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 120-2-103 - CERTIFICATES OF INSURANCE › Rule 120-2-103-.07 - Prohibited Practices

Current through Rules and Regulations filed through June 27, 2024
(1) No person, wherever located, shall demand
				or request the issuance of a certificate of insurance from an insurer,
				insurance producer, or policyholder that contains any false or misleading
				information, or which purports to affirmatively or negatively amend, extend,
				modify or alter in any way the coverage or any other term or condition
				concerning the policy of insurance to which the certificate makes reference. A
				certificate of insurance shall not confer to a certificate holder new or
				additional rights beyond what the referenced policy expressly
				provides.
(2) No certificate of
				insurance shall contain references to or language from a construction or
				service contract, other than that referenced in the contract of insurance. The
				certificate may contain a reference or contract number from the construction or
				service contract for identification purposes only. This may include but not be
				limited to project number, project name, project description or a general
				description of work to be performed. Nothing in the certificate can refer to
				any language or contents in the construction or service contracts.
(3) Neither an insurer nor a producer shall
				be required to issue an opinion letter or other document in addition to or in
				lieu of a certificate of insurance. If any opinion letter or other such
				document is issued, however, it must meet the provisions of this regulation and
				Code Section
				33-24-19.1. Insurers and producers
				may provide the certificate holder with the certificate and an actual copy of
				the policy, insurance binder or relevant policy provision to demonstrate
				contractual compliance.
O.C.G.A. §
										33-2-9 and
				  33-24-19.1(b).
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 120-2-103 - CERTIFICATES OF INSURANCE › Rule 120-2-103-.08 - Penalties

Current through Rules and Regulations filed through June 27, 2024
Any person, no matter where located, who commits a violation
				  of this regulation or requests information to be provided which is in conflict
				  with this regulation may be subject to a fine not to exceed $5,000 per
				  violation.
O.C.G.A. §
										33-2-9 and
				  33-24-19.1(b).
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 120-2-103 - CERTIFICATES OF INSURANCE › Rule 120-2-103-.09 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any rule or portion of a rule in this chapter or the
				  applicability thereof to any particular circumstances is held invalid by a
				  court of competent jurisdiction, the remainder of the rules or the
				  applicability of such provision to other persons or circumstances shall not be
				  affected.
O.C.G.A. §
										33-2-9 and
				  33-24-19.1(b).
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 120-2-104 - PREMIUM RATES AND PATIENT PROTECTION AND AFFORDABLE CARE ACT › Rule 120-2-104-.01 - Statutory Authority

Current through Rules and Regulations filed through June 27, 2024
This chapter is made and promulgated by the Insurance
				  Commissioner pursuant to O.C.G.A. Sections
				  33-2-9,
				  33-29-22, and
				  33-30-13.
O.C.G.A. Sections
				  33-2-9,
				  33-29-22, and
				  33-30-13.
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 120-2-104 - PREMIUM RATES AND PATIENT PROTECTION AND AFFORDABLE CARE ACT › Rule 120-2-104-.02 - Purpose and Interpretation

Current through Rules and Regulations filed through June 27, 2024
The purpose of this chapter is to inform the public about the
				  correlation between anticipated health insurance premium rate increases and the
				  Patient Protection and Affordable Care Act ("PPACA"). Nothing in this chapter
				  prohibits an insurer from disclosing to a consumer as a part of its notice a
				  summary of the changes created by PPACA, including enhanced minimum benefits or
				  the possible cost-shifting components of PPACA.
O.C.G.A. Section
				  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 120-2-104 - PREMIUM RATES AND PATIENT PROTECTION AND AFFORDABLE CARE ACT › Rule 120-2-104-.03 - Individual Accident and Sickness Policies

