reglab/statecodes huggingface dataset:
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-210 Reinstatement.

§431:10H-210 Reinstatement.
In addition to the requirements of sections 431:10H-208 and 431:10H-209, a long-term care insurance policy or certificate shall include a provision that provides for reinstatement of coverage, in the event of lapse if the insurer is provided proof that the policyholder or certificate holder was cognitively impaired or had a loss of functional capacity before the grace period contained in the policy expired. This option shall be available to the insured if requested within five months after termination and shall allow for the collection of past due premium, where appropriate. The standard of proof of cognitive impairment or loss of functional capacity shall not be more stringent than the benefit eligibility criteria on cognitive impairment or the loss of functional capacity contained in the policy and certificate. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-211 Disclosure; renewability.

§431:10H-211 Disclosure; renewability.
(a) Individual long-term care insurance policies shall contain a renewability provision. The provision shall be appropriately captioned, shall appear on the first page of the policy, and shall clearly state the duration, where limited, of renewability and the duration of the term of coverage for which the policy is issued and for which it may be renewed. This provision shall not apply to policies that do not contain a nonrenewability provision, and under which the right to nonrenew is reserved solely to the policyholder.
(b) A long-term care insurance policy or certificate, other than one where the insurer does not have the right to change the premium, shall include a statement that premium rates may change. [L 1999, c 93, pt of §2; am L 2007, c 233, §13]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-212 Disclosure; riders and endorsements.

§431:10H-212 Disclosure; riders and endorsements.
(a) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured under an individual long-term care insurance policy, all riders or endorsements added to an individual long-term care insurance policy after the date of issue or at reinstatement or renewal that reduce or eliminate benefits or coverage in the policy shall require signed acceptance by the individual insured.
(b) After the date of policy issuance, any rider or endorsement that increases benefits or coverage with a concomitant increase in premium during the policy term shall be agreed to in writing by the insured, except if the increased benefits or coverages are required by law.
(c) Where a separate additional premium is charged for benefits provided in connection with riders or endorsements, the premium charge shall be set forth in the policy, rider, or endorsement. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-213 Disclosure; payment of benefits.

§431:10H-213 Disclosure; payment of benefits.
A long-term care insurance policy that provides for the payment of benefits based on standards described as "usual and customary", "reasonable and customary", or similar words or phrases shall include a definition of these terms and an explanation of the terms in its accompanying outline of coverage. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-214 Disclosure; limitations.

§431:10H-214 Disclosure; limitations.
If a long-term care insurance policy or certificate contains any limitations with respect to preexisting conditions, the limitations shall appear as a separate paragraph of the policy or certificate and shall be labeled as "Preexisting Condition Limitations". [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-215 Disclosure; other limitations and conditions on eligibility for benefits.

§431:10H-215 Disclosure; other limitations and conditions on eligibility for benefits.
A long-term care insurance policy or certificate containing any limitations or conditions for eligibility other than those prohibited in section 431:10H-109 shall set forth a description of the limitations or conditions, including any required number of days of confinement, in a separate paragraph of the policy or certificate and shall be labeled as "Limitations or Conditions on Eligibility of Benefits". [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-216 Disclosure of tax consequences.

§431:10H-216 Disclosure of tax consequences.
With regard to life insurance policies that provide for an accelerated benefit for long-term care, a disclosure is required at the time of application for the policy and at the time the accelerated benefit payment request is submitted that receipt of these accelerated benefits may be taxable, and that assistance should be sought from a personal tax advisor. The disclosure statement shall be prominently displayed on the first page of the policy and any other related documents. This section shall not apply to qualified long-term care insurance contracts. [L 1999, c 93, pt of §2; am L 2007, c 233, §14]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-217 Disclosure; benefit triggers.

§431:10H-217 Disclosure; benefit triggers.
Activities of daily living and cognitive impairment shall be used to measure an insured's need for long-term care and shall be described in the policy or certificate in a separate paragraph and shall be labeled "Eligibility for the Payment of Benefits". Any additional benefit triggers shall also be explained in this section. If these benefit triggers differ for different benefits, explanation of the trigger shall accompany each benefit description. If an attending physician, advanced practice registered nurse, or other specified person is required to certify a certain level of functional dependency in order to be eligible for benefits, this requirement shall be specified. [L 1999, c 93, pt of §2; am L 2014, c 45, §10]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-219 Minimum standards for home health and community care benefits.

