reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14117 - Requirements for Modifying an Individual Insurance Product

Current through Register Vol. 50, No. 6, June 20, 2024
A. Pursuant to
				R.S.
				22:1074, a health insurance issuer may modify
				its drug coverage offered to individuals if each of the following conditions is
				met.
1. The modification occurs at the time of
				coverage renewal.
2. The
				modification is approved by the commissioner. However, modification affecting
				drug coverage as defined in
				R.S.
				22:1061(5)(y) and found in
				§14111.A of this
				regulation shall not require approval by the commissioner.
3. The modification is consistent with state
				law.
4. The modification is
				effective on a uniform basis among all individuals with that policy
				form.
5. The health insurance
				issuer, on a form approved by the Department of Insurance, notifies each
				affected individual of the modification no later than the sixtieth day before
				the date the modification is to become effective.
6. As an exception to the requirement that a
				modification must occur at the time of coverage renewal, modification of drug
				coverage for any drug increasing over $300 per prescription or refill with an
				increase in the wholesale acquisition cost of at least 25 percent in the prior
				365 days may occur at any time provided that 30-day notice of the modification
				of coverage is given. The 30-day notice of the modification of coverage shall
				include information on the health insurance issuer's process for an enrollee's
				physician to request an exception from the health insurance issuer's
				modification of drug coverage for purposes of continuity of care of the
				patient.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14119 - Modification Affecting Drug Coverage

Current through Register Vol. 50, No. 6, June 20, 2024
A. To facilitate the ability of the
				commissioner to comply with his statutory duty, the commissioner shall have the
				authority to enter into a contract with any person or entity he deems
				applicable, relevant and/or appropriate to provide advice and/or make a
				recommendation to the commissioner.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1068(F) and
				  R.S.
				  22:1074(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 141 - Regulation Number 100-Coverage of Prescription Drugs through a Drug Formulary › Section XIII-14120 - Effective Date

Current through Register Vol. 50, No. 6, June 20, 2024
A. This
				regulation shall be effective upon final publication in the Louisiana
				Register.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1068(F) and
				  R.S.
				  22:1074(F).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14301 - Purpose (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11 and
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14303 - Authority (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14305 - Applicability and Scope (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14307 - Definitions (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14309 - Registration of Navigators (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14311 - Required Education and Training (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14313 - Prohibited Conduct (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14315 - Required Reports and Reporting (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 143 - Regulation Number 101-Registration and Regulation of Navigators (Repealed) › Section XIII-14317 - Enforcement (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.22:11 and
				  R.S.
				  22:753.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14501 - Purpose and Intent

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose
				and intent of Regulation 102 is to exercise the authority and fulfill the
				duties and responsibilities of the commissioner with respect to the continued
				regulation of professional employer organizations ("PEOs"). Regulation 102
				delineates the qualifications of approved assurance organizations, the duties
				and responsibilities of approved assurance organizations, the methods by which
				approved assurance organizations may file electronic submissions on behalf of a
				professional employer organization with the department, and provides for
				related matters.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1750,
				  R.S.
				  22:1751, and the Administrative Procedure
				  Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14503 - Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation 102
				is promulgated pursuant to the authority of the commissioner under
				R.S.22:11,
				R.S.
				22:1750,
				R.S.
				22:1751, and pursuant to the authority and
				powers granted by law to the commissioner and the department.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1750,
				  R.S.
				  22:1751,
				  R.S.
				  22:1984, and the Administrative Procedure
				  Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14505 - Applicability and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Regulation 102 applies to any assurance organization that transacts business on
				behalf of a professional employer organization authorized to operate in the
				state of Louisiana. A professional employer organization shall not be required
				to utilize the services of an approved assurance organization.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1750,
				  R.S.
				  22:1751, and the Administrative Procedure
				  Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14507 - Qualifications for Approval of an Assurance Organization

