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 120-2-49 - ADMINISTRATOR REGULATION › Rule 120-2-49-.16 - Examination by Commissioner; On-Site Examinations

Current through Rules and Regulations filed through June 27, 2024
(1) An administrator shall, at the request of
				the Commissioner, respond in writing within fifteen (15) working days to any
				complaint received by the Commissioner concerning the administrator. Complaints
				shall include those pertaining to improper adjudication of claims and any
				complaints or concerns, by any other state agency, relating to the
				administrator. If, in the Commissioner's discretion, the frequency or severity
				of such complaints or infractions justifies an examination of the
				administrator's practices and procedures, any such examination by the
				Commissioner, or any person designated by him or her, shall be at the expense
				of the administrator. The Commissioner may, in addition to any other remedy
				available, suspend, revoke or refuse to renew a license in the event that the
				administrator does not fully cooperate with the Commissioner's office relating
				to this rule.
(2) The Commissioner
				or his or her designated representative is authorized to make a complete
				on-site examination of the affairs of each administrator as often as is deemed
				necessary. Whenever the Commissioner shall deem it expedient, he or she shall
				examine by use of an examiner duly authorized by him or her the affairs,
				transactions, accounts, records, documents, assets, liabilities, of an
				administrator and any other facts relative to its business methods, management,
				and dealings with policyholders, certificate holders, and members.
(3) Any administrator being examined shall
				provide to the Commissioner or his or her designee convenient and free access,
				at all reasonable hours at their offices, to all books, records, documents and
				other papers relating to such administrator's business affairs.
(4) At the direction of the Commissioner the
				administrator shall pay the fees and expenses of the examination. A
				consolidated account for the examination shall be filed by the examiner with
				the Commissioner.
(5) Nothing in
				this rule shall limit or abridge any other investigatory powers of the
				Commissioner vested in him or her by Title 33 of the Official Code of Georgia
				Annotated.
O.C.G.A. Secs.
				  33-2-9,
				  33-23-100
et seq.
,
				  33-23-103,
				  33-23-105.
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 120-2-49 - ADMINISTRATOR REGULATION › Rule 120-2-49-.17 - Unfair Practices; Marketing of Unapproved Products

Current through Rules and Regulations filed through June 27, 2024
(1) No
				administrator, nor their officers, directors, partners, trustees, agents or
				employees shall engage in any unfair trade practice defined in Chapter 6 of
				Title 33 of the Official Code of Georgia Annotated, or determined pursuant to
				this rule to be an unfair or deceptive act or practice. The provisions of
				Chapter 6 apply to administrators and their officers, directors, partners,
				trustees, agents or employees.
(2)
				In addition to the practices deemed unfair and deceptive in Chapter 6 of Title
				33 of the Official Code of Georgia Annotated, it shall be deemed an unfair or
				deceptive practice for any administrator, officer, director, partner, trustee,
				agent or employee to commit or perform any of the following:
(a) Misrepresenting or withholding any data
				or information that has been provided by the plan sponsor and is pertinent to
				underwriting conditions for a contract of insurance between the plan sponsor
				and any insurer, reinsurer or ultimate risk bearer, or for a contract of
				self-insurance between the plan sponsor and the administrator.
(b) Misrepresenting the existence or the
				terms of any actual or proposed insurance or reinsurance policy, or
				self-insurance contract.
(c)
				Failing to make an appropriate reply within fifteen working days to any
				inquiries of the Office of Commissioner of Insurance as they pertain to this
				regulation or O.C.G.A. §§
										33-23-100 to
				33-23-104.
(d) Failing to submit requested documentation
				to the Office of Commissioner of Insurance as it applies to any complaints or
				inquiries regarding the business practices of an administrator.
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 120-2-49 - ADMINISTRATOR REGULATION › Rule 120-2-49-.18 - Change of Management; Acquisition; Affiliation; Relationships with Third Parties

