reglab/statecodes huggingface dataset:
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6801 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of these rules is to set
				forth the financial and reporting requirements which the commissioner deems
				necessary for the regulation of captive insurance companies, as authorized by
				33-28-206, MCA.
33-28-206, MCA; IMP,
					 33-28-102,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6802 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
For purposes of these rules:
(1) "Company" means captive insurance company
				or companies, unless otherwise specified.
(2) "Commissioner" means the Commissioner of
				Securities and Insurance, Montana State Auditor.
33-28-206, MCA; IMP,
					 33-28-101,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6803 - ORGANIZATIONAL EXAMINATION

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				processing the application, the commissioner may perform an organizational
				investigation or examination before an applicant is licensed as a captive
				insurance company. This investigation or examination may consist of a general
				survey of the applicant's corporate records, including but not limited to:
(a) its charter, bylaws and minute
				books;
(b) verification of capital
				and surplus;
(c) verification of
				principal place of business;
(d)
				determination of assets and liabilities; and
(e) a review of such other factors, as the
				commissioner deems necessary.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6804 - ADDITIONAL SECURITY

Current through Register Vol. 13, July 5, 2024
(1) If the
				commissioner deems that the financial condition of the company warrants
				additional security, the commissioner may require the company to deposit
				through the State Auditor's Office in the manner described in
				33-2-604, MCA, cash or securities
				approved by the commissioner or, alternatively, to furnish the commissioner a
				clean irrevocable letter of credit issued by a bank chartered by the state of
				Montana or by a member of the bank of the federal reserve system and approved
				by the commissioner.
(2) The
				company may receive interest or dividends from the deposit, or exchange the
				deposits for other of equal value with the prior approval of the
				commissioner.
(3) If the company
				discontinues business, the commissioner shall return the deposit only after the
				commissioner is satisfied that all obligations of the company have been
				discharged.
33-28-206, MCA; IMP,
					 33-28-104,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6805 - PERMITTED REINSURANCE

Current through Register Vol. 13, July 5, 2024
(1) A captive
				insurance company authorized to do business in this state may take credit for
				reserves on risks ceded to a reinsurer subject to the following conditions:
(a) no credit is allowed for reinsurance if
				the reinsurance contract does not result in the complete transfer of the risk
				or liability to the reinsurer;
(b)
				no credit shall be allowed, as an asset or deduction from liability, to any
				ceding insurer for reinsurance unless the reinsurance is payable by the
				assuming insurer on the basis of the liability of the ceding insurer under the
				contract reinsured without diminution because of the insolvency of the ceding
				insurer;
(c) reinsurance must be
				effected through a written agreement of reinsurance setting forth the terms,
				provisions and conditions governing the reinsurance; and
(d) the commissioner may require that
				complete copies of all reinsurance treaties and contracts be filed and/or
				approved by him.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6806 - INSURANCE MANAGERS AND INTERMEDIARIES

Current through Register Vol. 13, July 5, 2024
(1)
				No person shall, within the state of Montana, act as a manager, broker, agent,
				salesperson, or reinsurance intermediary for a company without the
				authorization of the commissioner. Application for such authorization must be
				in a form prescribed by the commissioner.
33-28-206, MCA; IMP,
					 33-28-102,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6807 - CHANGES IN DIRECTORS - RESTRICTIONS ON FEES AND GIFTS

Current through Register Vol. 13, July 5, 2024
(1) Each company must report to the
				commissioner within 30 days after any change in its executive officers or
				directors, including in its report a statement of the business and professional
				affiliations of any new executive officer or director.
(2) No director, officer, or employee of a
				company may, except on behalf of the company, accept, or be the beneficiary of,
				any fee, brokerage, gift, or other emolument because of any investment, loan,
				deposit, purchase, sale, payment or exchange made by or for the company, but
				such person may receive reasonable compensation for necessary services rendered
				to the company in his or her usual private, professional or business
				capacity.
(3) Any profit or gain
				received by or on behalf of any person in violation of this rule shall inure to
				and be recoverable by the company.
33-28-206, MCA; IMP,
					 33-28-102,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6808 - CONFLICT OF INTEREST