Current through Rules and Regulations filed through June 27, 2024
(a) Notice of any premium increase shall be
				mailed or delivered to each holder of an individual accident and sickness
				insurance policy not less than 60 days prior to the effective date of such
				increase.
(b) Concurrently with any
				notice of premium increase or offer of new coverage because of discontinuance
				or termination of an existing plan of coverage, an insurer shall provide an
				estimate as to the amount or percentage of any premium increase which is
				attributable to the PPACA. Such notices shall include the following statement:
				"These increases are due to the federal Patient Protection and Affordable Care
				Act and not the enactment of any laws or regulations of the Governor of
				Georgia, the Georgia General Assembly, or the Georgia Department of
				Insurance."
(c) When determining
				estimates of the amount or percentage of premium increases which are
				attributable to the PPACA, insurers must analyze the following and may include
				additional relevant factors:
(1) The new taxes
				and fees imposed under PPACA;
(2)
				Policies being guaranteed issue with modified community rating;
(3) The Essential Health Benefits;
(4) The age rating bands;
(5) The effect of a 70% actuarial value
				(out-of-pocket limit impact factored);
(6) The impact of the individual mandate on
				the risk pool;
(7) The impact of
				subsidies on the risk pool; and
(8)
				The impact of the risk adjustment and reinsurance mechanisms in
				PPACA.
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 120-2-104 - PREMIUM RATES AND PATIENT PROTECTION AND AFFORDABLE CARE ACT › Rule 120-2-104-.04 - Small Group Accident and Sickness Policies

Current through Rules and Regulations filed through June 27, 2024
(a) Notice of the maximum amount of a group
				premium increase shall be mailed or delivered to the group policyholder and to
				each employer group or subgroup insured under the group policy not less than 60
				days prior to the effective date of such increase.
(b) Concurrently with any notice of premium
				increase or offer of new coverage because of discontinuance or termination of
				an existing plan of coverage, an insurer shall provide an estimate as to the
				amount or percentage of any premium increase which is attributable to the
				Patient Protection and Affordable Care Act. Such notices shall include the
				following statement: "These increases are due to the federal Patient Protection
				and Affordable Care Act and not the enactment of any laws or regulations of the
				Governor of Georgia, the Georgia General Assembly, or the Georgia Department of
				Insurance."
(c) When determining
				estimates of the amount or percentage of premium increases which are
				attributable to PPACA, insurers must analyze the following but may analyze
				additional relevant factors:
(1) Policies
				being issued using modified community rating;
(2) The Essential Health Benefits;
(3) The effect of a 70 percent actuarial
				value; and
(4) Taxes and
				fees;
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 120-2-104 - PREMIUM RATES AND PATIENT PROTECTION AND AFFORDABLE CARE ACT › Rule 120-2-104-.05 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any rule or portion of a rule in this chapter or the
				  applicability thereof to any particular circumstances is held invalid by a
				  court of competent jurisdiction, the remainder of the rules or the
				  applicability of such provision to other persons or circumstances shall not be
				  affected.
O.C.G.A. Sections
				  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 120-2-104 - PREMIUM RATES AND PATIENT PROTECTION AND AFFORDABLE CARE ACT › Rule 120-2-104-.06 - Repeal of Chapter

Current through Rules and Regulations filed through June 27, 2024
This chapter shall stand repealed on December 31,
				  2014.
O.C.G.A. Sections
				  33-2-9,
				  33-29-22, and
				  33-30-13.
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 120-2-105 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Rule 120-2-105-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
These regulations are promulgated pursuant to the authority
				  granted by O.C.G.A. §§
									33-2-9 and
				  33-65-4
.
O.C.G.A.
				  §§
											33-2-9,
				  33-65-4.
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 120-2-105 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Rule 120-2-105-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of these regulations are to set forth the
				  procedures for filing and the required contents of the Corporate Governance
				  Annual Disclosure ("CGAD"), deemed necessary by the Commissioner to carry out
				  the provisions of O.C.G.A. §
									33-65-1
et
				  seq
.
O.C.G.A.
				  §§
											33-2-9,
				  33-65-4.
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 120-2-105 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Rule 120-2-105-.03 - Definitions

