Georgia Administrative Code

(a) An insurer, or the insurance group of which the insurer is a member, required to file a CGAD by Code Section 33-65-1et seq., shall, no later than June 1 of each calendar year, submit to the Commissioner a CGAD that contains the information described in Rule . (b) The CGAD mus…

(a) The insurer or insurance group shall be as descriptive as possible in completing the CGAD, with inclusion of attachments or example documents that are used in the governance process, since these may provide a means to demonstrate the strengths of their governance framework an…

If any provision of these regulations, or the application thereof to any person or circumstance, is held invalid, such determination shall not affect other provisions or applications of these regulations which can be given effect without the invalid provision or application, and …

This Regulation is promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. §§ 33-2-9 and O.C.G.A §§33-20E.

This Regulation is made pursuant to the "Surprise Billing Consumer Protection Act," which was passed to provide a mechanism to resolve billing and payment disputes between insurers and out-of-network providers. It will also establish a fair and equitable arbitration process to ha…

For the purposes of this Regulation, the following definitions apply: (1) "Balance bill" means the amount that a non-participating provider charges for services provided to a covered person. Such amount equals the difference between the amount paid or offered by the insurer and t…

ERISA Exempt Plans subject to the exclusive jurisdiction of federal law and rules are not eligible for review under the "Surprise Billing Consumer Protection Act."

(1) Insurers shall pay covered emergency medical services for covered persons regardless of whether the provider or facility is participating or non-participating in their network according to this Regulation. Such an insurer shall make such payment without prior authorization an…

(1) If the provisions of 120-2-106.08 are met, an insurer that provides any benefits to covered persons with respect to non-emergency medical services shall pay for such services in the event that such services resulted in a surprise bill regardless of whether the healthcare prov…

No healthcare plan shall deny or restrict covered benefits from a participating provider to a covered person solely because the covered person obtained treatment from a non-participating provider leading to a balance bill. Notice of such protection shall be provided in writing to…

(1) Nothing in this chapter shall reduce a covered person's financial responsibilities in the event that such covered person chose to receive non-emergency medical services from an out-of-network provider. Such services shall not be considered a surprise bill for the purpose of t…

Pursuant to O.C.G.A 33-20E-8(a) appropriations for an all claims database were not provided, and subsection (b) of O.C.G.A 33-20E-8 will be triggered. The Department will utilize a verifiable median contracted amount paid by all eligible insurers for similar services calculated b…

(1) If an out-of-network provider concludes that payment received from an insurer pursuant to Rule or is not sufficient given the complexity and circumstances of the services provided. Or, if an out-of-network facility concludes that payment received from an insurer pursuant to R…

Insurers shall make available online and in print a health benefit plan surprise bill rating for hospitals as required in Chapter 20C of Title 33. For each hospital, health benefit plans shall clearly display a rating denoting the health benefit plan surprise bill rating factor. …

If any section or any portion of a section of this Regulation or the applicability thereof to any waiver or circumstances is held invalid by any court of competent jurisdiction, the remainder of the rules or applicability of such provisions shall not be affected.

(1) The primary purposes of this Rule are to ensure compliance with the "Consumer Access to Contracted Health Act" or "CATCH Act" by assessing and ensuring adequacy and breadth of an insurer's provider network, ensuring insurers do not illegally deny pre-authorization of healthca…

These rules and regulations of the Insurance Commissioner, entitled "Insurance Written in Connection with Loans Under the Georgia Installment Loan Act," are promulgated pursuant to the rulemaking authority of the Insurance Commissioner, O.C.G.A. 33-2-9, and pursuant to the Insura…

(1) Evidence of insurance. All insurance authorized and included in or incident to a loan contract made under the provisions of the Georgia Installment Loan Act shall be evidenced by a policy or certificate of insurance which shall be delivered to the borrower at the time the ind…

(1) Coverage. (a) Level term life insurance will pay the first beneficiary at the death of the insured the amount of the indebtedness, not exceeding the amount of insurance stated in the policy, and pay the second beneficiary the amount stipulated in excess of the indebtedness; o…

(1) Coverage. Credit accident and sickness insurance may be written on all loans made under the provisions of the Georgia Installment Loan Act. Provided, however, any such insurance written in connection with such a loan shall not provide for monthly benefits which exceed the amo…

(1) Coverage. (a) Dual interest household goods insurance shall insure both the creditor and the debtor as their interest may appear against loss or damage caused by fire, lightning and collision; (b) Single interest household goods insurance shall insure only the interest of the…

(1) Coverage. (a) Dual interest automobile insurance shall insure both creditor and debtor as their interest may appear against loss or damage caused by fire, theft, and collision. (b) Single interest automobile insurance shall insure only the interest of the creditor loss payee …

(1) No licensee shall charge any recording fee, or actual premiums on insurance used in lieu of such recording fee unless the amount of such fee or premium be fully set forth in the copy of the loan contract or voucher furnished to the borrower. (2) Non-recording insurance may be…

The actual and reasonable expenses of repossessing, storing and selling any collateral pledged as security under the Georgia Installment Loan Act shall not exceed the expenses of repossessing, storing and selling recoverable under other provisions of law.

