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H.B. 40
This document includes House Floor Amendments incorporated into the bill on Wed, Jan
27, 2010 at 12:59 PM by lerror. -->
This document includes Senate Committee Amendments incorporated into the bill on
Tue, Feb 2, 2010 at 7:45 AM by rday. -->
1
UTAH LIFE AND HEALTH INSURANCE
2
GUARANTY ASSOCIATION AMENDMENTS
3
2010 GENERAL SESSION
4
STATE OF UTAH
5
Chief Sponsor: James A. Dunnigan
6
Senate Sponsor:
Wayne L. Niederhauser
7
8
LONG TITLE
9
Committee Note:
10
The Business and Labor Interim Committee recommended this bill.
11
General Description:
12
This bill modifies the Utah Life and Health Insurance Guaranty Association Act to
13
make various amendments.
14
Highlighted Provisions:
15
This bill:
16
. addresses the coverage and limitations under the act;
17
. modifies definition provisions and terminology;
18
. directs the commissioner to appoint public members to the board of directors;
19
. addresses provisions related to the powers and duties under the act;
20
. adds additional requirements for a plan of operation;
21
. modifies reporting requirements of the commissioner;
22
. modifies time frames under the act; and
23
. makes technical and conforming amendments.
24
Monies Appropriated in this Bill:
25
None
26
Other Special Clauses:
27
None
28
Utah Code Sections Affected:
29
AMENDS:
30
31A-28-103, as last amended by Laws of Utah 2001, Chapters 116 and 161
31
31A-28-105, as last amended by Laws of Utah 2001, Chapter 161
32
31A-28-107, as last amended by Laws of Utah 2001, Chapter 161
33
31A-28-108, as last amended by Laws of Utah 2007, Chapter 309
34
31A-28-109, as last amended by Laws of Utah 2001, Chapters 116 and 161
35
31A-28-110, as last amended by Laws of Utah 2001, Chapter 161
36
31A-28-111, as last amended by Laws of Utah 2001, Chapter 161
37
31A-28-112, as last amended by Laws of Utah 2001, Chapter 161
38
31A-28-114, as last amended by Laws of Utah 2008, Chapter 250
39
31A-28-118, as repealed and reenacted by Laws of Utah 1991, Chapter 211
40
31A-28-119, as last amended by Laws of Utah 2001, Chapter 161
41
31A-28-120, as enacted by Laws of Utah 2001, Chapter 161
42
43
Be it enacted by the Legislature of the state of Utah:
44
Section 1.
Section
31A-28-103
is amended to read:
45
31A-28-103. Coverage and limitations.
46
(1) (a) This part provides coverage for [the policies and contracts] a policy or contract
47
specified in Subsection (2) to a person who is:
48
(i) a beneficiary, assignee, or payee of a person covered by Subsection (1)(a)(ii)
49
regardless of where that person resides, except for a nonresident certificate holder under a
50
group policy or contract; or
51
(ii) an owner of or a certificate holder under a policy or contract, other than an
52
unallocated annuity contract or structured settlement annuity, if the owner or certificate holder
53
is:
54
(A) a resident of Utah; or
55
(B) not a resident of Utah, but only if:
56
(I) the insurer that issued the policy or contract is domiciled in this state;
57
(II) the state in which the person resides has an association similar to the association
58
created by this part; and
59
(III) the person is not eligible for coverage by an association in any other state because
60
the insurer was not licensed in the state at the time specified in the state's guaranty association's
61
law.
62
(b) For an unallocated annuity contract specified in Subsection (2):
63
(i) [Subsections (1)(a)(i) and (ii) do] Subsection (1)(a) does not apply; and
64
(ii) except as provided in Subsections (1)(d) and (1)(e), this part [shall provide]
65
provides coverage for the unallocated annuity contract specified in Subsection (2) to a person
66
who is:
67
(A) the owner of the unallocated annuity contract if the contract is issued to or in
68
connection with a specific benefit plan whose plan sponsor has its principal place of business
69
in this state; and
70
(B) an owner of an unallocated annuity contract issued to or in connection with a
71
government lottery if the owner is a resident.
72
(c) For a structured settlement annuity specified in Subsection (2):
73
(i) [Subsections (1)(a)(i) and (ii) do] Subsection (1)(a) does not apply; and
74
(ii) except as provided in Subsections (1)(d) and (1)(e), this part [shall provide]
75
provides coverage for the structured settlement annuity specified in Subsection (2) to a person
76
who is a payee under a structured settlement annuity, or beneficiary of a payee if the payee is
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deceased, if the payee:
78
(A) is a resident, regardless of where the contract owner resides; or
79
(B) is not a resident, but only if [the] one or more of the contract [owner] owners of the
80
structured settlement annuity is a resident, or [the] no contract owner of the structured
81
settlement annuity is [not] a resident, but:
82
(I) the insurer that issued the structured settlement annuity is domiciled in this state;
83
(II) the state in which the contract owner resides has an association similar to the
84
association created by this part; and
85
(III) the payee, beneficiary, or the contract owner is not eligible for coverage by the
86
association of the state in which the payee or contract owner resides.
87
(d) This part may not provide coverage for [the policies and contracts] a policy or
88
contract specified in Subsection (2) to:
89
(i) a person who is a payee or beneficiary of a contract owner resident of this state, if
90
the payee or beneficiary is afforded any coverage by the association of another state; or
91
(ii) a person covered under Subsection (1)(b), if any coverage is provided to the person
92
by the association of another state.
93
(e) (i) This part provides coverage for a policy or contract specified in Subsection (2) to
94
a person who is a resident of this state and, in special circumstances, to a nonresident.
95
(ii) To avoid duplicate coverage, if a person who would otherwise receive coverage
96
under this part is provided coverage under the laws of any other state, the person may not be
97
provided coverage under this part.
98
(iii) In determining the application of this Subsection (1)(e) [in situations where] when
99
a person could be covered by the association of more than one state, whether as an owner,
100
payee, beneficiary, or assignee, this part shall be construed in conjunction with other state laws
101
to result in coverage by only one association.
102
(2) (a) (i) Except as limited by this part, this part provides coverage to [the persons] a
103
person specified in Subsection (1) for:
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(A) a direct, nongroup life, accident and health, or annuity policy or contract;
105
(B) a supplemental contract to a policy or contract described in Subsection (2)(a)(i)(A);
106
(C) a certificate under a direct group policy or contract; and
107
(D) an unallocated annuity contract issued by a member insurer.
108
(ii) For purposes of Subsection (2)(a)(i), an annuity contract and a certificate under a
109
group annuity contract includes:
110
(A) a guaranteed investment contract;
111
(B) a deposit administration contract;
112
(C) an unallocated funding agreement;
113
(D) an allocated funding agreement;
114
[(D)] (E) a structured settlement annuity;
115
[(E)] (F) an annuity issued to or in connection with a government lottery; and
116
[(F)] (G) an immediate or deferred annuity contract.
117
(b) This part does not provide coverage for:
118
(i) a portion of a policy or contract:
119
(A) not guaranteed by the insurer; or
120
(B) under which the risk is borne by the policy or contract owner;
121
(ii) a policy or contract of reinsurance, unless:
122
(A) an assumption certificate is issued before the coverage date;
123
(B) the assumption certificate required by Subsection (2)(b)(ii)(A) is in effect pursuant
124
to the reinsurance policy or contract; and
125
(C) the reinsurance contract is approved by the appropriate regulatory authorities; [or]
126
(iii) a portion of a policy or contract to the extent that the rate of interest on which it is
127
based or the interest rate, crediting rate, or similar factor determined by use of an index or other
128
external reference stated in the policy or contract employed in calculating returns or changes in
129
value, if the interest rate, crediting rate, or similar factor:
130
(A) is not excluded from coverage by Subsection (2)(b)[(xii)](xi); [and]
131
(B) averaged over the period of four years [prior to] before the date on which the
132
association becomes obligated with respect to the policy or contract, exceeds a rate of interest
133
determined by subtracting two percentage points from Moody's Corporate Bond Yield Average
134
averaged:
135
(I) for that same four-year period; or
136
(II) for the corresponding lesser period if the policy or contract was issued less than
137
four years before the association became obligated; and
138
(C) exceeds the rate of interest determined by subtracting three percentage points from
139
Moody's Corporate Bond Yield Average as most recently available as determined on or after
140
the earlier of the day on which the member insurer becomes:
141
(I) an impaired insurer under this part; or
142
(II) an insolvent insurer under this part;
143
(iv) a portion of a policy or contract issued to a plan or program of an employer,
144
association, or other person to provide life, accident and health, or annuity benefits to its
145
employees, members, or others, to the extent that the plan or program is self-funded or
146
uninsured, including benefits payable by an employer, association, or other person under:
147
(A) a multiple employer welfare arrangement as defined in 29 U.S.C. Sec. 1144;
148
(B) a minimum premium group insurance plan;
149
(C) a stop-loss group insurance plan; or
150
(D) an administrative services only contract;
151
(v) a portion of a policy or contract to the extent that it provides:
152
(A) a dividend;
153
(B) an experience rating credit;
154
(C) voting rights; or
155
(D) payment of a fee or allowance to any person, including the policy or contract
156
owner, in connection with the service to or administration of the policy or contract;
157
[(vi) a policy or contract issued in this state by a member insurer at a time when:]
158
[(A) it was not licensed; or]
159
[(B) did not have a certificate of authority to issue the policy or contract in this state;]
160
[(vii)] (vi) an unallocated annuity contract issued to or in connection with a benefit plan
161
protected under the federal Pension Benefit Guaranty Corporation, regardless of whether the
162
federal Pension Benefit Guaranty Corporation has yet become liable to make any payment with
163
respect to the benefit plan;
164
[(viii)] (vii) a portion of an unallocated annuity contract that is not issued to or in
165
connection with:
166
(A) a specific benefit plan of:
167
(I) employees;
168
(II) a union; or
169
(III) an association of natural persons; or
170
(B) a government lottery;
171
[(ix)] (viii) a portion of a policy or contract to the extent that the assessment required
172
by Section
31A-28-109
that applies to the policy or contract is preempted by federal or state
173
law;
174
[(x)] (ix) an obligation that does not arise under the express written terms of the policy
175
or contract issued by an insurer to the contract owner or policy owner, including:
176
(A) a claim based on marketing materials;
177
(B) a claim based on [documents that are] a side letter, rider, or other document that is
178
issued by the insurer without meeting applicable policy form filing or approval requirements;
179
(C) a misrepresentation regarding a policy benefit;
180
(D) an extra-contractual claim;
181
(E) a claim for penalties; or
182
(F) a claim for consequential or incidental damages;
183
[(xi)] (x) a contract that establishes the member insurer's obligations to provide a book
184
value accounting guaranty for defined contribution benefit plan participants by reference to a
185
portfolio of assets that is owned by a person that is:
186
(A) (I) the benefit plan; or
187
(II) the benefit plan's trustee; and
188
(B) not an affiliate of the member insurer; H. [
and
] .H
189
[(xii)] (xi) a portion of a policy or contract to the extent it provides for interest or other
190
changes in value:
191
(A) to be determined by the use of an index or other external reference stated in the
192
policy or contract; and
193
(B) (I) that have not been credited to the policy or contract; or
194
(II) as to which the policy or contract owner's rights are subject to forfeiture as of the
195
date the member insurer becomes an impaired or insolvent insurer under this part H. [
.
