reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 133 - Regulation Number 97-Vehicle Tracking Systems › Section XIII-13311 - Effective Date

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation
				97 shall become effective upon final publication in the Louisiana Register and
				shall apply to acts or practices committed on or after the effective
				date.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1457.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 133 - Regulation Number 97-Vehicle Tracking Systems › Section XIII-13313 - Severability

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any Section
				or provision of Regulation 97 or the application to any person or circumstance
				is held invalid, such invalidity or determination shall not affect other
				Sections or provisions or the application of Regulation 97 to any persons or
				circumstances that can be given effect without the invalid Section or provision
				or application, and for these purposes the Sections and provisions of
				Regulation 97 and the application to any persons or circumstances are
				severable.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1457.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13501 - Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation 93 is
				issued pursuant to the authority vested in the commissioner pursuant to the
				provisions of
				R.S.
				49:953 et seq., of the Administrative
				Procedure Act;
				R.S.
				22:11,
				R.S.
				22:1333(D) and
				22:1265(F).
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13503 - Purpose

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose of
				Regulation 93 is to implement the provisions of Acts 2008, No. 854 of the
				Regular Session of the Louisiana Legislature, which allows an insurer to make a
				filing to deviate from the requirements of
				R.S.22:1333(C)
				and
				22:1265(D) concerning
				deductibles for named storms and hurricanes.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13505 - Scope and Applicability

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Regulation 93 applies to authorized property and casualty insurers required to
				submit rates and rating plans for residential property insurance to the
				Louisiana Department of Insurance.
B. Regulation 93 applies to approved
				unauthorized insurers, i.e., surplus lines.
C. Regulation 93 applies to modular
				homes.
D. Regulation 93 does not
				apply to commercial properties or commercial residential properties with three
				or more units.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13507 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. As used in
				Regulation 93, these terms shall have the following meaning ascribed herein
				unless the context clearly indicates otherwise.
Commissioner
-
the
				  Commissioner of Insurance for the State of Louisiana.
Department
- Louisiana Department of
				  Insurance.
Deductible
- a named storm or hurricane
				  deductible as defined in a policy of homeowners' insurance.
Homeowners Insurance
- a policy of insurance
				  on a one- or two-family owner-occupied premises, which combines fire and allied
				  lines with any one or more perils of casualty, liability, or other types of
				  insurance within one policy form at a single premium, where the insurer's
				  liability for damage to the premises under said policy is determined with
				  reference to the replacement value of the premises, but does not include
				  insurance policies written to cover manufactured homes or mobile homes.
New Business
- the issuance of a new policy
				  of homeowners' insurance.
Region
-
a designated and
				  contiguous geographic area of the state identified by an insurer for the
				  purpose of establishing regional deductibles pursuant to
				  R.S.
				  22:1333(D) and
				  R.S.
				  22:1265(F).
Regional Deductible
-
a
s
pecified named storm deductible or hurricane deductible
				  established by an insurer for a particular region.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13509 - Business Plan for Authorized Property and Casualty Insurers; Approved Unauthorized Insurers

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
				authorized property and casualty insurer that makes a filing pursuant to
				R.S.
				22:1464 for authorization to deviate from the
				requirements of
				R.S.22:1333(C)
				 and
				22:1265(D) concerning
				deductibles for named storms and hurricanes shall file with the Commissioner a
				business plan setting forth the insurer's plan to write new business in the
				state of Louisiana. The business plan shall include, but not be limited to the
				following:
1. a written description of each
				proposed region for which mandated, minimum regional deductibles will
				vary;
2. a statewide graphic
				representation of each proposed region for which mandated, minimum regional
				deductibles will vary;
3. the
				proposed mandated minimum regional deductible for each proposed
				region;
4. for each region where
				the proposed regional deductible differs from the existing deductible, the
				insurer shall indicate in the business plan the methods by which it intends to
				write new business;
5. for each
				region where the proposed regional deductible is the same as the existing
				deductible, the insurer shall make a statement to that effect;
6. for the most recent quarter available, the
				number of policies in force and premium in force (at current rate level) in
				each proposed region, categorized by the current deductible on the
				policy;
7. for the most recent
				quarter available and categorized by the current deductible on the policy, the
				number of policies in force in each proposed region expected to be rolled to
				the proposed mandated minimum regional deductible;
8. for the most recent quarter available and
				categorized by the current deductible on the policy, the premium in force (at
				current rate level) adjusted to reflect the proposed mandated minimum regional
				deductible;
9. for the most recent
				quarter available and categorized by the current deductible on the policy, the
				difference between the current and the expected premium, represented in both
				premium dollars and percentage change from the policy premiums before policies
				are rolled to the proposed mandated minimum regional deductibles; and
10. for each proposed mandated minimum
				regional deductible, the premium credit associated with selected regional
				deductible.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13511 - Rescission

