Consistent with section 1882(z)(4) of the Act, section 9.2A. A: Yes. Disclosure to Viator . Section 2. If the commissioner 11 NCAC 12 .0843 NAIC MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS MODEL ACT (a) The North Carolina Department of Insurance incorporates by reference, including subsequent amendments and editions, the National Association of Insurance Commissioners Medicare Supplement Insurance Minimum Standards Model Act, Model No. endstream endobj 2286 0 obj <>stream Resident License . Purpose and Intent The purpose of this Act is to provide for the reasonable standardization of statewide claim audit guidelines of health care bills for health care services and their reimbursement […] Section 2. ���,H�HLO-����6�h62 �52�P&�BY@�$�u�C�Q�0 O�&� Insurers would now be required to establish a program for the payment of facility-based out-of-network provider bills in instances where the billed charge and the … The 2019 NAIC president is Eric A. Cioppa, who is also the superintendent of the Maine Bureau of Insurance. The Layers of Cause. The passage of the Balanced Budget Act of 1997 (BBA-97) created a new Part C of Medicare, commonly known as Medicare Supervisory Colleges Section 8. Section 6. States should review existing authority and determine whether to adopt this model as Authority to Develop Regulations . A: Yes. NAIC Model Laws, Regulations, Guidelines and Other Resources—June 2002 © 2002 National Association of Insurance Commissioners . Prohibited Investments Section 6. The NAIC acts as a forum for the creation of model laws and regulations. Section 22. Terrorism Risk Insurance Act, as amended in 2015, the definition of act of terrorism has changed. Although development of the newest model began in the late 1990s, it was Congress’ passage of the Gramm-Leach-Bliley Act (GLBA) that caused the NAIC to speed the development of the NAIC Producer Licensing Model Act (PLMA). PLMA Section 6D requires such insurers to furnish the program of instruction to those who sell limited lines insurance. Power of Commissioner. An insurer, or the insurance group of which the insurer is a member, shall, no later than June 1 of each calendar year, submit to the Commissioner a Corporate Governance Annual Disclosure (CGAD) that contains the information described in Section 5B below. Reporting Requirements and Privacy . The Model Act includes a specific stand-alone section governing unauthorized disclosure for research. Purpose The purpose of this regulation is to implement [insert reference to state law equivalent to the NAIC Accident and Sickness Insurance Minimum Standards Model Act] (the Act) to standardize and simplify the terms and coverages of individual accident and sickness insurance policies providing hospital indemnity or Purpose and Scope Section 2. Model Audit Rule is a financial reporting regulation applicable to insurance companies, and borrows significantly from the Sarbanes Oxley Act of 2002 (see ‘key sections’ below). Section 5. The program provides payment for certain medical expenses for persons 65 years of age or older, certain disabled individuals, persons with end-stage renal disease (ESRD), and c… 001. MODEL ACT ON CUSTODIAL AGREEMENTS AND THE USE OF CLEARING CORPORATIONS . The Medicare program was established by Congress in 1965 with the enactment of title XVIII of the Social Security Act (the Act). As defined in Section 102(1) of the Act: The term “act of terrorism” means any act or acts that are certified by the Secretary of the Treasury—in consultation with the Secretary of Homeland Security, and the Attorney General of the United States—to be an act of terrorism; to be a violent act or an act As of 09/30/2020. Ohio enacted the Model Law in the form of Ohio SB273 (Act), which, inter alia, adds Sections 3965.01-11 to the Ohio Revised Code. Section 6. Capital Standards . Section 4. Except as otherwise specifically provided in Sections 7, 13, 14, … A. Enforcement Provisions . insurers’ compliance with the Patient Protection and Affordable Care Act (ACA), the NAIC has developed a set of Model State Laws to implement the ACA’s consumer protections that became effective on Sept. 23, 2010. Examination Section 7. Section 1. 6IAƉ�=�cX+�50_L�nIA/;���C�D�@&��S��q� ��ñ��?��7c=�0�oˮ����S;л��A�E7���+��g�P��2ʦf|�{���%u��?M����-�E QB� �|���>��p�{�4V��{}��O������� �I��������͇fQ-X����'u��Ķ���(�a���ɜ�ʔ�m� e�Ě�˿#|;_&8�9�ό��n؇�d���ʜ����d����*&�� ʚ����:��]���XQv$8n|]���ɂ {���,p��V������s��+Y�������L���{}��O��]��7l�+��E��X�w7��L��jd�j��$.