reglab/statecodes huggingface dataset:
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-6 - Qualifications of Independent Certified Public Accountant

Current through 2024-29, July 17, 2024
A. Except as otherwise provided in this Rule,
				the Superintendent shall recognize an independent certified public accountant
				as qualified as long as he or she conforms to the standards of his or her
				profession, as contained in the Code of Professional Ethics of the American
				Institute of Certified Public Accountants and the rules of the Maine Board of
				Accountancy, or similar code; and as long as the accountant is in good standing
				with the American Institute of Certified Public Accountants and in all states
				in which the accountant is licensed to practice, and if applicable with the
				Public Company Accounting Oversight Board, or, for a Canadian or British
				company, is a chartered accountant in good standing.
B. The Superintendent shall not recognize a
				person or firm as a qualified independent certified public accountant if the
				person or firm:
(1) Is out of compliance with
				the requirements of Subsection A of this Section; or
(2) Has either directly or indirectly entered
				into any agreement of indemnity or release from liability with respect to the
				audit of the insurer, including any arrangement where the intent or effect is
				to shift or limit in any manner the potential liability of the person or firm
				for failure to adhere to applicable auditing or professional standards.
				Indemnification agreements are not permitted even if the liabilities to be
				indemnified result in part from knowing or other misrepresentations made by the
				insurer or its representatives. This Paragraph does not prohibit the purchase
				of appropriate professional liability insurance from a carrier unaffiliated
				with the insurer, nor does it prohibit the accountant from pursuing an action
				for contribution or other legal recourse against the insurer.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-7 - Consolidated or Combined Audits

Current through 2024-29, July 17, 2024
An insurer may make written application to the Superintendent
				  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% 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:
A. Amounts shown
				on the consolidated or combined audited financial report shall be shown on the
				worksheet;
B. Amounts for each
				insurer subject to this Section shall be stated separately;
C. Noninsurance operations may be shown on
				the worksheet on a combined or individual basis;
D. Explanations of consolidating and
				eliminating entries shall be included; and
E. 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.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-8 - Scope of Audit and Report of Independent Certified Public Accountant

Current through 2024-29, July 17, 2024
Financial statements furnished pursuant to Section
				  3 shall be examined by the independent
				  certified public accountant. The audit of the insurer's financial statements
				  shall be conducted in accordance with applicable generally accepted auditing
				  standards. 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.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-9 - Notification of Adverse Financial Condition

Current through 2024-29, July 17, 2024
A.
				The designated accountant shall make a written report to the Superintendent, to
				each member of the insurer's board of directors, and to the insurer's Audit
				Committee, within five business days after making any determination that the
				insurer has materially misstated its financial condition as reported to the
				Superintendent or that the insurer does not meet the minimum capital and
				surplus requirements of the Maine Insurance Code. An insurer that has received
				a report pursuant to this Subsection shall forward a copy of the report to the
				Superintendent within five business days after receiving the report, and shall
				provide the independent certified public accountant making the report with
				evidence that the report has been furnished to the Superintendent.
B. No independent public accountant shall be
				liable in any manner to any person for any statement made in good faith for the
				purpose of compliance with the requirements of this Section.
C. If the accountant, subsequent to the date
				of the audited financial report filed pursuant to this Rule, becomes aware of
				facts that might have affected his or her report, the accountant shall act in a
				manner consistent with applicable professional obligations, which at the time
				of adoption of this Rule include taking such action as prescribed in Volume 1,
				Section AU 561 of the Professional Standards of the American Institute of
				Certified Public Accountants.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-10 - Evaluation of Insurer's Internal Controls

Current through 2024-29, July 17, 2024
A.
				An insurer's board of directors and management shall have effective internal
				controls designed to provide reasonable assurance regarding the reliability of
				the financial statements required by Subsections
				3(B) through
				3(F) of this Rule,
				including policies and procedures that:
(1)
				Pertain to the maintenance of records that, in reasonable detail, accurately
				and fairly reflect the transactions and dispositions of assets;
(2) Provide reasonable assurance that
				transactions are recorded as necessary to permit preparation of the financial
				statements and that receipts and expenditures are being made only in accordance
				with authorizations of management and directors; and
(3) Provide reasonable assurance regarding
				prevention or timely detection of unauthorized acquisition, use, or disposition
				of assets that could have a material effect on the financial
				statements.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-11 - Accountant's Letter of Qualifications