Current through Register Vol. 50, No. 6, June 20, 2024
A. The Commissioner
				may subsequently rescind his approval of any filing made pursuant to this
				Subsection if the insurer fails to write new business in accordance with the
				business plan filed with and approved by the Commissioner pursuant to
				R.S.
				22:1333(D) and
				22:1265(F).
B. If a filing made pursuant to
				R.S.
				22:1333(D) and
				22:1265(F) has
				been approved and in effect for at least 180 days, any rescission by the
				Commissioner shall set forth the date when such rescission shall be
				effective.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13513 - Notification to Insured of Premium Savings

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any insurer receiving approval to deviate
				from the requirements of
				R.S.
				22:1333(C) and
				22:1265(D) concerning
				deductibles for named storms and hurricanes as a result of a filing made
				pursuant to Regulation 93 and
				R.S.
				22:1333(D) and
				22:1265(F) shall
				itemize and notify the insured of the premium savings associated with the new
				deductible by indicating the dollar amount of the premium savings on the
				renewal notice or as a separate insert with the renewal notice.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13515 - Multiple Deductibles

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
				homeowners policy of insurance that contains any provision that would apply
				more than one deductible to a loss resulting from any single incident covered
				by the policy shall be null and void and unenforceable as contrary to public
				policy.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13517 - Severability

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any Section
				or provision of Regulation 93 or the application to any person or circumstance
				is held invalid, such invalidity or determination shall not affect other
				Sections or provisions or the application of Regulation 93 to any persons or
				circumstances that can be given effect without the invalid Section or provision
				or application, and for these purposes the Sections and provisions of
				Regulation 93 and the application to any persons or circumstances are
				severable.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 135 - Regulation Number 93 - Named Storm and Hurricane Deductibles › Section XIII-13519 - Effective Date

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation
				93 shall become effective upon final publication in the
Louisiana
				Register
.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 to enforce the provisions of
				  R.S.
				  22:1333(D) and
				  22:1265(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13701 - Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation 98 is
				promulgated by the Commissioner of Insurance (commissioner) of the Louisiana
				Department of Insurance (department) pursuant to authority granted under the
				Louisiana Insurance Code Title 22,
				R.S.
				22:1 et seq., the "Audited Financial Reports
				Law"R.S. 22:671 et
				seq. more particularly
				R.S.
				22:675.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13703 - Purpose and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose
				of Regulation 98 is to improve the surveillance of the financial condition of
				insurers by the department by requiring:
1.
				an annual audit of financial statements reporting the financial position and
				the results of operations of insurers by independent certified public
				accountants;
2. the communication
				of internal control related matters noted in an audit; and
3. a management's report of internal control
				over financial reporting.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13707 - General Requirements Related to Filing and Extensions for Filing of Annual Audited Financial Reports and Audit Committee Appointments

Current through Register Vol. 50, No. 6, June 20, 2024
A. All insurers
				shall have an annual audit by an independent certified public accountant and
				shall file an audited financial report with the commissioner on or before June
				1 for the year ended December 31 immediately preceding. The commissioner may
				require an insurer to file an Audited financial report earlier than June 1 upon
				giving 90 days advance notice to the insurer.
B. Extensions of the June 1 filing date may
				be granted by the commissioner for 30 day periods upon a showing by the insurer
				and its independent certified public accountant of the reasons for requesting
				an extension and determination by the commissioner of good cause for an
				extension. The request for extension must be submitted in writing not less than
				10 days prior to the due date and must contain sufficient detail to permit the
				commissioner to make an informed decision with respect to the requested
				extension.
C. If an extension is
				granted in accordance with the provisions in Subsection B of this Section, a
				similar extension of 30 days is granted to the filing of management's report of
				internal control over financial reporting.
D. Every insurer required to file an annual
				audited financial report pursuant to Regulation 98 shall designate a group of
				individuals as constituting its audit committee, as defined in
				§13705 of Regulation 98. The audit
				committee of an entity that controls an insurer may be deemed to be the
				insurer's audit committee for purposes of Regulation 98 at the election of the
				controlling person.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13709 - Contents of Annual Audited Financial Report