] ; and
195a
S. [
(x)
] (xii) .S a policy providing hospital, medical, prescription drug, or other health care
benefit
195b
pursuant to United States Code, Title 42, Subchapter XVIII, Chapter 7, Part C or D, or
federal
195c
regulations issued under Part C or D. .H
196
(3) Subject to Subsection (4), the benefits for which the association may become liable
197
may not exceed the lesser of:
198
(a) the contractual obligations for which the insurer is liable or would have been liable
199
if it were not an impaired or insolvent insurer;
200
(b) with respect to one life, regardless of the number of policies or contracts:
201
(i) for a life insurance policy:
202
(A) if the insured died before the coverage date, $500,000 of the death benefit;
203
(B) if the insurer received a valid request for cash surrender before the coverage date
204
but has not paid the cash surrender value before the coverage date, H. [
[
] $200,000 [
]
]
204a
[
$250,000
] .H of
205
cash surrender benefits; or
206
(C) if neither Subsection (3)(b)(i)(A) nor (B) apply, the covered portion of each benefit
207
provided under the policy;
208
(ii) for an annuity contract, the covered portion of each benefit provided under the
209
contract;
210
(iii) for an accident and health policy:
211
(A) classified as health insurance, $500,000; or
212
(B) not classified as health insurance, the covered portion of each benefit provided
213
under the policy;
214
(c) for an individual, or a beneficiary of that individual if the individual is deceased,
215
participating in a governmental retirement plan established under Section 401, 403(b), or 457,
216
Internal Revenue Code, covered by an unallocated annuity contract, in the aggregate,
217
[$200,000] $250,000 in present value of annuity benefits, including:
218
(i) net cash surrender; and
219
(ii) net cash withdrawal values; or
220
(d) for a payee of a structured settlement annuity or a beneficiary of the payee if the
221
payee is deceased, the limits set forth in Subsection (3)(b).
222
(4) Notwithstanding Subsections (3)(a) through (d), the association may not be
223
obligated to cover more than:
224
(a) an aggregate of $500,000 in benefits for any one life under:
225
(i) Subsection (3)(b)(i)(A);
226
(ii) Subsection (3)(b)(i)(B);
227
(iii) Subsection (3)(b)(ii); [or] and
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(iv) Subsection (3)(b)(iii)(B);
229
(b) $5,000,000 in benefits for one owner of multiple nongroup policies of life
230
insurance:
231
(i) whether the policy owner is an individual, firm, corporation, or other person;
232
(ii) whether the persons insured are officers, managers, employees, or other persons;
233
and
234
(iii) regardless of the number of policies and contracts held by the owner; and
235
(c) $5,000,000 in benefits, regardless of the number of contracts held by the contract
236
owner or plan sponsor, for:
237
(i) one contract owner provided coverage under Subsection (1)(b)(ii)(B); or
238
(ii) one plan sponsor whose plans own, directly or in trust, one or more unallocated
239
annuity contracts not included in Subsection (3)(b)(ii).
240
(5) (a) Notwithstanding Subsection (4)(c) and except as provided in Subsection (5)(b),
241
the association shall provide coverage if one or more unallocated annuity contracts are:
242
(i) covered contracts under this part;
243
(ii) owned by a trust or other entity for the benefit of two or more plan sponsors; and
244
(iii) the largest interest in the trust or entity owning the contract or contracts is held by
245
a plan sponsor whose principal place of business is in the state.
246
(b) Notwithstanding Subsection (5)(a) the association may not be obligated to cover
247
more than $5,000,000 in benefits with respect to [all] the unallocated contracts described in
248
Subsection (5)(a).
249
(6) (a) The limitations set forth in Subsections (3) and (4) are limitations on the
250
benefits for which the association is obligated before taking into account:
251
(i) the association's subrogation and assignment rights; or
252
(ii) the extent to which those benefits could be provided out of the assets of the
253
impaired or insolvent insurer attributable to covered policies.
254
(b) The costs of the association's obligations under this part may be met by the use of
255
assets:
256
(i) attributable to covered policies, as described in Subsection
31A-28-114
(3)(c); or
257
(ii) reimbursed to the association pursuant to the association's subrogation and
258
assignment rights.
259
(c) On and after the date on which the association becomes obligated for [any] a
260
covered policy, the association may not be obligated to provide benefits to the extent that the
261
benefits are based on an interest rate, crediting rate, or similar factor determined by use of an
262
index or other external reference stated in the policy or contract employed in calculating returns
263
or changes in value if the interest rate, crediting rate, or similar factor exceeds the rate of
264
interest determined by subtracting three percentage points from Moody's Corporate Bond Yield
265
Average as most recently available on each date on which interest is credited or attributed to
266
the covered policy.
267
(d) In performing its obligations to provide coverage under Section
31A-28-108
, the
268
association may not be required to guarantee, assume, reinsure, perform, or cause to be
269
guaranteed, assumed, reinsured, or performed a contractual obligation of the insolvent or
270
impaired insurer under a covered policy or contract that does not materially affect the economic
271
values or economic benefits of the covered policy or contract.
272
Section 2.
Section
31A-28-105
is amended to read:
273
31A-28-105. Definitions.
274
As used in this part:
275
(1) "Association" means the Utah Life and Health Insurance Guaranty Association
276
continued under Section
31A-28-106
.
277
(2) (a) "Authorized assessment" or "authorized," when used in the context of
278
assessments, means that the board of directors passed a resolution whereby an assessment will
279
be called immediately or in the future from member insurers for an amount set forth in the
280
resolution.
281
(b) An assessment is authorized when the resolution is passed.
282
(3) "Benefit plan" means a specific benefit plan of:
283
(a) employees;
284
(b) a union; or
285
(c) an association of natural persons.
286
(4) (a) "Called assessment" or "called," when used in the context of assessments,
287
means that the association issued a notice to member insurers requiring that an authorized
288
assessment be paid within the time frame set forth in the notice.
289
(b) All or part of an authorized assessment becomes a called assessment when notice is
290
mailed by the association to member insurers.
291
(5) "Cash surrender value" means the cash surrender value without reduction for an
292
outstanding policy loan or surrender charge.
293
[(5)] (6) "Contractual obligation" means an obligation under any of the following for
294
which coverage is provided under Section
31A-28-103
:
295
(a) a policy or contract;
296
(b) a certificate under a group policy or contract; or
297
(c) a portion of a policy or contract.
298
[(6)] (7) "Coverage date" means the date on which the association becomes responsible
299
for the obligations of a member insurer.
300
[(7)] (8) "Covered policy" means any of the following for which coverage is provided
301
in Section
31A-28-103
:
302
(a) a policy or contract; or
303
(b) a portion of a policy or contract.
304
[(8)] (9) (a) "Covered portion" means:
305
(i) for [any] a covered policy that has a cash surrender value, a fraction [obtained by
306
dividing] calculated with:
307
(A) the numerator being the lesser of:
308
(I) H. (Aa) [
[
] $200,000 [
]
] for a life insurance policy; and
(Bb) .H $250,000 H. for a covered policy that is not a life insurance policy .H ; or
309
(II) the cash surrender value of the policy; [by] and
310
(B) the denominator being the cash surrender value of the policy; and
311
(ii) for [any] a covered policy that does not have a cash surrender value, a fraction
312
[obtained by dividing] calculated with:
313
(A) the numerator being the lesser of:
314
(I) H. (Aa) [
[
] $200,000 [
]
] for a life insurance policy; or
314a
(Bb) .H $250,000 H. for a covered policy that is not a life insurance policy .H ; or
315
(II) the policy's minimum statutory reserve; [by] and
316
(B) the denominator being the policy's minimum statutory reserve.
317
(b) The cash surrender value and the minimum statutory reserve are determined as of
318
the coverage date in accordance with the exclusions in Subsection
31A-28-103
(2)(b)(iii).
319
[(9)] (10) "Extra-contractual claim" includes a claim relating to:
320
(a) bad faith in the payment of a claim;
321
(b) punitive or exemplary damages; or
322
(c) [attorneys'] attorney fees and costs.
323
[(10)] (11) "Impaired insurer" means a member insurer that is not an insolvent insurer
324
and:
325
(a) is considered by the commissioner to be hazardous pursuant to this title; or
326
(b) is placed under an order of rehabilitation or conservation by a court of competent
327
jurisdiction.
328
[(11)] (12) "Insolvent insurer" means a member insurer that is placed under an order of
329
liquidation by a court of competent jurisdiction with a finding of insolvency.
330
[(12)] (13) (a) "Member insurer" means [a person that: (i) is an insurer; and (ii)] an
331
insurer that holds a certificate of authority to transact in this state any kind of insurance for
332
which coverage is provided under Section
31A-28-103
.
333
(b) "Member insurer" includes an insurer whose license or certificate of authority in
334
this state may have been:
335
(i) suspended;
336
(ii) revoked;
337
(iii) not renewed; or
338
(iv) voluntarily withdrawn.
