reglab/statecodes huggingface dataset:
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-6.06 - Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020

Current through June, 2024
(a) No policy or certificate that provides
			 coverage of the Medicare Part B deductible may be advertised, solicited,
			 delivered, or issued for delivery in this State as a Medicare supplement policy
			 or certificate to individuals newly eligible for Medicare on or after January
			 1, 2020. All policies must comply with the following benefit standards. Benefit
			 plan standards applicable to Medicare supplement policies and certificates
			 issued to individuals eligible for Medicare before January 1, 2020, remain
			 subject to the requirements of sections
			 16-12-5.5,
			 16-12-6,
			 and
			 16-12-6.05.
(b) Benefit requirements. The
			 standards and requirements of section
			 16-12-6.05
			 shall apply to all Medicare supplement policies or certificates delivered or
			 issued for delivery to individuals newly eligible for Medicare on or after
			 January 1, 2020, with the following exceptions:
(1) Standardized Medicare supplement benefit
			 Plan C is redesignated as Plan D and shall provide the benefits contained in
			 section
			 16-12-6.05(f)(3)
			 but shall not provide coverage for 100 per cent or any portion of the Medicare
			 Part B deductible.
(2) Standardized
			 Medicare supplement benefit Plan F is redesignated as Plan G and shall provide
			 the benefits contained in section
			 16-12-6.05(f)(5)
			 but shall not provide coverage for 100 per cent or any portion of the Medicare
			 Part B deductible.
(3) Standardized
			 Medicare supplement benefit Plans C, F, and F with high deductible may not be
			 offered to individuals newly eligible for Medicare on or after January 1,
			 2020.
(4) Standardized Medicare
			 supplement benefit Plan F with high deductible is redesignated as Plan G with
			 high deductible and shall provide the benefits contained in section
			 16-12-6.05(f)(6)
			 of this regulation but shall not provide coverage for 100 per cent or any
			 portion of the Medicare Part B deductible; provided further that, the Medicare
			 Part B deductible paid by the beneficiary shall be considered an out-of-pocket
			 expense in meeting the annual high deductible.
(5) The reference to Plans C or F contained
			 in section
			 16-12-6.05(b)(2)
			 is deemed a reference to Plans D or G for purposes of this
			 section.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-6.1 - Medicare Select policies and certificates

Current through June, 2024
(a)
(1) This section shall apply to Medicare
			 Select policies and certificates, as defined in this section.
(2) No policy or certificate may be
			 advertised as a Medicare Select policy or certificate unless it meets the
			 requirements of this section.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-6.2 - Open enrollment

Current through June, 2024
(a) No issuer shall
			 deny or condition the issuance or effectiveness of any Medicare supplement
			 policy or certificate available for sale in this State, nor discriminate in the
			 pricing of a policy or certificate because of the health status, claims
			 experience, receipt of health care, or medical condition of an applicant in the
			 case of an application for a policy or certificate that is submitted prior to
			 or during the six month period beginning with the first day of the first month
			 in which an individual is enrolled for benefits under Medicare Part B. Each
			 Medicare supplement policy and certificate currently available from an issuer
			 shall be made available to all applicants who qualify under this subsection
			 without regard to age.
(b)
(1) If an applicant qualifies under
			 subsection (a) and submits an application during the time period referenced in
			 subsection (a) and, as of the date of application, has had a continuous period
			 of creditable coverage of at least six months, the issuer shall not exclude
			 benefits based on a preexisting condition.
(2) If the applicant qualifies under
			 subsection (a) and submits an application during the time period referenced in
			 subsection (a) and, as of the date of application, has had a continuous period
			 of creditable coverage that is less than six months, the issuer shall reduce
			 the period of any preexisting condition exclusion by the aggregate of the
			 period of creditable coverage applicable to the applicant as of the enrollment
			 date. The Secretary shall specify the manner of the reduction under this
			 subsection.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-6.3 - Guaranteed issue for eligible persons

Current through June, 2024
(a) Guaranteed
			 issue.
(1) Eligible persons are those
			 individuals described in subsection (b) who seek to enroll under the policy
			 during the period specified in subsection (c), and who submit evidence of the
			 date of termination, disenrollment, or Medicare Part D enrollment with the
			 application for a Medicare supplement policy.
(2) With respect to eligible persons, an
			 issuer shall not deny or condition the issuance or effectiveness of a Medicare
			 supplement policy described in subsection (e) that is offered and is available
			 for issuance to new enrollees by the issuer, shall not discriminate in the
			 pricing of that Medicare supplement policy because of health status, claims
			 experience, receipt of health care, or medical condition, and shall not impose
			 an exclusion of benefits based on a preexisting condition under that Medicare
			 supplement policy.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-6.4 - Standards for claims payment

