reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 140.00 - Procedures Concerning The Merger Or Consolidation Of Insurance Companies › Section 140.13 - Approval by Stockholders or Policyholders

Current through Register 1525, July 5, 2024
(1)
Special Meeting
.
			 No Agreement shall be approved by the Commissioner unless it shall have been
			 approved by the votes of the Stockholders, if any, owning at least b of the
			 stock of each Company at a Special Meeting called for the purpose. If there are
			 no Stockholders, such Agreement shall have been approved by the votes of at
			 least b of such Policyholders of each Company as are present and voting at a
			 Special Meeting called for the purpose. Stockholders, if any, or, if there are
			 no Stockholders, Policyholders may vote in person, by proxy or by mail at the
			 Special Meeting. Neither the Special Meeting nor the last date upon which
			 proxies are eligible for inclusion in the Special Meeting vote count shall take
			 place prior to the commencement of any Hearing held under
			 211 CMR 140.00.
(2)
Notice of Special
			 Meeting
. Notice of the Special Meeting shall be given in
			 accordance with law and consistent with the Charter and By-laws of the Domestic
			 Company(ies), subject to the approval of the Commissioner. If the companies
			 merging or consolidating are mutual companies, the Domestic Company(ies) shall
			 send notice of the Special Meeting to its Policyholders as the Commissioner
			 deems appropriate. Notice of the Special Meeting shall be published at least
			 once a week for three successive weeks in some newspaper printed in the
			 Commonwealth, and if any of the merging or consolidating companies are
			 domiciled outside of the Commonwealth at least once a week for three successive
			 weeks in some newspaper printed in the town where such company has its
			 principal office, and, in any case, in a newspaper of national circulation or
			 other publication(s) if the Commissioner so directs.
(3)
Contents of
			 Notice
. The notice of Special Meeting shall set forth the reasons
			 for the ballot vote and the time and place of the Special Meeting. The notice
			 of Special Meeting and any ballot enclosed with the notice shall be in a form
			 satisfactory to the Commissioner.
(4)
Information Required in Proxy
			 Statement or Information Statement
. If
			 211 CMR 13.00 is applicable,
			 any proxy statement or information statement shall contain the information
			 required by
			 211
			 CMR 13.11(12).
(5)
Certification
. A
			 certification of the votes cast by Stockholders, if any, or Policyholders shall
			 be entered into the docket, which shall remain open for this purpose.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 140.00 - Procedures Concerning The Merger Or Consolidation Of Insurance Companies › Section 140.14 - Approval of Commissioner

Current through Register 1525, July 5, 2024
The Agreement to merge or consolidate, in its final form, shall
				be subject to the written approval of the Commissioner in such form as he or
				she may prescribe; provided that subsequent to the Special Meeting, it appears
				that the requirements of M.G.L. c. 175, § 19A or 19B,
				211 CMR 140.00 and other
				applicable laws, if any, have been satisfied. The Commissioner may, in his or
				her discretion, refuse to issue such an approval in any case, and his or her
				decision shall be final.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 140.00 - Procedures Concerning The Merger Or Consolidation Of Insurance Companies › Section 140.15 - Rights of Minority Stockholders

Current through Register 1525, July 5, 2024
If any Stockholder of a Domestic Company merging or
				consolidating under M.G.L. c. 175, § 19A or under M.G.L. c. 175, §
				19B objects to the proposed merger or consolidation in the manner provided in
				M.G.L. c. 156B, § 86, then the provisions of M.G.L. c. 156B, §§
				86 through 98 shall be applicable.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 140.00 - Procedures Concerning The Merger Or Consolidation Of Insurance Companies › Section 140.16 - Severability

Current through Register 1525, July 5, 2024
If any rule contained herein is found to be unconstitutional or
				invalid by a Court of competent jurisdiction, the validity of the remaining
				rules will not be so affected.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.01 - Scope and Purpose

Current through Register 1525, July 5, 2024
211 CMR
				142.00 is promulgated pursuant to St. 1998, c. 129:
An Act Providing Consumer Protection Relative to the Sale of Insurance
				by Banks
, St. 2002, c. 454:
An Act Relative to Credit Unions
and St. 2008, c. 423:
An Act Relative to the Operation of
				Credit Unions
. The purpose of
				211 CMR
				142.00 is to regulate the insurance sales activities
				of banks, credit unions and lenders in Massachusetts and to ensure that such
				business is conducted in compliance with the consumer protection laws of the
				Commonwealth.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.02 - Applicability

Current through Register 1525, July 5, 2024
211 CMR
				142.00 applies to any Bank which engages in insurance
				sales activities in Massachusetts.
				211 CMR
				142.00 shall not apply to the authority granted by
				M.G.L. c. 167F, § 2 paragraphs 16 and 17, M.G.L. 171, § 75, seventh
				paragraph and ninth paragraph, and M.G.L. c. 255, § 12G.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.07 - Anti-discrimination

