reglab/statecodes huggingface dataset:
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 32 - RULES OF PRACTICE AND PROCEDURE FOR CONTESTED CASES › Section 32-28 - Final Decision

Current through July 13, 2024
(a) A final decision entered by a hearing
				officer shall be in writing, filed with the agency, and served upon all parties
				to the contested case. A final decision entered by the agency shall be served
				upon all parties and the hearing officer.
(b) A final decision shall include findings
				of fact and conclusions of law, separately stated. When the hearing officer
				allows the parties to submit a proposed final order, the parties shall forward
				the original to the agency and serve copies of the proposed order on all other
				parties and the hearing officer.
(c) A hearing officer or agency may at any
				time prior to judicial review, correct clerical errors in final decisions or
				other parts of the record. A party may move that clerical errors or other parts
				of the record be corrected. During the pendency of judicial review, such errors
				may be corrected only with leave of the court having jurisdiction.
(d) If the Hearing Officer is not the
				commissioner, the Hearing Officer shall, immediately following the full and
				complete hearing, prepare and forward to the commissioner recommended findings
				of fact and conclusions of law.
(i) If upon
				reviewing the recommended findings of fact and conclusions of law the
				commissioner finds them to be sufficient to meet the requirements of the law,
				the commissioner shall enter a decision and order adopting the same which shall
				then be distributed in accordance with this Section.
(ii) If upon reviewing the recommended
				findings of fact and conclusions of law the commissioner determines they are
				not sufficient to meet the requirements of the law, he may remand the matter
				for additional or more complete findings of fact and conclusions of
				law.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 32 - RULES OF PRACTICE AND PROCEDURE FOR CONTESTED CASES › Section 32-29 - Record of Proceeding

Current through July 13, 2024
(a) Hearings in all contested cases or as
				otherwise required by law, including all testimony, shall be reported or
				preserved, verbatim by any appropriate means determined by the Hearing Officer.
				The compensation of a reporter shall be paid by the party or parties requesting
				such reporter. If a transcript of testimony is required by the Hearing Officer,
				the cost thereof shall be paid by the Department, or as otherwise provided by
				law. The Hearing Officer may direct any party or parties to assume the cost of
				the transcript if transcribed at his or their request. This rule shall not be
				construed to prohibit any party in any public hearing from providing for a
				reporting or preservation of the proceedings thereof, provided the same is
				produced at his expense.
(b)
				Compensation of Reporter.
(i) The reporter
				shall be paid by the party or parties requesting such reporter.
(A) If a transcript of testimony is required
				by the Hearing Officer, the cost thereof shall be paid by the Department, or as
				otherwise provided by law.
(B) The
				Hearing Officer may direct any party or parties to assume the cost of the
				transcript if transcribed at his or their
				request.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 33 - UNFAIR TRADE PRACTICES REGULATION › Section 33-1 - Authority

Current through July 13, 2024
This regulation is promulgated pursuant to W.S. §§
									
										16-3-101 through
				  16-3-115,
				  26-2-110,
				  26-9-217, and
				  26-13-101
et
				  seq
.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 33 - UNFAIR TRADE PRACTICES REGULATION › Section 33-2 - Unfair Discrimination

Current through July 13, 2024
The following are acts or practices which constitute unfair
				  discrimination between individuals or risks of the same class and essentially
				  the same hazard. This regulation is not exclusive and other acts not herein
				  specified may also be deemed to be violations:
(a) Refusing to issue, refusing to renew,
				cancelling, mandating increased deductibles or limiting the amount of insurance
				coverage on a property or casualty risk, by whatever means direct or indirect,
				because of the geographic location of the risk, unless it is:
(i) For a business purpose which is not a
				mere pretext for unfair discrimination, or
(ii) Required by law or regulatory
				mandate.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 33 - UNFAIR TRADE PRACTICES REGULATION › Section 33-3 - Prohibited Uses of Senior-Specific Certifications and Professional Designations