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any assurance organization that intends to
				be approved by the commissioner for authorization to transact business on
				behalf of a professional employer organization in the state of Louisiana shall
				apply for and obtain the approval of the commissioner.
B. To be considered for approval, the
				assurance organization shall submit a written request for approval to the
				commissioner which shall include:
1. evidence
				that the assurance organization is independent and has an established program
				for the accreditation and financial assurance of a professional employer
				organization;
2. evidence that the
				assurance organization has documented qualifications, standards, procedures and
				financial assurance acceptable to the commissioner to certify the
				qualifications of a professional employer organization;
3. the agreement of the assurance
				organization to provide the information, compliance monitoring services, and
				level of financial assurance acceptable to the commissioner and to share with
				the department in a timely manner the information and supporting documentation
				provided to the assurance organization by a professional employer organization
				that equals or exceeds the requirements for registration or renewal of
				registration under
				R.S. 22:1741
				through
				R.S.
				22:1751; and
4. the agreement of the assurance
				organization that it will use a comprehensive online application, quarterly
				compliance reporting, and an ongoing compliance monitoring process for PEO
				accreditation that ensures that:
a. the PEO is
				owned and operated by controlling persons with a history of honesty, law
				abidance, and responsible financial dealings both personally and in
				business;
b. the PEO and all
				related entities under common control are financially solvent and have positive
				working capital sufficient to sustain operations; and
c. the PEO and all related PEO entities meet
				the assurance organizations ethical, financial, and operational standards,
				including compliance with applicable state and federal laws.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14509 - Requirements for an Approved Assurance Organization to Represent a Professional Employer Organization

Current through Register Vol. 50, No. 6, June 20, 2024
A. For
				each professional employer organization that chooses to be represented by an
				approved assurance organization, the approved assurance organization shall
				submit to the department an application, executed by the professional employer
				organization, requesting that the assurance organization be permitted to
				transact business on behalf of the professional employer organization. Such
				application shall:
1. authorize the approved
				assurance organization to share with the department the application and
				compliance reporting information required under
				R.S. 22:1741
				through
				R.S.
				22:1751 that has been provided to the
				assurance organization by the professional employer organization;
2. authorize the department to accept
				information provided by the professional employer organization to the assurance
				organization to facilitate the registration or renewal of registration of the
				professional employer organization;
3. provide the certification of the
				professional employer organization, attesting that the information provided by
				the assurance organization to the department is true and complete and that the
				professional employer organization is in full and complete compliance with all
				requirements of
				R.S. 22:1741
				through
				R.S.
				22:1751; and
4. provide the certification of the assurance
				organization that the professional employer organization is in compliance with
				the standards and procedures of the assurance organization, which equals or
				exceeds the requirements of
				R.S. 22:1741
				through
				R.S.
				22:1751, and that the professional employer
				organization is qualified for registration or renewal of registration under
				R.S. 22:1741
				through
				R.S.
				22:1751.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14511 - Duties and Responsibilities of an Approved Assurance Organization

Current through Register Vol. 50, No. 6, June 20, 2024
A. An assurance
				organization that has been approved by the commissioner shall obtain
				authorization from the accredited professional employer organization and shall
				release to the department confidential information in support of each
				accredited professional employer organizations initial registration and/or
				renewal registration, including but not limited to the following information:
1. basic information of the applicant
				professional employer organization to include:
a. the name(s) of all professional employer
				organization entities under common control;
b. the address of the domicile, headquarters
				and principal place of business of the professional employer
				organization;
c. the physical
				location of all of the professional employer organizations office(s) or
				place(s) of business in Louisiana and elsewhere;
d. current contact information for the
				professional employer organizations clients that are doing business in
				Louisiana;
e. cross guarantees of
				all relevant entities; and
f. copy
				of surety bonds providing coverage to the professional employer
				organization;
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14513 - Duration of Approval of an Assurance Organization

Current through Register Vol. 50, No. 6, June 20, 2024
A. Provided the approved assurance
				organization remains in compliance with Regulation 102, the approval issued by
				the commissioner to an assurance organization shall remain in effect until the
				assurance organization withdraws from the state or until approval is suspended
				or revoked.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1750,
				  R.S.
				  22:1751, and the Administrative Procedure
				  Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14515 - Duties of Commissioner

Current through Register Vol. 50, No. 6, June 20, 2024
A. Upon
				the approval of an assurance organization, the commissioner shall:
1. issue a letter to the assurance
				organization notifying it that it meets the requirements of Regulation 102;
				and
2. include the assurance
				organization on the list of approved assurance organizations that is maintained
				by the department.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14517 - Severability