Current through Rules and Regulations filed through June 27, 2024
(1) The administrator shall, within 30 days
				after the event, notify the Commissioner of any material change in its
				management.
(2) An administrator's
				license shall not be sold or transferred to a non-affiliated or otherwise
				unrelated party.
(3) An
				administrator may not contract or sub-contract any of its negotiated services
				to any unlicensed business entity unless specifically approved by the
				Commissioner.
O.C.G.A. Secs.
				  33-2-9,
				  33-23-100
et seq.
,
				  33-23-104,
				  33-23-105.
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 120-2-49 - ADMINISTRATOR REGULATION › Rule 120-2-49-.19 - Forms

Current through Rules and Regulations filed through June 27, 2024
Standard administrator forms are required and will be
				  supplied upon request by the Commissioner's office either in paper form or
				  electronically over the internet. Applicants and licensed administrators shall
				  utilize all applicable forms in preparing applications, statements, notices of
				  required information, and other submissions required under Article 2 of Chapter
				  23 of Title 33 of the Official Code of Georgia Annotated.
O.C.G.A. Secs.
				  33-2-9,
				  33-23-100
et seq.
,
				  33-23-105.
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 120-2-49 - ADMINISTRATOR REGULATION › Rule 120-2-49-.20 - Penalties

Current through Rules and Regulations filed through June 27, 2024
Any business entity or affiliated party failing to comply
				  with the requirements of this Regulation Chapter shall be subject to such
				  penalties as may be appropriate under the insurance laws of this
				  State.
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 120-2-49 - ADMINISTRATOR REGULATION › Rule 120-2-49-.21 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any provision of this Regulation Chapter, or the
				  application thereof to any business entity or affiliated party or circumstance,
				  is held invalid by a court of competent jurisdiction, the remainder of the
				  Regulation Chapter or the applicability of such provision to other persons or
				  circumstances shall not be affected.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.01 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this Regulation is to implement the provisions
				  of O.C.G.A. Chapter 33-50 and to ensure the safe and proper operation of
				  multiple employer self-insured health plans in Georgia.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.02 - Definitions

Current through Rules and Regulations filed through June 27, 2024
(1) "Employee"
				means any person in the service of another under any contract of hire, express
				or implied, oral or written, where the employer has the power or right to
				control and direct the employee in the material details of how the work is to
				be performed.
(2) "Employer" means
				any person who employs the services of others or for whom the employees
				work.
(3) "Premium" means the
				consideration for insurance, by whatever name called. Any assessment, or any
				membership, policy, survey, inspection, or similar fee or charge in
				consideration for an insurance contract is deemed part of the
				premium.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.03 - Disclosure

Current through Rules and Regulations filed through June 27, 2024
Any person who advertises, solicits, sells, transacts, or
				  administers coverage, or who in any manner secures, helps or aids in the
				  placing or administration of coverage with any multiple employer self-insured
				  plan in Georgia shall prominently disclose in writing to every participating
				  employer, covered employee, and employer being solicited for participation, in
				  a form to be filed with and approved by the Commissioner at the time of
				  licensing, the following: that the plan is a self-insured plan and that
				  benefits are not guaranteed by a licensed insurer; that the plan is not covered
				  by the Georgia Life and Health Guaranty Association which provides protection
				  to Georgia residents from insolvent insurers; and that certain other major
				  protections offered to Georgia residents under the Georgia Insurance Code and
				  Rules and Regulations, such as conversion rights and certain mandated or
				  required benefits, may not be available through the multiple employer
				  self-insured plan.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.04 - Filing Requirements

