State Law Supplement -Mississippi

Insurance

-A mechanism by which a group of people who are fairly equally exposed to the same risks -Shift the risk to the insurer -In return for consideration (Premium)

Disclosure of exceptions and limitations (Pertaining to Accident and Health Insurance ONLY)

-Advertisements shall not use the words ONLY or MINIMUM or similar words to describe any exceptions and reductions.

Diabetes - Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

-Coverage not to exceed $250 must be offered annually for self management training/education and medical nutrition therapy. -Individual and group health insurance policies must offer coverage for diabetes treatments, including equipment, supplies used in connection with the monitoring of blood glucose and insulin administration, self-management training/education, and medical nutrition therapy.

Maternity/Newborn Coverage- Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

-Health Insurance Policies must provide benefits for maternity care as if it were a covered illness. -Individual and group health insurance policies and contracts that provide coverage for a family member of the insured must also provide coverage for newborn children from the moment of birth. -Injury and sickness coverage must include necessary care and treatment of medically diagnosed congenital defects, prematurities, birth abnormalities, and UP TO $200 FOR TRANSPORTATION. -If payment of a specific premium is required to provide coverage for a child, the policy may require that the insured notify the insurer within 31 days of the child's birth and pay any required fees no later than 30 days after the insurer mails the premium notice.

To protect the public interest, the Insurance Code Provides for:

-Licensing of insurance companies and agents -Examination of the financial health of insurance companies -Investigation into the business practices of insurance companies and agents.

Notice of Hearing

-if it appears to be in the public's best interest, the Commissioner may issue a Statement of charges against any person believed to be engaged in an unfair practice or method of competition. The statement must include notice of hearing to be held no earlier than 10 days after the notice is served.

Transaction

Includes any of the following actions in regard to a contract of insurance: -Soliciting -Selling -Advertising -Taking or transmitting applications -Receiving or delivering policies -Receiving, paying, collecting or transmitting a premium -Any other act involved in making or consummating an insurance contract.

Duties of Producers (MS Laws & Regulation - Life Insurance ONLY)

-A producer who initiates an application must submit a statement signed by the applicant and the producer as to whether the applicant has existing policies or contracts. -If the applicant has no existing policies, the producer's duties with respect to replacement are complete. -If applicant has no existing policies, the producer's duties with respect to replacement are complete. -If applicant indicates that he/she has existing policies, producer must present & read to the applicant before the taking of the application, a prescribed notice regarding replacements procedures. -The notice must be signed by both the applicant and the producer and a copy left with the applicant -Notice must list all life insurance policies or annuities proposed to be replaced, identified by the name of the insurer, the insured, or annuitant and policy number if available. -Must include a statement as to whether each policy will be replaced or whether a policy will be used as a source of financing for the new policy.

Advertising -Deceptive Words Prohibited (Pertaining to Accident and Health Insurance ONLY)

-Ads can't omit information or use works that have the tendency to mislead or deceive prospective purchasers regarding the nature or extent of all policy benefit, premium payable, or loss covered. -Using words such as ALL, FULL, COMPREHENSIVE, or UNLIMITED in a way that exaggerates benefits beyond the terms of the policy. It is against the law. -Using words such as TAX FREE and EXTRA INCOME when advertising benefits that are conditional upon confinement in a hospital. It is against the law.

Preexisting Conditions (Pertaining to Accident and Health Insurance ONLY)

-Advertisements must disclose the extent to which any loss is not covered for conditions existing prior to the effective date of the policy. -The phrase PREEXITING CONDITION can't be used without an appropriate definition. -This rule prohibits use of the phrase NO MEDICAL EXAMINATION REQUIRED.

Statement about the Insurer (Pertaining to Accident and Health Insurance ONLY)

-Advertisements must not contain untrue or misleading statements about the assets, corporate structure, financial standing, age, or relative position of an insurer in the insurance business. -They must not contain a recommendation by any commercial rating system without clearly indicating the purpose, limitations, scope, and extent of the recommendation.

