reglab/statecodes huggingface dataset:
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-114 - LIFE INSURANCE ILLUSTRATIONS › Section 482-1-114-.11 - Annual Certifications

Current through Register Vol. 42, No. 9, June 28, 2024
A. The
			 board of directors of each insurer shall appoint one or more illustration
			 actuaries.
B. The illustration
			 actuary shall certify that the disciplined current scale used in illustrations
			 is in conformity with the Actuarial Standard of Practice for Compliance with
			 the NAIC Model Regulation on Life Insurance Illustrations promulgated by the
			 Actuarial Standards Board, and that the illustrated scales used in
			 insurer-authorized illustrations meet the requirements of this
			 chapter.
C. The illustration
			 actuary shall:
(1) Be a member in good
			 standing of the American Academy of Actuaries;
(2) Be familiar with the standard of practice
			 regarding life insurance policy illustrations;
(3) Not have been found by the commissioner,
			 following appropriate notice and hearing to have:
(a) Violated any provision of, or any
			 obligation imposed by, the insurance law or other law in the course of his or
			 her dealings as an illustration actuary;
(b) Been found guilty of fraudulent or
			 dishonest practices;
(c)
			 Demonstrated his or her incompetence, lack of cooperation, or untrustworthiness
			 to act as an illustration actuary; or
(d) Resigned or been removed as an
			 illustration actuary within the past five (5) years as a result of acts or
			 omissions indicated in any adverse report on examination or as a result of a
			 failure to adhere to generally acceptable actuarial standards;
(4) Not fail to notify the
			 commissioner of any action taken by a commissioner of another state similar to
			 that under Paragraph (3) above;
(5)
			 Disclose in the annual certification whether, since the last certification, a
			 currently payable scale applicable for business issued within the previous five
			 (5) years and within the scope of the certification has been reduced for
			 reasons other than changes in the experience factors underlying the disciplined
			 current scale. If nonguaranteed elements illustrated for new policies are not
			 consistent with those illustrated for similar in force policies, this must be
			 disclosed in the annual certification. If nonguaranteed elements illustrated
			 for both new and in force policies are not consistent with the nonguaranteed
			 elements actually being paid, charged or credited to the same or similar forms,
			 this must be disclosed in the annual certification; and
(6) Disclose in the annual certification the
			 method used to allocate overhead expenses for all illustrations:
(a) Fully allocated expenses;
(b) Marginal expenses; or
(c) A generally recognized expense table
			 based on fully allocated expenses representing a significant portion of
			 insurance companies and approved by the National Association of Insurance
			 Commissioners or by the commissioner.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-114 - LIFE INSURANCE ILLUSTRATIONS › Section 482-1-114-.12 - Penalties

Current through Register Vol. 42, No. 9, June 28, 2024
In addition to any other penalties provided by the laws of this
				state, an insurer or producer that violates a requirement of this chapter shall
				be guilty of a violation of Section
				27-12-6,
Code of Ala.
				1975
.
Author:
Commissioner of
				Insurance
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-114 - LIFE INSURANCE ILLUSTRATIONS › Section 482-1-114-.13 - Severability Clause

Current through Register Vol. 42, No. 9, June 28, 2024
If any provision of this chapter, or the application thereof to
				any person or circumstance, is held invalid, such determination shall not
				affect other provisions or applications of this chapter which can be given
				effect without the invalid provision or application, and to that end the
				provisions of this chapter are severable.
Author:
Commissioner of
				Insurance
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-114 - LIFE INSURANCE ILLUSTRATIONS › Section 482-1-114-.14 - Effective Date

Current through Register Vol. 42, No. 9, June 28, 2024
This chapter shall become effective January 1, 1998, and shall
				apply to policies sold after December 31, 1997.
Author:
Commissioner of
				Insurance
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.01 - Authority And Short Title

Current through Register Vol. 42, No. 9, June 28, 2024
This chapter is adopted pursuant to Sections
				27-2-17 and
				27-52-1,
et
seq
.,
Code of
				Ala. 1975
. This chapter shall be known and may be cited as the
				Alabama Health Insurance Plan chapter.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-52-1,
et
seq
.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.02 - Purpose

Current through Register Vol. 42, No. 9, June 28, 2024
The purpose and intent of this chapter is to implement the
				Alabama Health Insurance Plan as created in the Act.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-52-1,
et
seq
.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.05 - Eligibility

