Bill Text: GA HB955 | 2011-2012 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Georgia Life and Health Insurance Guaranty Association; provide comprehensive revision of the provisions
Spectrum: Partisan Bill (Republican 4-0)
Status: (Engrossed - Dead) 2012-03-20 - Senate Read Second Time [HB955 Detail]
Download: Georgia-2011-HB955-Introduced.html
Bill Title: Georgia Life and Health Insurance Guaranty Association; provide comprehensive revision of the provisions
Spectrum: Partisan Bill (Republican 4-0)
Status: (Engrossed - Dead) 2012-03-20 - Senate Read Second Time [HB955 Detail]
Download: Georgia-2011-HB955-Introduced.html
12 LC
37 1359ER
House
Bill 955
By:
Representatives Hembree of the
67th,
Smith of the
131st,
and Meadows of the
5th
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Title 33 of the Official Code of Georgia Annotated, relating to insurance,
so as to provide for comprehensive revision of the provisions relating to the
Georgia Life and Health Insurance Guaranty Association; to provide for related
matters; to provide for an effective date; to repeal conflicting laws; and for
other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
Title
33 of the Official Code of Geogia Annotated, relating to insurance, is amended
by revising Chapter 38 of Title 33, relating to the Georgia Life and Health
Insurance Guaranty Association, as follows:
"CHAPTER
38
33-38-1.
The
purpose of this chapter is to protect
policy
owners, insureds, beneficiaries, annuitants, payees, and assignees of life
insurance policies, health insurance policies, annuity contracts, and
supplemental contracts,
the persons
specified in subsection (b) of Code Section
33-38-2, subject to certain limitations,
against failure in the performance of contractual
obligations,
under life and health insurance policies and annuity contracts specified in
subsection (a) of Code Section 33-38-2,
due to the impairment or insolvency of the insurer issuing such policies or
contracts. To provide this protection, (1) an association of insurers is
created to enable the guaranty of payment of benefits and continuation of
coverages as
limited by this chapter, (2) members of
the association are subject to assessment to provide funds to carry out the
purpose of this chapter, and (3) the association is authorized to assist the
Commissioner, in the prescribed manner, in the detection and prevention of
insurer impairments or insolvencies.
33-38-2.
(a)
This chapter shall provide coverage to the persons specified in subsection (b)
of this Code section for direct, nongroup life, health,
or
annuity,
and supplemental policies or contracts,
for certificates under direct group policies and contracts,
and for
supplemental contracts to any of these,
and for unallocated annuity
contracts, in
each case issued by member insurers,
except as limited by this chapter. Annuity contracts and certificates under
group annuity contracts include, but are not limited to, guaranteed investment
contracts, deposit administration contracts, unallocated funding agreements,
allocated funding agreements, structured settlement
agreements,
lottery contracts
annuities,
annuities issued to or in connection with government
lotteries, and any immediate or deferred
annuity contracts.
(b)(1)
Coverage under this chapter shall be provided only:
(1)(A)
To persons who, regardless of where they reside, except for nonresident
certificate holders under group policies or contracts, are the beneficiaries,
assignees, or payees of the persons covered under
paragraph
(2) of this subsection
subparagraph
(B) of this paragraph; and
(2)(B)
To persons who are owners of or certificate holders under such policies or
contracts,
other than
or, in the
case of unallocated annuity contracts
and structured
settlement annuities, to the persons who
are the contract holders and who:
(A)(i)
Are residents; or
(B)(ii)
Are not residents, but
only under
all of the following conditions:
(i)
The
the
insurers which issued such policies or contracts are domiciled in this
state;
(ii)
Such insurers never held a license or certificate of authority in
the
the
states in which such persons
reside;
(iii)
Such states have associations similar to
the association created by this article; and
(iv)
Such
such
persons are not eligible for coverage by
such
associations
an association
in any other state due to the fact that the insurer was not licensed in the
state at the time specified in the state's guaranty association
law.
(2)
For unallocated annuity contracts specified in subsection (a) of this Code
section, subparagraphs (A) and (B) of paragraph (1) of this subsection shall not
apply, and this chapter shall, except as provided in paragraphs (4) and (5) of
this subsection, provide coverage to:
(A)
Persons who are the owners of the unallocated annuity contracts if the contracts
are issued to or in connection with a specific benefit plan whose plan sponsor
has its principal place of business in this state; and
(B)
Persons who are owners of unallocated annuity contracts issued to or in
connection with government lotteries if the owners are residents.
(3)
For structured settlement annuities specified in subsection (a) of this Code
section, subparagraphs (A) and (B) of paragraph (1) of this subsection shall not
apply, and this chapter shall, except as provided in paragraphs (4) and (5) of
this subsection, provide coverage to a person who is a payee under a structured
settlement annuity, or beneficiary of a payee if the payee is deceased, if the
payee:
(A)
Is a resident, regardless of where the contract owner resides; or
(B)
Is not a resident, but only under both of the following conditions:
(i)(I)
The contract owner of the structured settlement annuity is a resident;
or
(II)
The contract owner of the structured settlement annuity is not a resident, but
the insurer that issued the structured settlement annuity is domiciled in this
state and the state in which the contract owner resides has an association
similar to the association created by this chapter; and
(ii)
Neither the payee or beneficiary nor the contract owner is eligible for coverage
by the association of the state in which the payee or contract owner
resides.
(4)
This chapter shall not provide coverage to:
(A)
A person who is a payee or beneficiary of a contract owner who is a resident of
this state, if the payee or beneficiary is afforded any coverage by the
association of another state; or
(B)
A person covered under paragraph (2) of this subsection, if any coverage is
provided by the association of another state to that person.
(5)
This chapter is intended to provide coverage to a person who is a resident of
this state and, in special circumstances, to a nonresident. In order to avoid
duplicate coverage, if a person who would otherwise receive coverage under this
chapter is provided coverage under the laws of any other state, the person shall
not be provided coverage under this chapter. In determining the application of
the provisions of this subsection in situations where a person could be covered
by the association of more than one state, whether as an owner, payee,
beneficiary, or assignee, this chapter shall be construed in conjunction with
other state laws to result in coverage by only one association.