`n �f������D����e�w~ The 2019 NAIC president is Eric A. Cioppa, who is also the superintendent of the Maine Bureau of Insurance. The commissioner shall consider this list in determining qualified jurisdictions. Internal Control & Quality Control Defined. Confidentiality . The potential updates to the Model Act will likely include the following: conforming definitions to the NRRA; The Big Three Connection Concept . Definitions . Section 4. Purpose and Scope . 295-1 . Risk Concentration . Examination . Purpose . Scope. Acquisitions of Control of or Merger With Domestic Insurer Section 3.1 Acquisitions Involving Insurers Not Otherwise Covered Section 4. The Model Act was initially adopted by the NAIC in 1994 and was last updated in 2002. Individual Remedies . The NAIC is an Internal Revenue Code Section 501(c)(3) non-profit organization. %%EOF Definitions . States can decide to adopt more stringent requirements. 870-1 . Section 9. Table of Contents. h�272S0P07�T03R���w�/�+Q02���L)�672��-��%��� Disclosure Requirement A. Severability Section 19. Section 8. (4-5-00) a. endstream endobj 715 0 obj <. Section 9. Reinsurance Table of Contents. Revised NAIC Suitability in Annuity Transactions Model Regulation. Section 10. 0 License Required . To assist states in adopting their own regulations, the NAIC has developed the Model Privacy of Consumer Financial and Health Information Regulation (Model Regulations). NONADMITTED INSURANCE MODEL ACT . Section 8. These provisions should protect insurers from disclosure of sensitive risk evaluation and help to ensure that insurers provide candid, thorough information to regulators charged with ensuring the stability of the U.S. insurance system. Investment Restrictions . 733 0 obj <>stream Each affiliate is to be identified [See amended CIC Section 1215.4(b)(2)]. References are made within each Model Law to particular states that have adopted the model law with corresponding citations to the state versions. Section 6. Section 2. The NAIC form of registration statement is to be used [See amended CIC Section 1215.4(b)]. Application for License . Exceptoi ns to Lciensni g . Purpose—Necessity for Regulation . Section 20. Section 5. Section 23. Drafting Note: In some States existing statutes may provide the commissioner with sufficient authority to promulgate the provisions of this Act as a regulation. Deming's 14 Quality Concepts. GENERAL PROVISIONS Section 1. The purpose of this Act is to promote the public welfare by creating a comprehensive legal framework within which Travel Insurance may be sold in this state. The Model Regulations include provisions … Contents of Corporate Governance Annual Disclosure . Disclosure to Insurer . Section 3. ~*~ 2 NAIC Producer Licensing Model Act Implementation Guidance. MORTGAGE GUARANTY INSURANCE MODEL ACT . Editor’s Note: Wherever the term “commissioner” appears, the title of the chief insurance regulatory official of the state should be inserted. %PDF-1.6 %���� Table of Contents . License and Bond Requirements . NAIC Model Acts SECTION 2 - INTERNAL CONTROL CONCEPTS. A document is a Model … Ohio enacted the Model Law in the form of Ohio SB273 (Act), which, inter alia, adds Sections 3965.01-11 to the Ohio Revised Code. Pursuant to Section [cite state law equivalent of Section 2A of the Credit for Reinsurance Model Law] the commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer that was licensed in this state as of any The Act is designed to “establish standards for data security and for the investigation and notification to the Superintendent of Insurance of a cybersecurity event.” First, unlike the NAIC model, the Act has a broader initial exception for small businesses, but this exception, based on the number of employees, becomes more narrow in 2021. Section 7. Section 18. Application for Examination . Section 9. Section 12. NAIC Model Laws, Regulations, Guidelines and Other Resources—October 2008 2008 National Association of Insurance Commissioners. Nonresident License Reciprocity . Coverage for acts of terrorism is included in your You are hereby notified that under thepolicy. Section 19. Section 3. These Model Laws are intended to provide states with a minimum level of protection required by the federal law. Definitions . B. Section 8. 727 0 obj <>/Filter/FlateDecode/ID[<39FDD766227064478E3DDA08CC68F21C><5990297F40C0574CBA5192BAF7CC725D>]/Index[714 20]/Info 713 0 R/Length 73/Prev 138523/Root 715 0 R/Size 734/Type/XRef/W[1 2 1]>>stream Section 3. Connecticut’s version of the NAIC model law was passed as part of its omnibus budget bill, Public Act 19-117, Section 230. Title . the NAIC Long-Term Care Insurance Model Act and by Section 7702B(b) of the Internal Revenue Code of 1986, as amended. Consolidated tax allocation agreements are to be reported [See new CIC Section 1215.4(b)(3)(H)]. The Model Act requires the insurance carrier to document that each annuity producer has completed a 4 hour CE training course that is approved by the state where the annuity is sold. Surplus Lines Insurance �K�'�%����6��A?