Current through Register Vol. 13, July 5, 2024
(1) Each company
				must prepare and adopt a conflict of interest statement for officers, directors
				and key employees. This statement must disclose that the individual does not
				have outside commitments, personal or otherwise, that would inhibit the
				individual's duty to further the interests of the company.
(2) The conflict of interest statement need
				not preclude an individual from being a director or officer of more than one
				insurance company.
(3) The
				disclosure statements must be filed annually with the company's board of
				directors.
33-28-206, MCA; IMP,
					 33-28-102,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6809 - ACQUISITION OF CONTROL OF OR MERGER WITH A DOMESTIC COMPANY

Current through Register Vol. 13, July 5, 2024
(1) No person, other than the issuer shall
				make a tender offer of or a request or invitation for tenders of, or enter into
				any agreement to exchange securities for, seek to acquire, or acquire in the
				open market or otherwise, any voting security of a domestic company if, after
				the consummation thereof, such person would, directly or indirectly (or by
				conversion or by exercise of any right to acquire) be in control of the
				company.
(2) No person shall enter
				into an agreement to merge with or otherwise to acquire control of a domestic
				company without the prior written approval of the commissioner.
(3) In considering an application for
				acquisition of control or merger with a domestic company, the commissioner
				shall consider all of the facts and circumstances surrounding the application
				as well as the criteria for establishing a company in these rules and Title 33,
				chapter 28, MCA.
33-28-206, MCA; IMP,
					 33-28-105,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6810 - CHANGE IN BUSINESS AND OTHER INFORMATION (REPEALED)

Current through Register Vol. 13, July 5, 2024
33-28-206, MCA; IMP,
					 33-28-102,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6811 - ANNUAL AUDIT

Current through Register Vol. 13, July 5, 2024
(1) Each company
				must have an annual audit by an independent certified public accountant,
				authorized by the commissioner, and must file the audited financial report with
				the commissioner within 180 days of the company's fiscal year end.
(2) The annual audit report is considered
				part of the company's annual report of financial condition, except with respect
				to the date by which it must be filed with the commissioner.
(3) The annual audit must contain the
				following information:
(a) opinion of the
				independent certified public accountant;
(b) report of evaluation of internal
				controls;
(c) the accountant's
				letter of qualifications;
(d)
				financial statements; and
(e)
				certification of loss reserves and loss expense reserves by an actuary approved
				by the commissioner.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6812 - THE OPINION OF THE CERTIFIED PUBLIC ACCOUNTANT

Current through Register Vol. 13, July 5, 2024
(1) Financial statements of the company
				furnished pursuant to these rules must be examined by a certified public
				accountant in accordance with generally accepted auditing standards.
(2) The opinion of the certified public
				accountant must cover all years presented.
(3) The opinion must be addressed to the
				company on the stationery of the accountant showing the address of issuance,
				must bear the original manual signatures and must be dated.
33-28-206, MCA; IMP,
					 33-28-107,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6813 - REPORT OF EVALUATION OF INTERNAL CONTROLS

Current through Register Vol. 13, July 5, 2024
(1) Each company shall file with the
				commissioner a report that includes an evaluation, in accordance with generally
				accepted auditing standards, of the internal controls of the company relating
				to the methods and procedures used in the securing of assets and the
				reliability of the financial records. The evaluation must include, but is not
				limited to, those controls governing the system of authorization and approval
				and separation of duties.
33-28-206, MCA; IMP,
					 33-28-107,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6814 - ACCOUNTANT'S LETTER

Current through Register Vol. 13, July 5, 2024
(1) The accountant
				who prepares the annual opinion for the company, must furnish the company, for
				inclusion in the filing of the audited annual report, a letter stating:
(a) that the accountant is independent with
				respect to the company and conforms to the standard of the profession as
				contained in the Code of Professional Ethics and pronouncements of the American
				institute of certified public accountants and pronouncements of the financial
				account standards board;
(b) the
				general background and experience of the staff engaged in the audit including
				the experience in auditing captives or other insurance companies;
(c) that the accountant understands that the
				audited annual report and the accountant's opinion will be filed with the
				commissioner;
(d) that the
				accountant consents and agrees to make available for review by the commissioner
				the working papers as described in ARM
				6.6.6819; and
(e) that the accountant is properly licensed
				by the appropriate state licensing authority and is a member in good standing
				in the American institute of certified public accountants.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6815 - FINANCIAL STATEMENTS