(c)
This chapter shall not
apply
provide
coverage to:
(1)
That portion or part of a
variable
life insurance or variable annuity
policy
or contract not guaranteed by an
insurer;,
or
(2)
That portion or part of any policy or
contract under which the risk is borne by
the
policyholder
policy or
contract owner;
(3)(2)
A policy or contract of reinsurance or any
Any
policy or contract or part thereof assumed by the impaired or insolvent insurer
under a contract of reinsurance,
other than
reinsurance for which
unless
assumption certificates have been issued
pursuant to
the reinsurance policy or
contract;
(3)
A portion of a policy or contract to the extent that the rate of interest on
which it is based, or the interest rate, crediting rate, or similar factor
determined by use of an index or other external reference stated in the policy
or contract employed in calculating returns or changes in value:
(A)
Averaged over the period of four years prior to the date on which the member
insurer becomes an impaired or insolvent insurer under this chapter, whichever
is earlier, exceeds the rate of interest determined by subtracting two
percentage points from Moody's Corporate Bond Yield Average averaged for that
same four-year period or for such lesser period if the policy or contract was
issued less than four years before the member insurer becomes an impaired or
insolvent insurer under this chapter, whichever is earlier; and
(B)
On and after the date on which the member insurer becomes an impaired or
insolvent insurer under this chapter, whichever is earlier, exceeds the rate of
interest determined by subtracting three percentage points from Moody's
Corporate Bond Yield Average as most recently available;
(4)
Any policy, contract, certificate, or subscriber agreement issued by a nonprofit
hospital service corporation referred to in Chapter 19 of this title, a health
care plan referred to in Chapter 20 of this title, a nonprofit medical service
corporation referred to in Chapter 18 of this title, a prepaid legal services
plan, as defined in Code Section 33-35-2, and a health maintenance organization,
as defined in Code Section 33-21-1;
(5)
Any policy, contract, or certificate issued by a fraternal benefit society, as
defined in Code Section 33-15-1;
(6)
Accident and sickness insurance as defined in Code Section 33-7-2 when written
by a property and casualty insurer as part of an automobile insurance
contract;
(7)
A portion of a policy or contract issued to a plan or program of an employer,
association, or other person to provide life, health, or annuity benefits to its
employees, members, or others, to the extent that the plan or program is
self-funded or uninsured, including, but not limited to, benefits payable by an
employer, association, or other person under:
(A)
A multiple employer welfare arrangement as defined in 29 U.S.C. Section
1002(40);
(B)
A minimum premium group insurance plan;
(C)
A stop-loss group insurance plan; or
(D)
An administrative services only contract;
(8)
A portion of a policy or contract to the extent that it provides
for:
(A)
Dividends or experience rating credits;
(B)
Voting rights; or
(C)
Payment of any fees or allowances to any person, including the policy or
contract owner, in connection with the service to or administration of the
policy or contract;
(9)
A policy or contract issued in this state by a member insurer at a time when it
was not licensed or did not have a certificate of authority to issue the policy
or contract in this state;
(7)(10)
Any unallocated annuity contract issued to an employee benefit plan protected
under the federal Pension Benefit Guaranty
Corporation,
regardless of whether the federal Pension Benefit Guaranty Corporation has yet
become liable to make any payments with respect to the benefit
plan;
or
(8)(11)
Any portion of any unallocated annuity contract which is not issued to or in
connection with a specific employee, union, or association of natural persons
benefit plan
or a
government lottery;
(12)
A portion of a policy or contract to the extent that the assessments required by
Code Section 33-38-15 with respect to the policy or contract are preempted by
federal or state law;
(13)
An obligation that does not arise under the express written terms of the policy
or contract issued by the insurer to the contract owner or policy owner,
including without limitation:
(A)
Claims based on marketing materials;
(B)
Claims based on side letters, riders, or other documents that were issued by the
insurer without meeting applicable policy form filing or approval
requirements;
(C)
Misrepresentations of or regarding policy benefits;
(D)
Extra-contractual claims; or
(E)
A claim for penalties or consequential or incidental damages;
(14)
A contractual agreement that establishes the member insurer's obligations to
provide a book value accounting guaranty for defined contribution benefit plan
participants by reference to a portfolio of assets that is owned by the benefit
plan or its trustee, which in each case is not an affiliate of the member
insurer;
(15)
A portion of a policy or contract to the extent it provides for interest or
other changes in value to be determined by the use of an index or other external
reference stated in the policy or contract, but which have not been credited to
the policy or contract, or as to which the policy or contract owner's rights are
subject to forfeiture, as of the date the member insurer becomes an impaired or
insolvent insurer under this chapter, whichever is earlier. If a policy's or
contract's interest or changes in value are credited less frequently than
annually, then for purposes of determining the values that have been credited
and are not subject to forfeiture under this paragraph, the interest or change
in value determined by using the procedures defined in the policy or contract
will be credited as if the contractual date of crediting interest or changing
values was the date of impairment or insolvency, whichever is earlier, and will
not be subject to forfeiture; or
(16)
A policy or contract providing any hospital, medical, prescription drug, or
other health care benefits pursuant to Part C or Part D of Subchapter XVIII,
Chapter 7 of Title 42 of the United States Code, commonly known as Medicare Part
C & D, or any regulations issued pursuant thereto.
(d)
The provisions of this Code section shall apply only to coverage the guaranty
association provides in connection with any member insurer that is placed under
an order of liquidation with a finding of insolvency after the effective date of
this Code section.
33-38-3.
This
chapter shall be
liberally
construed to effect the purpose set forth in Code Section
33-38-1,
which Code section shall constitute an aid and guide to
interpretation.
33-38-4.
As
used in this chapter, the term:
(1)
'Account' means any of the two accounts created under Code Section
33-38-5.
(2)
'Affiliate' means any person that directly, or indirectly through one or more
intermediaries, controls, is controlled by, or is under common control with the
person specified.
(3)
'Association' means the Georgia Life and Health Insurance Guaranty Association
created under Code Section 33-38-5.
(4)
'Authorized assessment,' or 'authorized' when used in the context of
assessments, means a resolution by the board of directors of the association has
been passed whereby an assessment will be called immediately or in the future
from member insurers for a specified amount. An assessment is authorized when
the resolution is passed.
(5)
'Benefit plan' means a specific employee, union, or association of natural
persons benefit plan.
(6)
'Called assessment,' or 'called' when used in the context of assessments, means
that a notice has been issued by the association to member insurers requiring
that an authorized assessment be paid within the time frame set forth within the
notice. An authorized assessment becomes a called assessment when notice is
mailed by the association to member insurers.
(4)(7)
'Contractual obligation' means any obligation under
a
covered
policies or
contracts
policy,
contract, or certificate under a group policy or contract, or portion thereof
for which coverage is provided under Code Section
33-38-2.
Notwithstanding
any other provision of this chapter, 'contractual obligation' shall not include
a claim filed after the final date set by the court for the filing of claims
against the liquidator or other such court appointed authority.
(5)(8)
'Control' or 'controlled' means the possession, direct or indirect, of the power
to direct or cause the direction of the management and policies of a person,
whether through ownership of voting securities, by contract other than a
commercial contract for goods or nonmanagement services, or
otherwise.
(6)(9)
'Covered policy' means
any
a
policy or contract
within the
scope of this chapter
or portion of
a policy or contract for which coverage is
provided under Code Section
33-38-2.
(7)
'Health insurance' means accident and sickness insurance, as that class of
insurance is defined in Code Section 33-7-2.
(10)
'Extra-contractual claims' shall include, for example, any claim not authorized
by, or outside the scope of, the underlying policy or contract to include any
claim based on bad faith, punitive or exemplary damages, treble damages,
prejudgment or postjudgment interest, attorney's fees, or costs of
litigation.
(8)(11)
'Impaired insurer' means a member insurer
deemed by
the Commissioner
which is not
an insolvent insurer and is placed under an order of rehabilitation or
conservation by a court of competent
jurisdiction on or after July 1,
1981, to be
potentially unable to fulfill its contractual obligations but not an insolvent
insurer.
(9)(12)
'Insolvent insurer' means a member insurer against which
a
final
an
order of liquidation containing a finding of insolvency has been entered by a
court of competent jurisdiction on or after July 1, 1981.
(10)(13)
'Member insurer' means any insurer which is licensed or which holds a
certificate of authority to transact in this state any kind of insurance for
which coverage is provided under Code Section 33-38-2 and includes any insurer
whose license or certificate of authority in this state may have been suspended,
revoked, not renewed, or voluntarily withdrawn, but does not
include:
(A)
A
nonprofit
hospital or medical service
corporation,
whether profit or nonprofit;
(B)
A health care corporation;
(C)
A health maintenance organization;
(D)
A fraternal benefit society;
(E)
A mandatory state pooling plan;
(F)
A mutual assessment company or any entity that operates on an assessment
basis;
(G)
An insurance exchange;
or
(H)
An
organization that has a certificate or license limited to the issuance of
charitable gift annuities under Code Sections 33-58-1 through 33-58-6;
or
(I)
Any entity similar to those described in subparagraphs (A) through
(G)
(H)
of this paragraph.
(14)
'Moody's Corporate Bond Yield Average' means the Monthly Average Corporates as
published by Moody's Investors Service, Inc., or any successor
thereto.
(15)
'Owner' of a policy or contract and 'policy owner' and 'contract owner' mean the
person who is identified as the legal owner under the terms of the policy or
contract or who is otherwise vested with legal title to the policy or contract
through a valid assignment completed in accordance with the terms of the policy
or contract and properly recorded as the owner on the books of the insurer. The
terms 'owner,' 'contract owner,' and 'policy owner' shall not include persons
with a mere beneficial interest in a policy or contract.
