Title 22, Insurance

0 chapters · 2,651 sections in this title.

2,651 sectionsFiltered byTitle 22

La. Rev. Stat. § 22:1149 Redesignated as R.S
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§1149. Redesignated as R.S. 22:1563 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:115 Surplus to be paid in cash
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§115. Surplus to be paid in cash The initial minimum surplus of any insurer shall be paid in cash within twelve months from the date of its charter and no policies shall be issued by it until the total amount required by law and specified in the charter is paid-in. A majority of …
La. Rev. Stat. § 22:1150 Redesignated as R.S
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§1150. Redesignated as R.S. 22:1564 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1151 Definitions
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§1151. Definitions For the purposes of this Subpart, the following words and phrases shall be defined as follows: (1) "Commissioner" means the commissioner of insurance of the state of Louisiana. (2) "Dental service contractor" means any person who accepts a prepayment from or fo…
La. Rev. Stat. § 22:1152 Qualification and regulation of dental service contractors
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§1152. Qualification and regulation of dental service contractors A. No person shall act as or hold himself out to be a dental service contractor in this state unless that person has qualified and has been issued a certificate of authority as a domestic insurer or has been admitt…
La. Rev. Stat. § 22:1153 Additional regulations
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§1153. Additional regulations A. Each contract between a dental service contractor and its subscribers shall be nonassessable, shall have a minimum term of six months, and shall guarantee unconditionally to the subscriber the performance of all dental services covered by the cont…
La. Rev. Stat. § 22:1154 Freedom of choice of dentist in health plans
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§1154. Freedom of choice of dentist in health plans A. As used in this Section: (1) "Dental care services" means any services furnished to any person for the purpose of preventing, alleviating, curing or healing human dental abnormalities, accidents, or diseases. (2) "Dentist" me…
La. Rev. Stat. § 22:1155 Denial of claims; appeal; prior authorization; preexisting conditions
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§1155. Denial of claims; appeal; prior authorization; preexisting conditions A.(1) A dental service contractor or a contract of dental insurance shall establish and maintain appeal procedures for any claim by a dentist or a subscriber that is denied based upon lack of medical nec…
La. Rev. Stat. § 22:1156 Dental reimbursement or payments
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§1156. Dental reimbursement or payments A. Every company that issues, delivers, amends, or renews a policy of dental insurance in this state providing coverage for dental health care treatment which provides that the payment of benefits under the policy shall be based upon the us…
La. Rev. Stat. § 22:1157 Dental reimbursement or payments
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§1157. Dental reimbursement or payments A. As used in this Section, the following definitions shall apply: (1) "Covered person" means any subscriber, enrollee, member, or participant in a dental plan, or his dependent, for whom benefits are payable when that person receives denta…
La. Rev. Stat. § 22:1157.1 Dental reimbursement or payments; procedure codes; downcoding; prohibitions
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§1157.1. Dental reimbursement or payments; procedure codes; downcoding; prohibitions A.(1) A dental service contractor shall not systematically downcode with the intent to deny reimbursement otherwise due to a dentist or other healthcare provider. (2) A violation of Paragraph (1)…
La. Rev. Stat. § 22:116 Methods of acquiring surplus
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§116. Methods of acquiring surplus The initial minimum sum required may be raised by the insurer in either of the following manners: (1) By payment in advance of premiums by persons who desire to become policyholders and members of the mutual insurer. Such payments must be made i…
La. Rev. Stat. § 22:1161 Short title
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§1161. Short title This Subpart shall be cited as the "Louisiana Dental Loss Ratios for Dental Healthcare Services Plans Act". Acts 2024, No. 357, §1, eff. Jan. 1, 2025.
La. Rev. Stat. § 22:1162 Purpose
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§1162. Purpose The purpose of this Subpart is to provide for transparency of the expenditures of dental healthcare service plan premiums and to require annual reports. Acts 2024, No. 357, §1, eff. Jan. 1, 2025.
