Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.31 - Long-Term Care › Rule 6.6.3120 - ADOPTION OF FORMS

Current through Register Vol. 13, July 5, 2024
(1) The following
				forms are adopted and made a part of these rules for all purposes, and the same
				must be used as herein directed in giving notice.
(a) LTC Form A Rescission Reporting Form
LTC Form A
RESCISSION REPORTING FORM FOR LONG-TERM CARE POLICIES FOR THE
				  STATE OF MONTANA FOR THE REPORTING YEAR 20[ ]
Company Name:
________________________________________________
Address:
________________________________________________
Phone Number:
________________________________________________
Due: March 1 annually
Instructions:
The purpose of this form is to report all rescissions of
				  long-term care insurance policies. Those rescissions voluntarily effectuated by
				  an insured are not required to be included in this report. Please furnish one
				  form per rescission.
Policy
Form #
Policy and
Certificate #
Name of
Insured
Date of
Policy
Issuance
Date/s
Claim/s
Submitted
Date of
Rescission
Detailed reason for rescission:
				  _________________________________________
_________________________________________________________________
				  _________________________________________________________________
_________________________________________________________________
_________________________________________________________________
__________________________________
Signature
__________________________________
Name and Title (please type)
__________________________________
Date
(b)
				LTC Form B Long-Term Care Insurance
Personal Worksheet
LTC FORM B
Long-Term Care Insurance
Personal Worksheet
This worksheet will help you understand some important
				  information about this type of insurance. Montana law requires companies
				  issuing this [policy][certificate][rider] to
give
you some
				  important facts about premiums and premium increases and to
ask
you some important questions to help you and the company decide if you should
				  buy this [policy][certificate][rider]. Long-term care insurance can be
				  expensive and it may not be right for everyone.
Premium Information
Policy Form Numbers_____________
The premium for the coverage you are considering will
				  be
$[__] per [insert payment interval]
or a total of
[
$
[__] per year][a one-time single premium of $[__]].
The premium quoted in this worksheet is not guaranteed
				  and may change during the underwriting process and in the future while this
				  [policy][certificate][rider] is in force.
Type of Policy & The Company's Right to Increase
				  Premiums on the Coverage You Choose:
[Noncancellable - The company cannot increase your premiums
				  on this [policy][certificate][rider]].
[Guaranteed renewable - The company can increase your
				  premiums on this [policy][certificate][rider] in the future if it increases the
				  premiums for all [policies][certificates][riders] like yours in
				  Montana.]
[Paid-up - This [policy][certificate][rider] will be paid-up
				  after you have paid all of the premiums specified in your
				  [policy][certificate][rider]].
Premium Increase History
[Name of company] has sold long-term care insurance since
				  [year] and has sold this [policy][certificate][rider] since [year].
[The company has never raised its premiums for any long-term
				  care [policy][certificate][rider] it has sold in this state or any other
				  state.]
[The company has not increased its premiums for this
				  [policy][certificate][rider] or similar [policies][certificates][riders] in
				  this state or any other state in the last 10 years.]
[The company has increased its premiums on this
				  [policy][certificate][rider] or similar [policies][certificates][riders] in the
				  last 10 years. Following is a summary of the increases.]
[Over the past 10 years, the company has increased premiums
				  on this [policy][certificate][rider] or similar
				  [policies][certificates][riders] by __%. A summary of the premium increases in
				  the last 10 years is attached to this worksheet.]
Questions Related to Your Income
You do not have to answer the following questions. They are
				  intended to make sure you have thought about how you'll pay premiums and the
				  cost of care your insurance does not cover. If you do not want to answer these
				  questions, you should understand that the company might refuse to insure
				  you.
What resources will you use to pay your
				  premium.
[] Current income from employment [] Current income from
				  investments [] Other current income [] Savings [] Sell investments [] Sell
				  other assets [] Money from my family
[] Other: ________________
Could you afford to keep this
				  [policy][certificate][rider] if your spouse or partner dies
				  first.
[] Yes [] No [] Had not thought about it [] Do not know []
				  Does not apply
[
What would you do if the premiums went up, for
				  example, by 50%.
[] Pay the higher premium [] Call the company/producer []
				  Reduce benefits [] Drop the [policy][certificate][rider] [] Do not know]
What is your household annual income from all
				  sources.
