Life Only, Chapter 5 - A. Insurance Commissioner

For any other inquiries (not relating to examination) from the Division of Insurance, companies must provide a complete and accurate response within ________________ days from the date of the inquiry

20 calendar (same for life and health insurance)

The Commissioner of Insurance may examine or investigate any company or person involved in insurance transactions as often as deemed appropriate, but at least once every ______ years (same for life and health insurance)

5

The license of an insurance agency/business entity may be revoked, suspended, or non-renewed if after the hearing, the Commissioner finds that..........

an individual licensee's violation was known or should have been known to any of the agency's or entity's partners, officers, or managers, and that such violation was not reported to the Division of Insurance, nor did the agency take any corrective action (same for life and health insurance)

All reasonable expenses and charges associated with the examination must be paid directly by the ____________ to the ______________

examinee; examiner (same for life and health)

Any person who knowingly or willfully testifies falsely in reference to any matter material to an insurance examination is guilty of a ____________________ and, upon conviction, can be punished by a fine of not more than ______________, or by imprisonment for not more than _____ months, or by both

misdemeanor; $5,000; 3 (same for life and health insurance)

If any person fails to obey a subpoena, the Commissioner of Insurance may..........

petition a court of competent jurisdiction for an order compelling the person to appear and testify or produce documentary evidence (same for life and health insurance)

If the Commissioner suspects that an insurer or its agent has committed a violation or is engaged in an unfair trade practice, the commissioner may issue a _________________ and hold a __________________ for any purpose deemed necessary. If the Commissioner receives any info regarding the possible violation, the accused person will be required to appear before the commissioner

statement of charges; hearing (same for life and health insurance)

An insurance producers license, although issued and delivered to the licensee, is considered at all times to be the property of _______________________________ and must be surrendered or returned promptly to the Commissioner by personal delivery or by certified or registered mail within _______ days if the license has been suspended, revoked, or terminated for any reason

the state of CO; 15 (same for life and health insurance)

Commissioner may place on probation, suspend, revoke, refuse to continue or renew, refuse to issue an insurance producer's license, or assess a civil penalty, after notice to the insurance producer, the commissioner finds the existence of any one or more of the following conditions (same for life and health):

*refer to Section A, "3. License Suspension and Revocation"

Every entity subject to the "Records and Requests for Information" regulation must maintain books, records and documents pertaining to all of the following (same for life and health insurance):

- operations and management - policyholder services - claims handling - rating - underwriting - advertising, marketing, and sales - complaint/grievance handling - producer licensing Health entities must also retain records regarding: - network adequacy - utilization review - quality assessment and improvement - provider credentialing

Companies must provide a complete and accurate response to an Examination Request/Comment Form or Examination Request/Memo Form within ______________ days from the date on the form, unless another time period is specified in writing

10 calendar (same for life and health insurance)

Whenever the Commissioner determines to not renew or to deny an application for a license, the Commissioner will notify the ________________ or _________________ of the reasons for such action in writing. The Commissioner will also notify the ____________________________

applicant; licensee; NAIC (same for life and health insurance)

If, after a hearing, the Commissioner determines that the person charged has engaged in an unfair method of competition or an unfair or deceptive act or practice, the Commissioner will send to the person a written copy of violations and a ___________________________ requiring the person to stop engaging in such a method of competition, act, practice, or violation

cease and desist order (same for life and health insurance)

Along with a cease and desist order, the Commissioner could impose a monetary fine up to $____________ for each violation, not to exceed an aggregate amount of $____________, unless a person knew or reasonably should have known he or she was in violation, in which case the penalty could be up to $____________ for each violation, not to exceed an aggregate amount of $____________ annually

3,000; 30,000; 30,000; 750,000

The Commissioner and the examiners have the power to issue _____________, administer _____________, and examine under oath any person as to any matter pertinent to the examination

subpoenas; oaths (same for life and health insurance)

The refusal of any company or its employees to submit to examination or to comply with any reasonable requests of the examiners will be grounds for ________________, _______________, _______________, or ________________ of any license held by the company

suspension, revocation, denial, or nonrenewal (same for life and health insurance)