La. Rev. Stat. § 22:1163 Definitions
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§1163. Definitions As used in this Subpart, the following definitions apply: (1) "Dental carrier" or "carrier" means a dental insurance company, dental service corporation, dental plan organization authorized to provide dental benefits, or a health insurance plan that includes co…
La. Rev. Stat. § 22:1164 Dental loss ratio calculations
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§1164. Dental loss ratio calculations The dental loss ratio is calculated by dividing the numerator by the denominator as follows: (1)(a) The numerator is the sum of the amount incurred for clinical dental services provided to enrollees, the amount incurred on activities that imp…
La. Rev. Stat. § 22:1165 Transparency of patient premium expenditures; dental loss ratio annual report
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§1165. Transparency of patient premium expenditures; dental loss ratio annual report A. In order to provide transparency of patient premium expenditures for dental healthcare services, all carriers that renew, deliver, or issue a dental healthcare service plan in this state shall…
La. Rev. Stat. § 22:1166 Rulemaking
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§1166. Rulemaking The commissioner shall promulgate rules and regulations in accordance with the Administrative Procedure Act as necessary to implement the provisions of this Subpart, including but not limited to definitions of eligible clinical dental services, activities to imp…
La. Rev. Stat. § 22:1167 Repealed by Acts 2021, No
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§1167. Repealed by Acts 2021, No. 86, §1.
La. Rev. Stat. § 22:117 Dividends
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§117. Dividends No domestic mutual insurer shall pay any dividends to its policyholders unless it has a surplus beyond the initial minimum surplus required and all other liabilities, except a liability created under R.S. 22:116(2), equal to fifteen percent of such initial minimum…
La. Rev. Stat. § 22:1171 Short title; definitions
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§1171. Short title; definitions A. This Subpart may be cited as the "Network Leasing Act". B. As used in this Subpart, the following definitions apply: (1) "Contracting entity" means any person or entity, including a third-party administrator and a dental carrier, that enters int…
La. Rev. Stat. § 22:1172 Fair and transparent network contracting; responsible leasing requirements;
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§1172. Fair and transparent network contracting; responsible leasing requirements; applicability; penalties; enforcement; waiver of contractual regulations prohibited; rules and regulations A. A contracting entity may grant a third party access to a provider network contract or a…
La. Rev. Stat. § 22:118 Impairment of surplus; how made good
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§118. Impairment of surplus; how made good Any impairment in the initial minimum surplus required of a mutual insurer may be made good by funds obtained in accordance with R.S. 22:116(2), provided the transaction is submitted to and approved by the commissioner of insurance. Acts…
La. Rev. Stat. § 22:1181 Purpose
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§1181. Purpose The purposes of this Subpart are: to promote the public interest; to promote the availability of long-term care insurance policies, or certificate if a group; to protect applicants for long-term care insurance, as defined, from unfair or deceptive sales or enrollme…
La. Rev. Stat. § 22:1182 Scope
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§1182. Scope The requirements of this Subpart shall apply to policies delivered or issued for delivery in this state on or after September 1, 1989. Renewal policies shall comply with this Subpart, as amended. This Subpart is not intended to supersede the obligations of entities s…
La. Rev. Stat. § 22:1183 Short title
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§1183. Short title This Subpart may be known and cited as the "Long-Term Care Insurance Act". Acts 1989, No. 448, §1, eff. Sept. 1, 1989; Redesignated from R.S. 22:1733 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1184 Definitions
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§1184. Definitions Unless the context requires otherwise, the following definitions in this Section shall apply for purposes of this Subpart: (1) "Applicant" means: (a) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits, an…
La. Rev. Stat. § 22:1185 Extraterritorial jurisdiction; group long-term care insurance
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§1185. Extraterritorial jurisdiction; group long-term care insurance 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 R.S. 22:1184(4)(d), unless this state has made a determi…
La. Rev. Stat. § 22:1186 Disclosure and performance standards for long-term care insurance
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§1186. Disclosure and performance standards for long-term care insurance A. The commissioner may adopt rules and regulations that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance po…
La. Rev. Stat. § 22:1187 Incontestability period