Current through Rules and Regulations filed through June 27, 2024
(1) All communications and filings must be
				made with the Regulatory Services Division, Georgia Insurance Department. To
				Complete the application for a license, the following items pertaining to the
				plan must be submitted:
(a) Each applicant
				for license shall make application on form ME-2, entitled "Application for
				License for Multiple Employer Self-Insured Health Plan," attached hereto as
				"Exhibit A" and incorporated herein.
(b) A copy of the plan's bylaws, all
				schedules of benefits, and all management, administration and trust agreements
				which the plan has made or proposes to make for the conduct of its business and
				affairs, certified to by a majority of the trustees. Any proposed change or
				amendment to the foregoing must also be filed with the Commissioner not less
				than sixty (60) days before the effective date of the change or
				amendment.
(c) An audited financial
				statement prepared by a certified public accountant (CPA), on form ME-3,
				entitled "Financial Statement," attached hereto as "Exhibit B" and incorporated
				herein.
(d) Signed and notarized
				biographical affidavits by all trustees of the plan on form ME-4, entitled
				"Biographical Questionnaire," attached hereto as "Exhibit C" and incorporated
				herein.
(e) A complete list of
				names, addresses, and telephone numbers of employers participating in the plan
				and the number of employees of each employer participating in the
				plan.
(f) A statement of the
				reasons for applying for a Georgia license, a description of exactly how the
				plan proposes to develop and Supervise its operations in Georgia, the name,
				title and qualifications of the person who will be responsible for the plan's
				operation in Georgia, and the location of and a description of the office
				facilities that will be provided by the plan in Georgia.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.05 - Stop-Loss Coverage Requirements

Current through Rules and Regulations filed through June 27, 2024
(1) A multiple employer self-insured health
				plan is required to obtain individual and aggregate excess stop-loss coverage
				from an insurer authorized to transact insurance in Georgia. Such coverage must
				be submitted for approval by the Commissioner.
(2) Plan participants are required to find
				benefits up to the point at which the excess stop-loss insurer assumes one
				hundred percent of the liability to pay benefits. In reviewing an excess
				stop-loss agreement for approval, the Commissioner will closely scrutinize the
				agreement to determine whether the levels of individual and aggregate risk
				retained by the plan are such as will put the plan in an unsound condition or
				will render its proceedings hazardous to the public or to persons covered under
				the plan. In making his determination, the Commissioner will consider all
				relevant factors including, but not limited to, reserving practices, adequacy
				of employer/employee contributions, benefits provided under the plan,
				administrative and other expenses, and management. If the Commissioner is of
				the opinion that the excess stop-loss agreement will put the plan in an unsound
				condition, will render the plan's proceedings hazardous to the public or
				persons covered under the plan, or is otherwise not in compliance with the law,
				the Commissioner will disapprove the agreement.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-5,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.06 - Security Deposits

Current through Rules and Regulations filed through June 27, 2024
Security Deposit in the amount of $100,000 shall be made with
				  the Commissioner on forms GID-5A through GID-6, as applicable. Referenced forms
				  are attached to Rules and Regulations of the Georgia Insurance Department,
				  Section 120-2-18-.04,
				  Exhibits B and C, and are hereby incorporated herein by reference. The
				  following types of security deposits are acceptable:
(a) Securities having a market value of not
				less than $100,000 registered in the name of the plan, both as to principal and
				interest, with forms GID-5A and GID-6. Forms GID-5B and 5C are not required
				with the deposit of U.S. Treasury Bonds or Notes.
(b) Certificates of Deposit in Georgia banks
				in an amount of $100,000, and for a duration of at least one year unless
				automatically renewable, with form GID-6.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-3,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.07 - Examinations

Current through Rules and Regulations filed through June 27, 2024
An examination will be performed by the Commissioner to
				  verify the books, accounts and records underlying the plan during the licensing
				  process. This examination will be performed at the expense of the applicant by
				  a representative of the Office of the Commissioner of Insurance. After
				  licensure, plans will be subject to periodic unscheduled and unannounced
				  examinations in accordance with O.C.G.A. Chapter 33-2.
O.C.G.A. Secs.
				  33-2-9,
				  33-2-11,
				  33-2-15,
				  33-50-8,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.08 - Powers of Attorney

