Montana Administrative Code

6.6.705 POLICIES TO BE ILLUSTRATED Each insurer marketing policies to which this subchapter is applicable shall notify the commissioner whether a policy form is to be marketed with or without an illustration. For all policy forms being actively marketed on January 1, 2002, the in…

6.6.706 GENERAL RULES AND PROHIBITIONS An illustration used in the sale of a life insurance policy shall satisfy the applicable requirements of this subchapter, be clearly labeled "life insurance illustration" and contain the following basic information: name of insurer; name and…

6.6.707 STANDARDS FOR BASIC ILLUSTRATIONS - FORMAT A basic illustration shall conform with the following requirements: the illustration shall be labeled with the date on which it was prepared; each page, including any explanatory notes or pages, shall be numbered and show its rel…

6.6.708 STANDARDS FOR BASIC ILLUSTRATIONS - NARRATIVE SUMMARY A basic illustration shall include the following: a brief description of the policy being illustrated, including a statement that it is a life insurance policy; a brief description of the premium outlay or contract pre…

6.6.709 STANDARDS FOR BASIC ILLUSTRATIONS - NUMERIC SUMMARY Following the narrative summary, a basic illustration shall include a numeric summary of the death benefits and values and the premium outlay and contract premium, as applicable. For a policy that provides for a contract…

6.6.710 STANDARDS FOR BASIC ILLUSTRATIONS - STATEMENTS Statements substantially similar to the following shall be included on the same page as the numeric summary and signed by the applicant, or the policy owner in the case of an illustration provided at time of delivery, as requ…

6.6.7101 AUTHORITY This subchapter's rules are promulgated by the Commissioner of Insurance pursuant to 33-2-409, MCA, and ARM 6.6.6707. Authorizing statute(s): 33-1-313, MCA Implementing statute(s): 33-2-409, MCA History: NEW, 2008 MAR p. 136, Eff. 2/1/08; AMD, 2017 MAR p. 1888,…

6.6.7102 PURPOSE The purpose of this subchapter's rules is to recognize, permit, and prescribe the use of mortality tables that reflect differences in mortality between preferred and standard lives in determining minimum reserve liabilities in accordance with 33-2-409, MCA, and A…

6.6.7103 DEFINITIONS For the purposes of ARM 6.6.7101, 6.6.7102, 6.6.7103, 6.6.7105, 6.6.7107, and 6.6.7109: "2001 CSO Mortality Table" means the mortality table, consisting of separate rates of mortality for male and female lives, developed by the American Academy of Actuaries C…

6.6.7105 2001 CSO PREFERRED CLASS STRUCTURE TABLE At the election of the company, for each calendar year of issue, for any one or more specified plans of insurance and subject to satisfying the conditions stated in this rule, the 2001 CSO Preferred Class Structure Mortality Table…

6.6.7107 CONDITIONS For each plan of insurance with separate rates for preferred and standard nonsmoker lives, an insurer may use the Super Preferred Nonsmoker, Preferred Nonsmoker, and Residual Standard Nonsmoker tables to substitute for the nonsmoker mortality table found in th…

6.6.7109 SEPARABILITY For the rules in this subchapter, if a part of a rule is invalid, all valid parts that are severable from the invalid part remain in effect. If a part of a rule is invalid in one or more of its applications, the part remains in effect in all valid applicatio…

6.6.711 STANDARDS FOR BASIC ILLUSTRATIONS - TABULAR DETAIL A basic illustration shall include the following for at least each policy year from one to 10 and for every fifth policy year thereafter ending at age 100, policy maturity or final expiration; and except for term insuranc…

6.6.712 STANDARDS FOR SUPPLEMENTAL ILLUSTRATIONS A supplemental illustration may be provided so long as: it is appended to, accompanied by, or preceded by a basic illustration that complies with this subchapter; the non-guaranteed elements shown are not more favorable to the poli…

6.6.713 DELIVERY OF ILLUSTRATIONS AND RECORD RETENTION If a basic illustration is used by an insurance producer or other authorized representative of the insurer in the sale of a life insurance policy and the policy is applied for as illustrated, a copy of that illustration, sign…