(11)(16)
'Person' means any individual, corporation,
limited
liability company, partnership,
association,
governmental
body or entity, or voluntary
organization.
(17)
'Plan sponsor' means:
(A)
The employer in the case of a benefit plan established or maintained by a single
employer;
(B)
The employee organization in the case of a benefit plan established or
maintained by an employee organization; or
(C)
In a case of a benefit plan established or maintained by two or more employers
or jointly by one or more employers and one or more employee organizations, the
association, committee, joint board of trustees, or other similar group of
representatives of the parties who establish or maintain the benefit
plan.
(12)(18)
'Premiums' means
direct
gross insurance premiums and annuity
amounts
or
considerations,
by whatever name called, received on
covered policies
or
contracts, less
return
returned
premiums,
and
considerations
and
deposits thereon and
less
dividends
paid or
credited to policyholders on such direct
business
and experience
credits. The term 'premiums'
does
shall
not include
premiums
and:
(A)
Amounts or considerations
on
received for
policies or contracts
between
insurers and reinsurers.
or for the
portions of policies or contracts for which coverage is not provided under this
chapter except that assessable premium shall not be reduced on account of
paragraph (3) of subsection (c) of Code Section 33-38-2, relating to interest
limitations, and paragraph (12) of Code Section 33-38-7, relating to limitations
with respect to one individual, one participant, and one contract
owner;
The term
'premiums' does not include any premiums
(B)
Premiums in excess of $5 million on
any
an
unallocated annuity
contract;
or
(C)
With respect to multiple nongroup policies of life insurance owned by one owner,
whether the policy owner is an individual, firm, corporation, or other person,
and whether the persons insured are officers, managers, employees, or other
persons, premiums in excess of $5 million with respect to these policies or
contracts, regardless of the number of policies or contracts held by the
owner.
(19)(A)
'Principal place of business' of a plan sponsor or a person other than a natural
person means the single state in which the natural persons who establish policy
for the direction, control, and coordination of the operations of the entity as
a whole primarily exercise that function, determined by the association in its
reasonable judgment by considering the following factors:
(i)
The state in which the primary executive and administrative headquarters of the
entity is located;
(ii)
The state in which the principal office of the chief executive officer of the
entity is located;
(iii)
The state in which the board of directors, or similar governing person or
persons, of the entity conducts the majority of its meetings;
(iv)
The state in which the executive or management committee of the board of
directors, or similar governing person or persons, of the entity conducts the
majority of its meetings;
(v)
The state from which the management of the overall operations of the entity is
directed; and
(vi)
In the case of a benefit plan sponsored by affiliated companies comprising a
consolidated corporation, the state in which the holding company or controlling
affiliate has its principal place of business as determined using the above
factors.
However,
in the case of a plan sponsor, if more than 50 percent of the participants in
the benefit plan are employed in a single state, that state shall be deemed to
be the principal place of business of the plan sponsor.
(B)
The principal place of business of a plan sponsor of a benefit plan described in
subparagraph (C) of paragraph (17) of this Code section shall be deemed to be
the principal place of business of the association, committee, joint board of
trustees, or other similar group of representatives of the parties who establish
or maintain the benefit plan that, in lieu of a specific or clear designation of
a principal place of business, shall be deemed to be the principal place of
business of the employer or employee organization that has the largest
investment in the benefit plan in question.
(20)
'Receivership court' means the court in the insolvent or impaired insurer's
state having jurisdiction over the conservation, rehabilitation, or liquidation
of the insurer.
(13)(21)
'Resident' means any person who
is
domiciled
resides
in this state at the time a member insurer is determined to be an impaired or
insolvent insurer and to whom contractual obligations are owed. A person may be
a resident of only one state, which, in the case of a person other than a
natural person, shall be its principal place of business.
Citizens of
the United States who are either residents of foreign countries or residents of
United States possessions, territories, or protectorates that do not have an
association similar to the association created by this chapter shall be deemed
residents of the state of domicile of the insurer that issued the policies or
contracts.
(22)
'State' means a state, the District of Columbia, Puerto Rico, and a United
States possession, territory, or protectorate.
(23)
'Structured settlement annuity' means an annuity purchased in order to fund
periodic payments for a plaintiff or other claimant in payment for or with
respect to personal injury suffered by the plaintiff or other
claimant.
(24)
'Supplemental contract' means a written agreement entered into for the
distribution of proceeds under a life, health, or annuity policy or
contract.
(25)
'Unallocated annuity contract' means an annuity contract or group annuity
certificate which is not issued to and owned by an individual, except to the
extent of any annuity benefits guaranteed to an individual by an insurer under
the contract or certificate.
33-38-5.
(a)
There is created a nonprofit, unincorporated association to be known as the
Georgia Life and Health Insurance Guaranty Association. All member insurers
shall be and remain members of the association as a condition of their authority
to transact insurance in this state. The association shall perform its
functions under the plan of operation established and approved under Code
Section 33-38-8 and shall exercise its powers through a board of directors
established under Code Section 33-38-6.
(b)
The association shall come under the immediate supervision of the Commissioner
and shall be subject to the applicable provisions of the insurance laws of this
state.
(c)
For purposes of administration and assessment, the association shall maintain
two accounts: (1) the health insurance account; and (2) the life insurance and
annuity account. The life insurance and annuity account shall contain three
subaccounts: (A) the life insurance account; (B) the annuity account; and (C)
the unallocated annuity account
which shall
include contracts qualified under Section 403(b) of the United States Internal
Revenue Code.
(d)
For purposes of assessment,
supplementary
supplemental
contracts shall be covered under the account in which the basic policy is
covered.
33-38-6.
(a)
The board of directors of the association shall consist of seven members and
shall at all times contain at least one member from a domestic insurer. The
members, who shall not be considered employees of the Insurance Department,
shall be appointed as follows:
(1)
The Commissioner shall compile a list of the two stock insurers most likely to
incur the largest assessment, per insurer, for each of the accounts under Code
Section 33-38-5; he shall compile a list of the two nonstock insurers most
likely to incur the largest assessment, per insurer, for each of the accounts
under Code Section 33-38-5; and he shall compile a list of the two domestic
insurers, either stock or nonstock, most likely to incur the largest assessment,
for each of the accounts listed under Code Section 33-38-5. The Commissioner
shall solicit from these 18 insurers the names of 18 individuals as nominees for
members to the board of directors. The Commissioner shall thereupon separately
certify in writing the nominations from stock and nonstock insurers and
separately for each account;
(2)
From the nominations so certified for each such account, the Commissioner shall
appoint one stock member and one nonstock member to the board of directors until
six directors have been appointed. Then the Commissioner shall appoint from the
remaining nominations the chairman of the board who shall also be its chief
executive; and
(a)
The board of directors of the association shall consist of not less than five
nor more than nine member insurers serving terms as established in the plan of
operation. The members of the board shall be selected by the Commissioner from
a list provided to the Commissioner from the board. Vacancies on the board
shall be filled for the remaining period of the term by a majority vote of the
remaining board members, subject to the approval of the
Commissioner.
(3)(b)
In approving selections
or in
appointing
of
members to the board, the Commissioner shall consider, among other things,
whether all member insurers are fairly represented.
(b)
Any member may be removed from office by the Commissioner when, in his judgment,
the public interest may so require.
(c)
Each member so appointed shall serve for a term of three years and until his
successor has been appointed and qualified.
(d)
If there occurs, for any reason, a vacancy in the board of directors, the
Commissioner shall appoint a member to fill the unexpired term of office from
the nominations as heretofore described.
(e)(c)
Members of the board may be reimbursed from the assets of the association for
reasonable expenses incurred by them in their capacity as members of the board
of directors, but members of the board shall not otherwise be compensated by the
association for their services.
33-38-7.