Current through Rules and Regulations filed through June 27, 2024
When used in this regulation, the term:
(a) "Commissioner" means the Insurance
				Commissioner of the State of Georgia.
(b) "Insurance group" means those insurers
				and affiliates included within an insurance holding company system as defined
				in paragraph (5) of Code Section
				33-13-1.
(c) "Insurer" has the same meaning as set
				forth in Code Section
				33-1-2, except that it shall not
				include agencies, authorities or instrumentalities of the United States, its
				possessions and territories, the Commonwealth of Puerto Rico, the District of
				Columbia, or a state or political subdivision of a state.
(d) "Senior Management" means any corporate
				officer responsible for reporting information to the board of directors at
				regular intervals or providing this information to shareholders or regulators
				and shall include, for example and without limitation, the Chief Executive
				Officer ("CEO"), Chief Financial Officer ("CFO"), Chief Operations Officer
				("COO"), Chief Procurement Officer ("CPO"), Chief Legal Officer ("CLO"), Chief
				Information Officer ("CIO"), Chief Technology Officer ("CTO"), Chief Revenue
				Officer ("CRO"), Chief Visionary Officer ("CVO"), or any other "C" level
				executive.
O.C.G.A.
				  §§
											33-2-9,
				  33-65-4.
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 120-2-105 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Rule 120-2-105-.05 - Contents of Corporate Governance Annual Disclosure

Current through Rules and Regulations filed through June 27, 2024
(a) The insurer or insurance group shall be
				as descriptive as possible in completing the CGAD, with inclusion of
				attachments or example documents that are used in the governance process, since
				these may provide a means to demonstrate the strengths of their governance
				framework and practices.
(b) The
				CGAD shall describe the insurer's or insurance group's corporate governance
				framework and structure including consideration of the following:
(1) The Board and various committees thereof
				ultimately responsible for overseeing the insurer or insurance group and the
				level(s) at which that oversight occurs (
e.g.
, ultimate
				control level, intermediate holding company, legal entity, etc.). The insurer
				or insurance group shall describe and discuss the rationale for the current
				Board size and structure; and
(2)
				The duties of the Board and each of its significant committees and how they are
				governed (
e.g.
, bylaws, charters, informal mandates, etc.), as
				well as how the Board's leadership is structured, including a discussion of the
				roles of CEO and Chairman of the Board within the organization.
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 120-2-105 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Rule 120-2-105-.06 - Severability Clause

Current through Rules and Regulations filed through June 27, 2024
If any provision of these regulations, or the application
				  thereof to any person or circumstance, is held invalid, such determination
				  shall not affect other provisions or applications of these regulations which
				  can be given effect without the invalid provision or application, and to that
				  end the provisions of these regulations are severable.
O.C.G.A.
				  §§
											33-2-9,
				  33-65-4.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation is promulgated by the Commissioner of
				  Insurance pursuant to the authority set forth in O.C.G.A. §§
									33-2-9 and O.C.G.A §§
									33-20E.
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.02 - Scope and Purpose

Current through Rules and Regulations filed through June 27, 2024
This Regulation is made pursuant to the "Surprise Billing
				  Consumer Protection Act," which was passed to provide a mechanism to resolve
				  billing and payment disputes between insurers and out-of-network providers. It
				  will also establish a fair and equitable arbitration process to handle such
				  disputes. This Regulation applies only to "healthcare plans" and "state
				  healthcare plans," as defined in this Regulation. Nothing in this Regulation
				  shall reduce a covered person's financial responsibilities concerning ground
				  ambulance transportation. Failure of an insurer to comply with the provisions
				  of Chapter 20E of Title 33 shall be deemed an unfair trade practice as defined
				  in 33-6-4.
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.03 - Definitions

Current through Rules and Regulations filed through June 27, 2024
For the purposes of this Regulation, the following
				  definitions apply:
(1) "Balance bill"
				means the amount that a non-participating provider charges for services
				provided to a covered person. Such amount equals the difference between the
				amount paid or offered by the insurer and the amount of the non-participating
				provider's bill charge but shall not include any amount for coinsurance,
				copayments, or deductibles due by the covered person.
(2) "Contracted amount" means the median
				in-network amount paid during the 2017 calendar year by an insurer for the
				emergency or non-emergency services provided by in-network providers engaged in
				the same or similar specialties and provided in the same or nearest
				geographical area. The Department shall annually adjust such amount for
				inflation, which may be based on the Consumer Price Index, and shall not
				include Medicare or Medicaid rates.
(3) "Covered person" means an individual who
				is insured under a healthcare plan.
(4) "Emergency medical provider" means any
				physician licensed by the Georgia Composite Medical Board who provides
				emergency medical services and any other healthcare provider licensed or
				otherwise authorized in this state to render emergency medical
				services.
(5) "Emergency medical
				services" means medical services rendered after the recent onset of a medical
				or traumatic condition, sickness, or injury exhibiting acute symptoms of
				sufficient severity, including, but not limited to, severe pain, that would
				lead a prudent layperson possessing an average knowledge of medicine and health
				to believe that his or her condition, sickness, or injury is of such a nature
				that failure to obtain immediate medical care could result in:
(a) Placing the patient's health in serious
				jeopardy;
(b) Serious impairment to
				bodily functions;
(c) Serious
				dysfunction of any bodily organ or part.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.04 - ERISA Exempt Plans