Use of Statistics

-Advertisements relating to the dollar amounts of claims paid must not use irrelevant facts. -Advertisements must not represent or imply that claim settlements by the insurer are "liberal" or "generous" or use similar words. -An unusual amount paid for a unique claim for the policy advertised is misleading and must not be used.

Identity of Insurer (Pertaining to Accident and Health Insurance ONLY)

-All advertisements must disclose the name of the insurer if used in these statistics. -The insurer's name and the form numbers for the policies advertised must be stated in all advertisements. -Advertisements must not use any combination of words or symbols that tend to mislead prospective insureds about any connection with a government program or agency

Licensing: Insurance Producer

-All agents must be licensed by the Commissioner for each type of insurance they plan to sell. -Must hold a certificate of authority from at least one admitted insurer. -Context of agent licensing, a certificate of authority, is granted by an insurer, authorizing agent to transact business. -Agents may be authorized to represent more than one insurer. -Commissioner must notify insurers when their agents are also appointed by other insurers. -Anyone who sells insurance contracts without the appropriate license is deemed guilty of a misdemeanor and, upon conviction, subject to a fine of between $200 and $500, imprisonment for between one and two years, or both.

Unlicensed Activities

-Any person who, either as principal or agent or pretending to be such, solicits, examines, or inspects any risk, examines into, adjusts, or aids in adjusting any loss, receives, collects, or transmits any premiums of insurance, or does any other act in the soliciting, making, or executing of any contract of insurance of any kind other than permitted under Mississippi Law is guilty of a misdemeanor. -May be fined not less than $200 or more than $500, be imprisoned not less than one nor more than 2 years or both.

Testimonials by Third Parties (Pertaining to Accident and Health Insurance ONLY)

-Any testimonials used in advertisement or sales must be genuine and accurate from the person who has given the testimony. -If payment or endorsement of financial reimbursement is made to the person giving the testimony, it must be disclosed. -When a testimonial refers to benefits received under a policy, the specific claim date, claim number, and other pertinent information must be obtained by the insurer are held for inspection for either 4 years or until the next regular examination report is filed, whichever is longer.

Before approving an application for producer's license, the Commissioner must find that the individual is:

-At least 18 years of age -Has not committed any act that is a ground for denial, suspension, or revocation of the license. -Completed required relicensing course of study for the lines of authority for which applied. -Paid all applicable license and application fees. -Successfully passed any required examinations for the lines of authority for which applied.

Continuing Education (CE) (Maintenance & Duration of License)

-If license in effect for more than 18 months, producer must complete 24 credit hours of CE with 3 of the credit hours being on the subject of Ethics. -To renew a producer license which has been in effect 18 months or less, a producer must complete 12 credit hours of CE.

Agent Appointment

-Insurer appoints a producer as its agent by filing a notice of appointment with the Commissioner within 15 days from the date of the agency agreement or submission of first application. -Before issuing a license to a producer, Commissioner will require insurer to verify that they have investigated the character and background of the producer and is satisfied that he/she is of good moral character and is qualified and trustworthy to act as an insurance producer.

Advertising Records (Pertaining to Accident and Health Insurance ONLY)

-Insurers must keep files of all advertisements, accompanied by notes indicating the manner and extent of distribution. -These files are subject to inspection by the Commissioner and must be kept either for 4 years or until the filing of the next examination report, whichever is longer.

Mammography/Prostate Screenings -Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

-Insurers must offer coverage for breast cancer with low-dose mammography for all women age 35 or older -Prostate Screenings for men age 50 and older. This coverage must be offered on an optional basis, and each primary insured must accept or reject such coverage in writing and accept responsibility for premium payment.

Temporary Agent License

-Issued by the Commissioner to the producer without requiring a State exam. -For a period not to exceed 120 days, for industrial life agents only -For a period not to exceed 180 days -To the surviving spouse or court appointed personal representative of a licensed insurance producer who dies or becomes mentally or physically disabled to allow time to settle the business. -In any circumstance the Commissioner deems the public is best served by the issuance of the license.