339
(c) "Member insurer" does not include:
340
(i) a for-profit or nonprofit:
341
(A) hospital;
342
(B) hospital service organization; or
343
(C) medical service organization;
344
[(i)] (ii) a health maintenance organization;
345
[(ii)] (iii) a fraternal benefit society;
346
[(iii)] (vi) a mandatory state pooling plan;
347
[(iv)] (v) a mutual assessment company or other person that operates on an assessment
348
basis;
349
[(v)] (vi) an insurance exchange; [or]
350
(vii) an organization described in Subsection
31A-22-1305
(2); or
351
[(vi)] (viii) an entity similar to an entity described in Subsections [(12)] (13)(c)(i)
352
through [(v)] (vii).
353
[(13)] (14) "Moody's Corporate Bond Yield Average" means the Monthly Average
354
Corporates as published by Moody's Investors Service, Inc., or any successor to Moody's
355
Investors Service, Inc.
356
[(14)] (15) (a) "Owner" of a policy or contract, "policy owner," or "contract owner"
357
means [the] a person who:
358
(i) is identified as the legal owner under the terms of the policy or contract; or
359
(ii) is otherwise vested with legal title to the policy or contract through a valid
360
assignment:
361
(A) completed in accordance with the terms of the policy or contract; and
362
(B) properly recorded as the owner on the books of the insurer.
363
(b) "Owner," "policy owner," or "contract owner" does not include a person with only a
364
beneficial interest in a policy or contract.
365
[(15)] (16) "Person" means [any]:
366
(a) an individual;
367
(b) a corporation;
368
(c) a limited liability company;
369
(d) a partnership;
370
(e) an association;
371
(f) a governmental body or entity; [or]
372
(g) a trust; or
373
[(g)] (h) a voluntary organization.
374
[(16)] (17) "Plan sponsor" means:
375
(a) the employer, in the case of a benefit plan established or maintained by a single
376
employer;
377
(b) the employee organization, in the case of a benefit plan established or maintained
378
by an employee organization; or
379
(c) the association, committee, joint board of trustees, or other similar group of
380
representatives of the parties who establish or maintain a benefit plan, in the case of a benefit
381
plan established or maintained by:
382
(i) two or more employers; or
383
(ii) jointly by:
384
(A) one or more employers; and
385
(B) one or more employee organizations.
386
[(17)] (18) (a) "Premiums" means an amount or consideration received on covered
387
policies or contracts, less:
388
(i) returned:
389
(A) premiums;
390
(B) considerations; and
391
(C) deposits; and
392
(ii) dividends and experience credits.
393
(b) (i) "Premiums" does not include an amount or consideration received for:
394
(A) a policy or contract for which coverage is not provided under Subsection
395
31A-28-103
(2); or
396
(B) the portion of a policy or contract for which coverage is not provided under
397
Subsection
31A-28-103
(2).
398
(ii) Notwithstanding Subsection [(17)] (18)(b)(i), an assessable premium may not be
399
reduced on account of:
400
(A) Subsection
31A-28-103
(2)(b)(iii) relating to interest limitations; and
401
(B) Subsection
31A-28-103
(3) relating to limitations for:
402
(I) one individual;
403
(II) any one participant; and
404
(III) any one contract owner.
405
(c) "Premiums" [may] does not include [any] premiums in excess of $5,000,000:
406
(i) on [any] an unallocated annuity contract not issued under a governmental retirement
407
plan established under Section 401, 403(b), or 457, Internal Revenue Code; or
408
(ii) for multiple nongroup policies of life insurance owned by one owner:
409
(A) whether the policy owner is an individual, firm, corporation, or other person;
410
(B) whether the persons insured are officers, managers, employees, or other persons;
411
and
412
(C) regardless of the number of policies or contracts held by the owner.
413
[(18)] (19) (a) Except as provided in Subsection [(18)] (19)(b), "principal place of
414
business" of a plan sponsor or a person other than a natural person means the single state:
415
(i) in which the natural persons who establish policy for the direction, control, and
416
coordination of the operations of the entity as a whole primarily exercise the function; and
417
(ii) determined by the association in its reasonable judgment by considering the
418
following factors:
419
(A) the state in which the primary executive and administrative headquarters of the
420
entity are located;
421
(B) the state in which the principal office of the chief executive officer of the entity is
422
located;
423
(C) the state in which the board of directors, or similar governing person or persons, of
424
the entity conducts the majority of its meetings;
425
(D) the state in which the executive or management committee of the board of
426
directors, or similar governing person, of the entity conducts the majority of its meetings;
427
(E) the state from which the management of the overall operations of the entity is
428
directed; and
429
(F) in the case of a benefit plan sponsored by affiliated companies comprising a
430
consolidated corporation, the state in which the holding company or controlling affiliate has its
431
principal place of business as determined using the factors described in Subsections [(18)]
432
(19)(a)(ii)(A) through (E).
433
(b) Notwithstanding Subsection [(18)] (19)(a), in the case of a plan sponsor, if more
434
than 50% of the participants in the benefit plan are employed in a single state, the state where
435
more than 50% of the participants are employed is considered to be the principal place of
436
business of the plan sponsor.
437
(c) (i) The principal place of business of a plan sponsor of a benefit plan described in
438
Subsection (3) is considered to be the principal place of business of the association, committee,
439
joint board of trustees, or other similar group of representatives of the parties who establish or
440
maintain the benefit plan.
441
(ii) If for a benefit plan described in Subsection (3) there is not a specific or clear
442
designation of a principal place of business under Subsection [(18)] (19)(c)(i), the principal
443
place of business is considered to be the principal place of business of the employer or
444
employee organization that has the largest investment in the benefit plan.
445
(20) "Receiver" means, as the context requires:
446
(a) a rehabilitator;
447
(b) a liquidator;
448
(c) an ancillary receiver; or
449
(d) a conservator.
450
[(19)] (21) "Receivership court" means the court in the insolvent or impaired insurer's
451
state having jurisdiction over the conservation, rehabilitation, or liquidation of the insurer.
452
[(20)] (22) (a) "Resident" means a person:
453
(i) to whom a contractual obligation is owed; and
454
(ii) who resides in this state on the earlier of the date a member insurer is an:
455
(A) impaired insurer; or
456
(B) insolvent insurer.
457
(b) A person may be a resident of only one state, which in the case of a person other
458
than a natural person [shall be] is where its principal place of business is located.
459
(c) A citizen of the United States that is either a resident of a foreign country or a
460
resident of a United States possession, territory, or protectorate that does not have an
461
association similar to the association created by this part, is considered a resident of the state of
462
domicile of the insurer that issued the policy or contract.
463
[(21)] (23) "State" means:
464
(a) a state;
465
(b) the District of Columbia;
466
(c) Puerto Rico; and
467
(d) a United States possession, territory, or protectorate.
468
[(22)] (24) "Structured settlement annuity" means an annuity purchased to fund
469
periodic payments for a plaintiff or other claimant in payment for personal injury suffered by
470
the plaintiff or other claimant.
471
[(23)] (25) "Supplemental contract" means a written agreement entered into for the
472
distribution of proceeds under a policy or contract for:
473
(a) life;
474
(b) accident and health; or
475
(c) annuity.
476
[(24)] (26) "Unallocated annuity contract" means an annuity contract or group annuity
477
certificate that is not issued to and owned by an individual, except to the extent of any annuity
478
benefits guaranteed to an individual by an insurer under the contract or certificate.
479
Section 3.
Section
31A-28-107
is amended to read:
480
31A-28-107. Board of directors.
481
(1) (a) The board of directors of the association shall consist of:
482
(i) at least five but not more than nine member insurers [serving] who:
483
(A) subject to Subsection (1)(e), serve terms as established in the plan of operation[.];
484
and
485
[(b) (i) The members of the board of directors shall be]
486
(B) are selected by member insurers, subject to the approval of the commissioner[.];
487
and
488
(ii) two public representatives appointed by the commissioner.
489
(b) (i) The commissioner shall make the appointment of a public representative
490
coincide with the association's annual meeting at which the association's board of directors is
491
elected.
492
(ii) A public representative may not be:
493
(A) an officer, director, or employee of an insurer; or
494
(B) a person engaged in the business of insurance.
495
(iii) Subject to Subsection (1)(e), a public representative shall serve a term of three
496
years.
497
[(ii)] (c) When a vacancy occurs in the membership of the board of directors for any
498
reason[,]:
499
(i) if the vacancy is of a member insurer, a replacement may be elected for the
500
unexpired term by a majority vote of the remaining board members, subject to the approval of
501
the commissioner[.]; and
502
(ii) if the vacancy is of a public representative, the commissioner shall appoint a
503
replacement for the unexpired term.
504
[(c)] (d) In approving [selections] a selection or in appointing [members] a member to
505
the board of directors, the commissioner shall consider, among other things, whether all
506
member insurers are fairly represented.
507
[(d)] (e) Notwithstanding [Subsection (1)(a)] Subsections (1)(a) and (b), the
508
commissioner shall, at the time of election [or], reelection, appointment, or reappointment
509
adjust the length of terms to ensure that the terms of board members are staggered so that
510
approximately half of the board of directors is selected during any two-year period.
511
(2) (a) A member of the board of directors may be reimbursed from the assets of the
512
association for expenses incurred by the member as a member of the board of directors.
513
(b) Except as provided in Subsection (2)(a), a member of the board of directors may
514
not be compensated by the association for the member's services.
515
Section 4.
Section
31A-28-108
is amended to read:
516
31A-28-108. Powers and duties of the association.
517
(1) (a) If a member insurer is an impaired insurer, subject to any conditions imposed by
518
the association that do not impair the contractual obligations of the impaired insurer, the
519
association may [elect to] provide the protections provided by this part [to the policyholders of
520
the impaired insurer].
521
(b) If the association makes the election described in Subsection (1)(a), the association
522
may proceed under one or more of the options described in Subsection (3).
523
(2) If a member insurer is an insolvent insurer, the association shall provide the
524
protections provided by this part [to the policyholders of the insolvent insurer] by electing in its
525
discretion to proceed under one or more of the options in Subsection (3).