Current through Register Vol. 13, July 5, 2024
(1) The financial
				statements which must be filed annually with the commissioner must include the
				following:
(a) balance sheet;
(b) statement of gain or loss from
				operations;
(c) statement of
				changes in financial position;
(d)
				statement of changes in capital paid up, gross paid in and contributed surplus
				and unassigned funds (surplus); and
(e) notes to the financial
				statements.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6816 - CERTIFICATION OF LOSS RESERVES AND LOSS EXPENSE RESERVES

Current through Register Vol. 13, July 5, 2024
(1) The annual audit report must include an
				opinion of the adequacy of the company's loss reserves and loss expense
				reserves. The individual who certifies the adequacy of the reserves must be
				approved by the commissioner and shall be a fellow of the casualty actuarial
				society, a member in good standing of the American academy of actuaries, or an
				individual who has demonstrated competence in loss reserve evaluation to the
				commissioner.
(2) The certification
				must be in a form which the commissioner deems appropriate.
33-28-206, MCA; IMP,
					 33-28-107,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6817 - DESIGNATION OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT

Current through Register Vol. 13, July 5, 2024
(1) Each company, within 90 days after
				receiving its license, shall report to the commissioner in writing, the name
				and address of the independent certified public accountant retained to conduct
				the annual audit as required by these rules.
33-28-206, MCA; IMP,
					 33-28-107,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6818 - NOTIFICATION OF ADVERSE FINANCIAL CONDITION

Current through Register Vol. 13, July 5, 2024
(1)
				A company must require the certified public accountant to immediately notify in
				writing an officer and all members of the board of directors of the company of
				any determination by the independent certified public accountant that the
				company has materially misstated its financial condition in its report to the
				commissioner as required by
				33-28-107, MCA.
(2) The company must furnish the notice to
				the commissioner within five days of the receipt of the notice from the
				accountant.
33-28-206, MCA; IMP,
					 33-28-107,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6819 - AVAILABILITY AND MAINTENANCE OF WORKING PAPERS OF THE INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT

Current through Register Vol. 13, July 5, 2024
(1) Each company
				shall require the independent certified public accountant to make available for
				review by the commissioner the working papers prepared in the conduct of the
				audit of the company.
(2) The
				company shall require that the accountant retain the audit working papers for a
				period of not less than five years after the period covered by the
				report.
(3) The commissioner's
				review of the working papers is considered an investigation during the course
				of which the papers shall remain confidential. The company shall require the
				independent certified public accountant to provide photocopies of any of the
				working papers which the commissioner requests. The photocopies may be retained
				by the commissioner.
(4) The term
				"working paper" as used in this rule includes, but is not limited to,
				schedules, analyses, reconciliations, abstracts, memoranda, narratives, flow
				charts, copies of company records or other documents prepared or obtained by
				the accountant and employees of the accountant in the conduct of the
				examination of the company.
33-28-206, MCA; IMP,
					 33-28-107,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6820 - REVOCATION OF THE COMPANY'S LICENSE

Current through Register Vol. 13, July 5, 2024
(1) The
				commissioner may revoke the license of a company in accordance with
				33-28-109, MCA, including, but not
				limited to, the following reasons:
(a) if the
				company has not commenced business in accordance with its plan of operation
				within two years of being licensed;
(b) if the company ceases to do business in
				or from within the state of Montana;
(c) at the request of the company;
				or
(d) for any other reason as
				described in
				33-28-109, MCA.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.68 - Formation and Regulation of Captive Insurance Companies › Rule 6.6.6821 - LIMIT OF RISK - CAPTIVE RISK RETENTION GROUPS

