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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.12 - Hearing

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9,
				  40-9-100.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.13 - Commissions

Current through Rules and Regulations filed through June 27, 2024
(1) Unless other
				arrangements have been made with the Commissioner, the commission under the
				Plan shall be as follows in paragraphs (2) through (5).
(2) For long haul trucking risks and public
				passenger carrying vehicles other than church and school buses, five (5%)
				percent of the policy premium for commission to a licensed producer designated
				by the insured.
(3) For other
				risks, ten (10%) percent of the policy premium for commission to a licensed
				producer designated by the insured.
(4) On any risk rated and domiciled outside
				of this State, the licensed producer may be paid only that portion of the
				producer's commission specified above which is permissible under the laws of
				the state in which the risk is rated and domiciled.
(5) There is to be no service charge to an
				applicant charged by the Producer of Record for the completing of an
				application for insurance under the Plan except the commissions referred to in
				paragraph (2), (3) and (4) above.
O.C.G.A. §§
										33-2-9,
				  40-9-100.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.14 - Claims against Plan; Members and Staff

Current through Rules and Regulations filed through June 27, 2024
(1) The Plan shall pay on behalf of any
				individual or subscriber all sums which the individual or subscriber shall
				become legally obligated to pay as a result of or in connection with the
				performance of official duties as an officer, employee or representative on any
				committee of the Plan.
(2) The Plan
				shall have the right and duty to defend any suit or claim against such
				individual or subscriber seeking damages as a result of or in connection with
				the performance of official duties as an officer, employee or representative on
				any committee of the Plan.
(3) The
				Plan shall be obligated under paragraphs (1) and (2) above regardless of when
				claim or suit is made, as long as the incident giving rise to the obligation
				occurred during the period of time that individual or subscriber served as an
				officer, employee or representative on any committee of the Plan, and was
				acting in such official capacity.
(4) The Plan may make such investigations and
				settlements of any claims or suits as it deems expedient.
(5) The cost of fulfilling the obligations of
				the Plan as described in this Rule shall be an expense incurred pursuant to
				Rule 120-2-14-.07.
(6) The obligations of the Plan as described
				in this Chapter do not arise:
(a) If the
				individual or subscriber fails to report the claim or suit to the manager of
				the Plan within ten (10) days of actual notice of such claim or suit;
				or
(b) If, after the defense of a
				claim or suit arising pursuant to this section it is adjudged that the officer,
				employee or representative acted in bad faith, then the Plan shall be
				reimbursed by such officer, employee or representative for expenses incurred in
				such defense.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.15 - Penalties

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9,
				  40-9-100.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.16 - Severability

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9,
				  40-9-100.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.17 - Effective Date

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A.
				  33-2-9,
				  40-9-100.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.18 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576; Ga. L. 1960, pp. 289, 305; Ga. L. 1974, pp. 113,
				  123.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.19 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576, as amended; Ga. L. 1960, pp. 289, 305; Ga. L. 1974, pp. 113,
				  123.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.20 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576, as amended; Ga. L. 1960, pp. 289, 305; Ga. L. 1974, pp. 113,
				  123.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.21 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576, as amended; Ga. L. 1960, pp. 289, 305; Ga. L. 1974, pp. 113,
				  123.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.22 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576, as amended.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.23 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576; Ga. L. 1960, pp. 289, 305; Ga. L. 1974, pp. 113,
				  123.
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 120-2-14 - GEORGIA AUTOMOBILE INSURANCE PLAN › Rule 120-2-14-.24 - Repealed

Current through Rules and Regulations filed through June 27, 2024
Ga. L. 1951, pp. 565,
				  576; Ga. L. 1960, pp. 289, 305; Ga. L. 1974, pp. 113,
				  123.
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 120-2-15 - REPORTING OF POLICY CANCELLATIONS AND NONRENEWALS › Rule 120-2-15-.01 - Definitions