(check one) [] [Under $10,000] [] [$10,000-20,000] []
				  [$20,000-30,000] [] [$30,000-50,000] [] [Over $50,000]
Do
you expect your income to change over
				  the next 10 years.
(check one)
[] No change[] Yes, expect increase[] Yes, expect
				  decrease
If you plan to pay premiums from your income, have you
				  thought about how a change in your income would affect your ability to continue
				  to pay the premium.
[] Yes [] No [] Do not know
Will you buy inflation protection:
(check one)
				  [] Yes [] No
Inflation may increase the cost of long-term care in
				  the future.
If you do not buy inflation protection, how will you
				  pay for the difference between future costs and your daily benefit
				  amount.
[] From my Income[] From my Savings[] [] From my investments
				  [] Sell other assets [] Money from my family [] Other: _______________
The national average annual cost of care in [insert year] was
				  [insert $ amount], but this figure varies across the country. In ten years the
				  national average annual cost would be about [insert $ amount] if costs increase
				  5% annually.
What [elimination period][waiting period][cash
				  deductible] are you considering.
[Number of days ________ in
				  [elimination period][waiting period]
Approximate cost of care for this period: $_______ .
($xxx per day times the number of days in [elimination
				  period][waiting period], where "xxx" represents the most recent estimate of the
				  national daily average cost of long-term care)]
[Cash deductible $_____]
How are you planning to pay for your care during the
				  [elimination period][waiting period][deductible period].
(check all that
				  apply)
[] From my Income [] From my savings/investments [] My family
				  will pay
Questions Related to Your Savings and
				  Investments
Not counting your home, about how much are all of your
				  assets (your savings and investments) worth.
(check one)
[] [Under $20,000] [] [$20,000-$30,000] [] [$30,000-$50,000]
				  [] [Over $50,000]
How do you expect your assets to change over the next 10
				  years. (check one)
[] Stay about the same [] Increase [] Decrease
If you are buying this [policy][certificate][rider]
				  to protect your assets and your assets are less than $50,000, experts suggest
				  you think about other ways to pay for your long-term care.
Disclosure Statement
[] The answers to the questions above describe my
							 financial situation.
Or
[] I choose not to complete this information.
(Check one.)
[] I acknowledge that the carrier and/or its producer
							 (below) has reviewed this form with me including the premium, premium rate
							 increase history and potential for premium increases in the future. [For direct
							 mail situations, use the following : I acknowledge that I have reviewed this
							 form including the premium, premium rate increase history and potential for
							 premium increases in the future.] I understand the information contained in
							 this worksheet. (This box must be checked.)
Signed: _____________________________
				  ________________________
(Applicant) (Date)
[[] I explained to the applicant the importance of completing
				  this information.]
Signed: _____________________________
				  ________________________
(Applicant) (Date)
Producer's Printed Name:
				  ____________________________________________]
[In order for us to process your application, please return
				  this signed statement to [name of company], along with your
				  application.]
[My producer has advised me that this
				  [policy][certificate][rider] does not seem to be suitable for me. However, I
				  still want the company to consider my application.
Signed: ___________________________
				  _____________________________
(Applicant) (Date)]
Someone from the company may contact you to discuss your
				  answers and the suitability of this [policy][certificate][rider] for you.
(c) LTC Form C Things You
				Should Know Before You Buy Long-Term Care Insurance
LTC FORM C
Things You Should Know Before You Buy Long-Term Care
				  Insurance
Long-Term .
A long-term care insurance policy may pay most of
								the costs for your care in a nursing home. Many policies also pay for care at
								home or other community settings. Since policies can vary in coverage, you
								should read this policy and make sure you understand what it covers before you
								buy it.
________.
[You should not buy this insurance policy unless
								you can afford to pay the premiums every year.] [Remember that the company can
								increase premiums in the future.]
________.
The personal worksheet includes questions designed
								to help you and the company determine whether this policy is suitable for your
								needs.
Medicare .
Medicare does not pay for most long-term
								care.
Medicaid .
Medicaid will generally pay for long-term care if
								you have very little income and few assets. You probably should not buy this
								policy if you are now eligible for Medicaid.
________.
Many people become eligible for Medicaid after they
								have used up their own financial resources by paying for long-term care
								services.
________.
When Medicaid pays your spouse's nursing home
								bills, you are allowed to keep your house and furniture, a living allowance,
								and some of your joint assets.
