AB 1391, as amended, Committee on Insurance. Insurance: omnibus.
(1) Existing law requires an entity seeking to be licensed as a risk retention group to be organized under California law and licensed as a liability insurance company. A risk retention group is a corporation, public entity, or other limited liability association that meets certain criteria, including that its primary activity consists of assuming and spreading all, or any portion, of the liability exposure of its group members. Existing law also exempts risk retention groups from the Business Transacted with Producer Controlled Insurer Act, which regulates controlled insurers, as prescribed.
This bill would require, on and after January 1, 2015, a risk retention group to comply with specified corporate governance requirements at the time of licensure, including that the board of directors have a majority of independent directors, as defined, that the term of any material service provider contract with a risk retention group not exceed 5 years, and that the risk retention group have an audit committee composed of at least 3 independent board members. The bill would also delete the risk retention group exemption from the Business Transacted with Producer Controlled Insurer Act.
(2) Existing law provides that no cancellation of a motor vehicle insurance policy, not subject to certain cancellation protections because it has been in effect less than 60 days, is effective unless a notice of cancellation, subject to certain notice provisions, is mailed or delivered by the insurer to the named insured not later than the 59th day following the effective date and at least 10 days prior to the effective date of cancellation. Existing law also provides no notice of cancellation of a motor vehicle insurance policy, where the cancellation is based on, among other things, nonpayment of premium, is effective unless mailed or delivered by the insurer to the named insured, lienholder, or additional interest at least 20 days prior to the effective date of cancellation, except as specified.
This bill would delete the requirements for cancellation of a motor vehicle insurance policy less than 60 days old, and would apply the requirements regarding notice of cancellation for nonpayment of premiums, and other specified reasons, to all cancellation circumstances.
(3) Existing law defines the term “Adjusted RBC Report” as a Risk-Based Capital (RBC) report that has been adjusted by the Insurance Commissioner in accordance with specified provisions governing the determination of a property and casualty insurer’s RBC.
This bill would revise that definition to also include an RBC report that has been adjusted by the commissioner in accordance with specified provisions governing the determination of a life or health insurer’s RBC.
(4) Existing law provides for continuing education requirements, prior to license renewals, for specified insurance agents and broker-agents, including personal lines broker-agents and limited lines automobile insurance agents.
This bill would require that those continuing education requirements include 3 hours of ethics.
(5) Existing law requires every life agent who sells annuities to satisfactorily complete 8 hours of training prior to soliciting individual consumers, and requires every life agent who sells annuities to satisfactorily complete 4 hours of training prior to each license renewal.
This bill would clarify the completion of an 8-hour training requirement to initially procure a license to sell annuities does not satisfy the requirement to complete a 4-hour training course in order to renew the annuity license.
(6) Existing law prohibits the Insurance Commissioner from granting authority to transact variable contracts unless the life agent or applicant furnishes proof that he or she is registered to sell securities in accordance with the rules of the United States Securities and Exchange Commission or the Financial Industry Regulatory Authority.
This bill would make clear that the life agent or applicant is required to furnish proof that he or she is registered to sell securities in California in accordance with the rules of the United States Securities and Exchange Commission or the Financial Industry Regulatory Authority.
(7) Existing law requires an individual holding an insurance adjuster license, not otherwise exempt, to complete a minimum of 24 hours of continuing education courses, as specified.
This bill would authorize an exemption from the continuing education requirements for an individual licensed as an insurance adjuster and as a property or casualty broker-agent who has met other specified continuing education requirements.
(8) Existing law defines an insurance solicitor as a natural person employed to aid an insurance agent or insurance broker in transacting insurance other than life.
This bill would redefine an insurance solicitor to mean a natural person employed to aid a property and casualty broker-agent acting as an insurance agent or insurance broker in transacting insurance other than life, disability, or health.
(9) Existing law provides that a nonresident licensee who applies for a property broker-agent, casualty broker-agent, personal lines broker-agent, or life agent resident license in this state, and who is currently licensed for the same lines of authority in the state of his or her current resident license, is not required to complete an examination. The application for examination is required to be received within 90 days of the cancellation of the applicant’s resident license and the producer database records, maintained by the National Association of Insurance Commissioners, are required to indicate that the producer is licensed in good standing for the line of authority requested.
This bill would provide that upon issuance of the California resident license, the examination waiver also applies to adding additional lines of authority to the California resident license provided that the individual was previously licensed in good standing for the requested additional lines of authority, and the application is received within 12 months of the cancellation of the applicant’s previous resident license in another state.
(10) Existing law regulates the sale of portable electronics insurance policies and requires all portable electronics vendors offering that insurance to be licensed, as specified.
This bill would authorize an insurer to terminate or otherwise change the terms and conditions of a policy of portable electronics insurance, as provided.
Existing law authorizes an underwritten title company to engage in the business of preparing title searches, title reports, title examinations, or certificates or abstracts of title, upon the basis of which a title insurer writes title policies. Existing law authorizes any insurer, upon payment of the fees and costs and surrender to the commissioner of its certificate of authority, to apply to withdraw from this state, as provided.
This bill would authorize underwritten title companies to apply to withdraw from the California insurance market.
This bill would make technical, conforming, and clarifying changes, and delete obsolete provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 131 of the Insurance Code is amended
(a) An entity seeking to be licensed in this state as a risk
4retention group shall be organized under the laws of this state and
5licensed as a liability insurance company pursuant to Article 3
6(commencing with Section 699) of Chapter 1 of Part 2.
7(b) An entity that has not completed its chartering and licensing
8as a risk retention group in its domiciliary state is subject to the
9requirements of Article 8 (commencing with Section 820) of
10Chapter 1 of Part 2.
11(c) In addition to the requirements of Article 3 (commencing
12with Section 699) of Chapter 1 of Part 2, a risk retention group
13licensed in this state shall submit to the commissioner a feasibility
14study or plan of operations and all other documentation required
15by the federal Liability Risk Retention Act of 1986 (15 U.S.C.
16Sec. 3901 et seq.) to be submitted by a risk retention group to a
18(d) In addition to the requirements of Article 3 (commencing
19with Section 699) of Chapter 1 of Part 2, a risk retention group
20licensed in this state shall comply with all of the following at the
21time of licensure, and thereafter:
22(1) (A) The “board of directors” or “board,” as used in this
23section, means the governing body of the risk retention group
24elected by the shareholders or members to establish policy, elect
P6 1or appoint officers and committees, and make other governing
3(B) “Director,” as used in this section, means a natural person
4designated in the articles of the risk retention group, or designated,
5elected, or appointed by any other manner, name, or title to act as
7(2) (A) The board of directors of the risk retention group shall
8have a majority of independent directors. If the risk retention group
9is a reciprocal risk retention group, the attorney-in-fact shall be
10required to adhere to the same standards regarding independence
11of operation and governance as imposed on the risk retention
12group’s board of directors and subscribers’ advisory committee
13under these standards, and, to the extent permissible under this
14state’s laws, service providers of a reciprocal risk retention group
15shall contract with the risk retention group and not the
17(B) No director qualifies as “independent” unless the board of
18directors affirmatively determines that the director has no “material
19relationship” with the risk retention group. Each risk retention
20group shall disclose these determinations to its domestic regulator,
21at least annually. For this purpose, any person that is a direct or
22indirect owner of, or subscriber in, the risk retention group, or is
23an officer, director, or employee, or all three, of an owner and
24insured, as contemplated by 15 U.S.C. Section 3901(a)(4)(E)(ii)
25of the federal Liability Risk Retention Act of 1986, is considered
26to be “independent,” unless some other position of that officer,
27director, or employee constitutes a “material relationship.”