Current through July 13, 2024
(a) An insurance producer or consultant may
				not use a senior-specific certification or professional designation that
				indicates or implies in such a way as to mislead a purchaser or prospective
				purchaser that the insurance producer or consultant has special certification
				or training in advising or servicing seniors in connection with the
				solicitation, sale or purchase of an annuity, accident and health, or life
				insurance product, or in the provision of advice as to the value of or the
				advisability of purchasing or selling an annuity, accident and health, or life
				insurance product, either directly or indirectly through publications or
				writings, or by issuing or promulgating analyses or reports related to an
				annuity, accident and health, or life insurance product.
(b) The prohibited use of senior-specific
				certifications or professional designations is an untrue, deceptive,
				misleading, dishonest, or untrustworthy act or practice and includes, but is
				not limited to, the following:
(i) Use of a
				certification or professional designation by an insurance producer who has not
				actually earned or is otherwise ineligible to use the certification or
				designation;
(ii) Use of a
				nonexistent or self-conferred certification or professional
				designation;
(iii) Use of a
				certification or professional designation that indicates or implies a level of
				occupational qualifications obtained through education, training or experience
				that the insurance producer using the certification or designation does not
				have; and
(iv) Use of a
				certification or professional designation obtained from a certifying or
				designating organization that:
(A) Is
				primarily engaged in the business of instruction in sales or
				marketing;
(B) Does not have
				reasonable standards or procedures for assuring the competency of its
				certificants or designees;
(C) Does
				not have reasonable standards or procedures for monitoring and disciplining its
				certificants or designees for improper or unethical conduct; or
(D) Does not have reasonable continuing
				education requirements for its certificants or designees in order to maintain
				the certificate or designation.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 33 - UNFAIR TRADE PRACTICES REGULATION › Section 33-4 - Adjustment of Physical Damage Claims

Current through July 13, 2024
(a) This section applies to the adjustment of
				physical damage claims under all motor vehicle policies issued in the State of
				Wyoming including, but not limited to, private passenger automobiles,
				recreational vehicles, commercial vehicles, motorcycles, or any other risk
				insured as a motor vehicle or trailer.
(b) Insurers shall adjust personal property
				losses, be it first or third party claims, by utilizing one of the following
				options:
(i) Pay for the loss in its entirety
				in money based on an appraisal of the damage sustained by insured's
				vehicle;
(ii) Repair the damaged
				property; or
(iii) Replace the
				damaged property.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 33 - UNFAIR TRADE PRACTICES REGULATION › Section 33-5 - Department Inquiries

Current through July 13, 2024
(a) All persons shall respond to Department
				inquiries, including, but not limited to, document and information requests
				during market conduct and financial examinations, investigations of complaints,
				and any other formal or informal investigation or examination conducted for the
				purpose of determining compliance with Wyoming law shall be as follows:
(i) Unless another time period is specified
				by statute, regulation or by the Department either electronically or in another
				written form, a complete and accurate response to any inquiry from the Division
				shall be provided within twenty (20) calendar days from the date of the
				inquiry.
(ii) "Complete and
				accurate response" means a written response that includes all of the
				information, documents and explanation requested in the Department's inquiry.
				If the requested information is not available the response shall include a
				detailed explanation of why it cannot be provided.
(iii) If additional time is required to
				respond to any Department inquiry, the person shall submit a written request
				for an extension of time to the commissioner. The request for an extension of
				time shall:
(A) Be made no later than 5:00 PM
				Mountain Time on the business day prior to the response due date;
(B) Include a specific period of time for the
				extension; and
(C) State in detail
				the reasons necessitating the extension.
(iv) An extension may be granted, at the
				discretion of the commissioner, for good cause shown. When a request for an
				extension is granted, the person shall provide a complete and accurate response
				within the new time period granted. If an extension is not granted, or the
				person requesting the extension does not receive written confirmation from the
				commissioner that the extension is granted, the original response due date
				applies.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Section 34-1 - Authority

Current through July 13, 2024
These regulations governing the advertisement and sale of
				  cancer insurance in the State of Wyoming supplement the provisions of
				  W.S.
				  26-13-101 et seq., W.S. W.S.
				  W.S.
				  26-15-101 et seq., and W.S. W.S.
				  W.S.
				  26-18-101 et seq. They are promulgated by
				  authority of and pursuant to the Wyoming Administrative Procedure Act (W.S.
				  W.S. W.S.
				  16-3-101 et seq.) and the Wyoming Insurance
				  Code (W.S. W.S.
				  W.S.
				  26-2-110 ).
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Section 34-2 - Purpose

