Title 21 — Insurance
53 chapters · 1,244 sections in this title.
AS 21.27.550 Appointment of insurance producer as an agent.
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(a) A person may not act as or represent to be a representative of, authorized or appointed agent of, or other term implying a contractual relationship with a particular admitted insurer, or accept applications on behalf of an admitted insurer, unless the person is licensed as an…
AS 21.27.560 Appointment of insurance producers as brokers.
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(a) A client who appoints an insurance producer as its broker in this state or relative to a subject resident, located, or to be performed in this state shall execute a written contract that specifically sets out the duties, functions, powers, authority, and compensation of the i…
AS 21.27.570 Operating requirements for controlling insurance producers.
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Article 3. Managing General Agents. (a) If the aggregate amount of gross written premium on business placed by a controlling insurance producer exceeds five percent of the admitted assets of the controlled insurer for a calendar year as reported in the insurer's most recent finan…
AS 21.27.590 Managing general agents qualifications.
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In addition to the general qualifications under AS 21.27.020, the director may require that a managing general agent maintain (1) a bond in an amount acceptable to the director and that requires the managing general agent to conduct business under this title; and (2) an errors an…
AS 21.27.600 Trainee managing general agents. [Repealed, § 53 ch 96 SLA 2004.]
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[Repealed or reserved.]
AS 21.27.610 Authority of managing general agents.
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A managing general agent has only the authority consistent with this title that is conferred by an admitted insurer. A managing general agent, resident or nonresident, qualified and licensed under this chapter, may exercise the powers conferred by this title upon insurance produc…
AS 21.27.620 Operating requirements for managing general agents; actions for loss.
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Article 4. Third-Party Administrators. (a) An insurer may not transact business with a managing general agent unless (1) the insurer holds a certificate of authority in this state; (2) the managing general agent is licensed under this chapter or has filed a certification with the…
AS 21.27.630 Registration required.
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(a) A person may not act as or represent to be a third-party administrator in this state or relative to a subject resident, located, or to be performed in this state, unless registered under this chapter or in another jurisdiction under AS 21.27.650. A person may not act as or re…
AS 21.27.640 Third-party administrator qualifications.
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(a) The director may not issue or renew a registration except in compliance with this chapter and may not issue a registration to a person, or to be exercised by a person, found by the director to be untrustworthy, incompetent, financially irresponsible, or who has not establishe…
AS 21.27.650 Operating requirements for third-party administrators.
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(a) An insurer may not transact business with a third-party administrator unless (1) the insurer holds a certificate of authority in this state if required under this title; (2) the third-party administrator is registered under this chapter or the third-party administrator has fi…
AS 21.27.660 Definitions.
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Article 5. Reinsurance Intermediary Brokers. In AS 21.27.630 — 21.27.660, (1) “insurer” includes the Comprehensive Health Insurance Association created under AS 21.55.010 and any person issued or required to obtain a certificate of authority under this title to transact life insu…
AS 21.27.670 Reinsurance intermediary broker qualifications.
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In addition to the general qualifications under AS 21.27.020, the director may require that a reinsurance intermediary broker maintain (1) a bond in an amount acceptable to the director in favor of insurers and this state that requires the reinsurance intermediary broker to condu…
AS 21.27.680 Trainee reinsurance intermediary brokers. [Repealed, § 53 ch 96 SLA 2004.]
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[Repealed or reserved.]
AS 21.27.690 Operating requirements for reinsurance intermediary brokers; actions for loss.
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(a) Except as provided in (b) of this section, an insurer may not transact business with a reinsurance intermediary broker unless the insurer holds a certificate of authority in this state, the reinsurance intermediary broker is licensed in this state, and there is in effect a wr…
AS 21.27.700 Reinsurance intermediary broker records.
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Article 6. Reinsurance Intermediary Managers. In addition to any other records requirements under this title, a reinsurance intermediary broker shall maintain in organized form a record of each transaction including (1) the type of contract, limits, underwriting restrictions, cla…
AS 21.27.730 Reinsurance intermediary manager qualifications.