28(C) “Material relationship” of a person with the risk retention
29group includes, but is not limited to, any of the following:
30(i) The receipt in any one 12-month period of compensation or
31payment of any other item of value by that person, a member of
32that person’s immediate family, or any business with which that
33person is affiliated from the risk retention group or a consultant
34or service provider to the risk retention group that is greater than,
35or equal to, 5 percent of the risk retention group’s gross written
36premium for that 12-month period or 2 percent of its surplus,
37whichever is greater, as measured at the end of any fiscal quarter
38falling in a 12-month period. The person or immediate family
39member of that person is not independent until one year after his
P7 1or her compensation from the risk retention group falls below the
3(ii) A relationship with an auditor as follows: a director or an
4immediate family member of a director who is affiliated with, or
5employed in, a professional capacity by a present or former internal
6or external auditor of the risk retention group is not independent
7until one year after the end of the affiliation, employment, or
9(iii) A relationship with a related entity as follows: a director
10or immediate family member of a director who is employed as an
11executive officer of another company where any of the risk
12retention group’s present executives serve on that other company’s
13board of directors is not independent until one year after the end
14of that service or the employment relationship.
15(3) The term of any material service provider contract with the
16risk retention group shall not exceed five years. Any contract, or
17its renewal, shall require the approval of the majority of the risk
18retention group’s independent directors. The risk retention group’s
19board of directors shall have the right to terminate any service
20provider, audit, or actuarial contracts at any time for cause after
21providing adequate notice as defined in the contract. The service
22provider contract is deemed material if the amount to be paid for
23that contract is greater than, or equal to, 5 percent of the risk
24retention group’s annual gross written premium or 2 percent of its
25surplus, whichever is greater.
26(A) For purposes of this standard, “service providers” shall
27include captive managers, auditors, accountants, actuaries,
28investment advisers, attorneys, and managing general underwriters
29or any other party responsible for underwriting, determination of
30rates, collection of premium, adjusting and settling claims, or the
31preparation of financial statements. Any reference to “attorneys”
32does not include defense counsel retained by the risk retention
33group to defend claims, unless the amount of fees paid to those
34attorneys are “material” as referenced in this paragraph.
35(B) A service provider contract meeting the definition of
36“material relationship” pursuant to paragraph (2) shall not be
37entered into unless the risk retention group has notified the
38commissioner in writing of its intention to enter into the transaction
39at least 30 days prior thereto, and the commissioner has not
40disapproved the transaction within that period.
P8 1(4) The risk retention group’s board of directors shall adopt a
2written policy in the plan of operation as approved by the board
3that requires the board to do all of the following:
4(A) Ensure that all owners or insureds, or both, of the risk
5retention group receive evidence of ownership interest.
6(B) Develop a set of governance standards applicable to the risk
8(C) Oversee the evaluation of the risk retention group’s
9management, including, but not limited to, the performance of the
10captive manager, managing general underwriter, or other parties
11responsible for underwriting, determination of rates, collection of
12premium, adjusting or settling claims, or the preparation of
14(D) Review and approve the amount to be paid for all material
16(E) Review and approve, at least annually, all of the following:
17(i) The risk retention group’s goals and objectives relevant to
18the compensation of officers and service providers.
19(ii) The officers’ and service providers’ performance in light of
20those goals and objectives.
21(iii) The continued engagement of the officers and material
23(5) The risk retention group shall have an audit committee
24composed of at least three independent board members as defined
25in paragraph (2). A nonindependent board member may participate
26in the activities of the audit committee, if invited by the members,
27but cannot be a member of that committee.
28(A) The audit committee shall have a written charter that defines
29the committee’s purpose, which, at a minimum, shall be to do all
30of the following:
31(i) Assist in board oversight of the integrity of the financial
32statements, the compliance with legal and regulatory requirements,
33and the qualifications, independence, and performance of the
34independent auditor and actuary.
35(ii) Discuss the annual audited financial statements and quarterly
36financial statements with management.
37(iii) Discuss the annual audited financial statements with its
38independent auditor and, if advisable, discuss its quarterly financial
39statements with its independent auditor.
P9 1(iv) Discuss policies with respect to risk assessment and risk
3(v) Meet separately and periodically, either directly or through
4a designated representative of the committee, with management
5and independent auditors.
6(vi) Review with the independent auditor any audit problems
7or difficulties and management’s response.
8(vii) Set clear hiring policies of the risk retention group as to
9the hiring of employees or former employees of the independent
11(viii) Require the external auditor to rotate the lead or
12coordinating audit partner having primary responsibility for the
13risk retention group’s audit as well as the audit partner responsible
14for reviewing that audit, so that neither individual performs audit
15services for more than five consecutive fiscal years.
16(ix) Report regularly to the board of directors.
17(B) If an audit committee is not designated by the insurer, the
18insurer’s entire board of directors shall constitute the audit
20(6) The board of directors shall adopt and disclose governance
21standards by making the information available through electronic
22means, such as posting the information on the risk retention group’s
23Internet Web site, or other means, and providing that information
24to members and insureds upon request. The information shall
25include all of the following:
26(A) A process by which the directors are elected by the owners,
27insureds, or both.
28(B) Director qualification standards.
29(C) Director responsibilities.
30(D) Director access to management and, as necessary and
31appropriate, independent advisers.
32(E) Director compensation.
33(F) Director orientation and continuing education.
34(G) The policies and procedures that are followed for
36(H) The policies and procedures that are followed for the annual
37performance evaluation of the board.
38(7) The board of directors shall adopt and disclose a code of
39business conduct and ethics for directors, officers, and employees
40and promptly disclose to the board of directors any waivers of the
P10 1code for directors or executive officers, including all of the
3(A) Conflicts of interest.
4(B) Matters covered under the corporate opportunity doctrine
5under the state of domicile.
7(D) Fair dealing.
8(E) Protection and proper use of risk retention group assets.
9(F) Compliance with all applicable laws, rules, and regulations.
10(G) Requiring the reporting of any illegal or unethical behavior
11that affects the operation of the risk retention group.
12(8) The captive manager, president, or chief executive officer
13of the risk retention group shall promptly notify the domestic
14regulator, in writing, if he or she becomes aware of any material
15noncompliance with any of these governance standards.
16(e) Domestic risk retention groups, licensed as of December 31,
172013, shall be governed by subdivision (d) on and after January
Section 662 of the Insurance Code is amended to read:
(a) A notice of cancellation of a policy shall not be
21effective unless mailed or delivered by the insurer to the named
22insured, lienholder, or additional interest at least 20 days prior to
23the effective date of cancellation; provided, however, that where
24cancellation is for nonpayment of premium, at least 10 days’ notice
25of cancellation accompanied by the reason for the cancellation
26shall be given. Unless the reason accompanies or is included in
27the notice of cancellation, the notice of cancellation shall state or
28be accompanied by a statement that upon written request of the
29named insured, mailed or delivered to the insurer not less than 15
30days prior to the effective date of cancellation, the insurer will
31specify the reason for the cancellation.
32(b) This section shall not apply to nonrenewal.