Current through July 13, 2024
The purpose of these rules is to provide for the approval of
				  all advertising materials used in the sale and marketing of cancer insurance in
				  the State of Wyoming, to prohibit certain illegal and unethical practices in
				  the advertising of cancer insurance, to assure truthful and adequate disclosure
				  of all material and relevant information in the sale and advertising of cancer
				  insurance, to provide for certain minimum benefits to ensure that the benefits
				  provided in the policy are reasonably related to the premium charged for the
				  coverage, to prohibit certain limitations, restrictions, and reductions used in
				  the policy forms to ensure that cancer policies do not contain any exceptions
				  and conditions which deceptively affect the risk purported to be assumed in the
				  general coverage of the contract, and to prohibit certain policy provisions
				  which tend to mislead, deceive and injure the insuring
				  public.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Section 34-3 - Applicability

Current through July 13, 2024
These rules shall apply to any advertisement for cancer
				  insurance and to any cancer policy, as those terms are hereinafter defined,
				  which any insurer intends to distribute, disseminate, issue, circulate or
				  deliver in the State of Wyoming.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Section 34-4 - Definitions

Current through July 13, 2024
(a) For the purposes of these rules an
				"advertisement'' shall include (1) printed and published material, audio-visual
				material and descriptive literature of an insurer used in direct mail,
				newspapers, magazines, radio scripts, television scripts, billboards and
				similar displays; (2) descriptive literature and sales aids of all kinds issued
				by an insurer, agent or broker for presentation to members of the insurance
				buying public, including but not limited to circulars, leaflets, booklets,
				depictions, illustrations, and form letters; and (3) prepared sales talks,
				presentations and material for use by agents, brokers and solicitors.
(b) "Cancer policy" for the purposes of these
				rules shall include any policy or contract of disability insurance (as defined
				by W.S.
				26-5-103 ) which provides benefits for loss
				caused by the disease of cancer only.
(c) "Stated benefit'' cancer policy for the
				purposes of these rules shall mean a policy which pays a stated benefit amount
				to the insured without regard to the actual amount of loss or expenses incurred
				by the insured, such amount being determined in accordance with the coverages
				afforded in the policy and by reference to periodic benefit tables contained
				therein.
(d) "Expense
				reimbursement'' cancer policy for the purposes of these rules shall mean a
				policy which wholly or partially reimburses the insured for specified costs
				associated with the diagnosis and treatment of cancer and the medical care of
				cancer patients in accordance with the policy provisions.
(e) "Department of Insurance" for the
				purposes of these rules shall mean the Wyoming Insurance Department.
(f) "Insurer" for the purpose of these rules
				shall include an individual, corporation, association, partnership, reciprocal
				exchange, interinsurer, Lloyds, fraternal benefit society, health maintenance
				organization, and any other legal entity which is defined as an insurer in the
				Wyoming Insurance Code and is engaged in the advertisement and marketing of a
				cancer policy as hereinabove defined.
(g) "Exception" for the purpose of these
				rules shall mean any provision in a policy whereby coverage for a specified
				hazard is entirely eliminated; it is a statement of a risk not assumed under
				the policy.
(h) "Reduction" for the
				purpose of these rules shall mean any provision which reduces the amount of the
				benefit; a risk of loss is assumed but payment upon the occurrence of such loss
				is limited to some amount or period less than would be otherwise payable had
				such reduction not been used.
(i)
				"Limitation" for the purpose of these rules shall mean any provision which
				restricts coverage under the policy other than an exception or a
				reduction.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 1 - Advertising › Section 1 - Approval of Advertising

Current through July 13, 2024
(a) All
				  advertisements for previously approved cancer policies shall be filed with the
				  Department of Insurance prior to being utilized for the purpose of solicitation
				  within the State of Wyoming and on or before the effective date of these
				  rules.
(b) No cancer policies shall
				  henceforth be submitted for approval to the Department of Insurance unless all
				  advertisements, as defined in these rules, which the insurer intends to use to
				  facilitate the marketing, solicitation or sale of such policies in the State of
				  Wyoming are also filed.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 1 - Advertising › Section 2 - Prohibited Practices