526
(3) With respect to the covered portions of covered policies of an impaired or insolvent
527
insurer, the association may:
528
(a) (i) (A) guaranty, assume, or reinsure, or cause to be guaranteed, assumed, or
529
reinsured, the policies or contracts of the insurer; or
530
(B) assure payment of the contractual obligations of the insolvent insurer; and
531
(ii) provide [such monies] the money, pledges, guarantees, or other means as are
532
reasonably necessary to discharge such duties; or
533
(b) provide benefits and coverages in accordance with Subsection (4).
534
(4) (a) In accordance with Subsection (3)(b), the association may:
535
(i) assure payment of benefits for premiums identical to the premiums and benefits,
536
except for terms of conversion and renewability, that would have been payable under the
537
policies or contracts of the insurer, for claims incurred:
538
(A) with respect to group policies:
539
(I) not later than the earlier of the next renewal date under the policies or contracts or
540
45 days after the coverage date; and
541
(II) in no event less than 30 days after the coverage date; or
542
(B) with respect to nongroup policies or contracts:
543
(I) not later than the earlier of the next renewal date, if any, under the policies or
544
contracts or one year from the coverage date; and
545
(II) in no event less than 30 days from the coverage date;
546
(ii) make diligent efforts to [provide 30 days' notice of] notify the following 30 days
547
before any termination of the benefits that are provided [to] under a policy or contract of the
548
insurer:
549
(A) [all] the known insureds or annuitants for nongroup policies and contracts; [or]
550
(B) owners if other than an insured or annuitant; or
551
[(B)] (C) group policy owners for group policies and contracts; and
552
(iii) with respect to nongroup life and accident and health insurance policies and
553
annuities, make available substitute coverage on an individual basis, in accordance with
554
Subsection (4)(b), to each known insured, annuitant, or owner and to each individual formerly
555
insured or formerly an annuitant under a group policy who is not eligible for replacement group
556
coverage on an individual basis in accordance with Subsection (4)(b), if the insured or
557
annuitant had a right under law or the terminated policy or annuity contract to:
558
(A) convert coverage to individual coverage; or
559
(B) continue an individual policy in force until a specified age or for a specified time
560
during which the insurer had:
561
(I) no right unilaterally to make changes in any provision of the policy; or
562
(II) a right only to make changes in premium by class.
563
(b) (i) In providing the substitute coverage required under Subsection (4)(a)(iii), the
564
association may offer to:
565
(A) reissue the terminated coverage; or
566
(B) issue an alternative policy.
567
(ii) An alternative or reissued policy under Subsection (4)(b)(i):
568
(A) shall be offered without requiring evidence of insurability; and
569
(B) may not provide for any waiting period or exclusion that would not have applied
570
under the terminated policy.
571
(iii) The association may reinsure [any] an alternative or reissued policy.
572
(c) (i) An alternative policy adopted by the association [shall be] is subject to the
573
approval of the commissioner.
574
(ii) The association may adopt alternative policies of various types for future issuance
575
without regard to any particular impairment or insolvency.
576
(iii) An alternative policy:
577
(A) shall contain at least the minimum statutory provisions required in this state; and
578
(B) provide benefits that are not unreasonable in relation to the premium charged.
579
(iv) The association shall set the premium for an alternative policy in accordance with
580
a table of rates that the association adopts. The premium shall reflect:
581
(A) the amount of insurance to be provided; and
582
(B) the age and class of risk of each insured.
583
(v) For an alternative policy issued under an individual policy of the impaired or
584
insolvent insurer:
585
(A) age shall be determined in accordance with the original policy provisions; and
586
(B) class of risk [shall be] is the class of risk under the original policy.
587
(vi) For an alternative policy issued to individuals insured under a group policy:
588
(A) age and class of risk shall be determined by the association in accordance with the
589
alternative policy provisions and risk classification standards approved by the commissioner;
590
and
591
(B) the premium may not reflect any changes in the health of the insured after the
592
original policy was last underwritten.
593
(vii) [Any] An alternative policy issued by the association shall provide coverage of a
594
type similar to that of the policy issued by the impaired or insolvent insurer, as determined by
595
the association.
596
(d) If the association elects to reissue terminated coverage at a premium rate different
597
from that charged under the terminated policy, the association shall set the premium [shall be
598
set by the association] in accordance with the amount of insurance provided and the age and
599
class of risk, subject to the approval of the commissioner or by a court of competent
600
jurisdiction.
601
(e) The association's obligations with respect to coverage under any policy of the
602
impaired or insolvent insurer or under any reissued or alternative policy [shall cease] ceases on
603
the date the coverage or policy is replaced by another similar policy by:
604
(i) the [policyholder] owner;
605
(ii) the insured; or
606
(iii) the association.
607
(f) (i) With respect to a claim unpaid as of the coverage date and a claim incurred
608
during the period defined in Subsection (4)(a)(i), a provider of health care services, by
609
accepting a payment from the association upon a claim of the provider against an insured
610
whose health care insurer is an insolvent member insurer, agrees to forgive the insured of 20%
611
of the debt which otherwise would be paid by the insurer had it not been insolvent, subject to a
612
maximum of $8,000 being required to be forgiven by any one provider as to each claimant.
613
(ii) The obligations of a solvent insurer to pay all or part of the covered claim are not
614
diminished by the forgiveness provided for in this section.
615
(5) When proceeding under Subsection (3)(b) with respect to any policy or contract
616
carrying guaranteed minimum interest rates, the association shall assure the payment or
617
crediting of a rate of interest consistent with Subsection
31A-28-103
(2)(b)(iii).
618
(6) Nonpayment of premiums within 31 days after the date required under the terms of
619
any guaranteed, assumed, alternative, or reissued policy or contract or substitute coverage
620
[shall terminate] terminates the association's obligations under the policy or coverage under
621
this part with respect to the policy or coverage, except with respect to any claims incurred or
622
any net cash surrender value that may be due in accordance with this part.
623
(7) (a) [Premiums] Premium due after the coverage date with respect to the covered
624
portion of a policy or contract of an impaired or insolvent insurer [shall belong to and be]
625
belongs to and is payable at the direction of the association. If a liquidator of an insolvent
626
insurer requests the report, the association shall report to the liquidator the premium collected
627
by the association.
628
(b) The association is liable to [the] a policy or contract [owners] owner for unearned
629
premiums due to the policy or contract [owners] owner arising after the coverage date with
630
respect to the covered portion of the policy or contract.
631
(8) The protection provided by this part does not apply if any guaranty protection is
632
provided to residents of this state by laws of the domiciliary state or jurisdiction of the
633
impaired or insolvent insurer other than this state.
634
(9) In carrying out its duties under [Subsections (1) and] Subsection (2), and subject to
635
approval by a court in this state, the association may:
636
(a) impose permanent policy or contract liens in connection with a guarantee,
637
assumption, or reinsurance agreement, if the association finds that:
638
(i) the amounts that can be assessed under this part are less than the amounts needed to
639
assure full and prompt performance of the association's duties under this part; or
640
(ii) the economic or financial conditions as they affect member insurers are sufficiently
641
adverse to render the imposition of the permanent policy or contract liens to be in the public
642
interest;
643
(b) impose temporary moratoriums or liens on payments of cash values and policy
644
loans, or any other right to withdraw funds held in conjunction with policies or contracts, in
645
addition to any contractual provisions for deferral of cash or policy loan value; and
646
(c) if the receivership court imposes a temporary moratorium or moratorium charge on
647
payment of cash values or policy loans, or on any other right to withdraw funds held in
648
conjunction with policies or contracts, out of the assets of the impaired or insolvent insurer,
649
defer the payment of cash values, policy loans, or other rights by the association for the period
650
of the moratorium or moratorium charge imposed by the receivership court, except for claims
651
covered by the association to be paid in accordance with a hardship procedure:
652
(i) established by the [liquidator or rehabilitator] receiver; and
653
(ii) approved by the receivership court.
654
(10) (a) A special deposit in this state held pursuant to law or required by the
655
commissioner for the benefit of creditors, including policy owners, that is not turned over to the
656
domiciliary [liquidator] receiver upon the entry of a final order of liquidation or order
657
approving a rehabilitation plan of an insurer domiciled in any state shall be promptly paid to
658
the association.
659
(b) Any amount paid under Subsection (10)(a) to the association less the amount
660
retained by the association shall be treated as a distribution of estate assets pursuant to Sections
661
31A-27a-601
,
31A-27a-602
, and [
31A-27a-702
]
31A-27a-701
.
662
(11) If the association fails to act within a reasonable period of time as provided in this
663
section, the commissioner [shall have] has the powers and duties of the association under this
664
part with respect to an impaired or insolvent insurer.
665
(12) The association may [render assistance and advice to] assist or advise the
666
commissioner, upon the commissioner's request, concerning:
667
(a) rehabilitation;
668
(b) payment of claims;
669
(c) continuance of coverage; or
670
(d) the performance of other contractual obligations of any impaired or insolvent
671
insurer.
672
(13) (a) The association has standing to appear or intervene before a court or agency in
673
this state with jurisdiction over:
674
(i) an impaired or insolvent insurer concerning which the association is or may become
675
obligated under this part; or
676
(ii) any person or property against which the association may have rights through
677
subrogation or otherwise.
678
(b) The standing referred to in Subsection (13)(a) extends to all matters germane to the
679
powers and duties of the association, including:
680
(i) proposals for reinsuring, modifying, or guaranteeing the policies or contracts of the
681
impaired or insolvent insurer; and
682
(ii) the determination of the policies or contracts and contractual obligations.
683
(c) The association has the right to appear or intervene before a court in another state
684
with jurisdiction over:
685
(i) an impaired or insolvent insurer for which the association is or may become
686
obligated; or
687
(ii) any person or property against which the association may have rights through
688
subrogation of the insurer's [policyholders] policyowners.
689
(14) (a) [Any] A person receiving benefits under this part [shall be] is considered to
690
have assigned the rights under, and any causes of action against any person for losses arising
691
under, resulting from, or otherwise relating to the covered policy or contract to the association
692
to the extent of the benefits received because of this part, whether the benefits are payments of,
693
or on account of:
694
(i) contractual obligations;
695
(ii) continuation of coverage; or
696
(iii) provision of substitute or alternative coverages.
