reglab/statecodes huggingface dataset:
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5701 - SUPERVISION, REHABILITATION, AND LIQUIDATION

Current through Register Vol. 13, July 5, 2024
(1) The commissioner has the authority to
				impose sanctions on any self-funded multiple employer welfare arrangement
				(MEWA) for failure to maintain sufficient reserves as required by
				33-35-209,
				MCA. The commissioner may impose and take any action or sanction as is
				authorized pursuant to the provisions of Title 33, chapter 2, part 13, MCA,
				which are adopted by reference and excepting therefrom
				33-2-1303(1) and
				(10), MCA;
				33-2-1335,
				MCA;
				33-2-1342(6)(b) and
				(6)(c), MCA;
				33-2-1344,
				MCA;
				33-2-1349,
				MCA; and
				33-2-1379
				through 33-2-1390, MCA.
AUTH:
					 33-35-209,
					 MCA; IMP:
					 33-35-209,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5702 - AUTHORITY IS LIMITED TO INSOLVENCY

Current through Register Vol. 13, July 5, 2024
(1) The
				commissioner's authority to supervise, rehabilitate and liquidate any
				self-funded multiple employer welfare arrangement applies only to those
				instances where they fail to maintain the level of reserves as are required by
				33-35-209, MCA.
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5703 - INAPPLICABILITY OF THE LIFE AND HEALTH GUARANTY PROVISIONS

Current through Register Vol. 13, July 5, 2024
(1) The provisions of Title 33, chapter 10,
				part 2, MCA, do not apply to a MEWA nor do any of the provisions of Title 33,
				chapter 2, part 13, MCA, such as
				33-2-1303(10) and
				33-2-1371(3), MCA
				as they relate to the life and health guaranty Association.
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5704 - APPLICATION OF THESE RULES ARE TO BE CONSISTENT WITH ERISA

Current through Register Vol. 13, July 5, 2024
(1) These rules are to be interpreted so as
				to be consistent with the provisions of the Employee Retirement Income Security
				Act(ERISA) and to the extent that they conflict with ERISA they shall not
				apply.
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5705 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) "Delinquency proceeding" as it appears in
				the statutory provisions means any proceeding instituted against an insurer for
				the purpose of liquidating, rehabilitating or reorganizing, or conserving such
				insurer due to the insolvency of the insurer.
(2) "Insurer" as it appears in the statutory
				provision shall be deemed to refer to a self-funded multiple employer welfare
				arrangement as defined in
				33-35-103(4),
				MCA.
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5706 - COMMISSIONER'S SUMMARY ORDERS AND SUPERVISION PROCEEDINGS

Current through Register Vol. 13, July 5, 2024
(1)
									33-2-1321(1),
				MCA, shall be deleted and in its place shall be inserted: "Whenever the
				commissioner has established than an insurer is insolvent, he may make and
				serve upon the insurer and any other person involved such orders as are
				reasonably necessary to correct such failure."
(2) Subsections (2) and (6) of
				33-2-1321, MCA, are not
				adopted.
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5707 - TERMINATION OF POLICY COVERAGE

Current through Register Vol. 13, July 5, 2024
(1)
									33-2-1343, MCA, shall be deleted
				and in its place shall be inserted: "All policies issued by an insurer in
				effect at the time of issuance of an order of liquidation shall terminate upon
				issuance of the order of liquidation."
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.57 - The Supervision, Rehabilitation and Liquidation of Self-Funded Multiple Employer Welfare Arrangements › Rule 6.6.5708 - PRIORITY OF DISTRIBUTION

Current through Register Vol. 13, July 5, 2024
(1) The
				introductory language in
				33-2-1360(1),
				MCA, shall be deleted and in its place the following language shall be
				inserted: "As soon as practicable but not more than 180 days from the date of
				an order of liquidation of an insurer which provides for assessment of its
				member employers, the liquidator shall make a report to the court setting
				forth." 33-2-1360(1) (a) through
				(d), MCA, are adopted as written in the
				statute.
Sec.
					 33-35-209, MCA; IMP, Sec.
					 33-35-209,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.58 - Managed Care Community Networks (Repealed) › Rule 6.6.5801 - MANAGED CARE COMMUNITY NETWORKS: DEFINITIONS (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 33-31-103,
					 33-31-115,
					 53-6-703, MCA; IMP:
					 53-6-703,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.58 - Managed Care Community Networks (Repealed) › Rule 6.6.5802 - CRITERIA FOR ASSESSING THE FINANCIAL SOUNDNESS OF A NETWORK (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 53-6-703(3), MCA;
					 IMP: 53-6-703,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.58 - Managed Care Community Networks (Repealed) › Rule 6.6.5803 - PROTECTION AGAINST INSOLVENCY (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 33-31-115,
					 53-6-703(6), MCA;
					 IMP: 53-6-703,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.58 - Managed Care Community Networks (Repealed) › Rule 6.6.5804 - REDUCTION OR ELIMINATION OF REQUIREMENTS (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 33-31-103,
					 33-31-115,
					 53-6-703(1)(a),
					 MCA; IMP: 53-6-703,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.58 - Managed Care Community Networks (Repealed) › Rule 6.6.5805 - APPLICATION REVIEW FEE (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 33-31-115,
					 53-6-703(4), MCA;
					 IMP: 53-6-703,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5901 - APPLICABILITY AND IDENTIFICATION OF DIFFERENT LEVELS OF ADEQUACY

