Alabama Administrative Code

(Repealed 7/18/05). Notes Ala. Admin. Code r. 482-1-084-.02

(Repealed 7/18/05). Notes Ala. Admin. Code r. 482-1-084-.03

(Repealed 7/18/05). Notes Ala. Admin. Code r. 482-1-084-.04

(Repealed 7/18/05). Notes Ala. Admin. Code r. 482-1-084-.05

(Repealed 7/18/05). Notes Ala. Admin. Code r. 482-1-084-.06

(Repealed 7/18/05). Author: Department of Insurance Notes Ala. Admin. Code r. 482-1-084-.07 Repealed: July 18, 2005; effective July 18, 2005. Filed with LRS July 18, 2005. Rule is not subject to the Alabama Administrative Procedure Act. Statutory Authority: Code of Ala. 1975, § 2…

This chapter is promulgated by the Commissioner of Insurance pursuant to Section 27-2-17, Code of Ala. 1975. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-085-.01 Effective October 20, 1988. Revised: July 5, 1994; Effective July 15, 1994. Revised: December 20,…

(1) The Alabama Insurance Department recognizes that licensed insurers routinely enter into reinsurance agreements that yield legitimate relief to the ceding insurer from strain to surplus. (2) However, it is improper for a licensed insurer, in the capacity of ceding insurer, to …

This chapter shall apply to all domestic life and accident and health insurers and to all other licensed life and accident and health insurers which are not subject to a substantially similar regulation in their domiciliary state. This chapter shall also similarly apply to licens…

(1) No insurer subject to this chapter shall, for reinsurance ceded, reduce any liability or establish any asset in any financial statement filed with the Department if, by the terms of the reinsurance agreement, in substance or effect, any of the following conditions exist: (a) …

(1) No reinsurance agreement or amendment to any agreement may be used to reduce any liability or to establish any asset in any financial statement filed with the Department, unless the agreement, amendment or a binding letter of intent has been duly executed by both parties no l…

Insurers subject to this chapter shall reduce to zero by December 31, 1997, any reserve credits or assets established with respect to reinsurance agreements entered into prior to the effective date of this chapter which, under the provisions of this chapter would not be entitled …

This chapter shall become effective ten (10) days from the date of certification that the properly executed chapter was delivered to the Secretary of the State. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-085-.07 Effective October 20, 1988. Revised: July 5, …

This chapter is adopted pursuant to Ala. Code §§ 27-2-17, 27-12-12, and 27-12-14. Notes Ala. Admin. Code r. 482-1-088-.01 Effective November 15, 1989. Revised: May 27, 2003; effective June 9, 2003. Filed with LRS May 30, 2003. Rule is not subject to the Alabama Administrative Pro…

The purpose of this chapter is to clarify questions raised by insurers regarding marketing practices that offer some form of free gifts, benefits, etc., and the amount of the free gifts, benefits, etc. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-088-.02 Effe…

This chapter shall apply to all insurers, insurance agencies, and producers doing business in the State of Alabama. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-088-.03 Effective November 15, 1989. Revised: May 27, 2003; effective June 9, 2003. Filed with LRS…

(1) For the purposes of this chapter, a free gift, benefit, etc. is defined as a gift, benefit, etc., to invite an inquiry or quote from the insurance buying public. It is not an inducement or invitation to enter into an insurance contract. (2) If necessary, a "reasonableness" te…

(1) The value of the amount of the gift, benefit, etc. will be no more than $100.00 payable to an individual or family (only one gift per family). This gift cannot be cash. (2) No rebate can be used as a part of a gift. Notes Ala. Admin. Code r. 482-1-088-.05 Effective November 1…

If any paragraph or a portion of a paragraph 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. Author: Commissi…

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. 482-1-088-.07 Effective N…

This chapter is made and promulgated by the undersigned Commissioner of Insurance pursuant to the authority set forth in Section 27-2-17, Code of Ala. 1975. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-090-.01 New Rule: July 26, 1990; effective August 15, 199…

This chapter is intended to implement and augment the provisions of Sections 27-13-1, et seq., Code of Ala. 1975. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-090-.02 New Rule: July 26, 1990; effective August 15, 1990. Filed for codification in the Alabama Ad…

This chapter is to authorize the payment of examination expenses incurred by the consulting actuaries employed by the Department in the review of rule, rate or form filings by rate-making organizations. These expenses are to be paid by the rate-making organization in the same man…

This chapter shall become effective ten (10) days from the date of certification that the properly executed chapter was delivered to the Secretary of State. Author: Commissioner of Insurance Notes Ala. Admin. Code r. 482-1-090-.04 New Rule: July 26, 1990; effective August 15, 199…

The purpose of this chapter is to implement the Alabama Long-Term Care Insurance Policy Minimum Standards Act (Article 3, Chapter 19, Title 27, beginning with Section 27-19-100, Code of Ala. 1975), to promote the public interest, to promote the availability of long-term care insu…

This chapter is made and promulgated by the undersigned Commissioner of Insurance pursuant to the authority set forth in Section 27-2-17, and in the Alabama Long-Term Care Insurance Policy Minimum Standards Act (Article 3, Chapter 19, Title 27, beginning with Section 27-19-100), …