Current through Rules and Regulations filed through June 27, 2024
For the purpose of this Regulation Chapter, the following
				  definitions shall apply:
(a) For the
				purposes of this Regulation Chapter and for the purpose of implementing and
				interpreting O.C.G.A. §
									33-24-46, the term "residential
				real property" shall mean any property on which the policy is issued to a
				natural person or persons insuring a specifically described owner occupied one
				(1) or two (2) family dwelling, including condominium, manufactured housing,
				standard fire, homeowners, farmowners, and contents policies.
(b) For purposes of this Regulation Chapter,
				the terms "cancellation" and "nonrenewal" shall be defined as in O.C.G.A.
				§§
									33-24-44 and
				33-24-46.
O.C.G.A. Sec.
				  33-2-9,
				  33-24-44,
				  33-24-45,
				  33-24-46,
				  33-39-1,
				  33-39-15.
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 120-2-15 - REPORTING OF POLICY CANCELLATIONS AND NONRENEWALS › Rule 120-2-15-.02 - Quarterly Reporting

Current through Rules and Regulations filed through June 27, 2024
On or before the first day of February, May, August and
				  November, unless notified by the Commissioner of Insurance to cease prior
				  thereto, and continuing until notified by the Commissioner to cease, all
				  insurance companies doing business in the State of Georgia and issuing policies
				  of property and/or casualty insurance shall file with the Office of
				  Commissioner of Insurance the following information:
(a) The total number of residential property
				policies cancelled or nonrenewed by the insurer during the preceding quarter
				together with the reasons for such cancellations and nonrenewals. Provided
				however, this Regulation Chapter shall not apply to any policy which has been
				cancelled or nonrenewed due to a failure of the named insured to discharge when
				due any of his or her obligations in connection with the payment of premium for
				a policy or any installment thereof.
(b) The information required in subsection
				(a) shall be submitted in such form as will show the total number of
				cancellations and nonrenewals together with the reasons for such cancellations
				and nonrenewals for each type of policy issued. The reasons for cancellations
				and nonrenewals shall be shown as follows:
Residential
								Property
(i)
Undesirable Insured
(ii)
Undesirable Property
(iii)
Credit Report
(iv)
Other (specify)
(v)
Misrepresentation
O.C.G.A. Secs.
				  33-2-9,
				  33-24-44,
				  33-24-45,
				  33-24-46,
				  33-39-1,
				  33-39-15.
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 120-2-15 - REPORTING OF POLICY CANCELLATIONS AND NONRENEWALS › Rule 120-2-15-.03 - Other Reporting Upon Written Notice

Current through Rules and Regulations filed through June 27, 2024
Any insurer doing business in the State of Georgia and
				  issuing policies of property and/or casualty insurance shall file with the
				  Office of Commissioner of Insurance the information required in §
									120-2-15-.02 and such other
				  specifically related information for such periods of time as the Commissioner
				  may require from time to time by written notice to any such insurer. The
				  information shall be submitted within ten (10) days from receipt of notice
				  unless, upon showing of good cause, an extension of time is granted by the
				  Commissioner. This regulation is not intended to limit or diminish any other
				  reporting or notice requirements found elsewhere in the Georgia Insurance Code
				  or the Rules and Regulations of the Georgia Insurance
				  Department.
O.C.G.A. Secs.
				  33-2-9,
				  33-24-44,
				  33-24-45,
				  33-24-46,
				  33-39-1,
				  33-39-15.
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 120-2-15 - REPORTING OF POLICY CANCELLATIONS AND NONRENEWALS › Rule 120-2-15-.05 - Penalties

Current through Rules and Regulations filed through June 27, 2024
Any insurer, representative, officer, or employee or such
				  insurer, failing to comply with the requirements of this Regulation Chapter
				  shall be subject to such penalties and other enforcement action as may be
				  appropriate under the insurance laws of this State.
O.C.G.A. secs.
				  33-2-9,
				  33-6-6,
				  33-24-44,
				  33-24-45,
				  33-24-46,
				  33-39-1,
				  33-39-15.
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 120-2-15 - REPORTING OF POLICY CANCELLATIONS AND NONRENEWALS › Rule 120-2-15-.06 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any provisions of this Regulation Chapter or the
				  application thereof to any person or circumstance is for any reason held to be
				  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. Secs.
				  33-2-9,
				  33-24-44,
				  33-24-45,
				  33-24-46,
				  33-39-1,
				  33-39-15.
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 120-2-15 - REPORTING OF POLICY CANCELLATIONS AND NONRENEWALS › Rule 120-2-15-.07 - Repealed