Current through June, 2024
(a) An issuer shall
			 comply with Section 1882(c)(3) of the Social Security Act (as enacted by
			 Section 4081(b)(2)(C) of the Omnibus Budget Reconciliation Act of 1987 (OBRA)
			 1987, Pub. L. No. 100-203 ) by:
(1) Accepting
			 a notice from a Medicare carrier on dually assigned claims submitted by
			 participating physicians and suppliers as a claim for benefits in place of any
			 other claim form otherwise required and making a payment determination on the
			 basis of the information contained in that notice;
(2) Notifying the participating physician or
			 supplier and the beneficiary of the payment determination;
(3) Paying the participating physician or
			 supplier directly;
(4) Furnishing,
			 at the time of enrollment, each enrollee with a card listing the policy name,
			 number, and a central mailing address to which notices from a Medicare carrier
			 may be sent;
(5) Paying user fees
			 for claim notices that are transmitted electronically or otherwise;
			 and
(6) Providing to the Secretary
			 of Health and Human Services, at least annually, a central mailing address to
			 which all claims may be sent by Medicare carriers.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-7 - Loss ratio standards and refund or credit of premium

Current through June, 2024
(a)
			 The following provisions of this subsection establish loss ratio standards:
(1)
(A) A
			 Medicare supplement policy form or certificate form shall not be delivered or
			 issued for delivery unless the policy form or certificate form can be expected,
			 as estimated for the entire period for which rates are computed to provide
			 coverage, to return to policyholders and certificate holders in the form of
			 aggregate benefits (not including anticipated refunds or credits) provided
			 under the policy form or certificate form:
(i)
			 At least 75 per cent of the aggregate amount of premiums earned in the case of
			 group policies; or
(ii) At least 65
			 per cent of the aggregate amount of premiums earned in the case of individual
			 policies;
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-7.3 - Filing and approval of policies and certificates and premium rates

Current through June, 2024
(a) An issuer shall not deliver or issue for
			 delivery a policy or certificate to a resident of this State unless the policy
			 form or certificate form has been filed with and approved by the commissioner
			 in accordance with filing requirements and procedures prescribed by the
			 commissioner.
(b) An issuer shall
			 file any riders or amendments to policy or certificate forms to delete
			 outpatient prescription drug benefits as required by the Medicare Prescription
			 Drug, Improvement, and Modernization Act of 2003 only with the commissioner in
			 the state in which the policy or certificate was issued.
(c) An issuer shall not use or change premium
			 rates for a Medicare supplement policy or certificate unless the rates, rating
			 schedule, and supporting documentation have been filed with and approved by the
			 commissioner in accordance with the filing requirements and procedures
			 prescribed by the commissioner.
(d)
(1) Except as provided in paragraph (2) of
			 this subsection, an issuer shall not file for approval more than one form of a
			 policy or certificate of each type for each standard Medicare supplement
			 benefit plan.
(2) An issuer may
			 offer, with the approval of the commissioner, up to four additional policy
			 forms or certificate forms of the same type for the same standard Medicare
			 supplement benefit plan, one for each of the following cases:
(A) The inclusion of new or innovative
			 benefits;
(B) The addition of
			 either direct response or agent marketing methods;
(C) The addition of either guaranteed issue
			 or underwritten coverage; and
(D)
			 The offering of coverage to individuals eligible for Medicare by reason of
			 disability.
(3) For the
			 purposes of this section, a "type" means an individual policy, a group policy,
			 an individual Medicare Select policy, or a group Medicare Select
			 policy.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-7.6 - Permitted compensation arrangements