Current through Rules and Regulations filed through June 27, 2024
A power of attorney appointing a person who is a resident of
				  Georgia to receive service of legal process must be submitted on form ME-5
				  entitled "Power of Attorney," attached hereto as "Exhibit D" and incorporated
				  herein. Such person must be readily accessible and available for service. Both
				  the residence and business address must be provided.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.09 - Bonds

Current through Rules and Regulations filed through June 27, 2024
Proof of bonding by a surety company having a certificate of
				  authority to transact insurance in Georgia in a minimum amount of $150,000 for
				  each plan trustee must be submitted.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-6,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.10 - Surplus

Current through Rules and Regulations filed through June 27, 2024
A detailed statement of the method used to arrive at the
				  plan's required surplus account as required in Section
				  33-50-7(b)  must
				  be submitted.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-7,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.11 - Loss Reserves

Current through Rules and Regulations filed through June 27, 2024
The plan must establish and maintain loss reserves in an
				  amount deemed appropriate by the Commissioner. Plans in existence and actually
				  operating in a sound manner for a period of at least 3 years prior to July 1,
				  1991, may maintain a reserve amount, which combined with surplus, will be 35%
				  of claims paid by such plan in the immediate preceding year. The 35% level
				  combined surplus/reserve may be deemed appropriate by the Commissioner so long
				  as a determination is made that the insured employees/employer plan is in sound
				  financial condition.
O.C.G.A. Secs.
				  33-2-9. 33-50-7,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.12 - Fees

Current through Rules and Regulations filed through June 27, 2024
(1) Any application
				for a license shall be accompanied by a fee as provided in O.C.G.A. Sec.
				33-8-1. This fee is
				nonrefundable.
(2) An annual
				license fee as provided in O.C.G.A. Sec.
				33-8-1, payable to the Georgia
				Commissioner of Insurance, is required upon licensing and on or before July 1
				of each year. The first license period is from the date of licensing through
				the following June 30th. The license fee will not be prorated for a period of
				less than one year.
O.C.G.A. Secs.
				  33-2-9,
				  33-8-1,
				  33-50-3,
				  33-50-30.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.13 - Reporting Requirements

Current through Rules and Regulations filed through June 27, 2024
A multiple employer self- insured health plan is required to
				  file, on or before March 1st of each year, a signed and certified statement of
				  its condition and affairs as of the preceding December 31st, on form ME-3. A
				  plan is further required to furnish any additional information concerning its
				  business and affairs which the Commissioner or his representatives shall
				  require.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-6,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.14 - Dissolution

Current through Rules and Regulations filed through June 27, 2024
Any application to dissolve must be made on form ME-6,
				  entitled "Application for Dissolution," attached hereto as "Exhibit E" and
				  incorporated herein. An application for dissolution will not be considered to
				  have been received by the Commissioner until it has been completed to his
				  satisfaction.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-9,
				  33-50-10.
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 120-2-50 - MULTIPLE EMPLOYER SELF-INSURED HEALTH PLANS › Rule 120-2-50-.15 - Penalties

Current through Rules and Regulations filed through June 27, 2024
Any person failing to comply with the requirements of this
				  Regulation shall be subject to such penalties as may be appropriate under the
				  insurance laws of Georgia.
O.C.G.A. Secs.
				  33-2-9,
				  33-50-10,
				  33-50-11.
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 120-2-51 - CONTINUING CARE PROVIDERS AND FACILITIES › Rule 120-2-51-.01 - Statutory Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation is issued pursuant to the authority vested in
				  the Commissioner of Insurance pursuant to O.C.G.A. Sections
				  33-2-9 and
				  33-45-4.
O.C.G.A. §§
										33-2-9,
				  33-45-4.
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 120-2-51 - CONTINUING CARE PROVIDERS AND FACILITIES › Rule 120-2-51-.02 - Scope and Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this Regulation is to implement the provisions
				  of Chapter 45 of Title 33 of the Official Code of Georgia Annotated. This
				  Regulation governs the issuance and renewal of Certificates of Authority, the
				  minimum provisions required in escrow agreements, and specific provisions
				  related to resident owned living units.
O.C.G.A. §§
										33-2-9,
				  33-45-4.
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 120-2-51 - CONTINUING CARE PROVIDERS AND FACILITIES › Rule 120-2-51-.03 - Definitions

