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 120-2-32 - VARIABLE LIFE INSURANCE › Rule 120-2-32-.12 - Qualification of Agents for the Sale of Variable Life Insurance

Current through Rules and Regulations filed through June 27, 2024
(1) Qualification
				to Sell Variable Life Insurance. Agents shall be qualified to sell variable
				life insurance upon satisfying the following requirements:
(a) No person may sell or offer for sale in
				this State any variable life insurance policy unless such person:
1. holds a current life agent's
				license.
2. holds a current
				N.A.S.D. Registration as certified by the Central Registration
				Depository.
3. has filed with the
				Commissioner evidence that such person holds any license or authorization which
				may be required by the solicitation or sale of variable life insurance by any
				federal or state securities law.
4.
				has submitted an application for licensing and a certification by his
				sponsoring company that the agent has completed a preexamination course meeting
				the requirements of this State.
5.
				has passed the variable life agent examination administered by this
				State.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-32 - VARIABLE LIFE INSURANCE › Rule 120-2-32-.13 - Separability Article

Current through Rules and Regulations filed through June 27, 2024
If any provision of this Regulation or the application
				  thereof to any person or circumstance is for any reason held to be invalid, the
				  remainder of the Regulation and the application of such provision to other
				  persons or circumstances shall not be affected thereby.
O.C.G.A. Secs.
				  33-2-9,
				  33-11-36.
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 120-2-32 - VARIABLE LIFE INSURANCE › Rule 120-2-32-.14 - Penalties

Current through Rules and Regulations filed through June 27, 2024
Any insurer or agent, representative, officer or employee of
				  such insurer, failing to comply with the requirements of this Regulation shall
				  be subject to such penalties as prescribed by the insurance laws of this
				  State.
O.C.G.A. Secs.
				  33-2-9,
				  33-11-36.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation is made and promulgated by the Commissioner
				  of Insurance pursuant to the authority set forth in O.C.G.A. Sections
				  33-21-18 and
				  33-2-9.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
(1) To govern and
				regulate various phases of operations of Health Maintenance Organizations
				("HMOs").
(2) To protect the
				interests of the enrolled public.
(3) To provide means by which the quality of
				care rendered, in conjunction with such Rules and Regulations as may be
				established by the Commissioner of Human Resources, and the fiscal stability of
				such organizations can be monitored.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.03 - Definitions

Current through Rules and Regulations filed through June 27, 2024
(1) All terms
				defined in Acts 1979, p. 1148 (O.C.G.A. Chapter 33-21), as amended, hereinafter
				referred to as the Health Maintenance Organization Act or Act, which are used
				in this Regulation, shall have the same meaning as in the Act.
(2) The following words and terms, when used
				in this Regulation, shall have the following meanings:
(a) "Basic Rates" means rates for various
				categories of individuals that are calculated by or certified by a qualified
				actuary using reasonable assumptions as to expected medical expenses,
				administrative expenses and margins for contingencies.
(b) "Commissioner" means the Commissioner of
				Insurance of the State of Georgia.
(c) "Complaint" means a written expression of
				concern or displeasure by an enrollee regarding any aspect of the HMO relative
				to the enrollee which is delivered to the HMO, Department of Insurance or the
				Department of Human Resources.
(d)
				"Department" means the Department of Insurance, State of Georgia.
(e) "Governing body" means the Board of
				Directors, or if otherwise designated in the Charter or Bylaws, those
				individuals vested with the ultimate responsibility for the management of a
				corporation which has been issued or is applying for a certificate of authority
				to operate as a Health Maintenance Organization.
(f) "Public Member" means an individual who
				has no vested interest, financial or otherwise, in the operations of the HMO by
				reason of his relationship with the HMO as an employee, provider, stockholder
				or director.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.04 - Establishment of Health Maintenance Organizations

