reglab/statecodes huggingface dataset:
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.11 - Open Enrollment

Current through Rules and Regulations filed through June 27, 2024
(1) An issuer shall not deny or condition the
				issuance or effectiveness of any Medicare supplement policy or certificate
				available for sale in this state, nor discriminate in the pricing of a policy
				or certificate because of the health status, claims experience, receipt of
				health care, or medical condition of an applicant in the case of an application
				for a policy or certificate that is submitted prior to or during the six (6)
				month period beginning with the first day of the first month in which an
				individual is both 65 years of age or older and is enrolled for benefits under
				Medicare Part B. Each Medicare supplement policy and certificate currently
				available from an insurer shall be made available to all applicants who qualify
				under this subsection.
(2)
(a) If an applicant qualifies under
				Subsection (1) and submits an application during the time period referenced in
				Subsection (1) and, as of the date of application, has had a continuous period
				of creditable coverage of at least six (6) months, the issuer shall not exclude
				benefits based on a preexisting condition.
(b) If the applicant qualifies under
				Subsection (1) and submits an application during the time period referenced in
				Subsection (1) and, as of the date of application, has had a continuous period
				of creditable coverage that is less than six (6) months, the issuer shall
				reduce the period of any preexisting condition exclusion by the aggregate of
				the period of creditable coverage applicable to the applicant as of the
				enrollment date. The Secretary shall specify the manner of the reduction under
				this subsection.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.12 - Guaranteed Issue for Eligible Persons

Current through Rules and Regulations filed through June 27, 2024
(1) Guaranteed Issue
(a) Eligible persons are those individuals
				described in Subsection (2) who seek to enroll under the policy during the
				period specified in Subsection (3), and who submit evidence of the date of
				termination, disenrollment, or Medicare Part D enrollment with the application
				for a Medicare supplement policy.
(b) With respect to eligible persons, an
				issuer shall not deny or condition the issuance or effectiveness of a Medicare
				supplement policy described in Subsection (5) that is offered and is available
				for issuance to new enrollees by the issuer, shall not discriminate in the
				pricing of such a Medicare supplement policy because of health status, claims
				experience, receipt of health care, or medical condition, and shall not impose
				an exclusion of benefits based on a preexisting condition under such a Medicare
				supplement policy.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.13 - Standards for Claims Payment

Current through Rules and Regulations filed through June 27, 2024
(1) An issuer shall comply with Section
				1882(c)(3) of the Social Security Act (as enacted by Section 4081(b)(2)(C) of
				the Omnibus Budget Reconciliation Act of 1987 (OBRA) 1987, Pub. L. No. 100-203)
				by:
(a) Accepting a notice from a Medicare
				carrier on dually assigned claims submitted by participating physicians and
				suppliers as a claim for benefits in place of any other claim form otherwise
				required and making a payment determination on the basis of the information
				contained in that notice;
(b)
				Notifying the participating physician or supplier and the beneficiary of the
				payment determination;
(c) Paying
				the participating physician or supplier directly;
(d) Furnishing, at the time of enrollment,
				each enrollee with a card listing the policy name, number and a central mailing
				address to which notices from a Medicare carrier may be sent;
(e) Paying user fees for claim notices that
				are transmitted electronically or otherwise; and
(f) Providing to the Secretary of Health and
				Human Services, at least annually, a central mailing address to which all
				claims may be sent by Medicare carriers.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.14 - Loss Ratio Standards and Refund or Credit of Premium

Current through Rules and Regulations filed through June 27, 2024
(1) Loss Ratio
				Standards
(a)
1. A Medicare Supplement policy form or
				certificate form shall not be delivered or issued for delivery unless the
				policy form or certificate form can be expected, as estimated for the entire
				period for which rates are computed to provide coverage, to return to
				policyholders and certificate holders in the form of aggregate benefits (not
				including anticipated refunds or credits) provided under the policy form or
				certificate form:
(i) At least seventy-five
				percent (75%) of the aggregate amount of premiums earned in the case of group
				policies; or
(ii) At least
				sixty-five percent (65%) of the aggregate amount of premiums earned in the case
				of individual policies;
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.15 - Filing and Approval of Policies and Certificates and Premium Rates