Current through Register Vol. 50, No. 6, June 20, 2024
A. The annual audited financial report shall
				report the financial position of the insurer as of the end of the most recent
				calendar year and the results of its operations, cash flows and changes in
				capital and surplus for the year then ended in conformity with statutory
				accounting practices prescribed, or otherwise permitted, by the department of
				insurance of the state of domicile.
B. The annual audited financial report shall
				include the following:
1. report of
				independent certified public accountant;
2. balance sheet reporting admitted assets,
				liabilities, capital and surplus;
3. statement of operations;
4. statement of cash flow;
5. statement of changes in capital and
				surplus;
6. notes to financial
				statements.
These notes shall be those required by the appropriate
				  National Association of Insurance Commissioners (NAIC)
Annual Statement
				  Instructions
and the NAIC
Accounting Practices and Procedures
				  Manual
. The notes shall include a reconciliation of differences, if
				  any, between the audited statutory financial statements and the annual
				  statement filed pursuant to
				  R.S.
				  22:571 and
				  22:252
				  with a written description of the nature of these differences.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13713 - Qualifications of Independent Certified Public Accountant

Current through Register Vol. 50, No. 6, June 20, 2024
A. The commissioner shall not recognize a
				person or firm as a qualified independent certified public accountant if the
				person or firm:
1. is not in good standing
				with the AICPA and in all states in which the accountant is licensed to
				practice, or, for a Canadian or British company, that is not a chartered
				accountant; or
2. has either
				directly or indirectly entered into an agreement of indemnity or release from
				liability, collectively referred to as
indemnification,
with
				respect to the audit of the insurer.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13715 - Consolidated or Combined Audits

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				An insurer may make written application to the commissioner for approval to
				file audited consolidated or combined financial statements in lieu of separate
				annual audited financial statements if the insurer is part of a group of
				insurance companies that utilizes a pooling or 100 percent reinsurance
				agreement that affects the solvency and integrity of the insurer's reserves and
				the insurer cedes all of its direct and assumed business to the pool. In such
				cases, a columnar consolidating or combining worksheet shall be filed with the
				report, as follows:
1. amounts shown on the
				consolidated or combined audited financial report shall be shown on the
				worksheet;
2. amounts for each
				insurer subject to this Section shall be stated separately;
3. noninsurance operations may be shown on
				the worksheet on a combined or individual basis;
4. explanations of consolidating and
				eliminating entries shall be included; and
5. a reconciliation shall be included of any
				differences between the amounts shown in the individual insurer columns of the
				worksheet and comparable amounts shown on the annual statements of the
				insurers.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13717 - Scope of Audit and Report of Independent Certified Public Accountant

Current through Register Vol. 50, No. 6, June 20, 2024
A. Financial
				statements furnished pursuant to
				§13709 shall be examined by the
				independent certified public accountant. The audit of the insurer's financial
				statements shall be conducted in accordance with generally accepted auditing
				standards. In accordance with AU
				Section
				319 of the Professional
				Standards of the AICPA,
Consideration of Internal Control in a
				Financial Statement Audit
, the independent certified public accountant
				should obtain an understanding of internal control sufficient to plan the
				audit. To the extent required by AU 319, for those insurers required to file a
				Management's Report of Internal Control over Financial Reporting pursuant to
				§13731, the independent certified public accountant should consider (as that
				term is defined in Statement on Auditing Standards (SAS) No. 102,
Defining Professional Requirements in Statements on Auditing
				Standards
or its replacement) the most recently available report in
				planning and performing the audit of the statutory financial statements.
				Consideration shall be given to the procedures illustrated in the
Financial Condition Examiners Handbook
promulgated by the
				National Association of Insurance Commissioners as the independent certified
				public accountant deems necessary.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13719 - Notification of Adverse Financial Condition

