Ga. Comp. R. & Regs. R. 120-2-49-.12 - Underwriting Provisions
(1) The written agreement between the
administrator and an insurer shall make provision with respect to the
underwriting or other standards pertaining to the business underwritten by such
insurer. The written agreement between the administrator and a self-insurer
shall make provision with respect to any underwriting requirements or other
standards pertaining to the benefit coverage to be provided.
(2) As to the administration of coverage
insured by an insurance company, the insurance company, and not the
administrator, shall be responsible for determining the benefits, rates,
underwriting criteria, and claims payment procedures applicable to such
coverage and for securing reinsurance, if any.
(3) No administrator shall place any
insurance or reinsurance coverage on behalf of a plan sponsor with an insurer
that is not authorized or approved to do business in Georgia.
(4) No administrator shall have the authority
to move the coverage of a group or subgroup to a new insurer unless such action
is at the request of the current insurer or the group policyholder following
notice of termination of the group coverage by the insurer or group
policyholder, and the new insurer must hold a Certificate of Authority to do
business in Georgia.
(5) Any
insured individual whose group insurance coverage terminates, regardless of the
situs of the group policy, shall be entitled to conversion rights as required
under O.C.G.A. ยงยง
33-24-21.1 and
120-2-10-.11 of the Rules and
Regulations of the Office of Commissioner of Insurance, or as provided in the
group insurance policy, if more favorable.
(6) Where group insurance coverage is
discontinued and replaced, the individual insureds shall be entitled to all
takeover rights provided under Rule
120-2-10-.10 of the Rules and
Regulations of the Office of Commissioner of Insurance.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.