33(c) Notices made to lienholders pursuant to this section may be
34done electronically with the consent of the lienholder.
Section 668.5 of the Insurance Code is repealed.
Section 739 of the Insurance Code is amended to read:
As used in this article, these terms shall have the following
P11 1(a) “Adjusted RBC Report” means a Risk-Based Capital (RBC)
2report that has been adjusted by the commissioner in accordance
3with subdivision (b) or (c) of Section 739.2.
4(b) “Corrective Order” means an order issued by the
5commissioner specifying corrective actions that the commissioner
6has determined are required.
7(c) “Domestic insurer” means any life or health insurer or
8property and casualty insurer organized in this state.
9(d) “Foreign insurer” means any life or health insurer or property
10and casualty insurer that is licensed to do business in this state but
11is not domiciled in this state.
12(e) “Life or health insurer” means any admitted insurer issuing
13insurance subject to Part 2 (commencing with Section 10110) of
14Division 2, or a licensed property and casualty insurer writing only
16(f) “NAIC” means the National Association of Insurance
18(g) “Negative trend” means, with respect to a life or health
19insurer, a negative trend over a period of time, as determined in
20accordance with the “Trend Test Calculation” included in the RBC
21Instructions defined in subdivision (i).
22(h) “Property and casualty insurer” means any admitted insurer
23writing insurance as described in Section 102, 103, 105, 107, 108,
24 109, 110, 111, 112, 113, 114, 115, 116, 118, 119.5, 119.6, or 120,
25but does not include monoline mortgage guaranty insurers,
26financial guaranty insurers, or title insurers.
27(i) “RBC Instructions” means the RBC Report, including
28risk-based capital instructions adopted by the NAIC, and as the
29RBC Instructions may be amended by the NAIC from time to time
30in accordance with the procedures adopted by the NAIC.
31(j) “RBC Level” means an insurer’s Company Action Level
32RBC, Regulatory Action Level RBC, Authorized Control Level
33RBC, or Mandatory Control Level RBC where:
34(1) “Company Action Level RBC” means, with respect to any
35insurer, the product of 2.0 and its Authorized Control Level RBC.
36(2) “Regulatory Action Level RBC” means the product of 1.5
37and its Authorized Control Level RBC.
38(3) “Authorized Control Level RBC” means the number
39determined under the risk-based capital formula in accordance
40with the RBC Instructions.
P12 1(4) “Mandatory Control Level RBC” means the product of .70
2and the Authorized Control Level RBC.
3(k) “RBC Plan” means a comprehensive financial plan
4containing the elements specified in subdivision (b) of Section
5739.3. If the commissioner rejects the RBC Plan, and it is revised
6by the insurer, with or without the commissioner’s
7recommendation, the plan shall be called the “Revised RBC Plan.”
8(l) “RBC Report” means the report required in Section 739.2.
9(m) “Total Adjusted Capital” means the sum of:
10(1) An insurer’s statutory capital and surplus.
11(2) Other items, if any, that the RBC Instructions may provide.
Section 739.3 of the Insurance Code is amended to
(a) “Company Action Level Event” means any of the
16(1) The filing of an RBC Report by an insurer that indicates any
17of the following:
18(A) The insurer’s Total Adjusted Capital is greater than or equal
19to its Regulatory Action Level RBC but less than its Company
20Action Level RBC.
21(B) If a life or health insurer, the insurer has Total Adjusted
22Capital that is greater than or equal to its Company Action Level
23RBC but less than the product of its Authorized Control Level
24RBC and 2.5, and has a negative trend.
25(C) If a property and casualty insurer, the insurer has Total
26Adjusted Capital that is greater than or equal to its Company Action
27Level RBC but less than the product of its Authorized Control
28Level RBC and 3.0, and triggers the trend test determined in
29accordance with the trend test calculation included in the Property
30and Casualty RBC instructions.
31(2) The notification by the commissioner to the insurer of an
32Adjusted RBC Report that indicates the event in paragraph (1),
33provided that the insurer does not challenge the Adjusted RBC
34Report under Section 739.7.
35(3) If the insurer challenges, under Section 739.7, an Adjusted
36RBC Report that indicates the event in paragraph (1), the
37notification by the commissioner to the insurer that the
38commissioner has, after a hearing, rejected the insurer’s challenge.
P13 1(b) In the event of a Company Action Level Event, the insurer
2shall prepare and submit to the commissioner a comprehensive
3financial plan that shall do all of the following:
4(1) Identify the conditions in the insurer that contribute to the
5Company Action Level Event.
6(2) Contain proposals of corrective actions that the insurer
7intends to take and would be expected to result in the elimination
8of the Company Action Level Event.
9(3) Provide projections of the insurer’s financial results in the
10current year and at least the four succeeding years, both in the
11absence of proposed corrective actions and giving effect to the
12proposed corrective actions, including projections of statutory
13operating income, net income, capital, or surplus, or a combination.
14The projections for both new and renewal business may include
15separate projections for each major line of business and separately
16identify each significant income, expense, and benefit component.
17(4) Identify the key assumptions impacting the insurer’s
18projections and the sensitivity of the projections to the assumptions.
19(5) Identify the quality of, and problems associated with, the
20insurer’s business, including, but not limited to, its assets,
21anticipated business growth and associated surplus strain,
22extraordinary exposure to risk, mix of business, and use of
23reinsurance in each case, if any.
24(c) The RBC Plan shall be submitted as follows:
25(1) Within 45 days of the Company Action Level Event.
26(2) If the insurer challenges an Adjusted RBC Report pursuant
27to Section 739.7, within 45 days after notification to the insurer
28that the commissioner has, after a hearing, rejected the insurer’s
30(d) Within 60 days after the submission by an insurer of an RBC
31Plan to the commissioner, the commissioner shall notify the insurer
32whether the RBC Plan shall be implemented or is, in the judgment
33of the commissioner, unsatisfactory. If the commissioner
34determines that the RBC Plan is unsatisfactory, the notification to
35the insurer shall set forth the reasons for the determination, and
36may set forth proposed revisions that will render the RBC Plan
37satisfactory, in the judgment of the commissioner. Upon
38notification from the commissioner, the insurer shall prepare a
39Revised RBC Plan, which may incorporate by reference revisions
P14 1proposed by the commissioner, and shall submit the Revised RBC
2Plan to the commissioner as follows:
3(1) Within 45 days after the notification from the commissioner.
4(2) If the insurer challenges the notification from the
5commissioner under Section 739.7, within 45 days after a
6notification to the insurer that the commissioner has, after a
7hearing, rejected the insurer’s challenge.
8(e) In the event of a notification by the commissioner to an
9insurer that the insurer’s RBC Plan or Revised RBC Plan is
10unsatisfactory, the commissioner may, at his or her discretion,
11subject to the insurer’s right to a hearing under Section 739.7,
12specify in the notification that the notification constitutes a
13Regulatory Action Level Event.
14(f) Every domestic insurer that files an RBC Plan or Revised
15RBC Plan with the commissioner shall file a copy of the RBC Plan
16or Revised RBC Plan with the insurance commissioner in any state
17in which the insurer is authorized to do business if both of the
19(1) That state has an RBC provision substantially similar to
20subdivision (a) of Section 739.8.
21(2) The insurance commissioner of that state has notified the
22insurer of its request for the filing in writing, in which case the
23insurer shall file a copy of the RBC Plan or Revised RBC Plan in
24that state no later than the later of:
25(A) Fifteen days after the receipt of notice to file a copy of its
26RBC Plan or Revised RBC Plan with the state.
