Massachusetts Administrative Code

211 CMR: DIVISION OF INSURANCE 211 CMR 140.00: PROCEDURES CONCERNING THE MERGER OR CONSOLIDATION OF INSURANCE COMPANIES Section 140.01: Scope and Purpose 140.02: Authority 140.03: Definitions 140.04: Standards of Review 140.05: Establishment of Working Group 140.06: Examination o…

211 CMR: DIVISION OF INSURANCE 211 CMR 142.00: INSURANCE SALES BY BANKS, CREDIT UNIONS AND LENDERS Section 142.01: Scope and Purpose 142.02: Applicability 142.03: Definitions 142.04: Application and Licensing 142.05: Consumer Protection Terms and Conditions Governing the Sale of …

211 CMR: DIVISION OF INSURANCE 211 CMR 143.00: CREDIT INSURANCE DISCLOSURE REQUIREMENTS Section 143.01: General 143.02: Required Disclosures 143.03: Readability of the Required Disclosures 143.01: General (1) Authority . 211 CMR 143.00 is promulgated under the authority granted b…

211 CMR: DIVISION OF INSURANCE 211 CMR 144.00: PROCEDURES FOR THE REGULATORY REVIEW OF AND PUBLIC HEARINGS ON PLANS OF REORGANIZATION OR CONVERSION PURSUANT TO M.G.L. C. 175, §§ 19F THROUGH 19W Section 144.01: Purpose, Scope, and Authority 144.02: Definitions 144.03: Submission o…

211 CMR: DIVISION OF INSURANCE 211 CMR 146.00: SPECIFIED DISEASE INSURANCE Section 146.01: Purpose 146.02: Applicability 146.03: Authority 146.04: Definitions 146.05: General Standards for Individual Policies 146.06: Minimum Benefit Standards for Individual Policies Written on an…

211 CMR: DIVISION OF INSURANCE 211 CMR 148.00: REGISTRATION AND REPORTING REQUIREMENTS FOR THIRD-PARTY ADMINISTRATORS Section 148.01: Purpose and Scope 148.02: Definitions 148.03: Initial Registration and Annual Renewal of Registration 148.04: Annual Reporting Requirements 148.05…

211 CMR: DIVISION OF INSURANCE 211 CMR 149.00: ANNUAL REPORTING PURSUANT TO M.G.L. C. 176O, § 21 Section 149.01: Authority 149.02: Purpose 149.03: Applicability 149.04: Definitions 149.05: Information Relative to Administrative Services Provided to Self-insured Groups 149.06: Aud…

211 CMR: DIVISION OF INSURANCE 211 CMR 15.00: REPORTING OF STATISTICAL DATA BY PROPERTY AND CASUALTY INSURANCE COMPANIES Section 15.01: Purpose and Scope 15.02: Definitions 15.03: Lines of Insurance 15.04: Authorization of Statistical Agents 15.05: Filing of Statistical Plans by …

211 CMR: DIVISION OF INSURANCE 211 CMR 150.00: STANDARDS AND COMMISSIONER'S AUTHORITY FOR PLACING COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION UNDER ADMINISTRATIVE SUPERVISION Section 150.01: Authority 150.02: Purpose 150.03: Standards 150.04: Commissioner's Authority …

211 CMR: DIVISION OF INSURANCE 211 CMR 151.00: CERTIFIED GROUP PURCHASING COOPERATIVES Section 151.01: Authority 151.02: Applicability and Purpose 151.03: Definitions 151.04: Approval as a Qualified Association 151.05: Application to be Approved as a Qualified Association 151.06:…

211 CMR: DIVISION OF INSURANCE 211 CMR 152.00: HEALTH BENEFIT PLANS USING LIMITED, REGIONAL OR TIERED PROVIDER NETWORKS Section 152.01: Purpose, Scope and Authority 152.02: Definitions 152.03: Limited and Regional Provider Network Plans 152.04: Tiered Provider Network Plans 152.0…

211 CMR: DIVISION OF INSURANCE 211 CMR 153.00: CONTINUITY OF CARE ACCESS TO COMPREHENSIVE CANCER CENTERS, PEDIATRIC HOSPITALS, AND PEDIATRIC SPECIALTY UNITS FOR SMALL GROUP HEALTH BENEFIT PLANS THAT UTILIZE LIMITED, REGIONAL OR TIERED PROVIDER NETWORKS Section 153.01: Purpose, Sc…