Current through 2024-29, July 17, 2024
The accountant shall furnish the insurer in connection with,
				  and for inclusion in, the filing of the annual audited financial report, a
				  letter stating:
A. 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 American Institute of Certified Public Accountants and
				the rules of professional conduct of the Maine Board of Accountancy, or similar
				code;
B. 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 this Rule 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;
C. That the accountant
				understands that the annual audited financial report and his opinion thereon
				must be filed in compliance with this Rule, and that the Superintendent will be
				relying on this information in the monitoring and regulation of the financial
				position of insurers;
D. That the
				accountant consents and agrees to retain and to make available for review by
				the Superintendent, or the Superintendent's designee or appointed agent, all
				work papers and other audit documents, as required pursuant to
				24 M.R.S.A.
				§2307(3), 24-A M.R.S.A.
				§414(5)24-A or M.R.S.A. §4233(2), as applicable;
E. That the accountant is properly licensed
				by an appropriate state licensing authority and is a member in good standing in
				the American Institute of Certified Public Accountants; and
F. That the accountant is in compliance with
				the requirements of Section
				6 of this Rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-12 - CPA Work Papers and Audit Communications

Current through 2024-29, July 17, 2024
A.
				The accountant shall preserve all work papers prepared in the conduct of the
				accountant's examination and make them available for review and copying by
				Bureau of Insurance examiners in accordance with the requirements of this
				Section and, as applicable, the requirements of
				24 M.R.S.A.
				§2307(3), 24-A M.R.S.A.
				§414(5)24-A or M.R.S.A. §4233(2). The accountant and the insurer
				shall in like manner preserve and make available any communications related to
				the audit between the accountant and the insurer. If the work papers or audit
				communications are maintained in electronic form, the Superintendent may make
				electronic copies.
B. Work papers
				include all 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 examination of the financial
				statements of an insurer. Work papers may include, but are not limited to,
				audit planning documentation, work programs, analyses, reconciliations,
				abstracts, narratives, flow charts, memoranda, letters of confirmation and
				representation, copies or abstracts of company documents and schedules, and
				commentaries prepared or obtained by the independent certified public
				accountant and the accountant's employees in connection with the accountant's
				examination of the financial statements of an insurer.
C. The Superintendent may have access to work
				papers and audit communications pursuant to this Section at the offices of the
				insurer, at the offices of the Bureau of Insurance, or at any other reasonable
				place designated by the Superintendent.
D. The audit work papers and communications
				shall be retained for at least six years after the audit report is filed. If no
				examination report covering the period of the audit has been filed in the
				Bureau of Insurance pursuant to
				24-A
				M.R.S.A. §226(3), the
				Superintendent, upon timely notice to the accountant or the insurer, as
				applicable, shall extend the retention period to seven years, or until the
				examination report has been filed, whichever is sooner.
E. All documents obtained or copied by the
				Superintendent in accordance with this Section are examination working papers
				within the meaning of
				24-A
				M.R.S.A. §225(3), and
				the Superintendent shall protect their confidentiality accordingly.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-14 - Internal Audit Function Requirements