Current through Register Vol. 50, No. 6, June 20, 2024
A. The insurer required to furnish the annual
				audited financial report shall require the independent certified public
				accountant to report, in writing, within five business days to the board of
				directors or its audit committee any determination by the independent certified
				public accountant that the insurer has materially misstated its financial
				condition as reported to the commissioner as of the balance sheet date
				currently under audit or that the insurer does not meet the minimum capital and
				surplus requirement of the Louisiana Insurance Code as of that date. An insurer
				that has received a report pursuant to this paragraph shall forward a copy of
				the report to the commissioner within five business days of receipt of the
				report and shall provide the independent certified public accountant making the
				report with evidence of the report being furnished to the commissioner. If the
				independent certified public accountant fails to receive the evidence within
				the required five business day period, the independent certified public
				accountant shall furnish the commissioner a copy of its report within the next
				five business days.
B. No
				independent certified public accountant shall be liable in any manner to any
				person for any statement made in connection with the above paragraph if the
				statement is made in good faith in compliance with §13719. A
C. If the accountant, subsequent to the date
				of the audited financial report filed pursuant to Regulation 98, becomes aware
				of facts that might have affected his or her report, the commissioner
				reiterates herein the obligation of the accountant to take such action as
				prescribed in Volume 1, Section AU 561 of the Professional Standards of the
				AICPA.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13721 - Communication of Internal Control Related Matters Noted in an Audit

Current through Register Vol. 50, No. 6, June 20, 2024
A. In addition to
				the annual audited financial report, each insurer shall furnish the
				commissioner with a written communication as to any unremediated material
				weaknesses in its internal control over financial reporting noted during the
				audit. Such communication shall be prepared by the accountant within 60 days
				after the filing of the annual audited financial report and shall contain a
				description of any unremediated material weakness as the term material weakness
				is defined by Statement on Auditing Standard 112,
Communication of
				Internal Control Related Matters Identified in an Audit
, or its
				replacement, including subsequent statements on auditing standards that may be
				issued requiring communications of internal control related matters identified
				in an audit to the audit committee or others charged with governance as of
				December 31 immediately preceding so as to coincide with the audited financial
				report discussed in §13707. A in the insurer's internal control over financial
				reporting noted by the accountant during the course of their audit of the
				financial statements. If no unremediated material weaknesses were noted, the
				communication should so state.
B.
				The insurer is required to provide a description of remedial actions taken or
				proposed to correct unremediated material weaknesses, if the actions are not
				described in the accountant's communication.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13723 - Accountant's Letter of Qualifications

Current through Register Vol. 50, No. 6, June 20, 2024
A. The accountant shall furnish the insurer
				in connection with, and for inclusion in, the filing of the annual audited
				financial report, a letter stating:
1. that
				the accountant is independent with respect to the insurer and conforms to the
				standards of his or her profession as contained in the Code of Professional
				Ethics and pronouncements of the AICPA and the Rules of Professional Conduct of
				the State Board of Certified Public Accountants of Louisiana and the Society of
				Louisiana Certified Public Accountants, or similar code;
2. the background and experience in general,
				and the experience in audits of insurers of the staff assigned to the
				engagement and whether each is an independent certified public accountant.
				Nothing within Regulation 98 shall be construed as prohibiting the accountant
				from utilizing such staff as he or she deems appropriate where use is
				consistent with the standards prescribed by generally accepted auditing
				standards;
3. that the accountant
				understands the annual audited financial report and his opinion thereon will be
				filed in compliance with Regulation 98 and that the commissioner will be
				relying on this information in the monitoring and regulation of the financial
				position of insurers;
4. that the
				accountant consents to the requirements of
				§13725 of Regulation 98 and that the
				accountant consents and agrees to make available for review by the commissioner, or the commissioner's designee or appointed agent, the workpapers, as defined
				in §13725;
5. a representation that
				the accountant is properly licensed by an appropriate state licensing authority
				and is a member in good standing in the AICPA; and
6. a representation that the accountant is in
				compliance with the requirements of
				§13713 of Regulation 98.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13725 - Definition, Availability and Maintenance of Independent Certified Public Accountants Workpapers