��3�+9%r��(��i���Gj4�+a�:K�7��y�)9��E��'km�pT��wFؙ%�f05X8uf�4�Qu�å��9��!�*�`�d=G�QV���C�����ҧ�<6>y� 9 ��HU�ң����6�T��e����ܕ˲���1���a�h����&�=߭C����~������G[�T�Hњr��:QH�@N�jyz��#���Uf��-���)�AlA 3�7u�o��χs��$�SȕM��^. PUBLIC ADJUSTER LICENSING MODEL ACT . Tone at the … Section 5. Section 1. Each state decides whether to pass each NAIC model law or regulation, and each state may make changes in the enactment process, but the models are widely, albeit somewhat irregularly, adopted. The American Heart Association’s Mohl notes that the NAIC is “a consensus-based organization” and “the expectation is that when NAIC passes a model act, a majority of states will take it up and pass it.” For purposes of this section: The term “NAIC Model Standards” means the “NAIC Model Regulation to Implement the Individual Accident and Sickness Insurance Minimum Standards Act”, adopted by the National Association of Insurance Commissioners on June 6, 1979, as it applies to medicare supplemental policies. Section 3. The direct application of this guidance manual is limited to those states that have passed the revised NAIC LTCI Model Regulation without modification. ��+�䷶��s�aòP�_+N��h�z�W;���{����L��f&Մ��>W���? h�b```�*^�ʰ !�������V�W���-�*l���˲����>j5wvՍ�5>U��`�:�^���4444_�in � 0�1p1��Ҟ�Zm�m{���q�BMƷ9@���A� �FL�@��� � ��: Mission - Values - Business Model Concept. Section 3. Short Title . The program is filed with the Commissioner in most states. Section 8. Assumed Names Section 3. The NAIC Model Laws, Regulations, and Guidelines (available in the library) contains documents promulgated by the National Association of Insurance Commissioners as proposed statements of insurance laws that should be adopted by the 50 states. Section 3. Definitions . General Investment Qualifications Section 4. Section 8 of the Model Act contains strong confidentiality provisions that extend to the NAIC and other third-party consultants. ~*~ 2 NAIC Producer Licensing Model Act Implementation Guidance. endstream endobj startxref NAIC Model Laws, Regulations ... INVESTMENTS OF INSURERS MODEL ACT (Defined Limits Version) ARTICLE I. This Act shall be known as the “Travel Insurance Model Act.” Section 2. Exemption From Examination . be deemed to have met the requirements of the relevant sections of this Act where comparable standards exist, except that accreditation should never exempt a health carrier from filing an access plan as required by Section 5. The NAIC Model Laws, Regulations, and Guidelines (available in the library) contains documents promulgated by the National Association of Insurance Commissioners as proposed statements of insurance laws that should be adopted by the 50 states. This regulation is a successor regulation that exceeds the requirements of the 2010 model regulation. Definitions . Section 4. Section 3. The amendments to this regulation made in recognition of Section 7702B do not require nor prohibit the continued sale of long-term care insurance policies and certificates that are not considered qualified long-term care insurance contracts. Table of Contents . Applicability and Scope A. NAIC Model Standards (2) For purposes of this section: (A) The term “NAIC Model Standards” means the “NAIC Model Regulation to Implement the Individual Accident and Sickness Insurance Minimum Standards Act”, adopted by the National Association of Insurance Commissioners on June 6, 1979 , as it applies to medicare supplemental policies. Prohibited Acts . June 2003 Many states are performing these exams currently if their respective legislature has enacted the law. 2285 0 obj <>stream The added complexity of delivering the appropriate training for each producer and distribution Obligation of Reimbursement Insurance Policy Insurers . Recordkeeping Requirements . Loans to Officers and Directors Section 7. Included with every model is a state action page that cites each state's enacted model or similar legislation. The National Association of Insurance Commissioners’ (NAIC) Executive Committee has adopted language that would allow for some types of “rebates” to be offered to consumers, unanimously approving amendments to Section 4 (H) (“Rebating”) of … PRODUCER LICENSING MODEL ACT . Section 1. Section 4. Section 7. In order to comply with examinations initiated by the commissioner, companies should ensure that adequate evidence is retained to support compliance with each section … Immunity . The NAIC began its