Alaska Administrative Code

A health care insurer against which a request for a standard external] review or an expedited external review is filed shall pay the cost of the independent review organization to conduct the external review. Notes 3 AAC 28.980 Eff. 3/15/2018,Register 225, April 2018 Authority:AS…

A health care insurer shall set out in, or attach to, a policy, certificate of coverage, membership booklet, or other evidence of coverage provided to a covered person a description of the external review procedures described under 3 AAC 28.950"3 AAC 28.982. The description must …

In 3 AAC 28.900 - 3 AAC 28.989, unless the context requires otherwise, (1) "adverse determination" includes a rescission of coverage determination and means (A) a determination by a health care insurer or the health care insurer's designee utilization review organization that (i)…

Notes 3 AAC 29.010 Eff. 3/26/82, Register 81; repealed 7/1/96, Register 138 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be a…

(a)3 AAC 29.200 - 3 AAC 29.300 apply to all insurance subject to rate regulation under AS 21.39. (b)3 AAC 29.200 - 3 AAC 29.300 do not apply to any insurance for which the filing requirement has been suspended or modified by a written order of the director. Notes 3 AAC 29.200 Eff…

(a) A rating organization may develop and submit to the director a filing consisting of prospective loss costs supported by statistical data, interpretation of the statistical data, relevant experience or judgment, and other supporting information. (b) A rating organization may d…

(a) An insurer may (1) develop and submit its own filing of rates supported by statistical data, interpretation of the statistical data, relevant loss and expense experience or judgment, and other supporting information as required by the director; or (2) submit a loss cost adjus…

Notes 3 AAC 29.230 Eff. 8/7/92, Register 123; repealed 12/24/93, Register 128 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be…

(a) Loss cost adjustments included in an insurer's lost cost adjustment filing may be based on the insurer's operating methods for each kind of insurance and the measurable variations of expenses within that kind of insurance. The loss cost adjustments in the filing must be suppo…

(a) Repealed 12/24/93. (b) Repealed 12/24/93. (c) An insurer's rate filing must be consistent with the estimate of future costs of a risk transfer as established in the Casualty Actuarial Society's Statement of Principles Regarding Property and Casualty Ratemaking, adopted May 19…

Notes 3 AAC 29.260 Eff. 8/7/92, Register 123; repealed 12/24/93, Register 128 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be…

Notes 3 AAC 29.270 Eff. 8/7/92, Register 123; repealed 12/24/93, Register 128 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be…

Notes 3 AAC 29.280 Eff. 8/7/92, Register 123; am 1/17/98, Register 145; repealed 12/20/2020, Register 236, January 2021 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly…

(a) An insurer may not cancel, deny, nonrenew, underwrite, or rate an automobile insurance policy based upon (1) an accident or claim involving an applicant or insured unless(A) the accident involved injury to a person or more than $1,000 damage to property; and (B) the applicant…

In 3 AAC 29.200 - 3 AAC 29.300, unless the context otherwise requires, (1) "director" means the director of the division of insurance; (2) "division" means the division of insurance; (3) "expenses" means that portion of a rate attributable to acquisition, field supervision, and c…

The purpose of 3 AAC 29.305 - 3 AAC 29.369 is to prevent abuses in the group-marketing of property and casualty insurance in this state, while preserving for consumers the potential benefits of this form of marketing. Notes 3 AAC 29.305 Eff. 1/4/95, Register 133 Authority:AS 21.0…

3 AAC 29.305 - 3 AAC 29.369 apply to all property and casualty insurance policies or renewals delivered or issued for delivery in this state after 12/31/94 that are sold through a group-marketed plan. Notes 3 AAC 29.310 Eff. 1/4/95, Register 133 Authority:AS 21.06.090 AS 21.36.02…

An insurer may group-market insurance only to employees of a particular employer or to members of an association, organization or other group formed for a specific purpose that is unrelated to the purpose of obtaining insurance through a group-marketed plan. Notes 3 AAC 29.315 Ef…