Current through June, 2024
(a) An issuer or
			 other entity may provide commission or other compensation to an agent or other
			 representative for the sale of a Medicare supplement policy or certificate only
			 if the first year commission or other first year compensation is no more than
			 200 per cent of the commission or other compensation paid for selling or
			 servicing the policy or certificate in the second year or period.
(b) The commission or other compensation
			 provided in subsequent (renewal) years must be the same as that provided in the
			 second year or period and must be provided for no fewer than five renewal
			 years.
(c) No issuer or other
			 entity shall provide compensation to its agents or other producers and no agent
			 or producer shall receive compensation greater than the renewal compensation
			 payable by the replacing issuer on renewal policies or certificates if an
			 existing policy or certificate is replaced.
(d) For purposes of this section,
			 "compensation" includes pecuniary or nonpecuniary remuneration of any kind
			 relating to the sale or renewal of the policy or certificate including but not
			 limited to bonuses, gifts, prizes, awards, and finders fees.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-8.3 - Notice requirements

Current through June, 2024
(a) As soon as
			 practicable, but no later than thirty days prior to the annual effective date
			 of any Medicare benefit changes, an issuer shall notify its policyholders and
			 certificate holders of modifications it has made to Medicare supplement
			 insurance policies or certificates in a format acceptable to the commissioner.
			 The notice shall:
(1) Include a description of
			 revisions to the Medicare program and a description of each modification made
			 to the coverage provided under the Medicare supplement policy or certificate;
			 and
(2) Inform each policyholder or
			 certificate holder as to when any premium adjustment is to be made due to
			 changes in Medicare.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-9 - Outline of coverage requirements for Medicare supplement policies

Current through June, 2024
(a) Issuers shall provide an outline of
			 coverage to all applicants at the time the application is presented to the
			 prospective applicant and, except for direct response policies, shall obtain an
			 acknowledgment of receipt of the outline from the applicant.
(b) If an outline of coverage is provided at
			 the time of application and the Medicare supplement policy or certificate is
			 issued on a basis which would require revision of the outline, a substitute
			 outline of coverage properly describing the policy or certificate shall
			 accompany the policy or certificate when it is delivered and contain the
			 following statement, in no less than twelve point type, immediately above the
			 company name:
"NOTICE: Read this outline of coverage carefully. It is
				not identical to the outline of coverage provided upon application and the
				coverage originally applied for has not been issued."
(c) The outline of coverage provided to
			 applicants pursuant to this section consists of four parts: a cover page,
			 premium information, disclosure pages, and charts displaying the features of
			 each benefit plan offered by the issuer. The outline of coverage shall be in
			 the language and format prescribed below in no less than twelve point type. All
			 Plans A-L shall be shown on the cover page, and the plan(s) that are offered by
			 the issuer shall be prominently identified. Premium information for plans that
			 are offered shall be shown on the cover page or immediately following the cover
			 page and shall be prominently displayed. The premium and mode shall be stated
			 for all plans that are offered to the prospective applicant. All possible
			 premiums for the prospective applicant shall be illustrated.
(d) The outline of coverage provided to the
			 applicant pursuant to subsections (a), (b), and (c) shall be in the form
			 prescribed in Exhibit A (revised 2019), located at the end of this chapter,
			 which is made a part of this section.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-10 - Notice regarding policies or certificates which are not Medicare supplement policies

Current through June, 2024
(a) Any accident
			 and sickness insurance policy or certificate other than a Medicare supplement
			 policy, any policy issued pursuant to a contract under Section 1876 of the
			 Federal Social Security Act (
			 42 U.S.C. Section
			 1395 et seq.), any disability income policy,
			 or any other policy identified in subsection
			 16-12-2(b)
			 of this chapter, issued for delivery in this State to persons eligible for
			 Medicare shall notify insureds under the policy that the policy is not a
			 Medicare supplement policy or certificate. The notice shall either be printed
			 or attached to the first page of the outline of coverage delivered to insureds
			 under the policy or, if no outline of coverage is delivered, to the first page
			 of the policy or certificate delivered to insureds. The notice shall be in no
			 less than twelve point type and shall contain the following language:
"This (policy or certificate) is not a Medicare
				supplement (policy or contract). If you are eligible for Medicare, review the
				Guide to Health Insurance for People with Medicare available from the
				company."
(b)
			 Applications provided to persons eligible for Medicare for the health insurance
			 policies or certificates described in subsection 16-12-10(a) shall disclose,
			 using the applicable statement in Appendix C (Exhibit F (revised 2019)), the
			 extent to which the policy duplicates Medicare. The disclosure statement shall
			 be provided as a part of, or together with, the application for the policy or
			 certificate.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-11 - Requirements for application forms and replacement coverage

