Georgia Administrative Code

Each applicant for a certificate of authority shall file with the application and shall immediately file any changes thereafter, a summary disclosure of any contractual or financial arrangements (or any future plans for contractual or financial arrangements) between the incorpora…

The Act provides for the Regulation of HMOs by the Department of Insurance and the Department of Human Resources. While those areas of HMO operation dealing with health care delivery will be monitored by the Commissioner, the quality of care and certain complaints which fall with…

Pursuant to O.C.G.A. Section 33-21-2(c)(1), any modification in the operation of the HMO which is not otherwise specifically referenced within this Regulation shall be filed prior to the modification. Examples of such changes would include, but not necessarily be limited to, serv…

If any section, term or provision of these Rules and Regulations shall be adjudged invalid for any reason, such adjudgement shall not affect, impair or invalidate any other section, term or provision of these Rules and Regulations and the remaining sections, terms and provisions …

(1) Violations of these Regulations by an HMO or an officer of the HMO shall be deemed grounds for the revocation of the HMO's certificate of authority as provided in O.C.G.A. Section 33-21-5, which shall be in addition to any other penalty provided by statute. (2) Violations of …

This Regulation is made and promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. Section 34-9-174.

(1) To provide for the establishment and regulation of Group Self- Insurance Funds by which Workers' Compensation Insurance benefits may be provided for employees of certain qualified associations or groups. (2) To protect the interests of the members of a Fund and those employee…

All terms defined in O.C.G.A. § 34-9-150et seq., hereinafter referred to as the "Group Self-Insurance Funds Act" or "Act", which are used in this Regulation shall have the same meaning as in the Act.

(1) At least thirty (30) days prior to forming a Group Self-Insurance Fund or signing the Intrastate Agreement, applicants shall first file with the Commissioner a "Notice of Intent to Form a Self- Insured Fund," referred to as form GSF-IN. The GSF-IN shall comply with O.C.G.A. §…

Each application for an original Certificate of Authority shall be made on Form GID-261-RS, entitled "Application for Certificate of Authority for Group Self-Insurance Fund." The application must be accompanied by all stipulated documents including, but not limited to: GID-261-RS…

Each application for renewal of a Certificate of Authority shall be made on or before the first day of March of each year on Form GID-254-RS entitled "Application for Renewal of Certificate of Authority for Group Self-Insurance Fund." It shall be accompanied by all stipulated doc…

(1) Each application for a Certificate of Authority shall be accompanied, for each member of the Fund, by a separate Form GID-263-RS or a comparable form containing the same information as the GID-263-RS, entitled "Application for Membership in Group Self-Insurance Fund." (2) Aft…

(1) A Fund may submit Termination Criteria to the Commissioner for approval. The criteria should stipulate reasons for terminating the relationship between the Fund and the member including, but not limited to, non-payment of premium, claims experience, and failure to report clai…

Each prospective officer, director or trustee of a Fund shall submit to the Fund and to the Commissioner a Form GID-265-RS, entitled "Application to Serve as Officer, Director or Trustee of Group Self-Insurance Fund".

Each prospective administrator of a Fund shall submit to the Fund and to the Commissioner a Form GID-266-RS, entitled "Application to Serve as Administrator of Group Self-Insurance Fund".

The following requirements must be met for the Intrastate Agreement to be properly executed: (a) The member must sign the signature page, or resolution if a government entity, certifying that: (1) The member subscribes to and abides by the Intrastate Agreement, the entire documen…

(1) The Commissioner may, in connection with any filing required by §120-2-34, submit a written request to the Fund within thirty (30) days of receipt for additional information needed to complete the review of the filing. (2) No filing shall be deemed complete until all such req…

(1) On or before the first day of March, each Fund shall file with the Commissioner financial statements on forms approved by the Commissioner. These forms shall relate to the financial condition of the Fund as of December 31st of the preceding calendar year. (2) Unless otherwise…

(1) The Commissioner or his representative may, upon good cause and prior notification to the Fund, either before granting a Certificate of Authority or at any time thereafter, examine the Fund for no more than the most recent five (5) years. The examination will include all affa…

(1) Each Fund granted a Certificate of Authority by the Commissioner shall be required to establish and maintain a security deposit as set forth in O.C.G.A. § 34-9-161. (2) Any surety bond pledged as security deposit must be on a Form GID-267-RS. (3) When a security deposit is pl…

(1) The Fund shall maintain a specific and aggregate excess loss funding program acceptable to the Commissioner. (2) A Fund shall submit a plan for funding excess losses which, in the opinion of the Commissioner, provides for stability and protection to the Fund members. Any subs…