Controlled Business

-Means policies of insurance to be issued to a producer, agent, or solicitor or their relatives, business associates, employees or which in either of them have an interest or control. -Licensee is not permitted to earn commissions from controlled business in excess of 35% of the aggregate commissions on all business written in any 24 month period.

PPACA Health Insurance Reforms began January 1, 2014: (Pertaining to Accident and Health Insurance ONLY)

-No preexisting condition limitations (for all eligible individuals) -Guaranteed issue of health insurance policies -No discrimination based on health status -Community rating rules for premiums -Health Insurance exchanges or marketplaces -Qualified Health Plans (QHPs) -Essential Health Benefits (EHBs) -Premium tax credits and cost-sharing subsidy -the creation of navigators

Who is not a member of the MS Life and Health Insurance Guaranty Association?

-Nonprofit hospital or medical service organizations -Health maintenance organizations -Fraternal Benefits Societies -Mandatory State Pooling plans -Mutual Assessment Companies -Insurance Exchanges

Producer Responsibilities

-Policy delivery- make sure that all policies written and approved are either delivered in person or mailed to the policy holder within the legal time frame. -Premium Accountability -Reply to Commissioner-reply promptly to any inquiry from the Commissioner-It is up to the agent to verify that the insurers they do business with are authorized.

Replacement of Group or Blanket Policies (Pertaining to Accident and Health Insurance ONLY)

-Preexisting condition limitations must not exceed the lesser of: -The benefits of the new policy (without applying the preexisting condition limitation) -The Benefits of the existing policy -Replacing insurers must give credit for any deductible or waiting periods that group members had satisfied under their existing polices (if similar benefits were provided.)

Renewal (Maintenance & Duration of License)

-Producer's license is effective for a two year term - Licenses expire on the last day of the month of the licensee's birthday in the second year following issuance or renewal. (mini. term of 13 months) -Business entity licenses expire on May 31 in the second year following issuance or renewal. (mini. term of 13 months) -Producer's may not obtain a certificate of authority unless they first have a license.

PPACA Health Insurance Reforms began in 2010: (Pertaining to Accident and Health Insurance ONLY)

-Prohibiting lifetime dollar limits and annual dollar limits on essential health benefits (EHBs) -No Rescissions (Repeal), except for fraud -Specified preventative services that must be covered with no cost sharing -Dependent coverage until a child's 26th birthday -Prohibited preexisting condition exclusions for children under age 19

Penalties for Noncompliance

-Refusal/Nonrenewable of the producer's license -Suspension/Revocation- Licensee with a revoked license may not apply for another producer's license for one year from the date of revocation. -Fines- Commissioner may levy a civil penalty of up to $1,000 per violation -Restitution -May order a licensee to repay to a consumer an amount equal to the financial harm done to the consumer by the licensee. -Violations

A nonresident person may receive a nonresident producer license if:

-The person is currently licensed as a resident and is in good standing in his home state. -The person has submitted the proper request for licensure and has paid the fees required. -The person has submitted to the Commissioner the application for licensure that the person submitted to his home state, or a completed uniform application -The person's home state awards nonresident producer licenses to residents of this state on the same basis.

Special Offers (Pertaining to Accident and Health Insurance ONLY)

-must not state or imply that the policy is an introductory or special offer, that applicants will receive substantial advantages not available at a later date, or that the offer is only available to a specified group of individuals, UNLESS THAT IS TRUE. -cannot advertise enrollment periods as limited if they use successive enrollment periods as their usual method of advertising accident and health insurance -May only offer an enrollment period during which a particular insurance product may be purchased on an individual basis if there has been a lapse of at least six months between the close of the preceding enrollment period for the same product and the opening of the new enrollment period. -must not state or imply that a specific number of policies will be sold or that a policy will be discontinued at a specific time because of its special advantages. -Policies that use reduced premium rates must not be advertised in a manner that overemphasizes availability and amount of the reduced initial premium.