Current through Rules and Regulations filed through June 27, 2024
(1) All applications for a certificate of
				authority will be reviewed in accordance with the standards set forth in the
				Act, these rules and the Rules and Regulations of the Department of Human
				Resources.
(2) An applicant
				applying for a certificate of authority to operate an HMO in the State of
				Georgia, shall fully comply with the requirements of O.C.G.A. Chapter 33-21. An
				applicant shall fully and truthfully supply and insert the information required
				in the following listed forms which have been adopted for use by Order of the
				Commissioner, and shall provide such other information as the Commissioner may
				require:
(a) Form GID-2-HMO, the Application;
				Form GID-3-HMO, Appointment of Attorney for Service of Process; Forms GID-5a,
				5b and 5c, as applicable for a Security Deposit; Forms GID-6, and 6c as
				applicable for a Security Deposit; and Form GID-41, Biographical Affidavit for
				the principal officers and directors of the HMO.
(b) A Foreign or Alien HMO shall provide, in
				addition to the items listed in (a) above, Form GID-4-HMO, Appointment of
				Commissioner as Attorney for Service of Process.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.05 - Change in HMO Status or Services

Current through Rules and Regulations filed through June 27, 2024
(1) No name, other than that approved by the
				Commissioner, may be used by the HMO and the name of the HMO may not be changed
				without prior approval of the Commissioner.
(2) No HMO may change a service within the
				contract period, unless approved arrangements equitable to enrollees are made
				providing for a rate adjustment or substitution or an equivalent service, and
				prior approval of the Commissioner is obtained.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.06 - Termination of Coverage or Service

Current through Rules and Regulations filed through June 27, 2024
(1) No HMO may cancel or refuse to renew the
				coverage of an enrollee for any reason which is not related to nonpayment of
				premium except as provided by the Rules and Regulations of the Office of
				Commissioner of Insurance Chapter 120-2-67.
(2) No HMO may cease offering a service or
				terminate a service within a contract period, unless approved arrangements
				equitable to enrollees are made providing for a rate adjustment or substitution
				of an equivalent service, and prior approval of the Commissioner is
				obtained.
(3) When an HMO
				terminates all or a portion of an enrollee's coverage, or the enrollee, access
				must be provided to the complaint system set forth in Rule
				120-2-33-.09. No such termination
				shall be effective until the enrollee, if he so desires, and in accordance with
				the Act and Rule
				120-2-33-.09, has exhausted the
				complaint system.
(4)
				Notwithstanding paragraphs (5) and (6), an HMO offering a point of service
				policy form may not terminate coverage under that policy form for a group or
				individual because no member of that group lives, resides, or works in the
				approved service area, or, in the case of individual policy coverage, the
				insured no longer lives, resides, or works in the approved service
				area.
(5) The HMO shall not
				terminate the coverage of an enrollee under a group contract or group policy
				because the enrollee moves out of the approved service area, provided the
				enrollee continues to be an eligible enrollee of the insured group and agrees
				in writing to return to the approved service area for covered medical
				care.
(6) The HMO shall not
				terminate the coverage of an enrollee under an individual contract because the
				enrollee moves out of the approved service area, provided the enrollee agrees
				in writing to return to the approved service area for covered medical
				care.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.07 - Financial and Statistical Reporting

Current through Rules and Regulations filed through June 27, 2024
(1) Each HMO shall annually, on or before the
				first day of March, file with the Commissioner, on Annual Statement Forms
				prescribed and adopted by Order of the Commissioner, an annual statement as of
				December 31st of the preceding year, certified by at least two principal
				officers, and a copy of said report shall also be delivered to the Commissioner
				of Human Resources, as required by O.C.G.A. Section
				33-21-15.
(2) Quarterly financial reports on forms
				adopted by the NAIC shall be filed by each HMO not later than forty-five (45)
				days after the end of each calendar quarter.
(3) In addition to the requirements of the
				Act, each federally qualified HMO shall file with the Department copies of any
				financial or statistical reports required by the federal government.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.08 - Rates and Forms