§431:10H-219 Minimum standards for home health and community care benefits.
(a) A long-term care insurance policy or certificate shall not, if it provides benefits for home health care or community care services, limit or exclude benefits by:
(1) Requiring that the insured or claimant would need care in a skilled nursing facility if home health care services were not provided;
(2) Requiring that the insured or claimant first or simultaneously receive nursing or therapeutic services, or both, in a home, community, or institutional setting before home health care services are covered;
(3) Limiting eligible services to services provided by registered nurses or licensed practical nurses;
(4) Requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide, or other licensed or certified home care worker acting within the scope of the person's licensure or certification;
(5) Excluding coverage for personal care services provided by a home health aide;
(6) Requiring that the provision of home health care services be at a level of certification or licensure greater than that required by the eligible service;
(7) Requiring that the insured or claimant have an acute condition before home health care services are covered;
(8) Limiting benefits to services provided by medicare-certified agencies or providers; or
(9) Excluding coverage for adult day care service.
(b) A long-term care insurance policy or certificate, if it provides for home health or community care services, shall provide total home health or community care coverage that is a dollar amount equivalent to at least one-half of one year's coverage available for nursing home benefits under the policy or certificate, at the time covered home health or community care services are being received. This requirement shall not apply to policies or certificates issued to residents of continuing care retirement communities.
(c) Home health care coverage may be applied to nonhome health care benefits provided in the policy or certificate when determining maximum coverage under the terms of the policy or certificate. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-222 Reporting requirements.

§431:10H-222 Reporting requirements.
(a) Every insurer shall maintain records for each producer of the producer's amount of replacement sales as a per cent of the producer's total annual sales and the amount of lapses of long-term care insurance policies sold by the producer as a per cent of the producer's total annual sales.
(b) Every insurer shall report annually by June 30 the ten per cent of its producers with the greatest percentages of lapses and replacements as measured in subsection (a). The form shall be in the format contained in Appendix G to the April, 2002, NAIC Long-Term Care Insurance Model Regulation.
(c) Reported replacement and lapse rates do not alone constitute a violation of insurance laws or necessarily imply wrongdoing. The reports are for the purpose of reviewing more closely producer activities regarding the sale of long-term care insurance.
(d) Every insurer shall report annually by June 30 the number of lapsed policies as a per cent of its total annual sales and as a per cent of its total number of policies in force as of the end of the preceding calendar year. The form shall be in the format contained in Appendix G to the April, 2002, NAIC Long-Term Care Insurance Model Regulation.
(e) Every insurer shall report annually by June 30 the number of replacement policies sold as a per cent of its total annual sales and as a per cent of its total number of policies in force as of the end of the preceding calendar year. The form shall be in the format contained in Appendix G to the April, 2002, NAIC Long-Term Care Insurance Model Regulation.
(f) For qualified long-term care insurance contracts, every insurer shall report annually by June 30, the number of claims denied for each class of business, expressed as a percentage of claims denied. The form shall be in the format contained in Appendix E to the April, 2002, NAIC Long-Term Care Insurance Model Regulation.
(g) Reports required under this section shall be filed with the commissioner.
(h) For purposes of this section:
"Claim" means a request for payment of benefits under an in force policy regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met. Claims shall be subject to the definition of "denied".
"Denied" means the insurer refuses to pay a claim for any reason other than for claims not paid for failure to meet the waiting period or because of an applicable preexisting condition.
"Policy" means only long-term care insurance.
"Report" means on a statewide basis. [L 1999, c 93, pt of §2; am L 2001, c 216, §22; am L 2007, c 233, §17]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-223 Discretionary powers of the commissioner.

§431:10H-223 Discretionary powers of the commissioner.
The commissioner may upon written request and after an administrative hearing, issue an order to modify or suspend a specific provision or provisions of this part with respect to a specific long-term care insurance policy or certificate upon a written finding that:
(1) The modification or suspension would be in the best interest of the insureds;
(2) The purposes to be achieved could not be effectively or efficiently achieved without the modification or suspension; and
(3) One of the following conditions have been met:
(A) The modification or suspension is necessary to the development of an innovative and reasonable approach for insuring long-term care;
(B) The policy or certificate is to be issued to residents of a life care or continuing care retirement community or some other residential community for the elderly and the modification or suspension is reasonably related to the special needs or nature of the community; or
(C) The modification or suspension is necessary to permit long-term care insurance to be sold as part of, or in conjunction with, another insurance product. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-224 Reserve standards; life insurance policies or riders.