Current through Rules and Regulations filed through June 27, 2024
(1) An issuer shall
				not deliver or issue for delivery a policy or certificate to a resident of this
				state unless the policy form or certificate form has been filed with and
				approved by the Commissioner in accordance with filing requirements and
				procedures prescribed by the Commissioner.
(2) An issuer shall file any riders or
				amendments to policy or certificate forms to delete outpatient prescription
				drug benefits as required by the Medicare Prescription Drug, Improvement, and
				Modernization Act of 2003 only with the Commissioner in the state in which the
				policy or certificate was issued.
(3) An issuer shall not use or change premium
				rates for a Medicare supplement policy or certificate unless the rates, rating
				schedule and supporting documentation have been filed with and approved by the
				Commissioner in accordance with the filing requirements and procedures
				prescribed by the Commissioner.
(4)
(a) Except as provided in Paragraph (b) of
				this subsection, an issuer shall not file for approval more than one form of a
				policy or certificate of each type for each standard Medicare supplement
				benefit plan.
(b) An issuer may
				offer, with the approval of the Commissioner, up to four (4) additional policy
				forms or certificate forms of the same type for the same standard Medicare
				supplement benefit plan, one for each of the following cases:
1. The inclusion of new or innovative
				benefits;
2. The addition of either
				direct response or agent marketing methods;
3. The addition of either guaranteed issue or
				underwritten coverage;
4. The
				offering of coverage to individuals eligible for Medicare by reason of
				disability.
(c) For the
				purposes of this section, a" type" means an individual policy, a group policy,
				an individual Medicare Select policy, or a group Medicare Select
				policy.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.16 - Permitted Compensation Arrangements

Current through Rules and Regulations filed through June 27, 2024
(1) An issuer or other entity may provide
				commission or other compensation to an agent or other representative for the
				sale of a Medicare supplement policy or certificate only if the first year
				commission or other first year compensation is no more than 200 percent of the
				commission or other compensation paid for selling or servicing the policy or
				certificate in the second year or period.
(2) The commission or other compensation
				provided in subsequent (renewal) years must be the same as that provided in the
				second year or period and must be provided for no fewer than five (5) renewal
				years.
(3) No issuer or other
				entity shall provide compensation to its agents or other producers and no agent
				or producer shall receive compensation greater than the renewal compensation
				payable by the replacing issuer on renewal policies or certificates if an
				existing policy or certificate is replaced.
(4) For purposes of this section,"
				compensation" includes pecuniary or non-pecuniary remuneration of any kind
				relating to the sale or renewal of the policy or certificate including but not
				limited to bonuses, gifts, prizes, awards, and finders fees.
O.C.G.A. Secs.
				  33-2-9,
				  33-43-3,
				  33-43-4,
				  33-43-5,
				  33-43-6.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.19 - Filing Requirements for Advertising

Current through Rules and Regulations filed through June 27, 2024
An issuer shall provide a copy of any Medicare supplement
				  advertisement intended for use in this state whether through written, radio or
				  television medium to the Commissioner of Insurance of this state for review or
				  approval by the Commissioner as provided in O.C.G.A. Section
				  33-43-7.
O.C.G.A. Secs.
				  33-2-9,
				  33-43-3,
				  33-43-4,
				  33-43-5,
				  33-43-6.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.20 - Standards for Marketing

