Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 101 - Regulation 78-Policy Form Filing Requirements › Section XIII-10109 - Filing and Review of Life and Annuity Insurance Policy Forms and Related Matters

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Definitions. As used in this Section, the following terms shall have the
				meaning or definition as indicated herein.
Affirmative Approval
-department approval, as
				  a result of the department taking action, following compliance review of a
				  complete filing, or a filing pursuant to Subsection D hereof
Amendatory Endorsement
-a written agreement
				  attached to or stamped on an insurance product to add or subtract coverage, or
				  otherwise modify the product.
Amendatory Rider
-a written document that is
				  attached to an insurance product that adds to or changes information in the
				  original document.
Association
-an organization which has been
				  formed for purposes other than procuring insurance for the members or
				  employees.
Basic Insurance Policy Form
-an insurance
				  contractual agreement delineating the terms, provisions and conditions of a
				  particular insurance or annuity product. It includes certificates of coverage,
				  application forms where written application is required and is to be attached
				  to the policy or be a part of the contract, and any life or health and accident
				  rider or endorsement form. It does not include policies, riders, or
				  endorsements designed, at the request of the individual policyholder, contract
				  holder, or certificate holder, to delineate insurance coverage upon a
				  particular subject or which relate to the manner of distribution of benefits or
				  to the reservation of rights and benefits under such policy.
Certification of Compliance
-certification by
				  an insurer, executed by an officer or authorized representative of the insurer
				  on a form prescribed by the department, that upon knowledge and belief a filing
				  is complete and in compliance with all applicable statutes, and rules and
				  regulations promulgated by the department. A certification of compliance must
				  be included with any filing for certified approval.
Certified Approval
-approval on the basis of
				  an expedited review by the department of a complete filing based upon the
				  inclusion of a statement of compliance and a certification of compliance,
				  executed by an officer or authorized representative of the filing insurer on
				  forms prescribed by the department. The department shall by directive determine
				  those specific types of coverage and particular types of contracts for which
				  the certified approval procedure is either required or available at the option
				  of the insurer
Commissioner
-the commissioner of insurance
				  of the Louisiana Department of Insurance.
Complete Filing
-the filing of a single
				  insurance product, including any required filing fees; a basic insurance policy
				  form, application form and supplemental application form, if any, to be
				  attached to the policy or be a part of the contract; any life or health and
				  accident rider or endorsement forms; all items required under Subsection C
				  hereof, "General Filing Requirements," and any other requirements as may be set
				  forth in the applicable statement of compliance.
Compliance Audit
-a retrospective review
				  conducted by the department of previously approved basic insurance policy forms
				  to determine compliance with applicable law.
Compliance Review
-department review of a
				  filing made pursuant to this Section to determine either that the filing is in
				  compliance with all applicable statutes, rules and regulations, or that the
				  filing should be disapproved for noncompliance.
Deemed Approval
-approval of a complete
				  filing based upon notice, as provided herein, made to the department by the
				  filing insurer, following expiration of the specific time periods as provided
				  herein, where affirmative approval has not been granted and the filing has not
				  been disapproved by the department.
Department
-the Louisiana Department of
				  Insurance.
Endorsement
-a written agreement attached to
				  an insurance product to add or subtract coverage, or otherwise modify the
				  product.
Insurance Product
-a basic insurance policy
				  form delineating the terms, provisions and conditions of a specific type of
				  coverage under a particular type of contract.
Insurer
-every person engaged in the business
				  of making contracts of insurance, as further defined in
				  R.S.
				  22:46(10). As used in this
				  Section, insurer shall also include fraternal benefit societies.
Method of Marketing
-marketing either through
				  independent or captive agents; telephone, electronic mail or direct mail
				  solicitation; groups, organizations, associations or trusts; and/or the
				  internet.
Optional Endorsement
or
Rider
-a form used to permits policyholders, certificate
				  holders, or enrollees to obtain supplemental benefits.
Required Filing Fee
-the fee assessed per
				  product or filing pursuant to
				  R.S.
				  22:821(11)(a).
Rider
-an endorsement to an insurance product
				  that modifies clauses and provisions of the product, including adding or
				  excluding coverage.
Statement of Compliance
-a form prescribed by
				  the department detailing the requirements specific to a particular form of
				  coverage and contract type.
Trust
-a fund established by an insurer on
				  behalf of participating employers, provided all participating employers and
				  employees have the same statutory protections that would apply if such policy
				  were purchased by the employer directly from the insurer, pursuant to
				  R.S.
				  22:941(A)(1).
B. Filing Required
1. Pursuant to
				R.S.
				22:861 (A), no basic insurance policy form,
				other than fidelity or surety bond forms, or application form where written
				application is required and is to be attached to the policy or be a part of the
				contract, or printed rider or endorsement form, shall be issued, delivered, or
				used in this state unless and until it has been filed with and approved by the
				commissioner This requirement applies to any group life insurance policy or
				annuity covering residents of Louisiana where issued or delivered in Louisiana.
				Every page of each such form including rider and endorsement forms filed with
				the department must be identified by a form number in the lower left corner of
				the page.
2. A filing description
				must accompany every filing, describing the items included in the filing, the
				insurance or annuity product for which the filing is being made, and the method
				of marketing to be used for the product. For nonelectronic paper filings, this
				description must be satisfied by the submission of a completed life and annuity
				transmittal document. If the filing includes health insurance to be offered as
				an optional benefit under the base life insurance contract, the appropriate
				statement of compliance for said health insurance product must be completed and
				submitted.