§431:10H-224 Reserve standards; life insurance policies or riders.
(a) When long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders to these policies, the policy reserves for the benefits shall be determined in accordance with section 431:5-307. Claim reserves shall also be established in the case where the policy or rider is in claim status.
(b) Reserves for policies subject to this section shall be based on the multiple decrement model utilizing all relevant decrements except for voluntary termination rates. Single decrement approximations are acceptable if the calculation produces essentially similar reserves, if the reserve is clearly more conservative, or if the reserve is immaterial. The calculations may take into account the reduction in life insurance benefits due to the payment of long-term care benefits. However, in no event shall the reserves for the long-term care benefit and the life insurance benefit be less than the reserves for the life insurance benefit assuming no long-term care benefit.
(c) In the development and calculation of reserves for policies and riders subject to this section, due regard shall be given to applicable policy provisions, marketing methods, administrative procedures, and all other considerations which have an impact on projected claim costs, including but not limited to the following:
(1) Definition of insured events;
(2) Covered long-term care facilities;
(3) Existence of home convalescence care coverage;
(4) Definition of facilities;
(5) Existence or absence of barriers to eligibility;
(6) Premium waiver provision;
(7) Renewability;
(8) Ability to raise premiums;
(9) Marketing method;
(10) Underwriting procedures;
(11) Claims adjustment procedures;
(12) Waiting period;
(13) Maximum benefit;
(14) Availability of eligible facilities;
(15) Margins in claim costs;
(16) Optional nature of benefit;
(17) Delay in eligibility for benefit;
(18) Inflation protection provisions; and
(19) Guaranteed insurability option.
(d) Any applicable valuation morbidity table shall be certified as appropriate as a statutory valuation table by a member of the American Academy of Actuaries. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-225 Reserve standards; insurance other than life.

§431:10H-225 Reserve standards; insurance other than life.
When long-term care benefits are provided through insurance other than as in section 431:10H-224, reserves shall be determined by a table certified as appropriate as a statutory valuation table by a member of the American Academy of Actuaries and filed with the commissioner. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-227 Filing requirements; extraterritorial.

§431:10H-227 Filing requirements; extraterritorial.
Prior to an insurer or similar organization offering group long-term care insurance to a resident of this State pursuant to section 431:10H-105, it shall file with the commissioner evidence that the group policy or certificate thereunder has been approved by a state having statutory or regulatory long-term care insurance requirements substantially similar to those adopted in this State. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-228 Filing requirements; advertisements.

§431:10H-228 Filing requirements; advertisements.
(a) Every insurer, health care service plan, or other entity providing long-term care insurance or benefits in this State shall provide a copy of any long-term care insurance advertisement intended for use in this State through written, radio, or television media to the commissioner for review or approval by the commissioner to determine compliance with this article. All advertisements subject to this section shall be retained by the insurer, health care service plan, or other entity for at least three years from the date the advertisement was first used.
(b) The commissioner may exempt from the requirements of this section any advertising form or material when, in the commissioner's opinion, this requirement may not reasonably be applied. [L 1999, c 93, pt of §2; am L 2011, c 81, §7]
Revision Note
Subsection (b) redesignated pursuant to §23G-15.
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-228.5 Disapproval of filings.

§431:10H-228.5 Disapproval of filings.
If the commissioner finds that a filing does not meet the requirements of this chapter in whole or in part and disapproves the filing, a written request for a hearing may be filed pursuant to section 431:14G-112. The insurer shall bear the burden of proving that the filing meets the requirements of this article. [L 2017, c 151, §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-232 Prohibition against preexisting conditions and probationary periods in replacement policies and certificates.

§431:10H-232 Prohibition against preexisting conditions and probationary periods in replacement policies and certificates.
If a long-term care insurance policy or certificate replaces another long-term care insurance policy or certificate, the replacing issuer shall waive any time periods applicable to preexisting conditions and probationary periods in the new long-term care policy for similar benefits to the extent that similar exclusions have been satisfied under the original policy. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-234 Standards for benefit triggers.