Current through Register Vol. 13, July 5, 2024
(1) A captive risk retention group shall not
				retain any risk on any one occurrence in an amount exceeding 10% of its surplus
				as regards policyholders.
(2) The
				maximum retained risk on any one occurrence pursuant to (1) may be increased by
				the commissioner after considering all relevant aspects of a captive risk
				retention group's business plan and/or operational history including, but not
				limited to, the following:
(a) the financial
				strength of the captive risk retention group;
(b) the ability of the risk retention group
				to raise capital;
(c) quality of
				corporate governance and captive management;
(d) rating and pricing methodologies;
				and
(e) loss prevention and risk
				management programs.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.69 - Insurance Information and Privacy Protection › Rule 6.6.6901 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of ARM
				6.6.6901 through
				6.6.6904 is to provide rules that
				interpret statutes and define terms within the Insurance Information and
				Privacy Protection Act, Title 33, chapter 19, MCA. The goals of these rules are
				to ensure that the purpose and scope of the Privacy Protection Act, as
				described in
				33-19-102 and
				33-19-103, MCA, are fully
				implemented.
Sec.
					 33-1-313 and
					 33-19-106, MCA; IMP, Sec.
					 33-19-102 and
					 33-19-103,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.69 - Insurance Information and Privacy Protection › Rule 6.6.6902 - NOTICE EXCEPTIONS FOR CERTIFICATE HOLDERS

Current through Register Vol. 13, July 5, 2024
(1) "Personally identifiable information"
				sufficient to trigger a notice to certificate holders as described in
				33-19-202(2) (a),
				MCA, does not include names, addresses, birth dates and identification numbers,
				used in any combination as personal identifiers obtained for the sole purpose
				of verifying eligibility for insurance coverage, provided that the insurance
				institution does not use that information for any purpose other than verifying
				benefits, does not collect further information, or disclose any personal
				information about that individual outside the provisions of
				33-19-306(7),
				MCA, and does not use this information for any marketing purpose.
(2) A notice to individual certificate
				holders is required if further information is collected, or personal
				information is used for purposes other than for eligibility determination, or
				disclosed for any other purpose, including disclosures to affiliates.
Sec.
					 33-1-313 and
					 33-19-106, MCA; IMP, Sec.
					 33-19-102 and
					 33-19-103,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.69 - Insurance Information and Privacy Protection › Rule 6.6.6903 - NOTICE REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) A licensee is
				not subject to the notice requirements set forth in
				33-19-202, MCA, if the licensee is
				an employee, agent or other representative of an insurance institution and:
(a) the insurance institution otherwise
				complies with, and provides the notices required by the provisions of this rule
				and 33-19-202, MCA, including notice
				to applicants; and
(b) the licensee
				does not collect or disclose personal information except as provided for in the
				insurance institution's privacy notice and except as required by his employment
				or contractual relationship with the insurance institution.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.69 - Insurance Information and Privacy Protection › Rule 6.6.6904 - DEIDENTIFICATION FOR GROUP POLICYHOLDER AUDITS

Current through Register Vol. 13, July 5, 2024
(1) For purposes of
				33-19-306(14),
				MCA, medical record information provided to a group policyholder is deemed to
				be "edited to prevent the identification of the applicant, policyholder, or
				certificate holder" if the following identifiers of the individual are removed:
(a) name;
(b) address;
(c) all elements of dates (except year) for
				dates directly related to the individual, including birth date, discharge date,
				and date of death;
(d) telephone
				numbers;
(e) fax numbers;
(f) electronic mail addresses;
(g) social security number;
(h) medical record numbers;
(i) health plan beneficiary
				numbers;
(j) account
				numbers;
(k) certificate/license
				numbers;
(l) vehicle identifiers
				and serial numbers, including license plate numbers;
(m) device identifiers and serial
				numbers;
(n) web universal resource
				locators (URLs) ;
(o) internet
				protocol (IP) address numbers;
(p)
				biometric identifiers, including finger and voice prints; and
(q) full face photographic images and any
				comparable images.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7001 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of these rules is to
				establish standards for developing and implementing administrative, technical
				and physical safeguards to protect the security, confidentiality and integrity
				of an individual's personal information requiring protection pursuant to the
				provisions of the Montana Insurance Information and Privacy Protection Act,
				Title 33, chapter 19, MCA (2001) (Privacy Act), as required by the
				Gramm-Leach-Bliley Act (GLBA), codified at
				15 USC
				6801,
				6805 (b) and 6807.
(2) Section 501(a) of GLBA provides that it
				is the policy of the congress that each financial institution has an
				affirmative and continuing obligation to respect the privacy of its customers
				and to protect the security and confidentiality of those "customers' nonpublic
				personal information." Section 501(b) of GLBA requires the state insurance
				regulatory authorities to establish appropriate standards relating to
				administrative, technical and physical safeguards:
(a) to ensure the security and
				confidentiality of "customer" records and information;
(b) to protect against any anticipated
				threats or hazards to the security or integrity of such records; and
(c) to protect against unauthorized access to
				or use of records or information that could result in substantial harm or
				inconvenience to a "customer."
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7002 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
For purposes of this subchapter, the following definitions
				  apply:
(1) "Individual" is defined in
				33-19-104, MCA. Any reference to
				the term "customer" in this subchapter means "individual."
(2) "Information systems" means the
				electronic or physical methods used to access, collect, store, use, transmit,
				protect or dispose of personal information.
(3) "Licensee" means a licensee as that term
				is defined in
				33-19-104, MCA.
(4) "Personal information" is defined in
				33-19-104, MCA. Any reference to
				the term "nonpublic customer information" in this subchapter means, for the
				purpose of these rules, "personal information."
(5) "Service provider" means a person that
				maintains, processes or otherwise is permitted access to personal information
				through its provision of services directly to the licensee.
33-19-106, MCA; IMP,
					 33-19-102 and
					 33-19-104,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7003 - EXEMPTION BASED ON FEDERAL STANDARDS FOR PRIVACY AND SECURITY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION

