Subject 120-2-99 SALE OF INDIVIDUAL HEALTH INSURANCE PRODUCTS APPROVED IN OTHER STATES
Article 3 of Chapter 29A of Title 33 directs the Commissioner to adopt implementing rules and regulations governing the filing, approval, and sale of individual health insurance products that have been approved for issuance in other states. This regulation is issued pursuant to the authority vested in the Commissioner under Chapter 2 of Title 33 and O.C.G.A. Sections O.C.G.A. 33-29A-30et seq.
|(1)||An insurer authorized to transact insurance in this state may file for approval and issuance in this state an individual health insurance product currently approved for issuance by the insurer or its affiliate in another state, provided that such product meets the requirements of Article 3 of Chapter 29A of Title 33, other applicable provisions of Title 33, and the regulations of the Commissioner.|
|(2)||An insurer authorized to transact insurance in this state may offer an individual health insurance product with benefits equivalent to those in any individual health insurance product approved pursuant to Article 3 of Chapter 29A of Title 33.|
|(3)||Any individual health insurance product offered or sold pursuant to Article 3 of Chapter 29A of Title 33 shall comply with O.C.G.A. § 9-9-2(c)(3) and shall not require the insured or his or her beneficiary to arbitrate disputes arising under the terms of the policy.|
|(1)||All individual health insurance products offered or sold pursuant to Article 3 of Chapter 29A of Title 33 shall be filed for prior review and approval and subject to the applicable SERFF filing and policy form filing fees.|
|(2)||Proof of current approval and product line authority in domicile state is required of foreign insurers.|
|(3)||Proof of current state approval other than Georgia, if different from domicile state should be furnished and referenced in filing.|
|(4)||Outlines of coverage must be prepared and filed for approval with the policy forms filing.|
|(5)|| Insurer filings shall conform to
applicable actuarial standards set forth by the National Association of
Insurance Commissioners or regulations promulgated by the Commissioner
including, but not limited to:
|(6)||Insurers shall include a cover letter describing the relationship between the insurer making the filing and the affiliate, if any, which currently has approval for the issuance of the individual health insurance product in another state, the original state where the proposed product was approved, and the date of such approval. Any insurer authorized to transact insurance in this state seeking to offer an individual health insurance product with benefits equivalent to those of individual health insurance product already approved pursuant to Article 3 of Chapter 29A of Title 33 shall disclose the name of the insurer, the policy form number of such insurer, and the date approved in this state.|
|(7)||All policies delivered or issued for delivery in Georgia are subject to Georgia jurisdiction and all legal disputes arising under the policy shall be resolved in accordance with applicable Georgia law, including specifically the requirements of Title 9 and Title 33.|
|(1)||Each policy application for a product offered or sold pursuant to Article 3 of Chapter 29A of Title 33 shall contain the following language in boldface type at the beginning of the document:|
"The benefits of this policy may primarily be governed by the laws of a state other than Georgia; therefore, all of the laws applicable to policies filed in this state may not apply to this policy. Any purchase of individual health insurance should be considered carefully since future medical conditions may make it impossible to qualify for another individual health insurance policy."
|(2)||Each delivered policy must contain the following language in boldface type at the beginning of the document:|
"The benefits of this policy providing your coverage may be governed primarily by the laws of a state other than Georgia. The benefits covered may be different from other policies you can purchase. Please consult your insurance agent or insurer to determine which health benefits are covered under this policy."
|(3)|| Each policy offered or sold pursuant to
Article 3 of Chapter 29A of Title 33 shall also contain the following standard
forms for the disclosure and comparison of benefits.
If any provision of these sections or the application thereof to any person or circumstance is held invalid for any reason, the invalidity shall not affect the other provisions or any other application of these sections which can be given effect without the invalid provisions or application. To this end all provisions of these sections are declared to be severable.