suitability model update project in 2017, to try to create a sales standard model that all state insurance regulators could support, to … Placement of Insurance Business . Section 2. This rule shall be cited in full as Idaho Department of Insurance Rules, IDAPA 18.01.54, “Rule to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act.” (3-29-10) 02. Page 2 NAIC Model State Laws, January 2011 Four things that could improve the NAIC’s Model Language The ACA, and the NAIC’s Model Language set out the minimum standard of consumer protections; any state can enact laws that are more protective. Paragraph (c)(2) of the July 2010 regulations sets forth the 16 minimum consumer protection standards from the NAIC Uniform Model Act that a State external review process must include in order to be authorized under section 2719(b)(1) of the PHS Act. Section 10. Effective Date . Separability Provision Legislative & Regulatory NAIC Developing Model Pet Health Insurance Law The goal of the pet insurance regulation standards is to create a much clearer set of rules for the industry. Section 6. Revised NAIC Suitability. Standards and Management of an Insurer Within an Insurance Holding Company System Section 6. Management and Own Risk and Solvency Assessment Model Act.] The NAIC acts as a forum for the creation of model laws and regulations. (4) of the revised NAIC Model redesignates Plan F With High Deductible as a new Plan G With High Deductible for an individual who is a “newly eligible Medicare beneficiary,” as defined by section 401 of MACRA. Third-party Consultants . Section 11. Exemptions from Examination . … Table of Contents. 01. The Act is designed to “establish standards for data security and for the investigation and notification to the Superintendent of Insurance of a cybersecurity event.” Section 7. Capital and Surplus . License Required . The NAIC model act also represents a bipartisan consensus of sorts. The purpose of this Act is to provide for the reasonable standardization of statewide claim audit guidelines of health care bills for health care services and their reimbursement by health carriers, preferred provider organizations, third party administrators, or any other health benefit plan to determine whether data in a health care record of an institutional provider is supported by services listed on the claim for payment of an insured or an institutional provider. Section 6. Termination of Reimbursement Insurance Policy . Severability . Section 2. GUIDELINE: ALTERNATIVE TO SECTION 712 OF . Section 4. The NAIC is an Internal Revenue Code Section 501(c)(3) non-profit organization. Obtaining Information Under False Pretenses . Insurer’s Authority to Transact Business . Long-Term Care Insurance (LTCI) Model Regulation (Model Regulation) that was adopted by the NAIC in August 2000 and for the contingent benefit upon lapse provision adopted in 2005. Nonresident Licensing . Section 4. �zQ=�'Il;�x7�X?n�Ƴ `���&~�ʃ� ͖,ѳcW�� �C����B��F씬r�R¨�+Q.O��i-�������f�q����fNp���w/����d�?e=]��Z�y)��dѷj��� kp�ၨ�SGt����f8������q������i�w��w�p���e��cs� �Y�5�v�O�& �\�9p��$EP�[��V�IJ�q`qPx�3��™B1���Sr�Ʌ�q_�*��֬챡���B���n.��,8ԚNLj}�}�/��T�ҡU�@s@c7S���#]�f���`PĘ�c�r����p׳�L����+��X��3,X4�8i>1i�Ά���ɓ�ߒq�6 ��a���B.��7���g�=��Gm% 0N��C������̫��US˗�3l Scope and Purposes . Registration of Insurers Section 5. How the World Works!. %PDF-1.5 %���� June 2003 Section 10. Reserves . Required Disclosures—Service Contracts . Part I incorporates language from the NAIC's "Holding Company Model Act and Model Regulation Act" into Chapter 58 and authorizes the Commissioner of Insurance to engage in the group-wide supervision of an internationally active insurance group (IAIG). The National Association of Insurance Commissioners’ (NAIC) Executive Committee has adopted language that would allow for some types of “rebates” to be offered to consumers, unanimously approving amendments to Section 4(H) (“Rebating”) of the NAIC Unfair Trade Practices Act (Model #880).The revised language will permit insurers or producers to “[o]ffer or give non-cash gifts, … Section 1. Section 8. Authorization of Investments by the Board of Directors Section 5. Mortgage Guaranty Insurance as Monoline . The publication is updated on a quarterly basis. As defined in Section 102(1) of the Act: The term The next phase was the NAIC Single License Procedure Model. Purpose and Scope . framework such as that contained in the NAIC’s model acts on the subject, to ensure the payment of policyholders’ obligations subject to appropriate restrictions and limitations when a company is deemed insolvent.” Although strict adherence to the NAIC Guaranty Fund Models is not required, states