Current through Register Vol. 13, July 5, 2024
(1) The
				obligations imposed under this subchapter do not apply to a licensee that is a
				covered entity under the provisions of federal regulations that are part of the
				Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45
				CFR, parts 160 and 164, standards for privacy of individually identifiable
				health information as to any use or disclosure of personal information that is
				covered under the HIPAA privacy regulations and the HIPAA security
				rule.
(2) If a licensee considers
				itself exempt from this subchapter for the reason provided in (1), the licensee
				shall give written notice to the commissioner of that exemption and a brief
				statement describing why it is a HIPAA-covered entity.
(3) A licensee may claim an exemption only as
				to those lines of business that are subject to HIPAA privacy and security
				regulations. All other lines of business are subject to this
				subchapter.
(4) A third-party
				administrator that is a party to a valid business associate agreement required
				by HIPAA privacy regulations is exempt from the provisions of this subchapter,
				but only as to the scope of that particular agreement. Any activities of the
				third-party administrator that fall outside of the scope of that agreement are
				subject to the provisions of this subchapter.
33-19-106, MCA; IMP,
					 33-19-105,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7007 - INFORMATION SECURITY PROGRAM

Current through Register Vol. 13, July 5, 2024
(1) Each
				licensee shall implement a comprehensive written information security program
				that includes administrative, technical and physical safeguards for the
				protection of personal information. The administrative, technical and physical
				safeguards included in the information security program shall be appropriate to
				the size and complexity of the licensee and the nature and scope of its
				activities.
33-19-106, MCA; IMP,
					 33-19-102 and
					 33-19-306,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7008 - OBJECTIVE OF INFORMATION SECURITY PROGRAM

Current through Register Vol. 13, July 5, 2024
(1)
				A licensee's information security program shall be designed to:
(a) ensure the security and confidentiality
				of personal information;
(b)
				protect against any anticipated threats or hazards to the security or integrity
				of the information; and
(c) protect
				against unauthorized access to or use of the information that could result in
				substantial harm or inconvenience to any individual or a violation of the
				Privacy Act.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7009 - EXAMPLES OF METHODS OF DEVELOPMENT AND IMPLEMENTATION

Current through Register Vol. 13, July 5, 2024
(1) The actions and procedures described in
				ARM 6.6.7010 through
				6.6.7013 are examples of methods of
				implementation of the requirements of ARM
				6.6.7007 and
				6.6.7008. These examples are
				non-exclusive illustrations of actions and procedures that licensees may follow
				to implement ARM
				6.6.7007 and 6.6.7008.
33-19-106, MCA; IMP,
					 33-19-102 and
					 33-19-306,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7010 - ASSESS RISK

Current through Register Vol. 13, July 5, 2024
(1) The licensee:
(a) identifies reasonable foreseeable
				internal or external threats that could result in unauthorized disclosure,
				misuse, alteration or destruction of an individual's personal information or a
				licensee's information systems;
(b)
				assesses the likelihood and potential damage of these threats, taking into
				consideration the sensitivity of the personal information involved;
				and
(c) assesses the sufficiency of
				policies, procedures, information systems and other safeguards in place to
				control risks.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7011 - MANAGE AND CONTROL RISK