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any provision
				of Regulation 102 or its application to any person or entity or any
				circumstance of its application is held invalid, such invalidity shall not
				affect other provisions or applications of Regulation 102 which can be given
				effect without the invalid provision or application, and to that end, the
				provisions of Regulation 102 are severable.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1750,
				  R.S.
				  22:1751, and the Administrative Procedure
				  Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 145 - Regulation Number 102-Approved Assurance Organizations › Section XIII-14519 - Effective Date

Current through Register Vol. 50, No. 6, June 20, 2024
A. This
				regulation shall become effective on January 1, 2015 after final publication in
				the
Louisiana Register.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  R.S.
				  22:1750,
				  R.S.
				  22:1751, and the Administrative Procedure
				  Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14901 - Purpose

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation 106
				implements the provisions of Act 844, of the 2014 Regular Session of the
				Louisiana Legislature, specifically
				R.S.
				22:1964(27) which mandates
				that the Department of Insurance promulgate rules and/or regulations addressing
				the replacement of limited benefit insurance policies as defined in
				R.S.
				22:47(2)(c).
B. The purpose of this regulation is:
1. to regulate the activities of insurers and
				producers with respect to the replacement of limited benefit insurance
				policies;
2. to protect the
				interests of limited benefit insurance policy purchasers by establishing
				minimum standards of conduct to be observed in a replacement transaction. It
				will:
a. assure that purchasers receive
				information with which a decision can be made in his or her own best
				interest;
b. reduce deliberate use
				of misrepresentation or false statements in the sale of limited benefit
				replacement policies.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14903 - Applicability and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Regulation 106 shall apply to transactions in the individual market involving
				existing limited benefit polices and the new sale of limited benefit insurance
				policies where it is known or should be known to the producer, or to the
				insurer if there is no producer that the sale of the limited benefit insurance
				policy will result in the replacement of an existing policy.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14905 - Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation 106
				is promulgated by the commissioner pursuant to the authority granted under the
				Louisiana Insurance Code,
				R.S.
				22:1 et seq., particularly
				R.S.
				22:11, and specifically
				R.S.
				22:1964(27).
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14907 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. For the purposes
				of Regulation 106 the following terms shall have the meaning ascribed herein
				unless the context clearly indicates otherwise.
Commissioner
-the Commissioner of Insurance
				  of the Louisiana Department of Insurance.
Existing Policy-
an in-force limited benefit
				  insurance policy or contract of insurance
.
Insurer
-as defined in
				  R.S.
				  22:1962(C).
Limited Benefit Policy
-any health and
				  accident insurance policy designed, advertised, and marketed to supplement
				  major medical insurance that includes accident-only, the Civilian Health and
				  Medical Program of the Uniformed Services (CHAMPUS), dental, disability income,
				  fixed indemnity, long-term care, Medicare supplement, specified disease,
				  vision, and any other health and accident insurance, other than basic hospital
				  expense, basic medical-surgical expense, or other major medical insurance or as
				  defined in
				  R.S.
				  22:47(2)(c).
Producer
-a person required to be licensed
				  under the laws of this state to sell, solicit, or negotiate insurance and
				  includes all persons or business entities otherwise referred to in the Title 22
				  of the Louisiana Revised Statutes as "insurance agent", "agent", "insurance
				  broker", "broker", "insurance solicitor", "solicitor", or "surplus lines
				  broker".
Replacement
-a transaction in which a new
				  policy or contract of insurance is to be purchased, and it is known or should
				  be known to the producer, or to the proposing insurer if there is no producer,
				  that by reason of the transaction, an existing policy or contract of insurance
				  has been or is to be lapsed, forfeited, surrendered or otherwise
				  terminated.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14909 - Exemptions

Current through Register Vol. 50, No. 6, June 20, 2024
A. Unless otherwise
				specifically included, this regulation shall not apply to transactions
				involving:
1. group and blanket group limited
				benefit policies;
2. medicare
				supplement policies;
3. long term
				care policies.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14911 - Duties of Insurers and Producers