Current through Rules and Regulations filed through June 27, 2024
(1) An issuer, directly or through its
				producers, shall:
(a) Establish marketing
				procedures to assure that any comparison of policies by its agents or other
				producers will be fair and accurate.
(b) Establish marketing procedures to assure
				excessive insurance is not sold or issued.
(c) Display prominently by type, stamp or
				other appropriate means, on the first page of the policy the following:
"Notice to buyer: This policy may not cover all of your
				  medical expenses."
(d)
				Inquire and otherwise make every reasonable effort to identify whether a
				prospective applicant or enrollee for Medicare supplement insurance already has
				accident and sickness insurance and the types and amounts of any such
				insurance.
(e) Establish auditable
				procedures for verifying compliance with this Subsection (1).
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.21 - Appropriateness of Recommended Purchase and Excessive Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) In recommending
				the purchase or replacement of any Medicare supplement policy or certificate an
				agent shall make reasonable efforts to determine the appropriateness of a
				recommended purchase or replacement.
(2) Any sale of a Medicare supplement policy
				or certificate that will provide an individual more than one Medicare
				supplement policy or certificate is prohibited.
(3) An issuer shall not issue a Medicare
				supplement policy or certificate to an individual enrolled in Medicare Part C
				unless the effective date of the coverage is after the termination date of the
				individual's Part C coverage.
O.C.G.A. Secs.
				  33-2-9,
				  33-43-3,
				  33-43-4,
				  33-43-5,
				  33-43-6.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.22 - Reporting of Multiple Policies

Current through Rules and Regulations filed through June 27, 2024
(1) On or before March 1 of each year, an
				issuer shall report the following information for every individual resident of
				this State for which the issuer has in force more than one Medicare supplement
				policy or certificate:
(a) Policy and
				certificate number, and
(b) Date of
				issuance.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.23 - Prohibition Against Preexisting Conditions, Waiting Periods, Elimination Periods and Probationary Periods in Replacement Policies or Certificates

Current through Rules and Regulations filed through June 27, 2024
(1) If a Medicare
				supplement policy or certificate replaces another Medicare supplement policy or
				certificate, the replacing issuer shall waive any time periods applicable to
				preexisting conditions, waiting periods, elimination periods and probationary
				periods in the new Medicare supplement policy or certificate to the extent such
				time was spent under the original policy.
(2) If a Medicare supplement policy or
				certificate replaces another Medicare supplement policy or certificate that has
				been in effect for at least six (6) months, the replacing policy shall not
				provide any time period applicable to preexisting conditions, waiting periods,
				elimination periods and probationary periods.
O.C.G.A. Secs.
				  33-2-9,
				  33-43-10.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.24 - Prohibition Against Use of Genetic Information and Requests for Genetic Testing

Current through Rules and Regulations filed through June 27, 2024
This Section applies to all policies with policy years
				  beginning on or after this Regulation becomes effective.
(1) An issuer of a Medicare supplement policy
				or certificate;
(a) shall not deny or
				condition the issuance or effectiveness of the policy or certificate (including
				the imposition of any exclusion of benefits under the policy based on a
				pre-existing condition) on the basis of the genetic information with respect to
				such individual; and
(b) shall not
				discriminate in the pricing of the policy or certificate (including the
				adjustment of premium rates) of an individual on the basis of the genetic
				information with respect to such individual.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.25 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any provision of this regulation or the application
				  thereof to any person or circumstance is for any reason held to be invalid, the
				  remainder of the regulation and the application of such provision to other
				  persons or circumstances shall not be affected thereby.
O.C.G.A. Secs.
				  33-2-9,
				  33-43-3 to
				  33-43-6.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Appendix (120-2-8) B - FORM FOR REPORTING MEDICARE SUPPLEMENT POLICIES

Current through Rules and Regulations filed through June 27, 2024
Company Name: ______________________________
Address: ______________________________
______________________________
Phone Number: ______________________________
Due March 1, annually
The purpose of this form is to report the following
				  information on each resident of this state who has in force more than one
				  Medicare supplement policy or certificate. The information is to be grouped by
				  individual policyholder.
Policy and Certificate
Date of # Issuance
___________________________________
Signature
___________________________________
Name and Title (please type)
___________________________________
Date
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.01 - Profit-Sharing Policies