211 CMR: DIVISION OF INSURANCE 211 CMR 154.00: ENFORCEMENT OF MENTAL HEALTH PARITY Section 154.01: Purpose, Scope and Authority 154.02: Definitions 154.03: Certification of Compliance with State and Federal Mental Health Parity Requirements 154.04: Complaints, Disclosures, Invest…

211 CMR: DIVISION OF INSURANCE 211 CMR 155.00: RISK-BEARING PROVIDER ORGANIZATIONS Section 155.01: Purpose and Scope 155.02: Definitions 155.03: Applicability 155.04: Risk Certificate Waivers 155.05: Risk Certificates 155.06: Actuarial Certifications 155.07: Examinations of Risk-…

211 CMR: DIVISION OF INSURANCE 211 CMR 156.00: DENTAL INSURANCE Section 156.01: Purpose 156.02: Applicability and Scope 156.03: Definitions 156.04: Coverage 156.05: Restrictions Relating to Premium Rates 156.06: Submission and Review of Rate Filings 156.07: Annual Comprehensive F…

211 CMR: DIVISION OF INSURANCE 211 CMR 157.00: LICENSING AND REGULATION OF PHARMACY BENEFIT MANAGERS (PBMs) Section 157.01: 157.02: 157.03: 157.04: 157.05: 157.06: 157.07: 157.08: 157.09: 157.10: 157.11: General Definitions Licensing Reporting Contracts between PBMs and Pharmacie…

211 CMR: DIVISION OF INSURANCE 211 CMR 16.00: PETITIONS FOR THE ADOPTION, AMENDMENT OR REPEAL OF REGULATIONS Section 16.01: Scope of Regulation and Definition 16.02: Petition for Adoption of Regulations 16.01: Scope of Regulation and Definition (1) Scope. 211 CMR 16.00 governs th…

211 CMR: DIVISION OF INSURANCE 211 CMR 20.00: RISK-BASED CAPITAL (RBC) FOR INSURERS Section 20.01: Definitions 20.02: RBC Reports 20.03: Company Action Level Event 20.04: Regulatory Action Level Event 20.05: Authorized Control Level Event 20.06: Mandatory Control Level Event 20.0…

211 CMR: DIVISION OF INSURANCE 211 CMR 24.00: LIMITEDLIABILITYCOMPANIES AND LIMITED LIABILITY PARTNERSHIPS; MINIMUM AMOUNT OF LIABILITY INSURANCE Section 24.01: Authority 24.02: Scope and Purpose 24.03: Definitions 24.04: Required Insurance and Capital Program 24.05: Exemptions f…

211 CMR: DIVISION OF INSURANCE 211 CMR 25.00: RISK-BASED CAPITAL (RBC) FOR HEALTH ORGANIZATIONS Section 25.01: Definitions 25.02: RBC Reports 25.03: Company Action Level Event 25.04: Regulatory Action Level Event 25.05: Authorized Control Level Event 25.06: Mandatory Control Leve…

211 CMR: DIVISION OF INSURANCE 211 CMR 26.00: ANNUAL FINANCIAL REPORTING FOR YEARS ENDING 2010 AND AFTER Section 26.01: Authority 26.02: Purpose 26.03: Applicability 26.04: Definitions 26.05: General Requirements Related to Filing and Extensions for Filing of Annual Audited Finan…

211 CMR: DIVISION OF INSURANCE 211 CMR 27.00: MILITARY SALES PRACTICES Section 27.01: Purpose 27.02: Scope 27.03: Exemptions 27.04: Definitions 27.05: Practices Declared False, Misleading, Deceptive or Unfair on a Military Installation 27.06: Practices Declared False, Misleading,…

211 CMR: DIVISION OF INSURANCE 211 CMR 28.00: LIFE INSURANCE ILLUSTRATIONS Section 28.01: Purpose 28.02: Authority 28.03: Applicability and Scope 28.04: Definitions 28.05: Policies to be Illustrated 28.06: General Rules and Prohibitions 28.07: Standards for Basic Illustrations 28…

211 CMR: DIVISION OF INSURANCE 211 CMR 29.00: VALUATION OF LIFE INSURANCE POLICIES Section 29.01: Purpose 29.02: Authority 29.03: Applicability 29.04: Definitions 29.05: General Calculation Requirements for Basic Reserves and Premium Deficiency Reserves 29.06: Calculation of Mini…