Current through Register Vol. 13, July 5, 2024
(1) The licensee:
(a) designs its information security program
				to control the identified risks, commensurate with the sensitivity of the
				information, as well as the complexity and scope of the licensee's
				activities;
(b) trains staff, as
				appropriate, to implement the licensee's information security program;
				and
(c) regularly tests or
				otherwise monitors the key controls, systems and procedures of the information
				security program. The frequency and nature of these tests are determined by the
				licensee's risk assessment.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7012 - OVERSEE SERVICE PROVIDER ARRANGEMENTS

Current through Register Vol. 13, July 5, 2024
(1) The
				licensee:
(a) exercises appropriate due
				diligence in selecting its service providers; and
(b) requires its service providers to
				implement appropriate measures designed to meet the objectives of this rule,
				and where indicated by the licensee's risk assessment, takes appropriate steps
				to confirm that its service providers have satisfied these
				obligations.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7013 - ADJUST THE PROGRAM

Current through Register Vol. 13, July 5, 2024
(1) The licensee
				monitors, evaluates and adjusts, as appropriate, the information security
				program in light of any relevant changes in technology, the sensitivity of an
				individual's personal information, internal or external threats to information,
				and the licensee's own changing business arrangements, such as mergers and
				acquisitions, alliances and joint ventures, outsourcing arrangements and
				changes to information systems.
33-19-106, MCA; IMP,
					 33-19-102 and
					 33-19-306,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7018 - DETERMINED VIOLATION

Current through Register Vol. 13, July 5, 2024
(1) A violation of
				these rules will result in a civil penalty as described in
				33-19-405, MCA.
33-19-106, MCA; IMP,
					 33-19-405,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.70 - Insurance Standards for Safeguarding Personal Information › Rule 6.6.7019 - IMPLEMENTATION DATE

Current through Register Vol. 13, July 5, 2024
(1) Each licensee
				shall establish and implement an information security program, including
				appropriate policies and systems pursuant to these rules by October 1,
				2005.
33-19-106, MCA; IMP,
					 33-19-102,
					 33-19-104,
					 33-19-105,
					 33-19-306, and
					 33-19-405,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.71 - Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities › Rule 6.6.7101 - AUTHORITY

Current through Register Vol. 13, July 5, 2024
(1) This subchapter's rules are promulgated
				by the Commissioner of Insurance pursuant to
				33-2-409, MCA, and ARM
				6.6.6707.
AUTH:
					 33-1-313, MCA IMP:
					 33-2-409,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.71 - Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities › Rule 6.6.7102 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of this subchapter's rules is
				to recognize, permit, and prescribe the use of mortality tables that reflect
				differences in mortality between preferred and standard lives in determining
				minimum reserve liabilities in accordance with
				33-2-409, MCA, and ARM
				6.6.6707.
AUTH:
					 33-1-313, MCA
IMP:
					 33-2-409,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.71 - Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities › Rule 6.6.7103 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
For the purposes of ARM
				  6.6.7101,
				  6.6.7102,
				  6.6.7103,
				  6.6.7105,
				  6.6.7107, and
				  6.6.7109:
(1) "2001 CSO Mortality Table" means the
				mortality table, consisting of separate rates of mortality for male and female
				lives, developed by the American Academy of Actuaries CSO Task Force from the
				Valuation Basic Mortality Table, developed by the Society of Actuaries
				Individual Life Insurance Valuation Mortality Task Force, and adopted by the
				NAIC in December 2002. The 2001 CSO Mortality Table is included in the
				"Proceedings of the NAIC (2nd Quarter 2002)," and supplemented by the 2001 CSO
				Preferred Class Structure Mortality Table defined in (2). Unless the context
				indicates otherwise, the "2001 CSO Mortality Table" includes both the ultimate
				form of that table, the select and ultimate form of that table, both the smoker
				and nonsmoker mortality tables, and the composite mortality tables. It also
				includes both the age-nearest-birthday and age-last-birthday bases of the
				mortality tables. Mortality tables in the 2001 CSO Mortality Table include the
				following:
(a) "2001 CSO Mortality Table (F)"
				means that mortality table consisting of the rates of mortality for female
				lives from the 2001 CSO Mortality Table;
(b) "2001 CSO Mortality Table (M)" means that
				mortality table consisting of the rates of mortality for male lives from the
				2001 CSO Mortality Table;
(c)
				"composite mortality tables" means mortality tables with rates of mortality
				that do not distinguish between smokers and nonsmokers; and
(d) "smoker and nonsmoker mortality tables"
				means mortality tables with separate rates of mortality for smokers and
				nonsmokers.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.71 - Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities › Rule 6.6.7105 - 2001 CSO PREFERRED CLASS STRUCTURE TABLE