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In addition to the general qualifications under AS 21.27.020, the director may require that a reinsurance intermediary manager maintain (1) a bond in an amount acceptable to the director that requires the reinsurance intermediary manager to conduct business under this title; and …
AS 21.27.740 Trainee reinsurance intermediary managers. [Repealed, § 53 ch 96 SLA 2004.]
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[Repealed or reserved.]
AS 21.27.750 Authority of reinsurance intermediary managers.
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A reinsurance intermediary manager has only the authority that is consistent with this title and that is conferred by the reinsurer. A reinsurance intermediary manager, resident or nonresident, qualified and licensed under this chapter, may exercise the powers conferred by this t…
AS 21.27.760 Operating requirements for reinsurance intermediary managers; actions for loss.
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(a) A reinsurer may not transact business with a reinsurance intermediary manager unless there is in effect a written contract approved by the reinsurer's board of directors between the parties that establishes the responsibilities of each party, indicates each party's share of r…
AS 21.27.770 Reinsurance intermediary manager records.
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Article 7. Surplus Lines Brokers. In addition to any other records requirements under this chapter, a reinsurance intermediary manager shall maintain in organized form a complete record of each transaction including (1) the type of contract, limits, underwriting restrictions, cla…
AS 21.27.790 Surplus lines broker qualifications.
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In addition to the general qualifications under AS 21.27.020, to qualify for issuance or for renewal of a resident surplus lines broker license, an applicant or licensee shall (1) be licensed as either an insurance producer or managing general agent for property and casualty line…
AS 21.27.800 Trainee surplus lines broker. [Repealed, § 53 ch 96 SLA 2004.]
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[Repealed or reserved.]
AS 21.27.810 Surplus lines broker records.
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In addition to any other records requirements under this chapter, a surplus lines broker shall maintain in organized form a complete record including (1) the amount of insurance and perils insured; (2) a complete description of property insured and the location of the property; (…
AS 21.27.820 Denial, nonrenewal, suspension, or revocation of surplus lines broker license.
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Article 8. Independent Adjusters. In addition to other action available under this title, the director may deny issuance of or not renew a license, or may suspend or revoke a license of a surplus lines broker issued under this chapter for any of the following causes: (1) removal …
AS 21.27.830 Independent adjuster qualifications.
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In addition to the general qualifications under AS 21.27.020, to qualify for issuance or renewal of an independent adjuster license, an applicant or licensee shall (1) have at least six months active working experience within the previous two calendar years as either an independe…
AS 21.27.840 Trainee independent adjusters.
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(a) An individual resident who does not have the experience with reference to the handling of loss claims but who otherwise meets the requirements of AS 21.27.830, may be employed by a licensed independent adjuster as a trainee independent adjuster, subject to the provisions of t…
AS 21.27.850 Insurance producer, managing general agent, surplus lines broker, reinsurance intermediary broker, and reinsurance intermediary manager as independent adjuster.
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Without being required by this chapter to be licensed also as an independent adjuster (1) a licensed insurance producer and a licensed managing general agent, incidental to acting as an insurance producer, may act as an adjuster and investigate, adjust, and report upon claims on …
AS 21.27.860 Unlicensed nonresident adjusters.
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(a) A nonresident independent adjuster not licensed by this state who is licensed by and in good standing with its resident state may act as an adjuster and adjust a single loss in this state during a calendar year, or may act as an adjuster and adjust losses arising out of a cat…
AS 21.27.870 Independent adjuster records.
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Article 9. Pharmacy Benefits Managers. In addition to any other records requirements under this chapter, an independent adjuster shall maintain in organized form a complete record of each investigation or adjustment undertaken or consummated, and a statement of the fee, commissio…
AS 21.27.901 Registration of pharmacy benefits managers; scope of business practice.
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(a) A person may not conduct business in the state as a pharmacy benefits manager unless the person is registered with the director. (b) A pharmacy benefits manager registered under this section may (1) contract with an insurer to administer or manage pharmacy benefits provided b…
AS 21.27.905 Renewal of registration.
