Kansas Administrative Code

Insurance companies; managing general agents; definitions; requirements. (a) The terms “managing general agent” and “MGA,” as defined in K.S.A. 40-2,130(d) and amendments thereto, shall include any person who, in addition to the criteria set forth in that statute, adjusts or pays…

Fire and casualty insurance; modification of rate filing requirements; rates that cannot be practicably filed before use. (a) Any insurer or rating organization identi- fying those kinds of insurance, subdivisions, class- es of risk, contracts, or combinations of these for which …

Fire and casualty insurance; rat- ing organizations; filing of forms. For the purpose of this regulation, the word “company” shall include a company of any type that is re- quired to file rates pursuant to K.S.A. 40-955 and amendments thereto. The word “forms” shall mean policies…

(Authorized by K.S.A. 40-103; im- plementing K.S.A. 1992 Supp. 40-1117; effective Nov. 29, 1993; revoked June 3, 2005.)

Fire and casualty insurance; title insurers; controlled business arrange- ments. (a) For the purpose of this regulation, “controlled business” shall have the meaning specified in K.A.R. 40-3-43. (b) As a part of the report stating the percent- age of closed title orders originati…

Fire and casualty insurance; electronic verification of insurance. (a) Each motor vehicle liability insurer writing insurance in the state shall provide the secretary of revenue with verification of each insured’s insurance on- 319 Fire and Casualty Insurance 40-3-58 line or elec…

Controlled insurance programs. Each controlled insurance program providing cov- erageforgeneralliabilityorworkerscompensation, or both, shall meet the following requirements: (a) Establish a method for the quarterly report- ing of the participant’s respective claims details and l…

Controlled insurance programs including general liability. Each controlled in- surance program including general liability cover- agefortheparticipantsshallrequirethefollowing: (a) Coverage for completed operations liability shall not, after substantial completion of a con- struc…

Controlled insurance programs including workers compensation liabilities. Each controlled insurance program including cov- erage for workers compensation liabilities of the participants shall require the following: 320 INSURANCE DEPARTMENT 40-3-59 (a) Workers compensation coverag…

Workers compensation policies. (a) For the purpose of this regulation and K.S.A. 40-955 and amendments thereto, each of the fol- lowing terms shall have the meaning specified in this subsection: (1) “Advisory organization” means an entity licensed by the commissioner for the repo…

Fire and casualty insurance; rates and forms; fictitious classification prohibited. (a) No insurer writing Kansas risks shall write fire, casualty, inland marine, or surety coverage upon any firm, corporation, individual, or association of individuals at any preferred rate, cover…

Workers compensation; affida- vit of exempt status. Each company that under- writes workers compensation insurance in Kansas shall accept each executed affidavit of exempt sta- tus provided by each insured, pursuant to K.S.A. 2016 Supp. 44-5,127 and amendments thereto, unless the…

Fire and casualty insurance; mu- tual insurers; reciprocal interinsurance ex- changes; capital stock insurers issuing partic- ipating policies; dividends; requirements. (a) Each fire and casualty insurance contract issued in Kansas by a mutual insurer or reciprocal interin- suran…

Fire and casualty insurance; par- ticipating policies; filing requirements. Each company writing fire, casualty, inland marine or surety coverages in Kansas on participating poli- cies shall file each participating plan with the in- surance department if the plan includes dividen…

Fire and casualty companies; par- ticipating policies; payment of dividends to insured required; conditioning dividends on continuance of policy prohibited. (a) Each fire and casualty company issuing participating or dividend-paying policies shall issue dividend checks that are p…

Accident and health insurance; individual policies; rate filings; require- ments. The national association of insurance commissioners’ “guidelines for filing of rates for individual health insurance forms,” July 1989 edition, is hereby adopted by reference subject to the followin…

Accident and health policies; application as part of the policy; notice re- quired. (a) Each individual policy of accident, sickness, or hospitalization insurance shall not be delivered in this state unless the following notice is attached to the policy: IMPORTANT NOTICE Please r…

Accident and health insurance; applications; “catchall” questions. An appli- cation for accident and health insurance shall not contain a nonspecific question concerning the general medical history of the applicant unless the question is limited in application to a specific peri-…

Accident and health insurance companies; record of loss experience re- quired; form adopted by the national asso- ciation of insurance commissioners; filing date. (a) Each insurance company transacting ac- cident and health insurance business in the state of Kansas shall maintain…

Accident and health insurance companies; releases; requirements. Each in- surance company writing health and accident in- surance shall not limit or attempt to limit its lia- bility under a contract by obtaining a release from the insured either in the form of enclosed check, pro…

(Authorized by K.S.A. 40-103, 40- 216, 40-1109, 40-2203(G), 40-2215(C); effective Jan. 1, 1966; amended May 1, 1979; revoked May 1, 1986.)

Accident and sickness insurance policies; franchise plan; requirements. (a) Forms for accident and sickness insurance poli- cies shall be approved for writing on a franchise plan when: (1) Accident and sickness insurance on a fran- chise plan may be issued to: (A) Three or more e…

(Authorized by K.S.A. 40-103, 40- 235, 40-2403, 40-2404(l); effective Jan. 1, 1966; revoked May 1, 1979.)

Accident and health insurance; reserve standards for individual policies. The national association of insurance commissioners’ reserve standards for individual health insurance policies, June 1985 edition, are hereby adopted by reference. (Authorized by K.S.A. 40-103; im- plement…

Accident and health insurance policies; right to return policy. Each individual accident and health policy, except travel accident policies or policies of a similar type, issued for delivery in this state, shall have printed on, or at- tachedtothefirstpageofthepolicy,anoticestati…

Accident and sickness insur- ance; deceptive practices; requirements; prohibitions. (a) Paragraphs (3), (4) and (5) of subsection (b) shall not apply to credit accident and sickness insurance, group accident and sick- ness insurance, nor to medicare supplement poli- cies as defin…

(Authorized by K.S.A. 1978 Supp. 40-2218; effective Feb. 15, 1977; revoked May 1, 1979.)