(a)
In addition to the powers and duties enumerated elsewhere in this chapter, the
association shall have the following powers and duties:
(1)
Whenever
If
a
domestic
member
insurer is an impaired insurer, the association, subject to any conditions,
other than those conditions which impair the contractual obligations of the
impaired insurer, imposed by the association and approved by the
impaired
insurer and the Commissioner,
may, in its
discretion:
(A)
Guarantee,
assume, or reinsure, or cause to be
guaranteed, assumed, or reinsured, any or all of the covered policies
or
contracts of the impaired insurer;
and
(B)
Provide such moneys, pledges,
loans,
notes, guarantees, or other means as are proper to effectuate subparagraph (A)
of this paragraph and assure payment of the contractual obligations of the
impaired insurer pending action under subparagraph (A) of this paragraph;
and
(C)
Loan money to the impaired insurer;
(2)
Whenever
If
a
domestic
member
insurer is an insolvent insurer, the association shall,
subject to
the approval of the Commissioner
in its
discretion, either:
(A)(i)(I)
Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or
reinsured, the covered policies
or
contracts of the insolvent insurer;
or
(B)(II)
Assure payment of the contractual obligations of the insolvent insurer;
and
(C)(ii)
Provide
such
moneys, pledges,
loans,
notes, guarantees, or other means as are reasonably necessary to discharge
such
the
association's duties;
or
(3)
Whenever a foreign or alien insurer is an insolvent insurer, the association
shall, subject to the approval of the Commissioner:
(A)
Guarantee, assume, or reinsure, or cause to be guaranteed, assumed, or
reinsured, the covered policies of residents;
(B)
Assure payment of the contractual obligations of the insolvent insurer to
residents; and
(C)
Provide such moneys, pledges, notes, guarantees, or other means as are
reasonably necessary to discharge such duties.
This
paragraph shall not apply where the Commissioner has determined that the foreign
or alien insurer's domiciliary jurisdiction or state of entry provides
protection by statute substantially similar to that provided by this chapter for
residents of this state;
(B)
Provide benefits and coverages in accordance with the following
provisions:
(i)
With respect to life and health insurance policies and annuities, assure payment
of benefits for premiums identical to the premiums and benefits, except for
terms of conversion and renewability, that would have been payable under the
policies or contracts of the insolvent insurer, for claims
incurred:
(I)
With respect to group policies and contracts, not later than the earlier of the
next renewal date under those policies or contracts or 45 days, but in no event
less than 30 days, after the date on which the association becomes obligated
with respect to the policies and contracts; and
(II)
With respect to nongroup policies, contracts, and annuities, not later than the
earlier of the next renewal date, if any, under the policies or contracts or one
year, but in no event less than 30 days, from the date on which the association
becomes obligated with respect to the policies or contracts;
(ii)
Make diligent efforts to provide all known insureds or annuitants, for nongroup
policies and contracts, or group policy owners with respect to group policies
and contracts, 30 days' notice of the termination, pursuant to division (i) of
this subparagraph, of the benefits provided;
(iii)
With respect to nongroup life and health insurance policies and annuities
covered by the association, make available to each known insured or annuitant,
or owner if other than the insured or annuitant, and with respect to an
individual formerly insured or formerly an annuitant under a group policy who is
not eligible for replacement group coverage, make available substitute coverage
on an individual basis in accordance with the provisions of division (iv) of
this subparagraph, if the insureds or annuitants had a right under law or the
terminated policy or annuity to convert coverage to individual coverage or to
continue an individual policy or annuity in force until a specified age or for a
specified time, during which the insurer had no right unilaterally to make
changes in any provision of the policy or annuity or had a right only to make
changes in premium by class;
(iv)
In providing the substitute coverage required under division (iii) of this
subparagraph, the association may offer either to reissue the terminated
coverage or to issue an alternative policy. Alternative or reissued policies
shall be offered without requiring evidence of insurability and shall not
provide for any waiting period or exclusion that would not have applied under
the terminated policy. The association may reinsure any alternative or reissued
policy;
(v)(I)
Alternative policies adopted by the association shall be subject to the approval
of the domiciliary insurance commissioner. The association may adopt
alternative policies of various types for future issuance without regard to any
particular impairment or insolvency.
(II)
Alternative policies shall contain at least the minimum statutory provisions
required in this state and provide benefits that shall not be unreasonable in
relation to the premium charged. The association shall set the premium in
accordance with a table of rates that it shall adopt. The premium shall reflect
the amount of insurance to be provided and the age and class of risk of each
insured, but shall not reflect any changes in the health of the insured after
the original policy was last underwritten.
(III)
Any alternative policy issued by the association shall provide coverage of a
type similar to that of the policy issued by the impaired or insolvent insurer,
as determined by the association;
(vi)
If the association elects to reissue terminated coverage at a premium rate
different from that charged under the terminated policy, the premium shall be
set by the association in accordance with the amount of insurance provided and
the age and class of risk, subject to approval of the domiciliary insurance
commissioner and the receivership court;
(vii)
The association's obligations with respect to coverage under any policy of the
impaired or insolvent insurer or under any reissued or alternative policy shall
cease on the date the coverage or policy is replaced by another similar policy
by the policy owner, the insured, or the association; and
(viii)
When proceeding under this subparagraph with respect to a policy or contract
carrying guaranteed minimum interest rates, the association shall assure the
payment or crediting of a rate of interest consistent with paragraph (3) of
subsection (c) of Code Section 33-38-2;
(3)
Nonpayment of premiums within 31 days after the date required under the terms of
any guaranteed, assumed, alternative, or reissued policy or contract or
substitute coverage shall terminate the association's obligations under the
policy or coverage under this chapter with respect to the policy or coverage,
except with respect to any claims incurred or any net cash surrender value which
may be due in accordance with the provisions of this chapter;
(4)
Premiums due for coverage after entry of an order of liquidation of an insolvent
insurer shall belong to and be payable at the direction of the association. The
association shall be liable for unearned premiums due to policy or contract
owners arising after the entry of the order;
(5)
The protection provided by this chapter shall not apply where any guaranty
protection is provided to residents of this state by the laws of the domiciliary
state or jurisdiction of the impaired or insolvent insurer other than this
state;
(4)(A)(6)
In carrying out its duties under
paragraphs
paragraph
(2) and
(3) of this Code section, the association
may:
impose
permanent policy liens or contract liens in connection with any guarantee,
assumption, or reinsurance agreement if the court:
(i)
Finds that the amounts which can be assessed under this chapter are less than
the amounts needed to assure full and prompt performance of the insolvent
insurer's contractual obligations or that the economic or financial conditions
as they affect member insurers are sufficiently adverse to render the imposition
of policy or contract liens to be in the public interest; and
(ii)
Approves the specific policy liens or contract liens to be used.