Report administrative or criminal action (Maintenance & Duration of License)

1) A producer must report to the Commissioner any administrative action taken against the producer in another jurisdiction or by another governmental agency in Mississippi within 30 days of the final disposition of the matter. 2) A producer must report to the Commissioner any criminal prosecution taken against the producer within 30 days of the initial pretrial hearing.

The Commissioner has the duty and authority to:

1- Grant or Withhold certificates of authority, certificates of compliance, and licenses 2- Approve policies, proxies, and advertising material 3- Conduct hearings on rates and other matters affecting the regulation of the insurance industry in Mississippi. 4- Administer and collect surplus lines premium taxes 5- Receive and examine (at least annually) reports and financial statements from all insurance companies authorized to do business in Mississippi 6- Prepare and present an annual report to the governor each year by May 1

Prelicensing Education Requirement

Every individual seeking to be licensed as an insurance producer: -Must complete an approved Prelicensing course of study -Course must consist of 20 hours of approved study per line of authority + One line (Life Insurance Only) course is 20 hours + Two lines (Life, Accident, & Health) would be 40 hours.

Duties of all insurers: (MS Laws & Regulation - Life Insurance ONLY)

Every insurer must maintain compliance with replacement requirements that include at least the following - Inform its producers of the requirements of the regulation concerning policy replacement & incorporate requirements into training manuals. -Provide each producer a written statement of company's position with respect to acceptability of replacements. -A system to review the appropriateness of each replacement transaction that the producer does not indicate is in accord with the company's position. -Procedures to confirm that the requirements of the replacement regulation have been met. -Procedures to detect transactions that are replacements of existing policies but that have not been reported as such by the applicant or producer.

Repeat Replacements (MS Laws & Regulation - Life Insurance ONLY)

If policyowners repeatedly replace policies with other policies from the same agent, the pattern is considered to be evidence of the agent's knowledge that replacement was intended in connection with the sale of those policies and that the agent intended to violate the regulation.

Unfair Trade Practices

Illegal to engage in any trade practice that is considered an unfair method of competition or deceptive act. -Unfair claim methods and trade practices -Producers compensation disclosure -Rebating/illegal dealing in premiums -Illegal for an insurer or agent to make any other insurance contract or agreement other than what is in the policy. (except Florida and California) -Ex: Splitting premiums with unlicensed agent (insured). Offering incentives to purchase the insurance. -Illegal Inducements- -Rebate of premium -Special advantages -Returning a percentage of premiums to the insured for the sale.

Failure to issue proper receipts

In MS, producers must provide proper receipts for premiums paid. It is a violation of the law not to do this. (conditional receipts, etc.)

Plan Enrollment- PPACA (Pertaining to Accident and Health Insurance ONLY)

Initial enrollment in the plans available through the exchange began October 1, 2013. Individuals families have annual open enrollment October 15 to December 7 each year, with the effective date of the coverage being January 1 of the following year.

Disclosure (MS Laws & Regulation - Life Insurance ONLY)

Insureds are entitled to have basic disclosures made to them about the coverage they are purchasing. The disclosure requirement is designed to provide this information. -The amount of benefits payable -The manner of payment -What consideration will be paid for the policy Any company or agency delivering a policy that does not comply with these specifications will be subject to a $50 fine for each offense.

Producer Compensation

It is illegal to pay commissions to any producer who is not currently licensed and does have a certificate of authority with the company a policy may be written on. -It is LEGAL for a company to pay: -renewals an deferred commissions to people who no longer hold agent licenses. - Commissions to temporary license applicants. - Referral fees to unlicensed employees of an agent or agency who refer prospective insureds to the agent or agency.

