a product offered by that insurer with more limited product benefits; to a product with higher deductibles; or to modify his or her existing coverage to elect any optional higher deductibles under that policy. If such product, benefit, or deductible change is elected by the insured during the 60 day required period after notice of renewal premium increase but before renewal date, such insured shall not be subject to any new preexisting conditions exclusion that did not apply to his or her original coverage.
(c)
The Commissioner shall adopt such rules and regulations as he or she deems necessary for the administration of this Code section.
Amended by 2019 Ga. Laws 140,§ 93, eff. 7/1/2019.
Amended by 2006 Ga. Laws 504,§ 1, eff. 7/1/2006.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-10 - Operation of provision establishing age for termination of coverage generally; effect of misstatement of age of insured

(a)
If any accident and sickness policy delivered or issued for delivery in this state contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective and, if the date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force until the end of the period for which premium has been accepted.
(b)
In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective or would have ceased prior to the acceptance of the premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-11 - Right of person to whom policy or contract issued to return policy or contract and receive premium refund; effect of return; proof of return

(a)
Every individual accident and sickness policy or contract, except single premium nonrenewable policies or contracts, issued for delivery in this state by an insurer shall have printed on or attached to the policy or contract a notice stating in substance that the person to whom the policy or contract is issued shall be permitted to return the policy or contract within ten days of its delivery to said purchaser and to have the premium paid refunded if, after examination of the policy or contract, the purchaser is not satisfied with it for any reason.
(b)
If the insured or purchaser, pursuant to such notice, returns the policy or contract to the insurer at its home or branch office, or to the agent through whom it was purchased, it shall be void from the beginning and the parties shall be in the same position as if no policy or contract had been issued. Without limiting any other method of returning a policy or contract under this Code section, it shall be prima-facie evidence of the fact and date of return of a policy or contract if the policy or contract is dispatched by certified mail or statutory overnight delivery to the insurer or agent, as provided in this Code section, and a return receipt provided by the United States Postal Service or commercial delivery company is obtained.
Amended by 2019 Ga. Laws 140,§ 94, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-12 - Policies issued for delivery or delivered within state by foreign or alien insurers; policies of domestic insurers issued for delivery in other states or countries

(a)
Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than those provisions contained in this chapter and which is prescribed or required by the law of the state under which the insurer is organized.
(b)
Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of the other state or country.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-13 - Furnishing of written outline of coverage to applicants for insurance; approval of outline

Every insurer shall furnish to any applicant for accident and sickness insurance in this state a written outline showing the major coverage of the policy applied for, the major exclusions of the policy applied for, the renewal provisions of the policy applied for, and a reference to the policy with respect to further provisions. The written outline shall be given to the applicant at the time of signing the application for the policy and the forms of the outlines shall be subject to the same requirements for filing and approval as are set forth for the filing and approval of policy forms as required in Code Sections
33-24-9
and
33-24-10
.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-14 - Application for, and ownership of, policies by persons other than insured

This chapter shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such policy to any indemnities, benefits, and rights provided in the policy.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-15 - Exemption of policy proceeds from liability for debts of insured and beneficiary

(a)
The proceeds or avails of all accident and sickness policies and of provisions providing benefits on account of the insured's disability which are supplemental to life insurance or annuity contracts, except credit accident and sickness policies and credit life policies, shall be exempt from all liability for any debt of the insured and from any debt of the beneficiary existing at the time the proceeds are made available for his or her use.
(b)
The exemption of income benefits payable as the result of disability shall not exceed an average of $250.00 of such benefits per month of the period of disability.
Amended by 2019 Ga. Laws 140,§ 95, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-16 - Compliance with chapter by attachment of rider or endorsement to policy

The requirements of this chapter may be complied with by the insurer by attaching to the policy such rider or endorsement as may be necessary for the purpose.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-17 - Validity and construction of policies delivered or issued for delivery in violation of chapter; effect of conflict between provisions subject to chapter and other provisions

(a)
No policy provision which is not subject to this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.
(b)
A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties, and obligations of the insurer, the insured, and the beneficiary shall be governed by this chapter.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-18 - Franchise insurance