(A)
Subject to approval by a court in this state, impose permanent policy or
contract liens in connection with a guarantee, assumption, or reinsurance
agreement, if the association finds that the amounts which can be assessed under
this chapter are less than the amounts needed to assure full and prompt
performance of the association's duties under this chapter, or that the economic
or financial conditions as they affect member insurers are sufficiently adverse
to render the imposition of such permanent policy or contract liens, to be in
the public interest; and
(B)
Before
being obligated under paragraphs (2) and (3) of this Code section, the
association may request that there be imposed temporary moratoriums or liens on
payments of cash values and policy loans in addition to any contractual
provisions for deferral of such cash value payments or policy loans. Such
temporary moratoriums and liens may be imposed if they are approved by a court
of competent jurisdiction
Subject to
approval by a court in this state, impose temporary moratoriums or liens on
payments of cash values and policy loans, or any other right to withdraw funds
held in conjunction with policies or contracts, in addition to any contractual
provisions for deferral of cash or policy loan value. In addition, in the event
of a temporary moratorium or moratorium charge imposed by the receivership court
on payment of cash values or policy loans, or on any other right to withdraw
funds held in conjunction with policies or contracts, out of the assets of the
impaired or insolvent insurer, the association may defer the payment of cash
values, policy loans, or other rights by the association for the period of the
moratorium or moratorium charge imposed by the receivership court, except for
claims covered by the association to be paid in accordance with a hardship
procedure established by the liquidator or rehabilitator and approved by the
receivership court;
(7)
A deposit in this state, held pursuant to law or required by the Commissioner
for the benefit of creditors, including policy owners, not turned over to the
domiciliary liquidator upon the entry of a final order of liquidation or order
approving a rehabilitation plan of an insurer domiciled in this state or in a
reciprocal state, pursuant to Code Sections 33-3-8 through 33-3-10, shall be
promptly paid to the association. The association shall be entitled to retain a
portion of any amount so paid to it equal to the percentage determined by
dividing the aggregate amount of policy owners claims related to that insolvency
for which the association has provided statutory benefits by the aggregate
amount of all policy owners' claims in this state related to that insolvency and
shall remit to the domiciliary receiver the amount so paid to the association
less the amount retained pursuant to this paragraph. Any amount so paid to the
association and retained by it shall be treated as a distribution of estate
assets pursuant to applicable state receivership law dealing with early access
disbursements.
(5)(8)
If the association fails to act within a reasonable period of time
with respect
to an insolvent insurer, as provided in
paragraphs
paragraph
(2) and
(3) of this Code section, the Commissioner
shall have the powers and duties of the association under this chapter with
respect to
the
insolvent insurers;
(6)(9)
Upon
his
the
Commissioner's request, the association
may render assistance and advice to the Commissioner concerning rehabilitation,
payment of claims, continuance of coverage, or the performance of other
contractual obligations of any impaired or insolvent insurer;
(7)(10)
The association shall have standing to appear
or
intervene before any court
or
agency in this state with jurisdiction
over an impaired or insolvent insurer concerning which the association is or may
become obligated under this chapter
or with
jurisdiction over any person or property against which the association may have
rights through subrogation or otherwise.
Such standing shall extend to all matters germane to the powers and duties of
the association, including but not limited to proposals for
reinsuring,
modifying, or guaranteeing the
covered
policies or
contracts of the impaired or insolvent
insurer and the determination of the
covered
policies or
contracts and contractual
obligations.
The association shall also have the right to appear or intervene before a court
or agency in another state with jurisdiction over an impaired or insolvent
insurer for which the association is or may become obligated or with
jurisdiction over any person or property against whom the association may have
rights through subrogation or
otherwise;
(8)(A)(11)(A)
Any person receiving benefits under this chapter shall be deemed to have
assigned the rights
under, and any
causes of action against any person for losses arising under, resulting from, or
otherwise relating to, the covered policy
or
contract to the association to the extent
of the benefits received because of this chapter, whether the benefits are
payments of or
on account of contractual
obligations,
or
continuation of
coverage, or
provision of substitute or alternative
coverages. The association may require an
assignment to it of such rights
and causes of
action by any payee, policy or contract
owner, beneficiary, insured, or annuitant as a condition precedent to the
receipt of any rights or benefits conferred by this chapter upon such person.
The association shall be subrogated to these rights against the assets of any
impaired
or insolvent insurer.
(B)
The subrogation rights of the association under this paragraph shall have the
same priority against the assets of the
impaired
or insolvent insurer as that possessed by
the person entitled to receive benefits under this
chapter;.
(C)
In addition to subparagraphs (A) and (B) of this paragraph, the association
shall have all common law rights of subrogation and any other equitable or legal
remedy that would have been available to the impaired or insolvent insurer or
owner, beneficiary, or payee of a policy or contract with respect to the policy
or contracts.
(D)
If subparagraphs (A) through (C) of this paragraph are invalid or ineffective
with respect to any person or claim for any reason, the amount payable by the
association with respect to the related covered obligations shall be reduced by
the amount realized by any other person with respect to the person or claim that
is attributable to the policies, or portion thereof, covered by the
association.
(E)
If the association has provided benefits with respect to a covered obligation
and a person recovers amounts as to which the association has rights as
described in this paragraph, the person shall pay to the association the portion
of the recovery attributable to the policies, or portion thereof, covered by the
association;
(9)
The contractual obligations of the insolvent insurer for which the association
becomes or may become liable shall be as great as, but no greater than, the
contractual obligations of the insolvent insurer would have been in the absence
of an insolvency, unless such obligations are reduced as permitted by paragraph
(4) of this Code section. With respect to any one contract holder covered by an
unallocated annuity contract, the association shall be liable for not more than
$5 million in benefits irrespective of the number of such contracts held by that
contract holder. With respect to any other covered policy, the aggregate
liability of the association on any one life shall not exceed $100,000.00 with
respect to the payment of cash values or $300,000.00 for all benefits including
cash values; provided, however, that with respect to claims under policies
written to provide benefits as required under Chapter 9 of Title 34, relating to
workers' compensation, such claims shall be in the full amount as provided by
such chapter; and
(12)
The benefits that the association may become obligated to cover shall in no
event exceed the lesser of:
(A)
The contractual obligations for which the insurer is liable or would have been
liable if it were not an impaired or insolvent insurer;
(B)
With respect to one life, regardless of the number of policies or
contracts:
(i)
The amount of $300,000.00 in life insurance death benefits, but not more than
$100,000.00 in net cash surrender and net cash withdrawal values for life
insurance;
(ii)
In health insurance benefits, $300,000.00 for disability insurance; $300,000.00
for long-term care insurance; $300,000.00 for health insurance other than
disability insurance as referenced above, long-term care insurance as referenced
above, and basic hospital, medical, and surgical insurance or major medical
insurance as referenced below, including any net cash surrender and net cash
withdrawal values; and $500,000.00 for basic hospital, medical, and surgical
insurance or major medical insurance; and
(iii)
The amount of $300,000.00 in the present value of annuity benefits, but not more
than $250,000.00 in net cash surrender and net cash withdrawal values for an
annuity;
(C)
With respect to each payee of a structured settlement annuity, or beneficiary or
beneficiaries of the payee if deceased, $300,000.00 in present value annuity
benefits, in the aggregate, including net cash surrender and net cash withdrawal
values, if any;
(D)
However, in no event shall the association be obligated to cover more
than:
(i)
An aggregate of $300,000.00 in benefits with respect to any one life under
subparagraph (B) of this paragraph except with respect to benefits for basic
hospital, medical, and surgical insurance and major medical insurance under
division (ii) of this subparagraph, in which case the aggregate liability of the
association shall not exceed $500,000.00 with respect to any one individual;
or
(ii)
With respect to one owner of multiple nongroup policies of life insurance,
whether the policy owner is an individual, firm, corporation, or other person,
and whether the persons insured are officers, managers, employees, or other
persons, more than $5 million in benefits, regardless of the number of policies
and contracts held by the owner;
(E)
With respect to either one contract owner provided coverage under subparagraph
(b)(2)(B) of Code Section 33-38-2 or one plan sponsor whose plans own directly
or in trust one or more unallocated annuity contracts, $5 million in benefits,
regardless of the number of contracts with respect to the contract owner or plan
sponsor. However, in the case where one or more unallocated annuity contracts
are covered contracts under this chapter and are owned by a trust or other
entity for the benefit of two or more plan sponsors, coverage shall be afforded
by the association if the largest interest in the trust or entity owning the
contract or contracts is held by a plan sponsor whose principal place of
business is in this state and in no event shall the association be obligated to
cover more than $5 million in benefits with respect to all these unallocated
contracts; and
(F)
The limitations set forth in this paragraph are limitations on the benefits for
which the association is obligated before taking into account either its
subrogation and assignment rights or the extent to which those benefits could be
provided out of the assets of the impaired or insolvent insurer attributable to
covered policies. The costs of the association's obligations under this chapter
may be met by the use of assets attributable to covered policies or reimbursed
to the association pursuant to its subrogation and assignment
rights;
(13)
In performing its obligations to provide coverage under Code Section 33-38-7,
the association shall not be required to guarantee, assume, reinsure, or
perform, or cause to be guaranteed, assumed, reinsured, or performed, the
contractual obligations of the insolvent or impaired insurer under a covered
policy or contract that do not materially affect the economic values or economic
benefits of the covered policy or contract;
(10)(14)
In addition to the rights and powers elsewhere in this chapter,
the
The
association may:
(A)
Enter into such contracts as are necessary or proper to carry out the provisions
and purposes of this chapter;
(B)
Bring or
defend actions
Sue or be
sued, including
the right to
seek a declaratory judgment in any superior court of this state as to
uncertainties with respect to the payment of benefits under this Code section.
