Title 33 — Title 33
0 chapters · 1,218 sections in this title.
O.C.G.A. § 33-41-4 Prerequisites to transacting insurance
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No captive insurance company may transact any insurance in this state unless: (1) It first obtains from the Commissioner a certificate of authority authorizing it to transact insurance in this state; (2) It maintains its principal place of business in this state; 851 33-41-5 (3) An…
O.C.G.A. § 33-41-5 Incorporation
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(a) For purposes of this Code section, an incorporated protected cell, as defined in Article 2 of this chapter, shall be included in the definition of ‘‘captive insurance company.’’ (a.1)(1) A pure captive insurance company or an agency captive insurance company may be incorporated…
O.C.G.A. § 33-41-6 Name
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(a) A captive insurance company shall not use any name which is either similar, misleading, or confusing with respect to any other name already in use by any other captive insurance company, domestic mutual or stock insurance company, corporation, or association organized or doin…
O.C.G.A. § 33-41-7 Directors or managers
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(a) The affairs of every captive insurance company shall be managed by not less than three directors or managers. (b) At least one of the directors or managers of every captive insurance company shall be a resident of this state. (c) Every captive insurance company shall report t…
O.C.G.A. § 33-41-8 Amount of capital or surplus
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(a) The amount of minimum capital or surplus required for each captive insurance company shall be determined on an individual basis, however: (1) A pure captive insurance company shall maintain at least $250,000.00 in surplus; (2) An association captive insurance company shall ma…
O.C.G.A. § 33-41-9 Letters of credit
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(a) Any letter of credit used to meet the requirements set forth in this chapter shall be: (1) Clean, irrevocable, and unconditional; (2) Issued by a bank approved by the Commissioner, which is either a bank chartered by the State of Georgia or a national bank which is a member o…
O.C.G.A. § 33-42-1 Short title
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This chapter may be known and cited as the ‘‘Long-term Care Insurance Act.’’ History. — Code 1981, § 33-42-1, enacted by Ga. L. 1988, p. 1541, § 1. Cross references. — Georgia Long-term Care Partnership Program Act, § 49-4-160 et seq.
O.C.G.A. § 33-42-2 Purpose of chapter
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The purpose of this chapter is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance as defined from unfair or deceptive sales or enrollment practices, to establish standards for long-te…
O.C.G.A. § 33-42-3 Applicability of chapter
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The requirements of this chapter shall apply to long-term care insurance policies issued, delivered, or issued for delivery in this state. This chapter is not intended to supersede the obligations of entities subject to this chapter to comply with the substance of other applicabl…
O.C.G.A. § 33-42-4 Definitions
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As used in this chapter, the term: (1) ‘‘Applicant’’ means: (A) In the case of an individual long-term care insurance policy, the person who seeks to contract for such benefits; and (B) In the case of a group long-term care insurance policy, the proposed certificate holder. (2) ‘‘C…
O.C.G.A. § 33-42-5 Group policy issued in another state
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No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described in subparagraph (B) of paragraph (3) of Code Section 33-42-4 unless this state or another state having statutory and regulatory …
O.C.G.A. § 33-42-6 Short title, §33-42-1
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LONG-TERM HEALTH CARE. Accounts and accounting. Continuing care providers and facilities. Reporting requirements, §33-45-6. Administration by department of insurance. Continuing care providers and facilities, §33-45-4. Continuing care providers and facilities, §§33-45-1 to 33-45-…
O.C.G.A. § 33-42-7 Regulations
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Repealed by Ga. L. 2019, p. 533, § 1-6/HB 99, effective July 1, 2019. 884 33-42-7 LONG-TERM CARE INSURANCE Editor’s notes. — Ga. L. 2020, p. 493, § 33/SB 429, effective July 29, 2020, part of an Act to revise, modernize, and correct 33-42-7 the Code, deleted the reservation of th…
O.C.G.A. § 33-43-1 Definitions
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As used in this chapter, the term: (1) ‘‘Applicant’’ means: (A) In the case of an individual medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and (B) In the case of a group medicare supplement policy, the proposed certifica…
O.C.G.A. § 33-43-2 Applicability of chapter
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(a) Except as otherwise specifically provided, this chapter shall apply to: (1) All medicare supplement policies delivered or issued for delivery in this state; and (2) All certificates issued under group medicare supplement policies, which certificates have been delivered or issued…
O.C.G.A. § 33-43-3 Duplicate benefits prohibited; establishment of standards
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(a) No medicare supplement insurance policy or certificate in force in this state shall contain benefits which duplicate benefits provided by medicare. (b) Notwithstanding any other provision of Georgia law, a medicare supplement policy or certificate shall not exclude or limit benefi…
O.C.G.A. § 33-43-4 Reasonable return of benefits required; minimum standards for loss ratios
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Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The Commissioner shall issue reasonable regulations to establish minimum standards for loss ratios of medicare supplement policies on the basis of incurred …
O.C.G.A. § 33-43-6 Notice of right to return policy and of right to refund
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Medicare supplement policies or certificates shall have a notice prominently printed on the first page of the policy or certificate stating in substance that the applicant shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium …
O.C.G.A. § 33-43-7 AFFIDAVITS
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Fraternal benefit societies. Amendment of charters, constitutions or laws. Prima-facie evidence of amendments, §33-15-41. Insurance companies. Motor vehicle stolen, §33-1-15. Surplus line brokers. Filing of quarterly affidavits, §§33-5-29, 33-5-32. 1106 INDEX AFFIDAVITS —Cont’d Li…
O.C.G.A. § 33-43-8 Regulations
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Regulations adopted pursuant to this chapter shall be subject to the provisions of this chapter and Code Section 33-2-9. 894 33-43-9 History. — Code 1981, § 33-43-8, enacted by Ga. L. 1992, p. 1395, § 1. 33-43-9. Enforcement.