Current through Rules and Regulations filed through June 27, 2024
(1) No policy may be sold or approved for
				sale in Georgia on or after November 1, 1967 which provides that the
				policyholder will be eligible to participate in any future distribution of
				general corporate profits, with special advantage not available to person
				holding other types of policies issued by the company to individuals of the
				same class and equal expectation of life, nor may any policy be sold or
				approved for sale which provides that the policy holder will be eligible to
				participate in any future distribution of profits, savings, or unabsorbed
				portions of premium unless the requirements set for in Regulation
				120-2-10-.08 have been
				met.
(2) No policy may be sold or
				approved for sale in Georgia after said date which uses a policy name implying
				or that may reasonably be construed as implying that only a limited number or a
				limited class of persons will be eligible to buy such policy, unless such
				limitation is related to actuarially sound underwriting practices.
(3) This section is not intended to restrict
				or prohibit the sale in this State of insurance policies or annuities
				authorized by 33-14-16 and 33-25-6 of the Georgia Insurance Code, nor is it
				intended to restrict an insurer from issuing both participating and
				nonparticipating policies.
Ga. L. 1960, pp. 289,
				  305; O.C.G.A. Sec.
				  33-2-9.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.02 - Coupon Policies or Policies with Annual Pure Endowment Benefits

Current through Rules and Regulations filed through June 27, 2024
(1) No policy
				containing pure endowment benefits during the premium paying period (whether or
				not evidenced by coupons, passbooks, or other devices generally identified with
				savings, banking or investment institutions), shall be sold or approved for
				sale in Georgia on or after November 1, 1967 unless it meets the following
				requirements:
(a) Contains, clearly and
				prominently displayed in the proximity to the language used to set forth the
				consideration for the policy contract, the following statement or similar
				wording approved by the Commissioner, "the premium shown includes an additional
				annual (semi-annual, quarterly, monthly, weekly, etc.) premium of $________ for
				coupon (or pure endowment, whichever is applicable) benefits", inserting in the
				blank space the said additional premium.
(b) Payment of any annual pure endowment
				benefits shall not be made contingent upon the payment of premiums falling due
				on or after the time the annual pure endowment benefit has matured.
(c) The amount of each of the pure endowment
				benefits shall be expressed in dollar amounts and not as a "percentage" of any
				premium or benefit.
(d) No annual
				pure endowment shall be described as being a guaranteed dividend, nor as
				earning on the premium investment.
(e) The language and terminology of a policy
				which has pure endowment benefits therein shall not purport to represent the
				pure endowment benefit or benefits to be anything other than guaranteed
				insurance benefits for which premium is being paid by the
				policyholder.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.03 - Medical or Surgical Policies-Outpatient Coverage

Current through Rules and Regulations filed through June 27, 2024
(1) In accordance with Section
				33-29-6 of the Georgia Insurance
				Code this rule is applicable to all individual accident and sickness policies
				that provide coverage for medical or surgical procedures which are required to
				be performed on an inpatient basis at a licensed hospital. These policies shall
				contain provisions on their face or by endorsement to reimburse policyholders
				for any otherwise covered medical or surgical procedures when such procedures
				are performed on an outpatient basis in a facility described in said
				policies.
(2) In ordinary
				circumstances when the general condition of the patient would not be placed in
				jeopardy, admission to the hospital as a registered bed patient may not be
				necessary for the sole purpose of performing the procedures described
				herein.
(3) All personnel and
				providers of services shall be currently licensed to perform the services they
				provide, when such services require licensure or registration under applicable
				State laws.
(4) All facilities and
				equipment needed and used for and in the delivery of services which are
				required to be licensed and/or certified by law shall be so licensed and/or
				certified.
(5) The medical or
				surgical procedures listed in paragraph (7) below may be performed on an
				outpatient basis unless the following situations exist which may contraindicate
				the use of an outpatient setting:
(a) Presence
				of medical conditions which make prolonged postoperative observation by a nurse
				or skilled medical personnel a necessity (including but not limited to heart
				disease and severe diabetes).
(b)
				An unrelated procedure is being done simultaneously which itself requires
				surgical hospitalization.
(c) Lack
				of proper home postoperative care.
(d) Another surgical procedure could follow
				the initial procedure (including but not limited to a one-stage breast biopsy
				followed by a mastectomy).
(e)
				Technical difficulties as documented by admission or operative notes.
(f) A specific State statute or State Agency
				Rule(s) or Regulation(s) prohibits and/or limits said procedure.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.04 - Misleading Terms Prohibited