The association may also take
taking
any legal actions necessary or proper for recovery of any unpaid assessments
under Code Section 33-38-15
and may settle
claims or potential claims against
it;
(C)
Borrow money to effect the purposes of this chapter. Any notes or other
evidence of indebtedness of the association not in default shall be legal
investments for domestic insurers and may be carried as admitted
assets;
(D)
Employ or retain such persons as are necessary to handle the financial
transactions of the association and to perform such other functions as become
necessary or proper under this chapter;
(E)
Negotiate and contract with any liquidator, rehabilitator, conservator, or
ancillary receiver to carry out the powers and duties of the
association;
(F)
Take such legal action as may be necessary to avoid payment of improper claims;
and
(G)
Exercise, for the purposes of this chapter and to the extent approved by the
Commissioner, the powers of a domestic life or health insurer; but in no case
may the association issue insurance policies or annuity contracts other than
those
necessary
issued
to perform
the
contractual
its
obligations
of the
impaired or insolvent insurer.
under this
chapter;
(15)
Organize itself as a corporation or in other legal form permitted by the laws of
the state;
(16)
Request information from a person seeking coverage from the association in order
to aid the association in determining its obligations under this chapter with
respect to the person, and the person shall promptly comply with the
request;
(17)
Take other necessary or appropriate action to discharge its duties and
obligations under this chapter or to exercise its powers under this
chapter;
(18)
The association may join an organization of one or more other state associations
of similar purposes, to further the purposes and administer the powers and
duties of the association;
(19)
With respect to covered policies for which the association becomes obligated
after an entry of an order of liquidation, the association may elect to succeed
to the rights of the insolvent insurer arising after the order of liquidation
under any contract of reinsurance to which the insolvent insurer was a party, to
the extent such contract provides coverage for losses occurring after the date
of the order of liquidation. As a condition to making such election, the
association must pay all unpaid premiums due under the contract for coverage
relating to periods before and after the date on which the order of liquidation
was entered;
(20)
The board of directors shall have discretion and may exercise reasonable
business judgment to determine the means by which the association is to provide
the benefits of this chapter in an economical and efficient manner;
(21)
Where the association has arranged or offered to provide the benefits of this
chapter to a covered person under a plan or arrangement that fulfills the
association's obligations under this chapter, the person shall not be entitled
to benefits from the association in addition to or other than those provided
under the plan or arrangement;
(22)
Exclusive venue in any action by or against the association is in the Superior
Court of DeKalb County. The association may, at its option, waive such venue as
to specific actions. The association shall not be required to give an appeal
bond in an appeal that relates to a cause of action arising under this chapter;
and
(23)
In carrying out its duties in connection with guaranteeing, assuming, or
reinsuring policies or contracts under paragraph (1) or (2) of this Code
section, the association may, subject to approval of the receivership court,
issue substitute coverage for a policy or contract that provides an interest
rate, crediting rate, or similar factor determined by use of an index or other
external reference stated in the policy or contract employed in calculating
returns or changes in value by issuing an alternative policy or contract in
accordance with the following provisions:
(A)
In lieu of the index or other external reference provided for in the original
policy or contract, the alternative policy or contract provides for a fixed
interest rate, payment of dividends with minimum guarantees, or a different
method for calculating interest or changes in value;
(B)
There is no requirement for evidence of insurability, waiting period, or other
exclusion that would not have applied under the replaced policy or contract;
and
(C)
The alternative policy or contract is substantially similar to the replaced
policy or contract in all other material terms.
(b)
The provisions of this Code section shall apply only to coverage the guaranty
association provides in connection with any member insurer that is placed under
an order of liquidation with a finding of insolvency after the effective date of
this Code section.
33-38-8.
(a)
The association shall submit to the Commissioner a plan of operation and any
amendments thereto necessary or suitable to assure the fair, reasonable, and
equitable administration of the association. The plan of operation and any
amendments thereto shall become effective upon approval in writing by the
Commissioner. If the association fails to submit a suitable plan of operation
within 180 days following July 1, 1981, or, if at any time thereafter the
association fails to submit suitable amendments to the plan, the Commissioner
shall, after notice and hearing, adopt and promulgate such reasonable rules as
are necessary or advisable to effectuate the provisions of this chapter. Such
rules shall continue in force until modified by the Commissioner or superseded
by a plan submitted by the association and approved in writing by the
Commissioner.
(b)
All member insurers shall comply with the plan of operation.
(c)
The plan of operation shall, in addition to requirements enumerated elsewhere in
this chapter:
(1)
Establish procedures for handling the assets of the association;
(2)
Establish the amount and method of reimbursing members of the board of directors
under Code Section 33-38-6;
(3)
Establish regular places and times for meetings of the board of
directors;
(4)
Establish procedures for records to be kept of all financial transactions of the
association, its agents, and the board of directors;
(5)
Establish any additional procedures for assessments under Code Section 33-38-15;
and
(6)
Contain additional provisions necessary or proper for the execution of the
powers and duties of the association.
33-38-9.
The
plan of operation described in Code Section 33-38-8 may provide that any or all
powers and duties of the association, except those under subparagraph (C) of
paragraph
(10)
(14)
of Code Section 33-38-7 and Code Section 33-38-15, shall be delegated to a
corporation, association, or other organization which performs or will perform
functions similar to those of this association or its equivalent in two or more
states. Such a corporation, association, or organization shall be reimbursed
for any payments made on behalf of the association and shall be paid for its
performance of any function of the association. A delegation under this Code
section shall take effect only with the approval of both the board of directors
and the Commissioner and may be made only to a corporation, association, or
organization which extends protection not substantially less favorable and
effective than that provided for by this chapter.
33-38-10.
In
addition to the duties and powers enumerated elsewhere in this
chapter:
(1)
The Commissioner shall:
(A)
Upon request of the board of directors, provide the association with a statement
of the premiums in the appropriate states for each member insurer;
and
(B)
When an impairment is declared and the amount of the impairment is determined,
serve a demand upon the impaired insurer to make good the impairment within a
reasonable time. Notice to the impaired insurer shall constitute notice to its
shareholders, if any. The failure of the insurer to comply promptly with such
demand shall not excuse the association from the performance of its powers and
duties under this chapter; and
(2)
The Commissioner may suspend or revoke, after notice and hearing, the
certificate of authority to transact insurance in this state of any member
insurer which fails to pay an assessment when due or fails to comply with the
plan of operation.
33-38-11.
Records
shall be kept of all negotiations and meetings in which the association or its
representatives are involved to discuss the activities of the association in
carrying out its powers and duties under Code Section 33-38-7.
Records
The
records of
such
negotiations or meetings shall be made public only
upon
the
association with respect to an impaired or insolvent insurer shall not be
disclosed prior to the termination of a
liquidation, rehabilitation, or conservation proceeding involving the impaired
or insolvent insurer,
except
(a) upon the termination of the
impairment or insolvency of the insurer, or
(b)
upon the order of a court of competent jurisdiction. Nothing in this Code
section shall limit the duty of the association to render a report of its
activities under Code Section 33-38-12.
33-38-12.
The
association shall be subject to examination and regulation by the Commissioner.