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Workpapers are the records kept by the independent certified public accountant
				of the procedures followed, the tests performed, the information obtained, and
				the conclusions reached pertinent to the accountant's audit of the financial
				statements of an insurer. Accordingly, workpapers may include audit planning
				documentation, work programs, analyses, memoranda, letters of confirmation and
				representation, abstracts of company documents and schedules or commentaries
				prepared or obtained by the independent certified public accountant in the
				course of his or her audit of the financial statements of an insurer and which
				support the accountant's opinion.
B. Every insurer required to file an audited
				financial report pursuant to Regulation 98, shall require the accountant to
				make available for review by department of insurance examiners, all workpapers
				prepared in the conduct of the accountant's audit and any communications
				related to the audit between the accountant and the insurer, at the offices of
				the insurer, at the department of insurance or at any other reasonable place
				designated by the commissioner. The insurer shall require that the accountant
				retain the audit workpapers and communications until the department of
				insurance has filed a report on examination covering the period of the audit
				but no longer than seven years from the date of the audit report.
C. In the conduct of the aforementioned
				periodic review by department of insurance examiners, it shall be agreed that
				photocopies or electronic copies of pertinent audit workpapers may be made and
				retained by the department. Such reviews by the department examiners shall be
				considered investigations and all working papers and communications obtained
				during the course of such investigations shall be afforded the same
				confidentiality as other examination workpapers generated by the
				department.
AUTHORITY NOTE:
				  Promulgated in accordance with the
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13728 - Internal Audit Function Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. Exemption. An insurer is exempt from the
				requirements of this section if:
1. the
				insurer has annual direct written and unaffiliated assumed premium, including
				international direct and assumed premium but excluding premiums reinsured with
				the Federal Crop Insurance Corporation and Federal Flood Program, less than
				$500,000,000; and
2. if the insurer
				is a member of a group of insurers, the group has annual direct written and
				unaffiliated assumed premium including international direct and assumed
				premium, but excluding premiums reinsured with the Federal Crop Insurance
				Corporation and Federal Flood Program, less than $1,000,000,000.
NOTE: An insurer or group of insurers exempt from the
				  requirements of this Section is encouraged, but not required, to conduct a
				  review of the insurer business type, sources of capital, and other risk factors
				  to determine whether an internal audit function is warranted. The potential
				  benefits of an internal audit function should be assessed and compared against
				  the estimated costs.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13729 - Conduct of Insurer in Connection with the Preparation of Required Reports and Documents

Current through Register Vol. 50, No. 6, June 20, 2024
A. No
				director or officer of an insurer shall, directly or indirectly:
1. make or cause to be made a materially
				false or misleading statement to an accountant in connection with any audit,
				review or communication required under Regulation 98; or
2. omit to state, or cause another person to
				omit to state, any material fact necessary in order to make statements made, in
				light of the circumstances under which the statements were made, not misleading
				to an accountant in connection with any audit, review or communication required
				under Regulation 98.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13735 - Canadian and British Companies

Current through Register Vol. 50, No. 6, June 20, 2024
A. In the case of Canadian and British
				insurers, the annual audited financial report shall be defined as the annual
				statement of total business on the form filed by such companies with their
				supervision authority duly audited by an independent chartered
				accountant.
B. For such insurers,
				the letter required in §13711. B shall state that the accountant is aware of
				the requirements relating to the annual audited financial report filed with the
				commissioner pursuant to
				§13707 and shall affirm that the
				opinion expressed is in conformity with those requirements.
AUTHORITY NOTE:
				  Promulgated in accordance with the
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13737 - Severability Provision

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any
				Section or portion of a Section of Regulation 98 or its applicability to any
				person or circumstance is held invalid by a court, the remainder of the
				regulation or the applicability of the provision to other persons or
				circumstances shall not be affected.
AUTHORITY NOTE:
				  Promulgated in accordance with the
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 137 - Regulation Number 98-Annual Financial Reporting › Section XIII-13739 - Effective Date

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation
				98 shall become effective upon promulgation in the Louisiana
				Register.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1 et seq., the "Audited Financial Reports
				  Law"R.S. 22:671 et
				  seq., more particularly
				  R.S.
				  22:675 and the Administrative Procedure Act.
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13901 - Authority (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13903 - Purpose (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13905 - Scope and Applicability (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13907 - Exemptions (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13909 - Definitions (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13911 - Effect and Use of Certificates of Insurance (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13913 - Filing Requirements (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13915 - Certificates of Insurance Approved Prior to Promulgation of Regulation 99 (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13917 - Use of ACORD, AAIS and ISO Forms (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13919 - Notice of Cancellation (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13921 - Investigations and Examinations of Complaints and Violations (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13923 - Severability (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 139 - Regulation 99-Certificates of Insurance (Repealed) › Subchapter A - General Provisions (Repealed) › Section XIII-13925 - Effective Date (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 22:881.1.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14101 - Purpose