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§1187. Incontestability period A. For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation tha…
La. Rev. Stat. § 22:1188 Nonforfeiture benefits
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§1188. Nonforfeiture benefits A. Except as provided in Subsection B of this Section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or cer…
La. Rev. Stat. § 22:1188.1 Prompt payment of clean claims
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§1188.1. Prompt payment of clean claims A. For purposes of this Section: (1) "Claim" means a request for payment of benefits under an in-force policy, regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met. (2)…
La. Rev. Stat. § 22:1189 Authority to promulgate regulations
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§1189. Authority to promulgate regulations The commissioner shall issue reasonable regulations to promote premium adequacy and to protect the policyholder in the event of substantial rate increases and to establish minimum standards for marketing practices, producer compensation,…
La. Rev. Stat. § 22:119 Policyholders' meetings; voting rights; proxies
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§119. Policyholders' meetings; voting rights; proxies A. Domestic mutual insurers shall hold at least one policyholders' meeting annually at a time and place, including by remote means, specified in the charter or bylaws of the insurer. B. Each policyholder shall be entitled to v…
La. Rev. Stat. § 22:1190 Administrative procedure
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§1190. Administrative procedure Regulations adopted pursuant to this Subpart shall be adopted in accordance with the provisions of the Administrative Procedure Act. Acts 2004, No. 780, §1, eff. Jan. 1, 2005; Redesignated from R.S. 22:1740 by Acts 2008, No. 415, §1, eff. Jan. 1, 2…
La. Rev. Stat. § 22:1191 Penalties
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§1191. Penalties In addition to any other penalties provided by law, any insurer and any 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 to a fine of up to thr…
La. Rev. Stat. § 22:1192 Redesignated as R.S
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§1192. Redesignated as R.S. 22:1572 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1193 Redesignated as R.S
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§1193. Redesignated as R.S. 22:1573 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194 Redesignated as R.S
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§1194. Redesignated as R.S. 22:2141 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.1 Redesignated as R.S
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§1194.1. Redesignated as R.S. 22:2142 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.2 Redesignated as R.S
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§1194.2. Redesignated as R.S. 22:2143 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.3 Redesignated as R.S
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§1194.3. Redesignated as R.S. 22:2144 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.4 Redesignated as R.S
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§1194.4. Redesignated as R.S. 22:2145 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.5 Redesignated as R.S
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§1194.5. Redesignated as R.S. 22:2146 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.6 Redesignated as R.S
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§1194.6. Redesignated as R.S. 22:2147 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:1194.7 Redesignated as R.S
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§1194.7. Redesignated as R.S. 22:2148 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.
La. Rev. Stat. § 22:12 Insurer; qualification required; compliance with Code required
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§12. Insurer; qualification required; compliance with Code required No person shall act as an insurer in this state unless properly qualified as an insurer of a type permitted under the provisions of this Code. No person shall be authorized to transact or shall transact a busines…
La. Rev. Stat. § 22:12.1 Maintenance of information in applications for licensure
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§12.1. Maintenance of information in applications for licensure All persons applying for any form of license or certificate of authority pursuant to this Title shall notify the commissioner of changes to the content of the application. Acts 2019, No. 66, §1, eff. July 1, 2019.
La. Rev. Stat. § 22:120 Elections of officers and directors
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§120. Elections of officers and directors Election of officers and directors shall be made in the manner specified in the charter or bylaws of the insurer, provided that: (1) Each policyholder shall be entitled to one vote in accordance with the provisions of R.S. 22:119; (2) At …
La. Rev. Stat. § 22:1201 Legislative findings; purpose; short title
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§1201. Legislative findings; purpose; short title A. Existing law does not establish a health coverage program to provide health insurance to Louisiana domiciliaries who are not otherwise able to obtain health insurance meeting prescribed criteria. B. Uninsurable Louisianians, le…