Current through Rules and Regulations filed through June 27, 2024
(1) Basic rates along with the method of
				computation of charges for enrollee coverage or any amendments thereto to be
				used in conjunction with any health benefits plan must be filed with and
				approved by the Commissioner prior to use.
(2) The Commissioner shall approve or
				disapprove any basic rate or method of computation of charges, or change
				thereto, as provided in O.C.G.A. Section
				33-21-13.
(3) Such basic rates and methods of
				computation of charges shall be established in accordance with actuarial
				principles for various categories of enrollees, provided that charges
				applicable to an enrollee shall not be individually determined based on the
				status of health.
(4) Basic rates
				and charges shall not be excessive, inadequate, or unfairly
				discriminatory.
(5) A certification
				by a qualified actuary to the appropriateness of the basic rates, based on
				reasonable assumptions, shall accompany the filing, along with adequate
				supporting information. Supporting information shall include a detailed
				description, as applicable, but not necessarily limited to the following:
(a) projected and actual hospital utilization
				in days per thousand members per year;
(b) projected and actual hospital costs
				attributable to those hospitals specifically utilized by the HMO through
				contract or otherwise;
(c)
				projected and actual utilization of physician services, expressed in terms of
				numbers of visits per member per year;
(d) projected and actual costs of physician
				services, expressed in terms of cost per visit;
(e) projected and actual costs of emergency
				and out of area services of non-HMO providers, differentiated as to hospital
				and medical service components;
(f)
				identification, justification and derivation of any trend or protection
				factors; and
(g) identification and
				justification for any reserve or surplus contribution factor included within
				its charges.
Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.09 - Complaint System

Current through Rules and Regulations filed through June 27, 2024
(1) Each HMO shall establish and maintain a
				complaint system to provide adequate and reasonable procedures for expeditious
				resolution of complaints made by enrollees concerning any matter related to any
				provision of such organization's health services, including, but not limited
				to, claims regarding the scope of coverage for health services, denials,
				cancellations, terminations or renewals of enrollee coverage, and the quality
				of health maintenance services rendered.
(2) The complaint system shall be organized
				in a manner that provides meaningful procedures for hearing and resolving
				complaints by enrollees. These procedures shall be fully set forth in group
				contracts, certificates and individual policies. The complaint system must be
				established and approved by the HMO's board of directors. Such complaint system
				shall include, but not be limited to:
(a) a
				definition of a legitimate complaint;
(b) details on how, when, where and with whom
				an enrollee is to file a complaint;
(c) appeals mechanisms and
				processes;
(d) the responsibilities
				of the various levels of the complaint system and the HMO staff;
(e) a written description of the process for
				timely review and disposition of all complaints; and
(f) a written policy about the reasonable
				time period for resolving complaints.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.10 - Regulation of Agents

Current through Rules and Regulations filed through June 27, 2024
(1) An agent representing an HMO must comply
				with all of the requirements for a life, accident and sickness agent in
				O.C.G.A. Chapter 33-23 and have a current license and certificate of authority
				to represent the HMO.
(2) The HMO
				must comply with the provisions of O.C.G.A. Section
				33-23-15 with regard to obtaining a
				certificate of authority for each agent representing the HMO as required in
				O.C.G.A. Section
				33-23-15(a),
				filing a certified listing of agents whose certificates of authority are to be
				renewed along with the appropriate fees, and maintaining a list of authorized
				agents as required in O.C.G.A. Section
				33-23-15(d).
(3) All HMO agents shall act in a fiduciary
				capacity in regard to monies collected or held by such agent.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.11 - Conflict of Interest and Required Disclosure

Current through Rules and Regulations filed through June 27, 2024
Each applicant for a certificate of authority shall file with
				  the application and shall immediately file any changes thereafter, a summary
				  disclosure of any contractual or financial arrangements (or any future plans
				  for contractual or financial arrangements) between the incorporators, all
				  members of the governing body, the principal officers or any members of their
				  immediate families, or any persons in which incorporators, members of the
				  governing body, or principal officers, or any members of their immediate
				  families, have any financial interest whatsoever in the HMO or a contracting
				  provider of the HMO. The Commissioner may require such additional information
				  as he may deem necessary to implement the Act or this
				  Regulation.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.12 - Department of Human Resources

Current through Rules and Regulations filed through June 27, 2024
The Act provides for the Regulation of HMOs by the Department
				  of Insurance and the Department of Human Resources. While those areas of HMO
				  operation dealing with health care delivery will be monitored by the
				  Commissioner, the quality of care and certain complaints which fall within the
				  expertise of the Department of Human Resources shall be regulated by the
				  Commissioner of the Department of Human Resources in accordance with the
				  provisions of the Act and the applicable Rules and
				  Regulations.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.13 - Notice of Modification in Operations