Current through June, 2024
(a)
			 Application forms shall include questions designed to elicit information as to
			 whether, as of the date of the application, the applicant currently has
			 Medicare supplement, Medicare Advantage, Medicaid coverage, or other health
			 insurance policy or certificate in force or whether a Medicare supplement
			 policy or certificate is intended to replace any other accident and sickness
			 policy or certificate presently in force. A supplementary application or other
			 form to be signed by the applicant and agent may be used containing the
			 questions and statements in substantially the form entitled Exhibit C (revised
			 2019), located at the end of this chapter, which is made a part of this
			 section.
(b) Agents shall list any
			 other health insurance policies they have sold to the applicant. Agents shall:
(1) List policies sold which are still in
			 force; and
(2) List policies sold
			 in the past five years which are no longer in force.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-12 - Filing requirements for advertising

Current through June, 2024
(a) An issuer shall
			 provide a copy of any Medicare supplement advertisement intended for use in
			 this State whether through written, radio, or television medium to the
			 commissioner for review or approval by the commissioner to the extent it may be
			 required under state law. That advertisement shall comply with all applicable
			 laws of this State.
(b) An issuer
			 shall file a certification signed by an officer of the issuer stating that the
			 advertisements filed pursuant to this subsection are in accordance with the
			 standards established by article 10A of chapter 431, HRS, and section
			 431:13-103,
			 HRS. In determining the accuracy of any certification, the commissioner may
			 require the issuer to submit any additional information.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-12.2 - Standards for marketing

Current through June, 2024
(a) An issuer,
			 directly or through its producers, shall:
(1)
			 Establish marketing procedures to assure that any comparison of policies by its
			 agents or other producers will be fair and accurate.
(2) Establish marketing procedures to assure
			 excessive insurance is not sold or issued.
(3) Display prominently by type, stamp, or
			 other appropriate means, on the first page of the outline of coverage and
			 policy the following:
"NOTICE TO BUYER: This policy may not cover all of your
				medical expenses."
(4) Inquire and otherwise make every
			 reasonable effort to identify whether a prospective applicant or enrollee for
			 Medicare supplement insurance already has accident and sickness insurance and
			 the types and amounts of that insurance.
(5) Establish auditable procedures for
			 verifying compliance with this subsection.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-12.4 - Appropriateness of recommended purchase and excessive insurance

Current through June, 2024
(a) In recommending the purchase or
			 replacement of any Medicare supplement policy or certificate an agent shall
			 make reasonable efforts to determine the appropriateness of a recommended
			 purchase or replacement.
(b) Any
			 sale of a Medicare supplement policy or certificate that will provide an
			 individual more than one Medicare supplement policy or certificate is
			 prohibited.
(c) An issuer shall not
			 issue a Medicare supplement policy or certificate to an individual enrolled in
			 Medicare Part C unless the effective date of the coverage is after the
			 termination date of the individual's Part C coverage.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-12.6 - Reporting of multiple policies

Current through June, 2024
(a) On or before
			 March 1 of each year, an issuer shall report to the commissioner in
			 substantially the form entitled Appendix B (Exhibit B (revised 2019)), located
			 at the end of this chapter, which is made a part of this section, the following
			 information for every individual resident of this State for which the issuer
			 has in force more than one Medicare supplement policy or certificate:
(1) Policy and certificate number;
			 and
(2) Date of issuance.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-12.8 - Prohibition against preexisting conditions, waiting periods, elimination periods, and probationary periods in replacement policies or certificates

Current through June, 2024
(a) If a Medicare supplement policy or
			 certificate replaces another Medicare supplement policy or certificate, the
			 replacing issuer shall waive any time periods applicable to preexisting
			 conditions, waiting periods, elimination periods, and probationary periods in
			 the new Medicare supplement policy or certificate for similar benefits to the
			 extent that time was spent under the original policy.
(b) If a Medicare supplement policy or
			 certificate replaces another Medicare supplement policy or certificate which
			 has been in effect for at least six months, the replacing policy or certificate
			 shall not provide any time period applicable to preexisting conditions, waiting
			 periods, elimination periods, and probationary periods for benefits similar to
			 those contained in the original policy or certificate.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-12.9 - Prohibition against use of genetic information and requests for genetic testing

Current through June, 2024
(a) This section
			 applies to all policies with policy years beginning on or after May 21,
			 2009.
(b) An issuer of a Medicare
			 supplement policy or certificate:
(1) Shall
			 not deny or condition the issuance or effectiveness of the policy or
			 certificate (including the imposition of any exclusion of benefits under the
			 policy based on a preexisting condition) on the basis of the genetic
			 information with respect to such individual; and
(2) Shall not discriminate in the pricing of
			 the policy or certificate (including the adjustment of premium rates) of an
			 individual on the basis of the genetic information with respect to such
			 individual.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 16-12-13 - Separability