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Any individual
			 person, who is and continues to be a resident and who has prior continuous
			 coverage shall be eligible for Plan coverage if evidence is provided of all of
			 the following:
(a) That prior coverage was
			 not terminated because of fraud or nonpayment of premium by the
			 individual.
(b) That if the person
			 was offered the option of continuation coverage under federal or state law, the
			 person has both elected and exhausted the continuation coverage.
(c) That the person's most recent prior
			 continuous coverage was under a "group health plan", a "government plan" or a
			 "church plan," (or health insurance offered in connection with any of these
			 plans) as these plans are defined by federal law or regulation.
(1) Each resident dependent of an individual
			 person who is eligible for Plan coverage shall be eligible for Plan
			 coverage.
(2) An individual person
			 shall not be eligible for coverage under the Plan in any of the following
			 instances:
(a) The person is eligible for
			 group coverage under other health insurance.
(b) The person is determined to be eligible
			 for health insurance under Medicaid.
(c) The person is determined to be eligible
			 for health insurance under Medicare.
(d) The person is enrolled in any other
			 health insurance plan.
(4) Coverage shall cease upon any of the
			 following events:
(a) On the date a person
			 requests coverage to end.
(b) Upon
			 the death of the covered person.
(c) On the date state law requires
			 cancellation of the policy.
(d)
			 Nonpayment of the required premiums.
(e) On the date a person ceases to be a
			 resident.
(f) On the last day of
			 the month in which a covered person is no longer eligible for the Plan.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.06 - Operations Administrator

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 Board shall select an Operations Administrator to conduct the daily operations
			 of the Board. In so doing, the Board may select an agency of the State of
			 Alabama as Operations Administrator or may utilize a competitive bidding
			 process for private entities. If a competitive bidding process is utilized, the
			 Board shall evaluate bids submitted on the basis of criteria which shall
			 include, but not be limited to, the following:
(a) The Operations Administrator's proven
			 ability to conduct the daily activities of a health insurance plan.
(b) The expertise and efficiency of the
			 Operations Administrator's staff.
(c) The Operations Administrator's estimate
			 of total charges to conduct the daily activities of the Plan.
(d) The Operations Administrator's ability to
			 apply effective cost containment programs and procedures and to administer the
			 Plan in a cost efficient manner.
(e) The financial condition and stability of
			 the Operations Administrator.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.07 - Claims Administrator

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 Board shall select a Claims Administrator or Administrators through a
			 competitive bidding process to process claims of members of the benefit plan or
			 plans and other administrative duties as determined by the Board. The Board
			 shall evaluate bids submitted based on criteria established by the Board which
			 shall include all of the following:
(a) The
			 Claims Administrator's proven ability to handle health insurance coverage for
			 individuals.
(b) The efficiency and
			 timeliness of the Claims Administrator's claim processing procedures.
(c) An estimate of total charges for the
			 services to be provided.
(d) The
			 Claims Administrator's ability to apply effective cost containment programs and
			 procedures and to administer the claims of the benefit plan or plans in a cost
			 efficient manner.
(e) The financial
			 condition and stability of the Claims Administrator.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.08 - Funding Of The Plan

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
			 Premiums.
(a) The Board shall establish
			 premium rates for the Plan as provided in Subparagraph (b). Separate schedules
			 of premium rates based on age, sex and geographical location may apply for
			 individual risks. Premium rates and schedules shall be submitted to the
			 Commissioner for approval prior to use.
(b) The Board, with the assistance of the
			 Commissioner, shall determine a standard risk rate by considering the premium
			 rates charged by other insurers offering health insurance coverage to
			 individuals. The standard risk rate shall be established using reasonable
			 actuarial techniques, and shall reflect anticipated experience and expenses for
			 such coverage. Initial rates for the Plan shall not be less than 125 percent of
			 rates established as applicable for individual standard risks. Subject to the
			 limits provided in this subparagraph subsequent rates shall consider the
			 expected costs of claims including recovery of prior losses, expenses of
			 operation, investment income of claim reserves, and any other cost factors
			 subject to the limitations described herein. In no event shall Plan rates
			 exceed 200 percent of rates applicable to individual standard risks.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.09 - Benefits