27(B) The date on which the RBC Plan or Revised RBC Plan is
28filed under subdivision (c) of Section 739.7.
Section 985 of the Insurance Code is amended to read:
(a) On or after January 1, 1970, as used in this article and
31in subdivision (i) of Section 1011, “insolvency” means either of
33(1) Any impairment of minimum “paid-in capital” or “capital
34paid in,” as defined in Section 36, required in the aggregate of an
35insurer by the provisions of this code for the class, or classes, of
36insurance that it transacts anywhere.
37(2) An inability of the insurer to meet its financial obligations
38when they are due.
39(b) On or after January 1, 1970, an insurer cannot escape the
40condition of insolvency by being able to provide for all its liabilities
P15 1and for reinsurance of all outstanding risks. An insurer must also
2be possessed of additional assets equivalent to the aggregate
3“paid-in capital” or “capital paid in” required by this code after
4making provision for all those liabilities and for that reinsurance.
5(c) On or after October 1, 1967, as used in this code provision
6for reinsurance of all outstanding risks and “gross premiums
7without any deduction, received and receivable upon all unexpired
8risks” means the greater of: (1) the aggregate amount of actual
9unearned premiums, or (2) the amount reasonably estimated as
10being required to reinsure in a solvent admitted insurer the
11unexpired terms of the risks represented by all outstanding policies.
12(d) On or after October 1, 1967, an insurer shall make
13for reinsurance of the outstanding risk on policies that provide
14premiums that are fully earned at inception and on policies that
15for any other reason do not provide for a return premium to the
16insured on cancellation prior to expiration.
17(e) On or after October 1, 1967, the commissioner shall prescribe
18standards for reasonably estimating the amount required to reinsure
19that will provide adequate safeguards for the policyholders,
20creditors, and the public.
21(f) On or after October 1, 1967, this section shall not be
22applicable to life, title, mortgage, or mortgage guaranty insurers.
23(g) In the application of this section to disability insurance, as
24defined in Section 106, reserves for unearned premiums and
25amounts reasonably estimated as required to reinsure outstanding
26risks shall be determined in accordance with the provisions of
Section 1011 of the Insurance Code is amended to
The superior court of the county in which the principal
31office of a person described in Section 1010 is located, upon the
32filing by the commissioner of the verified application showing any
33of the conditions in this subdivision exist, or a filing by the Federal
34Deposit Insurance Corporation of the verified application showing
35that the conditions enumerated in subdivision (j) exist and the
36conditions set forth in Section 5383(e)(3) of Title 12 of the United
37States Code having been satisfied, shall issue its order vesting title
38to all of the assets of that person, wheresoever situated, in the
39commissioner or his or her successor in office, in his or her official
40capacity, and direct the commissioner forthwith to take possession
P16 1of all of its books, records, property, real and personal, and assets,
2and to conduct, as conservator, the business of the person, or so
3much thereof as to the commissioner may seem appropriate, and
4enjoining the person and its officers, directors, agents, servants,
5and employees from the transaction of its business or disposition
6of its property until any of the following further order of the court:
7(a) That the person has refused to submit its books, papers,
8accounts, or affairs to the reasonable inspection of the
9commissioner or his or her deputy or examiner.
10(b) That the person has neglected or refused to observe an order
11of the commissioner to make good within the time prescribed by
12law any deficiency in its capital if it is a stock corporation, or in
13its reserve if it is a mutual insurer.
14(c) That the person, without first obtaining the consent in writing
15of the commissioner, has transferred, or attempted to transfer,
16substantially its entire property or business or, without consent,
17has entered into any transaction the effect of which is to merge,
18consolidate, or reinsure substantially its entire property or business
19in or with the property or business of any other person.
20(d) That the person is found, after an examination, to be in a
21condition that makes its further transaction of business hazardous
22to its policyholders, or creditors, or to the public.
23(e) That the person has violated its charter or any law of the
25(f) That any officer
of the person refuses to be examined under
26oath, touching its affairs.
27(g) That any officer or attorney in fact of the person has
28embezzled, sequestered, or wrongfully diverted any of the assets
29of the person.
30(h) That a domestic insurer does not comply with the
31requirements for the issuance to it of a certificate of authority, or
32that its certificate of authority has been revoked.
33(i) That the last report of examination of any person to whom
34the provisions of this article apply shows the person to be insolvent
35within the meaning of Article 13 (commencing with Section 980)
36of Chapter 1 of Part 2 of Division 1; or if a reciprocal or
37interinsurance exchange, within the applicable provisions of
38Section 1370.2, 1370.4, 1371, or 1372; or if a life insurer, within
39the applicable provisions of Sections 10510 and 10511.
P17 1(j) Notification is given by the United States Secretary of the
2Treasury that a determination has been made by the secretary, in
3accordance with and satisfying the provisions of Section 5383(b)
4of Title 12 of the United States Code, as to a person described in
5Section 1010 that is an insurance company as defined in Section
65381(a)(13) of Title 12 of the United States Code, and one of the
8(1) The board of directors, or body performing similar functions,
9of the person acquiesces or consents to the appointment of a
10receiver as provided for in Section 5832(a)(1)(A)(i) of Title 12 of
11the United States Code, with that consent to be considered to be
12consent to issuance of an order under this section.
13(2) The United States District Court for the District of Columbia
14issued an order for the appointment of a receiver of the person as
15provided for in Section 5382(a)(1)(A)(iv)(I) of Title 12 of the
16United States Code, without regard to whether an appeal of the
17order is pending.
18(3) A petition by the United States Secretary of the Treasury
19for appointment of a receiver was made to the United States District
20 Court for the District of Columbia and was granted by operation
21of the law as provided for in Section 5382(a)(1)(A)(v) of Title 12
22of the United States Code, without regard to whether an appeal of
23the order is pending.
Section 1011.1 of the Insurance Code is amended to
If a verified application is filed pursuant to Section
271011 that shows that the conditions set forth in subdivision (j) of
28Section 1011 exist and upon a showing that notice was provided
29to the person that is the subject of the verification application, all
30of the following apply:
31(a) A superior court hearing shall be held in which the person
32may oppose the verified application solely on the grounds that the
33conditions set forth in subdivision (j) of Section 1101 do not exist.
34The hearing shall be completed within 24 hours after the verified
35application is filed with the court.
36(b) The superior court shall issue an order as provided for in
37Section 1011 within 24 hours after the verified application was
38filed with the court.
39(c) If the superior court does not issue an order within 24 hours
40as provided for in subdivision (b), then an order described in
P18 1Section 1011 shall be deemed granted by operation of law upon
2expiration of the 24-hour period, without further notice.
