Georgia Administrative Code

This regulation is promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. §§ 33-59-1et seq.

(1) This regulation applies to any Provider of a Life Settlement Contract and any Life Settlement Broker as those terms are defined in O.C.G.A. § 33-59-2 as well as any person who enters into a life settlement contract with an owner of a policy or who facilitates any life settlem…

All terms defined in O.C.G.A. § 33-59-1et seq., hereinafter referred to as the "Life Settlements Act" or "Act" which are used in this Regulation shall have the same meaning as in the Act.

(1) Except as provided for in O.C.G.A. § 33-59-2(18), it is unlawful for any person to enter into a life settlement contract with an owner of a policy or to hold oneself out as a provider in this state without a valid provider license issued by the Commissioner of Insurance. To q…

(1) Each provider shall file with the Commissioner an annual renewal application by May 1st of every year. The renewal application shall include information and documents and other materials the Commissioner deems necessary to adequately assess the renewal application. (2) Each p…

(1) The Commissioner may conduct an examination of the business affairs of any licensee, registrant or applicant under this chapter as often as the Commissioner in his or her sole discretion deems appropriate with all expenses incurred to be paid by the licensee, registrant or ap…

(1) A provider shall comply with the requirements of this Chapter and O.C.G.A. §§ 33-59-1et seq. and shall not engage and or deal with any person to perform the functions of a life settlement broker as defined at O.C.G.A. § 33-59-2(10) unless such person holds a current, valid re…

(1) Life insurance companies are permitted to ask questions of any life insurance applicant as to whether the proposed owner is intending to finance the premiums with the assistance of financing from a lender that will use the policy as collateral to support the financing. The li…

(1) Any person failing to comply with the requirements of this Chapter and O.C.G.A. §§ 33-59-1et seq. shall be subject to all such penalties and relief as may be appropriate under the laws of this State. Furthermore, a violation of this Chapter shall be considered an unfair trade…

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 person or circumstances shall not be affected.

(1) The purpose of this regulation is to require producers, as defined in this regulation, to act in the best interest of the consumer when making a recommendation of an annuity and to require insurers to establish and maintain a system to supervise recommendations so that the in…

This regulation shall apply to any sale or recommendation of an annuity.

This regulation is issued under the authority of O.C.G.A. Sections 33-2-9, 33-6-4 and 33-6-12.

Unless otherwise specifically included, this regulation shall not apply to transactions involving: (1) Direct response solicitations where there is no recommendation based on information collected from the consumer pursuant to this regulation; (2) Contracts used to fund: (a) An e…

(1) "Annuity" means an annuity that is an insurance product under State law that is individually solicited, whether the product is classified as an individual or group annuity. (2) "Cash compensation" means any discount, concession, fee, service fee, commission, sales charge, loa…

(1) Best Interest Obligations. A producer, when making a recommendation of an annuity, shall act in the best interest of the consumer under the circumstances known at the time the recommendation is made, without placing the producer's or the insurer's financial interest ahead of …

(1) A producer shall not solicit the sale of an annuity product unless the producer has adequate knowledge of the product to recommend the annuity and the producer is in compliance with the insurer's standards for product training. A producer may rely on insurer-provided product-…

(1) An insurer is responsible for compliance with this regulation. If a violation occurs, either because of the action or inaction of the insurer or its producer, the commissioner may order: (a) An insurer to take reasonably appropriate corrective action for any consumer harmed b…

(1) Insurers, general agents, independent agencies and producers shall maintain or be able to make available to the commissioner records of the information collected from the consumer, disclosures made to the consumer, including summaries of oral disclosures, and other informatio…

The amendments to this regulation shall take effect six (6) months after the date the regulation is adopted or on July 1, 2023, whichever is later.

This Regulation is made and promulgated by the Commissioner of Insurance pursuant to the authority set forth in Sections O.G.G.A. §§ 33-2-9, 33-6-12, and 33-6-4(b)(14.1).

(1) The purpose of this regulation is to set forth standards to protect active duty service members of the United States Armed Forces from dishonest and predatory insurance sales practices by declaring certain identified practices to be dishonest, unfair, or deceptive. (2) Nothin…

This regulation shall apply only to the solicitation or sale of any life insurance or annuity product by an insurer or insurance producer to an active duty service member of the United States Armed Forces.

(1) This regulation shall not apply to solicitations or sales involving: (a) Credit insurance; (b) Group life insurance or group annuities where there is no in-person, face-to-face solicitation of individuals by an insurance producer or where the contract or certificate does not …

(1) "Active Duty" means full-time duty in the active military service of the United States and includes members of the reserve component (National Guard and Reserve) while serving under published orders for active duty or full-time training. The term does not include members of t…

(1) The following acts or practices when committed on a military installation by an insurer or insurance producer with respect to the in-person, face-to-face solicitation of life insurance are declared to be dishonest, unfair, or deceptive: (a) Knowingly soliciting the purchase o…

(1) The following acts or practices by an insurer or insurance producer constitute corrupt practices, improper influences or inducements and are declared to be dishonest, unfair, or deceptive: (a) Submitting, processing or assisting in the submission or processing of any allotmen…

If any provision of these sections or the application thereof to any person or circumstance is held invalid for any reason, the invalidity shall not affect the other provisions or any other application of these sections which can be given effect without the invalid provisions or …

This regulation shall become effective September 1, 2007, and shall apply to acts or practices committed on or after the effective date.