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The Plan shall
			 make available health care coverage consistent with the requirements of the Act
			 and the federal Health Insurance Portability and Accountability Act of 1996. In
			 particular, the Plan will make available two or more policy forms, at least one
			 of which provides coverage comparable to comprehensive major medical coverage
			 offered in the individual health insurance market in the state of
			 Alabama.
(2) The policy forms to be
			 issued by the Plan, along with the schedule of benefits, exclusions and other
			 limitations, shall be established by the Board, subject to the approval of the
			 Commissioner. The Plan benefits shall be inclusive of the provisions of
			 Sections 27-1-10 and
			 27-19-39,
Code of Ala.
			 1975
.
(3) Coverage
			 under all policy forms will be available to all individuals eligible for the
			 Plan, as defined in Rule
			 482-1-115-.05, on a "guaranteed
			 issue" basis, with no exclusions of coverage for pre-existing medical
			 conditions, and on a "guaranteed renewable" basis.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-52-1,
et
seq
.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.10 - Consultation With State Board Of Health

Current through Register Vol. 42, No. 9, June 28, 2024
All bylaws, policies, guidelines or directives issued by the
				Board related to the delivery of medical services, including but not limited to
				those items specified in Subparagraphs (h), (m), (n), and (o) of Paragraph (7)
				of Rule 482-1-115-.04 and in Rule
				482-1-115-.09, shall be
				promulgated with the concurrence of the State Board of Health.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-52-1,
et
seq
.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.11 - Separability

Current through Register Vol. 42, No. 9, June 28, 2024
If any provision of this chapter or the application thereof to
				any person or circumstances is for any reason held to be invalid, the remainder
				of the chapter and the application of its provisions to other persons or
				circumstances shall not be affected thereby.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-52-1,
et
seq
.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.12 - Effective Date

Current through Register Vol. 42, No. 9, June 28, 2024
The provisions of this chapter shall become effective upon its
				approval by the Commissioner of Insurance, with the concurrence of the State
				Board of Health, and upon its having been on file as a public document in the
				office of the Secretary of State for ten days.
Author:
Elizabeth Bookwalter, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §§
										27-2-17,
				  27-52-1,
et
seq
.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.01 - Authority And Short Title

Current through Register Vol. 42, No. 9, June 28, 2024
This regulation is adopted pursuant to Sections
				27-2-17 and
				27-52-20,
et
seq
.,
Code of
				Ala. 1975
. This Regulation shall be known and may be cited as the
				Alabama Small Employer Allocation Program Regulation.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-52-21.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.02 - Purpose

Current through Register Vol. 42, No. 9, June 28, 2024
The purpose and intent of this Regulation is to enhance the
				availability of health insurance coverage to small employers regardless of
				their health status or claims experience, to prevent abusive rating practices,
				to prevent segmentation of the health insurance market based upon health risk,
				to spread health insurance risk more broadly, to require disclosure of rating
				practices to purchasers, to establish rules regarding renewability of coverage,
				to limit the use of preexisting condition exclusions, and to improve the
				overall fairness and efficiency of the small group health insurance
				market.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-52-21.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.03 - Applicability And Scope

Current through Register Vol. 42, No. 9, June 28, 2024
(a) This
			 Regulation shall apply to any health benefit plan that provides coverage to the
			 employees of a small employer in this state if any of the following conditions
			 are met:
(1) Any portion of the premium or
			 benefits is paid by or on behalf of the small employer.
(2) An eligible employee or dependent is
			 reimbursed, whether through wage adjustments or otherwise, by or on behalf of
			 the small employer for any portion of the premium.
(3) The health benefit plan is treated by the
			 employer or any of the eligible employees or dependents as part of a plan or
			 program for the purposes of Section 162, Section 125 or Section 106 of the
			 United States Internal Revenue Code.
(4) The health benefit plan is marketed to
			 individual employees through an employer.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.05 - Restrictions Relating To Premium Rates

Current through Register Vol. 42, No. 9, June 28, 2024
(a) For rating periods beginning on and after
			 the effective date of this regulation, premium rates for health benefit plans
			 subject to this Regulation shall be subject to all of the following provisions:
(1) The small employer carrier shall develop
			 its base rate or rates utilizing an adjusted community rating methodology and
			 may only vary the adjusted community rate or rates for one or more of the
			 following:
a. Geographic area.
b. Family composition.
c. Age.
d. Sex.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.06 - Renewability Of Coverage