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9,
				  33-24-44,
				  33-24-45,
				  33-24-46,
				  33-39-1,
				  33-39-15.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.01 - Purpose

Current through Rules and Regulations filed through June 27, 2024
The purpose of this regulation is to implement O.C.G.A.
				  Chapter 33-42, to promote the public interest, to promote the availability of
				  long-term care insurance coverage, to protect applicants for long-term care
				  insurance, as defined, from unfair or deceptive sales or enrollment practices,
				  to facilitate public understanding and comparison of long-term care insurance
				  coverages, and to facilitate flexibility and innovation in the development of
				  long-term care insurance.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.02 - Authority

Current through Rules and Regulations filed through June 27, 2024
This regulation is issued pursuant to the authority vested in
				  the Commissioner under O.C.G.A. Sections
				  33-2-9 and
				  33-42-7.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.03 - Applicability and Scope

Current through Rules and Regulations filed through June 27, 2024
Except as otherwise specifically provided, this Regulation
				  applies to all long-term care insurance policies, including qualified long-term
				  care contracts and life insurance policies that accelerate benefits for
				  long-term care delivered or issued for delivery in this state on or after the
				  effective date by insurers; fraternal benefit societies; nonprofit health,
				  nonprofit hospital and medical service corporations; healthcare plans; health
				  maintenance organizations and all similar organizations. Certain provisions of
				  this Regulation apply only to qualified long-term care insurance contracts as
				  noted.
Additionally, this Regulation is intended to apply to
				  policies having indemnity benefits that are triggered by activities of daily
				  living and sold as disability income insurance, if:
(1) The benefits of the disability income
				policy are dependent upon or vary in amount based on the receipt of long-term
				care services;
(2) The disability
				income policy is advertised, marketed or offered as insurance for long-term
				care services; or
(3) Benefits
				under the policy may commence after the policyholder has reached Social
				Security's normal retirement age unless benefits are designed to replace lost
				income or pay for specific expenses other than long-term care
				services.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.04 - Definitions

Current through Rules and Regulations filed through June 27, 2024
For the purpose of this Regulation, the terms "long-term care
				  insurance," "qualified long-term care insurance," "group long-term care
				  insurance," "Commissioner," "applicant," "policy" and "certificate" shall have
				  the meanings set forth in O.C.G.A. Section
				  33-42-4. In addition, the
				  following definitions apply:
(1)
(a) "Exceptional increase" means only those
				increases filed by an insurer as exceptional for which the Commissioner
				determines the need for the premium rate increase is justified:
(i) Due to changes in laws or regulations
				applicable to long-term care coverage in this state; or
(ii) Due to increased and unexpected
				utilization that affects the majority of insurers of similar
				products.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.06 - Policy Practices and Provisions

Current through Rules and Regulations filed through June 27, 2024
(1) Renewability. The terms "guaranteed
				renewable" and "noncancellable" shall not be used in any individual long-term
				care insurance policy without further explanatory language in accordance with
				the disclosure requirements of Section
				120-2-16-.09 of this Regulation:
(a) A policy issued to an individual shall
				not contain renewal provisions other than "guaranteed renewable" or
				"noncancellable."
(b) The term
				"guaranteed renewable" may be used only when the insured has the right to
				continue the long-term care insurance in force by the timely payment of
				premiums and when the insurer has no unilateral right to make any change in any
				provision of the policy or rider while the insurance is in force, and cannot
				decline to renew, except that rates may be revised by the insurer on a class
				basis.
(c) The term
				"noncancellable" may be used only when the insured has the right to continue
				the long-term care insurance in force by the timely payment of premiums during
				which period the insurer has no right to unilaterally make any change in any
				provision of the insurance or in the premium rate.
(d) The term "level premium" may only be used
				when the insurer does not have the right to change the premium.
(e) In addition to the other requirements of
				this subsection, a qualified long-term care insurance contract shall be
				guaranteed renewable, within the meaning of Section 7702B(b)(1)(C) of the
				Internal Revenue Code of 1986, as amended.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.08 - Required Disclosure Provisions