Current through July 13, 2024
(a) No
				  advertisement, as defined in these rules, shall be used to facilitate the
				  marketing, solicitation and sale of cancer policies in the State of Wyoming if
				  the purpose of the advertisement, when read in its entire context, is to induce
				  or create fear in prospective policyholders.
(b) No advertisement, as defined in these
				  rules, shall contain any statistics which purport to represent or show:
(i) the frequency with which cancer will
				  strike certain areas of the body or certain organs of the body;
(ii) that cancer insurance is a "bargain" or
				  words of similar import that detract from the limited nature of cancer
				  coverage;
(iii) the frequency with
				  which cancer will strike an average family or the average individual including,
				  but not limited to, such statements that "cancer will strike one out of every
				  four living Americans" or "cancer will strike two of every three families over
				  the years";
(iv) a comparison of
				  the death rate of cancer with that of any other cause of death, including
				  automobile accidents or war;
(v) an
				  estimation of the number of deaths which will result from cancer during any
				  particular time period, the number of people who will be hospitalized for any
				  particular period of time, or the number of people who will discover they have
				  cancer in a particular time period;
(vi) the cost of cancer, including the
				  overall expense of cancer treatment, the average cost per victim, the average
				  cost per day or the rate at which such costs are increasing;
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 1 - Advertising › Section 3 - Outline of Coverage

Current through July 13, 2024
All materials advertising cancer insurance within the State
					 of Wyoming shall contain an outline of benefits, exclusions, and conditions of
					 coverage. Such outline must specify:
(a) any applicable waiting period;
(b) the period of time within which the
				  policy can be returned for a full refund;
(c) all exceptions, limitations, reductions
				  and conditions of coverage; and
(d)
				  a summarization of all benefits provided by the policy.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 1 - Advertising › Section 4 - Maximum or Lifetime Benefits

Current through July 13, 2024
(a) No insurer
				  shall advertise a maximum lifetime liability per person or a maximum lifetime
				  liability for any expense reimbursement or stated policy benefit if the policy
				  in question establishes a maximum benefit on a "per day," "per visit," "per
				  confinement," "per trip," "per month," "per operation," or "per loss" basis for
				  any benefit under the policy including, but not limited to, coverage for costs
				  and expenses associated with hospital confinement, drugs and medicine,
				  convalescence, surgery, attending physicians, radiation and chemotherapy,
				  anesthesia, blood and plasma, ambulance services, or transportation
				  expenses.
(b) No insurer shall
				  advertise a maximum lifetime liability per person or a maximum lifetime
				  liability for any policy benefit which is unreasonably related to the lifetime
				  benefits otherwise obtainable.
(c)
				  No insurer shall advertise a maximum monthly indemnity benefit without also
				  advertising the daily pro-rated indemnity benefit.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 1 - Insured to Have Thirty Days in Which to Return Policy

Current through July 13, 2024
No cancer policy shall contain any provision which
					 restricts the right of the insured to return his policy for full premium refund
					 to less than thirty days.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 2 - Policy Not to Be Canceled by Class

Current through July 13, 2024
No cancer policy shall contain any provision by which the
					 insurer reserves the right to cancel all like policies of a class or form
					 number.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 3 - Waiting Period Not to Exceed Thirty Days

Current through July 13, 2024
No cancer policy shall contain any provision which
					 establishes a waiting period in excess of thirty days from the effective date
					 of the policy or thirty days from the insurer's receipt of premium, whichever
					 shall first occur.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 4 - Certification Not Required

Current through July 13, 2024
No cancer policy shall contain a provision which requires,
					 as a prerequisite to an insurer's liability under such policy, any board
					 certification of any pathologist, radiologist, chemotherapist, or any physician
					 involved in the diagnosis, treatment or care of the insured, as long as the
					 pathologist, radiologist, chemotherapist, or physician has otherwise been duly
					 licensed as a doctor of medicine and is in good standing in the medical
					 community.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 5 - Coverage Not to Depend on Diagnosis Being Made in Hospital

Current through July 13, 2024
No cancer policy shall contain any provision under which
					 the coverage is made to depend upon the diagnosis of cancer being made while
					 the insured is confined in a hospital.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 6 - Insurer Liable for Losses Incurred Prior to Diagnosis of Cancer