§431:10H-234 Standards for benefit triggers.
(a) A long-term care insurance policy shall condition the payment of benefits on a determination of the insured's ability to perform activities of daily living and on cognitive impairment. Eligibility for the payment of benefits shall not be more restrictive than requiring either a deficiency in the ability to perform not more than three of the activities of daily living or the presence of cognitive impairment.
(b) Activities of daily living shall include at least the following as defined in section 431:10H-201 and the policy: bathing, continence, dressing, eating, toileting, and transferring. Insurers may use activities of daily living to trigger covered benefits in addition to those contained in the preceding sentence as long as they are defined in the policy.
(c) An insurer may use additional provisions for the determination of when benefits are payable under a policy or certificate, however the provisions shall not restrict and are not in lieu of the requirements under subsections (a) and (b).
(d) For purposes of this section the determination of a deficiency shall not be more restrictive than:
(1) Requiring the hands-on assistance of another person to perform the prescribed activities of daily living; or
(2) If the deficiency is due to the presence of a cognitive impairment, supervision or verbal cueing by another person is needed in order to protect the insured or others.
(e) Assessments of activities of daily living and cognitive impairment shall be performed by licensed or certified professionals, such as physicians, nurses, or social workers.
(f) Long-term care insurance policies shall include a clear description of the process for appealing and resolving benefit determinations.
(g) The requirements set forth in this section shall be effective July 1, 2000, and shall apply as follows:
(1) Except as provided in paragraph (2), this section applies to a long-term care policy issued in this State after June 30, 2000;
(2) For certificates issued after June 30, 2000, under a group long-term care insurance policy as defined in paragraph (1) under the definition of "group long-term care insurance" in section 431:10H-104, which policy was in force on July 1, 2000, this section shall not apply. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-235 Standard format outline of coverage; group and individual policies.

§431:10H-235 Standard format outline of coverage; group and individual policies.
This section implements, interprets, and makes specific, the provisions of section 431:10H-112 in prescribing a standard format and the content of an outline of coverage, as follows:
(1) The outline of coverage shall be a freestanding document, using no smaller than ten-point type;
(2) The outline of coverage shall contain no material of an advertising nature;
(3) Text that is capitalized or underscored in the standard format outline of coverage may be emphasized by other means that provide prominence equivalent to the capitalization or underscoring;
(4) Use of the text and sequence of text of the standard format outline of coverage is mandatory, unless otherwise specifically indicated; and
(5) The format for outline of coverage shall be substantially similar to the Outline of Coverage in section 29 of the April, 2002, NAIC Long-Term Care Insurance Model Regulation. [L 1999, c 93, pt of §2; am L 2007, c 233, §25]
Revision Note
Subsection designation deleted pursuant to §23G-15.
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-236 Delivery of shopper's guide; group and individual policies.

§431:10H-236 Delivery of shopper's guide; group and individual policies.
(a) A long-term care insurance shopper's guide in the format developed by the National Association of Insurance Commissioners, or a guide developed or approved by the commissioner, shall be provided to all prospective applicants of a long-term care insurance policy or certificate.
(b) In the case of producer solicitations, a producer shall deliver the shopper's guide prior to the presentation of an application or enrollment form.
(c) In the case of direct response solicitations, the shopper's guide must be presented in conjunction with application or enrollment form.
(d) Life insurance policies containing accelerated long-term care benefits are not required to furnish the above-referenced guide, but shall furnish the policy summary required under sections 431:10H-106 to 431:10H-114. [L 1999, c 93, pt of §2; am L 2001, c 216, §24]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-237 Penalties.

§431:10H-237 Penalties.
In addition to any other penalties provided by the laws of this State, any insurer or producer found to have violated any requirement of this State relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a fine of up to three times the amount of any commissions paid for each policy involved in the violation or up to $10,000, whichever is greater. [L 2007, c 233, pt of §4]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-301 Group long-term care insurance policies conformance to Health Insurance Portability and Accountability Act and Internal Revenue Code.