O.C.G.A. Section 33-51-2(1) authorizes the Commissioner of Insurance to "establish flexible guidelines" for HSA-High Deductible Health Plan filings submitted in connection with products that incorporate health promotion and wellness principles. Within the provisions of Chapter 33…

Under this Rule, a health insurance policy, which satisfies Internal Revenue Code requirements for a High Deductible Health Plan, may be used by an insurer in connection with a Wellness Program and with a Health Savings Account program. Health insurance product categories include…

(1) Preferred Provider Organization ("PPO") products offered under O.C.G.A. Section 33-51-5 may contain greater percentage differentials between preferred and non-preferred providers than the 30% percentage differential limitations under Rule . Notwithstanding O.C.G.A. Section 33…

Examples of plans that will not be allowable or approved under O.C.G.A. Section 33-51-2 would include, but not be limited to: (1) limited benefit insurance products, as defined in O.C.G.A. Section 33-30-12, where the term "limited benefit insurance" means accident and sickness in…

(1) Insurers proposing products for consideration and potential approval under O.C.G.A. Chapter 33-51 and this Rule shall, in cover letters or their equivalent if filed electronically under SERFF, indicate their intent and shall: (a) describe the type of comprehensive or major me…

This Regulation is promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. §§ 33-2-9 and 33-64-1 et seq. All terms defined in O.C.G.A. § 33-64-1, hereinafter referred to as the Pharmacy Benefits Managers Act, which are used in this Regulation,…

(1) This Regulation applies to any pharmacy benefits manager as defined in O.C.G.A. § 33-64-1. (2) The purposes of this Regulation include: (a) Providing the regulation and licensure of pharmacy benefits managers; (b) Promoting the financial responsibility of pharmacy benefits ma…

(1) It is unlawful for any person, business entity, or other entity to act as or hold itself out to be a pharmacy benefits manager in this State without a valid license issued by the Commissioner of Insurance. To qualify for and hold a license to act as a pharmacy benefits manage…

(1) Every pharmacy benefits manager shall file a bond with the Commissioner. The pharmacy benefits manager shall file a certificate of such bond, in a form acceptable by a corporate surety insurer authorized to transact insurance in this state in favor of Commissioner of Insuranc…

(1) Each authorized pharmacy benefits manager shall file with the Commissioner an annual renewal of its license on a form prescribed by the Commissioner. The statement shall be filed annually on or before May 1. The annual renewal shall be in such form and contain such matters as…

(1) The Commissioner or his or her designated representative is authorized to conduct financial examinations, compliance audits, and investigate complaints of the affairs of each pharmacy benefits manager as often as is deemed necessary. Whenever the Commissioner shall deem it ex…

(1) Standard pharmacy benefits manager forms are required and will be supplied upon request by the Commissioner's office either in paper form or electronically over the internet. Applicants and licensed pharmacy benefits managers shall utilize all applicable forms in preparing ap…

(1) Any person, business entity, or other entity acting as a pharmacy benefits manager without a license shall be subject to a monetary penalty of up to $2000.00 for each and every transaction in violation of the chapter. Any person, business entity, or other entity willfully act…

If any provision of this Regulation Chapter, or the application thereof to any person, business entity, or other entity or circumstance, is held invalid by a court of competent jurisdiction, the remainder of the Regulation Chapter or the applicability of such provision to other p…

Section 1003 of the Patient Protection and Affordable Care Act directs the Secretary of the Department of Health and Human Services ("HHS"), in conjunction with the States, to establish a process for the review of unreasonable health insurance rate increases. The federal regulati…

(1) "CMS" means the Centers for Medicare & Medicaid Services. (2) "Health benefit plan" has the same meaning as O.C.G.A. § 33-24-59.5(2) as that term is modified by the provisions of O.C.G.A. § 33-1-2(1.1) but does not include coverage offered by a person not subject to the juris…

Only rate increases for health benefit plans that are equal to or exceed 10% are subject to review under this regulation. The methodology for determining the amount of a rate increase prescribed in 45 C.F.R. § 154.200 shall be used to determine whether a rate increase is equal to…

In addition to other materials that are otherwise required to be filed, each insurer is required to file the following material for a rate increase subject to review: (1) The preliminary justification required by 45 C.F.R. § 154.215(b); (2) The documentary support for all assumpt…