Current through Register 1525, July 5, 2024
No Bank engaged in insurance sales activities shall unlawfully
				discriminate against an insurance applicant or allow an affiliate, a subsidiary
				corporation established for the purpose or a third party acting on its behalf
				to unlawfully discriminate against an applicant for any insurance products
				offered by it based upon his or her membership in any class protected by M.G.L.
				c. 151B, §§ 4(3A) and (3B), including but not limited to, race,
				color, national origin or residence. No Bank offering insurance products at its
				premises shall refuse to offer the same at every such branch of the
				Bank.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.08 - Customer Information and Record Keeping

Current through Register 1525, July 5, 2024
(1) A Bank licensed as an insurance producer
			 under M.G.L. c. 175, § 209 shall not permit the unauthorized release,
			 dissemination, or sharing of confidential information, including medical record
			 information, protected by M.G.L. c. 175I, M.G.L. c. 93H, M.G.L. c. 93I, and
			 201 CMR 17.00:
Standards for the Protection of Personal Information of Residents of
			 the Commonwealth
within the Bank's organization, including its
			 affiliates, subsidiary corporations and third party vendors, as well as to
			 third parties.
(2) A Bank shall at
			 all times remain in compliance with M.G.L. c. 175I, M.G.L. c. 93H, M.G.L. c.
			 93I, and
			 201 CMR 17.00:
Standards for the Protection of Personal Information of Residents of
			 the Commonwealth
.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.09 - Consumer Complaint Processing

Current through Register 1525, July 5, 2024
(1) A Bank
			 engaged in insurance sales activities, as an insurance producer, shall
			 forthwith forward copies of all Massachusetts consumer complaints relative to
			 such activities to the Office of Consumer Affairs. Said Office shall cause a
			 record of all such complaints received to be maintained and shall, depending
			 upon the nature of the complaint, refer any such complaint for resolution to
			 the Division or the Division of Banks.
(2) The processing and resolution of consumer
			 complaints under 211 CMR 142.09 shall be governed by the Interagency Agreement,
			 and any amendments thereto.
(3) A
			 Bank shall take reasonable steps to investigate all consumer complaints and
			 shall make a good faith effort to resolve such consumer complaints in a timely
			 manner.
(4) Nothing in 211 CMR
			 142.09(1) shall prohibit a consumer from filing a separate individual complaint
			 directly with the Office of Consumer Affairs, the Division or the Division of
			 Banks. Such complaints shall be processed pursuant to the Interagency
			 Agreement.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.10 - Fines and License Suspension or Revocation

Current through Register 1525, July 5, 2024
Any violation of
				211 CMR
				142.00 shall be subject to all applicable fines and
				penalties, including the suspension and revocation of licenses, pursuant to the
				provisions of M.G.L. c. 175, and c. 176D. Any violation of
				211 CMR
				142.00 shall be deemed to be an unfair method of
				competition and an unfair or deceptive act or practice pursuant to M.G.L. c.
				176D.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 142.00 - Insurance sales by banks, credit unions and lenders › Section 142.11 - Severability

Current through Register 1525, July 5, 2024
If any provision of
				211 CMR
				142.00 or the application thereof to any person or
				circumstance is for any reason held to be invalid, the remainder of
				211 CMR
				142.00 and the application of such provision to other
				persons or circumstances shall not be affected thereby.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 143.00 - Credit Insurance Disclosure Requirements › Section 143.01 - General

Current through Register 1525, July 5, 2024
(1)
Authority
.
			 211 CMR 143.00 is
			 promulgated under the authority granted by M.G.L. c. 176D, § 3.
(2)
Purpose
. The
			 purpose of
			 211 CMR 143.00 is to require
			 disclosure to consumers of the coverage, costs and other aspects of credit
			 insurance related to a credit transaction so that a consumer may make a more
			 informed decision.
(3)
Severability Clause
. The provisions of
			 211 CMR 143.00 are
			 severable.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 143.00 - Credit Insurance Disclosure Requirements › Section 143.02 - Required Disclosures