Current through 2024-29, July 17, 2024
A. Each
				insurer whose insurer-level or group-level premium equals or exceeds the
				thresholds for conducting an Own Risk and Solvency Assessment (ORSA), as set
				forth in
				24-A
				M.R.S. §§222(8)
				(B-3) and 423-F(1), shall establish and maintain an internal audit function in
				compliance with this Section. If an insurer becomes subject to this section due
				to an increase in premium volume, it shall have one year after the year the
				threshold is reached to come into full compliance.
Drafting Note:
An
				  insurer or group of insurers exempt from the requirements of this Section is
				  encouraged, but not required, to consider the establishment of an internal
				  audit function, based upon a review of its business type, sources of capital,
				  and other risk factors and an assessment, in light of these factors, of the
				  estimated costs and potential benefits of an internal audit
				  function.
B. An
				insurer that is a member of a group of affiliated insurers may establish its
				internal audit function at the ultimate controlling parent level, an
				intermediate holding company level, or the individual legal entity
				level.
C. The insurer or group
				shall establish an internal audit function that brings a systematic,
				disciplined approach to evaluate and improve the effectiveness of risk
				management, control, and governance processes. The internal audit function
				shall provide independent, objective, and reasonable assurance to the Audit
				Committee and insurer management regarding the insurer's governance, risk
				management and internal controls, by performing general and specific audits,
				reviews, and tests, and by employing other techniques deemed necessary to
				protect assets, evaluate control effectiveness and efficiency, and evaluate
				compliance with policies and statutory and regulatory requirements.
D. To ensure that internal auditors remain
				objective, the internal audit function shall be organizationally independent.
				The internal audit function may not defer ultimate judgment on audit matters to
				others, and shall appoint an individual to head the internal audit function who
				will have direct and unrestricted access to the board of directors. This
				Paragraph does not prohibit dual-reporting relationships as long as they do not
				impair the independence and objectivity of the internal audit
				function.
E. The head of the
				internal audit function shall report to the Audit Committee regularly, no less
				than annually, on the periodic audit plan, factors that may adversely impact
				the internal audit function's independence or effectiveness, material findings
				from completed audits, and the appropriateness of corrective actions
				implemented by management as a result of audit findings.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-15 - Conduct of Insurer in Connection with the Preparation of Required Reports and Documents

Current through 2024-29, July 17, 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 this Rule; or
(2) Omit to state, or cause another person to
				omit to state, any material fact whose omission renders misleading, in light of
				the circumstances under which the statement was made, a statement made to an
				accountant in connection with any audit, review, or communication required
				under this Rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-16 - SOX-Compliant Insurers

Current through 2024-29, July 17, 2024
A. For purposes of
				this Section, a "SOX-Compliant Insurer" means an insurer that complies, or is a
				direct or indirect wholly-owned subsidiary of an entity that complies, with all
				of the following provisions of the Sarbanes-Oxley Act of 2002: the preapproval
				requirements of Section 201 (Subsection
				10 A(i) of the Securities Exchange
				Act of 1934); the audit committee independence requirements of Section 301
				(Paragraph 10A(m)(3) of the Securities Exchange Act of 1934); and the internal
				control assessment requirements of Section 404. An insurer that is not directly
				or indirectly subject to these provisions of the Sarbanes-Oxley Act may elect
				to be treated as a SOX-Compliant Insurer by demonstrating to the satisfaction
				of the Superintendent that it or its direct or indirect parent complies
				voluntarily with these provisions.
B. A SOX-Compliant Insurer's compliance with
				the provisions set forth in Subsection A shall constitute compliance with the
				Audit Committee requirements of Section
				13 and the preapproval requirements
				of Subsection
				6(H).
C. In satisfaction of the internal control
				reporting requirements of Section
				10, a SOX-Compliant Insurer may file
				its or its parent's Section 404 Report, meaning management's report on
				"internal control over financial reporting" (as defined by the Securities and
				Exchange Commission) together with the related attestation report of the
				independent certified public accountant, as prepared in compliance with Section
				404 of the Sarbanes-Oxley Act and the rules and regulations promulgated
				thereunder by the Securities and Exchange Commission, along with either:
(1) A positive statement by management that
				the scope of the Section 404 Report encompasses all material processes
				(
e.g.,
assessments, accounting treatments, permitted
				practices, internal controls, or other internal reporting processes) having a
				material impact on the preparation of the insurer's or group's audited
				statutory financial statements filed pursuant to Subsections
				3(B) through
				3(F)  of this Rule;
				or
(2) A report prepared in
				compliance with Subsection
				10(C) on all
				material processes having a material impact on the preparation of the insurer's
				or group's audited statutory financial statements that were not covered by the
				Section 404 Report.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-17 - Effect of Changes in Premium Volume

Current through 2024-29, July 17, 2024
An insurer that ceases to be in compliance with the Audit
				  Committee independence requirements of Section
				  13 as a result of an increase in
				  premium volume or a business combination shall have one calendar year to come
				  into compliance with the new independence requirements. An insurer that becomes
				  subject to a reporting requirement as a result of an increase in premium volume
				  or a business combination shall have two calendar years to come into compliance
				  with the new reporting requirements.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-18 - Foreign and Alien Insurers