(1) Each administrator shall have and maintain a fidelity bond in the amount of at least $100,000, as required by Rule , on Form GID-268-RS. (2) Each administrator shall have and maintain errors and omissions coverage or other appropriate liability insurance, written by an insure…

(1) Each administrator, trustee or officer of the Fund, or any employee or agent of any or all of them, shall submit to the Commissioner a copy of any proposed contract entitling him or her to any direct or indirect compensation from the Fund for services performed or sales or pu…

(1) The Fund shall obtain prior approval of the Commissioner for any proposed rate, rating plan, or rating rule to be used by the Fund to determine premium. The Fund shall make any proposed rate filing with the Commissioner thirty (30) days prior to the proposed effective date. T…

(1) The Fund shall maintain loss reserves computed in the same manner and upon the same basis as required by O.C.G.A. § 34-9-163(1) and (2) and shall report these reserves in all financial reports filed with the Commissioner. (2) The Annual Report shall include an actuarial opini…

(1) Dividends may be returned to the members of the Fund pursuant to O.C.G.A. § 34-9-162(d). (2) A dividend shall not be paid out of a specific Fund year which would cause the Fund to show an overall negative surplus.

Bona fide members of trade associations and professional associations as well as groups of municipalities, counties, school boards and hospital authorities may extend workers' compensation benefits to their employees through group self-insurance programs, or "Funds". Any Fund may…

Any Fund administrator failing to comply with the requirements of this Regulation shall be subject to such penalties as prescribed in O.C.G.A. § 34-9-173 or § 34-9-181. Furthermore, if the Commissioner has cause to believe that improper rates, classifications or experience modifi…

If any provision of this Regulation or the application thereof to any person or circumstance, is held invalid by a court of competent jurisdiction, the remainder of the Regulation or the applicability of such provision to other persons or circumstances shall not be affected. EXHI…

The purpose of this Regulation Chapter is to set forth guidelines for book-entry securities eligible for deposit under O.C.G.A. §§ 33-11-1et seq. and 33-12-4 and for deposits required under O.C.G.A. §§ 33-3-8 through 33-3-10.

For the purpose of this Regulation Chapter, book-entry securities shall mean the following: (a) Any United States obligations as specified in § 33-11-9 of the Official Code of Georgia Annotated which are issued in the form of any entry on the records of a Federal Reserve Bank or …

When any company licensed in Georgia is required to have a deposit of securities in this state in accordance with O.C.G.A. §§ 33-12-7 or pursuant to any rule or regulation of the Office of Commissioner of Insurance, the amount of such deposit required shall be at the market value…

Interest checks from issuing agents or institutions on bonds, notes, debentures or other securities on deposit shall be forwarded to the custodian bank. The interest shall be transmitted to the insurance company in a manner as previously agreed to by the Office of Commissioner of…

The Commissioner of Insurance may receive and retain the interest on deposit of a company licensed in Georgia which is placed in conservatorship, rehabilitation or receivership by its state of domicile and when the Commissioner has reason to believe that such company may potentia…

The custodian bank may process and release securities that are matured without written request from the company and where adequate replacement has been made. Bonds or notes eligible for book-entry or DTC will be converted to shares of the cash management account on the day of mat…

(1) Any company that has previously deposited securities may have its deposit returned provided that all of the following conditions have been met: (a) The company makes a written request to the custodian bank asking that its deposit be returned; and (b) The company submits certi…

Any company that has previously deposited securities may have its deposit partially released provided that all of the following conditions have been met: (a) The company makes a written request to the custodian bank asking that its deposit be returned; and (b) The Commissioner of…

Any company which has an existing deposit of securities with the Commissioner of Insurance or the custodian bank may make a substitution of all or part of its deposit, provided that all of the following conditions have been met: (a) The company desiring to replace securities shal…

Deposits of securities of a licensed company which is merged into another company will be transferred to the account of the surviving company by the amount of the deposit of the merged company. The custodian bank shall combine deposits in this manner only when instructed to do so…

Insurance companies are prohibited from selling securities which are on deposit with the Commissioner of Insurance or the custodian bank without the express written consent of the Commissioner prior to the sale and only after arrangements for replacements of equal value have been…

The Commissioner of Insurance and a designated custodian bank may enter into a contract detailing the services to be performed by the custodian bank. The Commissioner of Insurance and the custodian bank will jointly develop procedures and instructions detailing the rights and res…

If any provision of this Regulation Chapter or the application thereof to any particular person or any particular circumstances is held invalid by a court of competent jurisdiction, the remainder of the Regulation Chapter or the applicability of such provision to other persons or…