Current through Register Vol. 50, No. 6, June 20, 2024
A. An application form submitted by an
				insurer or his producer for a limited benefits policy shall include a question
				designed to elicit information as to whether the insurance to be issued is
				intended to replace any other limited benefit insurance policy presently in
				force.
1. If the applicant indicates that
				there are no existing policies to be replaced, then the producers and insurers
				duties with respect to replacement are complete.
2. If the applicant indicates that there are
				existing policies, the producer shall present to the applicant, not later than
				at the time of taking the application, a notice regarding replacements in the
				form notice as described in Appendix A or such other form notice provided by
				the insurer and approved by the Commissioner of Insurance. The notice shall be
				signed by the applicant attesting that the notice has been received by the
				applicant and that the applicant understands that he/she is replacing an
				existing policy.
3. Notwithstanding
				Paragraph A.2 of this Section, when the sales presentation is conducted by
				electronic means and all signatures are obtained via electronic signature
				technology, the meaning of "at the time of taking the application" shall be
				extended to allow for the producers submission of electronic information to the
				insurer. The requirements of Paragraph A.2 of this Section are deemed met when
				a copy of the required replacement notice electronically signed at the
				presentation is provided to the applicant within five business days following
				submission of the policy or contract of insurance to the insurer. The notice
				may be provided to the applicant by electronic means exclusively only if the
				applicant has chosen the option to receive it exclusively by electronic means.
				In no event shall the time for providing the notice exceed seven business days
				from the date the applicant signed the application.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14913 - Duties of Direct Response Insurers

Current through Register Vol. 50, No. 6, June 20, 2024
A. Direct response insurers shall deliver to
				the applicant, upon acceptance of the application and prior to the issuance of
				the policy, the notice described in Appendix B or other substantially similar
				form notice approved by the Commissioner of Insurance.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14915 - Violations and Penalties

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
				failure to comply with this regulation shall be considered a violation of
				R.S.
				22:1964. Violations of this regulation shall
				subject the violators to penalties as provided by
				R.S.
				22:1969, 1970 and any other applicable
				provisions of law.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14917 - Effective Date

Current through Register Vol. 50, No. 6, June 20, 2024
A. Regulation
				106 shall become effective upon final publication in the
Louisiana
				Register
and shall apply to any act or practice committed on or after
				the effective date.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14919 - Severability

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any Section
				or provision of Regulation 106 or the application to any person or circumstance
				is held invalid, such invalidity or determination shall not affect other
				Sections or provisions or the application of Regulation 106 to any persons or
				circumstances that can be given effect without the invalid Section or provision
				or application, and for these purposes the Sections and provisions of
				Regulation 106 and the application to any persons or circumstances are
				severable.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14921 - Appendix A-Notice Required by Section 14911.A.2

Current through Register Vol. 50, No. 6, June 20, 2024
Notice to Applicant Regarding Replacement of Limited
				  Benefit Insurance
According to [your application] [information you have
				  furnished], you intend to lapse or otherwise terminate existing limited benefit
				  insurance and replace it with a policy to be issued by [insert company name]
				  Insurance Company. For your own information and protection, you should be aware
				  of and seriously consider certain factors that may affect the insurance
				  protection available to you under the new policy.
1. Health conditions which you may presently
				have, (preexisting conditions) may not be immediately or fully covered under
				the new policy. This could result in denial or delay of a claim for benefits
				present under the new policy, whereas a similar claim might have been payable
				under your present policy.
2. You
				may wish to secure the advice of your present insurer or its producer regarding
				the proposed replacement of your present policy. This is not only your right
				but it is also in your best interests to make sure you understand all the
				relevant factors involved in replacing your present coverage.
3. If, after due consideration, you still
				wish to terminate your present policy and replace it with new coverage, be
				certain to truthfully and completely answer all questions on the application
				concerning your medical/health history. Failure to include all material medical
				information on an application may provide a basis for the company to deny any
				future claims and to refund your premium as though your policy had never been
				in force. After the application has been completed and before you sign it,
				reread it carefully to be certain that all information has been properly
				recorded.
4. ______ By checking
				this blank, I agree to receive this notice exclusively by electronic means
				only.
The above "Notice to Applicant" was delivered to me on:
				  ___________
Applicants Signature
				  ________________________________________
Date ________________________
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 149 - Regulation Number 106-Replacement of Limited Benefit Insurance Policies › Section XIII-14923 - Appendix B-Notice Required by Section 14913.A