Current through 2024-29, July 17, 2024
A. Foreign or alien
				insurers filing audited financial reports and internal control reports in
				another state in compliance with that state's requirements are exempt from all
				other requirements of this Rule as long as:
(1) The Superintendent has determined that
				the other state's requirements for audited financial reports, internal control
				reporting, and audit committee independence are substantially similar to the
				requirements of this Rule;
(2) A
				copy of the Audited Financial Report, Communication of Internal Control Related
				Matters Noted in an Audit, and the Accountant's Letter of Qualifications that
				are filed with the other state are filed with the Superintendent, or filed with
				the National Association of Insurance Commissioners and made available to the
				Superintendent on request, in accordance with the filing dates specified in
				this Rule; and
(3) A copy of any
				Notification of Adverse Financial Condition Report filed with the other state
				is filed with the Superintendent within the time specified in Section
				9 of this Rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-19 - Effective Date

Current through 2024-29, July 17, 2024
This Rule is effective January 1, 2005. The five-year
				  rotation requirement in Subsection
				  6(D) applies to
				  audited financial reports beginning with the report for calendar year 2002. The
				  2009 amendments to this rule are effective January 1, 2010, and apply to
				  audited financial reports beginning with the report for calendar year 2010. The
				  2019 amendments to this Rule are effective January 1, 2020.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 235 - ANNUAL AUDITED FINANCIAL REPORTS › Section 031-235-20 - Severability

Current through 2024-29, July 17, 2024
If any section or portion of a section of this Rule or its
				  applicability to any person or circumstance is held invalid by a court, the
				  remainder of the Rule or the applicability of the provision to other persons or
				  circumstances shall not be affected.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-1 - AUTHORITY

Current through 2024-29, July 17, 2024
This Rule is adopted by the Superintendent of Insurance
				  pursuant to Title
				   24-A M.R.S.A.
				  §§212 and
				  2152-A.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-2 - Purpose

Current through 2024-29, July 17, 2024
(A) The purpose of this Rule is to require
				insurers to deliver to purchasers of life insurance information which will
				improve the buyer's ability to select the most appropriate plan of life
				insurance for his or her needs, improve the buyer's understanding of the basic
				features of the policy which has been purchased or which is under consideration
				and improve the ability of the buyer to evaluate the relative costs of similar
				plans of life insurance.
(B) This
				Rule does not prohibit the use of additional material which is not in violation
				of this Rule or any other Maine statute or Rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-3 - Scope

Current through 2024-29, July 17, 2024
(A) Except as hereafter exempted, this Rule
				shall apply to any solicitation, negotiation or procurement of life insurance
				occurring within this state. This Rule shall apply to any issuer of life
				insurance contracts including fraternal benefit societies.
(B) Unless otherwise specifically included,
				this Rule shall not apply to:
1.
				Annuities.
2. Credit life
				insurance.
3. Group life
				insurance.
4. Life insurance
				policies issued in connection with pension and welfare plans as defined by and
				which are subject to the federal Employee Retirement Income Security Act of
				1974 (ERISA).
5. Variable life
				insurance under which the death benefits and cash values vary in accordance
				with unit values of investments held in a separate account.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-4 - Definitions

Current through 2024-29, July 17, 2024
For the purposes of this Rule, the following definitions
				  shall apply:
(A) Buyer's Guide. A
				Buyer's Guide is a document which contains, and is limited to, the language
				contained in the Appendix to this Rule or language approved by the
				Superintendent of Insurance.
(B)
				Equivalent Level Death Benefit. The Equivalent Level Death Benefit of a policy
				or term life insurance rider is an amount calculated as follows:
1. Accumulate the guaranteed amount payable
				upon death, regardless of the cause of death, at the beginning of each policy
				year for ten and twenty years at five percent interest compounded annually to
				the end of the tenth and twentieth policy years respectively.
2. Divide each accumulation of Step 1 by an
				interest factor that converts it into one equivalent level annual amount that,
				if paid at the beginning of each year, would accrue to the value in Step 1 over
				the respective periods stipulated in Step 1. If the period is ten years, the
				factor is 13.207 and if the period is twenty years, the factor is
				34.719.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-5 - Disclosure requirements