Current through Register 1525, July 5, 2024
(1)
Written Disclosures
. Before the purchase of credit
			 life or credit accident and health insurance related to a transaction in which
			 credit will be offered or extended to a consumer primarily for personal, family
			 or household purposes, the following shall be disclosed to the consumer(s) in
			 writing:
(a) If other insurance exists that
			 covers the risk or that may cover the risk, one may not want or need credit
			 insurance.
(b) A brief description
			 of the coverage, including:
1. The
			 amount;
2. The term;
3. Any exceptions, limitations and
			 exclusions;
4. The insured
			 event(s);
5. Any waiting or
			 elimination period;
6. Any
			 deductible;
7. Any applicable
			 waiver of premium provision;
8. To
			 whom the benefits would be paid;
9.
			 The premium rate or, if applicable, the actual premium charge for each coverage
			 or for all coverages in a package.
(c) The financing rate, if any.
(d) If more than one kind of credit insurance
			 is being made available, the ability of the consumer(s) to purchase each kind
			 of credit insurance separately or only as a package.
(e) The conditions of eligibility.
(f) The conditions for cancellation and the
			 method of refund of unearned premiums.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 143.00 - Credit Insurance Disclosure Requirements › Section 143.03 - Readability of the Required Disclosures

Current through Register 1525, July 5, 2024
(1)
Readability of the Required Disclosures
. No written
			 disclosure shall be presented unless:
(a) The
			 text achieves a minimum Flesch scale readability score of at least
			 50.
(b) It is printed, except for
			 the tables, in not less than a ten-point type, one point leaded.
(c) The style, arrangement and overall
			 appearance gives no undue prominence to any portion of the text of the written
			 disclosures.
(d) The organization
			 of the content of the written disclosure form is conducive to the clarity of
			 the form as well as enhances the clarity of the form.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.01 - Purpose, Scope, and Authority

Current through Register 1525, July 5, 2024
211 CMR 144.00, promulgated
				pursuant to M.G.L.c. 175, § 19W, governs regulatory review of and public
				hearings on plans of reorganization or conversion pursuant to M.G.L. c. 175,
				§§ 19F through 19W.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.02 - Definitions

Current through Register 1525, July 5, 2024
As used in
				211 CMR 144.00, the
				following words mean:
Commissioner
. The Commissioner of
				Insurance appointed pursuant to M.G.L. c. 26, § 6, or his or her
				designee.
Company
. A mutual company or a mutual
				holding company, as defined in M.G.L. c. 175, § 19G, that proposes to
				reorganize or convert pursuant to M.G.L. c. 175, §§ 19F through
				19W.
Division
. The Division of Insurance
				established pursuant to M.G.L. c. 26, § 1, including outside consultants
				or advisors retained by the Division of Insurance.
Hearing
. The public hearing required
				by M.G.L. c. 175, § 19H(c)or§ 19U(b)(1), including any prehearing
				orders and conferences.
Intervenor
. A person who may be
				substantially and specifically affected by the plan and is granted permission,
				pursuant to
				211 CMR
				144.07, to intervene in all or a part of a
				hearing.
Papers
. All documents filed in a
				hearing.
Participant
. A person who may be
				affected by the plan and is granted permission, pursuant to
				211 CMR
				144.07, to participate in a hearing as
				determined by the presiding officer.
Party
. The company, the Division, and
				any intervenor.
Person
. An individual or legal
				entity.
Plan
. A plan of reorganization or
				conversion as defined in M.G.L. 175, § 19G
Policyholder
. A policyholder of the
				company.
Presiding Officer
. The person or
				persons who preside at the hearing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.03 - Submission of a Plan for Approval

Current through Register 1525, July 5, 2024
The company shall submit 12 copies of a plan for the
				Commissioner's approval. A copy of a plan must also be submitted o n a computer
				disk in a format determined by the Commissioner. The Commissioner or presiding
				officer may order the company to submit additional copies of a plan, and may
				specify electronic or other format requirements.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.04 - Designation of Division Staff

Current through Register 1525, July 5, 2024
The Commissioner may designate Division staff and outside
				consultants or advisors to conduct examinations of one or more of the companies
				involved in or that are a part of the reorganization or conversion for which
				approval is sought, pursuant to M.G.L. c. 175, § 4 and § 19H or
				§ 19U, to assist the Division and Commissioner in determining whether the
				reorganization or the conversion meets the requirements of M.G.L. c. 175,
				§§ 19F through 19W. The examination may include a review and
				evaluation of all documents and information in the custody or under the control
				of the company that the Division considers relevant to the reorganization or
				conversion or related issues.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.05 - Notice of Hearing