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose of
				Regulation 100 is to implement Act 350 of the 2011 Regular Session of the
				Louisiana Legislature pertaining to the coverage of prescription drugs through
				a drug formulary as set forth in
				R.S.
				22:1060.1 et seq. which provides for the
				continuation of drug coverage and notice to enrollees regarding drug
				formularies covered by a health insurance issuer as well as any modifications
				made thereto. The purpose of Regulation 100 is to clarify the requirements and
				notice forms now mandated by law.
B.
				The purpose of the amendment to Regulation 100 is to update the Regulation to
				account for the notice requirements that were added to
				R.S.
				22:1068(D)(3) and
				R.S.
				22:1074(D)(3) by Act No. 217
				of the 2021 Regular Session that a health insurance issuer must follow when
				modifying certain drug coverages offered in the group and individual
				markets.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11,
				  R.S. 1068(D) and
				  R.S.
				  22:1074(D).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14103 - Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation 100
				is promulgated pursuant to the authority granted in
				R.S.
				22:11,
				R.S.
				22:1068 F and
				R.S.
				22:1074 F.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1068(F) and
				  R.S.
				  22:1074(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14105 - Applicability and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Regulation 100 applies to all health insurance issuers as well as health
				maintenance organizations as defined by
				R.S.22:1060.1(6).
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1068(F) and
				  R.S.
				  22:1074(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14107 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. Definitions. As
				used in Regulation 100, the following terms shall have the meaning or
				definition as indicated herein.
Commissioner
-commissioner of insurance for
				  the state of Louisiana.
Enrollee
-any individual, including a
				  dependent, who is enrolled or insured by a health insurance issuer under a
				  health benefit plan.
Policy Form
- an insurance contractual
				  agreement delineating the terms, provisions and conditions of a particular
				  insurance product. It includes certificates of coverage and any other evidence
				  of coverage, subscriber agreements or application forms where written
				  application is required and is to be attached to the policy or be a part of the
				  contract, and any health and accident or health maintenance organization rider
				  or endorsement form.
Particular Product
-a basic insurance policy
				  form delineating the terms, provisions and conditions of a specific type of
				  coverage under a particular type of contract.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1068(F) and
				  R.S.
				  22:1074(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14111 - Requirements for the Modification Affecting Drug Coverage

Current through Register Vol. 50, No. 6, June 20, 2024
A. A modification affecting drug coverage
				shall mean any of the following:
1. removing a
				drug from a formulary;
2. adding a
				requirement that an enrollee receive prior authorization for a drug;
3. imposing or altering a quantity limit for
				a drug;
4. imposing a step-therapy
				restriction for a drug;
5. moving a
				drug to a higher cost-sharing tier, unless a generic alternative is
				available.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14113 - Enrollee's Right to Appeal Adverse Determination

Current through Register Vol. 50, No. 6, June 20, 2024
A. The refusal of a health insurance issuer
				to provide benefits to an enrollee for a prescription drug is an adverse
				determination for the purposes of Subpart F of Part III of Chapter 4 of the
				Louisiana Insurance Code,
				R.S.
				22:1121 et seq., relative to medical
				necessity review organizations, if each of the following conditions is met.
1. The drug is not included in a drug
				formulary used by the health benefit plan.
2. The enrollee's physician or other
				authorized prescriber has determined the drug is medically necessary.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14115 - Requirements for Modifying a Group Insurance Product

Current through Register Vol. 50, No. 6, June 20, 2024
A. Pursuant to
				R.S.
				22:1068, a health insurance issuer may modify
				its drug coverage offered to a group health plan if each of the following
				conditions is met.
1. The modification occurs
				at the time of coverage renewal.
2.
				The modification is approved by the commissioner. However, modification
				affecting drug coverage as defined in
				R.S.
				22:1061(5)(y) and found in
				§14111.A of this
				regulation shall not require approval by the commissioner.
3. The modification is consistent with state
				law.
4. The modification is
				effective on a uniform basis among all small or large employers covered by that
				group health plan.
5. The health
				insurance issuer, on the form approved by the Department of Insurance, notifies
				the small or large employer group and each enrollee therein of the modification
				no later than the sixtieth day before the date the modification is to become
				effective.
6. As an exception to
				the requirement that a modification must occur at the time of coverage renewal,
				modification of drug coverage for any drug increasing over $300 per
				prescription or refill with an increase in the wholesale acquisition cost of at
				least 25 percent in the prior 365 days may occur at any time provided that
				30-day notice of the modification of coverage is given. The 30-day notice of
				the modification of coverage shall include information on the health insurance
				issuer's process for an enrollee's physician to request an exception from the
				health insurance issuer's modification of drug coverage for purposes of
				continuity of care of the patient.