Current through 2024-29, July 17, 2024
(A) In the case of
				life insurance policies marketed through aproducer, insurers shall:
1. Except as provided in subsection (F),
				provide to all prospective purchasers a Buyer's Guide and a Preliminary
				Statement of Policy Cost before the application is signed.
2. Except as provided in subsection (F),
				provide a Policy Summary prior to or at the time the policy is
				delivered.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-6 - General rules

Current through 2024-29, July 17, 2024
(A) Each insurer
				shall maintain at its home office or principal office a complete file
				containing one copy of each document used by it authorized pursuant to this
				Rule. The file shall contain one copy of each authorized form for a period of
				three years following the date of its last authorized use.
(B) A producer shall inform the prospective
				purchaser, prior to commencing a life insurance sales presentation, that he or
				she is acting as a life insurance producer and inform the prospective purchaser
				of the full name of the insurance company which he or she is representing. In
				sales situations in which a producer is not involved, the insurer shall
				identify its full name.
(C) Terms
				such as financial planner, investment advisor, financial consultant, or
				financial counseling shall not be used in such a way as to imply that the
				insurance producer is primarily engaged in an advisory business in which
				compensation is unrelated to sales unless such is actually the case.
(D) Any reference to policy dividends must
				include a statement that dividends are not guaranteed.
(E) A system or presentation which does not
				recognize the time value of money through the use of appropriate interest
				adjustments shall not be used for comparing the cost of two or more life
				insurance policies. Such a system may be used for the purpose of demonstrating
				the cash-flow pattern of a policy if such presentation is accompanied by a
				statement disclosing that the presentation does not recognize that, because of
				interest, a dollar in the future has less value than a dollar today.
(F) A statement regarding the use of the Life
				Insurance Cost Indexes shall include an explanation to the effect that the
				indexes are useful only for the comparison of the relative costs of two or more
				similar policies.
(G) For the
				purposes of this Rule, the annual premium for a basic policy or rider, for
				which the company reserves the right to change the premium, shall be the
				maximum annual premium.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-7 - Failure to comply

Current through 2024-29, July 17, 2024
Failure of an insurer to provide or deliver a Buyer's Guide,
				  a Preliminary Statement of Policy Cost, or a Policy Summary as provided in
				  Section
				  5 shall constitute an omission which
				  misrepresents the benefits, advantages, conditions or terms of an insurance
				  policy in violation of Title
				   24-A M.R.S.A.
				  §2153. In situations where disclosure
				  occurs, negligent or intentional failure to provide complete and accurate
				  disclosure shall be deemed a violation of Title
				   24-A M.R.S.A.
				  §2153.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 240 - MAINE LIFE INSURANCE SOLICITATION AND COST DISCLOSURE › Section 031-240-8 - Effective date

Current through 2024-29, July 17, 2024
This Rule shall apply to all solicitations of life insurance
				  which commence on or after October 1, 1980. The 1999 amendments to this Rule
				  are effective
September 16, 1999
and shall apply to
				  all solicitations of life insurance which commence three months or more after
				  that date.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-1 - Purpose

Current through 2024-29, July 17, 2024
A. The purpose of this Rule is to set forth
				standards to protect active duty service members of the United States Armed
				Forces from dishonest and predatory insurance sales practices by declaring
				certain identified practices to be false, misleading, deceptive, or
				unfair.
B. Nothing herein shall be
				construed to create or imply a private cause of action for a violation of this
				Rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-2 - Scope

Current through 2024-29, July 17, 2024
This Rule shall apply only to the solicitation or sale of any
				  life insurance or annuity product by an insurer or insurance producer to an
				  active duty service member of the United States Armed Forces.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-3 - AUTHORITY

Current through 2024-29, July 17, 2024
This Rule is adopted under the authority of
				   24-A M.R.S.A.
				  §§212 and
				  2151-B.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-4 - Exemptions