Current through June, 2024
If any provision of this chapter or the application thereof to
				any person or circumstance is for any reason held to be invalid, the remainder
				of the chapter and the application of that provision to other persons or
				circumstances shall not be affected thereby."
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 12 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Exhibit B - Notice to Applicant Regarding Replacement of Medicare Supplement Insurance or Medicare Advantage › Appendix B - Form for Reporting Medicare Supplement Policies

Current through June, 2024
Company Name:
				  __________________________________________________________
Address:
				  __________________________________________________________
__________________________________________________________
Phone Number:
				  __________________________________________________________
Due: March 1, annually
The purpose of this form is to report the following
				  information on each resident of this State who has in force more than one
				  Medicare supplement policy or certificate. The information is to be grouped by
				  individual policyholder.
Policy and Certificate No.
Date of Issuance
__________________________________
Signature
__________________________________
Name - (Please Type)
__________________________________
Title - (Please Type)
__________________________________
Date
The amended
				  version of this section by
				  Hawaii
				  Administrative Rules Listing of Filings, 2019-01, July, eff.
				  8/1/2019 is not yet
				  available.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-1 - Definitions

Current through June, 2024
As used in this chapter:
"Executive officer" means chief executive officer, chief
				operating officer, chief financial officer, treasurer, secretary, controller,
				or any other individual performing functions corresponding to those performed
				by the foregoing officers under whatever title.
"Statement" means information required to be filed with the
				commissioner pursuant to sections
				431:11-104
				to
				431:11-104.5,
				431:11-105,
				and
				431:11-106,
				HRS, and the following guidelines set forth in Forms A, B, C, D, E, and F at
				the end of this chapter.
"Ultimate controlling person" means a person which is not
				controlled by any other person.
Unless the context requires otherwise, terms found in this
				chapter are used as defined in section
				431:11-102, HRS.
				Other terminology is used as defined in chapter
				431, HRS, or industry usage if not
				defined in chapter
				431, HRS.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-3 - Information unknown or unavailable

Current through June, 2024
If the person filing cannot practically furnish any required
				information, document, or report at the required time, the person shall file
				with the commissioner a separate document:
(1) Identifying the information, document, or
			 report in question;
(2) Stating why
			 filing at the required time is impractical; and
(3) Requesting an extension of time for
			 filing the information, document, or report to a specified date.
The request for an extension shall be deemed granted unless the
				commissioner enters an order denying the request within thirty days after
				receipt of the request.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-4 - Subsidiaries of domestic insurers

Current through June, 2024
The authority to invest in subsidiaries under section
				431:11-103(b),
				HRS, is in addition to any authority to invest in subsidiaries which may be
				contained in any other provision of chapter 431, HRS.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-5 - Statement for acquisition of control and preacquisition notification

Current through June, 2024
(a) A person required to file a statement
			 pursuant to section
			 431:11-104,
			 HRS, shall furnish the required information utilizing Form A and the required
			 information on Form E described in subsections (e), (f), and (g).
(b) The person filing the statement required
			 by section
			 431:11-104,
			 HRS, shall promptly advise the commissioner of any changes in the information
			 furnished on Form A arising after the date upon which the information was
			 furnished but before the commissioner's disposition of the application for
			 approval.
(c) If the person being
			 acquired is a "domestic insurer" as defined by section
			 431:11-104(a)(4),
			 HRS, the name of the domestic insurer on the cover page should be indicated as
			 follows: "ABC Insurance Company, a subsidiary of XYZ Holding
			 Company."
(d) Where a domestic
			 insurer is being acquired, references to "the insurer" contained in Form A
			 shall refer to both the domestic insurer and its subsidiaries.
(e) If a domestic insurer, including any
			 person controlling a domestic insurer, is proposing a merger or acquisition
			 pursuant to section
			 431:11-104(a)(1),
			 HRS, that person shall file a preacquisition notification form, Form
			 E.
(f) If a non-domiciliary insurer
			 licensed to do business in this State is proposing a merger or acquisition
			 pursuant to section
			 431:11-104.2, HRS, that
			 person shall file a preacquisition notification form, Form E. No preacquisition
			 notification form need be filed if the acquisition is beyond the scope of
			 section
			 431:11-104.2, HRS, as set
			 forth in section
			 431:11-104.2(b),
			 HRS.
(g) In addition to the
			 information required by Form E, the commissioner may require an expert opinion
			 as to the competitive impact of the proposed acquisition.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-6 - Annual registration