Current through Rules and Regulations filed through June 27, 2024
(1) Renewability. Individual long-term care
				insurance policies shall contain a renewability provision.
(a) The provision shall be appropriately
				captioned, shall appear on the first page of the policy, and shall clearly
				state that the coverage is guaranteed renewable or noncancellable. This
				provision shall not apply to policies that do not contain a renewability
				provision, and under which the right to nonrenew is reserved solely to the
				policyholder.
(b) A long-term care
				insurance policy or certificate, other than one where the insurer does not have
				the right to change the premium, shall include a statement that premium rates
				may change.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.09 - Required Disclosure of Rating Practices to Consumers

Current through Rules and Regulations filed through June 27, 2024
(1) This section
				shall apply as follows:
(a) Except as
				provided in paragraph (b), this section applies to any long-term care policy or
				certificate issued in this state on or after April 1, 2008.
(b) For certificates issued on or after the
				effective date of this amended regulation under a group long-term care
				insurance policy as defined in O.C.G.A. Section
				33-42-4, which policy was in force
				at the time this amended regulation became effective, the provisions of this
				section shall apply on the policy anniversary following April 1,
				2009.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.10 - Intial Filing Requirements

Current through Rules and Regulations filed through June 27, 2024
(1) This section applies to any long-term
				care policy issued in this state on or after April 1, 2008.
(2) An insurer shall provide the information
				listed in this subsection to the Commissioner 30 days prior to making a
				long-term care insurance form available for sale.
(a) A copy of the disclosure documents
				required in Section
				120-2-16-.09; and
(b) An actuarial certification consisting of
				at least the following:
(i) A statement that
				the initial premium rate schedule is sufficient to cover anticipated costs
				under moderately adverse experience and that the premium rate schedule is
				reasonably expected to be sustainable over the life of the form with no future
				premium increases anticipated;
(ii)
				A statement that the policy design and coverage provided have been reviewed and
				taken into consideration;
(iii) A
				statement that the underwriting and claims adjudication processes have been
				reviewed and taken into consideration;
(iv) A complete description of the basis for
				contract reserves that are anticipated to be held under the form, to include:
(A) Sufficient detail or sample calculations
				provided so as to have a complete depiction of the reserve amounts to be
				held;
(B) A statement that the
				assumptions used for reserves contain reasonable margins for adverse
				experience;
(C) A statement that
				the net valuation premium for renewal years does not increase (except for
				attained-age rating where permitted); and
(D) A statement that the difference between
				the gross premium and the net valuation premium for renewal years is sufficient
				to cover expected renewal expenses; or if such a statement cannot be made, a
				complete description of the situations where this does not occur;
(I) An aggregate distribution of anticipated
				issues may be used as long as the underlying gross premiums maintain a
				reasonably consistent relationship;
(II) If the gross premiums for certain age
				groups appear to be inconsistent with this requirement, the Commissioner may
				request a demonstration under subsection (3) based on a standard age
				distribution; and
(v)
(A) A
				statement that the premium rate schedule is not less than the premium rate
				schedule for existing similar policy forms also available from the insurer
				except for reasonable differences attributable to benefits; or
(B) A comparison of the premium schedules for
				similar policy forms that are currently available from the insurer with an
				explanation of the differences.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.11 - Prohibition Against Post - Claims Underwriting

Current through Rules and Regulations filed through June 27, 2024
(1) All applications for long-term care
				insurance policies or certificates except those that are guaranteed issue shall
				contain clear and unambiguous questions designed to ascertain the health
				condition of the applicant.
(2)
(a) If an application for long-term care
				insurance contains a question that asks whether the applicant has had
				medication prescribed by a physician, it must also ask the applicant to list
				the medication that has been prescribed.
(b) If the medications listed in the
				application were known by the insurer, or should have been known at the time of
				application, to be directly related to a medical condition for which coverage
				would otherwise be denied, then the policy or certificate shall not be
				rescinded for that condition.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.12 - Minimum Standards for Home Health and Community Care Benefits in Long - Term Care Insurance Policies