Current through Rules and Regulations filed through June 27, 2024
ERISA Exempt Plans subject to the exclusive jurisdiction of
				  federal law and rules are not eligible for review under the "Surprise Billing
				  Consumer Protection Act."
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.05 - Emergency Services

Current through Rules and Regulations filed through June 27, 2024
(1) Insurers shall pay covered emergency
				medical services for covered persons regardless of whether the provider or
				facility is participating or non-participating in their network according to
				this Regulation. Such an insurer shall make such payment without prior
				authorization and without retrospective payment denial for emergency medical
				services deemed to be medically necessary.
(2) If a covered person receives emergency
				medical services from a non-participating provider, such person shall not be
				liable to the non-participating provider or facility for any amount exceeding
				such person's deductible, coinsurance, copayment, or other cost-sharing amount
				as determined by such person's policy. The amount payable by an insurer for
				emergency medical services paid directly to the provider shall be the greater
				of:
(a) The verifiable median contracted
				amount paid by all eligible insurers for similar services calculated by a
				vendor utilized and chosen by the Commissioner;
(b) The most recent verifiable amount agreed
				to by the insurer and the non-participating emergency medical provider for the
				same services during which time the provider was in-network with the insurer;
				(if applicable)
(c) A higher amount
				as the insurer may deem appropriate given the complexity and circumstances of
				the services provided.
Any amount payable by an insurer under this section for
				  emergency medical services shall not include any amount of coinsurance,
				  copayment, or deductible owed by the covered person or already paid by such
				  person.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.06 - Non-emergency Medical Services

Current through Rules and Regulations filed through June 27, 2024
(1) If the provisions of 120-2-106.08 are
				met, an insurer that provides any benefits to covered persons with respect to
				non-emergency medical services shall pay for such services in the event that
				such services resulted in a surprise bill regardless of whether the healthcare
				provider furnishing non-emergency medical services is a participating provider
				with respect to non-emergency medical services.
(2) In the event a covered person receives
				care in a facility that generates a surprise bill for non-emergency medical
				services from a non-participating medical provider, the non-participating
				provider shall collect or bill the covered person no more than such person's
				deductible, coinsurance, copayment, or other cost-sharing amount as determined
				by such person's policy. The insurer shall directly pay such provider the
				greater of:
(a) The verifiable median
				contracted amount paid by all eligible insurers for similar services calculated
				by a vendor utilized and chosen by the Commissioner;
(b) The most recent verifiable amount agreed
				to by the insurer and the non-participating emergency medical provider for the
				same services during which time the provider was in-network with the insurer;
				(if applicable)
(c) A higher amount
				as the insurer may deem appropriate given the complexity and circumstances of
				the services provided.
Any amount that the insurer pays the non-participating
				  provider under this subsection shall not be required to include any amount of
				  coinsurance, copayment, or deductible owed by the covered person or already
				  paid by such person.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.07 - Balance Billing provision for covered benefits from non-participating providers

Current through Rules and Regulations filed through June 27, 2024
No healthcare plan shall deny or restrict covered benefits
				  from a participating provider to a covered person solely because the covered
				  person obtained treatment from a non-participating provider leading to a
				  balance bill. Notice of such protection shall be provided in writing to the
				  covered person by the insurer.
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.08 - Covered Person Choosing to receive Non-emergency medical Services from a non-participating provider, Referrals and Procedures

