Georgia Administrative Code

This regulation is issued pursuant to the authority vested in the Commissioner of Insurance of the State of Georgia under O.C.G.A. §§ 33-2-9 and 33-10-13. This Regulation will take effect for annual statements for the year 2010.

(1) This regulation shall apply to all life insurance companies and fraternal benefit societies doing business in this State and to all life insurance companies and fraternal benefit societies that are authorized to reinsure life insurance, annuities or accident and health insura…

(1) "Actuarial Opinion" means the opinion of an appointed actuary regarding the adequacy of the reserves and related actuarial items based on an asset adequacy analysis in accordance with of this regulation and with applicable Actuarial Standards of Practice. (2) "Actuarial Stand…

(1) Submission of Statement of Actuarial Opinion. (a) There is to be included on or attached to Page 1 of the annual statement for each year beginning with the year in which this regulation becomes effective the statement of an appointed actuary, entitled "Statement of Actuarial …

(1) General Description. The statement of actuarial opinion submitted in accordance with this section shall consist of: (a) A paragraph identifying the appointed actuary and his or her qualifications (see Subsection (2)(a)); (b) A scope paragraph identifying the subjects on which…

(1) General. (a) In accordance with O.C.G.A. § 33-10-13(b.1), the appointed actuary shall prepare a memorandum to the company describing the analysis done in support of his or her opinion regarding the reserves. The memorandum shall be made available for examination by the Commis…

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, or 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.

This Regulation Chapter is adopted and promulgated by the Commissioner of Insurance pursuant to authority set forth in O.C.G.A. §§ 33-2-9, 33-20-5 and 33-20-32.

The intent of this Regulation is to set forth those requirements for provider sponsored health care corporations which are established in accordance with the provisions of Chapter 20 of Title 33 of the Official Code of Georgia Annotated for the purpose of providing medical servic…

Unless otherwise provided, terms referenced in this Regulation are used as defined in O.C.G.A. §§ 33-1-2 and 33-20-3. Other terms are used in accordance with the Georgia Insurance Code and the Rules and Regulations of the Office of Commissioner of Insurance. (a) "Basic Rates" is …

A provider sponsored health care corporation may be established by providers for the purpose of providing health care services to enrollees or subscribers in this State under the provisions of Chapter 20 of Title 33 of the Official Code of Georgia Annotated. Such entity may be a …

(1) Each provider sponsored health care corporation shall obtain a certificate of authority from the Commissioner prior to establishing, maintaining and operating a health care plan in this State. In addition to the documents and information set forth in O.C.G.A. § 33-20-8, each …

(1) Subscriber Surplus Requirements. (a) A provider sponsored health care corporation shall have an initial net worth of at least one million dollars ($1,000,000) and shall thereafter maintain the minimum subscriber surplus required pursuant to O.C.G.A. § 33-20-13(d). (b) The Com…

Any provider sponsored health care corporation issued a license shall file annual and quarterly financial statements using forms prescribed by the Commissioner pursuant to O.C.G.A. § 33-20-24. The annual financial report is due March 1 each year and the quarterly statements are d…

(1) An agent representing a provider sponsored health care corporation must comply with all of the requirements for a life, accident and sickness agent in O.C.G.A. § 33-23-1et seq. and have a current license and certificate of authority to represent the health care corporation. (…

Any provider sponsored health care corporation which is part of an insurance company holding system must make all required filings and disclosures mandated by Chapter 13 of Title 33.

Any changes to the name, address, legal structure, provider contracts, rates, services area(s), enrollee contracts, composition and identity of directors and principal officers must be filed with the Commissioner at least thirty (30) days prior to the intended effective date of t…

Any person failing to comply with the requirements of this Regulation Chapter shall be subject to penalties and other enforcement action as may be appropriate under the insurance laws of the State of Georgia as well as any other applicable Georgia law.