________.
Your choice of long-term care services may be
								limited if you are receiving Medicaid. To learn more about Medicaid, contact
								your local or state Medicaid agency.
Shopper's . Guide
Make sure the insurance company or agent gives you
								a copy of a book called the National Association of Insurance Commissioners'
								"Shopper's Guide to Long-Term Care Insurance." Read it carefully. If you have
								decided to apply for long-term care insurance, you have the right to return the
								policy within 30 days and get back any premium you have paid if you are
								dissatisfied for any reason or choose not to purchase the policy.
Counseling .
Free counseling and additional information about
								long-term care insurance are available through your state's insurance
								counseling program. Contact your state insurance department or department on
								aging for more information about the senior health insurance counseling program
								in your state.
Facilities .
Some long-term care insurance contracts provide for
								benefit payments in certain facilities only if they are licensed or certified,
								such as in assisted living centers. However, not all states regulate these
								facilities in the same way. Also, many people move into a different state from
								where they purchased their long-term care insurance policy. Read the policy
								carefully to determine what types of facilities qualify for benefit payments,
								and to determine that payment for a covered service will be made if you move to
								a state that has a different licensing scheme for facilities than the one in
								which you purchased the policy.
(d)
				LTC Form D Long-Term Care Insurance Suitability Letter
LTC FORM D
Long-Term Care Insurance Suitability Letter
Dear [Applicant]:
Your recent application for long-term care insurance included
				  a "personal worksheet," which asked questions about your finances and your
				  reasons for buying long-term care insurance. For your protection, state law
				  requires us to consider this information when we review your application, to
				  avoid selling a policy to those who may not need coverage.
[Your answers indicate that long-term care insurance may not
				  meet your financial needs. We suggest that you review the information provided
				  along with your application, including the booklet "Shopper's Guide to
				  Long-Term Care Insurance" and the page titled "Things You Should Know Before
				  Buying Long-Term Care Insurance." Your state insurance department also has
				  information about long-term care insurance and may be able to refer you to a
				  counselor, free of charge, who can help you decide whether to buy this policy.]
[You chose not to provide any financial information for us to
				  review.]
We have suspended our final review of your application. If,
				  after careful consideration, you still believe this policy is what you want,
				  check the appropriate box below and return this letter to us within the next 60
				  days. We will then continue reviewing your application and issue a policy if
				  you meet our medical standards.
If we do not hear from you within the next 60 days, we will
				  close your file and not issue you a policy. You should understand that you will
				  not have any coverage until we hear back from you, approve your application and
				  issue you a policy.
Please check one box and return in the enclosed envelope.
Yes
, [although my worksheet indicates that
				  long-term care insurance may not be a suitable purchase.] I wish to purchase
				  this coverage. Please resume review of my application.
No
, I have decided not to buy a policy at this
				  time.
APPLICANT'S SIGNATURE DATE_____________
Please return to [issuer] at [address] by [date]
(e) LTC Form E Claims Denial
				Reporting Form
LTC FORM E
Claims Denial Reporting Form
Long-Term Care Insurance
For the State of Montana
For the Reporting Year of
__________
Company Name : ___________________________ Due: June 30
				  annually
Company Address: _________________________
Company NAIC: ___________________________ Number:
Contact Person: _________________________ Phone Number:
				  ___________
Line of Business: Individual Group
Instructions:
The purposes of this form is to report all long-term care
				  claim denials under in-force long-term care insurance policies. Indicate the
				  manner of reporting by checking one of the boxes below:
[] Per Claimant - counts each individual who makes one or a
				  series of claim requests.
[] Per Transaction - counts each claim payment
				  request.
"Denied" means a claim that is not paid for any reason other
				  than for claims not paid for failure to meet the waiting period or because of
				  an applicable preexisting condition.
Inforce Data
State Data
Nationwide
Data1
Total Number of Inforce Policies [Certificates] as of
							 December 31st
Claim & Denial Data
State Data
Nationwide
Data1
1
Total Number of Long-Term Care Claims Reported
2
Total Number of Long-Term Care Claims Denied/Not
							 Paid
3
Number of Claims Not Paid due to Preexisting
							 Condition Exclusion
4
Number of Claims Not Paid due to Waiting
							 (Elimination) Period Not Met
5
Net Number of Long-Term Care Claims Denied for
							 Reporting Purposes (Line 2 Minus Line 3 Minus Line 4)
6
Percentage of Long-Term Care Claims Denied of Those
							 Reported (Line 5 Divided by Line 1)
7
Number of Long-Term Care Claims Denied due to:
8
* Long-Term Care Services2
9
* Provider/Facility Not Qualified under the
							 Policy3
10
* Benefit Eligibility Criteria Not
							 Met4
11
* Other
1. The
				nationwide data may be viewed as a more representative and credible indicator
				where the data for claims reported and denied for your state are small in
				number.