Current through Register Vol. 13, July 5, 2024
(1) At the election of the company, for each
				calendar year of issue, for any one or more specified plans of insurance and
				subject to satisfying the conditions stated in this rule, the 2001 CSO
				Preferred Class Structure Mortality Table may be substituted in place of the
				2001 CSO Smoker or Nonsmoker Mortality Table as the minimum valuation standard
				for policies issued on or after April 1, 2008. No such election shall be made
				until the company demonstrates at least 20% of the business to be valued on
				this table is in one or more of the preferred classes. A table from the 2001
				CSO Preferred Class Structure Mortality Table used in place of a 2001 CSO
				Mortality Table, pursuant to the requirements of this rule, will be treated as
				part of the 2001 CSO Mortality Table only for purposes of reserve valuation
				pursuant to the requirements of the NAIC model regulation, "Recognition of the
				2001 CSO Mortality Table for Use in Determining Minimum Reserve Liabilities and
				Nonforfeiture Benefits Model Regulation."
33-1-313, MCA; IMP,
					 33-2-523,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.71 - Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities › Rule 6.6.7107 - CONDITIONS

Current through Register Vol. 13, July 5, 2024
(1) For each plan of insurance with separate
				rates for preferred and standard nonsmoker lives, an insurer may use the Super
				Preferred Nonsmoker, Preferred Nonsmoker, and Residual Standard Nonsmoker
				tables to substitute for the nonsmoker mortality table found in the 2001 CSO
				Mortality Table to determine minimum reserves. At the time of election and
				annually thereafter, except for business valued under the Residual Standard
				Nonsmoker Table, the appointed actuary shall certify that:
(a) the present value of death benefits over
				the next ten years after the valuation date, using the anticipated mortality
				experience without recognition of mortality improvement beyond the valuation
				date for each class, is less than the present value of death benefits using the
				valuation basic table corresponding to the valuation table being used for that
				class; and
(b) the present value of
				death benefits over the future life of the contracts, using anticipated
				mortality experience without recognition of mortality improvement beyond the
				valuation date for each class, is less than the present value of death benefits
				using the valuation basic table corresponding to the valuation table being used
				for that class.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.71 - Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities › Rule 6.6.7109 - SEPARABILITY

Current through Register Vol. 13, July 5, 2024
(1) For the rules in this subchapter, if a
				part of a rule is invalid, all valid parts that are severable from the invalid
				part remain in effect. If a part of a rule is invalid in one or more of its
				applications, the part remains in effect in all valid applications that are
				severable from the invalid applications.
33-1-313, MCA; IMP,
					 33-2-523,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.79 - Pharmacy Benefit Manager Network › Rule 6.6.7901 - NETWORK ADEQUACY DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) The
				following definitions apply to this subchapter:
(a) "Mail-order pharmacy" means a pharmacy
				that provides pharmacist services and primarily dispenses and delivers covered
				drugs via common carrier.
(b)
				"Pharmacy network" means a group of pharmacies contracted with a pharmacy
				benefit manager (PBM) to provide pharmacist services at negotiated prices to an
				enrollee or an injured worker of a workers' compensation insurance
				carrier.
(c) "Preferred pharmacy
				network" means a subset, group, or tier of pharmacies that is designated as
				preferred within a pharmacy network that agrees to charge an enrollee or an
				injured worker of a workers' compensation insurance carrier a lower copayment,
				coinsurance, or deductible for pharmacist services or to accept a lower
				reimbursement rate than other pharmacies in the pharmacy network.
(d) "Retail pharmacy" means any pharmacy that
				provides pharmacist services to the walk-in general public from which an
				enrollee or an injured worker of a workers' compensation insurance carrier
				could purchase a covered drug without being required to receive medical
				services from a provider or institution affiliated with that
				pharmacy.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.79 - Pharmacy Benefit Manager Network › Rule 6.6.7902 - NETWORK ADEQUACY