§431:10H-301 Group long-term care insurance policies conformance to Health Insurance Portability and Accountability Act and Internal Revenue Code.
(a) Every group long-term care insurance policy sold after June 30, 2000, may conform to Subtitle C of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and to Section 7702B of the Internal Revenue Code of 1986, as amended; provided that if it does not conform, then it shall not qualify for federal or state income tax benefits.
(b) A group long-term care insurance policy may provide coverage, at a minimum, for "qualified long-term care services", as defined in Subtitle C of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and in Section 7702B of the Internal Revenue Code of 1986, as amended.
(c) For the purpose of subsection (b) and for the purpose of describing examples of services typically found in this State, coverage shall be one or more of the following services or any combination of services:
(1) Home health care services, as defined in section 431:10H-201;
(2) Adult day care, as defined in section 431:10H-201;
(3) Adult residential care home, as defined in section 321-15.1;
(4) Extended care adult residential care home, as defined in section 323D-2;
(5) Nursing home, as defined in section 457B-2;
(6) Skilled nursing facilities and intermediate care facilities, as referenced in section 321-11(10);
(7) Hospices, as referenced in section 321-11;
(8) Assisted living facility, as defined in section 323D-2;
(9) Personal care, as defined in section 431:10H-201;
(10) Respite care, as defined in section 333F-1; and
(11) Any other care as provided by rule of the commissioner. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-302 Individual long-term care insurance policy coverages.

§431:10H-302 Individual long-term care insurance policy coverages.
(a) Every individual long-term care insurance policy sold after June 30, 2000, shall provide coverage for one or more of the types of care enumerated under section 431:10H-301(c).
(b) An individual long-term care insurance policy sold after June 30, 2000, shall not be required to conform to Subtitle C of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and to Section 7702B of the Internal Revenue Code of 1986, as amended; provided that if it does not conform, then it shall not qualify for federal or state income tax benefits. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-303 Conflict with Health Insurance Portability and Accountability Act.

§431:10H-303 Conflict with Health Insurance Portability and Accountability Act.
If a conflict occurs between a provision of this article and the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, the provision shall be deemed amended to comply with that federal Act and any related regulations, to the extent that a particular policy is intended to qualify for federal income tax benefits. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-304 Disclosure of qualification for tax benefits.

§431:10H-304 Disclosure of qualification for tax benefits.
(a) Every policy that is intended to be a qualified long-term care insurance contract as provided in the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, shall be identified as such by prominently displaying and printing on page one of the policy form and the outline of coverage and in the application the following words: "This contract for long-term care insurance is intended to be a federally qualified long-term care insurance contract and may qualify you for federal and state tax benefits."
(b) Every policy that is not intended to be a qualified long-term care insurance contract as provided in the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, shall be identified as such by prominently displaying and printing on page one of the policy form and the outline of coverage and in the application the following words: "This contract for long-term care insurance is not intended to be a federally qualified long-term care insurance contract and is not intended to qualify you for federal and state tax benefits." [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-401 Publicizing of policies.

§431:10H-401 Publicizing of policies.
For purposes of section 371-16, upon request by an employer, labor organization, retiree organization, or other entity specified under the definition of "group long-term care insurance" in section 431:10H-104, an insurer that is subject to this part shall be allowed, if it chooses, to publicize a long-term care policy and may sell and underwrite that policy. [L 1999, c 93, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:10H-402 Purchase of policy and payment of premiums on an individual's behalf.

[ §431:10H-402] Purchase of policy and payment of premiums on an individual's behalf.
An insurer shall allow a person to purchase an individual or group long-term care insurance policy and pay the premiums for an individual or group long-term care insurance policy that covers the person, the person's spouse, or reciprocal beneficiary, as well as their parents and grandparents, and in-law parents and grandparents. Nothing in this section shall preclude an insurer from underwriting such a policy. L 1999, c 93, pt of §2
DERIVATION TABLE OF ARTICLE 10H FROM THE NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS 1998 MODEL ACT OR REGULATIONS
1998 NAIC ACT § 1998 NAIC REGULATION § HRS §
1 0 431:10H-101
2 0 431:10H-102
3 0 431:10H-103
4 0 431:10H-104
5 0 431:10H-105
6A 0 431:10H-106
6B 0 431:10H-107
6C 0 431:10H-108
6D 0 431:10H-109
6E 17 431:10H-110
6F 0 431:10H-111
6G 0 431:10H-112
6H 0 431:10H-113
6I to K 0 431:10H-114
7 0 431:10H-115
8 0 431:10H-116
9 0 431:10H-117
0 5 431:10H-201
0 6A 431:10H-202
0 6B 431:10H-203
0 6C 431:10H-204
0 6D 431:10H-205
0 6E 431:10H-206
0 6F 431:10H-207
0 7A 431:10H-208
0 7A 431:10H-209
0 7B 431:10H-210
0 8A 431:10H-211
0 8B 431:10H-212
0 8C 431:10H-213
0 8D 431:10H-214
0 8E 431:10H-215
0 8F 431:10H-216
0 8G 431:10H-217
0 9 431:10H-218
0 10 431:10H-219
0 11 431:10H-220
0 12 431:10H-221
0 13 431:10H-222
0 15 431:10H-223
0 16A 431:10H-224
0 16B 431:10H-225
0 17 431:10H-226
0 18 431:10H-227
0 19 431:10H-228
0 20A, 20B 431:10H-229
0 20C 431:10H-230
0 21 431:10H-231
0 22 431:10H-232
0 23 431:10H-233
0 24 431:10H-234
0 25 431:10H-235
0 26 431:10H-236
0 0 431:10H-301
0 0 431:10H-302
0 0 431:10H-303
0 0 431:10H-304
0 0 431:10H-401
0 0 431:10H-402
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-101 Scope and purpose.