Current through Register Vol. 13, July 5, 2024
(1) A health care
				insurer who issues disability benefits and meets the requirements of
				33-22-1706(4)(c),
				MCA, is deemed to have an adequate network, for that category of health care
				providers, provided that the insurer submits the information and follows the
				requirements set forth in this chapter.
(2) The commissioner may also determine a
				network to be adequate pursuant to
				33-22-1706(4)(a),
				MCA, and ARM
				6.6.5902(1) and
				(3).
(3) If the commissioner determines an
				insurer's network to be "not adequate," the cost sharing may be adjusted to no
				greater than a 25% payment differential.
(a)
				The commissioner shall determine whether the payment difference between in- and
				out-of-network is 25% or less, based on the utilization of actuarial data
				developed by actuarial experts, such as the information found in the
				Tillinghast Manual.
(b) Even if
				the commissioner determines that the insurer utilizes an acceptable payment
				differential under (3), that insurer shall submit the information and follow
				the requirements set forth in this chapter.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5902 - NETWORK ADEQUACY

Current through Register Vol. 13, July 5, 2024
(1) The
				commissioner may determine that an insurer has an adequate network, even if the
				network does not meet all of the percentages for various types of providers or
				facilities specified in
				33-22-1706(4)(c),
				MCA.
(2) As used in
				33-22-1706(4)(c),
				MCA, and this chapter, the terms "physician" and "provider" include a specialty
				health care provider that delivers necessary medical services.
(3) For the purposes of determining network
				adequacy when the total percentage of any type of provider or facility is less
				than the minimum adequacy percentage set forth in
				33-22-1706(4)(c),
				MCA, the commissioner shall review the insurer's network to determine if it is
				sufficient in numbers and types of providers and facilities to assure that all
				covered health plan services to covered persons are accessible without
				unreasonable delay, within a reasonable proximity, and with sufficient provider
				choice, based on the availability of those types of providers and facilities.
(4) All insurers' networks must
				ensure that each covered person shall have adequate choice of each type of
				provider and facility, including but not limited to the following types:
(a) physicians;
(b) mental health and chemical dependency
				treatment providers;
(c)
				pharmacies;
(d)
				hospitals;
(e) surgi-centers;
				and
(f) residential treatment
				centers.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5903 - FILING PROVIDER LISTS

Current through Register Vol. 13, July 5, 2024
(1) An insurer
				shall file on the date specified in filing instructions from the commissioner,
				an electronic report of all participating providers in that insurer's network
				on a form and in a manner prescribed by the commissioner. If the insurer
				maintains health plans with different network access, the insurer must file a
				separate report for each network.
(2) An insurer shall file an updated report
				if:
(a) provider numbers decrease by five
				percent or more;
(b) a hospital,
				surgi-center, or other inpatient facility, with more than five beds, terminates
				its provider contract with that insurer; or
(c) requested by the commissioner.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5905 - CHOICE OF PRIMARY CARE PHYSICIAN

Current through Register Vol. 13, July 5, 2024
(1) If an insurer
				requires a covered person to choose a primary care provider and ties claims
				payment to that choice or requires a primary care provider referral before
				seeking specialty provider services, that insurer shall provide the covered
				person with access to the following:
(a) a
				list of participating primary care providers who are accepting new patients and
				who are located within a reasonable proximity of the home or business of the
				covered person. Covered persons must be permitted to change primary care
				providers at any time with the change becoming effective no later than 30 days
				following the covered person's request for the change; and
(b) a process whereby a covered person with a
				complex or serious medical or psychiatric condition may receive a standing
				referral to a participating specialist for an extended period of time. The
				standing referral must be consistent with the covered person's medical needs
				and the plan's benefits. A referral does not preclude the insurer from
				performing medical necessity reviews.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5906 - REQUIRED DISCLOSURES REGARDING NETWORK ADEQUACY