Current through Rules and Regulations filed through June 27, 2024
(1) Words such as "Founders Plan", "Charter
				Policy", "Expansion Plan", or "Profit-Sharing" have a tendency to mislead a
				purchaser or prospective purchaser of insurance or annuity to believe that he
				will receive something other than an insurance policy, annuity policy, or some
				benefit not available to other persons of the same class and expectation of
				life. Therefore, the use of such words or any other words that imply special
				privileges or benefits to the owner or insured persons not available to other
				persons of the same class and expectation of life in any insurance or annuity
				contract is prohibited.
(2) The use
				of such words in printed material or oral presentations in a context which will
				mislead a purchaser or prospective purchaser of insurance or annuity to believe
				he will receive something other than an insurance policy, annuity policy, or
				some benefit not available to a person of the same class and expectation of
				life is prohibited.
(3) Use of the
				words "investment" or "profit" in a context or under such circumstances or
				conditions as to have the capacity and tendency to mislead a purchaser or
				prospective purchaser to believe that he will receive, or that it is a
				possibility that he will receive, something other than an insurance policy,
				some benefit not provided in the policy, or some benefit not available to other
				persons of the same class and equal expectation of life is
				prohibited.
O.C.G.A. Sec.
				  33-2-9.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.05 - Describing Premiums as "Deposits", "Savings", or "Investments"

Current through Rules and Regulations filed through June 27, 2024
The use of the words "deposit," "savings," or "investments"
				  in any insurance or annuity contract, other printed material, or oral
				  presentation to refer to an amount where, in fact, the amount referred to is a
				  premium as defined in Section
				  33-24-1 of the Georgia Insurance
				  Code is prohibited unless:
(1) The
				premium payment establishes a debtor-creditor relationship between the
				insurance company and the policyholder; or
(2) The terms are used in conjunction with
				the word "premium" in such a manner as to clearly indicate the true character
				of the premium payment; or
(3) The
				terms are used in conjunction with a deposit administration plan.
Ga. L. 1960, pp. 289,
				  305; O.C.G.A. Sec.
				  33-2-9.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.07 - Agents, Payments for Furnishing Leads and Reference to Regulations

Current through Rules and Regulations filed through June 27, 2024
No insurer or agent holding a license as a permanent
				  insurance agent or other representative of an insurer shall:
(a) Pay, allow, or give, or offer to pay,
				allow, or give, directly or indirectly, any commission or other valuable
				consideration as a result of the sale of a life insurance or annuity policy to
				any person for furnishing a lead, unless such person is currently licensed in
				this State to sell life insurance.
(b) Apply for a temporary life insurance
				license, intending at the time of application not to qualify by written
				examination as a permanent insurance agent, provided, however, that this shall
				not prohibit the issuance of temporary licenses to persons entitled thereto as
				provided in Section
				33-23-8(1)(2)  of
				the Georgia Insurance Code.
(c)
				Sponsor for a life insurance license a person the sponsor could reasonably be
				expected to know has no intention of qualifying for a license as a permanent
				insurance agent, or a person whom the sponsor is not in good faith considering
				to contract with as a permanent insurance agent.
(d) Make any reference to the regulations of
				this Chapter in an attempt or effort to induce a policyholder to lapse, cancel
				or replace any insurance policy currently in force, or make any reference to
				these regulations in an attempt or effort to sell or induce any person to buy
				any particular kind or type of insurance policy approved for sale in
				Georgia.
O.C.G.A. Sec.
				  33-2-9.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.08 - Participating Policies

Current through Rules and Regulations filed through June 27, 2024
No participating life insurance or annuity policy shall be
				  sold or approved for sale in Georgia on or after January 1, 1968 unless each of
				  the following requirements has been met:
(a) There shall be filed with the
				Commissioner a participating scale or formula pursuant to which the right to
				and extent of participation of policyholders of such participating insurance
				policy shall be determined. Such participating scale or formula shall be
				reviewed by the Company's actuary not less frequently than each five years and
				shall then be amended, if necessary, to reflect the Company's current
				experience. Any change or amendment of such participating scale or formula
				shall be filed with a statement of the reasons in support of such proposed
				change or amendment.
(b) There
				shall be filed with the Commissioner the verified certificate of an actuary
				attesting that the participating scale or formula required in subsection (a)
				above was prepared for such policy form or series of policy forms, is
				actuarially sound and based upon a reasonable classification not unfairly
				discriminating as between policyholders within such classification.
(c) There shall be filed with the
				Commissioner a verified certificate of a duly authorized officer of the insurer
				attesting that the participating scale or formula required by subsection (a)
				above will be the basis upon which the insurer will annually determine the
				right to and extent of participation by the policyholders of such policy form
				or series of policy forms.
(d)
				Completion of Schedule M, including the footnote requirement, of the Annual
				Statement required to be filed with the Commissioner and the certification of
				the actuary, together with that of other executive officers, to the Annual
				Statement or specifically Schedule M thereof, shall constitute compliance with
				(a), (b) and (c) above.
O.C.G.A. Sec.
				  33-2-9.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.09 - Life, Annuities and Accident and Sickness Insurance Policy Language Simplification Standards