Each licensee of the Georgia Installment Loan Act shall maintain on a daily basis an insurance claims register. There shall be recorded on this register, with respect to any and all claims against insurance sold in connection with a loan made under the provisions of the Georgia I…

(1) With respect to any consumer loan transaction, the creditor shall not require any insurance other than insurance covering the loss of or damage to any property in which the creditor is given a security interest. Credit life and credit accident and sickness insurance if requir…

(1) The charge to the consumer for any insurance shall not exceed the premium charged by the insurer and the premium of premiums charged for such insurance shall be reasonable in relation to the amount and term of the credit and the risk covered and the benefits provided. (2) Upo…

(1) A creditor in a consumer loan transaction may not contract for or receive a charge for insurance against loss or damage to property unless: (a) the insurance covers a substantial risk of loss of or damage to property related to the loan transaction; (b) the amount, terms, and…

If any rule or portion thereof contained in this Chapter is held invalid by a court of competent jurisdiction, the remainder of the rules herein and the applicability of such provisions to other circumstances shall not be affected thereby.

(1) The purpose of this regulation is to provide: (a) Tables of select mortality factors and rules for their use; (b) Rules concerning a minimum standard for the valuation of plans with nonlevel premiums or benefits; and (c) Rules concerning a minimum standard for the valuation o…

This regulation is issued under the authority granted by O.C.G.A. § 33-2-9.

This regulation shall apply to all life insurance policies, with or without nonforfeiture values, issued on or after the effective date of this regulation, subject to the following exceptions and conditions. (1) Exceptions (a) This regulation shall not apply to any individual lif…

For purposes of this regulation: (1) "Basic reserves" means reserves calculated in accordance with O.C.G.A. § 33-10-13. (2) "Contract segmentation method" means the method of dividing the period from issue to mandatory expiration of a policy into successive segments, with the len…

(1) At the election of the company for any one or more specified plans of life insurance, the minimum mortality standard for basic reserves may be calculated using the 1980 CSO valuation tables with select mortality factors (or any other valuation mortality table adopted by the N…

(1) Basic Reserves Basic reserves shall be calculated as the greater of the segmented reserves and the unitary reserves. Both the segmented reserves and the unitary reserves for any policy shall use the same valuation mortality table and selection factors. At the option of the in…

(1) General (a) Policies with a secondary guarantee include: (1) A policy with a guarantee that the policy will remain in force at the original schedule of benefits, subject only to the payment of specified premiums; (2) A policy in which the minimum premium at any duration is le…

This regulation shall become effective for policies issued on or after January 1, 2000.

This regulation is issued under the authority granted by O.C.G.A. § 33-2-9 and O.C.G.A. § 33-7-14(d)(2)(B).

The purpose and intent of this regulation is to establish uniform, national standards governing reserve financing arrangements pertaining to life insurance policies containing guaranteed nonlevel gross premiums, guaranteed nonlevel benefits and universal life insurance policies w…

This regulation shall apply to reinsurance treaties that cede liabilities pertaining to Covered Policies, as that term is defined in , issued by any life insurance company domiciled in this state. This regulation and 120-2-78 shall both apply to such reinsurance treaties; provide…

This regulation does not apply to the situations described in Sections (1) through (6). (1) Reinsurance of: (a) Policies that satisfy the criteria for exemption set forth in or ; and which are issued before the later of: (i) The effective date of this regulation, and (ii) The dat…

(1) "Actuarial Method" means the methodology used to determine the Required Level of Primary Security, as described in . (2) "Covered Policies" means the following: Subject to the exemptions described in , Covered Policies are those policies, other than Grandfathered Policies, of…

(1) Actuarial Method The Actuarial Method to establish the Required Level of Primary Security for each reinsurance treaty subject to this regulation shall be VM-20, applied on a treaty-by-treaty basis, including all relevant definitions, from the Valuation Manual as then in effec…

(1) Requirements Subject to the exemptions described in and the provisions of section (2), credit for reinsurance shall be allowed with respect to ceded liabilities pertaining to Covered Policies pursuant to O.C.G.A. § 33-7-14(a) and (b) if, and only if, in addition to all other …

If any provision of this regulation is held invalid, the remainder shall not be affected.

No insurer that has Covered Policies as to which this regulation applies (as set forth in ) shall take any action or series of actions, or enter into any transaction or arrangement or series of transactions or arrangements if the purpose of such action, transaction or arrangement…

This regulation shall become effective [insert date] and shall pertain to all Covered Policies in force as of and after that date.