Current through Register 1525, July 5, 2024
(1)
Publication
. The company shall publish the hearing
			 notice issued by the Commissioner in newspapers or other publications as
			 determined by the Commissioner. The notice will specify the date on or before
			 which petitions to intervene or participate must be filed and served. The
			 notice must be published at least 15 days before the hearing, but not more than
			 60 days before the hearing. The Commissioner will specify the time for
			 publication. The company shall file proof of publication within 14 days of
			 publication.
(2)
Mailing
. At least 60 days before the hearing, the
			 company shall mail the notice of hearing, via first class mail or by such other
			 method as the Commissioner deems appropriate, to its directors, officers,
			 employees and eligible policyholders at their last known addresses as shown on
			 the records of the company. The notice shall be preceded or accompanied by a
			 true and complete copy of the plan, or by a summary of the plan approved by the
			 Commissioner, and any other explanatory information that the Commissioner shall
			 approve or require.
(3)
Other Notification
. At least 60 days before the
			 hearing, or at such time as otherwise ordered by the Commissioner, the company
			 shall post the notice of hearing on its internet site in accordance with any
			 instructions given by the Commissioner. Unless the Commissioner directs
			 otherwise, the company shall also post a complete copy of the plan and the
			 summary of the plan approved by the Commissioner, together with any other
			 explanatory information that the Commissioner shall approve or
			 require.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.07 - Appearances and Public Comment at the Hearing

Current through Register 1525, July 5, 2024
(1)
Appearance
. A
			 person may appear in his or her own behalf. A person may also be represented by
			 an authorized representative.
(2)
Public Comment.
(a)
Oral Statements
. Members of the public, including
			 policyholders, directors, officers, and employees of the company, ma y present
			 oral statements at the start of the public hearing or at another time
			 determined by the presiding officer. A person who wishes to offer an oral
			 statement shall file a written notice by the date specified in the notice of
			 hearing. Such notice shall contain the name, address and telephone number of
			 the person and his or her authorized representative, if any. The presiding
			 officer, in his or her discretion, may allow a person who has not filed a
			 notice of intention to make a statement to speak . The presiding officer may
			 specify the amount of time allowed to a speaker. If the presiding officer
			 determines that an oral statement is irrelevant, immaterial or unduly
			 repetitious, he or she may further restrict the time allowed to a
			 speaker.
(b)
Written
			 Statements
. Members of the public may file written statements
			 before the close of the evidentiary record or by such other time as determined
			 by the presiding officer.
(c)
Responses to Written Statements
. The presiding officer
			 may order a party to respond to written statements and to file and serve a copy
			 of its response.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.08 - Prehearing Procedures

Current through Register 1525, July 5, 2024
(1)
Pre-hearing Conference
. The presiding officer may hold
			 one or more pre-hearing conferences to consider: the simplification or
			 clarification of the issues; admissions of fact, a nd agreements on documents
			 to avoid unnecessary proof or to dispose of any issues; limits on the number of
			 witnesses and avoidance of duplicative, repetitious, or cumulative evidence;
			 the schedule of testimony; the organization of exhibits; the conduct and format
			 of the hearing; and other matters that may affect the hearing.
(2)
Prefiled
			 Evidence
. The presiding officer may order the submission in
			 advance of the hearing, at a time designated by the presiding officer, of sworn
			 written direct testimony of any or all witnesses. Such prefiled written
			 testimony will be received in evidence with the same force and effect as though
			 it were stated orally by the witnesses who have given the evidence, provided
			 that each witness shall be present at the hearing at which the prefiled
			 testimony is offered, shall adopt the written testimony under oath, and shall
			 be made available for cross- examination as directed by the presiding officer.
			 The presiding officer may also order that documentary evidence be filed in
			 advance of the hearing, at a time designated by the presiding
			 officer.
(3)
Discovery.
(a)
			 Voluntary discovery is encouraged. If voluntary discovery fails, a party may
			 file and serve an application for an order directing discovery. The application
			 must set forth, with reasonable particularity, the discovery sought, its
			 relevance to the issues to be considered at the hearing, and the efforts
			 previously made to obtain the requested discovery.
(b) The person from whom discovery is sought
			 may respond to the application within three days or at such other time as
			 determined by the presiding officer.
(c) The presiding officer may schedule a
			 hearing on the application for order directing discovery. Orders of the
			 presiding officer may include limitations on the scope, method, time and place
			 for discovery, provisions for protecting confidential information or documents,
			 and provisions to protect against annoyance, embarrassment, oppression or undue
			 burden or expense. Iallowed, discovery must be conducted expeditiously. An
			 application for discovery will not be grounds to delay the hearing except for
			 good cause.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.10 - Briefs

Current through Register 1525, July 5, 2024
The presiding officer may order the filing of briefs by the
				parties and participants, at times determined by the presiding officer. The
				presiding officer may set a page limit for briefs. Each brief must include: a
				concise statement of the case; a clear and specific identification of all
				evidence relied upon with references to the pages in the transcript of exhibits
				where the evidence appears; arguments and supporting authorities; a statement
				of the specific relief requested on every contested issue; and any other
				information required by the presiding officer, including proposed findings of
				fact and rulings of law. Unless otherwise ordered by the presiding officer,
				five copies of briefs must be filed, and one copy must be filed on a computer
				disk in an electronic format determined by the presiding
				officer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.11 - Final Decision