Current through Register Vol. 50, No. 6, June 20, 2024
Notice to Applicant Regarding Replacement of Limited
				  Benefit Insurance
According to [your application] [information you have
				  furnished], you intend to lapse or otherwise terminate existing limited benefit
				  insurance and replace it with a policy to be issued by [insert company name]
				  Insurance Company. Your new policy provides thirty days within which you may
				  decide without cost whether you desire to keep the policy. For your own
				  information and protection, you should be aware of and seriously consider
				  certain factors that may affect the insurance protection available to you under
				  the new policy.
1. Health conditions
				which you may presently have, (preexisting conditions) may not be immediately
				or fully covered under the new policy. This could result in denial or delay of
				a claim for benefits present under the new policy, whereas a similar claim
				might have been payable under your present policy.
2. You may wish to secure the advice of your
				present insurer or its producer regarding the proposed replacement of your
				present policy. This is not only your right but it is also in your best
				interests to make sure you understand all the relevant factors involved in
				replacing your present coverage.
3.
				If, after due consideration, you still wish to terminate your present policy
				and replace it with new coverage, be certain to truthfully and completely
				answer all questions on the application concerning your medical/health history.
				Failure to include all material medical information on an application may
				provide a basis for the company to deny any future claims and to refund your
				premium as though your policy had never been in force. After the application
				has been completed and before you sign it, reread it carefully to be certain
				that all information has been properly recorded.
[Company Name] _________________________________
Date Mailed or Provided to Applicant _________________
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:1964 and the Administrative Procedure Act,
				  R.S.
				  49:950 et
				  seq.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15101 - Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. This regulation
				is promulgated by the commissioner of insurance pursuant to authority granted
				under subpart C of chapter 1 of title 22 of the
Revised
				Statutes
(R.S.
				22:31 et seq., "equal opportunity in
				insurance"), which provides the following:
1.
				the Department of Insurance Division of Diversity and Opportunity shall review
				all complaints alleging a violation of the provisions of
				R.S.
				22:31 et seq.;
2. the commissioner of insurance shall
				promulgate rules and regulations to implement
				R.S.
				22:31 et seq.; and
3. the commissioner of insurance shall
				promulgate rules and regulations necessary for the enforcement of
				R.S.
				22:35.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15103 - Purpose, Scope, and Applicability

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose of this regulation is to
				implement the provisions of
				R.S.
				22:31 et seq., which prohibit discrimination
				within the business of insurance, mandate the review and disposition of all
				complaints alleging a violation of
				R.S.
				22:31 et seq., and require the commissioner
				to promulgate rules and regulations to implement
				R.S.
				22:31 et seq.
B. This regulation sets forth procedures
				through which complaints concerning the following types of discrimination shall
				be received and investigated:
1. employment
				discrimination prohibited by Part IV of Chapter 3-A of Title 23 (R.S. 23:331 et seq.), as
				provided in
				R.S.
				22:31(C) and
				R.S. 22:33;
				and
2. pursuant to
				R.S.
				22:34, the making or permitting of any unfair
				discrimination in favor of particular persons or between insureds or subjects
				of insurance having substantially like insuring risk and exposure factors or
				expense elements:
a. in the terms or
				conditions of any insurance contract;
b. in the rate or amount of premium charged
				therefor;
c. in the benefits
				payable thereunder; or
d. in any
				other rights or privileges accruing thereunder;
e. Paragraph B.2 of this Section shall not
				prohibit fair discrimination by a life insurer as between individuals having
				unequal life expectancies;
3. pursuant to
				R.S.
				22:35, the refusal to issue or the failure to
				renew any policy or contract of property and casualty insurance to a person,
				solely because of the race of the applicant or the economic condition of the
				area in which the property sought to be insured is located, unless such refusal
				to issue or failure to renew is based on sound actuarial principles or is
				related to actual experience.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15105 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. For the purposes
				of this regulation, these terms shall have the meaning ascribed herein unless
				the context clearly indicates otherwise.
Affirmative Action Plan
-a document that
				  contains a stated purpose of the insurer to foster equal opportunities for
				  minorities and the delineation of active steps and efforts by the insurer
				  reasonably calculated to achieve the stated purpose.
Department
-Department of Insurance.
Individual
-a natural person.
Insurer
-as defined in
				  R.S.
				  22:46.
Person
-any individual, company, insurer,
				  association, organization, reciprocal or inter-insurance exchange, partnership,
				  business, trust, limited liability company, or corporation.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:31(C), 32(B), and
				  35(C).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15107 - Eligibility; Filing a Complaint