Current through Register Vol. 42, No. 9, June 28, 2024
(a) A
			 health benefit plan subject to this Regulation shall be renewable with respect
			 to all eligible employees or dependents, at the option of the small employer,
			 except in any of the following cases:
(1)
			 Nonpayment of the required premiums.
(2) Fraud or intentional misrepresentation of
			 a material fact by the small employer or, with respect to coverage of
			 individual insureds, the insureds or their representatives.
(3) Noncompliance with the carrier's minimum
			 participation requirements.
(4)
			 Noncompliance with the carrier's employer contribution requirements.
(5) The small employer carrier elects to
			 nonrenew all of its health benefit plans delivered or issued for delivery to
			 small employers in this state. In such a case the carrier shall:
a. Provide advance notice of its decision
			 under this Subdivision to the commissioner in each state in which it is
			 licensed; and
b. Provide notice of
			 the decision not to renew coverage to all affected small employers, insureds
			 and to the commissioner in each state in which an affected insured individual
			 is known to reside at least 180 days prior to the nonrenewal of any health
			 benefit plans by the carrier. Notice to the commissioner under this Paragraph
			 shall be provided at least three (3) working days prior to the notice to the
			 affected small employers.
(6) The commissioner finds that the
			 continuation of the coverage would not be in the best interests of the
			 policyholders or certificate holders; or would impair the carrier's ability to
			 meet its contractual obligations. In such instance, the commissioner shall
			 assist affected small employers in finding replacement coverage. In the case of
			 a health maintenance organization, the decision by the Commissioner shall have
			 been made in consultation with, and with the approval of, the State Health
			 Officer.
(7) The small employer
			 carrier elects to discontinue the sale of the health benefit plan to small
			 employers in this state. In such a case, the carrier shall:
a. Provide 90 days advance notice of its
			 decision to the small employers covered by the discontinued health benefit plan
			 in this state; and
b. Offer each
			 affected small employer an option to purchase any other small group health
			 benefit plan offered by the carrier in this state.
c. The offer in Paragraph b. must be made
			 uniformly to all affected small employers in this state without regard to
			 health status related factors.
(8) Association membership ceases, provided
			 that the rules for cessation are applied uniformly without regard to health
			 status related factors.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.07 - Availability Of Coverage

Current through Register Vol. 42, No. 9, June 28, 2024
(a)
(1) Every small employer carrier shall, as a
			 condition of transacting business in this state with small employers, actively
			 offer to small employers all health benefit plans it actively markets to small
			 employers in this state. A small employer carrier shall be considered to be
			 actively marketing a health benefit plan if it offers that plan to any small
			 employer not currently receiving a health benefit plan by such small employer
			 carrier.
(2) Subject to Subdivision
			 (1), a small employer carrier shall issue any health benefit plan to any
			 eligible small employer that applies for such plan and agrees to make the
			 required premium payments and to satisfy the other reasonable provisions of the
			 health benefit plan not inconsistent with this Regulation.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.08 - Standards To Assure Fair Marketing

Current through Register Vol. 42, No. 9, June 28, 2024
(a) Subject to Subdivision (1) of Subsection
			 (a) of Section 7, each small employer carrier shall actively market all health
			 benefit plans sold by the carrier to eligible small employers in the
			 state.
(b)
(1) Except as provided in Subdivision (2), no
			 small employer carrier or producer shall, directly or indirectly, engage in the
			 following activities:
a. Encouraging or
			 directing small employers to refrain from filing an application for coverage
			 with the small employer carrier because of the health status, claims
			 experience, industry, occupation or geographic location of the small
			 employer.
b. Encouraging or
			 directing small employers to seek coverage from another carrier because of the
			 health status, claims experience, industry, occupation or geographic location
			 of the small employer.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.09 - Status Of Carriers As Small Employer Carriers

