(a)(1) (A) (i) No basic insurance policy, or annuity contract form, or application form when written application is required and is to be made a part of the policy or contract, or printed rider or endorsement form or form of renewal certificate, shall be issued, delivered, or used as to a subject of insurance resident, located, or to be performed in this state unless the form has been filed with and approved by the Insurance Commissioner and, in the case of individual accident and health contracts, the rates have been filed with and approved by the commissioner.
(ii)(a) The commissioner may consider a nonprofit insurer's surplus levels in determining whether a proposed rate is excessive.
(b)Subdivision (a)(1)(A)(ii) (a) of this section does not apply to a nonprofit insurer that offers o
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(a) (1) (A) (i) No basic insurance policy, or annuity contract form, or application form when written application is required and is to be made a part of the policy or contract, or printed rider or endorsement form or form of renewal certificate, shall be issued, delivered, or used as to a subject of insurance resident, located, or to be performed in this state unless the form has been filed with and approved by the Insurance Commissioner and, in the case of individual accident and health contracts, the rates have been filed with and approved by the commissioner. (ii) (a) The commissioner may consider a nonprofit insurer's surplus levels in determining whether a proposed rate is excessive. (b) Subdivision (a)(1)(A)(ii) (a) of this section does not apply to a nonprofit insurer that offers only limited scope dental benefits. (B) This subsection shall not apply to: (i) Policy or coverage forms for large commercial risks, as defined in subsection (g) of this section; (ii) Commercial umbrella policy or coverage forms; (iii) Excess umbrella policy or coverage forms; (iv) Excess of loss policy or coverage forms; (v) Public officials' liability policy or coverage forms; (vi) Fiduciary liability policy or coverage forms; (vii) Directors' and officers' liability policy or coverage forms; (viii) Kidnap and ransom policy or coverage forms; (ix) Political risk policy or coverage forms; (x) Expropriation coverage policy or coverage forms; (xi) Mortgage pool insurance policy or coverage forms; (xii) Railroad protective liability policy or coverage forms; (xiii) Equity loan programs, second mortgage coverage, policy or coverage forms; (xiv) Highly protected risk forms; (xv) Surety bonds; (xvi) Policies, orders, endorsements, or forms of unique character designed for, and used with relation to, insurance upon a particular subject, or that relate to the manner of distribution of benefits or to the reservation of rights and benefits under life and accident and health insurance policies and are used at the request of the individual policyholder, contract holder, or certificate holder; or (xvii) Policies, contracts, riders, endorsements, and certificates issued by surplus lines insurers. (C) The exemption of a particular type of insurance policy form from the requirement that it be filed with the commissioner and expressly approved thereby is not to be taken by an insurer as meaning that any insurance effected by the use of such a form may in any fashion be inconsistent with the statutory and common law of this state that is properly applicable thereto. (2) As to group insurance policies effectuated and delivered outside this state but covering persons resident in this state, the group certificates to be delivered or issued for delivery in this state shall be filed with and approved by the commissioner. (3) No group accident and health certificate of insurance may be extended to residents of this state under a group accident and health policy issued outside this state that does not include the provisions required for group policies issued in this state unless the commissioner determines that the provisions are not appropriate for the coverage provided. Upon request of the commissioner, copies of the group accident and health policies issued outside this state shall be made available on an informational basis. (4) On and after January 1, 1990, all Medicare supplement rates shall be based on a composite age basis only and shall not be based on any age banding or other groupings. (5) Nothing in this subsection shall prohibit an insurer or hospital and medical service corporation issuing Medicare supplement insurance policies from using its usual and customary underwriting procedures or excluding preexisting health conditions. However, no insurer shall refuse to issue a Medicare supplement policy based solely on the age of the applicant. (b) (1) Every filing shall be made not less than thirty (30) days in advance of any delivery. At the expiration