Current through Register Vol. 13, July 5, 2024
(1) Each insurer
				shall have a preferred provider directory on its web site and available in hard
				copy, if requested. The provider directory must be searchable by specialty,
				including primary provider designation, county and city or town. The directory
				must include facilities and must be updated monthly to reflect whether or not
				the provider is accepting new patients, if that information is available, and
				any additions or subtractions to the provider list. There must be a separate
				and clearly designated directory for each health plan type, if more than one
				network is offered by that insurer. In addition, each insurer shall provide
				access to a directory of out-of-state participating providers that includes
				location, provider type, and specialty.
(2) An insurer shall also include the
				following information displayed in a prominent manner in the outline of
				coverage:
(a) a description of the process
				required in ARM
				6.6.5902 regarding how patients are
				provided access to and compensated for medically necessary care if there are no
				participating providers with the necessary expertise within a reasonable
				proximity who are able to provide the health care service without unreasonable
				delay; and
(b) a statement advising
				that out-of-network emergency room services to treat an emergency medical
				condition are reimbursed as if obtained in-network, if an in-network emergency
				room cannot be reasonably reached. That disclosure must include the definition
				of emergency medical condition provided in applicable federal law.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5907 - GEOGRAPHIC SERVICES AREAS

Current through Register Vol. 13, July 5, 2024
(1) An insurer may
				offer health plans with a limited geographic area to individuals who live or
				work in that area, as long as the insurer meets the network adequacy
				requirements set forth in these rules and provides the commissioner with the
				following information:
(a) a description of
				the geographic area; and
(b) the
				rationale for limiting the sales of that product to that area.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.59 - Network Adequacy › Rule 6.6.5908 - CONTINUITY OF CARE

Current through Register Vol. 13, July 5, 2024
(1) When an
				insured's provider is dropped for any reason from the network, an insurer shall
				establish reasonable procedures to transition the insured to a preferred
				provider in a manner that ensures continuity of care.
(2) If the insured requests it and the
				treating provider agrees that the insured is in an active course of treatment,
				the treating provider may:
(a) request that
				the insured be permitted to continue treatment under the provider's
				care;
(b) agree to accept the same
				reimbursement from the insurer for that patient as provided for under that
				insurer's provider contract; and
(c) agree not to seek payment from the
				insured of any amount for which the insured would not be responsible if the
				provider were still a preferred provider.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.60 - Bail Bonds › Rule 6.6.6001 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
For the purposes of this subchapter, the following terms
				  have the following meanings:
(1) "Bail
				bond agency" means a surety bail insurance producer agency which may be a
				corporation, limited liability company, partnership, limited partnership,
				limited liability partnership, sole proprietorship, or other legal entity which
				is owned by, employs, or contracts with one or more individual surety bail
				insurance producers.
(2)
				"Commercial bail bond surety insurer" means a surety insurer who sells,
				solicits, or negotiates commercial bail bonds.
(3) "Indemnitor" is a person who, by
				agreement with a surety bail insurance producer, accepts liability for loss of
				the surety bail insurance producer in the event that a principal fails to
				perform according to the standards agreed upon between the principal and the
				surety bail insurance producer.
(4)
				"Premium" means the cost of a surety insurance bond, issued pursuant to
				33-26-101,
				et seq., MCA, and contained in the contract with the principal.
(5) "Principal" is a defendant or a witness
				who has been admitted to bail and who is obligated to appear in court as
				required upon penalty of forfeiting bail under a commercial bail
				bond.
(6) "Surety bail insurance
				producer" or "producer" means an insurance producer who sells, solicits, or
				negotiates commercial bail bonds, pursuant to
				33-26-101,
				et seq. and
				46-9-401,
				MCA.
AUTH:
					 33-1-313,
					 33-26-108,
					 MCA; IMP:
					 33-26-108,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.60 - Bail Bonds › Rule 6.6.6002 - BOND INSTRUMENTS

Current through Register Vol. 13, July 5, 2024
(1) A surety bail
				insurance producer may not sign or countersign bail bonds in blank. A surety
				bail insurance producer may not give power of attorney to, or otherwise
				authorize, anyone to countersign the surety bail insurance producer's signature
				to bonds.
(2) Bail bond
				applications shall be signed by the principal and the surety bail insurance
				producer, and an executed copy shall be given to the principal.
(3) Surety bail insurance producers shall
				maintain copies of all bail bonds issued for not less than three
				years.
AUTH:
					 33-1-313,
					 33-26-108,
					 MCA; IMP:
					 33-17-201,
					 33-26-108,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.60 - Bail Bonds › Rule 6.6.6003 - COLLATERAL, TRUST ACCOUNTS, RECORDS OF ARREST AND SURRENDER, LIST OF FORFEITURES, COSTS, NOTICE OF INCARCERATION