Current through Rules and Regulations filed through June 27, 2024
Pursuant to O.C.G.A. Section
				  33-21-2(c)(1),
				  any modification in the operation of the HMO which is not otherwise
				  specifically referenced within this Regulation shall be filed prior to the
				  modification. Examples of such changes would include, but not necessarily be
				  limited to, service area expansion, addition to or contraction in the number or
				  size of health facilities operated, amendments or to provider contracts and
				  loss of federal qualification.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.14 - Severability

Current through Rules and Regulations filed through June 27, 2024
If any section, term or provision of these Rules and
				  Regulations shall be adjudged invalid for any reason, such adjudgement shall
				  not affect, impair or invalidate any other section, term or provision of these
				  Rules and Regulations and the remaining sections, terms and provisions shall be
				  and remain in full force.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.15 - Penalties

Current through Rules and Regulations filed through June 27, 2024
(1) Violations of
				these Regulations by an HMO or an officer of the HMO shall be deemed grounds
				for the revocation of the HMO's certificate of authority as provided in
				O.C.G.A. Section
				33-21-5, which shall be in
				addition to any other penalty provided by statute.
(2) Violations of these Regulations by any
				agent or representative of an HMO shall be grounds for the revocation of an
				agent's license or any other penalty provided by statute.
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.16 - Repealed

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.17 - Repealed

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-33 - HEALTH MAINTENANCE ORGANIZATIONS › Rule 120-2-33-.18 - Repealed

Current through Rules and Regulations filed through June 27, 2024
O.C.G.A. Secs.
				  33-2-9, Ch.
				  33-21.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.01 - Authority

Current through Rules and Regulations filed through June 27, 2024
This Regulation is made and promulgated by the Commissioner
				  of Insurance pursuant to the authority set forth in O.C.G.A. Section
				  34-9-174.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Sec.
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.02 - Purpose

Current through Rules and Regulations filed through June 27, 2024
(1) To provide for
				the establishment and regulation of Group Self- Insurance Funds by which
				Workers' Compensation Insurance benefits may be provided for employees of
				certain qualified associations or groups.
(2) To protect the interests of the members
				of a Fund and those employees thereof that are provided Workers' Compensation
				benefits thereunder.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.03 - Definitions

Current through Rules and Regulations filed through June 27, 2024
All terms defined in O.C.G.A. §
									34-9-150
et seq.
,
				  hereinafter referred to as the "Group Self-Insurance Funds Act" or "Act", which
				  are used in this Regulation shall have the same meaning as in the
				  Act.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.04 - Notice of Intent to Form a Fund

Current through Rules and Regulations filed through June 27, 2024
(1) At least thirty (30) days prior to
				forming a Group Self-Insurance Fund or signing the Intrastate Agreement,
				applicants shall first file with the Commissioner a "Notice of Intent to Form a
				Self- Insured Fund," referred to as form GSF-IN. The GSF-IN shall comply with
				O.C.G.A. §
									34-9-151.1 and must contain:
(a) The name of the group forming the
				Fund;
(b) The name of the proposed
				administrator;
(c) The type or
				types of employers to be offered membership into the Fund;
(d) A statement that the group is
				knowledgeable of and will comply with the requirements of Article 5 of Chapter
				9 of Title 34 of the Official Code of Georgia Annotated and this regulation;
				and
(e) A copy of the intrastate
				agreement that will be used to establish the Fund.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.05 - Application for Certificate of Authority

Current through Rules and Regulations filed through June 27, 2024
Each application for an original Certificate of Authority
				  shall be made on Form GSF-1, entitled "Application for Certificate of Authority
				  for Group Self-Insurance Fund." The application must be accompanied by all
				  stipulated documents including, but not limited to: GSF-1, GSF-5, GSF-6, GSF-7
				  and GSF-11 as well as the required, non-refundable filing fee specified in
				  O.C.G.A. §
									33-8-1 and adhere to the following
				  conditions:
(a) Conditional on
				acceptance of the Fund under previous section.
(b) The Commissioner's decision on "Notice of
				Intent" is not binding on the "Certificate of Authority."
(c) The application must be submitted within
				ninety (90) days of the first signed intrastate agreement.
(d) If the application is not filed within
				six (6) months of the acceptance of the "Notice of Intent," the Commissioner's
				acceptance of the "Notice of Intent" is withdrawn.
(e) The Commissioner has ninety (90) days,
				from the date the application is received, to accept or reject the
				application.
(f) No application for
				a Certificate of Authority shall be deemed complete until all information
				requested, whether of any member, trustee or administrator of the Fund, or of
				the Fund itself, is provided to the Commissioner.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.06 - Renewal of Certificate of Authority