(a)
As used in this Code section, the term "employees" means the officers, managers, and employees and retired employees of the employer and the individual proprietor or partners if the employer is an individual proprietor or partnership.
(b)
Accident and sickness insurance on a franchise plan is that form of accident and sickness insurance issued to:
(1)
Two or more employees of any corporation, copartnership, or individual employer or any governmental corporation, agency, or department thereof; or
(2)
Ten or more members, employees, or employees of members of any trade or professional association or of a labor union or of any other association having had an active existence for at least two years, where the association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance; where the persons, with or without their dependents, are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by the persons under an arrangement whereby the premiums on the policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the association or union for its members, or by some designated person acting on behalf of such employee or association or union.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-20 - Insurance coverage for treatment of temporomandibular joint dysfunction or surgery for deformities of maxilla or mandible

(a)
As used in this Code section, the term:
(1)
"Functional deformity" means a deformity of the bone or joint structure of the maxilla or mandible such that the normal character and essential function of such bone structure is impeded.
(2)
"Policy" means any major medical benefit plan, contract, or policy except a credit insurance policy, disability income policy, specified disease policy, hospital indemnity policy, limited accident policy, or other similarly limited accident and sickness policy.
(3)
"Temporomandibular joint" means the connection of the mandible and the temporal bone through the articular disc surrounded by the joint capsule and associated ligaments and tendons.
(4)
"Temporomandibular joint dysfunction" means congenital or developed anomalies of the temporomandibular joint.
(b)
No policy may be issued or issued for delivery in this state which:
(1)
Excludes medically necessary surgical or nonsurgical treatment for the correction of temporomandibular joint dysfunction by physicians or dentists professionally qualified by training and experience; or
(2)
Excludes medically necessary surgery for the correction of functional deformities of the maxilla and mandible.
(c)
The provisions of this Code section shall not cover cosmetic or elective orthodontic or periodontic care or general dental care.
(d)
(1)
The coverage under paragraph (1) of subsection (b) of this Code section may contain such types of exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance provisions which apply to other benefits under the accident and sickness insurance benefit plan, policy, or contract.
(2)
Basic coverage for the nonsurgical treatment of temporomandibular joint dysfunction under paragraph (1) of subsection (b) of this Code section may be limited to history and examination; radiographs, which must be diagnostic for temporomandibular joint dysfunction; splint therapy with necessary adjustments, provided that removable appliances designed for orthodontic purposes would not be reimbursable under a major medical plan; and diagnostic or therapeutic masticatory muscle and temporomandibular joint injections.
(e)
Except as provided in paragraph (1) of subsection (c) of Code Section
33-30-23
, for policies limited only to dental coverage, nothing contained in this Code section shall be deemed to prohibit the payment of different levels of benefits or from having differences in coinsurance percentages applicable to benefit levels for services provided by preferred and nonpreferred providers as otherwise authorized under the provisions of Article 2 of Chapter 30 of this title, relating to preferred provider arrangements.
Amended by 2019 Ga. Laws 140,§ 96, eff. 7/1/2019.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-21 - Renewal or continuation at option of insured

Pursuant to the provisions of the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, and subject to applicable rules and regulations as issued by the Centers for Medicare and Medicaid Services, all insurers which issue, issue for delivery, deliver, or renew existing individual policies, certificates, or contracts of accident and sickness insurance in this state shall, subject only to timely payment of premiums, renew or continue such coverage at the option of the insured. Such other exemptions and exclusions as are permitted by the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, Section 2742 shall also apply to individual accident and sickness insurance and insurers in this state.
Amended by 2019 Ga. Laws 140,§ 97, eff. 7/1/2019.
Amended by 2002 Ga. Laws 462, § 33, eff. 4/18/2002.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-21.1 - Availability of accident and sickness policy upon termination of dependent coverage based on age of dependent

Every policy which contains a provision for termination of coverage of a dependent upon the reaching of a certain age shall contain a provision to the effect that, upon the date of the dependent reaching the age at which coverage would terminate under the provisions of the policy, the dependent shall be entitled to have issued to him or her, without evidence of insurability, upon application made to the company within 45 days following the date the dependent reaches the age at which coverage would terminate and upon the payment of the appropriate premium, an individual or family policy of accident and sickness insurance then being issued by the insurer which provides coverage most nearly similar to the coverage contained in the policy which was terminated by reason of such dependent reaching a certain age or any similar individual or family policy then being issued by the insurer which contains lesser coverage. Any and all probationary or waiting periods set forth in such an individual or family policy shall be considered as being met to the extent coverage was in force under the prior policy.
Amended by 2019 Ga. Laws 140,§ 98, eff. 7/1/2019.
Added by 2006 Ga. Laws 504,§ 2, eff. 7/1/2006.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29 - INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 33-29-1 — 33-29-22) › Section 33-29-22 - Notice of premium increase