Premium rates under a group-marketed plan must comply with AS 21.39. Rates are not unfairly discriminatory merely because different premiums result for policyholders with like loss exposures but different expense factors, or like expense factors but different loss exposures, as l…

An insurer selling insurance through a group-marketed plan shall maintain separate statistics for the loss and expense experience of the group-marketed plan. Notes 3 AAC 29.325 Eff. 1/4/95, Register 133 Authority:AS 21.06.090 AS 21.39.130 State regulations are updated quarterly; …

A person may not act as or represent to be an insurance producer for a group-marketed plan in this state unless licensed under AS 21.27. Notes 3 AAC 29.330 Eff. 1/4/95, Register 133 Authority:AS 21.06.090 AS 21.27.010 State regulations are updated quarterly; we currently have two…

An insurer may not sell insurance through a group-marketed plan if (1) the purchase of insurance through the group-marketed plan is a condition of employment or of membership in an association, organization, or other group; or (2) an employee or a member may be penalized for nonp…

An insurer may not sell insurance through a group-marketed plan in this state if (1) the purchase of insurance available under the plan is contingent upon the purchase of any other insurance, product, or service; or (2) the purchase or price of any other insurance, product, or se…

Before each sale, an insurer or producer selling insurance through a group-marketed plan shall disclose to a prospective insured all features of the plan, whether favorable or unfavorable, including premium rates, benefits, duration of coverage, policyholder services, conversion …

(a) An insurer may not use underwriting standards for individual risk selection in a group-marketed plan that are more restrictive overall than the standards used by the insurer for individual risk selection in the sale of the same kind of insurance in this state when a group-mar…

(a) For purposes of AS 21.36.210-21.36.290, if an employer, association, organization, or other group for any reason, including interruption or termination of employment or membership, fails to remit the premiums when due, the insurer may not regard this as nonpayment of premium …

In 3 AAC 29.305 - 3 AAC 29.369, (1) "casualty insurance" has the meaning given in AS 21.12.070 but excludes workers' compensation and employer's liability insurance listed in AS 21.12.070(a)(3); (2) "group-market" or "group-marketed" means a method of selling property or casualty…

(a) When a personal motor vehicle liability insurer secures the application of a potentially eligible applicant, the insurer shall notify the applicant in writing that a reduction in the premium charged is available under AS 21.96.025. The insurer shall also notify a potentially …

A written notice informing a potentially eligible applicant or insured of the rate reduction available under AS 21.96.025 must include (1) a statement that, to be eligible for a discount, the principal operator of the motor vehicle covered by the insurance policy must (A) be 55 y…

In 3 AAC 29.380 - 3 AAC 29.395, (1) "potentially eligible applicant" means a person who is 55 years of age or older and is identified on an application as an operator; (2) "potentially eligible insured" means an insured person who has been identified to the insurer as being 55 ye…

The purpose of 3 AAC 29.400 - 3 AAC 29.469 is to establish standards for schedule rating to ensure that (1) a credit or debit that modifies a premium under a schedule rating plan is based only on risk characteristics that can be reasonably expected to affect losses or loss adjust…

3 AAC 29.400 - 3 AAC 29.469 apply to all insurers and rating organizations subject to the requirements of AS 21.39. Notes 3 AAC 29.405 Eff. 7/24/98, Register 147 Authority:AS 21.06.090 AS 21.39.030 AS 21.39.040 State regulations are updated quarterly; we currently have two versio…

An insurer may only use a schedule rating plan under 3 AAC 29.400 - 3 AAC 29.469 for business or commercial insurance as defined in AS 21.36.310 and surety insurance as defined in AS 21.12.080. Notes 3 AAC 29.410 Eff. 7/24/98, Register 147 Authority:AS 21.06.090 AS 21.12.080 AS 2…