Current through Rules and Regulations filed through June 27, 2024
(1) A long-term care insurance policy or
				certificate shall not, if it provides benefits for home health care or
				community care services limit or exclude benefits:
(a) By requiring that the insured or claimant
				would need care in a skilled nursing facility if home health care services were
				not provided;
(b) By requiring that
				the insured or claimant first or simultaneously receive nursing or therapeutic
				services, or both, in a home, community or institutional setting before home
				health care services are covered;
(c) By limiting eligible services to services
				provided by registered nurses or licensed practical nurses;
(d) By requiring that a nurse or therapist
				provide services covered by the policy that can be provided by a home health
				aide, or other licensed or certified home care worker acting within the scope
				of his or her licensure or certification;
(e) By excluding coverage for personal care
				services provided by a home health aide;
(f) By requiring that the provision of home
				health care services be at a level of certification or licensure greater than
				that required by the eligible service;
(g) By requiring that the insured or claimant
				have an acute condition before home health care services are covered;
(h) By limiting benefits to services provided
				by Medicare-certified agencies or providers; or
(i) By excluding coverage for adult day care
				services.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.13 - Requirement to Offer Inflation Protection

Current through Rules and Regulations filed through June 27, 2024
(1) No insurer may offer a long-term care
				insurance policy unless the insurer also offers to the policyholder in addition
				to any other inflation protection the option to purchase a policy that provides
				for benefit levels to increase with benefit maximums or reasonable durations
				which are meaningful to account for reasonably anticipated increases in the
				costs of long-term care services covered by the policy. Insurers must offer to
				each policyholder, at the time of purchase, the option to purchase a policy
				with an inflation protection feature no less favorable than one of the
				following:
(a) Increases benefit levels
				annually in a manner so that the increases are compounded annually at a rate
				not less than five percent (5%);
(b) Guarantees the insured individual the
				right to periodically increase benefit levels without providing evidence of
				insurability or health status so long as the option for the previous period has
				not been declined. The amount of the additional benefit shall be no less than
				the difference between the existing policy benefit and that benefit compounded
				annually at a rate of at least five percent (5%) for the period beginning with
				the purchase of the existing benefit and extending until the year in which the
				offer is made; or
(c) Covers a
				specified percentage of actual or reasonable charges and does not include a
				maximum specified indemnity amount or limit.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.14 - Requirements for Application Forms and Replacement Coverage

Current through Rules and Regulations filed through June 27, 2024
(1) Application
				forms shall include the following questions designed to elicit information as
				to whether, as of the date of the application, the applicant has another
				long-term care insurance policy or certificate in force or whether a long-term
				care policy or certificate is intended to replace any other accident and
				sickness or long-term care policy or certificate presently in force. A
				supplementary application or other form to be signed by the applicant and
				agent, except where the coverage is sold without an agent, containing the
				questions may be used. With regard to a replacement policy issued to a group
				defined by O.C.G.A. Section
				33-42-4, the following questions
				may be modified only to the extent necessary to elicit information about health
				or long-term care insurance policies other than the group policy being
				replaced, provided that the certificateholder has been notified of the
				replacement.
(a) Do you have another long-term
				care insurance policy or certificate in force (including health care service
				contract, health maintenance organization contract)?
(b) Did you have another long-term care
				insurance policy or certificate in force during the last 12 months?
(i) If so, with which company?
(ii) If that policy lapsed, when did it
				lapse?
(c) Are you
				covered by Medicaid?
(d) Do you
				intend to replace any of your medical or health insurance coverage with this
				policy [certificate]?
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.15 - Reporting Requirements

Current through Rules and Regulations filed through June 27, 2024
(1) Every insurer shall maintain records for
				each agent of that agent's amount of replacement sales as a percent of the
				agent's total annual sales and the amount of lapses of long-term care insurance
				policies sold by the agent as a percent of the agent's total annual
				sales.
(2) Every insurer shall
				report annually by June 30 the 10 percent of its agents with the greatest
				percentages of lapses and replacements as measured by subsection (1) above.
				(Appendix G)
(3) Reported
				replacement and lapse rates do not alone constitute a violation of insurance
				laws or necessarily imply wrongdoing. The reports are for the purpose of
				reviewing more closely agent activities regarding the sale of long-term care
				insurance.
(4) Every insurer shall
				report annually by June 30 the number of lapsed policies as a percent of its
				total annual sales and as a percent of its total number of policies in force as
				of the end of the preceding calendar year. (Appendix G)
(5) Every insurer shall report annually by
				June 30 the number of replacement policies sold as a percent of its total
				annual sales and as a percent of its total number of policies in force as of
				the preceding calendar year. (Appendix G)
(6) Every insurer shall report annually by
				June 30, for qualified long-term care insurance contracts, the number of claims
				denied for each class of business, expressed as a percentage of claims denied.
				(Appendix E)
(7) For purposes of
				this section:
(a) "Policy" means only
				long-term care insurance;
(b)
				Subject to paragraph (c), "claim" means a request for payment of benefits under
				an in force policy regardless of whether the benefit claimed is covered under
				the policy or any terms or conditions of the policy have been met;
(c) "Denied" means the insurer refuses to pay
				a claim for any reason other than for claims not paid for failure to meet the
				waiting period or because of an applicable preexisting condition; and
(d) "Report" means on a statewide
				basis.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.16 - Licensing