Current through Rules and Regulations filed through June 27, 2024
Each application for renewal of a Certificate of Authority
				  shall be made on or before the first day of March of each year on Form GSF-2
				  entitled "Application for Renewal of Certificate of Authority for Group Self-
				  Insurance Fund." It shall be accompanied by all stipulated documents, including
				  the annual statement, and a renewal fee as specified in O.C.G.A. §
									33-8-1(1)(CC).
				  The Certificate of Authority issued pursuant to this chapter shall continue in
				  full force and effect until specifically refused or revoked by the Commissioner
				  in accordance with O.C.G.A. §
									34-9-169.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-153,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.07 - Application for Membership to a Fund

Current through Rules and Regulations filed through June 27, 2024
(1) Each application for a Certificate of
				Authority shall be accompanied, for each member of the Fund, by a separate Form
				GSF-3 or a comparable form containing the same information as the GSF-3,
				entitled "Application for Membership in Group Self-Insurance Fund."
(2) After the Fund has been granted a
				Certificate of Authority, it may add new members in the following manner:
(a) By submitting underwriting criteria to
				the Department in accordance with O.C.G.A. §
										34-9-155 and having the criteria
				approved by the Department; or
(b)
				By submitting a Form GSF-3 fifteen (15) days prior to the effective date of
				coverage; and
(c) For Funds that
				have a potential member which does not meet their approved underwriting
				criteria, they may submit a GSF-3 and ask for specific approval of the new
				member.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.08 - Termination of Membership

Current through Rules and Regulations filed through June 27, 2024
(1) A Fund may submit Termination Criteria to
				the Commissioner for approval. The criteria should stipulate reasons for
				terminating the relationship between the Fund and the member including, but not
				limited to, non-payment of premium, claims experience, and failure to report
				claims.
(2) A member electing to
				terminate its participation in the Fund shall submit to the Fund and to the
				Commissioner a Form GSF-4 entitled "Application for Termination of Membership
				in Group Self-Insurance Fund" at least ninety (90) days prior to the requested
				date of termination. If the Fund has an approved Termination Criteria in place,
				the member may submit a letter terminating its participation at least thirty
				(30) days prior to the requested date of termination.
(3) As a prerequisite to approval of
				termination of membership in the Fund, a member must demonstrate to the
				Commissioner, and to the Trustees, that it will, after termination, comply with
				its duty as an employer under O.C.G.A. §
									34-9-1 through §
									34-9-134.
(4) Except where termination criteria has
				been approved, within ten (10) days of receipt of the application for
				termination of membership, the Fund shall notify the Commissioner of the
				applicant's current standing, and state any reasons why the application should
				not be approved.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-156,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.09 - Application to Serve as Officer, Director or Trustee

Current through Rules and Regulations filed through June 27, 2024
Each prospective officer, director or trustee of a Fund shall
				  submit to the Fund and to the Commissioner a Form GSF-5, entitled "Application
				  to Serve as Officer, Director or Trustee of Group Self-Insurance
				  Fund".
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.10 - Application to Serve as Administrator

Current through Rules and Regulations filed through June 27, 2024
Each prospective administrator of a Fund shall submit to the
				  Fund and to the Commissioner a Form GSF-6, entitled "Application to Serve as
				  Administrator of Group Self-Insurance Fund".
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.11 - Execution of Intrastate Agreement

Current through Rules and Regulations filed through June 27, 2024
The following requirements must be met for the Intrastate
				  Agreement to be properly executed:
(a)
				The member must sign the signature page, or resolution if a government entity,
				certifying that:
1. The member subscribes to
				and abides by the Intrastate Agreement: the entire document does not have to be
				signed;
2. The member has received
				a copy of the Intrastate Agreement;
3. The member is aware of joint and several
				liability.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.12 - Request for Additional Information