Notwithstanding
the foregoing, whether such examinations shall be conducted and the frequency of
any such examination shall be at the sole discretion of the
Commissioner. The board of directors
shall submit to the Commissioner not later than May 1 of each year a financial
report and a report of its activities for the preceding calendar year on forms
approved by the Commissioner.
33-38-13.
The
association shall be exempt from all taxation in this state based upon income or
gross receipts and shall likewise be exempt from all state and local occupation
license and business fees and occupation license and business
taxes.
33-38-14.
There
shall be no liability on the part of and no cause of action of any nature shall
arise against any member insurer or its agents or employees, the association or
its agents or employees, members of the board of directors, or the Commissioner
or his or
her representatives, for any action
taken
or
omission by them in the performance of
their powers and duties under this chapter.
This immunity
shall extend to the participation in any organization of one or more other state
associations of similar purposes and to any such organization and its agents or
employees.
33-38-15.
(a)
For the purpose of providing the funds necessary to carry out the powers and
duties of the association, the board of directors shall assess the member
insurers separately for the health account and for each subaccount of the life
insurance and annuity account at such time and for such amounts as the board
finds necessary. Assessment shall be due not less than 30 days after prior
written notice to the member insurers.
(b)
There shall be two classes of assessments, as follows:
(1)
Class A assessments shall be
made
authorized and
called for the purpose of meeting
administrative costs and
legal
and other general expenses not related to
a particular impaired or insolvent insurer, and examinations conducted under the
authority of subsection (c) of Code Section 33-38-16; and
(2)
Class B assessments shall be
made
authorized and
called to the extent necessary to carry
out the powers and duties of the association under Code Section 33-38-7 with
regard to an impaired or insolvent insurer.
(c)(1)
The amount of any Class A assessment shall be determined by the board of
directors and may be made on a pro rata or non-pro rata basis. If a Class A
assessment is made on a pro rata basis, the board may provide that it be
credited against future Class B assessments. An assessment for costs and
expenses other than for examinations which is made on a non-pro rata basis shall
not exceed
$150.00
$300.00
per company in any one calendar year. The amount of any Class B assessment
shall be allocated for assessment purposes among the accounts or subaccounts in
subsection (c) of Code Section 33-38-5 pursuant to an allocation formula which
may be based on the premiums or reserves of the impaired or insolvent insurer or
any other standard deemed by the board in its sole discretion as being fair and
reasonable under the circumstances.
(2)
Class B assessments against member insurers for each account or subaccount shall
be in the proportion that the premiums received on business in this state by
each assessed member insurer on policies or contracts covered by each account or
subaccount for the three most recent calendar years for which information is
available preceding the year in which the insurer became impaired or insolvent,
as the case may be, bears to such premiums received on business in this state
for such calendar years by all assessed member insurers.
(3)
Assessments for funds to meet the requirements of the association with respect
to an impaired or insolvent insurer shall not be
made
authorized or
called until necessary to implement the
purposes of this chapter. Classification of assessments under subsection (b) of
this Code section and computation of assessments under this subsection shall be
made with a reasonable degree of accuracy, recognizing that exact determinations
may not always be possible.
The
association shall notify each member insurer of its anticipated pro rata share
of an authorized assessment not yet called within 180 days after the assessment
is authorized.
(d)
The association may abate or defer in whole or in part the assessment of a
member insurer if, in the opinion of the board of directors, payment of the
assessment would endanger the ability of the member insurer to fulfill its
contractual obligations. In the event an assessment against a member insurer is
abated or deferred in whole or in part, the amount by which such assessment is
abated or deferred may be assessed against the other member insurers in a manner
consistent with the basis for assessments set forth in this Code section.
Once the
conditions that caused a deferral have been removed or rectified, the member
insurer shall pay all assessments that were deferred pursuant to a repayment
plan approved by the association.
(e)(1)
The total of all assessments upon a member insurer for each account shall not in
any one calendar year exceed 2 percent of such insurer's premiums received in
this state on the policies covered by the account during the calendar year
preceding the assessment. If the maximum assessment in any account, together
with the other assets of the association, does not provide in any one year in
such account an amount sufficient to carry out the responsibilities of the
association, the necessary additional funds shall be assessed as soon thereafter
as permitted by this chapter.
(2)
The total of all assessments upon a member insurer for each subaccount of the
life insurance and annuity account shall not in any one calendar year exceed 2
percent of such insurer's premiums received in this state on the policies
covered by the subaccount during the calendar year preceding the assessment. If
the maximum assessment for any subaccount of the life insurance and annuity
account in any one year does not provide an amount sufficient to carry out the
responsibilities of the association, then the board shall assess the other
subaccounts of the life insurance and annuity account for the necessary
additional amount up to the maximum assessment level provided in paragraph (1)
of this subsection.
(f)
The board may, by an equitable method as established in the plan of operation,
refund to member insurers, in proportion to the contribution of each insurer to
that account or subaccount, the amount by which the assets of the account or
subaccount exceed the amount the board finds is necessary to carry out the
obligations of the association during the coming year with regard to that
account or subaccount, including assets accruing from net realized gains and
income from investments. A reasonable amount may be retained in any account or
subaccount to provide funds for the continuing expenses of the association and
for future losses if the board determines that refunds are
impractical.
(g)
It shall be proper for any member insurer in determining its premium rates and
policy owner dividends as to any kind of insurance within the scope of this
chapter to consider the amount reasonably necessary to meet its assessment
obligations under this chapter.
(h)
The association shall issue to each insurer paying an assessment under this
chapter, other than a Class A assessment, a certificate of contribution, in a
form prescribed by the Commissioner for the amount of the assessment paid. All
outstanding certificates shall be of equal dignity and priority without
reference to amounts or dates of issue. A certificate of contribution may be
shown by the insurer in its financial statement as an asset in such form, for
such an amount and for such period of time, not to exceed five years from the
date of assessment, as the Commissioner may approve.
(i)(1)
A member insurer that wishes to protest all or part of an assessment shall pay
when due the full amount of the assessment as set forth in the notice provided
by the association. The payment shall be available to meet association
obligations during the pendency of the protest or any subsequent appeal.
Payment shall be accompanied by a statement in writing that the payment is made
under protest and setting forth a brief statement of the grounds for the
protest.
(2)
Within 60 days following the payment of an assessment under protest by a member
insurer, the association shall notify the member insurer in writing of its
determination with respect to the protest unless the association notifies the
member insurer that additional time is required to resolve the issues raised by
the protest.
(3)
Within 30 days after a final decision has been made, the association shall
notify the protesting member insurer in writing of that final decision. Within
60 days of receipt of notice of the final decision, the protesting member
insurer may appeal that final action to the Commissioner.
(4)
In the alternative to rendering a final decision with respect to a protest based
on a question regarding the assessment base, the association may refer protests
to the Commissioner for a final decision, with or without a recommendation from
the association.
(5)
If the protest or appeal on the assessment is upheld, the amount paid in error
or excess shall be returned to the member company. Interest on a refund due a
protesting member shall be paid at the rate actually earned by the
association.
(j)
The association may request information of member insurers in order to aid in
the exercise of its power under this Code section and member insurers shall
promptly comply with a request.
33-38-16.
(a)
The board of directors may, upon majority vote, make reports and recommendations
to the Commissioner upon any matter germane to the solvency, liquidation,
rehabilitation, or conservation of any member insurer, or to the solvency of any
company seeking to do an insurance business in this state. Such reports and
recommendations shall not be considered public documents.
(b)
It shall be
the duty of the
The
board of directors
may,
upon majority vote,
to
notify the Commissioner of any information indicating any member insurer may be
an impaired or insolvent insurer.
(c)
The board of directors may, upon majority vote, request that the Commissioner
order an examination of any member insurer which the board in good faith
believes may be an impaired or insolvent insurer. Within 30 days of the receipt
of such request, the Commissioner shall begin such examination. The examination
may be conducted as a National Association of Insurance Commissioners'
examination or may be conducted by such persons as the Commissioner designates.