Current through Register Vol. 42, No. 9, June 28, 2024
(a) Within thirty (30) days after the
			 effective date of the Act, each carrier providing health benefit plans in this
			 state shall make a filing with the Commissioner indicating whether the carrier
			 intends to operate as a small employer carrier in this state under the terms of
			 this regulation.
(b) Subject to
			 Subsection (c), a carrier shall not offer health benefit plans to small
			 employers, or continue to provide coverage under health benefit plans
			 previously issued to small employers in this state, unless the filing provided
			 pursuant to Subsection (a) indicates that the carrier intends to operate as a
			 small employer carrier in this state.
(c) If the filing made pursuant Subsection
			 (a) indicates that a carrier does not intend to operate as a small employer
			 carrier in this state, the carrier may continue to provide coverage under
			 health benefit plans previously issued to small employers in this state only if
			 the carrier complies with all of the following provisions:
(1) The carrier complies with the
			 requirements of this Regulation with respect to each of the health benefit
			 plans previously issued to small employers by the carrier.
(2) The carrier provides coverage to each new
			 entrant to a health benefit plan previously issued to a small employer by the
			 carrier. The provisions of this Regulation shall apply to the coverage issued
			 to such new entrants.
(3) The
			 carrier complies with the requirements of Sections 10 and 11 of this regulation
			 as they apply to small employers whose coverage has been terminated by the
			 carrier and to individuals and small employers whose coverage has been limited
			 or restricted by the carrier.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.10 - Restoration Of Terminated Coverage

Current through Register Vol. 42, No. 9, June 28, 2024
(a)
(1)
			 Except as provided in Subdivision (2), a small employer carrier shall, as a
			 condition of continuing to transact business in this state with small
			 employers, offer to provide a health benefit plan as described in Subsection
			 (c) to any small employer whose coverage was terminated or not renewed by such
			 small employer carrier after January 31, 1997.
(2) The offer required under Subdivision (1)
			 shall not be required with respect to a health benefit plan that was not
			 renewed for either of the following reasons:
a. The health benefit plan was not renewed
			 for reasons permitted in Section 6 of this Regulation.
b. The nonrenewal was a result of the small
			 employer voluntarily electing coverage under a different health benefit
			 plan.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.11 - Restrictive Riders

Current through Register Vol. 42, No. 9, June 28, 2024
A restrictive rider, endorsement or other provision that would
				violate the provisions of Paragraph b. of Subdivision (5) of Subsection (c) of
				Section 7 of this Regulation and that was in force on the effective date of
				this regulation may not remain in force beyond the first anniversary date of
				the health benefit plan subject to the restrictive provision that follows the
				effective date of this regulation. A small employer carrier shall provide
				written notice to those small employers whose coverage will be changed pursuant
				to this subsection at least thirty (30) days prior to the required change to
				the health benefit plan.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-52-21.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.12 - Separability

Current through Register Vol. 42, No. 9, June 28, 2024
If any provision of this Regulation or the application thereof
				to any person or circumstances is for any reason held to be invalid, the
				remainder of the Regulation and the application of its provisions to other
				persons or circumstances shall not be affected thereby.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-52-21.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-116 - ALABAMA SMALL EMPLOYER ALLOCATION PROGRAM › Section 482-1-116-.13 - Effective Date

Current through Register Vol. 42, No. 9, June 28, 2024
The provisions of this Regulation shall become effective
				October 1, 2001, upon its approval by the Commissioner of Insurance, with the
				concurrence of the State Board of Health, and upon its having been on file as a
				public document in the office of the Secretary of State for ten days.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-52-21.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.01 - Authority And Short Title

Current through Register Vol. 42, No. 9, June 28, 2024
This chapter is adopted pursuant to Section
				27-2-17,
Code of Ala.
				1975
. This chapter shall be known and may be cited as the Alabama
				Credit Life and Disability Insurance Regulation.
Author
: Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.02 - Purpose

Current through Register Vol. 42, No. 9, June 28, 2024
The purpose of this chapter is to: establish guidelines for
				insurers and creditors that offer credit life insurance and credit disability
				insurance, as defined in this chapter, provided by the creditors to debtors;
				and interpret and implement certain Alabama statutes, including, but not
				limited to, the Alabama Consumer Credit Act and the Alabama Small Loan Act,
				with respect to credit life and disability insurance provided under those
				statutes. It is acknowledged that other types of credit insurance may be issued
				or sold, for example, credit property insurance; however, those other types of
				credit insurance are not covered by this chapter. Nothing in this chapter is
				intended to prohibit or discourage reasonable competition.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.03 - Applicability And Scope