Current through Rules and Regulations filed through June 27, 2024
As used in this Regulation, the term:
(1) "Continuing care" means furnishing
				pursuant to a continuing care agreement:
(a)
				Lodging that is not:
(i) In a skilled nursing
				facility, as such term is defined in O.C.G.A. Section
				31-6-2(34);
(ii) An intermediate care facility, as such
				term is defined in O.C.G.A. Section
				31-6-2(22);
(iii) An assisted living community, as such
				term is defined in O.C.G.A. Section
				31-7-12.2; or
(iv) A personal care home, as such term is
				defined in O.C.G.A. Section
				31-7-12;
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 120-2-51 - CONTINUING CARE PROVIDERS AND FACILITIES › Rule 120-2-51-.06 - Resident Owned Living Unit

Current through Rules and Regulations filed through June 27, 2024
(1) Continuing Care Agreements
(a) The lodging component of a continuing
				care agreement for resident owned living units may be expressed in a real
				estate purchase agreement for a resident owned living unit or other documents
				that govern the purchase and sale of such resident owned living unit,
				including, but not limited to, condominium declarations, homeowners association
				rules, and any other documents required for compliance with real property law
				related to the purchase and sale of resident owned living units. However, such
				documents must be incorporated by reference into the continuing care agreement
				for the resident owned living unit and a copy of each referenced documents must
				be attached as an exhibit.
(b)
				Continuing care agreements for resident owned living units may provide that the
				entrance fee can be collected simultaneously with the closing of the purchase
				and sale of a resident owned living unit.
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 120-2-51 - CONTINUING CARE PROVIDERS AND FACILITIES › Rule 120-2-51-.07 - Penalties

Current through Rules and Regulations filed through June 27, 2024
Any provider, or any agent, counselor, representative,
				  officer, or employee of such provider, failing to comply with the requirements
				  of this Regulation shall be subject to such penalties as may be appropriate
				  under the insurance laws of this State.
O.C.G.A. §§
										33-2-9,
				  33-45-1
et
				  seq.
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 120-2-51 - CONTINUING CARE PROVIDERS AND FACILITIES › Rule 120-2-51-.08 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any provision of this Regulation or the application of it
				  to any person or circumstance is held invalid, such invalidity shall not affect
				  the provisions or applications of the rules herein which can be given effect
				  without the invalid portion. To that end, the provisions of this Regulation are
				  declared to be severable.
O.C.G.A. §§
										33-2-9,
				  33-45-1
et
				  seq.
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 120-2-52 - FAIR AND EQUITABLE SETTLEMENT OF FIRST PARTY PROPERTY DAMAGE CLAIMS › Rule 120-2-52-.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. Sections
				  33-2-9 and
				  33-34-8.
O.C.G.A. Secs.
				  33-2-9,
				  33-34-8.
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 120-2-52 - FAIR AND EQUITABLE SETTLEMENT OF FIRST PARTY PROPERTY DAMAGE CLAIMS › Rule 120-2-52-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this Regulation is to provide procedures for
				  the expeditious and efficient settlement of first party property damage claims
				  arising under personal private passenger motor vehicle policies (hereinafter
				  referred to as "claims").
O.C.G.A. Secs.
				  33-2-9,
				  33-34-8.
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 120-2-52 - FAIR AND EQUITABLE SETTLEMENT OF FIRST PARTY PROPERTY DAMAGE CLAIMS › Rule 120-2-52-.04 - Vehicle Repairs