Current through July 13, 2024
Provided that the positive diagnosis of cancer has not been
					 made before thirty days of the effective date of the policy and provided
					 further that the policy claimant can substantiate by the weight of the evidence
					 that all costs and expenses for which claim is made were proximately caused by
					 the disease of cancer, no cancer policy shall contain any provision which
					 eliminates, reduces, restricts or otherwise limits the insurer's liability for
					 (i) any loss incurred prior to the date the positive diagnosis of cancer was
					 made; or (ii) any loss incurred after the policy was issued but prior to the
					 elapse of thirty days thereof
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 7 - Coverage Not to Be Cut off Subsequent to Expiration of Waiting Period

Current through July 13, 2024
No policy of cancer insurance shall contain any provision
					 which establishes a "cut-off period or otherwise reduces, restricts, limits or
					 eliminates the insurer's liability for losses proximately caused by the disease
					 of cancer anytime subsequent to thirty days after the effective date of the
					 policy.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 8 - Benefits Not to Be Reduced on Account of Age

Current through July 13, 2024
No cancer policy shall reduce, restrict, limit or eliminate
					 the benefits offered by the policy on account of the insured's age. The risk of
					 cancer, to the extent it can be associated with the age of the insured, shall
					 be recognized, if at all, by an increase or decrease of benefits otherwise
					 available under the policy.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 9 - Benefits Not to Be Denied Because Loss Was Incurred Outside of U.S

Current through July 13, 2024
No cancer policy shall contain any provision which
					 restricts the insurer's liability to losses incurred within the United States
					 or within the United States and Canada.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 10 - Benefits Not to Be Denied Because Loss Was Not Incurred in Hospital

Current through July 13, 2024
No cancer policy shall contain any provision which reduces,
					 restricts, limits or eliminates any policy benefits solely because the costs or
					 expenses for which claim is submitted were not incurred while the insured was
					 confined in a hospital.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 2 - Limitations and Restrictions on Coverage › Section 11 - Maximum or Lifetime Benefits

Current through July 13, 2024
(a) If any expense
				  reimbursement or stated benefit cancer policy sets, prescribes or establishes a
				  maximum lifetime liability per person for all benefits or a maximum lifetime
				  liability for any individual benefit or benefits, the insurer shall not
				  establish a maximum payment or indemnity for any benefit on a "per day," "per
				  visit," "per confinement," "per trip," "per month," or "per loss" basis.
				  Subject only to such maximum lifetime liability per person or the maximum
				  lifetime liability for any individual benefit, the insurer's liability for any
				  benefit under the policy shall then be limited only by the reasonable and
				  customary charges of the area or community where covered services are
				  provided.
(b) No such expense
				  reimbursement cancer policy or stated benefit policy shall contain a maximum
				  lifetime liability per person or a maximum lifetime liability for any policy
				  benefit which is unreasonably related to the lifetime benefits otherwise
				  obtainable.
(c) No stated benefit
				  cancer policy shall provide for a monthly indemnity benefit without also
				  conspicuously stating the daily indemnity benefit.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 1 - Cancer Defined

Current through July 13, 2024
No policy of cancer insurance issued in the State of
					 Wyoming shall define cancer in such a manner as to exclude leukemia or
					 Hodgkin's disease.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 2 - Policy Must Designate Limited Coverage

Current through July 13, 2024
No policy of cancer insurance shall be offered in the State
					 of Wyoming unless it states prominently and conspicuously that such policy is a
					 limited policy and is not designed to pay for all medical costs associated with
					 the disease of cancer.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 3 - Policy to Cover All Losses Caused by Cancer

Current through July 13, 2024
No expense reimbursement policy of cancer insurance shall
					 exclude from coverage any prescribed or necessary medical costs or expenses
					 proximately caused by the disease of cancer or its diagnosis and treatment, nor
					 shall any insurer attempt to circumvent this section by providing that the
					 insurer's liability under the policy only extends to losses resulting from
					 "definitive cancer treatment'' or "direct extension, metastatic spread or
					 recurrence" or words of similar import.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 4 - Radiation and Chemotherapy Benefits

Current through July 13, 2024
No expense reimbursement cancer policy shall provide
					 benefits for any type of radiation therapy without also providing the same
					 benefits for chemotherapy or any other therapy prescribed by a doctor of
					 medicine and designed to destroy or to arrest the uncontrolled spread of cancer
					 cells, including the use of drugs to alter immunological responses or in the
					 case of leukemia, the use of marrow transplants.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 5 - Private Nursing Benefit