§431:11-101 Scope and purpose.
(a) This article applies to all persons doing an insurance business in this State unless specifically exempted under subsection (b).
(b) The commissioner may exempt:
(1) Any insurer or class of insurers from any provision of this article, when the commissioner deems the exemption consistent with the purposes of this article and in the public interest; or
(2) Upon request of the person required to supply information or perform an act, that person from any provision of this article, when the commissioner deems the exception consistent with the purposes of this article and in the public interest.
(c) The purposes of this article include:
(1) Exercising surveillance over the acquisition of a domestic insurer, to ensure that in the process of making it part of an insurance holding company system, the interests of policyholders, shareholders, and the public are not harmed;
(2) Providing the regulatory monitoring of those intercorporate relationships and transactions among affiliates within an insurance holding company system that may affect the solidity of insurers;
(3) Controlling the payment of dividends that might affect the solidity of insurers; and
(4) Providing, in appropriate cases, recoupment of dividends paid. [L 1987, c 349, pt of §8; am L 2010, c 116, §1(22)]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-104.1 Definitions. The following definitions shall apply for the purposes of sections 431:11-104.2 through 431:11-104.6 only: "Acquisition" means any agreement, arrangement, or activity the consummation of which results in a person acquiring directly or indirectly the control of another person, and includes, but is not limited to, the acquisition of voting securities, the acquisition of assets, bulk reinsurance, and mergers. "Involved insurer" means an insurer which either acquires or is acquired, is affiliated with an acquirer or person acquired, or is the result of a merger. [L 1992, c 176, pt of §3]

§431:11-104.1
Definitions.
The following definitions shall apply for the purposes of sections 431:11-104.2 through 431:11-104.6 only:
"Acquisition" means any agreement, arrangement, or activity the consummation of which results in a person acquiring directly or indirectly the control of another person, and includes, but is not limited to, the acquisition of voting securities, the acquisition of assets, bulk reinsurance, and mergers.
"Involved insurer" means an insurer which either acquires or is acquired, is affiliated with an acquirer or person acquired, or is the result of a merger.
[L 1992, c 176, pt of §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-104.3 Preacquisition notification; waiting period.

§431:11-104.3 Preacquisition notification; waiting period.
(a) An acquisition covered by section 431:11-104.2 may be subject to an order pursuant to section 431:11-104.5 unless the acquiring person or the acquired person files a preacquisition notification and the waiting period has expired. The commissioner shall treat information submitted under this subsection as confidential in the same manner as provided in section 431:11-108.
(b) The preacquisition notification shall be in such form and contain such information as prescribed by the National Association of Insurance Commissioners, including information relating to those markets in which the acquisition would not be exempted pursuant to section 431:11-104.2(b)(5). The commissioner may require such additional material and information as the commissioner deems necessary to determine whether the proposed acquisition, if consummated, would violate the competitive standard of section 431:11-104.4. The required information may include an opinion of an economist as to the competitive impact of the acquisition in this State accompanied by a summary of the education and experience indicating that economist's ability to render an informed opinion.
(c) The waiting period required shall begin on the date of receipt by the commissioner of a preacquisition notification and shall end on the earlier of the thirtieth day after the date of that receipt, or termination of the waiting period by the commissioner. Prior to the end of the waiting period, the commissioner, on a one-time basis, may require the submission of additional information relevant to the proposed acquisition, in which event the waiting period shall end on the earlier of the thirtieth day after receipt of the additional information by the commissioner or termination of the waiting period by the commissioner.
[L 1992, c 176, pt of §3; am L 2006, c 189, §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-104.6 Inapplicable provisions. Sections 431:11-110(b), 431:11-110(c), and 431:11-112 do not apply to acquisitions to which sections 431:11-104.1 through 431:11-104.5 apply. [L 1992, c 176, pt of §3]

§431:11-104.6
Inapplicable provisions.
Sections 431:11-110(b), 431:11-110(c), and 431:11-112 do not apply to acquisitions to which sections 431:11-104.1 through 431:11-104.5 apply.
[L 1992, c 176, pt of §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-107.5 Supervisory colleges.