Except as otherwise specifically provided, this chapter applies to all long-term care insurance policies, contracts, subscriber agreements, riders and endorsements, and certificates, including qualified long-term care contracts and life insurance policies that accelerate benefits…

For the purpose of this chapter, the terms "long-term care insurance," "qualified long-term care insurance," "group long-term care insurance," "commissioner," "applicant," "policy" and "certificate" shall have the meanings set forth in Section 27-19-103, Code of Ala. 1975. In add…

No long-term care insurance policy delivered or issued for delivery in this state shall use the terms set forth below, unless the terms are defined in the policy and the definitions satisfy the following requirements: (a) "Activities of daily living" means at least bathing, conti…

(1) Renewability. The terms "guaranteed renewable" and "noncancellable" shall not be used in any individual long-term care insurance policy without further explanatory language in accordance with the disclosure requirements of Rule 482-1-091-.08. (a) A policy issued to an individ…

Each insurer offering long-term care insurance shall, as a protection against unintentional lapse, comply with the following: (a) 1. Notice before lapse or termination. No individual long-term care policy or certificate shall be issued until the insurer has received from the appl…

(1) Renewability. Individual long-term care insurance policies shall contain a renewability provision. (a) The provision shall be appropriately captioned, shall appear on the first page of the policy, and shall clearly state the duration, where limited, of renewability and the du…

(1) All applications for long-term care insurance policies or certificates except those that are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the health condition of the applicant. (2) (a) If an application for long-term care insurance cont…

(1) A long-term care insurance policy or certificate shall not, if it provides benefits for home health care or community care services, limit or exclude benefits as follows: (a) By requiring that the insured or claimant would need care in a skilled nursing facility if home healt…

(1) No insurer may offer a long-term care insurance policy unless the insurer also offers to the policyholder in addition to any other inflation protection the option to purchase a policy that provides for benefit levels to increase with benefit maximums or reasonable durations w…

(1) Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant has another long-term care insurance policy or certificate in force or whether a long-term care policy or certificate is inte…

The Commissioner may upon written request and after an administrative hearing, issue an order to modify or suspend a specific provision or provisions of this chapter with respect to a specific long-term care insurance policy or certificate upon a written finding of all of the fol…

(1) (a) When long-term care benefits are provided through the acceleration of benefits under group or individual life policies or riders to such policies, policy reserves for such benefits shall be determined in accordance with Chapter 36A of Title 27, Code of Ala. 1975. Claim re…

(1) Benefits under long-term care insurance policies shall be deemed reasonable in relation to premiums provided the expected loss ratio is at least sixty percent (60%), calculated in a manner which provides for adequate reserving of the long-term care insurance risk. In evaluati…

Prior to an insurer or similar organization offering group long-term care insurance to a resident of this state pursuant to Section 27-19-104, Code of Ala. 1975, it shall file with the Commissioner evidence that the group policy or certificate thereunder has been approved by a st…

This rule implements, interprets and makes specific, the provisions of Subsection (g) of Section 27-19-105, Code of Ala. 1975, in prescribing a standard format and the content of an outline of coverage. (a) The outline of coverage shall be a free-standing document, using no small…

(1) A long-term care insurance shopper's guide in the format developed by the National Association of Insurance Commissioners, or a guide developed or approved by the Commissioner, shall be provided to all prospective applicants of a long-term care insurance policy or certificate…

(1) Every insurer shall maintain records for each agent of that agent's amount of replacement sales as a percent of the agent's total annual sales and the amount of lapses of long-term care insurance policies sold by the agent as a percent of the agent's total annual sales. (2) E…

No entity shall provide compensation to its agents or other producers, and no agent or producer shall receive compensation, greater than the renewal compensation payable by the replacing insurer on renewal policies or certificates if an existing policy or certificate is replaced …

(1) Every insurer, health care service plan or other entity providing long-term care insurance or benefits in this state shall provide a copy of any long-term care insurance advertisement intended for use in this state whether through written, radio or television medium to the Co…

(1) Every insurer, health care service plan or other entity marketing long-term care insurance coverage in this state, directly or through its producers, shall: (a) Establish marketing procedures to assure that any comparison of policies by its agents or other producers will be f…

(1) This rule shall not apply to life insurance policies that accelerate benefits for long-term care. (2) Every insurer, health care service plan or other entity marketing long-term care insurance (the "issuer") shall do all of the following:(a) Develop and use suitability standa…

If a long-term care insurance policy or certificate replaces another long-term care policy or certificate, the replacing insurer shall waive any time periods applicable to preexisting conditions and probationary periods in the new long-term care policy for similar benefits to the…

(1) This rule does not apply to life insurance policies or riders containing accelerated long-term care benefits. (2) To comply with the requirement to offer a nonforfeiture benefit pursuant to the provisions of Section 27-19-107, Code of Ala. 1975: (a) A policy or certificate of…

(1) A long-term care insurance policy shall condition the payment of benefits on a determination of the insured's ability to perform activities of daily living and on cognitive impairment. Eligibility for the payment of benefits shall not be more restrictive than requiring either…