Current through 2024-29, July 17, 2024
A. This Rule shall not apply to solicitations
				or sales involving:
1. Credit
				insurance;
2. Group life insurance
				or group annuities where there is no in-person, face-to-face solicitation of
				individuals by an insurance producer or where the contract or certificate does
				not include a side fund;
3. An
				application to the existing insurer that issued the existing policy or contract
				when a contractual change or a conversion privilege is being exercised; or,
				when the existing policy or contract is being replaced by the same insurer
				pursuant to a program filed with and approved by the superintendent; or, when a
				term conversion privilege is exercised among corporate affiliates;
4. Individual stand-alone health policies,
				including disability income policies;
5. Contracts offered by Servicemembers' Group
				Life Insurance (SGLI) or Veterans' Group Life Insurance (VGLI), as authorized
				by 38 U.S.C. §§
											1965
et seq
.;
6. Life insurance contracts offered through
				or by a non-profit military association, qualifying under Section 501(c)(23) of
				the Internal Revenue Code (IRC), and which are not underwritten by an insurer;
				or
7. Contracts used to fund:
(a) An employee pension or welfare benefit
				plan that is covered by the Employee Retirement and Income Security Act
				(ERISA);
(b) A plan described by
				Sections 401(a), 401(k), 403(b), 408(k) or 408(p) of the IRC, as amended, if
				established or maintained by an employer;
(c) A government or church plan defined in
				Section 414 of the IRC, a government or church welfare benefit plan, or a
				deferred compensation plan of a state or local government or tax-exempt
				organization under Section 457 of the IRC;
(d) A nonqualified deferred compensation
				arrangement established or maintained by an employer or plan sponsor;
(e) Settlements of or assumptions of
				liabilities associated with personal injury litigation or any dispute or claim
				resolution process; or
(f)
				Prearranged funeral contracts.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-5 - Definitions

Current through 2024-29, July 17, 2024
A. "Active Duty" means full-time duty in the
				active military service of the United States and includes members of the
				reserve component (National Guard and Reserve) while serving under published
				orders for active duty or full-time training. The term does not include members
				of the reserve component who are performing active duty or active duty for
				training under military calls or orders specifying periods of less than 31
				calendar days.
B. "Department of
				Defense (DoD) Personnel" means all active duty service members and all civilian
				employees, including nonappropriated fund employees and special government
				employees, of the Department of Defense.
C. "Door to Door" means a solicitation or
				sales method whereby an insurance producer proceeds randomly or selectively
				from household to household without prior specific appointment.
D. "General Advertisement" means an
				advertisement having as its sole purpose the promotion of the reader's or
				viewer's interest in the concept of insurance, or the promotion of the insurer
				or the insurance producer.
E.
				"Insurer" means an insurance company required to be licensed under the laws of
				this state to provide life insurance products, including annuities.
F. "Insurance producer" means a person
				required to be licensed under the laws of this state to sell, solicit or
				negotiate life insurance, including annuities.
G. "Known" or "Knowingly" means, depending on
				its use herein, the insurance producer or insurer had actual awareness, or in
				the exercise of ordinary care should have known, at the time of the act or
				practice complained of, that the person solicited:
(1) is a service member; or
(2) is a service member with a pay grade of
				E-4 or below.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-6 - Practices Declared False, Misleading, Deceptive, or Unfair on a Military Installation

Current through 2024-29, July 17, 2024
A. The following
				acts or practices when committed on a military installation by an insurer or
				insurance producer with respect to the in-person, face-to-face solicitation of
				life insurance are declared to be false, misleading, deceptive or unfair:
(1) Knowingly soliciting the purchase of any
				life insurance product "door to door" or without first establishing a specific
				appointment for each meeting with the prospective purchaser.
(2) Soliciting service members in a group or
				"mass" audience or in a "captive" audience where attendance is not
				voluntary.
(3) Knowingly making
				appointments with or soliciting service members during their normally scheduled
				duty hours.
(4) Making appointments
				with or soliciting service members in barracks, day rooms, unit areas, or
				transient personnel housing or other areas where the installation commander has
				prohibited solicitation.
(5)
				Soliciting the sale of life insurance without first obtaining permission from
				the installation commander or the commander's designee.
(6) Posting unauthorized bulletins, notices,
				or advertisements.
(7) Failing to
				present DD Form 2885,
Personal Commercial Solicitation
				Evaluation
, to service members solicited or encouraging service
				members solicited not to complete or submit a DD Form 2885.
(8) Knowingly accepting an application for
				life insurance or issuing a policy of life insurance on the life of an enlisted
				member of the United States Armed Forces without first obtaining for the
				insurer's files a completed copy of any required form which confirms that the
				applicant has received counseling or fulfilled any other similar requirement
				for the sale of life insurance established by regulations, directives, or rules
				of the DoD or any branch of the Armed Forces.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-8 - Severability

