Title 24, Insurance

[§431:10H-228.5] Disapproval of filings. If the commissioner finds that a filing does not meet the requirements of this chapter in whole or in part and disapproves the filing, a written request for a hearing may be filed pursuant to section 431:14G-112. The insurer shall bear the…

§431:10H-229 Standards for marketing. (a) Every insurer, health care service plan, or other entity marketing long-term care insurance coverage in this State, directly or through producers, shall: (b) In addition to the acts or practices prohibited in article 13, all of the follow…

§431:10H-230 Standards of marketing--certain group policies. (a) With respect to the obligations set forth in this section, the primary responsibility of an association as defined in paragraph (2) of the definition of "group long-term care insurance" under section 431:10H-104, wh…

§431:10H-231 Suitability. (a) This section shall not apply to life insurance policies that accelerate benefits for long-term care. (b) Every insurer, health care service plan, or other entity marketing long-term care insurance (the "issuer") shall: (c) To determine whether the ap…

[§431:10H-232] Prohibition against preexisting conditions and probationary periods in replacement policies and certificates. If a long-term care insurance policy or certificate replaces another long-term care insurance policy or certificate, the replacing issuer shall waive any t…

§431:10H-233 Nonforfeiture benefit requirement. (a) This section does not apply to life insurance policies containing accelerated long-term care benefits. (b) To comply with the requirement to offer a nonforfeiture benefit pursuant to section 431:10H-116, the following shall be m…

[§431:10H-234] Standards for benefit triggers. (a) A long-term care insurance policy shall condition the payment of benefits on a determination of the insured's ability to perform activities of daily living and on cognitive impairment. Eligibility for the payment of benefits shal…

[§431:10H-234.5] Additional standards for benefit triggers for qualified long-term care insurance contracts. (a) For purposes of this section, the following definitions apply: "Chronically ill individual" has the meaning prescribed for this term by section 7702B(c)(2)(A) of the I…

§431:10H-235 Standard format outline of coverage; group and individual policies. This section implements, interprets, and makes specific, the provisions of section 431:10H-112 in prescribing a standard format and the content of an outline of coverage, as follows:

§431:10H-236 Delivery of shopper's guide; group and individual policies. (a) A long-term care insurance shopper's guide in the format developed by the National Association of Insurance Commissioners, or a guide developed or approved by the commissioner, shall be provided to all p…

[§431:10H-237] Penalties. In addition to any other penalties provided by the laws of this State, any insurer or producer found to have violated any requirement of this State relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject…

PART III. FEDERAL CONFORMITY [§431:10H-301] Group long-term care insurance policies conformance to Health Insurance Portability and Accountability Act and Internal Revenue Code. (a) Every group long-term care insurance policy sold after June 30, 2000, may conform to Subtitle C of…

[§431:10H-302] Individual long-term care insurance policy coverages. (a) Every individual long-term care insurance policy sold after June 30, 2000, shall provide coverage for one or more of the types of care enumerated under section 431:10H-301(c). (b) An individual long-term car…

[§431:10H-303] Conflict with Health Insurance Portability and Accountability Act. If a conflict occurs between a provision of this article and the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, the provision shall be deemed amended …

[§431:10H-304] Disclosure of qualification for tax benefits. (a) Every policy that is intended to be a qualified long-term care insurance contract as provided in the federal Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, shall be identified…

PART IV. UNIVERSAL AVAILABILITY OF LONG-TERM CARE INSURANCE [§431:10H-401] Publicizing of policies. For purposes of section 371-16, upon request by an employer, labor organization, retiree organization, or other entity specified under the definition of "group long-term care insur…

[§431:10H-402] Purchase of policy and payment of premiums on an individual's behalf. An insurer shall allow a person to purchase an individual or group long-term care insurance policy and pay the premiums for an individual or group long-term care insurance policy that covers the …

ARTICLE 11 INSURANCE HOLDING COMPANY SYSTEM §431:11-101 Scope and purpose. (a) This article applies to all persons doing an insurance business in this State unless specifically exempted under subsection (b). (b) The commissioner may exempt: (c) The purposes of this article includ…

§431:11-102 Definitions. As used in this article, unless the context shall otherwise require: "Affiliate" (including affiliate of, or person affiliated with, a specific person) means a person that, directly or indirectly through one or more intermediaries, controls or is controll…

§431:11-103 Subsidiaries of insurers. (a) Any domestic insurer, either by itself or in cooperation with one or more persons, may organize or acquire one or more subsidiaries engaged in the following kinds of business: (b) In addition to investments in common stock, preferred stoc…

§431:11-104 Acquisition of control or merger with domestic insurer. (a) The following are filing requirements for the acquisition of control of or merger with a domestic insurer: (b) The statement to be filed with the commissioner hereunder shall be made under oath or affirmation…

[§431:11-104.1] Definitions. The following definitions shall apply for the purposes of sections 431:11-104.2 through 431:11-104.6 only: "Acquisition" means any agreement, arrangement, or activity the consummation of which results in a person acquiring directly or indirectly the c…