O.C.G.A. § 33-43-9 Enforcement
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In addition to any other applicable penalties for violations of this title, the Commissioner may require issuers violating any provision of this chapter or regulations promulgated pursuant to this chapter to cease marketing any medicare supplement policy or certificate in this sta…
O.C.G.A. § 33-45-1 Definitions
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As used in this chapter, the term: (1) ‘‘Continuing care’’ means furnishing pursuant to a continuing care agreement: (A) Lodging that is not: (i) In a skilled nursing facility, as such term is defined in Code Section 31-6-2; (ii) An intermediate care facility, as such term is defin…
O.C.G.A. § 33-45-10 Information disclosure requirements
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(a) Each facility shall maintain as public information, available upon request, a copy of its current disclosure statement and the disclosure and all previous disclosure statements that have been filed with the department. Each facility shall post in a prominent position in the fa…
O.C.G.A. § 33-45-11 Maintaining financial reserves; requirements
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(a) A provider or facility shall maintain financial reserves equal to 25 percent of the total operating costs of the facility projected for the 12 month period following the period covered by the most recent audited financial statements included in the disclosure statement required…
O.C.G.A. § 33-45-12 Actions for recovery of damages and attorney’s fees
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Any resident injured by a violation of this chapter may bring an action for the recovery of damages plus reasonable attorney’s fees. History. — Code 1981, § 33-45-11, enacted by Ga. L. 1990, p. 1817, § 1; Code 1981, § 33-45-12, as redesignated by Ga. L. 2011, p. 315, § 1/SB 166. …
O.C.G.A. § 33-45-13 Motor vehicle accidents
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Sale, release or solicitation of accident information, §33-24-53. Motor vehicle insurance. Staging a collision, filing related fraudulent claim, §33-1-9.1. Venue. Insurance fraud, §33-1-9. D DAMAGES. Genetic testing. Breaches of confidentiality, §33-54-8. DAMAGES —Cont’d Insurance …
O.C.G.A. § 33-45-14 Period of applicability of chapter
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Any contract or continuing care agreement executed before July 1, 1991, which is amended or renewed subsequent to July 1, 1991, and any contract or continuing care agreement executed on or after July 1, 1991, shall be subject to this chapter. History. — Code 1981, § 33-45-12, ena…
O.C.G.A. § 33-45-2 Use of powers; providers or facilities charging an entrance fee
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(a) For the purpose of enforcing the requirements of this chapter, the Commissioner and the department shall be authorized to use the powers granted in Chapters 1 and 2 of this title. (b) A provider or facility which charges a resident an entrance fee for lodging in a residential…
O.C.G.A. § 33-45-4 Administration by Insurance Department
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The administration of this chapter is vested in the department, which shall: (1) Prepare and furnish all forms necessary under the provisions of this chapter; (2) Collect in advance, and the applicant shall pay in advance at the time of filing, a fee for an application for a certi…
O.C.G.A. § 33-45-5 Application for approval or renewal of certificate of authority
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33-45-6. Annual revised disclosure statement; statement to be made available to all residents of facility; submission of other necessary information as determined by Commissioner. 33-45-7. Requirements for continuing care agreements, addenda, and amendments. 33-45-7.1. Provider a…
O.C.G.A. § 33-45-6 LYMPH NODE DISSECTION
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Health insurance. Breast cancer patient care generally, §§33-24-70 to 33-24-72. M MACHINERY. Insurance, §33-7-3. MAIL. Insurance companies. Public adjuster contracts, rescission, §33-23-43.1. Insurance policies, §33-24-14.