(a) A rating organization, on behalf of its member and subscriber insurers, or an insurer may file, for the director's approval, a schedule rating plan that includes (1) the criteria that an applicant or insured must meet to be eligible for the plan; (2) a description of each ris…

If an insurer uses a schedule rating plan, the insurer (1) must uniformly apply the plan to all eligible insureds or applicants; (2) must apply the plan at each policy renewal; (3) must assign credits or debits only for risk characteristics described in the plan; however, for eac…

If an insurer using a schedule rating plan fails to comply with 3 AAC 29.420, the application of the plan is unfairly discriminatory and a violation of AS 21.36. Notes 3 AAC 29.425 Eff. 7/24/98, Register 147 In 2010 the revisor of statutes, acting under AS 01.05.031, renumbered f…

(a) For each policy of an eligible insured, an insurer shall maintain an underwriting file containing documentation of the application of the appropriate schedule rating plan. (b) The documentation required in (a) of this section must include a worksheet prepared annually that (1…

Notes 3 AAC 29.435 Eff. 7/24/98, Register 147; repealed 12/20/2020, Register 236, January 2021 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison…

In 3 AAC 29.400 - 3 AAC 29.469, (1) "experience rating plan" means a rating procedure using past insurance experience of an individual policyholder to forecast future losses by measuring the policyholder's loss experience against the loss experience of other policyholders in the …

The provisions of 3 AAC 29.500 - 3 AAC 29.550 apply to rate and form filings providing commercial insurance coverage as defined in AS 21.12.130 for exempt commercial policyholders as defined in 3 AAC 29.545. Notes 3 AAC 29.500 Eff. 6/11/2005, Register 174; am 8/20/2016, Register …

An insurer providing insurance coverage for an exempt commercial policyholder shall submit an informational rate filing to the director not later than 30 days after the proposed effective date of the filing. The informational filing is exempt from the filing requirements of AS 21…

An informational rate filing must (1) include the proposed effective date of the filing; (2) meet the rate standards of AS 21.39.030 and other applicable rate requirements of AS 21; (3) include a statement indicating whether the same rate structure has been filed for approval to …

(a) An insurer shall calculate the annual aggregate premium threshold for qualification as an exempt commercial policyholder using filed commercial insurance manual rates or rating systems. The annual aggregate premium must include objective discounts and surcharges, but may not …

(a) An insurer that issues a policy to an exempt commercial policyholder shall maintain records that show(1) how the policy premium was determined, including discounts or surcharges; and (2) unless all of the insurer's policies are issued to exempt commercial policyholders, annua…

An insurer providing insurance coverage for an exempt commercial policyholder shall submit an informational form filing to the director not later than 30 days after the proposed effective date of the filing. The informational filing is exempt from the filing requirements of AS 21…

The informational form filing must (1) include the proposed effective date of the filing; (2) include a statement indicating whether the same forms have been filed for approval to be used with policyholders who do not qualify as exempt commercial policyholders under 3 AAC 29.545;…

(a) At the time of solicitation, an insurer or insurance producer shall disclose to the exempt commercial policyholder and the policyholder's risk manager, if any, that a policy form may be used and a premium or rate may be quoted that is not subject to prior approval by the divi…

(a) An insurer providing insurance coverage for an exempt commercial policyholder shall (1) maintain adequate records to document that the exempt commercial policyholder meets the criteria under 3 AAC 29.545; (2) maintain all records and data for a period of at least five years a…

For purposes of 3 AAC 29.500 - 3 AAC 29.550, an exempt commercial policyholder is an entity that has sufficient insurance buying expertise to negotiate with insurers in a largely unregulated environment and that meets any two of the following criteria: (1) has net worth of over $…

For purposes of 3 AAC 29.500 - 3 AAC 29.550, a risk manager is an individual (1) whose primary economic activity consists of regularly and continuously identifying and analyzing loss exposures, selecting the technique or combination of techniques to be used to handle each exposur…