6.6.714 ANNUAL REPORT; NOTICE TO POLICY OWNERS In the case of a policy designated as one for which illustrations will be used, the insurer shall provide each policy owner with an annual report on the status of the policy that shall contain at least the following information: for …

6.6.715 ANNUAL CERTIFICATIONS The board of directors of each insurer shall appoint one or more illustration actuaries. The illustration actuary shall certify that the disciplined current scale used in illustrations is in conformity with the Actuarial Standard of Practice for Comp…

6.6.716 PENALTIES In addition to any other penalties provided by the laws of this state, an insurer or producer that violates a requirement of this subchapter shall be guilty of a violation of 33-18-202, MCA. Authorizing statute(s): Sec. 33-18-202 and 33-20-150, MCA Implementing …

6.6.717 SEVERABILITY If any provision of this subchapter or its application to any person or circumstance is for any reason held to be invalid by any court of law, the remainder of the subchapter and its application to other persons or circumstances shall not be affected. Authori…

6.6.718 EFFECTIVE DATE This subchapter shall become effective January 1, 2002, and shall apply to policies sold on or after the effective date. Authorizing statute(s): Sec. 33-20-150, MCA Implementing statute(s): Sec. 33-18-202 and 33-20-150, MCA History: NEW, 2001 MAR p. 2234, E…

6.6.7901 NETWORK ADEQUACY DEFINITIONS The following definitions apply to this subchapter: "Mail-order pharmacy" means a pharmacy that provides pharmacist services and primarily dispenses and delivers covered drugs via common carrier. "Pharmacy network" means a group of pharmacies…

6.6.7902 NETWORK ADEQUACY A PBM must establish and maintain a pharmacy network that is sufficient in numbers to ensure all pharmacist services are accessible without unreasonable delay, within a reasonable proximity to the business or personal residence of an enrollee or an injur…

6.6.7903 NETWORK ADEQUACY REPORTING A PBM must submit the following reports and information for each pharmacy network as part of its license or license renewal application to demonstrate to the commissioner a sufficient and adequate pharmacy network: a report in a form and in a m…

6.6.7904 NETWORK ADEQUACY DIRECTORIES A PBM must post electronically a current, accurate, and searchable directory of pharmacies for each pharmacy network. In making the directory available electronically, the PBM must ensure that the general public is able to view all pharmacies…

6.6.7905 BATCH APPEAL PROCESS A pharmacy benefit manager's appeals procedure described in 33-22-173, MCA, must allow for the submission of appeals received from a pharmacy or a pharmacy services administrative organization as part of a batch or group of appeals. Authorizing statu…

6.6.8001 AGENCY ORGANIZATION History. The classification review committee is created by statute. The district court held in Cause No. BDV-91-1585, state of Montana, first judicial district, entitled State Compensation Mutual Insurance Fund v. R/E. Developers, Inc. , decided Augus…

6.6.801 PURPOSE The purpose of this subchapter is to provide standards for the disclosure of certain minimum information about annuity contracts to protect consumers and foster consumer education. These rules specify the minimum information which must be disclosed and the method …

6.6.802 AUTHORITY These rules are issued based upon the authority granted the commissioner under 33-20-150 , and 33-20-308 , Montana Code Annotated, (MCA). Authorizing statute(s): Sec. 33-1-313, 33-20-150 and 33-20-308, MCA Implementing statute(s): Sec. 33-20-308, MCA History: NE…

6.6.803 APPLICABILITY AND SCOPE This subchapter applies to all annuity contracts and certificates except: registered or nonregistered variable annuities or other registered contracts; immediate and deferred annuities that contain no nonguaranteed elements; annuities used to fund:…

6.6.804 DEFINITIONS For the purposes of this subchapter: "Charitable gift annuity" means a transfer of cash or other property by a donor to a charitable organization in return for an annuity payable over one or two lives, under which the actuarial value of the annuity is less tha…

6.6.805 STANDARDS FOR THE DISCLOSURE DOCUMENT Where the application for an annuity contract is taken in a face-to-face meeting, the applicant shall at or before the time of application be given both the disclosure document described in (2) and the Buyer's Guide contained in Appen…