Current through Rules and Regulations filed through June 27, 2024
A producer is not authorized to sell, solicit or negotiate
				  with respect to long-term care insurance except as authorized by O.C.G.A.
				  Chapter 33-23.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.17 - Discretionary Powers of Commissioner

Current through Rules and Regulations filed through June 27, 2024
The Commissioner may upon written request and after an
				  administrative hearing, issue an order to modify or suspend a specific
				  provision or provisions of this Regulation with respect to a specific long-term
				  care insurance policy or certificate upon a written finding that:
(1) The modification or suspension would be
				in the best interest of the insureds;
(2) The purposes to be achieved could not be
				effectively or efficiently achieved without the modification or suspension;
				and
(3)
(a) The modification or suspension is
				necessary to the development of an innovative and reasonable approach for
				insuring long-term care; or
(b) The
				policy or certificate is to be issued to residents of a life care or continuing
				care retirement community or some other residential community for the elderly
				and the modification or suspension is reasonably related to the special needs
				or nature of such a community; or
(c) The modification or suspension is
				necessary to permit long-term care insurance to be sold as part of, or in
				conjunction with, another insurance product.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.18 - Reserve Standards

Current through Rules and Regulations filed through June 27, 2024
(1) When long-term care benefits are provided
				through the acceleration of benefits under group or individual life policies or
				riders to such policies, policy reserves for the benefits shall be determined
				in accordance with O.C.G.A. Section
				33-10-13. Claim reserves shall
				also be established in the case when the policy or rider is in claim status.
Reserves for policies and riders subject to this subsection
				  should be based on the multiple decrement model utilizing all relevant
				  decrements except for voluntary termination rates. Single decrement
				  approximations are acceptable if the calculation produces essentially similar
				  reserves, if the reserve is clearly more conservative, or if the reserve is
				  immaterial. The calculations may take into account the reduction in life
				  insurance benefits due to the payment of long-term care benefits. However, in
				  no event shall the reserves for the long-term care benefit and the life
				  insurance benefit be less than the reserves for the life insurance benefit
				  assuming no long-term care benefit.
In the development and calculation of reserves for policies
				  and riders subject to this subsection, due regard shall be given to the
				  applicable policy provisions, marketing methods, administrative procedures and
				  all other considerations which have an impact on projected claim costs,
				  including, but not limited to, the following:
(a) Definition of insured events;
(b) Covered long-term care
				facilities;
(c) Existence of home
				convalescence care coverage;
(d)
				Definition of facilities;
(e)
				Existence or absence of barriers to eligibility;
(f) Premium waiver provision;
(g) Renewability;
(h) Ability to raise premiums;
(i) Marketing method;
(j) Underwriting procedures;
(k) Claims adjustment procedures;
(l) Waiting period;
(m) Maximum benefit;
(n) Availability of eligible
				facilities;
(o) Margins in claim
				costs;
(p) Optional nature of
				benefit;
(q) Delay in eligibility
				for benefit;
(r) Inflation
				protection provisions; and
(s)
				Guaranteed insurability option.
Any applicable valuation morbidity table shall be certified
				  as appropriate as a statutory valuation table by a member of the American
				  Academy of Actuaries.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.19 - Loss Ratio