2. Example-home health care
				claim filed under a nursing home only policy.
3. Example-a facility that does not meet the
				minimum level of care requirements or the licensing requirements as outlined in
				the policy.
4. Examples-a benefit
				trigger not met, certification by a licensed health care practitioner not
				provided, no plan of care.
(f) LTC Form F Potential Premium Increase
				Reporting Form
LTC Form F
Instructions:
Insurers shall provide all
				  of the following information to the applicant regarding premium, premium
				  adjustments, potential premium increases, and policyholder options in the event
				  of a premium increase except as noted below. This form does not need to be
				  provided in the event the policy does not reserve the right to increase
				  rates.
As used in this form:
"Policy" shall mean policy, certificate, or rider, as
				  applicable.
"Premium" shall include premium schedules, as
				  applicable.
Companies may substitute whichever term is appropriate to
				  reflect the long-term care insurance for which the applicant is
				  applying.
Long-Term Care Insurance
Potential Premium Increase Disclosure
				  Form
Important Notice
: Your long-term care
							 insurance company
may
increase the premium for your policy
every year
. You have certain rights and it is important that you
							 understand them before you buy a long-term care insurance policy. Please read
							 this information and be sure you understand it before you buy a policy.
This policy is guaranteed
				  renewable
. Companies can increase the premiums for
				  guaranteed renewable policies in the future. The company cannot increase your
				  premiums because you are older or your health declines. It can increase
				  premiums based on the experience of all individuals with a policy like yours.
1.
What Is Your
				Premium.
The producer has quoted you a premium of $[__] for this
				  policy. This is
not
a final premium. The premium might change
				  during the underwriting process or if you choose different benefits. The
				  premium you will be required to pay for your policy will be [shown on the
				  schedule page of][attached to] your policy.
2.
How Will I Know If My Premium Is
				Changing.
The company will send you a notice. The notice will include
				  the new premium and when you will start paying it. It also will give you ways
				  you could avoid paying a higher premium. One likely choice will be to keep your
				  insurance policy, but with fewer or lower benefits than you bought. Another
				  choice may be to stop paying premiums and have a "paid-up" policy with fewer or
				  lower benefits than the policy you bought. You may have other choices.
Contingent Nonforfeiture
If the premium rate for your policy goes up in the future and
				  you didn't buy a nonforfeiture option, you may be eligible for contingent
				  nonforfeiture. Here's how to tell if you are eligible:
You will keep some long-term care insurance coverage,
				  if:
1. * Your premium after the increase exceeds your original
				  premium by the percentage shown (or more) in the following table; and
1. * You lapse (do not pay more premiums) within 120 days of
				  the increase.
The amount of coverage (i.e., new lifetime maximum benefit
				  amount) you will keep will equal the total amount of premiums you've paid since
				  your policy was first issued. If you have already received benefits under the
				  policy, so that the remaining maximum benefit amount is less than the total
				  amount of premiums you've paid, the amount of coverage will be that remaining
				  amount.
Except for this reduced lifetime maximum benefit amount, all
				  other policy benefits will remain at the levels attained at the time of the
				  lapse and will not increase thereafter.
Should you choose this Contingent Nonforfeiture option, your
				  policy, with this reduced maximum benefit amount, will be considered "paid-up"
				  with no further premiums due.
Example:
1. * You bought the policy at age 65 and paid the $1,000
				  annual premium for 10 years, so you have paid a total of $10,000 in
				  premium.
1. * In the eleventh year, you receive a rate increase of
				  50%, or $500 for a new annual premium of $1,500, and you decide to lapse the
				  policy (not pay any more premiums.)
1. * Your "paid-up" policy benefits are $10,000 (provided you
				  have at least $10,000 of benefits remaining under your policy.)