of the thirty (30) days, the form or rate so filed shall be deemed approved unless prior thereto it has been affirmatively approved or disapproved by the commissioner. (2) Approval of the form or rate by the commissioner shall constitute a waiver of any unexpired portion of the waiting period. (3) The commissioner may extend by not more than an additional thirty (30) days the period within which he or she may so affirmatively approve or disapprove the form or rate by giving notice of the extension before expiration of the initial thirty-day period. (4) At the expiration of the period as so extended, and in the absence of prior affirmative approval or disapproval, the form or rate shall be deemed approved. (5) The commissioner may at any time, after notice and for cause shown, withdraw approval. (c) Notification disapproving the form or withdrawing a previous approval shall state the grounds therefor. (d) By order, the commissioner may exempt from the requirements of this section, for so long as he or she deems proper, any insurance document or form or type thereof as specified in the order to which, in his or her opinion, this section may not practically be applied or the filing and approval of which are, in his or her opinion, not desirable or necessary for the protection of the public. (e) This section shall apply also to any form used by domestic insurers for delivery in a jurisdiction outside this state, if the insurance supervisory official of the jurisdiction informs the commissioner that the form is not subject to approval or disapproval by that official, and upon the commissioner's written notice requiring the form to be submitted to him or her for the purpose. The same standards that are applicable to forms for domestic use shall apply to such forms. (f) No policy or contract form providing coverage for personal automobile liability that provides for a policy term of less than six (6) months shall be approved by the commissioner or issued for delivery in this state and used by insurers on and after January 1, 1992. However, the provisions of this subsection shall not restrict premium payment options offered by insurers. (g) (1) For purposes of this section, "large commercial risk" means an insured that has: (A) A total premium of two hundred fifty thousand dollars ($250,000) or more for property and casualty insurance; (B) At least twenty-five (25) full-time employees; and (C) A full-time certified risk manager to procure property and casualty insurance. For purposes of this subsection, "certified risk manager" means a risk manager with one (1) or more of the following credentials: (i) Associate in risk management; (ii) Chartered property casualty underwriter; or (iii) Certified risk manager. (2) The exemption for large commercial risk policy or coverage forms set forth in subdivision (a)(1) of this section shall not apply to workers' compensation, or employers' liability or professional liability insurance, including, but not limited to, medical malpractice insurance. (3) (A) In procuring coverage, a large commercial risk shall certify that it: (i) Meets the eligible criteria for an exempt commercial policyholder set out in this subsection; (ii) Is aware that the policy is unregulated for rates and forms; and (iii) Has the necessary expertise to negotiate its own policy language. (B) This certification shall be completed annually and remain on file with the producing agent or broker. (h) If the commissioner deems that the review as to either rates or forms, or both, required by this section as to any particular line or lines of insurance, can be performed in some other manner that provides sufficient protection to the consumers of this state and results in greater efficiency in bringing new or modified products within the line to market, the approval required by this section may be waived for such period as is deemed appropriate, or until revoked. (i) (1) If the commissioner disapproves a rate, the insurer may request that the commissioner provide the insurer with an actuarial analysis, interpretation of statistical data, and other methodology that was reviewed by the commissioner or his or her staff. (2) The information required under subdivision (i)(1) of this section shall be provided within five (5) working days after the receipt of the request.
Amended by Act 2015, No. 1164,§ 4, eff. 7/22/2015. Amended by Act 2013, No. 1339,§ 1, eff. 8/16/2013. Amended by Act 2013, No. 1187,§ 1, eff. 8/16/2013. Acts 1959, No. 148, § 276; 1975, No. 841, § 1; 1979, No. 691, § 2; 1981, No. 809, § 13; 1985, No. 804, § 1; A.S.A. 1947, § 66-3209; Acts 1987, No. 268, § 1; 1989, No. 710, § 2; 1989, No. 815, § 1; 1991, No. 1123, § 11; 1992 (1st Ex. Sess.), No. 72, § 1; 1993, No. 901, § 39; 1999, No. 458, §§ 3, 4; 2001, No. 1604, §§ 84-87; 2009, No. 726, § 37.