6.6.806 ANNUAL NOTICE TO CONTRACT OWNERS For annuities in the payout period with changes in nonguaranteed elements and for the accumulation period of a deferred annuity, the insurer shall provide each contract owner with a report, at least annually, on the status of the contract …

6.6.807 PENALTIES In addition to any other penalties provided by the laws of this state, an insurer or producer that violates a requirement of this subchapter shall be guilty of a violation of 33-1-317 , MCA. Authorizing statute(s): 33-21-111, MCA Implementing statute(s): 33-21-2…

6.6.810 PURPOSE The purpose of these rules is to provide: model forms for mandatory disclosures to consumers prior to the recommendation or sale of an annuity and for documenting certain events at the time of a recommendation or sale of an annuity; and the process for approving, …

6.6.8101 ADOPTION OF MODEL RULES The classification review committee adopts and incorporates by reference the following of the attorney general's Model Procedural Rules: 1.3.102; 1.3.203 through 1.3.211; 1.3.216; 1.3.218; and 1.3.222 through 1.3.233. The attorney general's Model …

6.6.811 MODEL FORMS For purposes of the model forms to be provided by the insurance department under 33-20-805(4), MCA, the commissioner adopts and incorporates by reference Appendices A through C of the National Association of Insurance Commissioners (NAIC) Model Regulation No. …

6.6.812 GUIDELINES FOR APPROVAL OF TRAINING The commissioner will approve training on the subject of the suitability of annuities using the process for review and approval of continuing education courses set forth at 33-17-1201 et seq., MCA. A training course intended to fulfill …

6.6.813 STANDARDS FOR INSURER VERIFICATION An insurer's obligation to verify that a producer has completed the training requirements of 33-20-807, MCA, can be accomplished by either: obtaining certificate(s) of completion of a commissioner-approved training course; or obtaining r…

6.6.814 ALTERNATIVE SATISFACTION OF TRAINING REQUIREMENTS A producer may submit a written request to the commissioner to evaluate a training course or courses with components substantially similar to those required, and prohibited, by 33-20-807(2), MCA. The written request must: …

6.6.8201 DEFINITIONS The following definitions apply to this subchapter, unless context or the particular rule requires otherwise: "Classification" means a category of risk based on the nature of the work performed. "Classification decision" means the classification assigned by t…

6.6.8202 ADMINISTRATIVE APPEAL OF CLASSIFICATION DECISION An employer may appeal a classification decision by filing a notice of administrative appeal. The notice of administrative appeal must contain a short statement of the reasons for the appeal and a statement of the general …

6.6.8202A INFORMAL ADVISORY HEARING PROCEDURE The initial hearing conducted by the committee concerning objections filed by an employer or insurer in relation to classifications assigned to an employer shall be conducted informally, and in such manner as to ascertain the substant…

6.6.8203 INFORMAL CONTESTED CASE PROCEEDING This rule sets forth procedural steps that shall be followed in informal contested case hearings for administrative appeals involving classification determinations. Classification determination hearings must be informal proceedings held…

6.6.8204 NOTICE OF HEARING A hearing must be scheduled at a regular or special meeting of the committee. Written notice of a hearing must be mailed to the parties at least 20 days before the hearing or conference. A hearing notice must comply with 2-4-601, MCA, except that the he…

6.6.8205 PRE-HEARING EXCHANGE OF INFORMATION At least 10 days before a hearing, each party must mail or deliver the following information or documents to the committee and to all other parties: accurate copies of all documentary evidence; the names, addresses and telephone number…

6.6.8206 AUDIO, VIDEO, OR OTHER TELECOMMUNICATIONS TECHNOLOGY HEARINGS A hearing may be held byaudio, video, or other telecommunications technology or media if a request for an in-person hearing is not filed with the notice of administrative appeal. Authorizing statute(s): 33-16-…

6.6.8301 ESTABLISHMENT OF CLASSIFICATION FOR COMPENSATION PLAN NO. 2 AND PLAN NO. 3 The committee adopts and incorporates by reference the NCCI Basic Manual for Workers Compensation and Employers Liability Insurance, as supplemented, including classifications established or revis…