697
(b) As a condition precedent to the receipt of any right or benefits conferred by this part
698
upon that person, the association may require an assignment to it of the rights and causes of
699
action described in Subsection (14)(a) by any:
700
(i) payee;
701
(ii) policy or contract owner;
702
(iii) beneficiary;
703
(iv) insured; or
704
(v) annuitant.
705
(c) The subrogation rights obtained by the association under this Subsection (14)
706
[shall] have the same priority against the assets of the impaired or insolvent insurer as that
707
possessed by the person entitled to receive benefits under this part.
708
(d) In addition to Subsections (14)(a) through (c), the association has [all] the common
709
law rights of subrogation and any other equitable or legal remedy that would have been
710
available to the impaired or insolvent insurer or owner, beneficiary, or payee of a policy or
711
contract with respect to the policy or contract, including in the case of a structured settlement
712
annuity any rights of the owner, beneficiary, or payee of the annuity to the extent of benefits
713
received pursuant to this part against a person originally or by succession responsible for the
714
losses arising from the personal injury relating to the annuity or payment of the annuity.
715
(e) If a provision of this Subsection (14) is invalid or ineffective with respect to [any] a
716
person or claim for any reason, the amount payable by the association with respect to the
717
related covered obligations shall be reduced by the amount realized by any other person with
718
respect to the person or claim that is attributable to the policies, or portion of the policies,
719
covered by the association.
720
(f) If the association has provided benefits with respect to a covered policy and a
721
person recovers amounts as to which the association has rights as described in this Subsection
722
(14), the person shall pay to the association the portion of the recovery attributable to the
723
covered policies.
724
(15) (a) In addition to the rights and powers elsewhere in this part, the association may:
725
(i) enter into [contracts that are] a contract that is necessary or proper to carry out the
726
provisions and purposes of this part;
727
(ii) sue or be sued, including taking any legal actions necessary or proper to:
728
(A) recover any unpaid assessments under Section
31A-28-109
; and
729
(B) settle claims or potential claims against the association;
730
(iii) borrow money to effect the purposes of this part;
731
(iv) employ or retain the persons necessary or the appropriate staff members to:
732
(A) handle the financial transactions of the association; and
733
(B) perform other functions as become necessary or proper under this part;
734
(v) take necessary or appropriate legal action to avoid or recover payment of improper
735
claims;
736
(vi) exercise, for the purposes of this part and to the extent approved by the
737
commissioner, the powers of a domestic life or health insurer, but in no case may the
738
association issue insurance policies or annuity contracts other than those issued to perform its
739
obligation under this part;
740
(vii) request information from a person seeking coverage from the association to aid
741
the association in determining the association's obligations under this part with respect to the
742
person;
743
(viii) take other necessary or appropriate action to discharge the association's duties
744
and obligations under this part or to exercise the association's powers under this part; and
745
(ix) act as a special deputy [liquidator] receiver if appointed by the commissioner.
746
(b) Any note or other evidence of indebtedness of the association under Subsection
747
(15)(a)(iii) that is not in default:
748
(i) is a legal investment for a domestic insurer; and
749
(ii) may be carried as admitted assets.
750
(c) A person seeking coverage from the association shall promptly comply with a
751
request for information by the association under Subsection (15)(a)(vii).
752
(16) The association may join an organization of one or more other state associations
753
of similar purposes to further the purposes and administer the powers and duties of the
754
association.
755
(17) (a) [Except as provided in Subsection (17)(b), at] At any time within [one year]
756
180 days after the coverage date, the association may elect to succeed to the rights and
757
obligations of the member insurer that:
758
(i) accrue on or after the coverage date; and
759
(ii) relate to covered policies under any one or more indemnity reinsurance agreements:
760
(A) entered into by the member insurer as a ceding insurer and its reinsurer; and
761
(B) selected by the association.
762
[(b) Notwithstanding Subsection (17)(a), the association may not exercise an election
763
with respect to a reinsurance agreement if the receiver, rehabilitator, or liquidator of the
764
member insurer has previously and expressly disaffirmed the reinsurance agreement.]
765
[(c) The election described in Subsection (17)(a) shall be effected by a notice to:]
766
[(i) (A) the receiver;]
767
[(B) rehabilitator; or]
768
[(C) liquidator; and]
769
[(ii) the affected reinsurers.]
770
(b) An election made pursuant to Subsection (17)(a) is effective as of the date of the
771
order of liquidation.
772
(c) The association may make an election described in Subsection (17)(a) by notifying
773
an affected reinsurer in writing, with verification of receipt, through:
774
(i) the association; or
775
(ii) a nationally recognized association representing state guaranty associations that is
776
approved by the commissioner, that provides notice on behalf of the association.
777
(d) The association shall provide a copy of the notice described in Subsection (17)(c) to
778
the receiver.
779
(e) (i) The receiver of an insolvent insurer and each reinsurer of the ceding member
780
insurers shall make available as soon as possible after commencement of formal delinquency
781
proceedings the information described in Subsection (17)(e)(ii) to:
782
(A) the association; or
783
(B) a nationally recognized association representing state guaranty associations that is
784
approved by the commissioner, on behalf of the association.
785
(ii) This Subsection (17)(e) applies to:
786
(A) copies of in-force contracts of reinsurance and the related records relevant to the
787
determination of whether the in-force contracts of reinsurance should be assumed;
788
(B) notices of any default under a reinsurance contract; or
789
(C) any known event or condition that with the passage of time could become a default
790
under a reinsurance contract.
791
[(d)] (f) If the association makes an election under Subsection (17)(a), the association
792
shall comply with Subsections (17)[(d)](f)(i) through [(vi)] (vii) with respect to the agreements
793
selected by the association.
794
(i) For [contracts] a contract covered, in whole or in part, by the association, the
795
association [shall be] is responsible for:
796
(A) [all] the unpaid premiums due under the agreements for periods both before and
797
after the coverage date; and
798
(B) the performance of [all] the other obligations to be performed after the coverage
799
date.
800
(ii) The association may charge [contracts] a contract covered in part by the association
801
the costs for reinsurance in excess of the obligations of the association, through reasonable
802
allocation methods.
803
(iii) The association shall provide notice and an accounting to the receiver of a charge
804
made pursuant to Subsection (17)(f)(ii).
805
[(iii)] (iv) The association is entitled to any amounts payable by the reinsurer under the
806
agreements with respect to [losses or events] a loss or event that:
807
(A) [occur in periods] occurs after the coverage date; and
808
(B) [relate to contracts] relates to a contract covered by the association, in whole or in
809
part.
810
[(iv)] (v) On receipt of any amounts under Subsection (17)[(d)(iii)](f)(iv), the
811
association shall pay to the beneficiary under the policy or contract on account of which the
812
amounts were paid an amount equal to the [excess] lesser of:
813
(A) the amount received by the association; and
814
(B) the excess of the amount received by the association over the benefits paid or
815
payable by the association on account of the policy or contract less the retention of the insurer
816
applicable to the loss or event.
817
[(v)] (vi) (A) Within 30 days following the association's election, the association and
818
each indemnity reinsurer shall calculate the net balance due to or from the association under
819
each reinsurance agreement as of the date of the association's election, giving full credit to [all]
820
the items paid by either the member insurer, [or] its receiver, [rehabilitator, or liquidator,] or
821
the indemnity reinsurer [during the period between the coverage date and] before the date of
822
the association's election.
823
[(B) Either the association or indemnity reinsurer shall pay the net balance due the
824
other within five days of the completion of the calculation under Subsection (17)(d)(v)(A).]
825
(B) Within five days of the completion of the calculation under Subsection
826
(17)(f)(vi)(A):
827
(I) the reinsurer shall pay the receiver the amounts due for a loss or event before the
828
coverage date, subject to any set-off for premiums unpaid for a period before the coverage date;
829
and
830
(II) the association or the reinsurer shall pay any remaining balance due the other.
831
(C) A dispute over an amount due to either party shall be resolved:
832
(I) by arbitration pursuant to the terms of the affected reinsurance contract; or
833
(II) if the reinsurance contract contains no arbitration clause, as otherwise provided by
834
law.
835
[(C)] (D) If the receiver[, rehabilitator, or liquidator has received any amounts]
836
receives an amount due the association pursuant to Subsection (17)[(d)(iii)](f)(iv), the
837
receiver[, rehabilitator, or liquidator] shall remit [the same] that amount to the association as
838
promptly as practicable.
839
[(vi)] (vii) If the association, or the receiver on behalf of the association, within 60
840
days of the election, pays the premiums due for periods both before and after the coverage date
841
that relate to contracts covered by the association, in whole or in part, the reinsurer may not:
842
(A) terminate the reinsurance [agreements] agreement for failure to pay premium, to
843
the extent the [agreements relate to contracts] reinsurance agreement relates to a policy or
844
contract covered by the association, in whole or in part; and
845
(B) set off [any unpaid premium due for periods prior to the coverage date] against
846
amounts due the association[.] an amount due:
847
(I) under another contract; or
848
(II) as an unpaid amount due from a person other than the association.
849
(g) (i) This Subsection (17)(g) applies during the period that:
850
(A) begins on the coverage date; and
851
(B) ends:
852
(I) the election date; or
853
(II) if no election date occurs, 180 days after the coverage date.
854
(ii) During the period described in Subsection (17)(g)(i):
855
(A) neither the association nor the reinsurer have a right or obligation under a
856
reinsurance contract that the association may assume under Subsection (17)(a), whether for a
857
period before or after the coverage date; and
858
(B) the reinsurer, the receiver, and the association, to the extent practicable, shall
859
provide each other data and records reasonably requested.
860
(iii) Notwithstanding Subsection (17)(g)(ii), once the association elects to assume a
861
reinsurance contract, the parties' rights and obligations are governed by Subsections (17)(f)(i)
862
through (vi).
863
(h) If the association does not elect to assume a reinsurance contract by the election
864
date pursuant to Subsection (17)(a), the association has no right or obligation with respect to
865
the reinsurance contract, whether for a period before or after the coverage date.