3(d) An order entered by the superior court pursuant to
4subdivision (b) or entered by operation of law pursuant to
5subdivision (c) shall not be subject to any stay or injunction
Section 1012 of the Insurance Code is amended to
Except in the case of an order issued based on a verified
10application showing the conditions in subdivision (j) of Section
111011 to exist, the order shall continue in force and effect until, on
12the application either of the commissioner or of that person, it
13shall, after a full hearing, appear to the court that the ground for
14the order directing the commissioner to take title and possession
15does not exist or has been removed and that the person can properly
16resume title and possession of its property and the conduct of its
Section 1016 of the Insurance Code is amended to
(a) If at any time after the issuance of an order under
21Section 1011, or if at the time of instituting any proceeding under
22this article, including under Section 1011, it shall appear to the
23commissioner that it would be futile to proceed as conservator
24with the conduct of the business of that person, he or she may
25apply to the court for an order to liquidate and wind up the business
26of the person. Upon a full hearing of that application, the court
27may make an order directing the winding up and liquidation of the
28business of that person by the commissioner, as liquidator, for the
29purpose of carrying out the order to liquidate and wind up the
30business of that person.
subdivision (a), the court may issue an
32order to liquidate and wind up the business of a person as to whom
33a verified application is filed pursuant to subdivision (j) of Section
341011 based solely on the verified application and hearing as
35provided for in subdivision (a) of Section 1011.1, without further
36hearing, or may issue an order to liquidate and wind up the business
37of the person upon application by the commissioner after the
38issuance of an order under Section 1011. The court’s order may
39direct the winding up and liquidation of the business of the person
P19 1by the commissioner, as liquidator, for the purpose of carrying out
2the order to liquidate and wind up the business of the person.
Section 1070.6 of the Insurance Code is amended to
The withdrawal procedure and fees prescribed by this
6article shall not be required of a nonsurviving admitted constituent
7to a merger or consolidation into another admitted insurer in
8accordance with the applicable statutes and the commissioner’s
9prior written consent given pursuant to subdivision (c) of Section
101011, provided the commissioner is satisfied by documents,
11authenticated so as to be admissible in evidence over objection,
12filed with him or her, that:
13(a) The constituent has discharged all of its liabilities to residents
14of this state in the manner provided by Section 1071.5;
15(b) There will be an admitted insurer directly available to
16constituent’s policyholders: (1) to obtain policy changes and
17 endorsements, (2) to receive payment of premiums and refund
18unearned premiums, (3) to serve notice of claim, proof of loss,
19summons, process, and other papers, and (4) for purposes of suit;
20(c) The constituent shall timely file with the commissioner
21appropriate financial statements reporting its insurance business
22done in this state during the calendar year of the merger or
23consolidation and all appropriate tax returns required by law for
24the period, and shall timely pay all taxes found to be due on account
25of the business; and
26(d) The constituent has surrendered its current California
27certificate of authority to the commissioner for cancellation as of
28the effective date of the merger.
29The withdrawal procedure and fees prescribed by
30shall not be required of an insurer that has been liquidated by a
31final order of a court of record of this or any sister state provided
32a certified copy of the order reciting the fact of liquidation and
33discharge of all obligations has been filed with the commissioner.
Section 1216.1 of the Insurance Code is amended to
As used in this article, the following terms have the
38(a) “Accredited state” means a state in which the insurance
39department or regulatory agency having jurisdiction over the
40business of insurance has qualified as meeting the minimum
P20 1financial regulatory standards promulgated and established from
2time to time by the National Association of Insurance
3Commissioners’ (NAIC) Financial Regulation Standards and
5(b) “Control” or “controlled” has the meaning ascribed in
insurer” means an admitted insurer which is
8controlled, directly or indirectly, by a producer.
9(d) “Controlling producer” means a producer who, directly or
10indirectly, controls an insurer.
11(e) “Admitted insurer” or “insurer” means any person, firm,
12association, or corporation admitted to transact any property or
13casualty insurance business in this state. The following are not
14insurers for the purposes of this article:
15(1) All residual market pools and joint underwriting authorities
17(2) All captive insurers, other than risk retention groups as
18defined in the federal Superfund Amendments Reauthorization
19Act of 1986 (42 U.S.C. Sec. 9671), the federal Liability Risk
20Retention Act of 1986 (15 U.S.C. Sec. 3901 et seq.), and the
21California Risk Retention Act of 1991 (Chapter 1.5 (commencing
22with Section 125) of Part 1). For the purposes of this article, captive
23insurers are either insurance companies which are owned by
24another organization and whose exclusive purpose is to insure
25risks of the parent organization and affiliated companies, or in the
26case of groups and associations, insurance organizations which
27are owned by the insureds and whose exclusive purpose is to insure
28risks of member organizations and group or association members
29and their affiliates.
30(f) “Producer” means a fire and casualty licensee or licensees
31or any other person, firm, association, or corporation, when, for
32any compensation, commission, or other thing of value, the person,
33firm, association, or corporation acts or aids in any manner in
34soliciting, negotiating or procuring the making of any insurance
35contract on behalf of an insured other than the person, firm,
36association, or corporation.
Section 1624 of the Insurance Code is amended to
“Insurance solicitor” means a natural person employed
40to aid a property and casualty broker-agent acting as an insurance
P21 1agent or insurance broker in transacting insurance other than life,
2disability, or health.
Section 1675 of the Insurance Code is amended to
The following applicants who have theretofore been
6licensed under this code are exempt from the requirements of this
8(a) An applicant for a license to act as a property broker-agent
9or a casualty broker-agent who has been licensed as a property
10broker-agent, casualty broker-agent, or surplus line broker during
11any part of the license year in which the application is filed or the
12immediately preceding license year.
13(b) An applicant for a license to act as a life-only agent who has
14been licensed as a life-only agent during any part of the license
15year in which the application is filed or the immediately preceding
17(c) An applicant for a license to act as an accident and health
18agent who has been licensed as an accident and health agent during
19any part of the license year in which the application is filed or the
20immediately preceding license year.
21(d) An applicant for a license to act as a travel insurance agent.
22(e) An applicant specifically exempted from the particular
23qualifying examination requirement by other provisions of this
25(f) (1) A nonresident licensee who applies for a property
26broker-agent, casualty broker-agent, personal lines broker-agent,
27or life agent resident license in this state, and who is currently
28licensed for the same lines of authority in the state of his or her
29current resident license, shall not be required to complete an
30examination. The application shall be received within 90 days of
31the cancellation of the applicant’s resident license and the producer
32database records, maintained by the National Association of
33Insurance Commissioners, shall indicate that the producer is
34licensed in good standing for the line of authority requested.
35(2) Upon issuance of the California resident license, the
36examination waiver also applies to adding additional lines of
37authority to the California resident license provided that the
38individual was previously licensed in good standing for the
39requested additional lines of authority, and the application is
P22 1received within 12 months of the cancellation of the applicant’s
2previous resident license in another state.
Section 1749.3 of the Insurance Code is amended to
An individual licensed as a life-only agent or an
6accident and health agent and also licensed as a property or casualty
7broker-agent, or an individual only licensed as a property or
8casualty broker-agent, shall complete those courses, programs of
9instruction, or seminars approved by the commissioner for the type
10of license held. Completion of specified product training required
11in subdivision (d) of Section 1749.33, subdivision (b) of Section
121749.8, and paragraph (4) of subdivision (a) of Section 10234.93
13may result in the completion of more than the minimum of required
14continuing education hours. The minimum number of hours
15required is as follows:
16(a) Any licensee, as specified in this section, shall
17complete 24 hours of instruction, of which three hours shall be in
18ethics, prior to renewal of the license. These hours of instruction
19may be completed at any time prior to renewal of the license.
20(b) An individual licensed as a property broker-agent or casualty
21broker-agent and as a life-only agent or an accident and health
22agent shall satisfy the requirements of this section by demonstrating
23completion of the courses, programs of instruction, or seminars
24approved by the commissioner for any of the license types listed
25in this section.