Current through Rules and Regulations filed through June 27, 2024
(1) If losses are settled on the basis of a
				written estimate prepared by or for the insurer, the insurer shall supply, upon
				request of the insured, a copy of the estimate upon which the settlement is
				based. The estimate prepared by or for the insurer shall be reasonable, and of
				an amount which will allow for repairs to be made in a workmanlike manner which
				would restore the damaged vehicle to its preaccident condition relative to
				quality, safety, function and appearance. If the insured subsequently shows,
				based upon a written estimate which he obtains, that necessary repairs will
				exceed the written estimate prepared by or for the insurer, the insurer shall
				review and respond within fifteen (15) days. The insurer shall either provide
				the insured with the name of a repair shop that will make the repairs according
				to the written estimate obtained by the insurer which are commercially
				acceptable and conform with industry standards, or pay the difference between
				the written estimate and the one obtained by the insured.
(2) When the monetary amount claimed by the
				insured is reduced because of betterment or depreciation, all reasons for such
				reduction shall be contained and documented in the insurer's claim file. Such
				deductions shall be itemized and specified as to dollar amount and shall be
				appropriate for the amount of deductions. Deductions for betterment and
				depreciation shall be allowable only if:
(a)
				They reflect a measurable decrease in market value attributable to the poorer
				condition of; or prior damage to, the vehicle;
(b) They reflect the general overall
				condition of the vehicle considering its age, for either or both:
1. The wear and tear, or rust, limited to no
				more than a deduction of $1,000, and/or
2. Missing parts, limited to no more of a
				deduction than the replacement cost of such part or parts.
(c) The deductions set forth in subparagraphs
				(2)(a) and (b) above shall be limited to 20% of the market value of the vehicle
				prior to the loss.
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 120-2-52 - FAIR AND EQUITABLE SETTLEMENT OF FIRST PARTY PROPERTY DAMAGE CLAIMS › Rule 120-2-52-.05 - Aftermarket Crash Parts

Current through Rules and Regulations filed through June 27, 2024
(1) Purpose. The purpose of this section is
				to set forth standards for the use of aftermarket crash parts. It sets forth
				certain requirements relative to the identity, quality and disclosure of after
				market crash parts.
(2) Definition.
				For purposes of this regulation, the term "aftermarket crash part" shall mean a
				replacement for any of the non-mechanical sheet metal or plastic parts which
				generally constitute the exterior of a motor vehicle, including inner and outer
				panels.
(3) Identification. All
				aftermarket crash parts which are subject to this section and manufactured
				after the effective date of this section, shall carry sufficient permanent
				identification so as to identify their manufacturer. Such identification shall
				be accessible to the extent practicable after installation.
(4) The price of nonoriginal manufacturer
				aftermarket crash parts may be used by insurers to determine repair costs,
				provided the use of such parts would restore the damaged vehicle to its
				preaccident condition relative to quality, safety, function and appearance. If
				an insurer includes nonoriginal manufacturer aftermarket crash parts in its
				repair estimate, the insurer shall notify the insured in writing as follows:
(a) The written repair estimate shall clearly
				identify each such part.
(b) A
				disclosure document containing the following information in no smaller print
				than 10 point type shall appear on or be attached to the insurers copy of the
				estimate:
"THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF
				  AFTERMARKET CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF
				  YOUR MOTOR VEHICLE.
THE AFTERMARKET CRASH PARTS USED IN THE PREPARATION OF THIS
				  ESTIMATE ARE WARRANTED BY THE MANUFACTURER OR DISTRIBUTION OF SUCH PARTS RATHER
				  THAN THE MANUFACTURER OF YOUR VEHICLE."
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 120-2-52 - FAIR AND EQUITABLE SETTLEMENT OF FIRST PARTY PROPERTY DAMAGE CLAIMS › Rule 120-2-52-.07 - Loss of Use