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Any person may file a complaint regarding any action taken by an insurer that
				is alleged to be the result of an insurers engagement in discrimination as
				described in §15103. B of this Part. Complaints may be filed by mail,
				facsimile, or by using the departments consumer complaint form, available upon
				request from the department or on the departments website.
B. Every complaint alleging unlawful
				discrimination as described in §15103. B of this Part shall be filed for review
				with the department in written form within one year of the date the
				discrimination alleged was known or should have been known to the
				complainant.
C. Each written
				complaint shall state specifically the discrimination alleged to have occurred,
				in sufficient detail to enable the Division of Diversity and Opportunity to
				understand what occurred, when it occurred, and the basis of the alleged
				discrimination. The complaint should also contain the names and other
				identifying information of each party involved and any other supporting
				documentation relevant to the complaint.
D. When a complaint is filed by a producer, a
				claims adjuster, or employee of an insurer, the commissioner shall not disclose
				to the insurer the identity of the complainant without his or her consent. If
				it is determined that such disclosure is required for an administrative
				proceeding or other court proceeding based upon the findings of the
				investigation, or if such disclosure is in the interest of due process and
				necessary to the insurers investigation of the complaint, then the commissioner
				shall notify the complainant prior to disclosure of his or her
				identity.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:31(C), 32(B), and
				  35(C).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15109 - Notification of Insurer; Responses of Insurer

Current through Register Vol. 50, No. 6, June 20, 2024
A. After receipt of a complaint, the Division
				of Diversity and Opportunity shall notify the insurer against whom the
				complaint was filed. Notice to the insurer shall state the nature of the
				complaint and shall request that the insurer file a written response to the
				allegations of discrimination. The Division of Diversity and opportunity shall
				submit such notice to the contact person designated by the insurer to respond
				to inquiries from minority groups pursuant to
				R.S.
				22:31(A)(2).
B. Within 20 days of receipt of the notice of
				complaint, unless provided an extension of time by the division, the insurer
				shall file a written response to the allegations. The insurers response shall
				be filed by mail, facsimile, or electronically. The response filed by the
				insurer shall respond to each complaint of discrimination alleged to have
				occurred. As part of the response, the insurer may submit any affirmative
				action plan that was in effect at the time of the alleged violation.
C. Failure of the insurer to respond timely
				shall result in a fine pursuant to
				R.S.
				22:1995.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:31(C), 32(B), and
				  35(C).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15111 - Investigation; Findings

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				Division of Diversity and Opportunity shall consider any affirmative action
				plan submitted to it, along with any other pertinent information submitted to
				it, in investigating complaints alleging employment discrimination prohibited
				by part IV of chapter 3-A of title 23 (R.S.
				23:331 et seq.)
B. Following the completion of its review of
				a properly filed complaint, the receipt of the insurers response, and any
				further investigation the department requires, the Division of Diversity and
				Opportunity shall issue its finding to the commissioner.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:31(C), 32(B), and
				  35(C).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15113 - Enforcement; Sanctions

Current through Register Vol. 50, No. 6, June 20, 2024
A. In the
				event the Division of Diversity and Opportunity finds an apparent violation of
				R.S.
				22:31 et seq., the commissioner may apply
				penalties as provided for in the Insurance Code.
1. for employment discrimination prohibited
				by part IV of chapter 3-A of title 23 (R.S.
				23:331 et seq.), the commissioner may issue a
				cease and desist order and other penalties, as provided in
				R.S.
				22:33;
2. for violations of
				R.S.
				22:35, the commissioner shall fine the
				insurer $10,000 for each occurrence, as provided for in
				R.S.
				22:35; or
3. for violations of
				R.S.
				22:34, the commissioner shall issue a cease
				and desist order and other penalties as provided for in
				R.S.
				22:1969 and 1970.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15115 - Administrative Hearing