Notice of any premium increase shall be mailed or delivered to each holder of an individual accident and sickness insurance policy not less than 60 days prior to the effective date of such increase.
Amended by 2016 Ga. Laws 625,§ 33, eff. 5/3/2016.
Amended by 2014 Ga. Laws 669,§ 33, eff. 4/29/2014.
Amended by 2013 Ga. Laws 338,§ 1, eff. 7/1/2013.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29A - INDIVIDUAL HEALTH INSURANCE COVERAGE AVAILABILITY AND ASSIGNMENT SYSTEMS (§§ 33-29A-1 — 33-29A-35) › Article 1 - AVAILABILITY AND ASSIGNMENT SYSTEM (§§ 33-29A-1 — 33-29A-9) › Section 33-29A-1 - Intent; federal references

(a)
It is the intention of this chapter together with Code Section
33-24-21.1
to provide an acceptable alternative mechanism for the availability of individual health insurance coverage, as contemplated by Section 2741 of the federal Public Health Service Act,
42 U.S.C.A. Section 300gg-41
. This chapter shall be construed and administered so as accomplish such intention.
(b)
Any reference in this chapter to any federal statute shall refer to that federal statute as it existed on January 1, 1997, including its amendment by the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29A - INDIVIDUAL HEALTH INSURANCE COVERAGE AVAILABILITY AND ASSIGNMENT SYSTEMS (§§ 33-29A-1 — 33-29A-35) › Article 1 - AVAILABILITY AND ASSIGNMENT SYSTEM (§§ 33-29A-1 — 33-29A-9) › Section 33-29A-2 - Definitions

(a)
As used in this chapter, the terms:
(1)
"Creditable coverage" and "eligible individual" have the same meaning as specified in Sections 270l and 2741 of the federal Public Health Service Act,
42 U.S.C.A. Sections 300gg
and
300gg-41
except that a person shall not be an eligible individual under this chapter if such person is eligible for or has declined any continuation or conversion coverage or has terminated any such coverage prior to its exhaustion.
(2)
"Health insurance issuer" and "health maintenance organization" have the same meaning as specified in Section 2791 of the federal Public Health Service Act,
42 U.S.C.A. Section 300gg-92
.
(3)
"Health insurer" means any health insurance issuer which is not a managed care organization.
(4)
"Managed care organization" means a health maintenance organization or a nonprofit health care corporation.
(b)
Any other term which is used in this chapter and which is also defined in Section 2791 of the federal Public Health Service Act,
42 U.S.C.A. Section 300gg-92
, and not otherwise defined in this chapter shall have the same meaning specified in said Section 2791.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29A - INDIVIDUAL HEALTH INSURANCE COVERAGE AVAILABILITY AND ASSIGNMENT SYSTEMS (§§ 33-29A-1 — 33-29A-35) › Article 1 - AVAILABILITY AND ASSIGNMENT SYSTEM (§§ 33-29A-1 — 33-29A-9) › Section 33-29A-3 - Condition to licensure

Each health insurer and managed care corporation which is licensed to and does offer health insurance coverage in the individual market in this state shall as a condition of such licensure agree to participation in its respective assignment system provided by this chapter. This Code section shall not apply to an entity which offers only excepted benefits as specified in Section 2791(c) of the federal Public Health Service Act,
42 U.S.C.A. Section 300gg
-
91(c)
.
2023 CODE OF GEORGIA › Title 33 - INSURANCE (§§ 33-1-1 — 33-66-8) › Chapter 29A - INDIVIDUAL HEALTH INSURANCE COVERAGE AVAILABILITY AND ASSIGNMENT SYSTEMS (§§ 33-29A-1 — 33-29A-35) › Article 1 - AVAILABILITY AND ASSIGNMENT SYSTEM (§§ 33-29A-1 — 33-29A-9) › Section 33-29A-6 - Contracting between managed care organizations

Any combination of one or more health insurers and one or more managed care organizations may contract with each other for the assumption by one or more health insurers of the obligations otherwise imposed by this chapter on one or more managed care organizations. Under any such contract the responsibility for providing the coverage required by this chapter shall be with a health insurer licensed to do business in this state. Where the obligations of a managed care organization are contractually assumed by a health insurer, the assuming health insurer may substitute coverage under a standard policy of health insurance for coverage under a standard health benefit plan, and provision of such substituted coverage shall satisfy the obligation otherwise owed to an affected eligible individual.