Current through Rules and Regulations filed through June 27, 2024
(1) Nothing in this
				chapter shall reduce a covered person's financial responsibilities in the event
				that such covered person chose to receive non-emergency medical services from
				an out-of-network provider. Such services shall not be considered a surprise
				bill for the purpose of this chapter.
(2) The covered person's choice described in
				subsection (1) of this Code section must:
(a)
				Be documented through such covered person's written and oral consent in advance
				of the provision of such services; and
(b) Occur only after such person has been
				provided with an estimate of the potential charges.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.09 - Claims Database

Current through Rules and Regulations filed through June 27, 2024
Pursuant to O.C.G.A
				  33-20E-8(a)
				   appropriations for an all claims database
				  were not provided, and subsection (b) of O.C.G.A
				  33-20E-8 will be triggered. The
				  Department will utilize a verifiable median contracted amount paid by all
				  eligible insurers for similar services calculated by a vendor utilized and
				  chosen by the Commissioner.
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.11 - Hospital Surprise Bill Rating

Current through Rules and Regulations filed through June 27, 2024
Insurers shall make available online and in print a health
				  benefit plan surprise bill rating for hospitals as required in Chapter 20C of
				  Title 33. For each hospital, health benefit plans shall clearly display a
				  rating denoting the health benefit plan surprise bill rating factor. This
				  factor shall range from 0, denoting no specialties are in-network, to 4, which
				  means all specialty groups are in-network. For any rating less than 4, the
				  health benefit plan shall display which specialty group is not in-network by
				  marking the specialty with a red
X
and any specialty group that is
				  included by a green checkmark
X
. If a hospital does not provide
				  one of the qualified hospital-based specialties, the absence of that specialty
				  shall be designated by a green N/A. The factor and markings shall be clearly
				  displayed for the covered person or potential covered person to easily
				  understand. Qualified hospital-based specialty groups are medical groups that
				  include anesthesiologists, pathologists, radiologists, or emergency medicine
				  physicians. Any changes in the hospital rating factor shall be changed by the
				  health benefit plan within 30 days.
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-106 - SURPRISE BILLING › Rule 120-2-106-.12 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any section or any portion of a section of this Regulation
				  or the applicability thereof to any waiver or circumstances is held invalid by
				  any court of competent jurisdiction, the remainder of the rules or
				  applicability of such provisions shall not be affected.
O.C.G.A.
				  §§
											33-2-9,
				  33-20E.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.01 - Promulgation and Purpose