Current through July 13, 2024
If any expense reimbursement policy provides benefits for
					 nursing services, no such policy shall deny such coverage if such services have
					 been prescribed and are deemed medically necessary by a duly licensed doctor of
					 medicine.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 6 - Ambulance Benefits

Current through July 13, 2024
An insurer's liability for ambulance benefits under an
					 expense reimbursement policy of cancer insurance shall not be made to depend on
					 the duration of the insured's stay in a hospital, provided that hospital
					 confinement was intended when the ambulance services were
					 utilized.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 7 - Government Hospital Confinement Benefit

Current through July 13, 2024
(a) If any expense
				  reimbursement cancer policy issued in the State of Wyoming excludes from
				  coverage a hospital confinement benefit for a facility contracted for or
				  operated by the United States Government for the treatment of members or
				  veterans of the armed services, the application for such policy shall contain a
				  question asking whether the applicant is a member or ex-member of the armed
				  services and shall advise the applicant that coverage for benefits received
				  from a hospital contracted for or operated by the United States Government has
				  been excluded.
(b) If any expense
				  reimbursement cancer policy offers a Government Hospital Confinement benefit,
				  such benefits thereunder shall not be reduced for hospital confinement below
				  the benefits specified for non-governmental hospitals without a corresponding
				  reduction in premium.
(c) No
				  expense reimbursement cancer policy shall offer a Government Hospital
				  Confinement benefit to members or ex-members of the armed forces while
				  excluding any or all other benefits of the policy ordinarily available to
				  non-members of the armed services without a corresponding reduction in premium
				  rates. If the policy only provides a hospital confinement benefit for members
				  or ex-members of the armed forces, the policy shall prominently and
				  conspicuously so state.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 3 - Minimum Benefits-Extended Benefits › Section 8 - Extended Benefits

Current through July 13, 2024
No policy of cancer insurance shall contain any provision
					 for the payment of extended benefits when such benefits can only be obtained by
					 confinement in a hospital for a period in excess of twelve consecutive days,
					 nor shall any insurer provide for extended benefits which require confinement
					 in a hospital for any unreasonable length of time.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 4 - Minimum Loss Ratios › Section 1 - Previously Approved Policies

Current through July 13, 2024
The previous approval of any expense reimbursement or
					 stated benefit cancer policy shall not be continued past July 1, 1980, unless
					 on or prior thereto proper and adequate certification is submitted to the
					 Department of Insurance for each policy approved showing that the benefits in
					 relation to premium charged have or will produce a minimum sixty (60) percent
					 loss ratio over a five year period of time. Such certifications shall be
					 submitted annually thereafter. If the certification shows in any year for which
					 it has been filed that any previously approved cancer policy has produced or
					 will produce less than a sixty (60) percent loss ratio over a five year period
					 of time, such policy may be withdrawn from use and refilled within thirty days
					 from the time the certification was submitted to reflect necessary premium
					 adjustments or changes in policy benefits.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 4 - Minimum Loss Ratios › Section 2 - Subsequently Filed Policies

Current through July 13, 2024
No cancer policy filed with the Department of Insurance
					 subsequent to the effective date of these rules, be it an expense reimbursement
					 or stated benefit policy, shall be approved for use in the State of Wyoming
					 unless proper and adequate certification is submitted along with the policy
					 filed showing that benefits in relation to the premium charged are designed to
					 produce a minimum loss ratio of not less than sixty (60) percent over a given
					 year period of time. Such certifications shall be made annually thereafter in
					 accordance with the provisions of Section 1 of this Part. If subsequent to the
					 approval of a cancer policy, such certification shows in any year for which it
					 was filed that the policy has produced or will produce less than a sixty (60)
					 percent loss ratio over a five year period of time, it may be withdrawn and
					 refiled in accordance with the provisions of Section 1 of this
					 Part.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 4 - Minimum Loss Ratios › Section 3 - Policies May Be Otherwise Disapproved

Current through July 13, 2024
Nothing in these rules shall be construed to otherwise
					 prohibit the Department of Insurance from disapproving or withdrawing previous
					 approval of any expense reimbursement or stated benefit cancer policy form in
					 accordance with the provisions of
					 W.S.
					 26-15-111.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 34 - CANCER INSURANCE REGULATION › Part 5 - Miscellaneous › Section 1 - Severability

