Georgia Administrative Code

All underwriting questions must be phrased in such a manner as to elicit a factual response. For example: A question such as: "Do you have any immunodeficiency disorders?" is too broad and would not be readily understood by an applicant and is not designed to elicit a factual ans…

(1) No health insurance policy, individual or group, may contain a provision which excludes expenses due to AIDS or ARC or places lower limits on the benefits available if the insured is being treated for AIDS or ARC under the policy. "Limits" would include, but not be limited to…

Whenever an applicant is requested to take an AIDS-related test in connection with an application for insurance, the use of such a test must be revealed to the applicant and his or her written consent obtained. No adverse underwriting decision shall be made on the basis of a posi…

This Chapter is promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A §§ 33-30-27, 33-29-3.2, 33-29-3.4 and 33-2-9.

The purposes of this Chapter are: (a) To regulate individual and group accident and sickness insurance plans, providing for differentials in benefit levels payable for preferred and non-preferred providers. (b) To protect the interests of the enrolled public. (c) To provide for d…

(1) "Co-pay" means a discrete, specified dollar amount an insured must pay for specified covered services at the time of service. (2) "Preferred Benefits" means services and/or benefits due or payable when the insured seeks covered health care services from a Preferred Provider i…

(1) Preferred provider arrangements shall contain provisions for the continuous review of the utilization of services and facilities, and costs. (2) Each individual policy or group preferred provider insurance policy shall contain a provision that the policyholder is entitled to …

(1) In no event may a health care insurer deny at least non-preferred level of covered benefit reimbursement to an insured for services provided by a nonpreferred provider on the grounds that the insured was not referred to a preferred provider by a person acting on behalf of or …

(1) In accordance with the Rules and Regulations of the Office of Commissioner of Insurance §, every group policy or contract, certificate, rider, endorsement, and application to be issued, delivered, or issued for delivery in this State in connection with a health plan having a …

Only preferred provider arrangements and preferred provider insurance policies which contain payment plans for preferred providers and nonpreferred providers and insurance policy provisions conforming to the provisions of Article 2 of Chapter 30 of Title 33 or other applicable se…

(1) The health care insurer shall provide each insured individual or group member with a current preferred provider roster or directory of health care providers under contract to provide services at alternative rates under the health care benefit plan. The roster shall be updated…

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

Any insurer, or any agent, counselor, representative, officer, of employee of such insurer failing to comply with the requirements of this Regulation Chapter shall be subject to such penalties as may be appropriate under the insurance laws of this State.

(1) Any person required to register as a rental preferred provider network must submit the requisite forms in accordance with the instructions on the Commissioner's website. (2) All registrations must be renewed on an annual basis by July 1st of each year per the instructions on …

This Chapter is promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. § 33-41-23.

The purpose of this Chapter is to provide for the establishment and regulation of captive insurance companies.

(1) "Commissioner" means the Commissioner of Insurance of the State of Georgia. (2) "Captive manager" means a third party person that is designated to manage a captive insurance company and to correspond with the Commissioner regarding the business of such company. (3) "Captive i…

(1) Each application for a certificate of authority shall be made on the appropriate form prescribed by the Commissioner and found on the Commissioner's website. It shall be accompanied by all required documents. The application and related documents are subject to review and wri…

(1) Authorization Required. No person shall, in or from within this state, act as a service provider without the authorization of the Commissioner. Application for such authorization must be made by completing the appropriate application form, which can be found on the Commission…

(1) General Requirement - Direct or Indirect Control. Each officer, director, and each owner of more than ten percent (10%) of the outstanding shares of stock of a company with management rights and duties, including, but not limited to the right to vote upon and appoint members …

(1) Annual Reports Requirement for Pure Captives. On or before March 1, all companies doing business in this state shall annually submit to the Commissioner a report of its financial condition as of December 31 of the calendar year preceding then verified by oath by an executive …

(1) Examinations Generally. The Commissioner or his or her representative may examine a company at any time the Commissioner deems appropriate, but no less frequently than once every five (5) years unless the Commissioner makes a written finding that a longer period is warranted …

(1) Audit Requirement. Each captive insurance company shall engage an independent certified public accountant authorized by the Commissioner to conduct a comprehensive audit and shall file such audited financial report with the Commissioner on or before June 30th of each year. Th…

(1) Compliance Generally. Letters of credit must comply with this Regulation. (2) Defined Terms. As used in this Rule, the terms below shall have the following meaning: (a) "Applicant" means the party who applies for and causes the bank to issue the letter of credit. (b) "Benefic…

(1) Original Plan of Operation. The plan of operation shall be submitted in accordance with the Commissioner's instructions which are available on the Commissioner's website. (2) Changes to Plan of Operation. Any material change to the company's management or operations, includin…

(1) License Fee. A license fee of $600 shall be paid at the time of the filing of an Application for Certificate of Authority, for a Captive Insurance Company. (2) Renewal Fee. A renewal fee of $500 shall be due for each year after initial licensure of a company.