Current through Rules and Regulations filed through June 27, 2024
These rules and regulations of the Insurance Commissioner,
				  entitled "Insurance Written in Connection with Loans Under the Georgia
				  Installment Loan Act," are promulgated pursuant to the rulemaking authority of
				  the Insurance Commissioner, O.C.G.A.
				  33-2-9, and pursuant to the
				  Insurance Commissioner's authority under O.C.G.A. §
									7-3-11(3), as
				  amended in 2020.
O.C.G.A.
				  §§
											33-2-9,
				  7-3-11(3).
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.02 - General Regulations, All Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) Evidence of insurance. All insurance
				authorized and included in or incident to a loan contract made under the
				provisions of the Georgia Installment Loan Act shall be evidenced by a policy
				or certificate of insurance which shall be delivered to the borrower at the
				time the indebtedness is incurred. The policy and the certificate of insurance
				shall describe the amount and term of the coverage, the amount of the premium
				and a description of the coverage including any exceptions, limitations or
				restrictions. If a policy or certificate of insurance is not delivered to the
				borrower at the time the indebtedness is incurred, the insurer shall cause to
				be delivered to the borrower a policy or certificate of insurance within 30
				days of incurred indebtedness. An application or notice of proposed insurance
				form shall serve as a binder during the first 30 days of incurred
				indebtedness.
(2) If any loan
				within the Georgia Installment Loan Act is made in conjunction with the sale of
				insurance authorized and included in or incidental to the advancement of funds
				at the expense of the borrower, then the licensee shall provide to the borrower
				a separate written disclosure statement. The disclosure statement shall
				disclose, in no smaller than twelve-point type, the following:
(a) The cost to the borrower of any such
				insurance.
(b) A copy of the signed
				document shall be provided to the borrower, and the licensee shall retain the
				original in the loan file.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.03 - Credit Life Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) Coverage.
(a) Level term life insurance will pay the
				first beneficiary at the death of the insured the amount of the indebtedness,
				not exceeding the amount of insurance stated in the policy, and pay the second
				beneficiary the amount stipulated in excess of the indebtedness; or if there be
				no indebtedness, the full face amount of the policy shall be paid to the second
				beneficiary.
(b) Reducing term life
				insurance will pay the first beneficiary the amount of indebtedness, if any,
				owing by the insured to the first beneficiary at the time of the death of the
				insured.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.04 - Credit Accident and Sickness Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) Coverage. Credit accident and sickness
				insurance may be written on all loans made under the provisions of the Georgia
				Installment Loan Act. Provided, however, any such insurance written in
				connection with such a loan shall not provide for monthly benefits which exceed
				the amount of one monthly repayment installment loan.
(2) Rates.
(a) On loans where the actual amount of cash
				advanced is one hundred dollars ($100.00) or less, no credit accident and
				sickness insurance shall be written which provides a waiting period in excess
				of three (3) days, coverage shall be retroactive and no premium shall be
				charged for such insurance in excess of $3.06 per annum per five dollars
				($5.00) per month benefit unless otherwise authorized by law and applicable
				Rules and Regulations.
(b) On loans
				where the actual amount of cash advanced is in excess of one hundred dollars
				($100.00), no credit accident and sickness insurance shall be written which
				provides a waiting period in excess of seven days. Coverage shall be
				retroactive and no premium shall be charged for such insurance in excess of
				$2.10 per annum for five dollars ($5.00) per month benefit unless otherwise
				authorized by law and applicable Rules and Regulations. Provided, however, if
				the waiting period is three (3) days, no premium shall be charged for such
				insurance in excess of $3.06 per annum for five dollars ($5.00) per month
				benefit unless otherwise authorized by law and applicable Rules and
				Regulations.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.05 - Household Goods Fire Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) Coverage.
(a) Dual interest household goods insurance
				shall insure both the creditor and the debtor as their interest may appear
				against loss or damage caused by fire, lightning and collision;
(b) Single interest household goods insurance
				shall insure only the interest of the Creditor Loss Payee or assignees against
				loss or damage caused by fire, lightning and collision.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.06 - Automobile Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) Coverage.
(a) Dual interest automobile insurance shall
				insure both creditor and debtor as their interest may appear against loss or
				damage caused by fire, theft, and collision.
(b) Single interest automobile insurance
				shall insure only the interest of the creditor loss payee or assignee against
				loss caused by fire, theft and collision.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.07 - Non-Recording Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) No licensee shall charge any recording
				fee, or actual premiums on insurance used in lieu of such recording fee unless
				the amount of such fee or premium be fully set forth in the copy of the loan
				contract or voucher furnished to the borrower.
(2) Non-recording insurance may be written on
				loans with a face amount in excess of $100.00. Such insurance may be written in
				lieu of recording the security instrument with the proper "public official or
				agency of the State" and protects the lender against losses.
(3) Rates. The rates for such non-recording
				insurance shall be those which meet the applicable standards and requirements
				contained in Chapter 9 of Title 33 of the Official Code of Georgia Annotated
				and the applicable Rules and Regulations of the Georgia Insurance
				Department.
(4) Restrictions.
(a) If no security exists on a loan, charges
				for non-recording insurance are illegal.
(b) A licensee shall not select non-recording
				insurance instead of recording if the choice will cost the borrower more
				money.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.08 - Repossession Expenses

Current through Rules and Regulations filed through June 27, 2024
The actual and reasonable expenses of repossessing, storing
				  and selling any collateral pledged as security under the Georgia Installment
				  Loan Act shall not exceed the expenses of repossessing, storing and selling
				  recoverable under other provisions of law.
O.C.G.A.
				  §§
											33-2-9,
				  7-3-11(3).
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.09 - Insurance Claims Register