Current through July 13, 2024
If any section or portion of a section of these rules
					 (including Part I, Part II, and Part III), or the applicability thereof to any
					 person or circumstance is held invalid by a court of law, the remainder of the
					 rules, or the applicability of such provision to other persons or
					 circumstances, shall not be affected thereby.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-1 - Purpose

Current through July 13, 2024
The purpose of this regulation is to provide for the
				  reasonable standardization of coverage and simplification of terms and benefits
				  of Medicare supplement policies; to facilitate public understanding and
				  comparison of such policies; to eliminate provisions contained in such policies
				  which may be misleading or confusing in connection with the purchase of such
				  policies or with the settlement of claims; and to provide for full disclosures
				  in the sale of accident and sickness insurance coverages to persons eligible
				  for Medicare.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-3 - Applicability and Scope

Current through July 13, 2024
(a) Except as otherwise specifically provided
				in Sections
				7,
				13,
				14,
				17 and
				22, this regulation shall apply to:
(i) All Medicare supplement policies
				delivered or issued for delivery in this state on or after the effective date
				of this regulation; and
(ii) All
				certificates issued under group Medicare supplement policies, which
				certificates have been delivered or issued for delivery in this
				state.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-4 - Definitions

Current through July 13, 2024
For purposes of this regulation:
(a) "Applicant" means:
(i) In the case of an individual Medicare
				supplement policy, the person who seeks to contract for insurance benefits,
				and
(ii) In the case of a group
				Medicare supplement policy, the proposed certificate holder.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-5 - Policy Definitions and Terms

Current through July 13, 2024
No policy or certificate may be advertised, solicited or
				  issued for delivery in this state as a Medicare supplement policy or
				  certificate unless the policy or certificate contains definitions or terms that
				  conform to the requirements of this section.
(a) "Accident," "accidental injury," or
				"accidental means" shall be defined to employ "result" language and shall not
				include words that establish an accidental means test or use words such as
				"external, violent, visible wounds" or similar words of description or
				characterization.
(i) The definition shall not
				be more restrictive than the following: "Injury or injuries for which benefits
				are provided means accidental bodily injury sustained by the insured person
				which is the direct result of an accident, independent of disease or bodily
				infirmity or any other cause, and occurs while insurance coverage is in
				force."
(ii) The definition may
				provide that injuries shall not include injuries for which benefits are
				provided or available under any workers' compensation, employer's liability or
				similar law, or motor vehicle no-fault plan, unless prohibited by
				law.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-6 - Policy Provisions

Current through July 13, 2024
(a) Except for permitted preexisting
				condition clauses as described in Section
				7(a)(i), Section
				8(a)(i), and Section
				8.1(a)(i) of this regulation, no policy or certificate may be advertised,
				solicited or issued for delivery in this state as a Medicare supplement policy
				if the policy or certificate contains limitations or exclusions on coverage
				that are more restrictive than those of Medicare.
(b) No Medicare supplement policy or
				certificate may use waivers to exclude, limit or reduce coverage or benefits
				for specifically named or described preexisting diseases or physical
				conditions.
(c) No Medicare
				supplement policy or certificate in force in the state shall contain benefits
				that duplicate benefits provided by Medicare.
(d) Outpatient Prescription Drug Policies.
(i) Subject to Sections
				7(a)(iv), (v) and (vii),
				and
				8(a)(iv) and (v) of this
				regulation, a Medicare supplement policy with benefits for outpatient
				prescription drugs in existence prior to January 1, 2006 shall be renewed for
				current policyholders who do not enroll in Part D at the option of the
				policyholder.
(ii) A Medicare
				supplement policy with benefits for outpatient prescription drugs shall not be
				issued after December 31, 2005.
(iii) After December 31, 2005, a Medicare
				supplement policy with benefits for outpatient prescription drugs may not be
				renewed after the policyholder enrolls in Medicare Part D unless:
(A) The policy is modified to eliminate
				outpatient prescription coverage for expenses of outpatient prescription drugs
				incurred after the effective date of the individual's coverage under a Part D
				plan and;
(B) Premiums are adjusted
				to reflect the elimination of outpatient prescription drug coverage at the time
				of Medicare Part D enrollment, accounting for any claims paid, if
				applicable.
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-9.1 - Standard Medicare Supplement Benefit Plans for 2010 Standardized Medicare Supplement Benefit Plan Policies or Certificates with an Effective Date for Coverage on or After June 1, 2010