26(c) A licensee shall not be required to comply with the
27requirements of this article if the licensee submits proof satisfactory
28to the commissioner that he or she has been a licensee in good
29standing for 30 continuous years in this state and is 70 years of
30age or older. This exemption shall not apply to those individuals
31licensed for the first time on or after January 1, 2010.
Section 1749.31 of the Insurance Code is amended
(a) An individual licensed as a personal lines
35broker-agent shall complete required continuing education courses,
36programs of instruction, or seminars approved by the
37commissioner. The personal lines broker-agent shall complete 24
38hours, of which three hours shall be in ethics, during each two-year
39license term as defined in subdivision (d) of Section 1625.5.
P23 1(b) An individual licensed as a personal lines broker-agent and
2as a life-only agent or accident and health agent shall satisfy the
3requirements of this section by satisfactorily completing 24 hours
4of instruction prior to renewal of the license.
Section 1749.32 of the Insurance Code is amended
(a) An individual licensed as a limited lines
8automobile insurance agent shall complete required continuing
9education courses, programs of instruction, or seminars approved
10by the commissioner. The minimum number of hours required is
1120 hours, of which three hours shall be in ethics, per license term
12prior to the renewal of the license.
13(b) An individual licensed as a limited automobile insurance
14agent and as a life-only agent or accident and health agent shall
15satisfy the requirements of this section by satisfactorily completing
1624 hours of instruction prior to renewal of the license.
Section 1749.33 of the Insurance Code is amended
(a) A life-only agent licensee shall satisfactorily
20complete 24 hours of instruction, of which three hours shall be in
21ethics, prior to renewal of the license. These hours of instruction
22may be completed at any time prior to renewal of the license.
23(b) An accident and health agent licensee shall satisfactorily
24complete 24 hours of instruction, of which three hours shall be in
25ethics, prior to renewal of the license. These hours of instruction
26may be completed at any time prior to renewal of the license.
27(c) An agent licensed as both a life-only agent and as an accident
28and health agent shall satisfactorily complete a total of 24 hours
29of instruction, of which three hours shall be in ethics, prior to
30renewal of the license. These hours of instruction may be
31completed at any time prior to renewal of the license.
32(d) Any accident and health agent who wishes to sell 24-hour
33care coverage, as defined in Section 1749.02, shall complete a
34course, program of instruction, or seminar of an approved
35continuing education provider on workers’ compensation and
36general principles of employer liability, which shall be completed
37by examination approved by the commissioner as part of the
38continuing education course, program of instruction, or seminar
39prior to selling this coverage. The required number of instruction
40hours shall be equal to but no greater than that required by the
P24 1curriculum board for the prelicensing requirements of a property
2broker-agent or a casualty broker-agent on these subjects. For
3resident licensees, this requirement shall count toward the
4licensee’s continuing education requirement, but may still result
5in completing more than the minimum number of continuing
6education hours set forth in this section. Nothing in this section
7shall be deemed to allow an accident and health agent to satisfy
8the obligations set forth in this section by other than a proctored
9examination administered or approved by the department.
Section 1749.8 of the Insurance Code is amended to
(a) Every life agent who sells annuities shall
13satisfactorily complete eight hours of training prior to soliciting
14individual consumers in order to sell annuities.
15(b) Every life agent who sells annuities shall satisfactorily
16complete four hours of training prior to each license renewal.
17Completion of the eight-hour annuity training required by
18subdivision (a) does not satisfy the four-hour annuity training
19required by this subdivision. For resident licensees, this
20requirement shall count toward the licensee’s continuing education
21requirement, but may still result in completing more than the
22minimum number of continuing education hours set forth in this
24(c) The training required by this section shall be approved by
25the commissioner and shall consist of topics related to annuities,
26and California law, regulations, and requirements related to
27annuities, prohibited sales practices, the recognition of indicators
28that a prospective insured may lack the short-term memory or
29judgment to knowingly purchase an insurance product, and
30fraudulent and unfair trade practices. Subject matter determined
31by the commissioner to be primarily intended to promote the sale
32or marketing of annuities shall not qualify for credit toward the
33training requirement. Any course or seminar that is disapproved
34under the provisions of this section shall be presumed invalid for
35credit toward the training requirement of this section unless it is
36approved in writing by the commissioner.
37(d) The training requirements set forth in this section shall not
38apply to nonresident agents representing an insurer that is a direct
P25 1For the purposes of this section, “direct response provider” means
2an insurer that meets each of the following criteria:
3(1) The insurer does not initiate telephone contact with insureds
4or prospective insureds.
5(2) Agents of the insurer speak with insureds and prospective
6insureds only by telephone, and at the request of the insureds or
8(3) Agents of the insurer are assigned to speak with insureds or
9prospective insureds on a random basis, when contacted.
10(4) Agents of the insurer are salaried and do not receive
11commissions for sales or referrals.
Section 1758.3 of the Insurance Code is amended to
The commissioner shall not grant authority to transact
15variable contracts unless the life agent or applicant furnishes proof
16that he or she is registered to sell securities in California in
17accordance with the rules of the United States Securities and
18Exchange Commission or the Financial Industry Regulatory
19Authority. Any authority granted to a life agent to transact variable
20contracts shall immediately terminate upon the life agent no longer
21being registered to sell securities in accordance with the rules of
22the United States Securities and Exchange Commission or the
23Financial Industry Regulatory Authority.
Section 1758.681 is added to the Insurance Code, to
Notwithstanding any other law:
27(a) As used in this section, “portable electronics vendor
28policyholder” means a portable electronics insurance agent licensee
29pursuant to subdivision (f) of Section 1758.69.
30(b) An insurer may terminate a portable electronics insurance
31policy or otherwise change the terms and conditions of a portable
32electronics insurance policy only upon providing the portable
33electronics vendor policyholder and enrolled customers with at
34least 30 calendar days’ written notice.
35(c) If the insurer changes the terms and conditions of a policy
36of portable electronics insurance, the insurer shall provide the
37portable electronics vendor policyholder with a revised policy or
38endorsement and each enrolled customer with a revised certificate,
39endorsement, updated brochure, or other evidence indicating that
P26 1a change in the terms and conditions has occurred and a summary
2of those changes.
3(d) Notwithstanding subdivision (b), an insurer may terminate
4an enrolled customer’s enrollment under a portable electronics
5insurance policy upon 15 calendar days’ notice for discovery of
6fraud or material misrepresentation in obtaining coverage or in the
7presentation of a claim under the policy.
8(e) Notwithstanding subdivision (b), an insurer may immediately
9terminate an enrolled customer’s enrollment under a portable
10electronics insurance policy without prior notice for any of the
12(1) For nonpayment of premium.
13(2) If the enrolled customer ceases to have an active service
14with the vendor of portable electronics.
15(3) If the enrolled customer exhausts the aggregate limit of
16liability, if any, under the terms of the portable electronics
17insurance policy and the insurer sends notice of termination to the
18enrolled customer within 30 calendar days after exhaustion of the
19limit. However, if notice is not sent within 30 calendar days,
20enrollment shall continue notwithstanding the aggregate limit of
21liability until 30 calendar days from the date the insurer sends
22notice of termination to the enrolled customer.