The cost of such examination shall be paid by the association and the
examination report shall be treated the same as other examination reports. In
no event shall such examination report be released to the board of directors
prior to its release to the public, but this shall not preclude the Commissioner
from complying with subsection (a) of this Code section. The Commissioner shall
notify the board of directors when the examination is completed. The request
for an examination shall be kept on file by the Commissioner, but it shall not
be open to public inspection prior to the release of the examination report to
the public.
(d)
The board of directors may, upon majority vote, make recommendations to the
Commissioner for the detection and prevention of insurer
insolvencies.
(e)
The board of directors shall, at the conclusion of any insurer insolvency in
which the association was obligated to pay covered claims, prepare a report to
the Commissioner containing such information as it may have in its possession
bearing on the history and causes of such insolvency. The board shall cooperate
with the board of directors of guaranty associations in other states in
preparing a report on the history and causes of insolvency of a particular
insurer and may adopt by reference any report prepared by such other
associations.
33-38-17.
(a)
This chapter
shall not be construed to reduce the liability for unpaid assessments of the
insureds of an impaired or insolvent insurer operating under a plan with
assessment liability.
(b)
For the purpose of carrying out its obligations under this chapter, the
association shall be deemed to be a creditor of the impaired or insolvent
insurer to the extent of the assets attributable to covered policies, reduced by
any amounts to which the association is entitled as subrogee pursuant to
paragraph
(8)
(11)
of Code Section 33-38-7.
All
The
assets of the impaired or insolvent insurer attributable to covered policies
shall be used by the association to continue
all
the
covered policies and pay
all
the
contractual obligations of the impaired or insolvent insurer as required by this
chapter. For purposes of this subsection, that portion of the total assets of
an impaired or insolvent insurer that is attributable to covered policies shall
be determined by using the same proportion as the reserves that should have been
established for such policies bears to the reserves that should have been
established for all policies of insurance written by the impaired or insolvent
insurer.
(c)
As a creditor of the impaired or insolvent insurer as established in subsection
(b) of this Code section and consistent with Code Section 33-37-33, the
association and other similar associations shall be entitled to receive a
disbursement of assets out of the marshaled assets, from time to time as the
assets become available to reimburse it, as a credit against contractual
obligations under this chapter. If the liquidator has not, within 120 days of a
final determination of insolvency of an insurer by the receivership court, made
an application to the court for the approval of a proposal to disburse assets
out of marshaled assets to guaranty associations having obligations because of
the insolvency, then the association shall be entitled to make application to
the receivership court for approval of its own proposal to disburse these
assets.
(b)(1)(d)(1)
Prior to the termination of any liquidation, rehabilitation, or conservation
proceeding, the court may take into consideration the contributions of the
respective parties, including the association, the shareholders, policy owners
of the insolvent insurer, and any other party with a bona fide interest, in
making an equitable distribution of the ownership rights of such insolvent
insurer. In such a determination, consideration shall be given to the welfare
of the policyholders of the continuing or successor insurer.
(2)
No distribution to stockholders of an impaired or insolvent insurer shall be
made until and unless the total amount of valid claims of the association
with interest
thereon for funds expended in carrying out
its powers and duties under Code Section 33-38-7, with respect to such insurer,
has been fully recovered by the association.
(3)
No insurer that is subject to any delinquency proceedings, whether formal or
informal, administrative or judicial, shall have any of its assets returned to
the control of its shareholders or private management until all payments of or
on account of the insurer's contractual obligations by all guaranty
associations, along with all expenses thereof and interest on all such payments
and expenses, shall have been repaid to the guaranty associations or a plan of
repayment by the insurer shall have been approved by the guaranty
association.
(c)(1)(e)(1)
If an order for liquidation or rehabilitation of an insurer domiciled in this
state has been entered, the receiver appointed under such order shall have a
right on behalf of the insurer to recover from any affiliate the amount of
distributions, other than stock dividends paid by the insurer on its capital
stock, made at any time during the five years preceding the petition for
liquidation or rehabilitation, subject to the limitations of this
subsection
and subsections (a) and (b) of this Code
section.
(2)
No such distribution shall be recoverable if the insurer shows that the
distribution was lawful and reasonable when paid and that the insurer did not
know and could not reasonably have known that the distribution might adversely
affect the ability of the insurer to fulfill its contractual
obligations.
(3)
Any person who was an affiliate that controlled the insurer at the time the
distributions were paid shall be liable to the extent of the distributions
received. Any person who was an affiliate that controlled the insurer at the
time the distributions were declared shall be liable to the extent of the
distributions that would have been received if such distributions had been paid
immediately. Whenever two persons are liable with respect to the same
distribution, they shall be jointly and severally liable.
(4)
The maximum amount recoverable under this subsection shall be the amount needed,
in excess of all other available assets of the insolvent insurer, to pay the
contractual obligations of the insolvent insurer.
(5)
Whenever any person liable under paragraph (3) of this subsection is insolvent,
all affiliates that controlled it at the time the distribution was paid shall be
jointly and severally liable for any resulting deficiency in the amount
recovered from the insolvent affiliate.
33-38-18.
All
proceedings in any court in this state in which the insolvent insurer is a party
shall be stayed
60
180
days from the date of a final order of liquidation, rehabilitation, or
conservation to permit proper legal action by the association on any matters
germane to its powers or duties. As to judgment entered under any decision,
order, verdict, or finding based on default, the association may apply to have
such judgment set aside by the same court that made such judgment and shall be
permitted to defend against such action on the merits.
33-38-19.
The
liquidator, rehabilitator, or conservator of any impaired insurer may notify all
interested persons of the effect of this chapter.
33-38-20.
Any
action of the board of directors may be appealed to the Commissioner by any
member insurer if such appeal is taken within
30
60
days of its
receipt of notice of the action being
appealed. Any final action or order of the Commissioner shall be subject to
judicial review in a court of competent jurisdiction
in accordance
with the laws of this state that may apply to the actions or orders of the
Commissioner.
33-38-21.
(a)
No person, including an insurer or agent or affiliate of an insurer, shall make,
publish, disseminate, circulate, or place before the public or cause directly or
indirectly to be made, published, disseminated, circulated, or placed before the
public, in any newspaper, magazine, or other publication; in the form of a
notice, circular, pamphlet, letter, or poster; over any radio station or
television station; or in any other way, any advertisement, announcement, or
statement which uses the existence of the association for the purposes of sales,
solicitation, or inducement to purchase any form of insurance covered by this
chapter. This Code section shall not apply to the association or any other
entity which does not sell or solicit insurance.
(b)
Any person who violates subsection (a) of this Code section may, after notice
and hearing and upon order of the Commissioner, be subject to one or more of the
following:
(1)
A monetary penalty of not more than $1,000.00 for each act or violation, but not
to exceed an aggregate penalty of $10,000.00; or
(2)
Suspension or revocation of his
or
her license or certificate of
authority.
33-38-22.
(a)
A member insurer may offset against its premium tax liability to this state an
assessment described in Code Section 33-38-15 to the extent of 20 percent of the
amount of such assessment for each of the five calendar years following the year
in which such assessment was paid. In the event a member insurer should cease
doing business, all uncredited assessments may be credited against its premium
tax liability for the year it ceases doing business.
(b)
Any sums which are acquired by refund, pursuant to subsection (f) of Code
Section 33-38-15, from the association by member insurers and which have
theretofore been offset against premium taxes as provided in subsection (a) of
this Code section shall be paid by such insurers to this state in such manner as
the Commissioner may require. The association shall notify the Commissioner
that such refunds have been made."
SECTION
2.
This
Act shall become effective upon its approval by the Governor or upon its
becoming law without such approval.
SECTION
3.
All
laws and parts of laws in conflict with this Act are repealed.