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All credit
			 life insurance and credit disability insurance issued or sold in connection
			 with credit transactions primarily for personal, family or household purposes
			 shall be subject to the provisions of this chapter, except:
(a) Insurance sold as an isolated transaction
			 on the part of the insurer and not related to an agreement or a plan for
			 insuring debtors of the creditor.
(b) Insurance for which no identifiable
			 charge is made to the debtor.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.05 - Types Of Consumer Credit Insurance

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The types of consumer credit insurance
			 defined in Rule
			 482-1-117-.04 may each be written
			 separately, jointly, or in combination with other types of credit insurance on
			 an individual policy or group policy basis, whether or not the other types of
			 credit insurance are subject to this chapter.
(2) There are two categories of credit life
			 insurance:
(a) Group Credit Life Insurance. A
			 policy of credit life insurance issued to a creditor, who shall be deemed the
			 policyholder, to insure debtors of the creditor, subject to the following
			 requirements:
1. The debtors eligible for
			 insurance under the policy shall be all of the debtors of the creditor or all
			 of any class or classes thereof. The policy may provide that the term "debtors"
			 shall include the debtors of one or more affiliates.
2. The premium for the policy shall be paid
			 by the policyholder, either from the creditor's funds or from charges collected
			 from the insured debtors, or from both.
3. A policy may reserve to the insurer the
			 right to require evidence of individual insurability.
4. The insurance shall be payable to the
			 policyholder. Such payment shall reduce or extinguish the unpaid indebtedness
			 of the debtor to the extent of such payment.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.06 - Amount Of Consumer Credit Insurance

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Credit Life Insurance.
(a) The maximum amount of credit life
			 insurance that may be written in connection with a consumer loan or consumer
			 credit sale which is to be repaid in substantially equal installments shall at
			 no time exceed the greater of the following:
1. The approximate unpaid balance of the
			 debt, excluding unearned finance charges, if any.
2. The approximate unpaid scheduled balance
			 of the debt, excluding unearned finance charges, if any, plus the amount of one
			 scheduled payment.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.07 - Term Of Consumer Credit Insurance

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Effective Date of Coverage.
(a) For consumer credit insurance made
			 available to and elected by the debtor before or contemporaneous with a credit
			 transaction to which the insurance relates, the term of the insurance shall,
			 subject to acceptance by the insurer, commence on the date when the debtor
			 becomes obligated to the creditor, except that when evidence of individual
			 insurability is required and such evidence is received by the insurer more than
			 thirty (30) days after the date when the debtor becomes obligated to the
			 creditor, the term of the credit insurance may commence on the date on which
			 the insurance company determines the evidence to be satisfactory.
(b) For insurance coverage made available to
			 and elected by the debtor on a date subsequent to the date of the consumer
			 credit transaction to which the insurance relates, the insurance shall, subject
			 to acceptance by the insurer, commence on a date not earlier than the date the
			 election is made by the debtor nor later than thirty (30) days following the
			 date on which the insurance company accepts the risk for coverage, according to
			 an objective method such as one related to a particular date within a billing
			 or repayment cycle or a calendar month.
(c) Notwithstanding the provisions of
			 Subparagraphs (a) and (b) of this Paragraph (1), when a group policy provides
			 coverage with respect to debts existing on the policy effective date, the
			 insurance relating to the debt shall not commence before the effective date of
			 the group policy.
(d) No charge for
			 insurance shall be retained with respect to any time prior to commencement of
			 the consumer credit insurance to which the charge is related. If a charge is
			 made and the debtor's application for insurance is subsequently rejected or
			 delayed, an appropriate refund of the premium charge shall be made to the
			 debtor within thirty (30) days after a determination that the refund is
			 due.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.08 - Provisions Of Policies And Certificates Of Insurance