Current through Rules and Regulations filed through June 27, 2024
If a policy provides loss of use or rental reimbursement
				  coverage, reimbursement is limited to actual expenses incurred while an insured
				  vehicle is inoperable due to a loss payable under either comprehensive or
				  collision coverage. It is not necessary that the policy include coverage for
				  the kind of loss itself (i.e., a comprehensive loss, but no comprehensive
				  coverage), as long as rental reimbursement is applicable to the loss.
(a) Actual expenses include reasonable fares
				for substitute transportation. If a rental car is used, the expenses can
				include daily charges, mileage expenses and taxes, subject to policy
				limitations.
(b) The insurer may
				apply daily or aggregate monetary limitations to the actual expenses subject to
				policy provisions.
(c) The insurer
				may limit the benefits to the period the vehicle is inoperable or under repair,
				or ending when an offer to pay for a total loss is made. The offer to pay for
				the total loss must be made in accordance with these rules, and the date of the
				offer must be clearly documented in the insurer's claim file.
O.C.G.A. Secs.
				  33-2-9,
				  33-34-8.
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 120-2-52 - FAIR AND EQUITABLE SETTLEMENT OF FIRST PARTY PROPERTY DAMAGE CLAIMS › Rule 120-2-52-.08 - 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 held invalid by a court of competent
				  jurisdiction, the remainder of the Regulation or the applicability of such
				  provision to other persons or circumstances shall not be
				  affected.
O.C.G.A. Secs.
				  33-2-9,
				  33-34-8.
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 120-2-53 - CANCELLATION AND NONRENEWAL REGULATION › Rule 120-2-53-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation made and promulgated by the Commissioner of
				  Insurance pursuant to the authority set forth in O.C.G.A. §
									33-24-45.
O.C.G.A. Secs.
				  33-24-45,
				  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 120-2-53 - CANCELLATION AND NONRENEWAL REGULATION › Rule 120-2-53-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this Regulation is to establish the notice
				  requirements an insurer shall include in the notice of cancellation or notice
				  of nonrenewal sent to an insured and to provide for procedures for a review by
				  the Commissioner when an insured believes his or her policy has been canceled
				  or nonrenewed in violation of O.C.G.A. §
									33-24-45.
O.C.G.A. Secs.
				  33-2-9,
				  33-24-45.
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 120-2-53 - CANCELLATION AND NONRENEWAL REGULATION › Rule 120-2-53-.04 - Tender of Premiums During Period of Review, Refund of Premiums

Current through Rules and Regulations filed through June 27, 2024
During this period of review of the cancellation or
				  nonrenewal, the insured shall tender to, and the insurer shall accept, a 30 day
				  pro rata portion of the premiums applicable to the policy at the time the
				  cancellation or nonrenewal is issued. The insured shall submit proof of such
				  tender of premium as a part of the request for review by the
				  Commissioner.
O.C.G.A. Secs.
				  33-24-45,
				  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 120-2-53 - CANCELLATION AND NONRENEWAL REGULATION › Rule 120-2-53-.05 - Disposition and Penalties