Current through Register Vol. 13, July 5, 2024
(1) Any
				collateral security required by a surety bail insurance producer must be
				commercially reasonable in relation to the amount of the bond. The value of any
				collateral security received by a surety bail insurance producer must not
				exceed two-and-one-half times (250%) the amount of the bond unless no other
				collateral is available. Any collateral must be acquired and secured by a
				signed security agreement and in accordance with Montana law.
(2) A surety bail insurance producer who
				accepts collateral shall give the principal the security agreement and a
				written receipt for the collateral. The receipt must give a detailed
				description of the collateral received.
(3) Collateral security must be held and
				maintained in trust. When collateral security is received in the form of cash,
				check, or other negotiable instrument, and unless cash collateral is deposited
				with and held in trust by the commercial bail bond surety insurer, the surety
				bail insurance producer shall deposit the cash or instrument, within five
				banking days after receipt, in a trust account in a bank insured by the Federal
				Deposit Insurance Corporation. The trust account may not contain operating or
				personal funds.
(4) When personal
				property is received as collateral, the surety bail insurance producer must
				comply with the Montana Uniform Commercial Code-Secured Transactions,
				30-9A-101,
				et seq, MCA.
(5) Each surety bail
				insurance producer shall keep records identifying all collateral received, the
				source of funds placed into all trust accounts, security agreements, and the
				terms of all commercial bail bond transactions. The records are open to
				inspection without notice by the commissioner.
(6) If the court exonerates a bail bond, the
				surety bail insurance producer shall return all collateral or other security to
				the person entitled to it within five business days after receipt of written
				notification of exoneration. All collateral or security must be returned in the
				condition it was received, and at the location it was received, at the
				principal's address, or the parties may mutually agree to another
				location.
(7) Each surety bail
				insurance producer shall maintain and retain for three years, and update on a
				continual basis:
(a) a list of forfeitures,
				which must include the names of the principal and indemnitor, the case name and
				number, the date of the forfeiture; and
(b) a list of arrests and surrenders, which
				must include the names of the principal and indemnitor, the case name and
				number, and the date of the failure of the principal to appear.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.60 - Bail Bonds › Rule 6.6.6004 - PROHIBITED PRACTICES

Current through Register Vol. 13, July 5, 2024
(1) A surety bail
				insurance producer may not:
(a) pay a fee or
				rebate, or give or promise anything of value, directly or indirectly to any
				public official, employee, or agent, who has power to arrest or hold in
				custody, in order to secure a settlement, compromise, remission, or reduction
				of the amount of any bail bond, or the forfeiture thereof;
(b) pay a fee or rebate, or give, or promise
				anything of value to the principal or anyone on his or her behalf;
(c) participate in the capacity of an
				attorney at a trial or hearing of a person on whose bond the surety bail
				insurance producer is a surety;
(d)
				advise or assist the principal for the purpose of forfeiting bond;
(e) fail to report, preserve without use,
				retain separately, or return after payment in full collateral taken as security
				on any bail bond to the party entitled to the collateral;
(f) fail to return collateral within five
				business days of receiving written notice of exoneration;
(g) gain access to a prospective principal in
				a prisoner confinement facility for the purpose of solicitation by
				misrepresenting to facility officials that the prospective principal or someone
				on the prospective principal's behalf had so requested; or
(h) sell, solicit, or negotiate surety bail
				insurance while employed as an investigator with the Office of the Public
				Defender.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.60 - Bail Bonds › Rule 6.6.6005 - PORTION OF BOND PREMIUM PAYMENTS DEFERRED

Current through Register Vol. 13, July 5, 2024
(1)
				If an agreement between the principal and surety bail insurance producer calls
				for some portion of the bond premium payments to be deferred or paid after the
				principal is released from custody, the surety bail insurance producer shall
				keep the agreement on file and provide a copy to the principal and indemnitor,
				if applicable. The agreement must contain the following information:
(a) the amount of the premium payment
				deferred, or not yet paid, at the time the principal is released from
				custody;
(b) the method and
				schedule of payment to be made by the principal or indemnitor to the surety
				bail insurance producer, including the dates of payment and amount to be paid
				on each date; and
(c) the interest
				rate.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.60 - Bail Bonds › Rule 6.6.6006 - BAIL BOND DOCUMENTS