23(f) If a portable electronics insurance policy is terminated by a
24portable electronics vendor policyholder, the portable electronics
25vendor policyholder shall mail or deliver written notice to each
26enrolled customer advising the enrolled customer of the termination
27of the policy and the effective date of termination. The written
28notice shall be mailed or delivered by the portable electronics
29vendor policyholder to the enrolled customer at least 30 days prior
30to the termination. However, if notice is not sent within 30
31calendar days, enrollment shall continue
begin delete notwithstanding the until 30
calendar days from the date the
32aggregate limit of liabilityend delete
33portable electronics vendor policyholder sends notice of
34termination to the enrolled customer.
36(g) Whenever notice or correspondence with respect to a policy
37of portable electronics insurance is required pursuant to this section,
38it shall be in writing and sent within the notice period required
39pursuant to this section. Notices and correspondence shall be sent
40to the portable electronics vendor policyholder at the portable
P27 1electronics vendor policyholder’s mailing address specified for
2that purpose and to its affected enrolled customers’ last known
3mailing addresses on file with the insurer or the portable electronics
4vendor policyholder. The insurer or portable electronics vendor
5policyholder shall maintain proof that the notice or correspondence
6was sent for not less than three years after that notice or
7correspondence was sent.
Section 1872.87 of the Insurance Code is amended
(a) Each insurer required to pay special purpose
11assessments pursuant to Sections 1872.8, 1872.81, 1872.85, 1874.8,
12or subdivision (a) of Section 1872.86 may, over a reasonable length
13of time, but in no event later than the calendar year in which the
14assessment is paid, recoup the special purpose assessments by way
15of a surcharge on premiums charged for the insurance policies to
16which those sections apply or by including the assessments within
17the insurer’s rates. Amounts recouped shall not be considered
18premiums for any purpose, including the computation of gross
19premium tax or agents’ commission.
20(b) The amount of the surcharge shall be separately stated on
21either a billing or policy declaration sent to an insured.
Section 10234.93 of the Insurance Code is amended
(a) Every insurer of long-term care in California
26(1) Establish marketing procedures to assure that any comparison
27of policies by its agents or other producers will be fair and accurate.
28(2) Establish marketing procedures to assure excessive insurance
29is not sold or issued.
30(3) Submit to the commissioner within six months of the
31effective date of this act, a list of all agents or other insurer
32representatives authorized to solicit individual consumers for the
33sale of long-term care insurance. These submissions shall be
34updated at least semiannually.
35(4) Provide the following training and require that each agent
36or other insurer representative authorized to solicit individual
37consumers for the sale of long-term care insurance shall
38satisfactorily complete the following training requirements that,
39for resident licensees, shall count toward the licensee’s continuing
40education requirement, but may still result in completing more
P28 1than the minimum number of continuing education hours set forth
2in this section:
3(A) For licensees issued a license after January 1, 1992, eight
4hours of training in each of the first four 12-month periods
5beginning from the date of original license issuance and thereafter
6eight hours of training prior to each license renewal.
7(B) For licensees issued a license before January 1, 1992, eight
8hours of training prior to each license renewal.
9(C) For nonresident licensees that are not otherwise subject to
10the continuing education requirements set forth in Section 1749.3,
11the evidence of training required by this section shall be filed with
12and approved by the commissioner as provided in subdivision (g)
13of Section 1749.4.
14Licensees shall complete the initial training requirements of this
15section prior to being authorized to solicit individual consumers
16for the sale of long-term care insurance.
17The training required by this section shall consist of topics related
18to long-term care services and long-term care insurance, including,
19but not limited to, California regulations and requirements,
20available long-term care services and facilities, changes or
21improvements in services or facilities, and alternatives to the
22purchase of private long-term care insurance. On or before July
231, 1998, the following additional training topics shall be required:
24differences in eligibility for benefits and tax treatment between
25policies intended to be federally qualified and those not intended
26to be federally qualified, the effect of inflation in eroding the value
27of benefits and the importance of inflation protection, and NAIC
28consumer suitability standards and guidelines.
29(5) Display prominently on page one of the policy or certificate
30and the outline of coverage: “Notice to buyer: This policy may not
31cover all of the costs associated with long-term care incurred by
32the buyer during the period of coverage. The buyer is advised to
33review carefully all policy limitations.”
34(6) Inquire and otherwise make every reasonable effort to
35identify whether a prospective applicant or enrollee for long-term
36care insurance already has accident and sickness or long-term care
37insurance and the types and amounts of any such insurance.
38(7) Every insurer or entity marketing long-term care insurance
39shall establish auditable procedures for verifying compliance with
P29 1(8) Every insurer shall provide to a prospective applicant, at the
2time of solicitation, written notice that the Health Insurance
3Counseling and Advocacy Program (HICAP) provides health
4insurance counseling to senior California residents free of charge.
5Every agent shall provide the name, address, and telephone number
6of the local HICAP program and the statewide HICAP number,
8(9) Provide a copy of the long-term care insurance shoppers
9guide developed by the California Department of Aging to each
10prospective applicant prior to the presentation of an application or
11enrollment form for insurance.
12(10) Clearly post on its Internet Web site and provide written
13notice at the time of solicitation that a specimen individual policy
14form or group master policy and certificate form for each policy
15form offered in this state is available to a prospective applicant
16upon request. The individual specimen policy form or group master
17policy and certificate form shall be provided to a requesting party
18within 15 calendar days of receipt of a request.
19(b) In addition to other unfair trade practices, including those
20identified in this code, the following acts and practices are
22(1) Twisting. Knowingly making any misleading representation,
23incomplete, or fraudulent comparison of any insurance policies or
24insurers for the purpose of inducing, or tending to induce, any
25person to lapse, forfeit, surrender, terminate, retain, pledge, assign,
26borrow on, or convert any insurance policy or to take out a policy
27of insurance with another insurer.
28(2) High pressure tactics. Employing any method of marketing
29having the effect of or tending to induce the purchase of insurance
30through force, fright, threat, whether explicit or implied, or undue
31pressure to purchase or recommend the purchase of insurance.
32(3) Cold lead advertising. Making use directly or indirectly of
33any method of marketing that fails to disclose in a conspicuous
34manner that a purpose of the method of marketing is solicitation
35of insurance and that contact will be made by an insurance agent
36or insurance company.
Section 10785 of the Insurance Code is amended to
(a) A disability insurer that covers hospital, medical,
40or surgical expenses under an individual health benefit plan as
P30 1defined in subdivision (a) of Section 10198.6 may not, with respect
2to a federally eligible defined individual desiring to enroll in
3individual health insurance coverage, decline to offer coverage to,
4or deny enrollment of, the individual or impose any preexisting
5condition exclusion with respect to the coverage.
6(b) For purposes of this section, “federally eligible defined
7individual” means an individual who, as of the date on which the
8individual seeks coverage under this section, meets all of the
10(1) Has had 18 or more months of creditable coverage, and
11whose most recent prior creditable coverage was under a group
12health plan, a federal governmental plan maintained for federal
13employees, or a governmental plan or church plan as defined in
14the federal Employee Retirement Income Security Act of 1974
15(29 U.S.C. Sec. 1002).
16(2) Is not eligible for coverage under a group health plan,
17Medicare, or Medi-Cal, and does not have other health insurance
19(3) Was not terminated from his or her most recent creditable
20coverage due to nonpayment of premiums or fraud.
21(4) If offered continuation coverage under COBRA or
22Cal-COBRA, has elected and exhausted that coverage.