Current through Rules and Regulations filed through June 27, 2024
(1) The purpose of this Rule is to establish
				minimum ease of reading standards, pursuant to O.C.G.A. Sections
				33-2-9 and
				33-3-25, for language used in
				policies, contracts, coverage booklets provided by insurers to certificate
				holders, and certificates of life insurance, accident and sickness insurance,
				credit life insurance and credit accident and sickness insurance delivered or
				issued for delivery in this State on and after January 1, 1984. This Rule is
				not intended to increase the risk assumed by insurance companies or other
				entitles subject to this Rule or to supersede their obligation to comply with
				the substance of other insurance legislation applicable to life, annuities,
				accident and sickness, credit life or credit accident and sickness insurance
				policies. This Rule is not intended to impede flexibility and innovation in the
				development of policy forms or content or to lead to the standardization of
				policy forms or content.
(2) As
				used in this Rule:
(a) 'Policy' or 'policy
				form' means any policy contract, plan or agreement of life, annuities or
				accident and sickness insurance, including credit life and credit accident and
				sickness insurance, delivered or issued for delivery in this State by any
				company subject to this Rule; any certificate, contract or policy issued by a
				fraternal benefit society; any coverage booklet provided by insurers to
				certificate holders or any certificate issued pursuant to a group insurance
				policy delivered or issued for delivery in this State.
(b) 'Company' or insurer' means any life or
				accident and sickness insurance company, fraternal benefit society, nonprofit
				medical service corporation, nonprofit hospital service corporation, health
				care plan, dental care plan, vision care plan, pharmaceutical plan, health
				maintenance organization, and all similar type organizations.
(c) 'Commissioner' means the Insurance
				Commissioner of this State.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.10 - Group Coverage Discontinuance and Replacement

Current through Rules and Regulations filed through June 27, 2024
(1) This Rule is
				applicable to all insurance policies, subscriber contracts, and any other
				insurance coverage by whatever name called issued in this State or provided
				through an out-of-state multiple employer trust or arrangement by an insurer on
				a group or group-type basis covering persons as employees of employers or as
				members of unions (or associations).
(2) The term "group type basis" means a
				benefit plan, other than "salary budget" plans utilizing individual insurance
				policies or subscriber contracts, which meets the following conditions:
(a) Coverage is provided through insurance
				policies or subscriber contracts to classes of employees or members defined in
				terms of conditions pertaining to employment or membership.
(b) The coverage is not available to the
				general public and can be obtained and maintained only because of the covered
				person's membership in or in connection with the particular organization or
				group.
(c) There are arrangements
				for bulk payment of premiums or subscription charges to the insurer or
				non-profit service corporation.
(d)
				There is sponsorship of the plan by the employer, union (or
				association).
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.13 - Severability Provision

Current through Rules and Regulations filed through June 27, 2024
If any section or portion of a section of this Regulation or
				  the applicability thereof to any insurer, agent, counselor, broker, solicitor,
				  or circumstances is held invalid by a court of competent jurisdiction, the
				  remainder of the rules or the applicability of such provisions to other
				  insurers, agents, counselors, brokers, solicitors or circumstances, shall not
				  be affected thereby.
Ga. L. 1960, pp. 289,
				  305.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-10 - REGULATIONS REGARDING INSURANCE CONTRACT › Rule 120-2-10-.14 - Penalties