Current through Rules and Regulations filed through June 27, 2024
(1) If the Commissioner determines the
				cancellation or nonrenewal is lawful, termination under the policy shall be
				effective as of the date and time originally set forth under the notice of
				cancellation or nonrenewal. Termination of the interim coverage provided
				pursuant to O.C.G.A. §
									33-24-45(o)
				 during the pendency of the Commissioner's
				review shall not be effective less than five (5) days following the date of the
				Commissioner's decision. The Commissioner's decision shall establish the
				effective date of the termination of the interim coverage provided during the
				review of the cancellation or nonrenewal and shall serve as the official notice
				of termination of coverage referenced in O.C.G.A. §
									33-24-45(e)(1).
(2) In the event that the cancellation or
				nonrenewal is upheld by the Commissioner,
(a)
				the insurer shall retain that portion of the pro rata premiums tendered for the
				period of time beginning with the original date of cancellation or nonrenewal
				and ending with the date of the termination of the interim coverage as
				established by the Commissioner pursuant to Rule
				120-2-53-.05(1);
				and
(b) the insurer shall refund
				all remaining premiums to the insured within ten (10) working days of receipt
				of the Commissioner's decision establishing the effective date of the
				termination of the interim coverage.
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 120-2-53 - CANCELLATION AND NONRENEWAL REGULATION › Rule 120-2-53-.06 - 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 held invalid by a court of competent
				  jurisdiction, the remainder of the Regulation or the applicability of such
				  provision to other persons or circumstances shall not be
				  affected.
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 120-2-54 - REGULATION TO DEFINE STANDARDS AND COMMISSIONER'S AUTHORITY FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION › Rule 120-2-54-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
This regulation is adopted and promulgated by the
				  Commissioner pursuant to the authority granted by O.C.G.A. §§
									33-2-9,
				  33-3-17,
				  33-3-18,
				  33-37-11, and
				  33-37-16.
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 120-2-54 - REGULATION TO DEFINE STANDARDS AND COMMISSIONER'S AUTHORITY FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION › Rule 120-2-54-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this regulation is to set forth the standards
				  which the Commissioner may use for identifying insurers found to be in such
				  condition as to render the continuance of their business hazardous to their
				  policyholders, creditors, or the general public.
This regulation shall not be interpreted to limit the powers
				  granted the Commissioner by any laws or parts of laws of this State, nor shall
				  this regulation be interpreted to supersede any laws or parts of laws of this
				  State.
O.C.G.A. Secs.
				  33-2-9,
				  33-2-11,
				  33-3-17,
				  33-3-18.
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 120-2-54 - REGULATION TO DEFINE STANDARDS AND COMMISSIONER'S AUTHORITY FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION › Rule 120-2-54-.04 - Commissioner's Authority

Current through Rules and Regulations filed through June 27, 2024
(a) For the purposes of making a
				determination of an insurer's financial condition under this regulation, the
				Commissioner may:
(1) Disregard any credit or
				amount receivable resulting from transactions with a reinsurer that is
				insolvent, impaired, or otherwise subject to a delinquency
				proceeding;
(2) Make appropriate
				adjustments including disallowance to asset values attributable to investments
				in or transactions with parents, subsidiaries, or affiliates consistent with
				the NAIC Accounting Practices And Procedures Manual, State laws, and
				regulations;
(3) Refuse to
				recognize the stated value of accounts receivable if the ability to collect
				receivables is highly speculative in view of the age of the account or the
				financial condition of the debtor; or
(4) Increase the insurer's liability in an
				amount equal to any contingent liability, pledge, or guarantee not otherwise
				included if there is a substantial risk that the insurer will be called upon to
				meet the obligation undertaken within the next twelve-month period.
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 120-2-54 - REGULATION TO DEFINE STANDARDS AND COMMISSIONER'S AUTHORITY FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION › Rule 120-2-54-.05 - 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 held invalid by a court of competent
				  jurisdiction, the remainder of the Regulation or the applicability of such
				  provision to other persons or circumstances shall not be
				  affected.
O.C.G.A. Secs.
				  33-2-9,
				  33-3-17,
				  33-3-18.
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 120-2-55 - ADMINISTRATIVE SUPERVISION › Rule 120-2-55-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation is promulgated pursuant to the authority
				  granted by O.C.G.A. Sections
				  33-2-9 and
				  33-3-1.
O.C.G.A. Secs.
				  33-2-9,
				  33-3-1.
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 120-2-55 - ADMINISTRATIVE SUPERVISION › Rule 120-2-55-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this Regulation is to set forth the rules and
				  procedural requirements which the Commissioner of Insurance deems necessary to
				  carry out the provisions of Chapter 3, Title 33 of the Georgia Insurance Code,
				  relating to administrative supervision.
(a) This Regulation shall not be interpreted
				to limit the powers granted the Commissioner by any laws or parts of laws of
				this state.
O.C.G.A. Secs.
				  33-2-9,
				  33-2-11,
				  33-3-1,
				  33-3-17,
				  33-3-18,
				  33-3-19.