are required to have a regulatory framework Section 1. Section 5. According to the NAIC, the Model Act is an important step in the NAIC’s modernization efforts and is intended to comprehensively address the administration of an impaired or insolvent insurer from conservation and rehabilitation to the liquidation and winding up of a receivership estate. Judicial Review of Orders and Reports . The NAIC also acts at the national level to advance laws and policies supported by state insurance regulators. Section 7. ��H�3U�ܖ�S��d��C����n�!Rf��7�#*���\ �&K8)8�։����OLF�D��[QV=H�muR�]���� The NAIC added a new section to the Network Adequacy Model Act to address the issue of surprise bills. Rules and Regulations . Section 7. (National Association of Insurance Commissioners) Title This Act shall be known and may be cited as the Health Carrier Claim Audit Guidelines Model Act. Section 4. Section 7. Section 24. ��I&{�cN4_:�0�H!G�>�2�—ę��Z7�JOr��ʀID����� Section 5. The NAIC model provides an exception for licensees with fewer than 10 employees. hބYێܸ������G�]�b���N,6� $������Z�%�.��H���S����IX��B�U��N]:���b�"��>�gq�� bq��w��Y�,NXc}�K2����{QȰ�{���zK� h �1�L"�z3��$�_|����S|��`�c������]�3?�!K!X�=$ˢ���s��Yx��/�ISę�Ҍ��2�zX�q���Wa ������,da��>�r��a�=�A�$��i�,�_�=l�Zv̰�c���~�Egr/dQ�E��‹Y��%,J-eQ��E���pj�2�a��������8`�.`�9'#��&�ab�H`�&�q �߃P�$��� �WO|Xw�'SE� endstream endobj 2287 0 obj <>stream There are currently two statutory authority options … Section 3. Section 7. License . appropriate section of state law providing authority for minimum benefit standards regulations or the NAIC Medicare Supplement Insurance Minimum Standards Model Act]. Section 5. (Only Those Sections With Amendments Are Shown.) Model Act Section 2.E(3)(b): If the NAIC publishes a list of qualified jurisdictions, the commissioner may defer to this list. Many models also include a legislative history (Proceedings Citations) that explains why the model was adopted and why certain provisions were included. With the adoption of the model law, the insurance commissioner is granted the power to examine insurance entities for compliance with their adopted data security regulation. Under the NAIC Model Act and most state laws, there are special rules for determining which guaranty association will provide coverage for structured settlement annuities (see Section 2, question 3, below) and “unallocated annuity contracts” (see Section 2, question 8). Section 4. Overview REG BI SECURE Act CARES Act Revised NAIC Suitability NY Reg 187 AG49-A Section 7702 . Annuity Transactions Model Regulation.” Section 989J of the Dodd-Frank Act confirmed this exemption of certain annuities from the Securities Act of 1933 and confirmed state regulatory authority. Section 5. Confidential Treatment CORPORATE GOVERNANCE ANNUAL DISCLOSURE MODEL ACT . Use of Book-Entry Systems . Approval of Viatical Settlement Contracts and Viatical SettlementDisclosure Statements . Effective Date Section 1. Title. Understanding the 'Real Risks" - Pareto's Principle. The Model Regulations have been controversial from the time they were adopted in September of 2000, because they go beyond the basic requirements of the GLB Act. Enterprise Risk Management Concept. 651. Section 6. INSURER RECEIVERSHIP MODEL ACT (#555) “ADMINISTRATION OF LOSS REIMBURSEMENT POLICIES” Drafting Note: Having the necessary statutory authority specific to large deductible workers’ compensation products in receiverships is key to the successful resolution of these insurers. Section 1. Section 10. Section 9. h�bbd``b`:$g�9 ��$X�@,O ��b��X�A��$vH�nb`bd��щ��E� �� General Rules For example, states could improve on this Model Language in the following ways: 1. The NAIC acts as a forum for the creation of model laws and regulations. Purpose and Scope . PLMA Section 6D requires such insurers to furnish the program of instruction to those who sell limited lines insurance. h�272W0P07�P07S���w�/�+Q0���L)�676J)�I�LZ��X��ĢT�rs#��~HeA*P,=����,C�QF�BAL3$l@� ��*U Definitions . Definitions . Section 3. Section 9. Application for License . The Model Audit Rule is co-developed by the American Institute of Certified Public Accountants (“AICPA”) and National Association of Insurance Commissioners (“NAIC”) and issued by NAIC with revisions in 2006 and has … References are made within each Model Law to particular states that have adopted the model law with corresponding citations to the … The Model Act requires adherence to more detailed protocols that those included in Section 2-104(a)(7) although there is no specific provision requiring approval by an institutional review board.

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