Current through Rules and Regulations filed through June 27, 2024
(1) Violation of
				these regulations by an insurer or by an officer of an insurer shall be deemed
				grounds for revocation of the insurer's certificate of authority as provided in
				Section 33-3-17(2)  of
				the Georgia Insurance Code, which shall be in addition to any other penalty
				provided by statute.
(2) Violation
				of these regulations by an agent, counselor, broker, solicitor or other
				representative of an insurer shall be deemed to be a fraudulent and dishonest
				practice, a material misrepresentation, an unfair method of competition and
				unfair and deceptive acts and practices in the business of insurance furnishing
				grounds for the revocation of his license.
Ga. L. 1960, pp. 289,
				  305. Ga. L. 1986, p. 688.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-11 - ADVERTISING OF LIFE INSURANCE AND ANNUITY CONTRACTS › Rule 120-2-11-.01 - Statutory Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation is made and promulgated by the Insurance
				  Commissioner pursuant to the authority set forth in Section
				  33-2-9 and Chapter 33-6 of the
				  Georgia Insurance Code.
Ga. L. 1960, pp. 289,
				  305, 394, 395.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-11 - ADVERTISING OF LIFE INSURANCE AND ANNUITY CONTRACTS › Rule 120-2-11-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
(1) To implement
				the Insurance Laws of the State of Georgia with respect to advertising in the
				solicitation, replacement, advisement and sale of life insurance and annuity
				contracts and to protect the interests of the public so that they will be able
				to more adequately make insurance purchasing decisions in their own best
				interest,
(2) To establish minimum
				standards of conduct and guidelines requiring truthful, complete, clear and
				accurate disclosure of all material and relevant information used or intended
				for use with respect to advertising in the solicitation, replacement,
				advisement or sale of life insurance or annuity contracts in this State,
				and
(3) To prevent the use of
				unfair methods of competition and unfair practices among insurers, agents and
				counselors with regard to advertising in the solicitation, replacement,
				advisement and sale of life insurance and annuity contracts in this
				State.
(4) The provisions of this
				regulation are not intended to discourage competition or comparison of life
				insurance and annuity contracts, but to provide for correct and truthful
				information and comparison in connection therewith.
Ga. L. 1960, pp. 289,
				  305, 394, 395.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-11 - ADVERTISING OF LIFE INSURANCE AND ANNUITY CONTRACTS › Rule 120-2-11-.03 - Definitions

Current through Rules and Regulations filed through June 27, 2024
For the purpose of these Regulations:
(1) "Commissioner" shall mean the Insurance
				Commissioner of the State of Georgia.
(2) "Policy" shall include any policy, plan,
				certificate, contract, agreement, statement of coverage, rider or endorsement
				which provides for life insurance or annuity benefits.
(3) "Insurer" shall include any individual,
				corporation, association, partnership, or any other legal entity which is
				defined as an "insurer" in the Georgia Insurance Code or issues life insurance
				or annuity contracts for delivery in this State.
(4) "Advertisement" shall be verbal, printed,
				written or other material or communication of any type from any source which is
				designed to create or has the effect of creating public interest in life
				insurance, annuities or in an insurer, agent or counselor, or induces or tends
				to induce the public to purchase, increase, modify, reinstate, surrender or
				retain a policy including, but not limited to:
(a) printed and/or published material,
				audiovisual material, mailing envelopes, descriptive literature used by an
				insurer in direct mail, newspapers, magazines, radio and television scripts,
				billboards or similar displays;
(b)
				descriptive literature and sales aids of all kinds issued, distributed or used
				by an insurer, agent or counselor, including but not limited to circulars,
				leaflets, booklets, depictions, illustrations, and form letters, including the
				use of pamphlets, brochures, books or portions thereof, authored by third
				parties;
(c) materials, statements
				or communications of any type used for the recruitment, training, and education
				of an insurer's sales personnel and agents which are designed to be used or are
				used to induce the public to purchase, increase, modify, reinstate, surrender
				or retain a policy; and
(d)
				prepared or extemporaneous sales talks, presentations, and material for use or
				used by sales personnel, agents or counselors.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-11 - ADVERTISING OF LIFE INSURANCE AND ANNUITY CONTRACTS › Rule 120-2-11-.04 - Applicability