Current through Register Vol. 50, No. 6, June 20, 2024
A. Prior to the
				imposition of a penalty or sanction for an apparent violation of
				R.S.
				22:31 et seq., an aggrieved party affected by
				a decision, act, or order of the commissioner may make a written demand for a
				hearing in accordance with
				R.S. 22:2191
				et seq.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:31(C), 32(B), and
				  35(C).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15117 - Violations Reported by Employees; Retaliation by Insurer Prohibited

Current through Register Vol. 50, No. 6, June 20, 2024
A. This regulation
				shall not preclude or in any way limit the applicability of
				R.S.
				22:14(A), which prohibits
				any insurer transacting business in this state from penalizing any of its
				employees for reporting to the commissioner or other appropriate authorities,
				in good faith, a suspected violation of the Insurance Code, including
				discrimination prohibited by
				R.S.
				22:31 et seq. As provided in
				R.S.
				22:14(A),
penalizing
shall include the following:
1. discharging, disciplining, demoting,
				transferring, or otherwise discriminating against an employee of the
				insurer;
2. reducing the benefits,
				pay, or work privileges of the employee of the insurer;
3. preparing a negative work performance
				evaluation of an employee of the insurer;
4. threatening to take any of the above
				actions.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 151 - Regulation 108-Investigation of Discrimination Complaints › Section XIII-15119 - Severability

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any Section
				or provision of Regulation 108 or its application to any persons or
				circumstances is held invalid, such invalidity or determination shall not
				affect other Sections or provisions or the application of Regulation 108 to any
				persons or circumstances that can be given effect without the invalid Section
				or provision or application.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:31(C), 32(B), and
				  35(C).
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 153 - Regulation 107-Homeowner and Fire/Commercial Insurance Policy Disclosure Forms › Section XIII-15301 - Purpose

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose of
				Regulation 107 is to repromulgate the fire/commercial insurance policy
				disclosure form contained in Appendix A and to amend the homeowners insurance
				policy disclosure forms contained in Appendices B and C developed by the
				commissioner of insurance for use by all property and casualty insurers
				issuing, delivering or renewing homeowners and fire/commercial insurance
				policies that provide coverage for damages to property in Louisiana.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  22:1319
				  and
				  22:1332.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 153 - Regulation 107-Homeowner and Fire/Commercial Insurance Policy Disclosure Forms › Section XIII-15303 - Applicability and Scope

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				Regulation 107 shall be applicable to all property and casualty insurers for
				all new fire/commercial policies and homeowner policies and all renewals of
				existing fire/commercial policies and homeowner policies.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  22:1319
				  and
				  22:1332.
Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 153 - Regulation 107-Homeowner and Fire/Commercial Insurance Policy Disclosure Forms › Section XIII-15305 - Disclosure Forms

Current through Register Vol. 50, No. 6, June 20, 2024
A. Every
				property and casualty insurer issuing, delivering or renewing homeowners or
				fire/commercial insurance policies that provide coverage for damage to property
				in Louisiana shall present to the insured as an insert in the front of the
				policy upon issuance, delivery or renewal the appropriate disclosure
				form.
B. Formatting Instructions.
				The text of the disclosure form should be formatted as shown in the applicable
				appendix in bold type of not less than a fourteen-point font.
C. Appendix A contains the form that sets
				forth the disclosures required by
				R.S.
				22:1319 for use by all property and casualty
				insurers issuing fire/commercial policies covering property in
				Louisiana.
D. Appendix B contains
				the form that sets forth the disclosures required by
				R.S.
				22:1332(B)(1)-(6) and (8)
				for use by all property and casualty insurers issuing homeowner policies
				covering property in Louisiana.
E.
				Appendix C contains the form that sets forth the disclosures required by
				R.S.
				22:1332(B)(1)-(8) for use by
				all property and casualty insurers issuing homeowner policies covering property
				in Louisiana that use claims that do not exceed the policy deductible and that
				do not result in a payment either to the insured or on behalf of the insured to
				increase the cost of the policy premium in the future or as part of the basis
				for cancellation of a policy.
AUTHORITY NOTE:
				  Promulgated in accordance with
				  R.S.
				  22:11,
				  22:1319
				  and
				  22:1332.