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All consumer credit insurance shall be
			 evidenced by an individual policy or a group certificate of insurance which
			 shall be delivered to the debtor.
(2) The individual policy or group
			 certificate shall, in addition to other requirements of law, set forth all of
			 the following:
(a) The name and home office
			 address of the insurer.
(b) The
			 name or names of the debtor or debtors, or in the case of a group certificate,
			 the identity by name or otherwise (e.g., loan number) of the debtor or
			 debtors.
(c) The premium rate and
			 basis of calculation or the premium or amount of payment to be paid by the
			 debtor, separately for each kind of coverage or for all coverages in a
			 package.
(d) A full description of
			 the coverage or coverages including the amount and term thereof, and any
			 exceptions, limitation and exclusions.
(e) A statement that the benefits shall be
			 paid to the creditor to reduce or extinguish the unpaid debt and, whenever the
			 amount of insurance benefit exceeds the unpaid debt that any such excess shall
			 be payable to a beneficiary, other than the creditor, named by the debtor, or
			 to the debtor's estate.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.10 - Premiums

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All schedules
			 of rates, premiums or identifiable charges on all consumer credit insurance
			 issued and sold in this State shall be filed for informational purposes with
			 the Commissioner by the concerned insurer. An insurer may revise its schedules
			 of rates or premiums from time to time, and shall file the revised schedules
			 with the Commissioner. No insurer shall issue any consumer credit insurance
			 policy for which the rate or premium exceeds that determined by the schedules
			 of the insurer as then on file with the Commissioner.
(2) The Superintendent promulgates maximum
			 rates for credit life insurance for consumer loans and consumer credit sales.
			 The rates for credit life insurance for lease transactions shall be the rates
			 filed with the Commissioner pursuant to Rule
			 482-1-117-.09 unless disapproved
			 by the Commissioner. The maximum rates shall apply to a plan of credit life
			 insurance offered to all eligible debtors, with or without evidence of
			 individual insurability, which provides the following:
(a) No exclusions or limitations other than
			 the following:
1. An exclusion for death due
			 to suicide within one year after the effective date of coverage.
2. In a group policy, an exclusion for death
			 due to a condition for which the insured debtor received consultation,
			 diagnosis or treatment from a doctor within six months before the effective
			 date of coverage and from which death occurs within six months after the
			 effective date of coverage, but only if and to the extent that the amount of
			 coverage to which it would otherwise apply in the absence of this limitation
			 exceeds $1,000.00; provided, however, that no such exclusion shall apply to any
			 insurance that becomes effective within six (6) months following the debtor's
			 having furnished evidence of individual insurability to the insurer.
3. For the purposes of the exclusions, the
			 effective date of coverage for each part of the insurance attributable to a
			 different advance under an open-end credit plan is the date on which the
			 advance occurs.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.11 - Refunds

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 requirements of the consumer credit insurance law that refund formulas be filed
			 with the Commissioner shall be considered fulfilled if the refund formulas are
			 set forth in the individual policy or group certificate filed with the
			 Commissioner.
(2) Each individual
			 policy or group certificate shall provide for a refund in the event of
			 termination of the insurance prior to the scheduled maturity date of the
			 insurance and upon notice to the insurer. The refund of an amount paid by or
			 charged to the debtor for insurance shall be paid or credited promptly to the
			 person entitled thereto; provided, however, that no refund need be made which
			 would be less than that established by the Superintendent, or with respect to
			 leases, less than $1.00. The formula to be used in computing the refund shall
			 be filed with and approved by the Commissioner. A formula filed and approved in
			 accordance with this rule shall be deemed to be in compliance in all respects
			 with the laws of this State.
(3)
			 The refund of the premium or the amount charged to the debtor for insurance
			 provided on a single premium basis shall be calculated by multiplying the
			 original single premium, charge or periodic payment by the appropriate refund
			 factor.
(a) In determining the refund, if
			 less than 15 days of insurance coverage have been provided during the credit
			 transaction month, no charge shall be made for that month. If 15 or more days
			 of coverage have been provided during the credit transaction month, a full
			 month may be charged.
(b) For level
			 term credit life insurance, the refund shall be no less than the refund
			 computed based on a pro rata basis.
(c) For decreasing term credit life insurance
			 and credit disability insurance provided on the single premium basis, the
			 refund shall be no less than the refund computed, in the discretion of the
			 insurer, either on the basis of the Rule of 78s or an actuarial
			 basis.
(d) For any plans not listed
			 above, the refund method shall be the "Actuarial Method" and the formula shall
			 be filed with the Commissioner.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.12 - Issuance Of Policies