Insurance Commissioner

Mike Chaney, 4 Year Term (Elected by the people) Must take an oath of office and furnish a $25,000 bond, which guarantees the faithful performance of the duties of the office, and which will otherwise be forfeited. -Also serves as the State Fire Marshal -Prepares & presents an annual report to the governor each year by May 1st. -Will be fired immediately if he has any connection with management or control of any company, corporation, or association affected by the Insurance Code.

Mississippi Life & Health Insurance Guaranty Association

Mission: To protect policy holders, insureds, and beneficiaries of life and health companies and annuities that have become insolvent or otherwise unable to perform their contractual obligations. Membership: All life and health insurers that hold certificates of authority in MS and sell in MS. (Including insurers whose licenses or certificates of authority have been suspended, revoked, voluntarily withdrawn, or not renewed) must be members of the Association -Under the direct supervision of the Commissioner.

Notify Commissioner of Change of Address (Maintenance & Duration of License)

Producers must promptly notify the Commissioner of any change of address within 30 days of the change.

QHP

Qualified Health Plans Insurance plans sold on the health insurance exchange/marketplace. They must be certified by the health insurance exchange/marketplace. They provide essential health benefits, follow established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meet other requirements. These are only available on the health insurance exchange/marketplace and are the only plans that provide premium tax credits and cost-sharing reductions for eligible individuals.

Replacement (MS Laws & Regulation - Life Insurance ONLY)

Refers to any transaction involving new coverage that will cause an existing life insurance policy or annuity to be: -Lapsed, forfeited, surrendered or otherwise terminated -Reissued with a reduction in cash value -Converted to reduced paid up insurance, continued as extended term insurance -Amended either to reduce benefits or the term for which coverage would remain in force. -Pledged as collateral or subjected to borrowing.

Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

The HIPAA provides that a preexisting condition exclusion can only relate to a condition for which medical advice, diagnosis, care, or treatment was recommended or received within the six-month period ending on the enrollment date. -Prior coverage is considered creditable if it ended within 63 days of the new coverage. Ex: Insurers must give credit for any deductibles or waiting periods under the prior policy. -Every health insurer in MS must fully comply with these requirements.

All Medicare Supplements & Long Term Care Policies have a _____ _____ Free Look.

30 Day

Notice of Claim - Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

Written notice of a claim must be given to the insurer within 30 DAYS after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible.

Limited Lines Producer

A person authorized by the Commissioner to sell, solicit, or negotiate limited lines insurance.

Insurance Producer

A person licensed to sell, solicit, or negotiate insurance. Producers who represent companies are known as agents.

Limited Line Credit Insurance Producer

A person who sells, solicits, or negotiates one or more forms of limited line credit insurance coverage to individuals through a master, corporate, group, or individual policy.

Pregnancy Complications- Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

A preexisting condition exclusion may not apply to a pregnancy existing on the effective date of coverage.

Income tax credit for long-term care insurance premiums

A taxpayer is allowed a MS income tax credit in an amount equal to 25% of the qualified long-term care insurance policy premium paid during the taxable year. The tax credit shall not exceed $500 or the taxpayer's income tax liability, whichever is less, for each qualified long-term care insurance policy.

Insurer

(Insurance Company) Any domestic or foreign corporation, indemnity or guaranty company, partnership, fraternal order, association, or individual that transacts insurance business.

Prompt Pay - Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

-"Clean" (undisputed) claims to be paid within a certain period of time. -Clean electronic claim must be paid within 25 days and a clean paper claim must be paid within 35 days. -If the claim is not paid within that time, the payee is entitled to collect interest on the payment amount at the rate of 1.5% per month.

Renewability and Cancellability (Pertaining to Accident and Health Insurance ONLY)

-When an advertisement refers to a dollar amount, a period of time for which a benefit is payable, or the cost of the policy, it must disclose the provisions relating must to renewability, termination, or any modification of benefits in a policy.

Referral Fee

Agents are permitted to pay a referral fee to an unlicensed employee for referring a prospective insured to the agent.

