Georgia Administrative Code

This Regulation is issued pursuant to the authority vested in the Commissioner of Insurance by O.C.G.A. Sections 33-2-9 and 33-24-10.1.

The purpose of this Regulation Chapter is to implement the provisions of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, provide for a standardized form to be used in the billing and reimbursement of health care, reduce the number of forms utilized and increase …

(1) Except as otherwise specifically provided, this Regulation Chapter shall apply to all issuers, health care practitioners, and institutional care practitioners. (2) Nothing in this Regulation Chapter shall prohibit an issuer, health care practitioner or institutional care prac…

For the purposes of O.C.G.A. 33-24-10.1 and this Regulation Chapter: (a) "HCFA" means the Health Care Financing Administration of the United States Department of Health and Human Services. (b) "HCFA Form 1450" means the health insurance claim form maintained by HCFA for use by in…

(1) Health care practitioners and institutional care practitioners shall use and accept the most current editions of the HCFA Form 1450, HCFA Form 1500, or J512 Form and most current instructions for these forms in the billing of patients or their representatives and filing claim…

If any provision of this Regulation Chapter or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the Regulation Chapter and the application of such provision to other persons or circumstances shall not be affected thereby…

(1) On or before March 1 of each year, each insurer doing business in Georgia shall file an "Annual Premium Tax Return" on a form prescribed by the Commissioner, representing such insurer's insurance transactions necessary to complete such form. (2) Premium tax return shall be ac…

On or before March 1 of each year, each insurer claiming abatement of gross premium tax shall file with the Commissioner a calculation for abatement of gross premium tax on a form prescribed by the Commissioner.

On or before March 1 of each year, each domestic insurer claiming retaliatory tax credit shall file a statement in support of claims for retaliatory credit entitled "Statement in Support of Claim for Retaliatory Tax Credits" on a form prescribed by the Commissioner.

(1) Unless otherwise indicated, and to the extent provided, each filing required under this Regulation Chapter is to be made on forms or electronic format obtained from the Commissioner. (2) Forms may be reproduced and the format of the forms may be altered to accommodate manual …

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.

This rule is promulgated by the Commissioner of Insurance pursuant to Sections 33-2-9 and 33-3-21 of the Georgia Insurance Code.

(1) The purpose of this rule is to improve the Georgia Insurance Department's surveillance of the financial condition of insurers by requiring an annual examination by independent certified public accountants of the financial statements reporting the financial position and the re…

(1) "Accountant" or "independent certified public accountant" means an independent certified public accountant or accounting firm in good standing with the American Institute of Certified Public Accountants (AICPA) and in all states in which they are licensed to practice; for Can…

(1) All insurers shall have an annual audit by an independent certified public accountant and shall file an Audited financial report with the Commissioner on or before June 1 for the year ended December 31 immediately preceding. The Commissioner may require an insurer to file an …

(1) The annual Audited financial report shall report the financial position of the insurer as of the end of the most recent calendar year and the results of its operations, cash flows and changes in capital and surplus for the year then ended in conformity with statutory accounti…

(1) Each insurer required by this rule to file an annual Audited financial report must within sixty (60) days after becoming subject to such requirement, register with the Commissioner in writing the name and address of the independent certified public accountant or accounting fi…

(1) The Commissioner shall not recognize any person or firm as a qualified independent certified public accountant if that person or firm: (a) Is not in good standing with the AICPA and in all states in which the accountant is licensed to practice, or, for a Canadian or British c…

An insurer may make written application to the Commissioner for approval to file audited consolidated or combined financial statements in lieu of separate annual audited financial statements if the insurer is part of a group of insurance companies which utilizes a pooling or one …

Financial statements furnished pursuant to hereof shall be audited by an independent certified public accountant. The audit of the insurer's financial statements shall be conducted in accordance with generally accepted auditing standards. In accordance with AU Section 319 of the …

(1) The insurer required to furnish the annual Audited financial report shall require the independent certified public accountant to report, in writing, within five (5) business days to the board of directors or its Audit committee any determination by the independent certified p…

(1) In addition to the annual audited financial Statements, each insurer shall furnish the Commissioner with a written communication as to any unremediated material weaknesses in its Internal control over financial reporting noted during the audit. Such communication shall be pre…

The accountant shall furnish the insurer in connection with, and for inclusion in, the filing of the annual Audited financial report, a letter stating: (a) That the accountant is independent with respect to the insurer and conforms to the standards of his or her profession as con…

(1) Workpapers are the records kept by the independent certified public accountant of the procedures followed, the tests performed, the information obtained, and the conclusions reached pertinent to the audit of the financial statements of an insurer. Workpapers, accordingly, may…