§431:11-107.5 Supervisory colleges.
(a) With respect to any insurer registered under section 431:11-105, and in accordance with subsection (c), the commissioner may participate in a supervisory college for any domestic insurer that is part of an insurance holding company system with international operations to determine compliance by the insurer with this article. The powers of the commissioner with respect to supervisory colleges shall include but not be limited to:
(1) Initiating the establishment of a supervisory college;
(2) Clarifying the membership and participation of other supervisors in the supervisory college;
(3) Clarifying the functions of the supervisory college and the role of other regulators, including the establishment of a group-wide supervisor;
(4) Coordinating the ongoing activities of the supervisory college, including planning meetings, supervisory activities, and processes for information sharing; and
(5) Establishing a crisis management plan.
(b) Each registered insurer subject to this section shall be liable for and shall pay the reasonable expenses of the commissioner's participation in a supervisory college in accordance with subsection (c), including reasonable travel expenses. For purposes of this section, a supervisory college may be convened as either a temporary or permanent forum for communication and cooperation between the regulators charged with the supervision of the insurer or its affiliates, and the commissioner may establish a regular assessment to the insurer for the payment of these expenses.
(c) To assess the business strategy, financial position, legal and regulatory position, risk exposure, risk management, and governance processes, and as part of the examination of individual insurers in accordance with section 431:11-107, the commissioner may participate in a supervisory college with other regulators charged with supervision of the insurer or its affiliates, including other state, federal, and international regulatory agencies. The commissioner may enter into agreements in accordance with section 431:11-108 providing the basis for cooperation between the commissioner and the other regulatory agencies, and the activities of the supervisory college. Nothing in this section shall delegate to the supervisory college the authority of the commissioner to regulate or supervise the insurer or its affiliates within the commissioner's jurisdiction. [L 2014, c 234, §6]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-110 Injunctions; prohibitions against voting securities; sequestration of voting securities.

§431:11-110 Injunctions; prohibitions against voting securities; sequestration of voting securities.
(a) Whenever it appears to the commissioner that any insurer or any director, officer, employee, or agent thereof has committed or is about to commit a violation of this article or of any rule or order issued by the commissioner hereunder, the commissioner may apply to the circuit court of the first judicial circuit for an order enjoining the insurer or the director, officer, employee, or agent thereof from violating or continuing to violate this article or any rule or order, and for other equitable relief as the nature of the case and the interest of the insurer's policyholders, creditors, and shareholders or the public may require.
(b) No security which is the subject of any agreement or arrangement regarding acquisition, or which is acquired or to be acquired, in contravention of the provisions of this article or of any rule or order issued by the commissioner hereunder may be voted at any shareholders' meeting, or may be counted for quorum purposes, and any action of shareholders requiring the affirmative vote of a percentage of shares may be taken as though the securities were not issued and outstanding. No action taken at any such meeting shall be invalidated by the voting of the securities, unless the action would materially affect control of the insurer or unless the courts of this State have so ordered. If an insurer or the commissioner has reason to believe that any security of the insurer has been or is about to be acquired in contravention of the provisions of this article or of any rule or order issued by the commissioner hereunder the insurer or the commissioner may apply to the circuit court of the first judicial circuit to enjoin any offer, request, invitation, agreement, or acquisition made in contravention of section 431:11-104 or any rule or order issued by the commissioner thereunder to enjoin the voting of any security so acquired, to void any vote of the security already cast at any meeting of shareholders and for such other equitable relief as the nature of the case and the interest of the insurer's policyholders, creditors, and shareholders or the public may require.
(c) In any case where a person has acquired or is proposing to acquire any voting securities in violation of this article or any rule or order issued by the commissioner hereunder, the circuit court of the first judicial circuit may, on such notice as the court deems appropriate, upon the application of the insurer or the commissioner seize or sequester any voting securities of the insurer owned directly or indirectly by the person, and issue an order with respect thereto as may be appropriate to effectuate the provisions of this article.
Notwithstanding any other provisions of law, for the purposes of this article, the sites of the ownership of the securities of domestic insurers shall be deemed to be in this State. [L 1987, c 349, pt of §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-112 Receivership.