Current through Register Vol. 13, July 5, 2024
(1) The following
				requirements apply to documentation a surety bail insurance producer uses in
				connection with transacting business:
(a) an
				indemnity agreement must:
(i) be in
				writing;
(ii) be signed by the
				principal;
(iii) be signed by the
				indemnitor, if any;
(iv) be signed
				by the surety bail insurance producer;
(v) set forth the amount of bail, the name of
				the principal, the amount and type of collateral held by the surety bail
				insurance producer, and the conditions under which the collateral is to be
				returned, in compliance with these rules;
(vi) state that the principal and the
				indemnitor have received copies of signed and dated disclosure forms referred
				to in (1)(e);
(vii) if the
				principal or indemnitor is illiterate or does not read English, state that the
				surety bail insurance producer or a third party has read or translated the
				agreement for the principal or indemnitor; and,
(viii) conform to all requirements of, and
				use the forms designated by the surety company.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6501 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of these rules is to
				prescribe:
(a) guidelines and standards for
				statements of actuarial opinion which are to be submitted in accordance with
				33-2-407(5) and
				(6) and
				33-7-118(2), MCA,
				and for memoranda in support thereof;
(b) rules applicable to the appointment of an
				appointed actuary; and
(c)
				guidance as to the meaning of "adequacy of reserves."
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6502 - AUTHORITY

Current through Register Vol. 13, July 5, 2024
(1) These rules are issued pursuant to the
				authority vested in the Commissioner of Insurance of the state of Montana under
				33-2-407, MCA. These rules will
				take effect for annual statements for the year 2009.
AUTH:
					 33-1-313,
					 33-2-407, MCA
IMP:
					 33-2-407,
					 33-2-408,
					 33-2-409,
					 33-2-410,
					 33-2-411,
					 33-2-412,
					 33-2-413,
					 33-2-414,
					 33-2-415,
					 33-2-416,
					 33-2-417,
					 33-7-118,
					 33-7-411,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6503 - SCOPE

Current through Register Vol. 13, July 5, 2024
(1) These rules shall apply to all life
				insurance companies and fraternal benefit societies doing business in this
				state and to all life insurance companies and fraternal benefit societies which
				are authorized to reinsure life insurance, annuities or disability insurance
				business in this state.
(2) This
				rule shall be applied in a manner that allows the appointed actuary to utilize
				his or her professional judgment in performing the asset analysis and
				developing the actuarial opinion and supporting memoranda, consistent with
				relevant actuarial standards of practice. However, the commissioner shall have
				the authority to specify specific methods of actuarial analysis and actuarial
				assumptions when, in the commissioner's judgment, these specifications are
				necessary for an acceptable opinion to be rendered relative to the adequacy of
				reserves and related items.
(3)
				These rules shall be applicable to all annual statements filed with the office
				of the commissioner after the effective date of these rules. A statement of
				opinion on the adequacy of the reserves and related actuarial items based on an
				asset adequacy analysis in accordance with ARM
				6.6.6508, and a memorandum in
				support thereof in accordance with ARM
				6.6.6509, shall be required each
				year.
AUTH:
					 33-1-313,
					 33-2-407, MCA
IMP:
					 33-2-407,
					 33-2-408,
					 33-2-409,
					 33-2-410,
					 33-2-411,
					 33-2-412,
					 33-2-413,
					 33-2-414,
					 33-2-415,
					 33-2-416,
					 33-2-417,
					 33-7-118,
					 33-7-411,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6504 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) "Actuarial opinion" means the opinion of
				an appointed actuary regarding the adequacy of the reserves and related
				actuarial items based on an asset adequacy test in accordance with ARM
				6.6.6508 and with applicable
				Actuarial Standards of Practice.
(2) "Actuarial Standards Board" means the
				board established by the American Academy of Actuaries to develop and
				promulgate Actuarial Standards of Practice.
(3) "Annual statement" means that statement
				required by
				33-2-701 and
				33-7-118, MCA, of the insurance
				law to be filed by the company with the office of the commissioner
				annually.
(4) "Appointed actuary"
				means any individual who is appointed or retained in accordance with the
				requirements set forth in ARM
				6.6.6505(3) to
				provide the actuarial opinion and supporting memorandum as required by
				33-2-407(5) and
				(6), and
				33-7-118(2),
				MCA.
(5) "Asset adequacy analysis"
				means an analysis that meets the standards and other requirements referred to
				in ARM 6.6.6505(4).
(6) "Commissioner" means the insurance
				commissioner of this state.
(7)
				"Company" means a life insurance company, fraternal benefit society or
				reinsurer subject to the provisions of this rule.
(8) "Qualified actuary" means any individual
				who meets the requirements set forth in ARM
				6.6.6505(2).
AUTH:
					 33-1-313,
					 33-2-407, MCA
IMP:
					 33-2-407,
					 33-2-408,
					 33-2-409,
					 33-2-410,
					 33-2-411,
					 33-2-412,
					 33-2-413,
					 33-2-414,
					 33-2-415,
					 33-2-416,
					 33-2-417,
					 33-7-118,
					 33-7-411,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6505 - GENERAL REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) As to the
				submission of Statement of Actuarial Opinion, the following requirements apply:
(a) there is to be included on or attached to
				page one of the annual statement for each year beginning with the year in which
				this regulation becomes effective the statement of an appointed actuary,
				entitled "Statement of Actuarial Opinion," setting forth an opinion relating to
				reserves and related actuarial items held in support of policies and contracts,
				in accordance with ARM
				6.6.6508; and
(b) upon written request by the company, the
				commissioner may grant an extension of the date for submission of the statement
				of actuarial opinion.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6506 - REQUIRED OPINIONS (REPEALED)