Current through June, 2024
(a) An insurer
			 required to file an annual registration statement pursuant to section
			 431:11-105,
			 HRS, shall furnish the required information utilizing Form B and Form
			 C.
(b) An amendment to Form B shall
			 be filed within fifteen days after the end of any month in which there is a
			 material change to the information provided in the annual registration
			 statement.
(c) Amendments to Form B
			 shall be filed in the Form B format, but only those items which are being
			 amended shall be reported. Each amendment shall include at the top of the cover
			 page "Amendment No._ to Form B for (insert year)" and shall indicate the date
			 of the change and not the date of the original filing.
(d) Any authorized insurer may file a
			 registration statement on behalf of any affiliated insurer or insurers which
			 are required to register under section
			 431:11-105,
			 HRS. A registration statement may include information regarding any insurer in
			 the holding company system even if the insurer is not authorized to do business
			 in this State. In lieu of filing a registration statement on Form B, the
			 authorized insurer may file a copy of the registration statement or similar
			 report which it is required to file in its state of domicile, provided that:
(1) The statement or report contains
			 substantially the same information required to be furnished on Form B;
			 and
(2) The filing insurer is the
			 principal insurance company in the insurance holding company system and the
			 filing contains a brief statement of facts which will substantiate the filing
			 insurer's claim that it is the principal insurer in the insurance holding
			 company system.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-7 - Disclaimers and termination of registration

Current through June, 2024
(a) A disclaimer of
			 affiliation or a request for termination of registration may be made when a
			 person does not, or will not upon the taking of some proposed action, control
			 another person (hereinafter referred to as "the subject"). The disclaimer shall
			 contain the following information:
(1) The
			 number of authorized, issued, and outstanding voting securities of the
			 subject;
(2) The number and
			 percentage of shares of the subject's voting securities which the person whose
			 control is disclaimed, and all affiliates of that person, hold of record, own
			 beneficially, or have a right to acquire, directly or indirectly;
(3) All material relationships and bases for
			 affiliation between the subject and the person whose control is disclaimed and
			 all affiliates of that person; and
(4) A statement explaining why the person
			 whose control is disclaimed does not control the subject.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-8 - Transactions subject to prior notice

Current through June, 2024
(a) An insurer
			 required to give notice of a proposed transaction pursuant to section
			 431:11-106,
			 HRS, shall furnish the required information on Form D.
(b) Management agreements, service
			 agreements, and cost sharing arrangements shall at a minimum and as applicable:
(1) Identify the person providing services
			 and the nature of such services;
(2) Set forth the methods to allocate
			 costs;
(3) Require timely
			 settlement, not less frequently than on a quarterly basis, and compliance with
			 the requirements in the National Association of Insurance Commissioners"
			 Accounting Practices and Procedures Manual;
(4) Prohibit advancement of funds by the
			 insurer to the affiliate except to pay for services defined in the
			 agreement;
(5) State that the
			 insurer will maintain oversight for functions provided to the insurer by the
			 affiliate and that the insurer will monitor services annually for quality
			 assurance;
(6) Define books and
			 records of the insurer to include all books and records developed or maintained
			 under or related to the agreement;
(7) Specify that all books and records of the
			 insurer are and remain the property of the insurer and are subject to control
			 of the insurer;
(8) State that all
			 funds and invested assets of the insurer are the exclusive property of the
			 insurer, held for the benefit of the insurer and are subject to the control of
			 the insurer;
(9) Include standards
			 for termination of the agreement with cause;
(10) Include procedures for termination of
			 the agreement without cause;
(11)
			 Include provisions for indemnification of the insurer in the event of gross
			 negligence or wilful misconduct on the part of the affiliate providing the
			 services;
(12) Specify that, if the
			 insurer is placed in receivership or seized by the commissioner under article
			 15, chapter
			 431, HRS:
(A) All of the rights of the insurer under
			 the agreement extend to the receiver or commissioner; and
(B) All books and records will immediately be
			 made available to the receiver or the commissioner, and shall be turned over to
			 the receiver or commissioner immediately upon the receiver or the
			 commissioner's request;
(13) Specify that the affiliate has no
			 automatic right to terminate the agreement if the insurer is placed in
			 receivership pursuant to article 15, chapter
			 431, HRS; and
(14) Specify that the affiliate will continue
			 to maintain any systems, programs, or other infrastructure notwithstanding a
			 seizure by the commissioner under article 15, chapter
			 431, HRS, and will make them
			 available to the receiver, for so long as the affiliate continues to receive
			 timely payment for services rendered.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-10 - Extraordinary dividends and other distributions