Current through 2024-29, July 17, 2024
If any provision of this Rule or the application thereof to
				  any person or circumstance is held invalid for any reason, the invalidity shall
				  not affect the other provisions of this Rule or any other application of the
				  subject Provision that can be given effect without the invalid provisions or
				  application. To this end all provisions of this Rule are declared to be
				  severable.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 245 - MILITARY LIFE INSURANCE AND ANNUITY SALES PRACTICES › Section 031-245-9 - Effective Date

Current through 2024-29, July 17, 2024
This Rule shall become effective January 1, 2008 and shall
				  apply to acts or practices committed on or after the effective date.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 250 - REQUIREMENTS OF ELIGIBILITY TO SELF-INSURE WORKERS' COMPENSATION BENEFITS › Section 031-250-II - Individual Self-Insurance Plans

Current through 2024-29, July 17, 2024
A.
Eligibility for Self-Insurance.
An applicant employer is eligible to
				self-insure if the employer and any required guarantor furnishes proof to the
				satisfaction of the Superintendent of solvency and financial ability to pay
				compensation and benefits required under the Act, the employer meets all other
				requirements for eligibility as a self-insurer as required by the Act and this
				Rule, and the employer provides the security, as determined by the
				Superintendent, required under Section
				II(D). An applicant
				employer is eligible to self-insure if the subsidiary employer and parent
				corporation jointly file an application; if the parent corporation and
				subsidiary employer submit an irrevocable contract of assignment of the
				subsidiary employer's obligations incurred pursuant to the Act; if the parent
				corporation is solvent and demonstrates an ability to pay the compensation and
				benefits of the subsidiary employer; if the subsidiary employer meets all other
				requirements for eligibility as a self-insurer as required by the Act and this
				Rule; and if the employer provides the security, as determined by the
				Superintendent, required under Section
				II(D). The identity
				of an employer authorized to self-insure is determined by the ownership of the
				entity on the date on which its certificate of authorization is issued. An
				entity that is not currently self-insured which becomes controlled by an
				approved self-insurer is not automatically authorized to self-insure.
1.
Financial Considerations.
To
				qualify for self-insurance authority, the employer and any required guarantor
				or parent corporation must demonstrate to the satisfaction of the
				Superintendent, where applicable, that the applicant meets the following
				financialqualifications, considered in light of the level of retained workers'
				compensation losses:
a. An historical record
				of profits;
b. An historical record
				of liquidity;
c. An historical
				record of adequate working capital;
d. An historical record of an adequate degree
				of leverage;
e. An historical
				record of adequate coverage of outstanding debt and related interest expense;
				and
f. An historical record of
				positive net worth.
For the purposes of this subsection, adequate means
				  sufficient for the ongoing operation of the business as evidenced either by a
				  history of ongoing operations or equivalence to similar businesses that have
				  operated viably over a comparable period of time.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 250 - REQUIREMENTS OF ELIGIBILITY TO SELF-INSURE WORKERS' COMPENSATION BENEFITS › Section 031-250-III - Group Self-Insurance Plans

Current through 2024-29, July 17, 2024
A.
Eligibility for Self Insurance
. Two or more employers may apply to
				self-insure by forming a group and proving to the satisfaction of the
				Superintendent its financial ability to pay compensation for the employers in
				the group and its revenues, their source and assurance of continuance and by
				providing the security, as determined by the Superintendent, required under
				Section
				III(D). For the
				purposes of this section, each"employer" is a member.
1.
Initial Member
				Qualifications.
To qualify initially for self-insurance authority, the
				group must demonstrate to the satisfaction of the Superintendent, where
				applicable, that each initial member meets the following conditions, considered
				in light of the level of retained workers' compensation losses:
a. An historical record of profits;
b. An historical record of
				liquidity;
c. An historical record
				of adequate working capital;
d. An
				historical record of an adequate degree of leverage;
e. An historical record of adequate coverage
				of outstanding debt and related interest expense;
f. An historical record of positive net
				worth;
g. The level of retained
				workers' compensation losses
For the purposes of this subsection, adequate means
				  sufficient for the ongoing operation of the group members as evidenced either
				  by a history of ongoing operations or equivalence to similar businesses that
				  have operated viably over a comparable period of time.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 260 - INSURANCE INSPECTION SERVICES - LIMITATION OF LIABILITY › Section 031-260-1 - Contents of the Notice