Current through Register 1525, July 5, 2024
The final decision of the Commissioner will be in writingand
				will be issued no more than 60 days following the final oral or written
				submissions or arguments in the hearing.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 144.00 - Procedures For The Regulatory Review Of And Public Hearings On Plans Of Reorganization Or Conversion Pursuant To M.g.l. C.175 Secs. 19f-19w › Section 144.12 - Policyholders Vote

Current through Register 1525, July 5, 2024
(1)
Supervision of Vote
. The Commissioner will have the
			 authority to supervise and direct and prescribe rules governing the procedure
			 for the conduct of voting on a plan submitted to policyholders for approval
			 consistent with M.G.L. c. 175, §§ 19F through 19W.
(2)
Good Faith Efforts by the
			 Company to Encourage Voting
. The company shall use good faith
			 efforts to encourage eligible policyholders or members to vote on a plan. The
			 company must describe its efforts in the plan. Subject to approval or direction
			 by the Commissioner, these efforts should include, but need not be limited to,
			 one or more of the following: establishing a toll-free call center,
			 establishing an internet site, adding messages to routine policy statements,
			 providing written communications to policyholders entitled to vote, and
			 advertising in national publications.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.01 - Purpose

Current through Register 1525, July 5, 2024
The purpose of 211 CMR 146. 00 is to provide for full and fair
				disclosure of the provisions of specified disease insurance policies offered
				for sale in Massachusetts and to promote the public interest by protecting
				applicants for specified disease insurance from unfair or deceptive sales and
				enrollment practices.
				211
				CMR 146.00
et seq.
establishes
				minimum benefit levels for individual policies and minimum standards for
				disclosure, marketing and agent training for both individual specified disease
				policies and group specified disease policies that are not employment-based.
				211
				CMR 146.00 also restricts or prohibits provisions
				which may be misleading, confusing or contrary to the needs of the public, and
				prohibits coverages that are so limited in scope as to be of no substantial
				economic value to the insured.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.02 - Applicability

Current through Register 1525, July 5, 2024
211
				CMR 146.00 applies to specified disease insurance
				policies offered in Massachusetts after January 1, 2003. The requirements
				contained in
				211
				CMR 146.00 are in addition to any other applicable
				statutory provisions or lawful regulations.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.03 - Authority

Current through Register 1525, July 5, 2024
211
				CMR 146.00 is issued under the authority of M.G.L. c.
				175, § 108, c. 176, 176M and c. 176D,§11.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.05 - General Standards for Individual Policies

Current through Register 1525, July 5, 2024
(1) An individual policy covering a single
			 specified disease or combination of specified diseases may not be sold or
			 offered for sale other than as specified disease coverage pursuant to
			 211
			 CMR 146.00. An individual specified disease insurance
			 policy shall cover all forms of the disease or diseases specified in t he p
			 olicy.
(2) Any individual specified
			 disease policy issued which conditions payment upon pathological diagnosis of a
			 covered disease, shall also provide that if such a pathological diagnosis is
			 medically inappropriate or life threatening, a clinical diagnosis will be
			 accepted in lieu thereof. Any form of medically appropriate diagnosis shall be
			 accepted.
(3) An individual
			 specified disease policy shall be either guaranteed renewable or
			 noncanceable.
(4) Except for any
			 policy provision regarding other specified disease coverage with the same
			 insurer, benefits for specified disease coverage shall be paid regardless of
			 other coverage.
(5) An individual
			 specified disease policy may only include pre-existing condition limitations
			 which exclude coverage for no more than six months after the effective date of
			 coverage under the policy. The pre-existing condition limitation may only apply
			 to a condition for which medical advice was given or treatment was recommended
			 by, or received from, a licensed health care provider within the six-month
			 period immediately preceding the effective date of coverage. If an individual
			 specified disease policy contains any limitation with respect to pre-existing
			 conditions, such limitations shall appear as a separate paragraph in the policy
			 and shall be labeled as "Pre-Existing Condition Limitations".
(6) No policy shall provide for a reduction
			 of benefits upon attainment of any age or other condition, or upon the
			 occurrence of any event(s).
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.06 - Minimum Benefit Standards for Individual Policies Written on an Indemnity and Recurring Basis