Current through Rules and Regulations filed through June 27, 2024
(1) The Commissioner may, in connection with
				any filing required by §120-2-34, submit a written request to the Fund for
				additional information needed to complete the review of the filing.
(2) No filing shall be deemed complete until
				all such requested information is provided to the Commissioner.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.13 - Financial Reporting: Annual and Quarterly Statements

Current through Rules and Regulations filed through June 27, 2024
(1) On or before
				the first day of March, each Fund shall file with the Commissioner financial
				statements on forms approved by the Commissioner. These forms shall relate to
				the financial condition of the Fund as of December 31st of the preceding
				calendar year.
(2) Unless otherwise
				exempted by the Commissioner, on or before the fifteenth (15) day of May,
				August and November, each Fund shall file a quarterly statement on forms
				approved by the Commissioner.
(3)
				Only forms approved by the Commissioner will be accepted as financial
				statements for the Funds. All other forms used will be returned to the
				Fund.
(4) Funds operating on a
				fiscal year, versus a calendar year, shall annually file a financial statement
				on or before the first day of March and quarterly statements on or before the
				fifteenth (15th) of May, August, and November. Each statement shall reflect the
				appropriate complete reporting period of either 3, 6, 9, or 12
				months.
(5) Upon written request
				from a Fund, and payment of the necessary fee as specified by O.C.G.A. §
									33-8-1, the Commissioner may allow
				for an amended or updated filing of an annual or quarterly statement and such
				statement shall then be substituted for the original filing.
(6) Pursuant to O.C.G.A. §
									33-8-1(6)(W), a
				per day late fee will apply to late filings.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-159,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.14 - Books and Records: Examination

Current through Rules and Regulations filed through June 27, 2024
(1) The Commissioner or his representative
				may, either before granting a Certificate of Authority or at any time
				thereafter, at least once every five (5) years, examine the Fund. The
				examination will include all affairs that relate to the business of operating a
				Fund. All fund-related accounts, books, publications, records and vouchers
				shall be held for a term of at least five (5) years and maintained at the
				principal address shown on its Certificate of Authority. All materials
				pertaining to an active claim for which benefits are being paid shall be
				maintained until the claim is settled or otherwise terminated and then held for
				one year after the file is closed or until such file has been subject to an
				Insurance Department examination, whichever period is longer.
(2) The Commissioner or his representative
				shall have free access to all fund-related accounts, records, books,
				publications and vouchers. The administrators, officers, trustees, employees
				and representatives of the Fund shall aid the Commissioner or his
				representative, as far as it is in their power, in making the
				examination.
(3) If, at any time,
				the Commissioner finds the records or accounts to be inadequate or incorrectly
				kept or posted, he may employ experts to rewrite, post or balance such records
				at the expense of the Fund being examined if the Fund has failed to correct
				such records or accounts within sixty (60) days after the Commissioner has
				given it notice to do so.
(4) The
				costs of any examination performed by the Commissioner, or his designated
				representative under this section, shall be borne by the Fund being examined,
				in accordance with O.C.G.A. §
									33-2-15.
(5) The examination report shall be processed
				in accordance with O.C.G.A. §
									33-2-14.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-172,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.15 - Security Deposit

Current through Rules and Regulations filed through June 27, 2024
(1) Each Fund granted a Certificate of
				Authority by the Commissioner shall be required to establish and maintain a
				security deposit as set forth in O.C.G.A. §
									34-9-161.
(2) Any surety bond pledged as security
				deposit must be on a form approved by the Commissioner.
(3) When a security deposit is pledged in
				cash or eligible securities, the agreement with the bank or institution must be
				reviewed and approved by the Commissioner prior to the pledge of the security
				deposit.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-161,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.17 - Administrator's Bond and Errors and Omissions Coverage