866
[(e)] (i) An insurer other than the association [shall succeed] succeeds to the rights and
867
obligations of the association under Subsections (17)(a) through [(d)] (f) effective as of the date
868
agreed upon by the association and the other insurer and regardless of whether the association
869
has made the election referred to in Subsections (17)(a) through [(d)] (f) provided that:
870
(i) the association transfers its obligations to the other insurer;
871
(ii) the association and the other insurer agree to the transfer;
872
(iii) the indemnity reinsurance agreements automatically terminate for new reinsurance
873
unless the indemnity reinsurer and the other insurer agree to the contrary;
874
(iv) the obligations described in Subsection (17)[(d)(iv)](f)(v) may not apply on and
875
after the date the indemnity reinsurance agreement is transferred to the third party insurer;
876
[and]
877
(v) the transferring party shall give notice in writing, with verification of receipt, to the
878
affected reinsurer not less than 30 days before the effective date of the transfer; and
879
[(v)] (vi) this Subsection (17)[(e)](i) may not apply if the association has previously
880
expressly determined in writing that the association will not exercise the election referred to in
881
Subsections (17)(a) through [(d)] (f).
882
[(f)] (j) (i) This Subsection (17) supersedes the provisions of any law of this state or of
883
any affected reinsurance agreement that provides for or requires any payment of reinsurance
884
proceeds on account of losses or events that occur in periods after the coverage date, to:
885
(A) the receiver[, liquidator, or rehabilitator] of an insolvent member insurer[.]; or
886
(B) another person.
887
(ii) The receiver[, rehabilitator, or liquidator shall remain] is entitled to any amounts
888
payable by the reinsurer under the reinsurance agreement with respect to [losses or events that
889
occur in periods prior to] a loss or event that occurs before the coverage date, subject to
890
applicable setoff provisions.
891
[(g)] (k) Except as otherwise expressly provided in Subsections (17)(a) through [(f)]
892
(j), this Subsection (17) does not:
893
(i) alter or modify the terms and conditions of [the indemnity] a reinsurance
894
[agreements] agreement of the insolvent member insurer;
895
(ii) abrogate or limit [any rights] [of] a right any reinsurer to claim that it is entitled to
896
rescind a reinsurance agreement; [or]
897
(iii) give a policy owner or beneficiary an independent cause of action against [an
898
indemnity] a reinsurer that is not otherwise set forth in the [indemnity] reinsurance
899
agreement[.];
900
(iv) limit or affect the association's rights as a creditor of the estate of an insolvent
901
insurer against the assets of the estate; or
902
(v) apply to a reinsurance agreement that covers property or casualty risks.
903
(18) The board of directors of the association [shall have] has discretion and may
904
exercise reasonable business judgment to determine the means by which the association is to
905
provide the benefits of this part in an economical and efficient manner.
906
(19) If the association [has arranged or offered] arranges or offers to provide the
907
benefits of this part to a covered person under a plan or arrangement that fulfills the
908
association's obligations under this part, the person is not entitled to benefits from the
909
association in addition to or other than those provided under the plan or arrangement.
910
(20) (a) Venue in a suit against the association arising under this part [shall be in] is
911
Salt Lake County.
912
(b) The association may not be required to give an appeal bond in an appeal that relates
913
to a cause of action arising under this part.
914
Section 5.
Section
31A-28-109
is amended to read:
915
31A-28-109. Assessments.
916
(1) (a) For the purpose of providing the funds necessary to carry out the powers and
917
duties of the association, the board of directors shall assess the member insurers, separately for
918
each class or subclass, at the time and for the amounts that the board of directors finds
919
necessary.
920
(b) Member insurer liability for an assessment is established as of the coverage date.
921
(c) Subject to Subsection (1)(d), a called assessment:
922
(i) is due not less than 30 days after prior written notice to the member insurer; and
923
(ii) shall accrue interest at 10% per annum on and after the due date.
924
(d) Notwithstanding Subsection (1)(c), the association may:
925
(i) assess the association's members as of the coverage date; and
926
(ii) defer the collection of the assessment described in Subsection (1)(d)(i).
927
(e) An assessment:
928
(i) has the force and effect of a judgment lien against the member insurer; and
929
(ii) may not be extinguished until paid.
930
(2) The two classes of assessment are described in Subsections (2)(a) and (2)(b).
931
(a) A Class A assessment shall be authorized and called for the purpose of meeting
932
administrative and legal costs and other expenses. A Class A assessment may be authorized
933
and called whether or not related to a particular impaired or insolvent insurer.
934
(b) A Class B assessment shall be authorized and called to the extent necessary to carry
935
out the powers and duties of the association under Section
31A-28-108
with regard to an
936
impaired or an insolvent insurer.
937
(3) (a) (i) The amount of a Class A assessment:
938
(A) shall be determined by the board of directors; and
939
(B) may be authorized and called on a pro rata or non-pro rata basis.
940
(ii) If the Class A assessment is pro rata, the board of directors may credit the
941
assessment against future Class B assessments.
942
(iii) The total of [all] the non-pro rata assessments may not exceed $300 per member
943
insurer in any one calendar year.
944
(b) The amount of a Class B assessment shall be allocated for assessment purposes
945
among subclasses pursuant to an allocation formula that may be based on:
946
(i) the premiums or reserves of the impaired or insolvent insurer; or
947
(ii) any other standard determined by the board of directors in the board of directors'
948
sole discretion as being fair and reasonable under the circumstances.
949
(c) (i) A Class B assessment against a member insurer for the life insurance subclass,
950
the annuity subclass, and the unallocated annuity subclass shall be in the proportion that the
951
premiums received on business in this state by the member insurer on policies or contracts
952
included in the subclass for the three most recent calendar years for which information is
953
available preceding the year which includes the coverage date bears to the premiums received
954
on business in this state for the same period by [all] the assessed member insurers.
955
(ii) A Class B assessment against a member insurer for an accident and health
956
insurance subclass shall be in the proportion that the premiums received on business in this
957
state by each assessed member insurer on policies or contracts included in the subclass for the
958
most recent calendar year for which information is available preceding the year in which the
959
assessment is made bears to the premiums received on business in this state on policies or
960
contracts included in the subclass for that calendar year by [all] the assessed member insurers.
961
(d) Assessments for funds to meet the requirements of the association with respect to
962
an impaired or insolvent insurer may not be authorized or called until necessary to implement
963
the purposes of this part.
964
(e) Classification of assessments and premiums under Subsection (3)(b) and
965
computation of assessments under this Subsection (3) shall be made with a reasonable degree
966
of accuracy, recognizing that exact determinations may not always be possible.
967
(f) The association shall notify each member insurer of its anticipated pro rata share of
968
an authorized assessment not yet called within 180 days after the day on which the assessment
969
is authorized.
970
(4) (a) The association may abate or defer, in whole or in part, the assessment of a
971
member insurer if, in the opinion of the board of directors, payment of the assessment would
972
endanger the ability of the member insurer to fulfill its contractual obligations.
973
(b) If an assessment against a member insurer is abated or deferred in whole or in part
974
under Subsection (4)(a), the amount by which the assessment is abated or deferred may be
975
assessed against the other member insurers in a manner consistent with the basis for
976
assessments set forth in this section.
977
(c) Once a condition that caused a deferral is removed or rectified, the member insurer
978
shall pay [all] the assessments that were deferred pursuant to a repayment plan approved by the
979
association.
980
(5) (a) (i) Subject to Subsection (5)(b), the total of [all] the assessments authorized by
981
the association on a member insurer for each subclass may not in any one calendar year exceed
982
2% of that member's total average annual assessable premium in that subclass as defined in
983
Subsection (3).
984
(ii) If two or more assessments are authorized in one calendar year with respect to one
985
or more insurers that become impaired or insolvent in different calendar years, the average
986
annual premiums for purposes of the aggregate assessment percentage limitation in Subsection
987
(5)(a)(i) shall be equal and limited to the highest of the total average annual assessable
988
premiums of the different calendar year periods involved in the assessment or assessments.
989
(iii) If the maximum assessment together with the other assets of the association do not
990
provide in one year an amount sufficient to carry out the responsibilities of the association, the
991
necessary additional funds shall be assessed as soon after as permitted by this part.
992
(b) The board of directors may provide in the plan of operation a method of allocating
993
funds among claims, whether relating to one or more impaired or insolvent insurers, when the
994
maximum assessment will be insufficient to cover anticipated claims.
995
(c) If the maximum assessment for the life insurance or annuity subclass in any one
996
year does not provide an amount sufficient to carry out the responsibilities of the association,
997
the board of directors shall assess the other of the subclasses of the life insurance and annuity
998
class for the necessary additional amount:
999
(i) pursuant to Subsection (3)(b); and
1000
(ii) subject to the maximum stated in Subsection (5)(a).
1001
(6) (a) The board of directors may, by an equitable method established in the plan of
1002
operation, refund to member insurers in proportion to the contribution of each insurer to that
1003
subclass the amount by which the assets of the subclass exceed the amount the board of
1004
directors finds is necessary to carry out the obligations of the association with regard to that
1005
subclass, including assets accruing from:
1006
(i) assignment;
1007
(ii) subrogation;
1008
(iii) net realized gains; and
1009
(iv) income from investments.
1010
(b) Notwithstanding Subsection (6)(a), a reasonable amount may be retained to provide
1011
funds for the continuing expenses of the association and for future losses.
1012
(7) A member insurer, in determining its premium rates and policyowner dividends as
1013
to any kind of insurance within the scope of this part, may consider the amount reasonably
1014
necessary to meet its assessment obligations under this part.
1015
(8) (a) The association shall issue to each insurer paying an assessment under this part,
1016
other than a Class A assessment, a certificate of contribution, in a form approved by the
1017
commissioner, for the amount of the assessment paid.
1018
(b) [All] The outstanding certificates described in Subsection (8)(a) shall be of equal
1019
dignity and priority without reference to amounts or dates of issue.
1020
(c) (i) A certificate of contribution described in Subsection (8)(a) may be shown by the
1021
insurer in its financial statement as an asset in the amount of the certificate of contribution less
1022
the amount by which the insurer's premium taxes have already been reduced with respect to the
1023
certificate.
1024
(ii) For good cause shown, the commissioner may order the insurer to show a different
1025
amount in its financial statement than the amount under Subsection (8)(c)(i).
1026
(9) (a) The association may request information from a member insurer to aid in the
1027
exercise of the association's power under this part.