(1) Premiums Collected Prior to July 1, 2015. Companies shall file a premium tax return and pay premium taxes in accordance with Chapter 8 of Title 33 for all direct premiums collected prior to July 1, 2015. (2) Premium Collected On or After July 1, 2015. Companies shall file a p…

(1) General Requirements. Each company is required to adopt a conflict of interest policy statement for its officers, directors, and key employees. There shall be filed one informational copy filed with the Commissioner with the company's Application for Certificate of Authority …

(1) Dividends Generally. All shareholder dividends or distributions shall be filed with the Commissioner for approval using the form provided by the Commissioner at least thirty (30) days prior to the proposed payment or distribution date. No dividend payment or distribution can …

No tender offer for or a request or invitation for tenders of, or enter into any agreement to exchange securities for, seek to acquire, or acquire in the open market or otherwise, any voting security of a captive insurance company shall be effective without the prior written appr…

(1) Authorized Redomestication Procedures. A foreign or alien captive insurance company, upon approval of the Commissioner, may become a captive insurance company authorized to transact business in this state by complying with all of the requirements of the Georgia law relative t…

(1) Required Notice. No company may make a loan to or an investment in its parent company or affiliates unless the company has notified the Commissioner in writing of its intention to enter into such transaction at least thirty (30) days prior thereto, or such shorter period as t…

A person is prohibited from transacting insurance in this state without first obtaining a certificate of authority to operate as a captive insurance company or registering as a risk retention group. Failure to obtain a certificate of authority or make the required registration is…

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.

The purpose of this Chapter is promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. Sections 33-2-9 and 40-9-101.

To implement O.C.G.A. Section 40-9-101 and to provide for the regulation of automobile self-insurers by the Commissioner of Insurance.

(1) An application for self-insurance shall be made on an approved form to the Commissioner of Insurance. The application shall contain: (a) A list of all vehicles registered in the name of the applicant including the make, model, year, manufacturer's identification number, title…

(1) Upon approval of the application by the Commissioner of Insurance, a certificate of self-insurance may be issued. Approval shall be conditioned upon a showing of sufficient net worth, sufficient claims handling procedures, and a guarantee of compliance with the "Georgia Motor…

(1) A self-insurer shall be required to submit quarterly reports showing the vehicles covered under the certificate of self-insurance. Such reports shall be due on January 1, April 1, July 1, and October 1 of each year. (2) Quarterly reports of vehicles shall specify additions to…

All certificates issued or renewed by the Commissioner of Insurance on or after July 1, 1989, shall conform to the rules contained in this Chapter. All certificates of self-insurance shall expire one year from the date of issuance. In order to be issued a new certificate on such …

A certificate of self-insurance may be revoked by the Commissioner of Insurance upon the following grounds: (a) The self-insurer has failed to satisfy any judgment within thirty (30) days after such judgment has become final; (b) The self-insurer has failed to pay any claim for w…

The Commissioner of Insurance shall: (a) Notify the Department of Public Safety of any self-insurance certificate which is revoked pursuant to this Chapter; (b) Notify the Department of Public Safety of the name of any self-insurer who does not reapply for a certificate of self-i…

All hearings and administrative proceedings involving self-insurers under this Chapter or under applicable laws pertaining to self-insurers shall be under such procedures as are set forth in O.C.G.A. Title 33 and the Rules and Regulations of the Georgia Insurance Department.

This Regulation is made and promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. Section 33-7-6.

The purpose of this Regulation is to provide for the regulation of vehicle service agreements and extended warranty agreements.

(1) "Commissioner" means the Commissioner of Insurance. (2) "Extended warranty agreement" means a vehicle service contract. (3) "Service contract holder" means a person who purchases or otherwise obtains a service contract. (4) "Vehicle service contract" or "VSC" means a contract…

A service contract shall not be issued, sold, or offered for sale in this State unless the provider of the service contract is a named insured under a service contract reimbursement insurance policy issued by an insurer authorized to do business in this state, or by a surplus lin…