Contingent Nonforfeiture
Cumulative Premium Increase over Initial
							 Premium
That Qualifies for Contingent
							 Nonforfeiture
(Percentage increase is cumulative from date of
							 original issue. It does NOT represent a one-time increase.)
Issue Age
Percent Increase Over Initial
							 Premium
29 and under
200%
30-34
190%
35-39
170%
40-44
150%
45-49
130%
50-54
110%
55-59
90%
60
70%
61
66%
62
62%
63
58%
64
54%
65
50%
66
48%
67
46%
68
44%
69
42%
70
40%
71
38%
72
36%
73
34%
74
32%
75
30%
76
28%
77
26%
78
24%
79
22%
80
20%
81
19%
82
18%
83
17%
84
16%
85
15%
86
14%
87
13%
88
12%
89
11%
90 and over
10%
[The following contingent nonforfeiture disclosure need only
				  be included for those limited pay policies to which ARM
				  6.6.3119(4)(c)
				  and (e) of the regulation are
				  applicable].
In addition to the contingent nonforfeiture benefits
				  described above, the following reduced "paid-up" contingent nonforfeiture
				  benefit is an option in all policies that have a fixed or limited premium
				  payment period, even if you selected a nonforfeiture benefit when you bought
				  your policy. If both the reduced "paid-up" benefit AND the contingent benefit
				  described above are triggered by the same rate increase, you can choose either
				  of the two benefits.
You are eligible for the reduced "paid-up" contingent
				  nonforfeiture benefit when all three conditions shown below are met:
1. The premium you are required to pay after
				the increase exceeds your original premium by the same percentage or more shown
				in the chart below:
Triggers for a Substantial Premium
							 Increase
Percent Increase
Issue Age
Over Initial Premium
Under 65
50%
65-80
30%
Over 80
10%
2.
				You stop paying your premiums within 120 days of when the premium increase took
				effect; and
3. The ratio of the
				number of months you already paid premiums is 40% or more than the number of
				months you originally agreed to pay.
If you exercise this option your coverage will be converted
				  to reduced "paid-up" status. That means there will be no additional premiums
				  required. Your benefits will change in the following ways:
a. The total lifetime amount of benefits your
				reduced paid up policy will provide can be determined by multiplying 90% of the
				lifetime benefit amount at the time the policy becomes paid up by the ratio of
				the number of months you already paid premiums to the number of months you
				agreed to pay them.
b. The daily
				benefit amounts you purchased will also be adjusted by the same ratio.
If you purchased lifetime benefits, only the daily benefit
				  amounts you purchased will be adjusted by the applicable ratio.
Example:
* You bought the policy at age 65 with an annual premium
				  payable for 10 years.
* In the sixth year, you receive a rate increase of 35% and
				  you decide to stop paying premiums.
* Because you already paid 50% of your total premium payments
				  and that is more than the 40% ratio, your "paid-up" policy benefits are .45
				  (.90 times .50) times the total benefit amount that was in effect when you
				  stopped paying your premiums. If you purchased inflation protection, it will
				  not continue to apply to the benefits in the reduced "paid-up" policy.
(g) LTC Form G Replacement and Lapse
				Reporting Form
LTC Form G
Long-Term Care Insurance
Replacement and Lapse Reporting Form
For the State of Montana For the Reporting Year of
				  __________
Company Name: ______________ Due: June 30 annually
Company Address: ___________________ Company NAIC #
				  _______
Company NAIC Number: ____________________
Contact Person: ____________________________
Phone Number: __(___)______________________
Instructions
The purpose of this form is to report, on a statewide basis,
				  information regarding long-term care insurance policy replacements and lapses.
				  Specifically, every insurer shall maintain records for each agent on that
				  agent's amount of long-term care insurance replacement sales as a percent of
				  the agent's total annual sales and the amount of lapses of long-term care
				  insurance policies sold by the agent as a percent of the agent's total annual
				  sales. The tables below should be used to report the 10% of the insurer's
				  agents with the greatest percentages of replacements and lapses.