1028
(b) A member insurer shall comply promptly with a request of the association under
1029
this Subsection (9).
1030
Section 6.
Section
31A-28-110
is amended to read:
1031
31A-28-110. Plan of operation.
1032
(1) (a) The association shall submit to the commissioner a plan of operation and any
1033
amendments to the plan necessary or suitable to assure the fair, reasonable, and equitable
1034
administration of the association.
1035
(b) The plan of operation and any amendments become effective:
1036
(i) upon the commissioner's written approval; or
1037
(ii) after 30 days from the date the plan of operation or amendment is submitted to the
1038
commissioner if the commissioner has not disapproved the plan or amendment.
1039
(c) (i) If the association fails to submit a suitable amendment to the plan, the
1040
commissioner, after notice and hearing, shall adopt reasonable rules that are necessary or
1041
advisable to effectuate the provisions of this part.
1042
(ii) The rules described in Subsection (1)(c)(i) [shall] continue in force until:
1043
(A) modified by the commissioner; or
1044
(B) superseded by an amendment to the plan:
1045
(I) submitted by the association; and
1046
(II) approved by the commissioner.
1047
(2) [All member insurers] A member insurer shall comply with the plan of operation.
1048
(3) The plan of operation shall, in addition to any other requirement in this part:
1049
(a) establish procedures for handling the assets of the association;
1050
(b) establish the amount and method of reimbursing members of the board of directors
1051
under Section
31A-28-107
;
1052
(c) establish regular places and times for meetings of the board of directors, including
1053
telephone conference calls;
1054
(d) establish procedures for records to be kept of [all] the financial transactions of:
1055
(i) the association;
1056
(ii) the association's agents; and
1057
(iii) the board of directors;
1058
(e) subject to Section
31A-28-107
, establish the procedures to be followed for:
1059
(i) selecting members to the board of directors; and
1060
(ii) submitting the selected members to the commissioner for approval;
1061
(f) establish any additional procedures for assessments under Section
31A-28-109
;
1062
[and]
1063
(g) establish procedures under which a member insurer may be removed from the
1064
board of directors for cause, including when the member insurer becomes an impaired or
1065
insolvent insurer;
1066
(h) require the board of directors to establish policies and procedures that address
1067
conflicts of interests; and
1068
[(g)] (i) contain additional provisions necessary or proper for the execution of the
1069
powers and duties of the association.
1070
(4) (a) The plan of operation may provide that any or all powers and duties of the
1071
association, except those under Subsection
31A-28-108
(14)(d) and Section
31A-28-109
, are
1072
delegated to a corporation, association, or other organization that will perform functions similar
1073
to those of the association, or its equivalent, in two or more states.
1074
(b) A corporation, association, or organization described in Subsection (4)(a) shall be:
1075
(i) reimbursed for any payments made on behalf of the association; and
1076
(ii) paid for its performance of any function of the association.
1077
(c) A delegation under this Subsection (4):
1078
(i) [shall take] takes effect only with the approval of:
1079
(A) the board of directors; and
1080
(B) the commissioner; and
1081
(ii) may be made only to a corporation, association, or organization that extends
1082
protection not substantially less favorable and effective than that provided by this part.
1083
Section 7.
Section
31A-28-111
is amended to read:
1084
31A-28-111. Duties and powers under this part.
1085
In addition to the duties and powers enumerated elsewhere in this part, the persons
1086
[listed] described in this section have the duties and powers described in Subsections (1)
1087
through (6).
1088
(1) The commissioner shall:
1089
(a) upon request of the board of directors, provide the association with a statement of
1090
the premiums for each member insurer:
1091
(i) in this state; and
1092
(ii) any other appropriate state; and
1093
(b) if an impairment is declared and the amount of the impairment is determined, serve
1094
a demand upon the impaired insurer to make good the impairment within a reasonable time[;
1095
and].
1096
[(c) in a liquidation or rehabilitation proceeding involving a domestic insurer, be
1097
appointed as the liquidator or rehabilitator.]
1098
(2) Notice to the impaired insurer under Subsection (1)(b) [shall constitute] constitutes
1099
notice to the shareholders of the impaired insurer if the impaired insurer has shareholders.
1100
(3) The failure of the insurer to promptly comply with the commissioner's demand
1101
under Subsection (1)(b) does not excuse the association from the performance of its powers
1102
and duties under this part.
1103
(4) (a) After notice and hearing, the commissioner may suspend or revoke the
1104
certificate of authority to transact insurance in this state of [any] a member insurer not
1105
domiciled in this state that fails to:
1106
(i) pay an assessment when due; or
1107
(ii) comply with the plan of operation.
1108
(b) (i) As an alternative to suspending or revoking a certificate of authority under
1109
Subsection (4)(a), the commissioner may levy a forfeiture on any member insurer that fails to
1110
pay an assessment when due.
1111
(ii) A forfeiture described in Subsection (4)(b)(i):
1112
(A) may not exceed 5% of the unpaid assessment per month; and
1113
(B) may not be less than $100 per month.
1114
(5) (a) A final action of the board of directors or the association may be appealed to the
1115
commissioner by any member insurer if appeal is taken within 60 days of the date the member
1116
insurer received notice of the final action being appealed.
1117
(b) If a member insurer is appealing an assessment, the amount assessed shall be:
1118
(i) paid to the association; and
1119
(ii) made available to meet association obligations during the pendency of an appeal.
1120
(c) If the appeal on the assessment described in Subsection (5)(b) is upheld, the amount
1121
paid in error or excess shall be returned to the member insurer.
1122
(d) Any final action or order of the commissioner [shall be] is subject to judicial review
1123
in a court of competent jurisdiction in accordance with the laws of this state that apply to the
1124
actions or orders of the commissioner.
1125
(6) The [liquidator, rehabilitator, or conservator of any] receiver of an impaired insurer
1126
shall notify [all] the interested persons of the effect of this part.
1127
Section 8.
Section
31A-28-112
is amended to read:
1128
31A-28-112. Reports.
1129
[(1) The purpose of this section is to aid in the detection and prevention of insurer
1130
insolvencies or impairments.]
1131
[(2)] (1) The commissioner shall:
1132
[(a) notify the commissioner of every state within 30 days following the action taken or
1133
the date the action occurs, when the commissioner takes the following actions against a
1134
member insurer:]
1135
[(i) revokes its license;]
1136
[(ii) suspends its license; or]
1137
[(iii) makes a formal order that the member insurer:]
1138
[(A) restrict its premium writing;]
1139
[(B) obtain additional contributions to surplus;]
1140
[(C) withdraw from the state;]
1141
[(D) reinsure all or any part of its business; or]
1142
[(E) increase capital, surplus, or any other account for the security of policy owners or
1143
creditors;]
1144
[(b)] (a) report to the board of directors when [the commissioner has]:
1145
[(i) taken any of the actions set forth in Subsection (2)(a); or]
1146
(i) the commissioner takes an action set forth in Section
31A-27a-201
;
1147
(ii) an event described in Section
31A-17-603
,
31A-17-604
, or
31A-17-605
occurs; or
1148
[(ii) received] (iii) the commissioner receives a report from any other commissioner
1149
indicating that an action described in Subsection [(2)(a)] (1)(a)(i) has been taken in another
1150
state;
1151
[(c)] (b) include in the report to the board of directors required by Subsection [(2)(b)]
1152
(1)(a):
1153
(i) [all] the significant details of the action taken; [or]
1154
(ii) the significant details of an event described in Subsection (1)(a)(ii); or
1155
[(ii)] (iii) the report received from another commissioner;
1156
[(d)] (c) promptly report to the board of directors when the commissioner has
1157
reasonable cause to believe from an examination of any member insurer, whether completed or
1158
in process, that the insurer may be an impaired or insolvent insurer; and
1159
[(e)] (d) furnish to the board of directors the National Association of Insurance
1160
Commissioners Insurance Regulatory Information System ratios and listings of companies not
1161
included in the ratios developed by the National Association of Insurance Commissioners.
1162
[(3)] (2) (a) The board of directors may use the information contained in the ratios and
1163
listings described in Subsection [(2)(e)] (1)(d) in carrying out the board of directors' duties and
1164
responsibilities under this [section] part.
1165
(b) The board of directors shall keep the report and the information contained in the
1166
ratios and listings [shall be kept] confidential [by the board of directors] until the commissioner
1167
or other lawful authority publishes the information.
1168
[(4)] (3) The commissioner may seek the advice and recommendations of the board of
1169
directors concerning any matter affecting the commissioner's duties and responsibilities
1170
regarding the financial condition of member insurers and companies seeking admission to
1171
transact insurance business in this state.
1172
[(5)] (4) (a) The board of directors may make reports and recommendations to the
1173
commissioner upon any matter germane to:
1174
(i) the solvency, liquidation, rehabilitation, or conservation of any member insurer; or
1175
(ii) the solvency of any company seeking to do an insurance business in this state.
1176
(b) The reports and recommendations of the board of directors described in
1177
[Subsection (5)(a) may not be considered] Subsection (4)(a) are not public documents.
1178
[(6)] (5) The board of directors may, upon majority vote, notify the commissioner of
1179
any information indicating a member insurer may be an impaired or insolvent insurer.
1180
[(7)] (6) The board of directors may make recommendations to the commissioner for
1181
the detection and prevention of insurer insolvencies.
1182
[(8)] (7) (a) At the conclusion of any insurer insolvency in which the association was
1183
obligated to pay covered claims, the board of directors shall prepare a report to the
1184
commissioner containing the information the board of directors has in its possession bearing on
1185
the history and causes of the insolvency.
1186
(b) In preparing a report on the history and causes of insolvency of a particular insurer,
1187
the board of directors may cooperate with:
1188
(i) the board of directors of a guaranty association in another state; or
1189
(ii) an organization described in Subsection
31A-28-108
(16).
1190
(c) The board of directors may adopt by reference any report prepared by:
1191
(i) a guaranty association in another state; or
1192
(ii) an organization described in Subsection
31A-28-108
(16).
1193
Section 9.
Section
31A-28-114
is amended to read:
1194
31A-28-114. Miscellaneous provisions.