Current through July 13, 2024
The following standards are applicable to all Medicare
				  supplement policies or certificates delivered or issued for delivery in this
				  state with an effective date for coverage on or after June 1, 2010. No policy
				  or certificate may be advertised, solicited, delivered or issued for delivery
				  in this state as a Medicare supplement policy or certificate unless it complies
				  with these benefit plan standards Benefit plan standards applicable to Medicare
				  supplement policies and certificates issued with an effective date for coverage
				  before June 1, 2010 remain subject to the requirements of Section
				  8.
(a) Policy or Certificate Form.
(i) An issuer shall make available to each
				prospective policyholder and certificate holder a policy form or certificate
				form containing only the basic (core) benefits, as defined in Section 8.1(b) of
				this regulation.
(ii) If an issuer
				makes available any of the additional benefits described in Section 8.1(c), or
				offers standardized benefit Plans K or L (as described in Sections 9.1(e)
				(viii) and (ix) of this regulation), then the issuer shall make available to
				each prospective policyholder and certificate holder, in addition to a policy
				form or certificate form with only the basic (core) benefits as described in
				subsection (a)(i) above, a policy form or certificate form containing either
				standardized benefit Plan C (as described in Section 9.1(e)(iii) of this
				regulation) or standardized benefit Plan F (as described in 9.1(e)(v) of this
				regulation).
Wyoming Administrative Code › Agency 044 - Insurance Dept › Sub-Agency 0002 - General Agency, Board or Commission Rules › Chapter 35 - MEDICARE SUPPLEMENT INSURANCE › Section 35-9.2 - Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare on or After January 1, 2020

Current through July 13, 2024
The Medicare Access and CHIP Reauthorization Act of 2015
				  (MACRA) requires the following standards are applicable to all Medicare
				  supplement policies or certificates delivered or issued for delivery in this
				  state to individuals newly eligible for Medicare on or after January 1, 2020.
				  No policy or certificate that provides coverage of the Medicare Part B
				  deductible may be advertised, solicited, delivered or issued for delivery in
				  this state as a Medicare supplement policy or certificate to individuals newly
				  eligible for Medicare on or after January 1, 2020All policies must comply with
				  the following benefit standards Benefit plan standards applicable to Medicare
				  supplement policies and certificates issued to individuals eligible for
				  Medicare before January 1, 2020, remain subject to the requirements of Section
				  8 of this regulation.
(a) Benefit Requirements. The standards and
				requirements of Section 9.1 shall apply to all Medicare supplement policies or
				certificates delivered or issued for delivery to individuals newly eligible for
				Medicare on or after January 1, 2020, with the following exceptions:
(i) Standardized Medicare supplement benefit
				Plan C is redesignated as Plan D and shall provide the benefits contained in
				Section 9.1(e)(iii) of this regulation but shall not provide coverage for one
				hundred percent (100%) or any portion of the Medicare Part B
				deductible.
(ii) Standardized
				Medicare supplement benefit Plan F is redesignated as Plan G and shall provide
				the benefits contained in Section 9.1(e)(v) of this regulation but shall not
				provide coverage for one hundred percent (100%) or any portion of the Medicare
				Part B deductible.
(iii)
				Standardized Medicare supplement benefit plans C, F, and F with High Deductible
				may not be offered to individuals newly eligible for Medicare on or after
				January 1, 2020.
(iv) Standardized
				Medicare supplement benefit Plan F With High Deductible is redesignated as Plan
				G With High Deductible and shall provide the benefits contained in Section
				9.1(e)(vi) of this regulation but shall not provide coverage for one hundred
				percent (100%) or any portion of the Medicare Part B deductible; provided
				further that, the Medicare Part B deductible paid by the beneficiary shall be
				considered an out-of-pocket expense in meeting the annual high
				deductible.
(v) The reference to
				Plans C or F contained in Section 9.1(a)(ii) is deemed a reference to Plans D
				or G for purposes of this section.