Current through Register Vol. 13, July 5, 2024
33-2-521, MCA; IMP,
					 33-2-521 through
					 33-2-537,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6507 - STATEMENT OF ACTUARIAL OPINION NOT INCLUDING AN ASSET ADEQUACY ANALYSIS (REPEALED)

Current through Register Vol. 13, July 5, 2024
33-2-521, MCA; IMP,
					 33-2-521 through
					 33-2-537,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6508 - STATEMENT OF ACTUARIAL OPINION BASED ON AN ASSET ADEQUACY ANALYSIS

Current through Register Vol. 13, July 5, 2024
(1) The statement of actuarial opinion
				submitted in accordance with this rule shall consist of:
(a) a paragraph identifying the appointed
				actuary and his or her qualifications (see (2)(a));
(b) a scope paragraph identifying the
				subjects on which an opinion is to be expressed and describing the scope of the
				appointed actuary's work, including a tabulation delineating the reserves and
				related actuarial items which have been analyzed for asset adequacy and the
				method of analysis, (see (2)(b)) and identifying the reserves and related
				actuarial items covered by the opinion which have not been so
				analyzed;
(c) a reliance paragraph
				describing those areas, if any, where the appointed actuary has deferred to
				other experts in developing data, procedures or assumptions, (e.g., anticipated
				cash flows from currently owned assets, including variation in cash flows
				according to economic scenarios (see (2)(c)), supported by a statement of each
				such expert in the form prescribed by (5); and
(d) an opinion paragraph expressing the
				appointed actuary's opinion with respect to the adequacy of the supporting
				assets to mature the liabilities (see (2)(f)).
(e) one or more additional paragraphs will be
				needed in individual company cases as follows:
(i) if the appointed actuary considers it
				necessary to state a qualification of his or her opinion;
(ii) if the appointed actuary must disclose
				an inconsistency in the method of analysis or basis of asset allocation used at
				the prior opinion date with that used for this opinion;
(iii) if the appointed actuary must disclose
				whether additional reserves as of the prior opinion date are released as of
				this opinion date, and the extent of the release; or
(iv) if the appointed actuary chooses to add
				a paragraph briefly describing the assumptions which form the basis for the
				actuarial opinion.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.65 - Actuarial Opinions › Rule 6.6.6510 - ADDITIONAL CONSIDERATIONS FOR ANALYSIS (REPEALED)

Current through Register Vol. 13, July 5, 2024
33-2-521, MCA; IMP,
					 33-2-521 through
					 33-2-537,
					 MCA;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.66 - Fidelity Bond › Rule 6.6.6601 - FIDELITY BOND

Current through Register Vol. 13, July 5, 2024
(1) The amount of
				fidelity bond coverage required by
				33-3-307, MCA, for officers of a
				domestic insurer must be calculated as follows:
(a) The sum of the calculations in (i) and
				(ii) equals the amount of the insurer's exposure index:
(i) 5% of the insurer's admitted assets, as
				reported in the insurer's most recent annual statement; plus
(ii) 10% of the insurer's gross income. Gross
				income equals the total of direct and assumed premiums written plus investment
				income collected, as reported in the insurer's most recent annual
				statement.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6701 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of ARM 6.6.6701 through
				6.6.6713
				is to provide:
(a) tables of select mortality
				factors and rules for their use;
(b) rules concerning a minimum standard for
				the valuation of plans with nonlevel premiums or benefits; and
(c) rules concerning a minimum standard for
				the valuation of plans with secondary guarantees.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6703 - applicability