1195
(1) Nothing in this part shall be construed to reduce the liability for unpaid assessments
1196
of the insureds of an impaired or insolvent insurer operating under a plan with assessment
1197
liability.
1198
(2) (a) [Records shall be kept of all meetings of the] The board of directors shall keep a
1199
record of a meeting of the board of directors to discuss the activities of the association in
1200
carrying out its powers and duties under Section
31A-28-108
.
1201
(b) [Records] A record of the association with respect to an impaired or insolvent
1202
insurer may not be disclosed before the earlier of:
1203
(i) the termination of a liquidation, rehabilitation, or conservation proceeding involving
1204
the impaired or insolvent insurer;
1205
(ii) the termination of the impairment or insolvency of the insurer; or
1206
(iii) upon the order of a court of competent jurisdiction.
1207
(c) Nothing in this Subsection (2) [shall limit] limits the duty of the association to
1208
render a report of its activities under Section
31A-28-115
.
1209
(3) (a) For the purpose of carrying out its obligations under this part, the association
1210
[shall be] is considered to be a creditor of an impaired or insolvent insurer to the extent of
1211
assets attributable to covered policies reduced by any amounts to which the association is
1212
entitled as subrogee pursuant to Subsection
31A-28-108
(14).
1213
(b) Assets of the impaired or insolvent insurer attributable to covered policies shall be
1214
used to continue [all] the covered policies and pay [all] the contractual obligations of the
1215
impaired or insolvent insurer as required by this part.
1216
(c) As used in this Subsection (3), assets attributable to covered policies are that
1217
proportion of the assets which the reserves that should have been established for covered
1218
policies bear to the reserves that should have been established for all policies of insurance
1219
written by the impaired or insolvent insurer.
1220
(4) (a) As a creditor of the impaired or insolvent insurer under Subsection (3) and
1221
consistent with Section
31A-27a-701
, the association and any other similar association are
1222
entitled to receive a disbursement of assets out of the marshaled assets, from time to time as the
1223
assets become available to reimburse the association and any other similar association.
1224
(b) If, within [120] 180 days of a final determination of insolvency of an insurer by the
1225
receivership court, the [liquidator] receiver has not made an application to the court for the
1226
approval of a proposal to disburse assets out of marshaled assets to [all] the guaranty
1227
associations having obligations because of the insolvency, the association is entitled to make
1228
application to the receivership court for approval of the association's proposal for disbursement
1229
of these assets.
1230
(5) (a) [Prior to] Before the termination of [any] a liquidation, rehabilitation, or
1231
conservation proceeding, the court may take into consideration the contributions of the
1232
respective parties, including:
1233
(i) the association;
1234
(ii) the shareholders;
1235
(iii) policyowners of the insolvent insurer; and
1236
(iv) any other party with a bona fide interest in making an equitable distribution of the
1237
ownership rights of the insolvent insurer.
1238
(b) In making a determination under Subsection (5)(a), the court shall consider the
1239
welfare of the [policyholders] policyowners of the continuing or successor insurer.
1240
(c) A distribution to any stockholder of an impaired or insolvent insurer may not be
1241
made until and unless the total amount of valid claims of the association with interest has been
1242
fully recovered by the association for funds expended in carrying out its powers and duties
1243
under Section
31A-28-108
with respect to the insurer.
1244
[(6) (a) If an order for liquidation or rehabilitation of an insurer domiciled in this state
1245
has been entered, the receiver appointed under the order shall have a right to recover on behalf
1246
of the insurer, from any affiliate that controlled the insurer, the amount of distributions, other
1247
than stock dividends paid by the insurer on its capital stock, made at any time during the five
1248
years preceding the petition for liquidation or rehabilitation subject to the limitations of
1249
Subsections (6)(b) through (d).]
1250
[(b) A distribution described in Subsection (6)(a) may not be recovered if the insurer
1251
shows that:]
1252
[(i) when paid the distribution was lawful and reasonable; and]
1253
[(ii) the insurer did not know and could not reasonably have known that the
1254
distribution might adversely affect the ability of the insurer to fulfill its contractual
1255
obligations.]
1256
[(c) (i) A person that was an affiliate that controlled the insurer at the time the
1257
distributions were paid shall be liable up to the amount of distributions received.]
1258
[(ii) A person that was an affiliate that controlled the insurer at the time the
1259
distributions were declared shall be liable up to the amount of distributions that would have
1260
been received if they had been paid immediately.]
1261
[(iii) If two or more persons are liable with respect to the same distributions, they shall
1262
be jointly and severally liable.]
1263
[(d) The maximum amount recoverable under this Subsection (6) shall be the amount
1264
needed in excess of all other available assets of the insolvent insurer to pay the contractual
1265
obligations of the insolvent insurer.]
1266
[(e) If any person liable under Subsection (6)(c) is insolvent, all of its affiliates that
1267
controlled it at the time the distribution was paid shall be jointly and severally liable for any
1268
resulting deficiency in the amount recovered from the insolvent affiliate.]
1269
Section 10.
Section
31A-28-118
is amended to read:
1270
31A-28-118. Stay of proceedings -- Reopening default judgments.
1271
[All proceedings] (1) A proceeding in which the insolvent insurer is a party in any
1272
court in this state shall be stayed [60] 180 days from the date an order of liquidation,
1273
rehabilitation, or conservation is final to permit proper legal action by the association on any
1274
matters germane to its powers or duties.
1275
(2) The association may apply to have a judgment under any decision, order, verdict, or
1276
finding based on default set aside by the same court that made the judgment. The association
1277
shall be permitted to defend against the suit on the merits.
1278
Section 11.
Section
31A-28-119
is amended to read:
1279
31A-28-119. Prohibited advertisement of the association -- Notice to owners of
1280
policies and contracts.
1281
(1) (a) Except as provided in Subsection (1)(b), a person, including an insurer, agent, or
1282
affiliate of an insurer may not make, publish, disseminate, circulate, or place before the public,
1283
or cause directly or indirectly to be made, published, disseminated, circulated, or placed before
1284
the public, in [any] a newspaper, magazine, or other publication, or in the form of a notice,
1285
circular, pamphlet, letter, or poster, or over [any] a radio station or television station, or in any
1286
other way, any advertisement, announcement, or statement written or oral, [which] that uses the
1287
existence of the association for the purpose of sales, solicitation, or inducement to purchase any
1288
form of insurance.
1289
(b) Notwithstanding Subsection (1)(a), this section does not apply to:
1290
(i) the association; or
1291
(ii) [any other] another entity that does not sell or solicit insurance.
1292
(2) (a) [Prior to January 1, 2002, the] The association shall:
1293
(i) [prepare] have a summary document describing the general purposes and current
1294
limitations of this part that complies with Subsection (3); and
1295
(ii) submit the summary document described in Subsection (2)(a)(i) to the
1296
commissioner for approval.
1297
(b) [Sixty days after the day on which the commissioner approves the summary
1298
document described in Subsection (2)(a), an] An insurer may not deliver a policy or contract to
1299
a policy or contract owner unless the summary document is also delivered to the policy or
1300
contract owner [prior to] before, or at the time of, delivery of the policy or contract.
1301
(c) The summary document shall be available upon request by a policy owner.
1302
(d) The distribution, delivery, or contents or interpretation of the summary document
1303
does not guarantee that:
1304
(i) the policy or the contract is covered in the event of the impairment or insolvency of
1305
a member insurer; or
1306
(ii) the owner of the policy or contract is covered in the event of the impairment or
1307
insolvency of a member insurer.
1308
(e) The summary document shall be revised by the association as amendments to this
1309
part may require.
1310
(f) Failure to receive the summary document as required in Subsection (2)(b) does not
1311
give the [policyholder, contract holder] owner of a policy or contract, certificate holder, or
1312
insured any greater rights than those stated in this part.
1313
(3) (a) The summary document [prepared under] described in Subsection (2) shall
1314
contain a clear and conspicuous disclaimer on its face.
1315
(b) The commissioner shall, by rule, establish the form and content of the disclaimer
1316
described in Subsection (3)(a), except that the disclaimer shall:
1317
(i) state the name and address of:
1318
(A) the association; and
1319
(B) the [insurance] department;
1320
(ii) prominently warn [the] a policy or contract owner that:
1321
(A) the association may not cover the policy or contract; or
1322
(B) if coverage is available, it is:
1323
(I) subject to substantial limitations and exclusions; and
1324
(II) conditioned on continued residence in the state;
1325
(iii) state the types of policies or contracts for which the association will provide
1326
coverage;
1327
(iv) state that the insurer and its agents are prohibited by law from using the existence
1328
of the association for the purpose of sales, solicitation, or inducement to purchase any form of
1329
insurance;
1330
(v) state that the policy or contract owner should not rely on coverage under the
1331
association when selecting an insurer;
1332
(vi) explain the rights available and procedures for filing a complaint to allege a
1333
violation of this part; and
1334
(vii) provide other information as directed by the commissioner including sources for
1335
information about the financial condition of insurers provided that the information:
1336
(A) is not proprietary; and
1337
(B) is subject to disclosure under public records laws.
1338
(4) (a) An insurer or agent may not deliver a policy or contract described in Subsection
1339
31A-28-103
(2)(a) and wholly excluded under Subsection
31A-28-103
(2)(b)(i) from coverage
1340
under this part unless the insurer or agent, prior to or at the time of delivery, gives the policy or
1341
contract holder a separate written notice that clearly and conspicuously discloses that the policy
1342
or contract is not covered by the association.
1343
(b) The commissioner shall by rule specify the form and content of the notice required
1344
by Subsection (4)(a).
1345
(5) A member insurer shall retain evidence of compliance with Subsection (2) for the
1346
later of:
1347
(a) three years; or
1348
(b) until the conclusion of the next market conduct examination by the department of
1349
insurance where the member insurer is domiciled.
1350
Section 12.
Section
31A-28-120
is amended to read:
1351
31A-28-120. Prospective application.
1352
Notwithstanding any prior or subsequent law, the provisions of this part that are in
1353
effect on the date on which the association first becomes obligated for the policies or contracts
1354
of an insolvent or impaired member [shall] govern the association's rights and obligations to
1355
the [policyholders] policyowners of the insolvent or impaired member.
Legislative Review Note
as of 10-26-09 9:08 AM