Termination of Appointment

An insurer terminates the appointment, employment, or contract with a producer must notify Commissioner within 30 days following the effective date of the termination.

Contractual Rights of Minors (MS Laws & Regulation - Life Insurance ONLY)

Any minor age 15 or older may contract for life, health, and accident insurance on his own life for the benefit of anyone who has an insurable interest.

EHBs

Essential Health Benefits Set of health care services categories that must be covered by all individual and small group health plans subject to the PPACA. Essential health benefits must include items and services within at least the following 10 categories: -Ambulatory Patient Services -Emergency Services -Hospitalization -Maternity and newborn care -Mental Health and substance use disorder services, including behavioral health treatment -Prescription drugs -Rehabilitative and habilitative services and devices -Laboratory services -Preventive and wellness services and chronic disease management -Pediatric services, including oral and vision care

Policy Loans

Fixed Interest Rates CANNOT exceed 8% interest per year in MS.

One, Mississippi (Pertaining to Accident and Health Insurance ONLY), PPACA

For small businesses, MS has a Small Business Health Options Program (SHOP) marketplace called "One, Mississippi". To participate in One, Mississippi, the employer: -Must have 50 or fewer full-time employees -Must attest to offering coverage to all full-time equivalent employees who average 30+ hours worked per week -May offer coverage to part-time employees. +The SHOP marketplace provides an online application where small employers can shop and compare a variety of health insurance plans. Health insurance plans offered through SHOP use the same four metal tiers previously discussed: Bronze, Silver, Gold, and Platinum. All plans must provide essential health benefits previously discussed. +One, Mississippi enrollment for employers began May 1, 2014, with an insurance coverage effective date of July 1, 2014.

Navigators (Pertaining to Accident and Health Insurance ONLY), PPACA

Funded by the federal government to help individuals determine their eligibility for public assistance programs using the health insurance exchange/marketplace website. Navigators cannot legally provide advice to consumers about which health insurance plan to choose and are not permitted to sell insurance.

Hearings (Penalties for Noncompliance)

If action is taken against an application or license, the applicant or licensee may make a written demand upon the Commissioner within 10 days for a hearing to determine the reasonableness of the Commissioner's action. The hearing must be held within 30 days.

Unfair Practices- Penalties

If commissioner determines that person has engaged in unfair competition or deceptive practice. -Commissioner will document the findings and serve with order to cease and desist from the practice. - In lieu a cease and desist order, the Commissioner may impose an administrative fine up to $5k per violation. - Anyone who willfully violates the cease and desist order will be subject to a fine of up to $1k for each violation and license suspension or revocation.

Certificate of Authority

Is an insurance company's license to transact business in Mississippi. -It certifies that the company has complied with the requirements of the MS insurance laws and that it is admitted (Authorized to transact business) in the state. -Companies must pay the required licensing fees and meet the capital requirements for each type of insurance they plan to market. -Certificates of authority must be renewed annually, on or by June 1.

Twisting/Misrepresentation

It is illegal for any insurance company, agent, solicitor, or representative to inform any current or prospective policyholder that an insurance company was required by regulation to change a policy form or related material to pressure that policyholder into changes policies. -Replacing a policy with another policy is not illegal as long as it is in the best interest of the client.

Discrimination

It is illegal to make written or oral statements which are malicious or attempting to do injury to the reputation of an agent or company. -Blindness -In MS, it is illegal to discriminate against an insured solely on the basis of being blind on an insurance policy.

Advertising

It is illegal to mislead anyone about any advertisement of a company that is untrue and not factual

Action against entity license (Penalties for Noncompliance)

License of a business entity may be suspended, revoked, or refused if the Commissioner finds, after hearing, that an individual licensee's violation was known or should have been known by one or more of the partners, officers, or managers. Nor took corrective action.

Agent/Broker Participation (Pertaining to Accident and Health Insurance ONLY), PPACA

Licensed agents and brokers are required to complete training to be permitted to enroll individuals and families in the Health Insurance Marketplace. Agents and brokers must register on the website and agree to comply with federal and state laws and regulations.