Accident and sickness insur- ance standards for benefits. (a) K.A.R. 40-4-26 through 40-4-33 shall apply to each individual ac- cident and sickness insurance policy and subscrib- er contract of hospital and medical and dental ser- vice corporations delivered or issued for deliver…

Same; basic hospital expense coverage. (a) “Basic hospital expense coverage” means a policy of accident and sickness insurance which provides coverage for a period of not less than 31 days during any one period of confine- ment, for each person insured under the policy, and for e…

Same; basic medical-surgical expense coverage. “Basic medical-surgical ex- pense coverage” means a policy of accident and sickness insurance which, for each person in- sured under the policy, provides coverage for the expenses incurred in providing the necessary services, rendere…

Same; hospital confinement in- demnity coverage. “Hospital confinement in- demnity coverage” means a policy of accident and sickness insurance which provides, for each person insured under the policy, daily benefits for hospital confinement, on an indemnity basis, in an amount no…

Same; major medical expense coverage. (a) “Major medical expense coverage” means an accident and sickness insurance policy which: (1) Provides hospital, medical and surgical ex- pense coverage to an aggregate maximum of not less than $25,000; (2) is not subject to a co-payment by…

Same; renewability of individ- ual hospital, medical, or surgical expense policy. (a) Except as specifically authorized by K.S.A. 40-2257(b) and amendments thereto, an insurer shall not terminate an individual hospital, medical, or surgical expense policy for any insured who is e…

Accident and health insurance policies; renewal and cancellation condi- tions; description required; cross-reference of renewal and cancellation provisions. (a) When an individual or family policy does not con- tain either a brief description or separate state- ment printed on th…

Same; disability income protec- tion coverage. (a) “Disability income protec- tion coverage” means a policy which provides for weekly or monthly payments, for a specified peri- od during the continuance of disability resulting from either sickness or injury, or a combination of b…

Same; standards for benefits, accident only coverage. “Accident only cover- age” means a policy of accident insurance which provides coverage, singly or in combination, for death, dismemberment, disability or hospital and medical care caused by accident. Accidental death and doub…

Same; standards for benefits; specified disease coverage. “Specified disease coverage” means a policy which meets one of the following definitions: (a) A policy which provides coverage, for each person insured under the policy, for a specifical- ly named disease or diseases with …

Same; standards for benefits; specified accident coverage. “Specified ac- cident coverage” means an accident insurance policy which provides coverage for a specifically identified kind of accident or accidents for each person insured under the policy for accidental death or accid…

Accident and health insurance; coordination of benefits. The Kansas insurance department’s “policy and procedure relating to coordination of benefits,” dated January 27, 2016, including the appendices, is hereby adopted by reference. (Authorized by K.S.A. 40-103, 40- 2404a; imple…

Medicare supplement policies; minimum standards. (a) The Kansas insurance department’s “policy and procedure to implement medicare supplement insurance minimum stan- dards,” including the appendices, dated May 18, 2017, is hereby adopted by reference, except for sections 1, 2, 25…

Medicare supplement policies; medicare catastrophic coverage repeal act of 1989; transitional requirements. Sections 3, 4, 5, 6, 7, 8, 9, 10 and appendix A of the national as- sociation of insurance commissioner’s model reg- ulation to implement transitional requirements for the …

Accident and sickness insur- ance; conversion policies; reasonable no- tice of right to convert. (a) The requirements for reasonable notice by the insurer of the right to convert specified in K.S.A. 40-19c06, K.S.A. 40-2209, and K.S.A. 40-3209, and amendments thereto, shall be fu…

Long-term care insurance; ap- plication; definitions. (a) These regulations shall apply to individual or group long-term care insurance policies, subscriber contracts, endorse- ments, and riders delivered or issued for delivery in this state by the following: (1) Insurance compan…

Long-term care insurance; re- newal provisions; requirements. (a) A certif- icate or individual policy delivered or issued for delivery shall not contain renewal provisions less favorable to the insured than “guaranteed renew- able” for life. Any insurer may receive approval of a…

Long-term care insurance; marketing practices; prohibitions; limita- tions. A policy shall not be advertised, described, solicited, delivered or issued for delivery in this state as long-term care insurance if the policy, contract or rider limits or excludes coverage by type of i…

Long-term care insurance; ter- mination; recurrent confinements; continua- tion of benefits. (a) If a long-term care insurance policy is terminated while an insured is confined in a nursing facility, benefits provided as a result of receiving nursing facility services shall conti…

Long-term care insurance; benefits; medical condition; activities of dai- ly living; definitions; requirements. (a) A long- term care policy may require a recommendation by a physician that the services are necessary due to illness, injury, or functional impairment but shall not …

Long-term care insurance; prohibitions. Each long-term care policy shall be prohibited from the following: (a) Containing more than one elimination peri- od for periods of confinement in a nursing home that are due to the same or related causes and sep- arated from each other by …

Long-term care insurance; no- tices, limited policy; right to return require- ments. (a) A long-term care insurance policy shall have the words “this is a limited policy—read it carefully” printed on or attached to the face of the policy in not less than 18 point bold face type o…

Long-term care insurance; benefit standards; definitions; explanations. (a)Along-termcareinsurancepolicythatprovides for the payment of benefits based on standards described as “usual and customary,” “reasonable and customary” or words of similar import shall include a definition…