Alabama Administrative Code

Rule 1. Scope of Rules. (a) These rules shall be applicable for all hearings conducted by a hearing officer under the provisions of any section in the Alabama Code requiring a hearing and also for any hearing held by the Commissioner under his or her discretionary or implied powe…

The attorneys for the parties, including the attorney for the Department prosecuting or defending the case before a hearing officer, are forbidden from discussing such case with the hearing officer outside the presence of the other party's counsel. This prohibition shall not appl…

(1) Any party or any person whose pecuniary interests are directly and immediately affected by any order of the Commissioner (or refusal or failure to issue any order) may appeal to the appropriate Circuit Court pursuant to Section 27-2-32. (2) (a) An appeal from an order of a he…

A copy of this chapter shall accompany every complaint or notice of hearing and a notation of the existence of the rules shall be made in the complaint or notice of hearing. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-065-.07 New Rule: June 11, 1979, Effecti…

This chapter shall become effective upon its approval by the Commissioner of Insurance and upon its having been on file as a public document in the office of the Secretary of State for ten days. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-065-.08 New Rule: J…

This chapter is intended to prescribe procedures to be used by insurers in handling unclaimed funds which fall under the unclaimed and abandoned property laws of Alabama. Many times in the past, insurers took into surplus those funds which may be due and owing, but because of ina…

The authority for the promulgation of this chapter is under the provisions of Sections 27-2-17 and 27-36-1(2), Code of Ala. 1975. Notes Ala. Admin. Code r. 482-1-066-.02 New Rule: June 1, 1979, effective June 11, 1979. Revised: Filed December 19, 2007; effective January 1, 2008. …

(1) "Unclaimed funds," as used in this chapter, shall mean any funds of whatever nature which are due and owing from an insurer and which are presently or may, in the future, fall under the provisions of the Uniform Disposition of Unclaimed Property Act, in Sections 35-12-70 thro…

All unclaimed funds in the possession, or under the control of an insurer shall, at all times, be maintained as a liability on the books of the insurer. This requirement shall remain in effect until the funds are claimed or transferred to the custody of the State of Alabama under…

If any portion of this chapter or its applicability to any person or circumstance is held invalid by a court, the remainder of the chapter or the applicability of the provision to other persons or circumstances shall not be affected. Notes Ala. Admin. Code r. 482-1-066-.05 New Ru…

This chapter shall become effective January 1, 2008, upon its approval by the Commissioner of Insurance and upon its having been on file as a public document in the office of the Secretary of State) for ten (10) days. No insurer shall be required to amend any financial statement …

Notes Ala. Admin. Code r. 482-1-067-.01 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

Notes Ala. Admin. Code r. 482-1-067-.02 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

Notes Ala. Admin. Code r. 482-1-067-.03 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

Notes Ala. Admin. Code r. 482-1-067-.04 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

Notes Ala. Admin. Code r. 482-1-067-.05 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

Notes Ala. Admin. Code r. 482-1-067-.06 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

Notes Ala. Admin. Code r. 482-1-067-.07 New Rule: June 1, 1979; effective June 11, 1979. Revised: May 7, 2008; effective May 20, 2008. Filed with LRS May 9, 2008. Rule is not subject to the Alabama Administrative Procedure Act. Repealed: August 13, 2008. Filed with LRS August 13,…

The purpose of this chapter 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 policie…

This chapter is issued pursuant to the authority vested in the commissioner under Sections 27-2-17 and 27-19-50, et seq., Code of Ala. 1975. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-071-.02 New Rule: Rule: September 18, 1981; effective January 1, 1982. Re…

A. Except as otherwise specifically provided in Sections 7, 13, 14, 17 and 22, this chapter shall apply to:(1) All Medicare supplement policies delivered or issued for delivery in this State on or after the effective date of this chapter, and (2) All certificates issued under gro…

For purposes of this chapter: A. "Applicant" means: (1) In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits, and (2) In the case of a group Medicare supplement policy, the proposed certificateholder. B. "Bankruptcy" mea…

No policy or certificate may be advertised, solicited or issued for delivery in this State as a Medicare supplement policy or certificate unless such policy or certificate contains definitions or terms which conform to the requirements of this section. A. "Accident," "Accidental …

A. Except for permitted preexisting condition clauses as described in Section 7A(1) and Section 8A(1) of this chapter, 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 …

No policy or certificate may be advertised, solicited or issued for delivery in this State as a Medicare supplement policy or certificate unless it meets or exceeds the following minimum standards. These are minimum standards and do not preclude the inclusion of other provisions …