§431:11-112 Receivership.
Whenever it appears to the commissioner that any person has committed a violation of this article which so impairs the financial condition of a domestic insurer as to threaten insolvency or make the further transaction of business by it hazardous to its policyholders, creditors, shareholders, or the public, then the commissioner may proceed as provided in article 15 to take possession of the property of the domestic insurer and to conduct the business thereof. [L 1987, c 349, pt of §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-113 Recovery.

§431:11-113 Recovery.
(a) If an order for liquidation or rehabilitation of a domestic insurer has been entered, the receiver appointed under the order shall have a right to recover on behalf of the insurer:
(1) From any parent corporation or holding company or person or affiliate who otherwise controlled the insurer, the amount of distributions (other than distributions of shares of the same class of stock) paid by the insurer on its capital stock, or
(2) Any payment in the form of a bonus, termination settlement, or extraordinary lump sum salary adjustment made by the insurer or its subsidiary(ies) to a director, officer, or employee.
Where the distribution or payment pursuant to items (1) or (2) is made at any time during the one year preceding the petition for liquidation, conservation or rehabilitation, as the case may be, subject to the limitations of subsections (b), (c), and (d).
(b) No distribution shall be recoverable if the parent or affiliate shows that when paid the distribution was lawful and reasonable, and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations.
(c) Any person who was a parent corporation or holding company or a person who otherwise controlled the insurer or affiliate at the time the distributions were paid shall be liable up to the amount of distributions or payments under subsection (a) the person received. Any person who otherwise controlled the insurer at the time the distributions were declared shall be liable up to the amount of distributions the person would have received if they had been paid immediately. If two or more persons are liable with respect to the same distributions, they shall be jointly and severally liable.
(d) The maximum amount recoverable under this section shall be the amount needed in excess of all other available assets of the impaired or insolvent insurer to pay the contractual obligations of the impaired or insolvent insurer and to reimburse any guaranty funds.
(e) To the extent that any person liable under subsection (c) is insolvent or otherwise fails to pay claims due from it pursuant to subsection (c), its parent corporation or holding company or person who otherwise controlled it at the time the distribution was paid, shall be jointly and severally liable for any resulting deficiency in the amount recovered from the parent corporation or holding company or person who otherwise controlled it. [L 1987, c 349, pt of §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-114 Revocation, suspension, or nonrenewal of insurer's license.

§431:11-114 Revocation, suspension, or nonrenewal of insurer's license.
Whenever it appears to the commissioner that any person has committed a violation of this article which makes the continued operation of an insurer contrary to the interests of policyholders or the public, the commissioner may, after giving notice and an opportunity to be heard, determine to suspend, revoke or refuse to renew the insurer's license or authority to do business in this State for the period the commissioner finds is required for the protection of policyholders or the public. Any determination shall be accompanied by specific findings of fact and conclusions of law. [L 1987, c 349, pt of §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-115 Judicial review; mandamus.

§431:11-115 Judicial review; mandamus.
(a) Any person aggrieved by any act, determination, rule or order or any other action of the commissioner pursuant to this article may appeal therefrom to the circuit court of the first judicial circuit. The court shall conduct its review without a jury and by trial de novo, except that if all parties, including the commissioner, so stipulate, the review shall be confined to the record. Portions of the record may be introduced by stipulation into evidence in a trial de novo as to those parties so stipulating.
(b) The filing of an appeal pursuant to this section shall stay the application of any rule, order, or other action of the commissioner to the appealing party unless the court, after giving the party notice and an opportunity to be heard, determines that a stay would be detrimental to the interest of policyholders, shareholders, creditors or the public.
(c) Any person aggrieved by any failure of the commissioner to act or make a determination required by this article may petition the circuit court of the first judicial circuit for a writ in the nature of a mandamus or a peremptory mandamus directing the commissioner to act or make the determination forthwith. [L 1987, c 349, pt of §8]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:11-117 Severability of provisions.

§431:11-117 Severability of provisions.
If any provision of this article or the application thereof to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of this article which can be given effect without the invalid provisions or applications, and for this purpose the provisions of this article are severable. [L 1987, c 349, pt of §8]