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(a) A pharmacy benefits manager shall biennially renew a registration with the director. (b) To renew a registration under this section, a pharmacy benefits manager shall pay a renewal fee established by the director. The director shall set the amount of the renewal fee to allow …
AS 21.27.907 Duty of care.
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(a) A pharmacy benefits manager owes a duty of care to a plan sponsor, benefits administrator, and covered person. A pharmacy benefits manager shall adhere to the practices set out in this section. (b) A pharmacy benefits manager shall (1) perform the manager's duties with care, …
AS 21.27.910 Pharmacy audit procedural requirements.
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(a) When a pharmacy benefits manager conducts an audit of the records of a pharmacy, the period covered by the audit of a claim may not exceed two years from the date that the claim was submitted to or adjudicated by the pharmacy benefits manager, whichever is earlier. Except as …
AS 21.27.915 Overpayment or underpayment.
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(a) When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager shall base a finding of overpayment or underpayment by the pharmacy on the actual overpayment or underpayment and not on a projection based on the number of patients served having …
AS 21.27.920 Recoupment.
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(a) When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager shall base the recoupment of overpayments on the actual overpayment of the claim, except as provided in AS 21.27.915(b). (b) A pharmacy benefits manager conducting an audit of a ph…
AS 21.27.925 Pharmacy audit reports.
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(a) A pharmacy benefits manager shall deliver a preliminary audit report to the pharmacy audited within 60 days after the conclusion of the audit. (b) A pharmacy benefits manager shall allow the pharmacy at least 30 days following receipt of the preliminary audit report to provid…
AS 21.27.930 Pharmacy audit appeal; future repayment.
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(a) A pharmacy benefits manager conducting an audit shall establish a written appeals process. (b) Recoupment of disputed funds or repayment of funds to the pharmacy benefits manager by the pharmacy, if permitted by contract, shall occur, to the extent demonstrated or documented …
AS 21.27.935 Fraudulent activity.
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When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager may not consider unintentional clerical or record-keeping errors, including typographical errors, writer's errors, or computer errors regarding a required document or record, to be fra…
AS 21.27.940 Pharmacy audits; restrictions.
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The requirements of AS 21.27.901 — 21.27.975 do not apply to an audit (1) in which suspected fraudulent activity or other intentional or wilful misrepresentation is evidenced by a physical review, a review of claims data, a statement, or another investigative method; or (2) of cl…
AS 21.27.945 Drug pricing list.
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(a) A pharmacy benefits manager shall (1) provide to each network pharmacy at the beginning of the term of the network pharmacy's contract, and upon renewal of the contract, the methodology and sources used to determine the list; (2) provide the list to a network pharmacy without…
AS 21.27.950 Multi-source generic drug appeal.
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[Repealed or reserved.]
AS 21.27.951 Patient access to clinician-administered drugs.
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(a) An insurer or its pharmacy benefits manager may not (1) refuse to authorize, approve, or pay a provider for providing covered clinician-administered drugs and related services to a covered person if the provider has agreed to participate in the insurer's health care insurance…
AS 21.27.952 Penalties.
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In addition to any other penalty provided by law, if a person violates AS 21.27.945 — 21.27.975, the director may, after notice and hearing, impose a penalty in accordance with AS 21.27.440.
AS 21.27.953 Regulations relating to pharmacy benefits manager claims, grievances, activities, and appeals.
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The director shall adopt regulations that provide standards and criteria for (1) the structure and operation of pharmacy benefits manager reimbursement of pharmacy claims under this chapter; (2) procedures maintained by a pharmacy benefits manager to ensure that a pharmacy has th…
AS 21.27.955 Definitions.
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[Repealed or reserved.]
AS 21.27.975 Definitions.
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Article 10. General Provisions. In AS 21.27.901 — 21.27.975, (1) “affiliate” means a business, pharmacy, pharmacist, or provider who, directly or indirectly through one or more intermediaries, controls, is controlled by, or is under common control with a pharmacy benefits manager…
AS 21.27.990 Definitions.
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In this chapter, (1) “accredited state” means a state in which the insurance department or regulatory agency of that state has qualified as meeting the minimum financial regulatory standards adopted and established by the National Association of Insurance Commissioners; (2) “affi…