O.C.G.A. § 33-45-7 Requirements for continuing care agreements, addenda, and amendments
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(a) In addition to other provisions considered proper to effectuate any continuing care agreement, addendum, or amendment, each such agreement, addendum, or amendment shall be in writing and shall: (1) Provide for the continuing care or limited continuing care of only one residen…
O.C.G.A. § 33-45-9 Definitions, §33-45-1
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Department authority to remediate violations, §33-45-13. Disclosure requirements, §33-45-10. Financial reporting, §33-45-6. Entrance fee for lodging, facilities that charge, §33-45-2. Holding portion in escrow account, §33-45-8. Financial reporting requirements, §33-45-6. Financi…
O.C.G.A. § 33-46-1 Legislative purposes and intent
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(a) The purpose of this chapter is to promote the delivery of quality health care in Georgia. Furthermore, it is to foster the delivery of such care in a cost-effective manner through greater coordination between health care providers, claims administrators, payors, employers, pa…
O.C.G.A. § 33-46-10 Reporting requirements
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The Commissioner shall establish such reporting requirements upon private review agents as are necessary to determine if the utilization review programs are in compliance with the provisions of this chapter and applicable rules and regulations. History. — Code 1981, § 33-46-10, e…
O.C.G.A. § 33-46-11 Insurance companies
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Administrators. Licensing of administrators, §§33-23-104, 33-23-105. Agents, subagents, counselors and adjusters, §33-23-44. Corporate governance annual disclosure, §33-65-4. Division of domestic insurers, §33-14-128. Insider trading of domestic stock insurer equity securities, §…
O.C.G.A. § 33-46-12 Exemptions from certificate requirements
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No certificate is required for utilization review by any Georgia licensed pharmacist or pharmacy while engaged in the practice of pharmacy, including but not limited to review of the dispensing of drugs, participation in drug utilization review, and monitoring patient drug therapy…
O.C.G.A. § 33-46-13 Exemptions from applicability of chapter
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(a) This chapter shall not apply to any contract with the federal government for utilization and review of patients eligible for hospital services under Title XVIII or XIX of the Social Security Act. (b) This chapter shall not apply to any private review agent when such private r…
O.C.G.A. § 33-46-14 Commissioner to issue annual report
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The Commissioner shall issue an annual report to the Governor and the General Assembly concerning the conduct of utilization review in this state. Such report shall include a description of utilization review programs and the services they provide, an analysis of complaints filed …
O.C.G.A. § 33-46-2 Definitions
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As used in this chapter, the term: (1) ‘‘Certificate’’ means a certificate of registration granted by the Commissioner to a private review agent. (2) ‘‘Claim administrator’’ means any entity that reviews and determines whether to pay claims to enrollees of health care providers on …
O.C.G.A. § 33-46-3 Certification of private review agents; exemption
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(a) A private review agent may not conduct utilization review of health care provided in this state unless the Commissioner has granted the private review agent a certificate pursuant to this chapter. No individual conducting utilization review shall require certification if 920 33…
O.C.G.A. § 33-46-4 Requirements for certification
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As a condition of certification or renewal thereof, a private review agent shall be required to maintain compliance with the following: (1) The medical protocols including reconsideration and appeal processes as well as other relevant medical issues used in the private review prog…
O.C.G.A. § 33-46-5 Certificate application fees; information to be submitted with application
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(a) An applicant for a certificate shall submit an application on a form prescribed by the Commissioner and pay an application fee and a certificate fee as provided in Code Section 33-8-1. The application shall be signed and verified by the applicant. 922 33-46-6 (b) In conjunction …
O.C.G.A. § 33-46-6 Expiration and renewal of certificate
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(a) A certificate shall expire on the second anniversary of its effective date unless the certificate is renewed for a two-year term as provided in this Code section. (b) Before the certificate expires but no sooner than 90 days prior to such expiration, a certificate may be renewed …
O.C.G.A. § 33-46-7 Legislative purposes and intent
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Definitions. Certification of private review agents; exemption. Requirements for certification. Certificate application fees; information to be submitted with application. Expiration and renewal of certificate. Jurisdiction of Commissioner over private review agents.
O.C.G.A. § 33-46-8 Legislative declaration, §33-46-1
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Pharmacists and pharmacies. Exemption from certification requirement, §33-46-12. Purposes of provisions, §33-46-1. Reports. Commissioner of insurance. Annual report, §33-46-14. Establishment of reporting requirements, §33-46-10. Rules and regulations. Commissioner of insurance, §3…
O.C.G.A. § 33-46-9 Listings of certificate holders
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The Commissioner shall periodically, not less than once a year, provide a list of private review agents issued certificates and the renewal date for those certificates to all hospitals and to any other individual or organization requesting such list. History. — Code 1981, § 33-46-9…
O.C.G.A. § 33-47-1 Short title
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This chapter shall be known and may be cited as the ‘‘Managing General Agents Act.’’ History. — Code 1981, § 33-47-1, enacted by Ga. L. 1991, p. 1424, § 8. 33-47-2. Definitions.
O.C.G.A. § 33-47-2 Definitions
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As used in this chapter, the term: (1) ‘‘Actuary’’ means a person who is a member in good standing of the American Academy of Actuaries. (2) ‘‘Insurer’’ means an insurer as defined in Code Section 33-1-2. 927 33-47-3 (3)(A) ‘‘Managing general agent’’ means any person, firm, associa…
O.C.G.A. § 33-47-3 Short title
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Definitions. License required; surety bond; errors and omissions policy. 33-47-4. Written contract with insurer required; contents. 33-47-4.1. Fully earned policy fees.