Current through Register 1525, July 5, 2024
(1) Notwithstanding
			 any other provisions of 211 CMR 146.06, an individual policy shall provide
			 benefits to any covered person not only for the specified disease(s) but also
			 for any other condition(s) or disease(s) directly caused or aggravated by the
			 specified disease(s) or the treatment of the specified disease(s).
(2) If payments are to be conditioned upon a
			 covered person receiving medically necessary care or treatment, given in a
			 medically appropriate location, under a medically accepted course of diagnosis
			 or treatment, this is to be clearly stated in the policy and the carrier must
			 be accredited pursuant to M.G.L. c. 176O and 211 CMR 146.000.
(3) No individual policy or certificate
			 issued pursuant to 211 CMR 146.06 shall contain a waiting period lasting longer
			 than 30 days from the coverage effective date. A provision shall be included in
			 the policy or certificate indicating that for a specified disease diagnosed
			 within the initial 30 days of coverage, the policy or certificate is either
			 void from its beginning with a full premium refund to the insured, or the
			 coverage for such diagnosed specified disease is subject to a pre-existing
			 condition limitation not exceeding six month from the coverage effective date.
			 The provision shall also indicate that the insured must elect whether the
			 policy or certificate is to be voided with a full premium refund or coverage is
			 to be delayed.
(4) Except as
			 otherwise noted in 211 CMR 146.06, an individual specified disease policy's
			 benefits shall begin with the first day of medical care or hospital confinement
			 if such care or confinement is for a covered disease, even though the diagnosis
			 is made at some later date.
(5)
			 Benefits for confinement in a skilled nursing home or for home health care are
			 optional. If a policy or certificate provides these benefits, the coverage must
			 equal a fixed sum payment of at least one-half of the hospital confinement
			 in-patient benefit for each day of skilled nursing home confinement for at
			 least 100 days, and a fixed sum payment of at least ½ of the hospital
			 confinement in-patient benefit for each day of home health care for at least
			 100 days. Notwithstanding any other provision of this Part, any restriction or
			 limitation applied to the benefits in the above requirements, whether by
			 definition or otherwise, shall be no more restrictive than those under title
			 XVIII of the Social Security Act (
			 42 U.S.C.
			 1395c
et seq
., 1395j
et seq
.).
(6) If
			 benefits are not payable for a period of 180 days, then a covered person shall
			 be entitled to a new benefit period.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.07 - Minimum Benefit Standards for an Individual Policy Where a Benefit is a Lump-sum Payment for the Diagnosis of a Specified Disease without Further Coverage for Treatment of the Disease

Current through Register 1525, July 5, 2024
(1) An individual
			 specified disease policy may only be offered with face value amounts in even
			 increments of $1,000 not to exceed $500,000. Carriers may offer a plan with
			 benefits based on a percent of the face amount that results in less than an
			 even $1,000 benefit.
(2) No
			 individual policy or certificate issued pursuant to 211 CMR 146.07 shall
			 contain a waiting period lasting longer than 30 days from the coverage
			 effective date. A provision shall be included in the policy or certificate
			 indicating that for a specified disease diagnosed within the initial 30 days of
			 coverage, the policy is either void from its beginning with a full premium
			 refund to the insured, or the coverage for such diagnosed specified disease is
			 subject to a pre-existing condition limitation not to exceed six month from the
			 coverage effective date. The provision shall also indicate that the insured
			 must elect whether the policy or certificate is to be voided with a full
			 premium refund or coverage is to be delayed.
(3) Indemnity amounts for any one specified
			 disease cannot be required to be paid in more than two equal installments for
			 any reoccurrences or spread of the same specified disease or a new primary
			 occurrence of the same specified disease or the resulting death of the insured
			 due to the same specified disease.
(4) New waiting periods for any one specified
			 disease cannot be instituted for any reoccurrences or spread of the same
			 specified disease or a new primary occurrence of the same specified disease.
			 Waiting periods in addition to those allowed by 211 CMR 146.07(2) are
			 prohibited. However, the insurer can require reasonable and appropriate medical
			 certification that the insured is afflicted with a specified disease covered by
			 the policy.
(5) Benefit amounts
			 payable for any one specified disease can be subject to a maximum policy
			 benefit for all specified diseases covered under the policy.
(6) A benefit shall always be pay able upon
			 initial and medically appropriate diagnosis of the specified disease covered by
			 the policy. There shall be no requirement that the insured survive for any
			 period of time in order for the benefit to be payable.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.08 - Form and Rate Filing Procedures for Individual Policies

Current through Register 1525, July 5, 2024
(1) Carriers shall file all individual policy
			 forms, including applications, disclosure statements and replacement forms, and
			 associated rates pursuant to the provisions of
			 211 CMR
			 42.06.
(2) Applications forms must meet the
			 requirements set forth in
			 211 CMR
			 42.08,
			 211 CMR
			 42.09(2), 211 CMR 42.99,
			 M.G.L. c. 175I and any other applicable Massachusetts statute or
			 regulation.
(3) All rate filings
			 are to specify the rates proposed to be charged to all under writing classes.
			 The rate filing is to define each underwriting class in a way to make clear how
			 it will be applied to any occupation, actual or expected health condition,
			 claims experience, duration of coverage or medical condition of such person in
			 relation to
			 211 CMR 42.00 and M.G.L.
			 c.175, § 108.
(4) In the event
			 that any provision of
			 211 CMR 42.00 is in
			 consistent with the provisions of
			 211
			 CMR 146.00, the provisions of
			 211
			 CMR 146.00 shall govern all matters concerning any
			 policy form that is within the definition of specified disease coverage in
			 211
			 CMR 146.00.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.09 - Requirements for Agent Training and Marketing