Current through June, 2024
(a) Requests
			 to the commissioner for approval of extraordinary dividends or any other
			 extraordinary distribution to shareholders shall include the following:
(1) The amount of the proposed
			 dividend;
(2) The date established
			 for payment of the dividend;
(3) A
			 statement as to whether the dividend is to be in cash or other property and, if
			 in property, a description of the property, its cost, and its fair market
			 value, together with an explanation of the basis for the valuation;
(4) A copy of the calculations determining
			 that the proposed dividend is extraordinary, including:
(A) The amounts, dates, and form of payment
			 of all dividends or distributions (including regular dividends but excluding
			 distributions of the insurer's own securities) paid during the previous twelve
			 consecutive months;
(B) Surplus as
			 regards policyholders (total capital and surplus) as of the preceding December
			 31;
(C) If the insurer is not a
			 life insurer, the net income less realized capital gains for the twelve month
			 period ending on the preceding December 31 and the two preceding twelve month
			 periods; and
(D) If the insurer is
			 not a life insurer, the dividends paid to stockholders, excluding distributions
			 of the insurer's own securities in the preceding two calendar years;
(5) A balance sheet and statement
			 of income for the period between the last annual statement filed with the
			 commissioner and the end of the month preceding the month in which the request
			 for dividend approval is submitted; and
(6) A brief statement as to the effect of the
			 proposed dividend upon the insurer's surplus, the reasonableness of the surplus
			 in relation to the insurer's outstanding liabilities, and the adequacy of the
			 surplus relative to the insurer's financial needs.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Section 16-14-11 - Adequacy of surplus

Current through June, 2024
The factors set forth in section
				431:11-106(d),
				HRS, are not intended to be an exhaustive list. In determining the adequacy and
				reasonableness of an insurer's surplus, no single factor is necessarily
				controlling. The commissioner shall consider the net effect of all of the
				factors, along with other factors bearing on the financial condition of the
				insurer. In comparing the surplus maintained by other insurers, the
				commissioner shall consider the extent to which each of these factors varies
				among insurers. In determining the quality and liquidity of investments in
				subsidiaries, the commissioner shall consider the individual subsidiary and may
				discount or disallow its valuation to the extent warranted by individual
				investments.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Form A - STATEMENT REGARDING THE ACQUISITION OF CONTROL OF OR MERGER WITH A DOMESTIC INSURER

Current through June, 2024
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Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Form B - INSURANCE HOLDING COMPANY SYSTEM ANNUAL REGISTRATION STATEMENT

Current through June, 2024
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Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 14 - INSURANCE HOLDING COMPANY SYSTEM › Form E - PRE-ACQUISITION NOTIFICATION FORM REGARDING THE POTENTIAL COMPETITIVE IMPACT OF A PROPOSED MERGER OR ACQUISITION BY A NON-DOMICILIARY INSURER DOING BUSINESS IN THIS STATE OR BY A DOMESTIC INSURER

Current through June, 2024
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Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-1 - Purpose and authority

Current through June, 2024
The purpose of this chapter is to set forth the financial,
				reporting, recordkeeping, and other requirements the commissioner deems
				necessary for the regulation of captive insurance companies, as authorized by
				the captive insurance code.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-2 - Definitions