23(c) Every disability insurer that covers hospital, medical, or
24surgical expenses shall comply with applicable federal statutes
25and regulations regarding the provision of coverage to federally
26eligible defined individuals, including any relevant application
28(d) A disability insurer shall offer the following health benefit
29plans under this section that are designed for, made generally
30available to, are actively marketed to, and enroll, individuals:
31(1) either the two most popular products as defined in Section
32300gg-41(c)(2) of Title 42 of the United States Code and Section
33148.120(c)(2) of Title 45 of the Code of Federal Regulations or
34(2) the two most representative products as defined in Section
35300gg-41(c)(3) of the United States Code and Section
36148.120(c)(3) of Title 45 of the Code of Federal Regulations, as
37determined by the insurer in compliance with federal law. An
38insurer that offers only one health benefit plan to individuals,
39excluding health benefit plans offered to Medi-Cal or Medicare
40beneficiaries, shall be deemed to be in compliance with this chapter
P31 1if it offers that health benefit plan contract to federally eligible
2defined individuals in a manner consistent with this chapter.
3(e) (1) In the case of a disability insurer that offers health benefit
4plans in the individual market through a network plan, the insurer
5may do both of the following:
6(A) Limit the individuals who may be enrolled under that
7coverage to those who live, reside, or work within the service area
8for the network plan.
9(B) Within the service area covered by the health benefit plan,
10deny coverage to individuals if the insurer has demonstrated to the
11commissioner that the insured will not have the capacity to deliver
12services adequately to additional individual insureds because of
13its obligations to existing group policyholders, group
14contractholders and insureds, and individual insureds, and that the
15insurer is applying this paragraph uniformly to individuals without
16regard to any health status-related factor of the individuals and
17without regard to whether the individuals are federally eligible
19(2) A disability insurer, upon denying health insurance coverage
20in any service area in accordance with subparagraph (B) of
21paragraph (1), may not offer health benefit plans through a network
22in the individual market within that service area for a period of
23180 days after the coverage is denied.
24(f) (1) A disability insurer may deny health insurance coverage
25in the individual market to a federally eligible defined individual
26if the insurer has demonstrated to the commissioner both of the
28(A) The insurer does not have the financial reserves necessary
29to underwrite additional coverage.
30(B) The insurer is applying this subdivision uniformly to all
31individuals in the individual market and without regard to any
32health status-related factor of the individuals and without regard
33to whether the individuals are federally eligible defined individuals.
34(2) A disability
insurer, upon denying individual health
35insurance coverage in any service area in accordance with
36paragraph (1), may not offer that coverage in the individual market
37within that service area for a period of 180 days after the date the
38coverage is denied or until the insurer has demonstrated to the
39commissioner that the insurer has sufficient financial reserves to
40underwrite additional coverage, whichever is later.
P32 1(g) The requirement pursuant to federal law to furnish a
2 certificate of creditable coverage shall apply to health benefits
3plans offered by a disability insurer in the individual market in the
4same manner as it applies to an insurer in connection with a group
5health benefit plan policy or group health benefit plan contract.
6(h) A disability insurer shall compensate an accident and health
7agent or a life and accident and health agent whose activities result
8in the enrollment of federally eligible defined individuals in the
9same manner and consistent with the renewal commission amounts
10as the insurer compensates accident and health agents or life and
11accident and health agents for other enrollees who are not federally
12eligible defined individuals and who are purchasing the same
13individual health benefit plan.
14(i) Every disability insurer shall disclose as part of its COBRA
15or Cal-COBRA disclosure and enrollment documents, an
16explanation of the availability of guaranteed access to coverage
17under the federal Health Insurance Portability and Accountability
18Act of 1996, including the necessity to enroll in and exhaust
19COBRA or Cal-COBRA benefits in order to become a federally
20eligible defined individual.
21(j) No disability insurer may request documentation as to
22whether or not a person is a federally eligible defined individual
23other than is permitted under applicable federal law or regulations.
24(k) This section shall not apply to coverage defined as excepted
25benefits pursuant to Section 300gg(c) of Title 42 of the United
27(l) This section shall apply to policies or contracts offered,
28delivered, amended, or renewed on or after January 1, 2001.
(a) The commissioner, after a public hearing, shall
32approve or issue a reasonable plan for the equitable apportionment,
33among insurers admitted to transact liability insurance, of those
34applicants for automobile bodily injury and property damage
35liability insurance who are in good faith entitled to but are unable
36to procure that insurance through ordinary methods. The
37commissioner shall require the payment of five hundred ninety
38dollars ($590), in advance, as a fee for the filing of amendments
39to the plan with the commissioner. The commissioner may approve
40or issue reasonable amendments to the plan if he or she first holds a public
2hearing to determine whether the amendments are in keeping with
3the intent and purpose of this section. All
begin delete suchend delete insurers shall
4subscribe to the plan and its amendments and participate in the
6(b) Judicial review of rate
7revision proceedings shall be in accordance with Section 1858.6.
8(c) Public hearings held pursuant to this section shall be
9conducted in accordance with the rulemaking provisions of the
10Administrative Procedure Act (Chapter 3.5 (commencing with
11Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Section 12389.7 is added to the Insurance Code, to
(a) Sections 1070, 1070.5, 1070.6, 1071.5, 1072, and
401076 shall be applicable to underwritten title companies.
P34 1(b) The following terms from Sections 1070, 1070.5, 1070.6,
21071.5, 1072, and 1076 shall be applicable to underwritten title
3companies as follows:
4(1) “Certificate of Authority” shall mean an underwritten title
6(2) “Insurer” shall mean an underwritten title company.
7(3) “Reinsurer” shall mean a title underwriter or another
8underwritten title company.
9(c) For the purposes of this section, Sections 1070, 1070.5,
101070.6, 1071.5, 1072, and 1076 shall be construed in accordance
11with the nature of underwritten title companies and the business
12of title insurance.
Section 12414.25 of the Insurance Code is amended
(a) Any person, title insurer, underwritten title
17company, or controlled escrow company who fails to comply with
18a final order of the commissioner under this chapter shall be liable
19to the state in an amount not exceeding one hundred dollars ($100),
20but if that failure is willful he, she, or it shall be liable to the state
21in an amount not exceeding five thousand dollars ($5,000) for that
22failure. The commissioner shall collect the amount so payable and
23may bring an action in the name of the people of the State of
24California to enforce collection. Those penalties may be in addition
25to any other penalties provided by law.
26(b) (1) A willful violation of the provisions of this chapter is a
28(2) This subdivision is not applicable to Section 12389.7.
Section 14090.1 of the Insurance Code is amended
(a) An individual who holds an insurance adjuster
33license and who is not exempt under subdivision (b) shall
34satisfactorily complete a minimum of 24 hours, of which three
35hours are to be in ethics, of continuing education courses pertinent
36to the duties and responsibilities of an insurance adjuster license
37reported to the insurance commissioner on a biennial basis in
38conjunction with his or her license renewal cycle.
39(b) This section does not apply to any of the following:
P35 1(1) A licensee not licensed for one full year prior to the end of
2the applicable continuing education biennium.
3(2) A licensee holding a nonresident insurance adjuster license
4who has met the continuing education requirements of his or her
5designated resident state.
6(3) An individual licensed as an insurance adjuster and as a
7property or casualty broker-agent, pursuant to Section 1625, who
8has met the continuing education requirements specified in Section