Current through Register 1525, July 5, 2024
(1) Each carrier shall provide appropriate
			 training to agents about its specified disease insurance products, maintain
			 records regarding agents who have satisfactorily completed such training and
			 file at least annually with the commissioner lists identifying those agents who
			 have completed the carrier's specified disease insurance training program No
			 agent may offer for sale a company's product unless the agent is identified on
			 the list filed with the Commissioner.
(2) All specified disease insurance marketing
			 and advertising shall conform to the provisions of
			 211 CMR 40.00. In addition,
			 carriers shall establish auditable internal marketing procedures, methods for
			 assuring compliance by agents, and prohibitions against twisting, high-pressure
			 tactics and cold-lead advertising. No advertisement of a policy shall imply
			 coverage beyond the terms of the policy. Synonymous terms shall not be used to
			 refer to any disease so as to imply broader coverage than is the
			 fact.
(3) All agents or persons
			 marketing a carrier's specified disease insurance shall clearly identify which
			 plans being offered are individual products and which are group products. When
			 marketing group products, the agent shall clearly identify the name of the
			 group policyholder and any conditions that the eligible person must satisfy to
			 join and remain a member of the group.
(4) All agents marketing a carrier's
			 specified disease insurance shall disclose to potential applicants the name of
			 the carrier that the agent represents in the sale. The carrier's name must be
			 disclosed on any and all printed sales or appropriate materials provided,
			 distributed or shown to potential applicants and/or during presentations made
			 to potential applicants in association with a sale, whether part of a
			 presentation or not.
(5) All agents
			 marketing a carrier's specified disease insurance policy must disclose the fact
			 that the agent receives compensation in connection with the sale or replacement
			 of all specified disease insurance.
(6) All agents marketing a carrier's
			 specified disease insurance shall not misrepresent their expertise,
			 qualifications or training to potential clients and shall not comment on the
			 legal or tax implications of purchasing specified disease insurance to the
			 extent that they lack the training, qualifications or license to provide such
			 advice.
(7) A carrier whose agent
			 fails to comply with any provisions of
			 211
			 CMR 146.00, including but not limited to 211 CMR
			 146.09, will be deemed to have committed an unfair and deceptive act in the
			 business of insurance subject to M.G.L. c.176D.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.10 - Requirements for Disclosure

Current through Register 1525, July 5, 2024
All individualand group policies ofspecified disease insurance
				must adequately disclose all policy provisions, including but not limited to
				the following provisions;
(1) The
			 first page of the policy must include the following:
(a) The following statement in 14-point
			 boldface type: "Notice to buyer: This insurance provides a limited benefit in
			 the event you are diagnosed with [the specified disease or diseases]. This
			 policy is a supplement and not a substitute for a health benefit plan. You must
			 have a health benefit plan in order to purchase this insurance.
(b) A section in boldface type that lists all
			 pre-existing condition exclusions or limitations or clearly refers to the
			 separate or stand-alone section within the policy that lists all pre-existing
			 condition exclusions or limitations.
(c) A section that clearly identifies whether
			 the policyis noncancelable or guaranteed renewable, and whether it is being
			 issued on other than an individual basis (policies providing conversion
			 privileges must specify the benefits to be provided or must state that the
			 converted coverage shall be on the policy form then being issued by the carrier
			 for this purpose).
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.11 - Prohibition Against Post Claims Underwriting

Current through Register 1525, July 5, 2024
(1) All applications and enrollment forms for
			 individual and group specified disease insurance policies, except those that
			 are guaranteed issue, shall contain clear and unambiguous questions designed to
			 ascertain the health condition of the applicant, including information
			 regarding the health history of the applicant. Carriers are also required to
			 provide, along with these forms, a clear explanation in writing of the
			 applicant's rights as set forth in M.G.L. c.175I.
(2) If an application or enrollment form
			 contains a question that asks whether the applicant has had medication
			 prescribed by a physician, then it must also ask the applicant to list the
			 medication that has been prescribed and the reason that the medication was
			 prescribed.
(3) Except for policies
			 that are guaranteed issue:
(a) The following
			 language shall be set out conspicuously near the applicant's signature block on
			 an application:
"Caution: If your answers on this application are incorrect or
				untrue, [carrier] has the right to deny benefits or rescind your
				policy."
(b) The following
			 language, or language substantially similar to the following, shall be set out
			 conspicuously on the policy, as well as the outline of coverage, at the time of
			 delivery:
"Caution: The issuance of this specified disease [policy]
				[certificate] is based upon your responses to the questions on your
				application. A copy of your [application] [enrollment form] [is enclosed] [was
				retained by you when you applied]. If your answers were incorrect or untrue as
				of the date you signed the application, the carrier has the right to deny
				benefits or rescind your policy subject to the [time limit on certain defenses,
				incontestable] section of your policy. The best time to clear up any questions
				is now, before a claim arises! If, for any reason, any of your answers are
				incorrect, contact the carrier at this address: [insert address]".
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.13 - Severability