Hospice/Home Health Care- Policy Requirements (Pertaining to Accident and Health Insurance ONLY)

May be provided in a hospice care facility if relating to hospice care or at home. -Ex: Hospice care basically controls pain and suffering but does not attempt to cure. These benefits are normally available to people with terminally illnesses and not expected to live. +Home Health Care- Care at home for people who cannot perform the activities of daily living (ADLs) and need assistance.

Limited Lines Insurance

Means industrial fire, surety, title, travel, trip accident and baggage, car rental, crop, and industrial life or accident and health insurance.

Domestic Insurer

One that has been incorporated or formed in MS under the laws of MS and sells insurance in MS.

Foreign Insurer

One that has been incorporated or formed under the laws of any other state or government whose home office is not located in MS but sells in MS. (In MS there are NO Alien Insurers. ALL companies OUTSIDE of the US are called this.)

Coverage Tiers (Pertaining to Accident and Health Insurance ONLY)

PPACA new coverage Tiers -Bronze: Insurance covers 60% of covered expenses -Silver: Insurance covers 70% of covered expenses -Gold: Insurance covers 80% of covered expenses -Platinum: Insurance covers 90% of covered expenses

Health Insurance Exchange (Pertaining to Accident and Health Insurance ONLY)

PPACA requires states to have a health insurance exchange operated by either the state or the federal government. The state of MS has chosen to use the federal Gov't Health Insurance Marketplace to provide individuals and families with health insurance options. Individuals and families can access, view, and sign up for health insurance plans at www.healthcare.gov.

PPACA

Patient Protection and Affordable Care Act, AKA Health Care Reform or Obamacare This was enacted in March 2010. It addresses the quality of care, cost of care, and gaps in insurance coverage.

Who is covered under the MS Life & Health Insurance Guaranty Association?

Policy Owners, Insureds, Beneficiaries Products: Life, Health, Disability, Annuities +Benefits Maximum Coverage -$300k in life insurance death benefits (up to $100k in net cash surrender and net cash withdrawal values) -$100k in health insurance benefits other than disability or basic hospital insurance -$300k for disability insurance -$100k in the present value of annuity benefits.

Examination of Records

The Commissioner has the authority to examine and investigate the affairs of all parties engaged in the insurance business in MS to determine whether they are participating in any deceptive practice or unfair method of competition. -Commissioner may also +Examine the insurer's books, records, and documents +Question the company's officers and agents under oath.

Revocation of certificate of authority

The Commissioner may suspend or revoke an insurance company's certificate of authority to do business in the state if so deemed by the Commissioner. - After a 30-day notice has been issued, the company continues to violate (or fail to comply with) any applicable provisions of the insurance code. -Company's Financial condition is unsound -Company's assets in excess of liabilities are less than the amount of its original capital or the unimpaired funds required -A judgment rendered against the company by any court in MS has not been satisfied within 90 days after it has become final. -Commissioner may, in lieu of or in addition to suspending or revoking a company's certificate, assess an admin. fine of up to $5,000 per violation. Fines are deposited in the state treasury.

Existing Insurer

The insurance company that issued the policy to be terminated.

Replacing Insurer

The insurance company that issues the new policy to replace existing life insurance.

Annual Report

This is something the Commissioner has to prepare for the Governor each year by May 1st. Contains: -A review of the official acts taken by the Commissioner -An evaluation of the condition of insurance companies doing business in Mississippi -A summary of insurers' financial reports filed with the Commissioner -A list of the licenses issued by the Commissioner -A record of the taxes received by the Commissioner's office -Recommendations by the Commissioner for changes in the laws that affect the Department of Insurance.

Penalties

Violators of any provision of the MS insurance code are guilty of a misdemeanor and, upon conviction, must pay a fine of up to $5,000 in addition to any other specific penalties for that violation. -Commissioner could make the violator pay the investigation expenses.