Current through Rules and Regulations filed through June 27, 2024
(1) Each administrator shall have and
				maintain a fidelity bond in the amount of at least $100,000, as required by
				Rule 120-2-49-.07,
				on a form approved by the Commissioner.
(2) Each administrator shall have and
				maintain errors and omissions coverage or other appropriate liability
				insurance, written by an insurer authorized to transact insurance in this
				State, in an amount of at least $100,000.
(3) Any policy written in accordance with
				paragraph (2) of this Rule shall be for a term of at least one year and shall
				contain provisions that:
(a) cancellation or
				termination of the policy is not effective except upon sixty (60) days written
				notice by registered or certified mail;
(b) the policy is automatically renewable at
				the expiration of the policy period except upon sixty (60) days written notice
				of either party; and
(c) copies of
				notices required in subparagraphs (a) and (b) be mailed to the Commissioner by
				registered or certified mail.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.18 - Compensation of Administrator or Trustee

Current through Rules and Regulations filed through June 27, 2024
(1) Each administrator, trustee or officer of
				the Fund, or any employee or agent of any or all of them, shall submit to the
				Commissioner a copy of any proposed contract entitling him or her to any direct
				or indirect compensation from the Fund for services performed or sales or
				purchases made to or for the Fund.
(2) The Commissioner shall determine whether
				the compensation is reasonable and equitable under the circumstances and
				consistent with the provisions of the laws of Georgia and this Regulation. The
				Commissioner may accept or reject the proposed contract. The trustee, officer
				or administrator, or any employee or agent of any or all of them, may withdraw
				his or her proposed contract prior to its effective date.
(3) Any forms of direct or indirect
				compensation to a trustee, officer or administrator or to a corporation or firm
				in which a trustee, officer or administrator is in any way financially
				interested, other than that provided by this Regulation, O.C.G.A. §
									34-9-180(c), or
				the Bylaws of the Fund, shall be a violation of the trustee, officer or
				administrator's fiduciary responsibility. In such event, the Commissioner may,
				in addition, suspend, revoke or refuse to renew the Certificate of Authority of
				the Fund.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174,
				  34-9-180.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.19 - Rates and Premiums

Current through Rules and Regulations filed through June 27, 2024
(1) The Fund shall obtain prior approval of
				the Commissioner for any proposed rate, rating plan, or rating rule to be used
				by the Fund to determine premium. The Fund shall make any proposed rate filing
				with the Commissioner thirty (30) days prior to the proposed effective date.
				The filing shall include all supporting data to justify the proposed rates or
				rating plan. The Commissioner may require an actuarial report certifying that
				the proposed rates are adequate, not excessive nor unfairly
				discriminatory.
(2) Each charter
				and subsequent member of the Fund shall pay yearly premiums as outlined in the
				Intrastate Agreement or according to a plan approved by the Fund's Board of
				Trustees and the Commissioner. Payment plans will not be approved if they
				conflict with the Intrastate Agreement.
(3) Any rate, rating plan, or rating rule
				filing shall include a letter from the excess carrier(s) stating they have
				acknowledged the proposed changes.
(4) The Fund shall obtain prior approval for
				any other assessment against any member that falls outside of subsection (1)
				above. The method used to determine the assessment shall also be
				submitted.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-174.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.20 - Reserve Requirement

Current through Rules and Regulations filed through June 27, 2024
(1) The Fund shall maintain loss reserves
				computed in the same manner and upon the same basis as required by O.C.G.A.
				§
									34-9-163(1) and
				(2), and shall report these reserves in all
				financial reports filed with the Commissioner.
(2) The Annual Report shall include an
				actuarial opinon specifically stating that carried reserves:
(a) meet the requirements of O.C.G.A. §
										34-9-163(1) and
				(2);
(b) are computed in accordance with accepted
				loss reserving standards and principles; and
(c) make a reasonable provision for all
				unpaid loss and loss expense obligations of the Fund under the terms of its
				agreement.
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 120-2-34 - GROUP SELF-INSURANCE FUNDS › Rule 120-2-34-.21 - Dividends

Current through Rules and Regulations filed through June 27, 2024
(1) Dividends may
				be returned to the members of the Fund pursuant to O.C.G.A. §
									34-9-162(d).
(2) A dividend shall not be paid out of a
				specific Fund year which would cause the Fund to show an overall negative
				surplus.
Ga. L. 1960, pp. 289,
				  305; Ga. L. 1981, pp. 1759, 1778; O.C.G.A. Secs.
				  33-2-9,
				  34-9-162,
				  34-9-174.