Current through Register 1525, July 5, 2024
If any section or portion of a section of
				211
				CMR 146.00, or the applicability thereof to any person
				or circumstance is held invalid by any Court of competent jurisdiction, the
				remainder of
				211
				CMR 146.00, or the applicability thereof to other
				persons or circumstances, shall not be affected thereby.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.100 - Policy Disclosure Form

Current through Register 1525, July 5, 2024
(1) Policies of
			 individual insurance and certificates and policies of group insurance shall use
			 the following prescribed statement only, except that appropriate policy and
			 certificate identification may be included:
COMPANY NAME
SPECIFIED DISEASE COVERAGE ONLY
REQUIRED DISCLOSURE STATEMENT
This policy or certificate is (an individual policy of
				insurance) (a group policy or certificate). This policy or certificate provides
				specified disease coverage ONLY. This policy orcertificatedoes NOT provide
				basic hospital, basic medical or major medical insurance. It is a supplement to
				your health benefit plan and cannot replace your health benefit plan.
(Accurately list benefits, exclusions, reductions and
				limitations of the policy or certificate in a manner which does not encourage
				misrepresentation of the actual coverage provided.)
This disclosure statement is a very brief summary of your
				policy or certificate.
The policy or certificate itself sets forth the rights and
				obligations of both you and the insurance company. It is therefore imperative
				that you READ YOUR POLICY OR CERTIFICATE carefully.
The expected benefit ratio for this policy or certificate is
				___%. This ratio is the portion of future premiums which the company expects to
				return as benefits, when averaged over all people with this policy or
				certificate.
(2)
Required Disclosure for Medicare-EligibleApplicants
.
			 Carriers shall provide the Guide to Health Insurance for People with Medicare
			 and disclosure notice as required by
			 211 CMR
			 42.09(4).
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 146.00 - Specified Disease Insurance › Section 146.101 - Outline of Coverage

Current through Register 1525, July 5, 2024
[CARRIER NAME]
[ADDRESS - CITY & STATE],[TELEPHONE
				NUMBER]
SPECIFIED DISEASE INSURANCE - OUTLINE OF
				COVERAGE
Policy Number:
1. This policy is [an individual policy of
			 insurance/a group policy which was issued in (indicate jurisdiction in which
			 group policy was issued)]. THIS IS A LIMITED POLICY.
[Except for policies or certificates that are guaranteed issue,
				the following caution statement, or language substantially similar, must appear
				as follows in the outline of coverage.]
Caution
: The issuance of this specified disease
				insurance [policy] [certificate] is based upon your responses to the questions
				on your application. A copy of your [application] [enrollment form] [is
				enclosed] [was retained by you when you applied]. If your answers are incorrect
				or untrue as of the date you signed the applications, the carrier has the right
				to deny benefits or rescind your policy subject to the [Time Limit on Certain
				Defenses, Incontestable] section of your policy. The best time to clear up any
				questions is now, before a claim arises! If, for any reason, any of your
				answers were incorrect, contact the carrier at this address: [insert
				address]
2.
SUMMARY OF
			 POLICY FEATURES
This policy
:
1. is not a Medicare Supplement
			 policy.
2. [is guaranteed
			 renewable/is noncancelable] for your lifetime.
3. [is/is not] subject to automatic premium
			 increases as you get older.
4. [may
			 be/is not] subject to across the board premium increases for all policyholders
			 in your class.
5. [does/does not]
			 offer an option to purchase inflation protection.
6. [does/does not] offer an option to
			 purchase nonforfeiture protection.
7. [does/does not] contain special age
			 limitations for purchase.
8. [does
			 not cover services due to pre-existing conditions (existing health problems)
			 for a period of __ months from policy issue][does not have a waiting period
			 before pre-existing conditions (existing health problems) are
			 covered].
9. [may have/has] a
			 waiting period of __ days before benefits are payable by policy.
10. [offers a waiver of premium after __ days
			 of __ benefits][does not offer a waiver of premium].