Duties of the commissioner of insurance (Same for Health and Life Insurance):

- adopt rules and regulations to enforce provisions of the Insurance Code - File and safely keep all books and papers required by law - Issue insurance licenses and certificates of authority for transacting insurance business in this state - conduct examinations, investigations, and hearings to determine whether any person has violated any insurance laws of Colorado - supervise the business of insurance in this state to assure that it is conducted in accordance with the laws of this state and in such a manner as to protect policyholders and the general public - transmit all monies collected by the Division of Insurance to the department of the treasury's general fund - encourage the dissemination to the public of general information concerning insurance so as to work toward informed choices of insurance needs and options - generally, perform with justice and impartiality all the duties that are imposed on the Commissioner by the laws in relation to the business of insurance in this state - must also file annual reports to the Governor and the General Assembly regarding the state of the insurance business in Colorado

If additional time is required to respond to an inquiry, the person must submit a written a request for an extension of time to the Division making the inquiry. The request must be (same for life and health insurance):

- be made no later than 5 PM Mountain Time on the business day prior to the response due date - include a specific period of time for the extension - state in detail the reasons necessitating the extension

The following may result in a $500 civil penalty for an initial violation, and may be increased up to a max penalty of $5,000 for each subsequent violation (same for life and health insurance):

- failure to provide a complete and accurate response to a Division inquiry - failure to request an extension for a specified period - failure to provide a complete and accurate response to a Division inquiry when an extension is not granted

Any person who violates a cease and desist order of the Commissioner may, after notice and hearing and upon order of the Commissioner, be subject to any one or more of the following penalties (same for life and health insurance):

- monetary fine up to $10,000 per violation by an insurer - monetary fine up to $500 per violation by an individual - license suspension and revocation

Along with a cease and desist order, the commissioner may also, at their discretion, impose one or more of the following penalties for unfair method of competition/unfair practice (same for life and health insurance):

- monetary fine up to $3,000 for each violation, not to exceed an aggregate of $30,000, unless a person knew or reasonably should have known he or she was in violation, in which case the penalty could be up to $30,000 for each violation, not to exceed an aggregate of $750,000 annually - suspension or revocation of the persons license who reasonably should have known he or she was in violation - payment of a contractual claim to an insured or beneficiary pursuant to an insurance policy if the Commissioner finds that the violation caused the failure to pay the claim

All insurance companies doing business in this state are required to make a statement under oath and file it with the Commissioner annually (on or before March 1) including the following (same for life and health insurance):

- the amount of all premiums collected during the year ending the last day of preceding December - the amounts actually paid to policyholders - the amount of insurance reinsured in other companies authorized to do business in this state and the amount of premiums paid - amount of insurance reinsured in companies (naming them) not authorized to do business in this state and the amount of premiums paid - amount of reinsurance accepted from admitted companies and the premiums received from such reinsurance, with the name of the companies so reinsured

Any person who violates a cease and desist order of the Commissioner may, after notice and hearing and upon order of the Commissioner, be subject to any one or more of the following penalties: (1) A monetary fine up to $____________ per violation by an insurer; (2) A monetary fine up to $____________ per violation by an individual; or (3) License suspension and revocation

10,000; 500

If the Commissioner revokes a license or if an insurance producer surrenders a license to avoid disciplinary action by the Commissioner, the insurance producer will not be eligible to apply for a new insurance producer license for ___________ after the date the license is revoked or surrenders and returned to the Commissioner

2 years (same for life and health insurance)

The purpose of the examination is to ensure that (same for life and health insurance)..............

companies remain solvent and conduct business of insurance in compliance with state laws and regulations pertaining to licensing, policy forms, rates, claims, and market conduct

The costs of financial examination of foreign companies made outside of Colorado must be paid by the ____________________ and must include expenses of the ____________________

company examined; commissioner (same for life and health insurance)

All insurance companies doing business in this state must maintain all books, documents, and other business records for the ____________________ year plus ____________________ years unless a longer time period is specified by other laws (same for life and health insurance)

current calendar year; 2 prior calendar years - includes internal & external communications - purpose of this regulation is to clarify rules regarding retention, maintenance, access to and retrievability of records