Current through Rules and Regulations filed through June 27, 2024
(1) This section shall apply to all long-term
				care insurance policies or certificates except those covered under Sections
				120-2-16-.10 and
				120-2-16-.20.
(2) Benefits under long-term care insurance
				policies shall be deemed reasonable in relation to premiums provided the
				expected loss ratio is at least 60 percent, calculated in a manner which
				provides for adequate reserving of the long-term care insurance risk. In
				evaluating the expected loss ratio, due consideration shall be given to all
				relevant factors, including:
(a) Statistical
				credibility of incurred claims experience and earned premiums;
(b) The period for which rates are computed
				to provide coverage;
(c)
				Experienced and projected trends;
(d) Concentration of experience within early
				policy duration;
(e) Expected claim
				fluctuation;
(f) Experience
				refunds, adjustments or dividends;
(g) Renewability features;
(h) All appropriate expense
				factors;
(i) Interest;
(j) Experimental nature of the
				coverage;
(k) Policy
				reserves;
(l) Mix of business by
				risk classification; and
(m)
				Product features such as long elimination periods, high deductibles and high
				maximum limits.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.20 - Premium Rate Schedule Increases

Current through Rules and Regulations filed through June 27, 2024
(1) This section shall apply as follows:
(a) Except as provided in paragraph (2), this
				section applies to any long-term care policy or certificate issued in this
				state on or after October 1, 2008.
(b) For certificates issued on or after the
				effective date of this amended regulation under a group long-term care
				insurance policy as defined in O.C.G.A. Section
				33-42-4, which policy was in force
				at the time this amended regulation became effective, the provisions of this
				section shall apply on the policy anniversary following April 1,
				2009.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.21 - Filing Requirement

Current through Rules and Regulations filed through June 27, 2024
Prior to an insurer or similar organization offering group
				  long-term care insurance to a resident of this state pursuant to O.C.G.A.
				  Section 33-42-5, it shall file with the
				  Commissioner evidence that the group policy or certificate thereunder has been
				  approved by a state having statutory or regulatory long-term care insurance
				  requirements substantially similar to those adopted in this
				  state.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.22 - Filing Requirements for Advertising

Current through Rules and Regulations filed through June 27, 2024
(1) Every insurer, health care service plan
				or other entity providing long-term care insurance or benefits in this state
				shall provide a copy of any long-term care insurance advertisement intended for
				use in this state whether through written, radio or television medium to the
				Commissioner for review or approval by the Commissioner to the extent it may be
				required under state law. In addition, all advertisements shall be retained by
				the insurer, health care service plan or other entity for at least three years
				from the date the advertisement was first used.
(2) The Commissioner may exempt from these
				requirements any advertising form or material when, in the Commissioner's
				opinion, this requirement may not be reasonably applied.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.23 - Standards for Marketing

Current through Rules and Regulations filed through June 27, 2024
(1) Every insurer, health care service plan
				or other entity marketing long-term care insurance coverage in this state,
				directly or through its producers, shall:
(a)
				Establish marketing procedures and agent training requirements to assure that:
(i) Any marketing activities, including any
				comparison of policies, by its agents or other producers will be fair and
				accurate; and
(ii) Excessive
				insurance is not sold or issued.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.24 - Suitability

Current through Rules and Regulations filed through June 27, 2024
(1) This section
				shall not apply to life insurance policies that accelerate benefits for
				long-term care.
(2) Every insurer,
				health care service plan or other entity marketing long-term care insurance
				(the "issuer") shall:
(a) Develop and use
				suitability standards to determine whether the purchase or replacement of
				long-term care insurance is appropriate for the needs of the
				applicant;
(b) Train its agents in
				the use of its suitability standards; and
(c) Maintain a copy of its suitability
				standards and make them available for inspection upon request by the
				Commissioner.
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 120-2-16 - LONG TERM CARE INSURANCE › Rule 120-2-16-.25 - Prohibition Against Preexisting Conditions and Probationary Periods in Replacement Policies or Certificates

Current through Rules and Regulations filed through June 27, 2024
If a long-term care insurance policy or certificate replaces
				  another long-term care policy or certificate, the replacing insurer shall waive
				  any time periods applicable to preexisting conditions and probationary periods
				  in the new long-term care policy for similar benefits to the extent that
				  similar exclusions have been satisfied under the original
				  policy.
O.C.G.A. Secs.
				  33-2-9,
				  33-42-6,
				  33-42-7,
				  49-4-164,
				  49-4-165.