§431:11-104.2 Scope. (a) Except as otherwise provided in subsection (b), this section and sections 431:11-104.3 through 431:11-104.6 apply to any acquisition in which there is a change in control of an insurer authorized to do business in this State. (b) This section and sections…

§431:11-104.3 Preacquisition notification; waiting period. (a) An acquisition covered by section 431:11-104.2 may be subject to an order pursuant to section 431:11-104.5 unless the acquiring person or the acquired person files a preacquisition notification and the waiting period …

[§431:11-104.4] Competitive standard. (a) The commissioner may enter an order under section 431:11-104.5 with respect to an acquisition if there is substantial evidence that the effect of the acquisition may be to substantially lessen competition in any line of insurance in this …

[§431:11-104.5] Orders and penalties. (a) If an acquisition violates the competitive standards of section 431:11-104.4, the commissioner may enter an order: (b) Such an order shall not be entered unless there is a hearing, notice of such hearing is issued before the end of the wa…

[§431:11-104.6] Inapplicable provisions. Sections 431:11-110(b), 431:11-110(c), and 431:11-112 do not apply to acquisitions to which sections 431:11-104.1 through 431:11-104.5 apply. [L 1992, c 176, pt of §3]

§431:11-105 Registration of insurers. (a) Every insurer that is authorized to do business in this State and is a member of an insurance holding company system shall register with the commissioner, except a foreign insurer subject to registration requirements and standards adopted…

§431:11-106 Standards and management of an insurer within a holding company system. (d) For purposes of this article, in determining whether an insurer's surplus as regards policyholders is reasonable in relation to the insurer's outstanding liabilities and adequate to its financ…

§431:11-107 Examination. (a) Subject to the limitation contained in this section and in addition to the powers that the commissioner has under article 2 relating to the examination of insurers, the commissioner may examine any insurer registered under section 431:11-105 as reason…

[§431:11-107.5] Supervisory colleges. (a) With respect to any insurer registered under section 431:11-105, and in accordance with subsection (c), the commissioner may participate in a supervisory college for any domestic insurer that is part of an insurance holding company system…

[§431:11-107.7] Group-wide supervision of internationally active insurance groups. (a) The commissioner is authorized to act as the group-wide supervisor for any internationally active insurance group in accordance with this section; provided that the commissioner may otherwise a…

§431:11-108 Confidential treatment. (b) Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner or with whom the documents, materials, or other information are shared pursuant to this art…

§431:11-109 Rules and regulations. The commissioner may, upon notice and opportunity for all interested persons to be heard, issue such rules and orders as shall be necessary to carry out the provisions of this article. [L 1987, c 349, pt of §8]

§431:11-110 Injunctions; prohibitions against voting securities; sequestration of voting securities. (a) Whenever it appears to the commissioner that any insurer or any director, officer, employee, or agent thereof has committed or is about to commit a violation of this article o…

§431:11-111 Sanctions. (a) Any insurer failing, without just cause, to file any registration statement as required in this article shall be required, after notice and hearing, to pay a fine in an amount of not less than $100 and not more than $500 for each day's delay, to be reco…

§431:11-112 Receivership. Whenever it appears to the commissioner that any person has committed a violation of this article which so impairs the financial condition of a domestic insurer as to threaten insolvency or make the further transaction of business by it hazardous to its …

§431:11-113 Recovery. (a) If an order for liquidation or rehabilitation of a domestic insurer has been entered, the receiver appointed under the order shall have a right to recover on behalf of the insurer: Where the distribution or payment pursuant to items (1) or (2) is made at…

§431:11-114 Revocation, suspension, or nonrenewal of insurer's license. Whenever it appears to the commissioner that any person has committed a violation of this article which makes the continued operation of an insurer contrary to the interests of policyholders or the public, th…

§431:11-115 Judicial review; mandamus. (a) Any person aggrieved by any act, determination, rule or order or any other action of the commissioner pursuant to this article may appeal therefrom to the circuit court of the first judicial circuit. The court shall conduct its review wi…

§431:11-116 Conflict with other laws. All laws and parts of laws of this State inconsistent with this article are hereby superseded with respect to matters covered by this article. [L 1987, c 349, pt of §8]

§431:11-117 Severability of provisions. If any provision of this article or the application thereof to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of this article which can be given effect without the invalid provi…

[ARTICLE 11A] BUSINESS TRANSACTED WITH PRODUCER CONTROLLED PROPERTY/CASUALTY INSURER §431:11A-101 Definitions. For purposes of this article: "Accredited state" means a state in which the insurance department or regulatory agency meets the minimum financial regulatory standards pr…

[§431:11A-102] Applicability. This article shall apply to insurers either domiciled in this State or domiciled in a state that is not an accredited state having in effect a substantially similar law. All provisions of article 11, to the extent they are not in conflict with this a…

[§431:11A-103] Minimum standards. (a) The minimum standards specified in this section shall apply if, in any calendar year, the aggregate amount of gross written premiums on business placed with a controlled insurer by a controlling producer is equal to or greater than five per c…

[§431:11A-104] Disclosure. Prior to the effective date of the policy, the controlling producer shall deliver written notice to the prospective insured disclosing the relationship between the controlling producer and the controlled insurer; except that, if the business is placed t…