If any provision of this Regulation Chapter or the application thereof to any person or 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 or circumstances shall not …

(1) Insurance may be sold by certain lending institutions, bank holding companies, or subsidiaries or affiliates of either of the foregoing doing business in this State. However, insurance is underwritten by insurers and sold by insurance agents. Therefore, the purpose of this Re…

As used in this Regulation Chapter, the term: (a) "Agency" means a person, including corporations, subsidiary corporations, partnerships, non-natural persons, etc., associated with or in the form of a financial institution who represents one or more insurers and is engaged in the…

(1) Prior to marketing insurance products, a financial institution shall provide notification to the Department of Insurance on Form GID 423FI and file a copy with the Department of Banking and Finance (DBF). Such report shall: (a) Identify any financial institution location wher…

(1) The conduct of insurance transactions in association with a financial institution shall be subject to the requirements of O.C.G.A. § 33-23-3 and Georgia Insurance Department Regulation . (2) Each financial institution where a licensed and appointed insurance agent is engaged …

(1) Any individual soliciting, selling or marketing insurance products to individuals permanently or temporarily residing in this state must be licensed and appointed as an insurance agent in accordance with the provisions of the Georgia Insurance Code and Georgia Insurance Depar…

Nothing in this Regulation Chapter shall authorize a state or federally chartered bank or other federally insured lending institution to itself directly assume the obligation to provide the benefits of an insurance contract or otherwise undertake to perform the obligations of an …

(1) If insurance is sold on the premises of a financial institution, the area utilized by an insurance agent for such transactions must be sufficiently segregated and distinct from areas utilized by the financial institution for accepting insured deposits so as to avoid confusion…

(1) Any insurer marketing insurance in association with one or more financial institutions shall notify the Office of Commissioner of Insurance in writing of the existence of such program(s).

(1) Only a licensed and appointed agent shall: (a) solicit the sale of insurance or describe the benefits of the insurance contract or otherwise describe the terms of coverage including premiums or rates of return; (b) provide an application, enrollment form or other document by …

If employees of the financial institution that have contact with the general public or financial institution customers with respect to lending, checking, deposit taking, or trust activities are licensed as insurance agents to sell insurance, in addition to the other disclosures r…

(1) Only a licensed agent or insurance agent may accept the initial premium paid for an insurance contract. (2) A financial institution or affiliate may, at the request of the purchaser, send premium billings or notices to purchasers and debit the purchaser's account or credit ar…

(1) Any financial institution may contract with agents or an insurance agency on a full-time or part-time basis for the sale of insurance products from bank locations. Such agents shall be appointed by the licensed insurers issuing and underwriting the insurance product. Commissi…

Licensed independent agents may be paid by an insurer for their activities in connection with the sale of insurance. The insurer and agent shall independently determine the terms of the agent contract including compensation.

(1) An insurance agent marketing insurance is responsible for maintaining such records as are necessary to enable the Department to determine that transactions under his or her license comply with all applicable requirements of the insurance code and for making such records avail…

(1) Advertisements of insurance products marketed pursuant to this regulation shall be subject to the provisions of O.C.G.A. § 33-6-1et seq. and other applicable Georgia law and Insurance Department and Department of Banking and Finance regulations. (2) No licensed or unlicensed …

(1) Premium notices, notices of cancellation, renewal notices, statements of values or other communications relating to in-force insurance shall be separated from financial institution account information. (2) A financial institution shall not provide to an affiliated insurance a…

Disclosures to the customer must be made in accordance with Department of Banking and Finance Regulation .

Endorsements, announcements, or advertisements regarding insurance by a financial institution in conjunction with an agent or insurer, communicated to financial institution customers or prospective customers by direct mail or otherwise shall be subject to the requirements of O.C.…

(1) Tying availability of credit, establishment or maintenance of a trust account or deposit account, or the provision of other traditional bank products from a lending institution to the purchase of insurance from that lending institution is not permitted. Federal bank on these …

In addition to the statutes and rules referenced herein products and transactions addressed by these Rules shall be subject to all applicable provisions of Title 33 and Title 7 of the Official Code of Georgia Annotated.

Any person, insurer, agent, agency, or financial institution violating the provisions of this Regulation Chapter shall be subject to the administrative actions and procedures, including but not limited to suspension, fine, revocation of license, as provided to the Commissioner of…

If any provision of this Regulation Chapter or the application of it to any person or circumstance is held invalid, such invalidity shall not affect the provisions or applications of the rules herein which can be given effect without the invalid portion. To that end, the provisio…

The purpose and intent of this Regulation Chapter is to specifically recognize that the adherence to manual rules may not adequately service the unique needs of certain large commercial insurance risks and to permit, but not mandate, negotiated departure from manual rates for cer…

Classifications, rates, and premiums developed in full compliance with this Regulation Chapter shall not be considered as filed and approved for the purpose of interpreting O.C.G.A. § 33-6-5(6)(B).