211 CMR: DIVISION OF INSURANCE 211 CMR 3.00: MOTORCYCLE INSURANCE Section 3.01: Definitions 3.02: Exemption from Personal Injury Coverage 3.03: Policy Forms and Approvals 3.04: Severability 3.01: Definitions Commissioner . The Commissioner of Insurance, appointed pursuant to M.G.…

211 CMR: DIVISION OF INSURANCE 211 CMR 30.00: REINSURANCE OF PROPERTY AND CASUALTY RISKS BY LIFE INSURERS Section 30.01: Authority 30.02: Purpose 30.03: Severability 30.04: Applicability 30.05: Notice of Intention and Securing of Approval 30.06: Financial Requirements 30.07: Limi…

211 CMR: DIVISION OF INSURANCE 211 CMR 31.00: LIFE INSURANCE SOLICITATION Section 31.01: Authority 31.02: Purpose 31.03: Scope 31.04: Definitions 31.05: Duties of Insurers 31.06: Pre-need Funeral Contracts and Arrangements 31.07: General Rules 31.08: Failure to Comply 31.09: Seve…

211 CMR: DIVISION OF INSURANCE 211 CMR 32.00: USE OF GENDER-BLENDED AND SMOKER/NONSMOKER MORTALITY TABLES Section 32.01: Authority 32.02: Purpose 32.03: Applicability and Scope 32.04: Definitions 32.05: Rule for Gender-Blended Mortality Tables 32.06: Rule for Smoker/Nonsmoker Mor…

211 CMR: DIVISION OF INSURANCE 211 CMR 34.00: THE REPLACEMENT OF LIFE INSURANCE AND ANNUITIES Section 34.01: Purpose 34.02: Definitions 34.03: Exemptions 34.04: Duties of Agents and Brokers 34.05: Duties of All Insurers 34.06: Duties of Insurers that Use Agents or Brokers 34.07: …

211 CMR: DIVISION OF INSURANCE 211 CMR 36.00: THE USE OF HIV-RELATED INFORMATION FOR LIFE AND HEALTH INSURANCE AND INFORMED CONSENT Section 36.01: Purpose and Scope 36.02: Definitions 36.03: Prohibited Practices 36.04: Informed Consent 36.05: Disclosure of Positive HIV Test Resul…

211 CMR: DIVISION OF INSURANCE 211 CMR 37.00: INFERTILITY BENEFITS Section 37.01: Authority 37.02: Purpose 37.03: Definitions 37.04: Scope of Coverage 37.05: Required Infertility Benefits 37.06: Prescription Drugs 37.07: Optional Infertility Benefits 37.08: Prohibited Limitations…

211 CMR: DIVISION OF INSURANCE 211 CMR 38.00: COORDINATION OF BENEFITS (COB) Section 38.01: Purpose and Applicability 38.02: Definitions 38.03: COB Contract Provisions 38.04: Rules for Coordination of Benefits 38.05: Order of Benefit Determination 38.06: Procedure to be Followed …

211 CMR: DIVISION OF INSURANCE 211 CMR 39.00: ANNUITY MORTALITY TABLES FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES Section 39.01: Purpose 39.02: Definitions 39.03: Individual Annuity or Pure Endowment Contracts 39.04: Application of the 2012 IAR Mortality Table 39.05…

211 CMR: DIVISION OF INSURANCE 211 CMR 40.00: MARKETING OF INSURED HEALTH PLANS Section 40.01: Purpose 40.02: Applicability 40.03: Definitions 40.04: Identity of Insurer 40.05: Method of Disclosure or Required Information 40.06: Form and Content of Marketing Method 40.07: Benefit…

211 CMR: DIVISION OF INSURANCE 211 CMR 41.00: NONGROUP HEALTH INSURANCE RATE AND POLICY FORM FILINGS, REVIEW, AND HEARING PROCEDURES UNDER M.G.L. C. 176M Section 41.01: Purpose, Scope and Authority 41.02: Definitions 41.03: Geographic Regions for Area Rate Adjustments 41.04: Pre-…

211 CMR: DIVISION OF INSURANCE 211 CMR 42.00: THE FORM AND CONTENTS OF INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE Section 42.01: Purpose 42.02: Applicability 42.03: Authority 42.04: Definitions 42.05: Policy Types 42.06: Review of Policy Forms and Rate Filings 42.07: Loss Ratio G…