Current through Register Vol. 13, July 5, 2024
(1) A PBM must
				establish and maintain a pharmacy network that is sufficient in numbers to
				ensure all pharmacist services are accessible without unreasonable delay,
				within a reasonable proximity to the business or personal residence of an
				enrollee or an injured worker of a workers' compensation insurance carrier, and
				with sufficient choice based on the availability of retail
				pharmacies.
(2) Each pharmacy
				network offered by a PBM will be considered a separate pharmacy
				network.
(3) The commissioner may
				consider reasonable criteria or standards to determine the sufficiency and
				adequacy of a pharmacy network, including:
(a)
				whether the pharmacy network includes at least 80% of retail
				pharmacies;
(b) the criteria the
				PBM used to build a pharmacy network, including the criteria used to select
				pharmacies for participation in the pharmacy network;
(c) the criteria the PBM used to build any
				preferred pharmacy network, including the criteria used to place pharmacies in
				subsets, groups, or tiers;
(d) the
				criteria the PBM used to select pharmacies to dispense specialty drugs in the
				pharmacy network;
(e) the access
				standards and other information provided in the PBM's application and reports;
				and
(f) the willingness of retail
				pharmacies in the applicable geographic service area to contract with the PBM
				based upon the same or similar terms and conditions applicable to pharmacies of
				the same type participating in the pharmacy network. The commissioner may
				require the PBM to submit credible evidence documenting a retail pharmacy's
				refusal to contract based upon the same or similar terms and conditions
				applicable to pharmacies of the same type participating in the pharmacy
				network.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.79 - Pharmacy Benefit Manager Network › Rule 6.6.7903 - NETWORK ADEQUACY REPORTING

Current through Register Vol. 13, July 5, 2024
(1) A PBM
				must submit the following reports and information for each pharmacy network as
				part of its license or license renewal application to demonstrate to the
				commissioner a sufficient and adequate pharmacy network:
(a) a report in a form and in a manner
				prescribed by the commissioner that designates the number and location of all
				retail pharmacies, mail-order pharmacies, and specialty pharmacies, if any, in
				each pharmacy network;
(b) a
				network accessibility report that includes:
(i) the access standard or standards the PBM
				establishes to determine network adequacy based on the number of miles between
				an enrollee or an injured worker of a workers' compensation insurance carrier
				and nearest retail pharmacy in the pharmacy network;
(ii) the number of enrollees or injured
				workers of a workers' compensation insurance carrier with access to a retail
				pharmacy in the pharmacy network using the access standard established by the
				PBM;
(iii) the average number of
				miles between the enrollees and injured workers of a workers' compensation
				insurance carrier identified in (ii) and the nearest retail pharmacy in the
				pharmacy network;
(iv) the number
				of enrollees and injured workers of a workers' compensation insurance carrier
				without access to a retail pharmacy in the pharmacy network using the access
				standard established by the PBM;
(v) the average number of miles between the
				enrollees and injured workers of a workers' compensation insurance carrier
				identified in (iv) and the nearest retail pharmacy in the pharmacy network;
				and
(vi) the ratios of retail
				pharmacies in the pharmacy network to an enrollee or an injured worker of a
				workers' compensation insurance carrier; and
(c) the PBM's process for monitoring and
				ensuring on an ongoing basis a sufficient and adequate pharmacy network to meet
				the pharmacist services needs of enrollees and injured workers of a workers'
				compensation insurance carrier.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.79 - Pharmacy Benefit Manager Network › Rule 6.6.7904 - NETWORK ADEQUACY DIRECTORIES

Current through Register Vol. 13, July 5, 2024
(1) A PBM
				must post electronically a current, accurate, and searchable directory of
				pharmacies for each pharmacy network.
(a) In
				making the directory available electronically, the PBM must ensure that the
				general public is able to view all pharmacies included in each pharmacy network
				through a clearly identifiable link or tab, without creating an account or
				entering a policy or contract number.
(b) A PBM must clearly identify in its
				electronic directories the pharmacies that are in each pharmacy
				network.
(c) A PBM must include in
				its electronic directory a customer service email address and telephone number
				or electronic link that enrollees, injured workers of a workers' compensation
				insurance carrier, or the general public may use to notify the PBM of
				inaccurate directory information.