This section shall not apply to foreign or alien insurers licensed in this state or an insurer that is a SOX Compliant Entity or a direct or indirect wholly-owned subsidiary of a SOX Compliant Entity. (a) The Audit committee shall be directly responsible for the appointment, comp…

(1) Exemption - An insurer is exempt from the requirements of this section if: (a) The insurer has annual direct written and unaffiliated assumed premium, including international direct and assumed premium but excluding premiums reinsured with the Federal Crop Insurance Corporati…

(1) No director or officer of an insurer shall, directly or indirectly: (a) Make or cause to be made a materially false or misleading statement to an accountant in connection with any audit, review or communication required under this regulation; or (b) Omit to state, or cause an…

(1) Every insurer required to file an Audited financial report pursuant to this regulation that has annual direct written and assumed premiums, excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of $500,000,000 or more shall prepar…

(1) Upon written application of any insurer, the Commissioner may grant an exemption from compliance with this rule if the Commissioner finds, upon review of the application, that compliance with this rule would constitute a financial or organizational hardship upon the insurer. …

(1) In the case of Canadian and British insurers, the Annual audited financial report shall be defined as the annual statement of total business on the form filed by such companies with their domiciliary supervision authority duly audited by an independent chartered accountant. (…

If any section or portion of a section of this rule or the applicability thereof to any person or circumstance is held invalid by a court, the remainder of the rule or the applicability of such provision to other persons or circumstances shall not be affected thereby.

This rule is adopted and promulgated by the Commissioner of Insurance pursuant to Sections 33-2-9 and 33-7-14 of the Georgia Insurance Code.

(1) The Georgia Insurance Department recognizes that licensed insurers routinely enter into reinsurance agreements that yield legitimate relief to the ceding insurer from strain to surplus. (2) However, it is improper for a licensed insurer, in the capacity of ceding insurer, to …

This Regulation shall apply to all domestic life and accident and health insurers and to all other licensed life and accident and health insurers which are not subject to a substantially similar regulation in their domiciliary state. This regulation shall also similarly apply to …

(1) No insurer subject to this regulation shall, for reinsurance ceded, reduce any liability or establish any asset in any financial statement filed with the Department if, by the terms of the reinsurance agreement, in substance or effect, any of the following conditions exist: (…

(1) No reinsurance agreement or amendment to any agreement may be used to reduce any liability or to establish any asset in any financial statement filed with the Department, unless the agreement, amendment or a letter of intent has been duly executed by both parties no later tha…

Insurers subject to this Regulation shall reduce to zero by December 31, 1995, any reserve credits or assets established with respect to reinsurance agreements entered into prior to the effective date of this regulation which, under the provisions of this regulation would not be …

Any insurer which violates or fails to comply with any provision of this regulation will be subject to fines and penalties applicable to licensed insurers generally, including revocation of its license or right to do business in this State.

If any section or portion of a section of this rule or the applicability thereof to any person or circumstance is held invalid by a court, the remainder of the rule or the applicability of such provision to other persons or circumstances shall not be affected thereby.

This regulation is adopted and promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. Sections 33-2-9, 33-52-3 and 33-52-6.

The purpose of this regulation is to implement Chapter 52 of Title 33 of the Official Code of Georgia Annotated to provide for the regulation of the transfer and novation of contracts of insurance by way of assumption reinsurance. This chapter sets forth a "Notice of Transfer" an…

"Applicant" means either the transferring or the assuming insurer required to submit the "Application for Approval of Assumption Reinsurance Agreement" based on the following criteria: (a) If both insurers are licensed to transact the business of insurance in the State of Georgia…

Notice in forms identical or substantially similar to the "Notice of Transfer" and "Second Notice of Transfer," attached hereto and incorporated herein as "EXHIBIT A" and "EXHIBIT B" respectively, shall be deemed to comply with the requirements of O.C.G.A. Section 33-52-3(a).

The following items shall be submitted to the Commissioner of Insurance: (a) A completed Form GID-67, entitled the "Application for Approval of Assumption Reinsurance Agreement," attached hereto and incorporated herein as "EXHIBIT C"; and (b) A copy of the proposed notices of tra…

Any insurer which violates or falls to comply with any provision of this regulation will be subject to fines and penalties applicable to licensed insurers generally, including revocation of its license or right to do business in this State.

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

This rule is adopted and promulgated by the Commissioner of Insurance pursuant to O.C.G.A. Secs. 33-2-9 and 33-40-1 through 33-40-21.