211 CMR: DIVISION OF INSURANCE 211 CMR 43.00: HEALTH MAINTENANCE ORGANIZATIONS (HMOs) Section 43.01: Applicability 43.02: Definitions 43.03: Licensing 43.04: Reporting 43.05: Deposit Requirements 43.06: Net Worth Requirements 43.07: Premium Rates 43.08: Evidence of Coverage 43.09…

211 CMR: DIVISION OF INSURANCE 211 CMR 44.00: CONFIDENTIALITY OF BIDS SUBMITTED FOR RESTRICTED PHARMACY NETWORK CONTRACTS -- TO FACILITATE THE IMPLEMENTATION OF M.G.L. c. 176D, § 3B Section 44.01: Purpose 44.02: Applicability, Scope and Effective Date 44.03: Definitions 44.04: Bi…

211 CMR: DIVISION OF INSURANCE 211 CMR 45.00: ESTABLISHMENT OF SERVICE FEE TO INSURANCE PRODUCERS ASSISTING EMPLOYER S IN OBTAINING WORKERS’ COMPENSATION INSURANCE Section 45.01: Authority 45.02: Purpose 45.03: Eligibility to Receive Service Fee 45.04: Amount of Service Fee 45.01…

211 CMR: DIVISION OF INSURANCE 211 CMR 50.00: CONTINUING EDUCATION FOR INSURANCE PRODUCERS Section 50.01: Purpose 50.02: Definitions 50.03: Applicability 50.04: Hours of Study 50.05: Forms of Submission 50.06: Application for Program Credit 50.07: Failure to Comply 50.01: Purpose…

211 CMR: DIVISION OF INSURANCE 211 CMR 51.00: PREFERRED PROVIDER HEALTH PLANS AND WORKERS’ COMPENSATION PREFERRED PROVIDER ARRANGEMENTS Section 51.01: Authority 51.02: Definitions 51.03: Applicability 51.04: Approval of Preferred Provider Health Plans and Workers’ Compensation Pr…

211 CMR: DIVISION OF INSURANCE 211 CMR 52.00: MANAGED CARE CONSUMER PROTECTIONS AND ACCREDITATION OF CARRIERS Section 52.01: Applicability 52.02: Definitions 52.03: Accreditation of Carriers 52.04: Deemed Accreditation 52.05: Application for Accreditation 52.06: Review of Applica…

211 CMR: DIVISION OF INSURANCE 211 CMR 54.00: PROCEDURE FOR SURRENDER AND NON-RENEWAL OF LICENSES BY INSURERS AUTHORIZED TO WRITE MOTOR VEHICLE INSURANCE Section 54.01: Purpose and Scope 54.02: Applicability 54.03: Definitions 54.04: Filing Requirements 54.05: Review and Approval…

211 CMR: DIVISION OF INSURANCE 211 CMR 55.00 DISCLOSURE REQUIREMENTS FOR LIFE INSURANCE POLICIES WITH ACCELERATED BENEFIT PROVISIONS AND ANNUITY CONTRACTS WITH WAIVERS OF SURRENDER CHARGES FOR EARLY WITHDRAWAL OF ANNUITY PROCEEDS IN THE EVENT OF TOTAL AND PERMANENT DISABILITY Sec…

211 CMR: DIVISION OF INSURANCE 211 CMR 56.00: REDUCTIONS IN PREMIUM CHARGES FOR PRIVATE PASSENGER MOTOR VEHICLE INSURANCE FOR INSUREDS ELECTING OPTIONAL PARTICIPATING REPAIR SHOP ENDORSEMENT PLANS Section 56.01: Scope 56.02: Purpose 56.03: Definitions 56.04: Procedure for Approva…

211 CMR: DIVISION OF INSURANCE 211 CMR 57.00: RECOGNITION OF THE 2001 CSO MORTALITY TABLE FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NON-FORFEITURE BENEFITS Section 57.01: Purpose 57.02: Authority 57.03: Definitions 57.04: 2001 CSO Mortality Table 57.05: Conditions 57…

211 CMR: DIVISION OF INSURANCE 211 CMR 58.00: PERMITTING THE RECOGNITION OF PREFERRED MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES Section 58.01: Purpose 58.02: Authority 58.03: Definitions 58.04: 2001 CSO Preferred Class Structure Table 58.05: Conditions 5…