Current through 2024-29, July 17, 2024
The notice given by an insurer as a condition of qualifying
				  for the exemption from liability for certain inspection services pursuant to
				  the terms of
				   14 M.R.S.A.
				  §167 shall contain the following
				  language:
THE FOLLOWING LIMITS OUR LIABILITY
We, the insurance company, our agents, employees, or service
				  contractors, are not liable for damages from injury, death or loss occurring as
				  a result of any act or omission in the furnishing of or the failure to furnish
				  insurance inspection services related to, in connection with or incidental to
				  the issuance or renewal of a policy of property or casualty insurance.
This exemption from liability does not apply:
A. If the injury, loss or death occurred
				during the actual performance of inspection services and was proximately caused
				by our negligence or by the negligence of our agents, employees or service
				contractors;
B. To any inspection
				services required to be performed under the provisions of a written contract or
				defined loss prevention program;
C.
				In any action against us, our agents, employees, or service contractors for
				damages proximately caused by our acts or omissions which are determined to
				constitute a crime, actual malice or gross negligence; or
D. If we fail to provide this written notice
				to the insured whenever a policy is issued or when new policy forms are issued
				upon renewal.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 260 - INSURANCE INSPECTION SERVICES - LIMITATION OF LIABILITY › Section 031-260-2 - Manner in Which Notice to be Given

Current through 2024-29, July 17, 2024
In order to comply with the provisions of
				   14 M.R.S.A.
				  §167 an insurer must provide notice in
				  the form prescribed by section
				  1 above whenever the policy is issued
				  or renewed. An insurer is not required to give the notice upon a renewal
				  effected by issuance of a continuation certificate pursuant to
				   24-A M.R.S.A.
				  §2421, provided, that the notice was
				  previously given to the insured in accordance with this regulation. The
				  required wording may appear on an insurance binder, on the face of a policy
				  jacket, as a separate endorsement, or within the policy language in a manner
				  reasonably intended to give notice.
This notice requirement applies to any policy outstanding on,
				  and effective on or after January 1, 1982. Pursuant to Title
				   24-A M.R.S.A.
				  Section2412, individual insurers must submit
				  the proposed form or endorsement to the Superintendent of Insurance for
				  approval, or this filing requirement may be satisfied on behalf of member or
				  subscriber companies by an authorized rating organization.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 270 - MEDICARE SUPPLEMENT INSURANCE RULE - REVISED › Section 031-270-1 - Purpose

Current through 2024-29, July 17, 2024
The purpose of this Rule is to provide for the reasonable
				  standardization of coverage and simplification of terms and benefits of
				  Medicare supplement policies and contracts; to establish minimum standards for
				  benefits; to facilitate public understanding and comparison of such policies;
				  to prohibit provisions contained in such policies which are unjust, unfair,
				  inequitable, or unfairly discriminatory to any person insured or proposed for
				  coverage under such policies or which may be misleading or confusing; to reduce
				  unfair, misleading, or confusing sales and claims settlement practices; and to
				  provide for full disclosures in the sale of health insurance coverage to
				  persons eligible for Medicare by reason of age.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 270 - MEDICARE SUPPLEMENT INSURANCE RULE - REVISED › Section 031-270-2 - AUTHORITY

Current through 2024-29, July 17, 2024
This Rule is issued pursuant to the authority vested in the
				  Superintendent of Insurance under
				  24
				  M.R.S.A. §
										2328 and 24-A M.R.S.A.
				  §§24-AM.R.S.A. §§ 212,
				  2413(1)
				  F, 4207(9), 5002, 5003, and 5005.