Current through Register Vol. 13, July 5, 2024
(1) ARM
				6.6.6701,
				6.6.6703,
				6.6.6705,
				6.6.6707,
				6.6.6709,
				6.6.6711, and
				6.6.6713 shall apply to all life
				insurance policies, with or without nonforfeiture values, issued on or after
				January 1, 2000, subject to the following exceptions:
(a) these rules shall not apply to any
				individual life insurance policy issued on or after January 1, 2000, if the
				policy is issued in accordance with and as a result of the exercise of a
				reentry provision contained in the original life insurance policy of the same
				or greater face amount, issued before January 1, 2000, that guarantees the
				premium rates of the new policy. T hese rules also shall not apply to
				subsequent policies issued as a result of the exercise of such a provision, or
				a derivation of the provision, in the new policy.
(b) these rules shall not apply to any
				universal life policy that meets all the following requirements:
(i) secondary guarantee period, if any, is 5
				years or less;
(ii) specified
				premium for the secondary guarantee period is not less than the net level
				reserve premium for the secondary guarantee period based on the CSO valuation
				tables as defined in ARM
				6.6.6705(6) and
				the applicable valuation interest rate; and
(iii) the initial surrender charge is not
				less than 100% of the first year annualized specified premium for the secondary
				guarantee period.
(c)
				these rules shall not apply to any variable life insurance policy that provides
				for life insurance, the amount or duration of which varies according to the
				investment experience of any separate account or accounts.
(d) these rules shall not apply to any
				variable universal life insurance policy that provides for life insurance, the
				amount or duration of which varies according to the investment experience of
				any separate account or accounts.
(e) these rules shall not apply to a group
				life insurance certificate unless the certificate provides for a stated or
				implied schedule of maximum gross premiums required in order to continue
				coverage in force for a period in excess of one year.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6707 - GENERAL CALCULATION REQUIREMENTS FOR BASIC RESERVES AND PREMIUM DEFICIENCY RESERVES

Current through Register Vol. 13, July 5, 2024
(1) At the election
				of the insurer for any one or more specified plans of life insurance, the
				minimum mortality standard for basic reserves may be calculated using the 1980
				CSO valuation tables with select mortality factors (or any other valuation
				mortality table adopted by the NAIC after January 1, 2000, and promulgated by
				rule by the commissioner for this purpose). If select mortality factors are
				elected, they may be:
(a) the 10-year select
				mortality factors incorporated into the 1980 amendments to the NAIC Standard
				Valuation Law;
(b) the select
				mortality factors in ARM
				6.6.6713;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6709 - CALCULATION OF MINIMUM VALUATION STANDARD FOR POLICIES WITH GUARANTEED NONLEVEL GROSS PREMIUMS OR GUARANTEED NONLEVEL BENEFITS (OTHER THAN UNIVERSAL LIFE POLICIES)

Current through Register Vol. 13, July 5, 2024
(1) Basic reserves
				shall be calculated as the greater of the segmented reserves and the unitary
				reserves. Both the segmented reserves and the unitary reserves for any policy
				shall use the same valuation mortality table and selection factors. At the
				option of the insurer, in calculating segmented reserves and net premiums,
				either of the adjustments described in (1)(a) or (b) below may be made:
(a) treat the unitary reserve, if greater
				than 0, applicable at the end of each segment as a pure endowment and subtract
				the unitary reserve, if greater than 0, applicable at the beginning of each
				segment from the present value of guaranteed life insurance and endowment
				benefits for each segment; or
(b)
				treat the guaranteed cash surrender value, if greater than 0, applicable at the
				end of each segment as a pure endowment and subtract the guaranteed cash
				surrender value, if greater than 0, applicable at the beginning of each segment
				from the present value of guaranteed life insurance and endowment benefits for
				each segment.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6711 - CALCULATION OF MINIMUM VALUATION STANDARD FOR FLEXIBLE PREMIUM AND FIXED PREMIUM UNIVERSAL LIFE INSURANCE POLICIES THAT CONTAIN PROVISIONS RESULTING IN THE ABILITY OF A POLICYOWNER TO KEEP A POLICY

Current through Register Vol. 13, July 5, 2024
(1)
				Policies with a secondary guarantee include:
(a) a policy with a guarantee that the policy
				will remain in force at the original schedule of benefits, subject only to the
				payment of specified premiums;
(b)
				a policy in which the minimum premium at any duration is less than the
				corresponding 1-year valuation premium, calculated using the maximum valuation
				interest rate and the 1980 CSO valuation tables with or without 10-year select
				mortality factors; or
(c) a policy
				with any combination of (1)(a) and (b).
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6713 - SELECT MORTALITY FACTORS

Current through Register Vol. 13, July 5, 2024
(1) This rule
				contains tables of select mortality factors that are the bases to which the
				respective percentage of ARM
				6.6.6707(1)(b), (2)(b) and
				(2)(c) are applied.
(2) The six tables of select mortality
				factors contained herein include:
(a) male,
				aggregate;
(b) male,
				nonsmoker;
(c) male,
				smoker;
(d) female,
				aggregate;
(e) female, nonsmoker;
				and
(f) female, smoker.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6720 - PURPOSE AND INTENT