Listing of the 10% of Agents with the Greatest
				  Percentage of Replacements
Agent's Name
Number of Policies Sold by This Agent
Number of Policies Replaced by This Agent
Number of Replacements as % of Number Sold by this
								Agent
Listing of the 10% of Agents with the Great Percentage
				  of Lapses
Agent's Name
Number of Policies Sold by This Agent
Number of Policies Lapsed by This Agent
Number of Lapses as % of Number Sold by This Agent
Company Totals:
Percentage of Replacement Policies Sold to Total Sales
				  _____%
Percentage of Replacement Policies Sold to Policies in Force
				  (as of the end of the preceding calendar year) ____%
Percentage of Lapsed Policies to Total Annual Sales
				  _____%
Percentage of Lapsed Policies to Policies in Force (as of the
				  end of the preceding calendar year) _____%
(h) LTC Form H Guidelines for Long-Term Care
				Independent Review Entities LTC FORM H
Guidelines for Long-Term Care Independent Review
				  Entities
In order for an organization to qualify as an independent
				  review organization for long-term care insurance benefit trigger decisions, it
				  shall comply with all of the following:
a. The independent review organization shall
				ensure that all health care professionals on its staff and with whom it
				contracts to provide benefit trigger determination reviews hold a current
				unrestricted license or certification to practice a health care profession in
				the United States.
b. The
				independent review organization shall ensure that any health care professional
				on its staff and with whom it contracts to provide benefit trigger
				determination reviews who is a physician holds a current certification by a
				recognized American medical specialty board in a specialty appropriate for
				determining an insured's functional or cognitive impairment.
c. The independent review organization shall
				ensure that any health care professional on its staff and with whom it
				contracts to provide benefit trigger determination reviews who is not a
				physician holds the current certification in the specialty in which that person
				is licensed, by a recognized American specialty board in a specialty
				appropriate for determining an insured's functional or cognitive
				impairment.
d. The independent
				review organization shall ensure that all health care professionals on its
				staff and with whom it contracts to provide benefit trigger determination
				reviews have no history of disciplinary actions or sanctions including, but not
				limited to, the loss of staff privileges or any participation restriction taken
				or pending by any hospital or state or federal government regulatory
				agency.
e. The independent review
				organization shall ensure that neither it, nor any of its employees, agents, or
				licensed health care professionals it utilizes for benefit trigger
				determination reviews receives compensation of any type that is dependent on
				the outcome of the review.
f. The
				independent review organization shall ensure that neither it, nor any of its
				employees, agents, or licensed healthcare professionals it utilizes for benefit
				trigger determination reviews are in any manner related to, employed by, or
				affiliated with the insurer, insured, or with a person who previously provided
				medical care or long-term care services to the insured.
g. The independent review organization shall
				provide a description of the qualifications of the reviewers retained to
				conduct independent review of long-term care insurance benefit trigger
				decisions, including the reviewer's current and past employment history,
				practice affiliations, and a description of past experience with decisions
				relating to long-term care, functional capacity, dependency in activities of
				daily living, or in assessing cognitive impairment. Specifically, with regard
				to reviews of tax qualified long-term care insurance contracts, it must
				demonstrate the ability to assess the severity of cognitive impairment
				requiring substantial supervision to protect the individual from harm, or with
				assessing deficits in the ability to perform without substantial assistance
				from another person at least two activities of daily living for a period of at
				least 90 days due to a loss of functional capacity.
h. The independent review organization shall
				provide a description of the procedures employed to ensure that reviewers
				conducting independent reviews are appropriately licensed, registered, or
				certified; trained in the principles, procedures, and standards of the
				independent review organization; and knowledgeable about the functional or
				cognitive impairments associated with the diagnosis and disease staging
				processes, including expected duration of such impairment, which is the subject
				of the independent review.
i. The
				independent review organization shall provide the number of reviewers retained
				by the independent review organization and a description of the areas of
				expertise available from such reviewers and the types of cases such reviewers
				are qualified to review (e.g., assessment of cognitive impairment or inability
				to perform activities of daily living due to a loss of functional
				capacity).
j. The independent
				review organization shall provide a description of the policies and procedures
				employed to protect confidentiality of protected health information, in
				accordance with federal and state law.
k. The independent review organization shall
				provide a description of its quality assurance program.
l. The independent review organization shall
				provide the names of all corporations and organizations owned or controlled by
				the independent review organization or which own or control the organization,
				and the nature and extent of any ownership or control. The independent review
				organization shall ensure that neither it, nor any of its employees, agents, or
				licensed health care professionals utilized are not a subsidiary of, or owned
				or controlled by, an insurer or by a trade association of insurers of which the
				insured is a member.
m. The
				independent review organization shall provide the names and resumes of all
				directors, officers, and executives of the independent review
				organization.