Current through Rules and Regulations filed through June 27, 2024
Each licensee of the Georgia Installment Loan Act shall
				  maintain on a daily basis an insurance claims register. There shall be recorded
				  on this register, with respect to any and all claims against insurance sold in
				  connection with a loan made under the provisions of the Georgia Installment
				  Loan Act, the loan account number, the name of the borrower/insured, the type
				  of claim filed, the date of loss, the amount of claim, the date the claim was
				  filed with the insurer, the date the claim was paid, the amount of the claim
				  payment and the name and address of the person or entity to whom the proceeds
				  of the claim payment were disbursed. In addition to the foregoing information,
				  if a claim is filed against credit life insurance coverage, the date of the
				  insured's death shall be shown on the insurance claims register. In addition to
				  the foregoing information, if a claim is filed against credit life insurance
				  coverage, the date of the insured's death shall be shown on the insurance
				  claims register. In addition to the foregoing information, if a claim is filed
				  against credit accident and sickness insurance coverage, the number of days for
				  which the disability claim is filed shall be recorded on the insurance claims
				  register. Register will include all denied claims and all paid
				  claims.
O.C.G.A.
				  §§
											33-2-9,
				  7-3-11(3).
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.10 - Insurance Permitted

Current through Rules and Regulations filed through June 27, 2024
(1) With respect to any consumer loan
				transaction, the creditor shall not require any insurance other than insurance
				covering the loss of or damage to any property in which the creditor is given a
				security interest. Credit life and credit accident and sickness insurance if
				required by the creditor, may be provided by the creditor through an insurer
				authorized to issue such insurance in this State.
(2) If a creditor requires any insurance
				permitted under subsection (1) above in any consumer loan transaction, the
				debtor shall be given written notice of the option of providing such insurance
				through an existing policy or a policy independently obtained and paid for by
				the debtor. If the creditor requires credit life insurance, the creditor shall
				give the debtor written notice of the debtor's right to choose either level
				term life insurance or reducing term life insurance coverage. The creditor may
				for reasonable cause before credit is extended decline the insurance provided
				by the debtor.
O.C.G.A.
				  §§
											33-2-9,
				  7-3-11(3).
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.11 - Premiums

Current through Rules and Regulations filed through June 27, 2024
(1) The charge to
				the consumer for any insurance shall not exceed the premium charged by the
				insurer and the premium of premiums charged for such insurance shall be
				reasonable in relation to the amount and term of the credit and the risk
				covered and the benefits provided.
(2) Upon prepayment, refinancing, or renewal
				of the debt before final maturity date the debtor shall be entitled to receive
				that portion of the premiums on any insurance refunded by the insurance
				carrier.
O.C.G.A.
				  §§
											33-2-9,
				  7-3-11(3).
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.12 - Insurance on Property; Amounts; Terms

Current through Rules and Regulations filed through June 27, 2024
(1) A creditor in a consumer loan transaction
				may not contract for or receive a charge for insurance against loss or damage
				to property unless:
(a) the insurance covers a
				substantial risk of loss of or damage to property related to the loan
				transaction;
(b) the amount, terms,
				and conditions of insurance are reasonable in relation to the character and
				value of the property insured or to be insured; and
(c) the term of the insurance is reasonable
				in relation to the term of credit.
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 120-2-107 - INSURANCE WRITTEN IN CONNECTION WITH LOANS UNDER THE GEORGIA INSTALLMENT LOAN ACT › Rule 120-2-107-.13 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any rule or portion thereof contained in this Chapter is
				  held invalid by a court of competent jurisdiction, the remainder of the rules
				  herein and the applicability of such provisions to other circumstances shall
				  not be affected thereby.
O.C.G.A.
				  §§
											33-2-9,
				  7-3-11(3).
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 120-2-108 - VALUATION OF LIFE INSURANCE POLICIES › Rule 120-2-108-.01 - Purpose

Current through Rules and Regulations filed through June 27, 2024
(1) The purpose of
				this regulation is to provide:
(a) Tables of
				select mortality factors and rules for their use;
(b) Rules concerning a minimum standard for
				the valuation of plans with nonlevel premiums or benefits; and
(c) Rules concerning a minimum standard for
				the valuation of plans with secondary guarantees.
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 120-2-108 - VALUATION OF LIFE INSURANCE POLICIES › Rule 120-2-108-.02 - Authority

Current through Rules and Regulations filed through June 27, 2024
This regulation is issued under the authority granted by
				  O.C.G.A. §
									33-2-9.
O.C.G.A. §§
											33-2-9,
				  33-10-13.