Current through June, 2024
For purposes of this chapter:
"Adverse financial condition" means one or more of the
				following conditions:
(1) The
			 impairment of capital resulting from an imbalance of liabilities and
			 assets;
(2) Financial ratios
			 exceeding levels established by the commissioner, if any; or
(3) The material degradation of financial
			 results envisioned by the designated captive insurance manager or independent
			 certified public accountant through predictive forecasting to the end of the
			 next annual reporting period.
"Applicant captive" means a captive applying for a certificate
				of authority under the captive insurance code.
"Captive" or "captive insurance company" shall have the same
				meaning as provided for "captive insurance company" in section
				431:19-101, Hawaii
				Revised Statutes.
"Captive insurance code" means article 19 of chapter
				431, Hawaii Revised Statutes.
"Commissioner" means the insurance commissioner of the State of
				Hawaii or a duly authorized representative.
"Credit for reinsurance" means taking credit for reserves on
				risks ceded to a reinsurer by a captive on the captive's financial
				statements.
"Governing body" shall have the same meaning as provided in
				section
				431:19-101, Hawaii
				Revised Statutes.
"Organizational documents" shall have the same meaning as
				provided for "organizational document" in section
				431:19-101, Hawaii
				Revised Statutes.
"Risk retention captive" shall have the same meaning as
				provided for "risk retention captive insurance company" in section
				431:19-101, Hawaii
				Revised Statutes.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-5 - Repealed

Current through June, 2024
The amended
				version of this section by
				Hawaii
				Administrative Rules Listing of Filings, 2016-01, August,
				eff.8/18/2016 is not
				yet available.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-6 - Fee schedule

Current through June, 2024
(a) Each applicant
			 captive shall pay to the commissioner a nonrefundable application fee of $1,000
			 for examining, investigating, and processing its license application. Upon
			 approval of the application for a certificate of authority, the applicant
			 captive shall pay to the commissioner a license fee for the certificate of
			 authority in the amount set forth in subsection (b). Thereafter, each captive
			 shall pay to the commissioner a renewal fee in the amount set forth in
			 subsection (b) for each succeeding year on or before April 1.
(b) Depending on its class, a captive shall
			 be subject to the following license and annual renewal fees:
(1) $300 for each class 1 or class 2 captive
			 insurance company;
(2) $500 for
			 each class 3 captive insurance company; or
(3) $1,000 for each class 4 or class 5
			 captive insurance company.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-7 - Examination, investigation, and financial surveillance expenses

Current through June, 2024
(a) Captive insurance companies subject to
			 examination, investigation, or financial surveillance shall be responsible for
			 the payment of expenses associated with the examination, investigation, or
			 financial surveillance. Examination, investigation, and financial surveillance
			 expenses shall include costs, mileage, and other reasonable and appropriate
			 expenses associated with the examination, investigation, or financial
			 surveillance, as determined by the commissioner.
(1) If insurance division staff are employed
			 in the examination, investigation, or financial surveillance of a captive
			 insurance company, the captive insurance company shall be liable for the
			 following additional examination fees:
(A)
			 Administration at a rate of $30 per hour or fraction thereof;
(B) Examiner I at a rate of $50 per hour or
			 fraction thereof;
(C) Examiner II
			 at a rate of $55 per hour or fraction thereof; and
(D) Examiner III at a rate of $60 per hour or
			 fraction thereof.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-10 - Notification of material misstatement of financial condition or adverse financial condition

Current through June, 2024
(a) A captive shall
			 require its independent certified public accountant to immediately notify the
			 captive's governing body or audit committee in writing of any determination by
			 the independent certified public accountant that the captive has materially
			 misstated its financial condition in the captive's annual report or is in
			 adverse financial condition. The independent certified public accountant shall
			 provide written notification of material misstatement of financial condition or
			 adverse financial condition to the commissioner within five working days of
			 providing notice to the captive. The captive manager shall provide a written
			 remediation or corrective action plan to the commissioner within thirty days of
			 the independent certified public accountant providing notice to the
			 commissioner.
(b) As used in this
			 section, "annual report" means the National Association of Insurance
			 Commissioners" annual statement and the audited financial statement prepared by
			 an independent certified public accountant for a captive and required to be
			 filed with the commissioner pursuant to section
			 431:19-107,
			 Hawaii Revised Statutes.
Hawaii Administrative Rules › Title 16 - DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS › Chapter 17 - CAPTIVE INSURANCE COMPANIES › Section 16-17-11 - Additional deposit requirement

Current through June, 2024
(a) Whenever the
			 commissioner deems the financial condition or change in business plan of a
			 captive warrants additional security, the commissioner may require the captive
			 to deposit with the commissioner, in trust for the captive, cash, securities
			 approved by the commissioner, or an irrevocable letter of credit issued by a
			 bank chartered by the State of Hawaii or a member bank of the Federal Reserve
			 System.
(b) The commissioner shall
			 return the captive insurance company's deposit or letter of credit if the
			 captive ceases doing any business, provided the commissioner is satisfied that
			 all obligations of the company have been discharged.