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All
			 policies of consumer credit insurance shall be delivered or issued for delivery
			 in this state only by an insurer authorized to engage in the business of
			 insurance in this state. Only a life insurer authorized for life insurance in
			 this state can issue credit life insurance policies, whereas credit disability
			 insurance policies can be issued by life insurers authorized for disability
			 insurance or by casualty insurers also authorized for disability
			 insurance.
(2) Each policy of
			 insurance must contain a provision allowing a thirty-one (31) day grace period
			 within which to pay the premium.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.13 - Claims

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All claims
			 shall be promptly reported to the insurer or its designated claim
			 representative, and the insurer shall maintain adequate claim files. All claims
			 shall be settled as soon as reasonably possible and in accordance with the
			 terms of the insurance contract.
(2) All claims shall be paid either by draft
			 drawn upon the insurer, by electronic funds transfer, or by check of the
			 insurer to the order of the claimant to whom payment of the claim is due
			 pursuant to the policy provisions, or upon direction of such claimant to one
			 specified.
(3) No plan or
			 arrangement shall be used whereby any person, firm or corporation other than
			 the insurer or its designated claim representative shall be authorized to
			 settle or adjust claims. The creditor shall not be designated as claim
			 representative for the insurer in adjusting claims; provided, that a group
			 policyholder may, by arrangement with the group insurer, draw drafts, checks,
			 or electronic transfers in payment of claims due to the group policyholder
			 subject to audit and review by the insurer.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.14 - Duties Of An Insurer

Current through Register Vol. 42, No. 9, June 28, 2024
Except as otherwise prohibited by law, duties imposed upon an
				insurer within this chapter may be carried out by a creditor if the creditor is
				acting on behalf of the insurer, but nothing herein shall be deemed to require
				a creditor to carry out a duty imposed upon an insurer or to absolve an insurer
				of its obligations.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.15 - Licensed Insurance Agent

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All
			 policies of consumer credit insurance shall be solicited, negotiated and
			 effectuated by duly licensed agents and no commission or other compensation
			 shall be paid in connection with such insurance to any person other than such
			 licensed agent.
(2) As used in this
			 rule, the term agent shall not include persons who secure and furnish
			 information for the purpose of group life insurance, group or blanket health
			 insurance or for enrolling individuals in such plans, or issuing certificates
			 thereunder or otherwise assisting in administering such plans where no
			 commission is paid to such person for such services. These persons may enroll
			 debtors without any license; however, commissions may be paid on this business
			 only to licensed agents or agencies.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.16 - Rights And Treatment Of Debtors

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Termination of Group Consumer Credit
			 Insurance Policy.
(a) If a debtor is covered
			 by a group consumer credit insurance policy providing for the payment of single
			 premiums to the insurer, or any other premium payment method which prepays
			 coverage beyond one month, then provision shall be made by the insurer that in
			 the event of termination of the policy without replacement of coverage,
			 insurance coverage with respect to any debtor insured under the policy shall be
			 continued for the entire period for which the premium has been paid or the
			 premium shall be refunded as provided herein after at least thirty (30) days'
			 notice of termination.
(b) If a
			 debtor is covered by a group consumer credit insurance policy providing for the
			 payment of premiums to the insurer on a monthly basis, then the policy shall
			 provide that, in the event of termination of the policy, termination notice
			 shall be given to the insured debtor at least thirty (30) days prior to the
			 effective date of termination except where replacement of the coverage by the
			 same or another insurer in the same or greater amount takes place without lapse
			 of coverage. The insurer shall provide or cause to be provided this required
			 information to the debtor.
Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-117 - CREDIT LIFE AND DISABILITY INSURANCE › Section 482-1-117-.17 - Credit Disability Insurance Rates

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Premium rates for Credit Disability
			 Insurance shall be filed with the Commissioner and the creditor (person, firm
			 or corporation) shall not add any additional charge to the premium set by the
			 insurance company and on file with the Commissioner, for coverage to the
			 insured borrower or purchaser.
(2)
			 In the case of group Credit Disability Insurance, the amounts paid by the
			 insured borrower or purchaser for the insurance shall be consistent with the
			 premium set by the insurance company.
(3) In the case of individual Credit
			 Disability Insurance, the premium paid by the insured borrower or purchaser
			 shall not exceed the premium rate filed by the insurance company with the
			 Commissioner.
Author:
Reyn Norman, Associate
				Counsel
Statutory Authority:
Code of Ala.
				  1975
, §
										27-2-17.