The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state on or after March 25, 1996. No policy or certificate may be advertised, solicited, delivered or issued for delivery in this state as a Medicar…

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 …

A. An issuer shall make available to each prospective policyholder and certificateholder a policy form or certificate form containing only the basic core benefits, as defined in Rule 482-1-071-.08 B. B. No groups, packages or combinations of Medicare supplement benefits other tha…

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 d…

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the following standards to be 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, …

A. (1) This rule shall apply to Medicare Select policies and certificates, as defined in this rule. (2) No policy or certificate may be advertised as a Medicare Select policy or certificate unless it meets the requirements of this rule. B. For the purposes of this rule: (1) "Comp…

A. An issuer shall not deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in this state, nor discriminate in the pricing of a policy or certificate because of the health status, claims experience, receipt of health …

A. Guaranteed Issue. (1) Eligible persons are those individuals described in Subsection B who seek to enroll under the policy during the period specified in Subsection C, and who submit evidence of the date of termination, disenrollment, or Medicare Part D enrollment with the app…

A. An issuer shall comply with section 1882(c)(3) of the Social Security Act (as enacted by section 4081(b)(2)(C) of the Omnibus Budget Reconciliation Act of 1987 (OBRA) 1987, Pub. L. No. 100-203) by: (1) Accepting a notice from a Medicare carrier on dually assigned claims submit…

A. Loss Ratio Standards. (1) (a) A Medicare Supplement policy form or certificate form shall not be delivered or issued for delivery unless the policy form or certificate form can be expected, as estimated for the entire period for which rates are computed to provide coverage, to…

A. An issuer shall not deliver or issue for delivery a policy or certificate to a resident of this state unless the policy form or certificate form has been filed with and approved by the commissioner in accordance with filing requirements and procedures prescribed by the commiss…

A. An issuer or other entity may provide commission or other compensation to an agent or other representative for the sale of a Medicare supplement policy or certificate only if the first year commission or other first year compensation is no more than two hundred percent (200%) …

A. General Rules. (1) Medicare supplement policies and certificates shall include a renewal or continuation provision. The language or specifications of the provision shall be consistent with the type of contract issued. The provision shall be appropriately captioned and shall ap…

A. Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant currently has Medicare supplement, Medicare Advantage, Medicaid coverage, or another health insurance policy or certificate in…

A. An issuer and insurance producer shall submit a copy of any Medicare supplement advertisement, mailers or other marketing material to the Commissioner of Insurance for approval before use in this state. Marketing material includes, but is not limited to, written, broadcast, di…

A. An issuer, directly or through its producers, shall: (1) Establish marketing procedures that are not false or deceptive and which assure that marketing materials used have received prior approval of the Commissioner as required. (2) Establish marketing procedures to assure tha…

A. In recommending the purchase or replacement of any Medicare supplement policy or certificate an agent shall make reasonable efforts to determine the appropriateness of a recommended purchase or replacement. B. Any sale of a Medicare supplement policy or certificate that will p…

A. On or before March 1 of each year, an issuer shall report the following information for every individual resident of this State for which the issuer has in force more than one Medicare supplement insurance policy or certificate: (1) Policy and certificate number, and (2) Date …

A. If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate, the replacing issuer shall waive any time periods applicable to preexisting conditions, waiting periods, elimination periods and probationary periods in the New Rule: Med…

If any provision of this chapter or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the chapter, and the application of such provision to other persons or circumstances shall not be affected thereby. Author: Commissione…

This chapter shall be effective upon its approval by the Commissioner of Insurance, and upon its having been on file as a public document in the office of the Secretary of State for ten days. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-071-.25 New Rule: Sept…

This chapter shall be effective upon its approval by the Commissioner of Insurance, and upon its having been on file as a public document in the office of the Secretary of State for ten days. Notes Ala. Admin. Code r. 482-1-071-.26 New Rule: September 18, 1981; effective January …

All insurers licensed to do business in Alabama shall inform their producers of the existence and of the requirements of this Chapter. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 428-1-072-.05 New Rule: July 7, 1982; effective October 1, 1982. Revised: December 22…

This chapter is promulgated under the provisions of Section 27-2-17 and the implied power of the Commissioner of Insurance under Section 27-2-7(4), Code of Ala. 1975. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-072-.01 New Rule: July 7, 1982; effective Octob…

The purposes of this chapter are: (1) To regulate the activities of insurers and producers, with respect to the collection of monies for certain types of insurance coverages; (2) To assure that the prospective policyowner receives adequate proof of payment for insurance purchased…