Current through Register Vol. 13, July 5, 2024
(1) The purpose and
				intent of ARM 6.6.6720 through 6.6.6727 is to establish uniform, national
				standards governing reserve financing arrangements pertaining to life insurance
				policies containing guaranteed nonlevel gross premiums, guaranteed nonlevel
				benefits and universal life insurance policies with secondary guarantees; and
				to ensure that, with respect to each such financing arrangement, funds
				consisting of primary security and other security, as defined in ARM 6.6.6723,
				are held by or on behalf of ceding insurers in the forms and amounts required
				herein.
(2) In general, reinsurance
				ceded for reserve financing purposes has one or more of the following
				characteristics:
(a) some or all of the assets
				used to secure the reinsurance treaty or to capitalize the reinsurer:
(i) are issued by the ceding insurer or its
				affiliates; or
(ii) are not
				unconditionally available to satisfy the general account obligations of the
				ceding insurer; or
(iii) create a
				reimbursement, indemnification, or other similar obligation on the part of the
				ceding insurer or any of its affiliates (other than a payment obligation under
				a derivative contract acquired in the normal course and used to support and
				hedge liabilities pertaining to the actual risks in the policies ceded pursuant
				to the reinsurance treaty).
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6721 - APPLICABILITY

Current through Register Vol. 13, July 5, 2024
(1) ARM 6.6.6720 through 6.6.6727pertain to
				all covered policies, in force as of and after September 1, 2022.
(2) ARM 6.6.6720 through 6.6.6727 shall apply
				to reinsurance treaties that cede liabilities pertaining to covered policies,
				as that term is defined in ARM 6.6.6723, issued by any life insurance company
				domiciled in this state. ARM 6.6.6720 through 6.6.6727 and ARM Title 6,
				chapter, 6, subchapter 38 shall apply to such reinsurance treaties, provided
				that in the event of a direct conflict between ARM 6.6.6720 through 6.6.6727
				and ARM Title 6, chapter, 6, subchapter 38, ARM 6.6.6720 through 6.6.6727 shall
				apply, but only to the extent of the conflict.
AUTH:
					 33-1-313,
					 33-2-1517,
					 MCA; IMP:
					 33-2-1216,
					 33-2-1217,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6722 - EXEMPTIONS

Current through Register Vol. 13, July 5, 2024
(1) ARM 6.6.6720 through 6.6.6727 do not
				apply to the situations described below:
(a)
				reinsurance of:
(i) Policies that satisfy the
				criteria for exemption set forth in ARM
				6.6.6709(5)
				and (6) and (11) through (13) or ARM
				6.6.6709(14),
				and which are issued before the later of:
(A)
				September 1, 2022; and
(B) The date
				on which the ceding insurer begins to apply the provisions of VM-20 to
				establish the ceded policies' statutory reserves, but in no event later than
				January 1, 2020;
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6723 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
For purposes of ARM 6.6.6720 through 6.6.6727:
(1) "Actuarial method" means the methodology
				used to determine the required level of primary security, as described in ARM
				6.6.6725.
(2) "Covered policies"
				means, subject to the exemptions described in ARM 6.6.6722, those policies,
				other than grandfathered policies, of the following types:
(a) Life insurance policies with guaranteed
				nonlevel gross premiums and/or guaranteed nonlevel benefits, except for
				flexible premium universal life insurance policies; or,
(b) Flexible premium universal life insurance
				policies with provisions resulting in the ability of a policyholder to keep a
				policy in force over a secondary guarantee period.
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6726 - PROHIBITION AGAINST AVOIDANCE

Current through Register Vol. 13, July 5, 2024
(1) No insurer
				that has covered policies as to which ARM 6.6.6720 through 6.6.6727 apply (as
				set forth in ARM 6.6.6721) shall take any action or series of actions, or enter
				into any transaction or arrangement or series of transactions or arrangements
				if the purpose of such action, transaction, or arrangement or series thereof is
				to avoid the requirements of ARM 6.6.6720 through 6.6.6727, or to circumvent
				their purpose and intent, as set forth in ARM 6.6.6720.
AUTH:
					 33-1-313,
					 33-2-1517,
					 MCA; IMP:
					 33-2-1216,
					 33-2-1217,
					 MCA
Administrative Rules of Montana › Department 6 - STATE AUDITOR › Chapter 6.6 - INSURANCE DEPARTMENT › Subchapter 6.6.67 - Valuation of Life Insurance Policies › Rule 6.6.6727 - SEVERABILITY

Current through Register Vol. 13, July 5, 2024
(1) If any provision of ARM 6.6.6720 through
				6.6.6727 is held invalid, the remainder shall not be affected.
AUTH:
					 33-1-313,
					 33-2-1517,
					 MCA; IMP:
					 33-2-1216,
					 33-2-1217,
					 MCA