Current through Rules and Regulations filed through June 27, 2024
(1) This Regulation
				shall apply to any life insurance policy or annuity contract or service or
				advice related thereto, wherein an "advertisement," as that term is
				hereinbefore defined, is used or is intended for presentation, distribution or
				dissemination in this State when such use, presentation, distribution or
				dissemination is made either directly or indirectly by or on behalf of an
				insurer, agent, or counselor as those terms are defined in the Georgia
				Insurance Code and this Regulation.
(2) Every insurer shall establish and at all
				times maintain a system of control over the content, form and method of
				dissemination of all advertisements of its policies. All such advertisements,
				regardless of by whom written, created, designed, or presented, shall be the
				responsibility of the insurer.
Ga. L. 1960, pp. 289,
				  305, 394, 395.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-11 - ADVERTISING OF LIFE INSURANCE AND ANNUITY CONTRACTS › Rule 120-2-11-.05 - Form and Content of Advertisements

Current through Rules and Regulations filed through June 27, 2024
(1) Advertisements shall be truthful and not
				misleading in fact or by implication. The form and content of an advertisement
				of a policy shall be sufficiently accurate, complete and clear so as to avoid
				deception or the capacity or tendency to mislead or deceive. Whether an
				advertisement has the capacity or tendency to mislead or deceive shall be
				determined by the Commissioner from the overall impression that the
				advertisement may be reasonably expected to create upon a person of average
				education or intelligence within the segment of the public to which it is
				directed.
(2) No advertisement
				shall use the terms "investment," "investment plan," "founder's plan," "charter
				plan," "expansion plan," "profit," "profits," "profit sharing," "deposit,"
				"interest plan," "savings," "savings plan," or other similar terms in
				connection with a policy in a context or under such circumstances or conditions
				as to have the capacity or tendency to mislead a purchaser or prospective
				purchaser of such policy or a policyholder to believe that he will receive, or
				that it is possible that he will receive, something other than a policy or some
				benefit not available to other persons of the same class and equal expectation
				of life, when such is not the fact.
Ga. L. 1960, pp. 289,
				  305, 394, 395.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-11 - ADVERTISING OF LIFE INSURANCE AND ANNUITY CONTRACTS › Rule 120-2-11-.07 - Identity of Insurer

Current through Rules and Regulations filed through June 27, 2024
(1) The name of the insurer shall be clearly
				identified and prominently displayed, and if any specific individual policy is
				advertised it shall be identified either by form number or other appropriate
				description. An advertisement shall not use a trade name, an insurance group
				designation, name of the parent company of the insurer, name of a particular
				division of the insurer, service mark, slogan, symbol, or other device or
				reference without disclosing the name of the insurer, if the advertisement
				would have the capacity or tendency to mislead or deceive as to the true
				identity of the insurer, or create the impression that a company other than the
				insurer would have any responsibility for the financial obligation under a
				policy.
(2) No advertisement shall
				use any combination of words, symbols, or physical materials which by their
				content, phraseology, shape, color, or other characteristics are so similar to
				a combination of words, symbols, or physical materials used by a governmental
				program or agency or otherwise appear to be of such a nature that they tend to
				mislead prospective insureds into believing that the solicitation is in some
				manner connected with such governmental program or agency.
(3) No advertisement shall use any
				combination of words, symbols, or physical materials which by their content,
				phraseology, shape, color, or other characteristics are so similar to a
				combination of words, symbols, or physical materials used by a non-insurance
				company with which the individual has a financial relationship or otherwise
				appear to be of such a nature that it tends to mislead or deceive prospective
				insureds into believing that the purchase of insurance is required by such
				company.
(4) An advertisement for
				any specific policy shall clearly inform the prospective purchaser of the full
				name of the insurance company which will issue the policy. An advertisement for
				the sale of life insurance by any agent shall clearly inform the prospective
				purchaser of the full name of all insurance companies which said agent is
				authorized to represent.
Ga. L. 1960, pp. 289,
				  305, 394, 395.