GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2019
SESSION LAW 2019-179
HOUSE BILL 220
AN ACT to make technical and clarifying changes to the insurance laws, as recommended by the department of insurance.
The General Assembly of North Carolina enacts:
Part I. Holding Company act changes
SECTION 1. G.S. 58‑19‑10(b) reads as rewritten:
"(b) In addition to investments in common stock, preferred stock, debt obligations, and other securities permitted under this Chapter, a domestic insurer may also:
(1) Invest, in common stock, preferred stock, debt obligations, and other securities of one or more affiliates or subsidiaries, amounts that do not exceed the lesser of ten percent (10%) of the insurer's admitted assets or fifty percent (50%) of the insurer's policyholders' surplus, provided that after those investments, the insurer's policyholders' surplus will be reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs. In calculating the amount of the investments, investments in domestic or foreign insurance affiliates or subsidiaries and health maintenance organizations shall be excluded, and there shall be included: (i) total net monies or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of the subsidiary whether or not represented by the purchase of capital stock or issuance of other securities; and (ii) all amounts expended in acquiring additional common stock, preferred stock, debt obligations, and other securities, and all contributions to the capital or surplus, of a subsidiary subsequent to its acquisition or formation;
…
(3) With the approval of the Commissioner, invest any greater amount in common stock, preferred stock, debt obligations, or other securities of one or more affiliates or subsidiaries; provided that after such investment the insurer's policyholders' surplus will be reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs."
Part II. SURPLUS LINES CHANGES
SECTION 2.(a) G.S. 58‑21‑35(b) reads as rewritten:
"(b) The licensee
shall complete and retain a copy of the report in paper or electronic form as
required by the Commissioner. The report required by this section and the
quarterly report required by G.S. 58-21-80 shall be completed on a standardized
form or forms prescribed by the Commissioner and are not public records is
not a public record under G.S. 132‑1 or G.S. 58‑2‑100."
SECTION 2.(b) G.S. 58‑21‑40(b)(3) is repealed.
SECTION 2.(c) G.S. 58‑21‑75 reads as rewritten:
"§ 58‑21‑75. Records of surplus lines licensee.
Each surplus lines licensee shall
keep in his or her office in this State a full and true record of each
surplus lines insurance contract placed by or through the licensee, including a
copy of the policy, certificate, cover note, or other evidence of insurance.
The record shall include the following items:
(1) Amount of the insurance and perils insured;
(2) Brief description of the property insured and its location;
(3) Gross premium charged;
(4) Any return premium paid;
(5) Rate of premium charged upon the several items of property;
(6) Effective date of the contract, and the terms of the contract;
(7) Name and address of the insured;
(8) Name and address of the insurer;
(9) Amount of tax and other
sums to be collected from the insured; andinsured;
(10) Identity of the producing
broker, any confirming correspondence from the insurer or its representative,
and the application.application; and
(11) Copy of the compliance agreement.
The record of each contract shall be kept open at all reasonable times to examination by the Commissioner without notice for a period not less than five years following termination of the contract."
SECTION 2.(d) G.S. 58‑21‑80 is repealed.
SECTION 2.(e) G.S. 58‑21‑95 reads as rewritten:
"§ 58‑21‑95. Suspension, revocation or nonrenewal of surplus lines licensee's license.
The Commissioner may suspend, revoke, or refuse to renew the license of a surplus lines licensee after notice and hearing as provided under G.S. 58‑2‑70 upon any one or more of the following grounds:
(1) Removal of the surplus
lines licensee's office from this State;
(2) Removal of the surplus
lines licensee's office accounts and records from this State during the
period during which such accounts and records are required to be maintained
under G.S. 58‑21‑75;
(3) Closing of the surplus lines licensee's office for a period of more than 30 business days, unless permission is granted by the Commissioner;
(4) Failure to make and file required reports;
(5) Failure to transmit the required tax on surplus lines premiums;
(6) Failure to maintain
the required bond;Failure to pay the stamping fee to the stamping
office;
(7) Violation of any provision of this Article; or
(8) For any other cause for which an insurance license could be denied, revoked, suspended, or renewal refused under the Insurance Law."
part Iii. Align State law WITH NAIC MODEL LAW REGARDING IMMUNITY FOR CONTRACTORS HIRED BY THE DEPARTMENT
SECTION 3.(a) G.S. 58‑30‑71(a) reads as rewritten:
"(a) For the purposes
of this section, the persons Persons entitled to protection under
this section are:
(1) All receivers responsible for the conduct of a delinquency proceeding under this Article, including present and former receivers; and
(2) Their employees All
of the receiver's employees, meaning all present and former special
deputies and assistant special deputies appointed by the Commissioner, staff
assigned to the delinquency proceeding employed by the Attorney General's
Office, and all persons whom the Commissioner, special deputies, or assistant
special deputies have employed to assist in a delinquency proceeding under this
Article. Attorneys, accountants, auditors, and other professional persons or
firms, who are retained by the receiver as independent contractors and their
employees are not employees of the receiver for purposes of this section.
(3) All of the receiver's contractors, meaning all persons who are retained by the receiver or the receiver's employees as independent contractors to assist in a delinquency proceeding under this Article, including attorneys, accountants, auditors, and other professional persons or firms and their employees."
SECTION 3.(b) G.S. 58‑30‑71(b) reads as rewritten:
"(b) The receiver and
his employees have receiver, the receiver's employees, and the receiver's
contractors shall have official immunity and are immune from suit and
liability, both personally and in their official capacities, for any claim for
damage to or loss of property or personal injury or other civil liability
caused by or resulting from any alleged act, error, or omission of the receiver
or any employee arising out of or by reason of any of the following:
(1) their Their duties or employment;employment.
(2) Any matters that have been subject to review by the Court after notice and opportunity to be heard, provided that the alleged act, error, or omission was not disapproved or disallowed by the Court.
provided that nothing Provided, however, that nothing in this section holds the receiver or any employee receiver,
the receiver's employees, or the receiver's contractors immune from suit or
liability for any damage, loss, injury, or liability caused by the intentional
or willful and wanton misconduct of the receiver or any employee receiver,
the receiver's employees, or the receiver's contractors or for any bodily
injury caused by the operation of a motor vehicle."
SECTION 3.(c) G.S. 58‑30‑71(j) reads as rewritten:
"(j) Nothing in this
section deprives the receiver or any employee receiver, the receiver's
employees, or the receiver's contractors of any immunity, indemnity,
benefits of law, rights, or any defense otherwise available."
PART iV. Clarify Consent to rate
SECTION 4.(a) G.S. 58‑36‑30(b) reads as rewritten:
"(b) This subsection
applies only to insurance against loss to automobile physical damage and
related expenses. A rate in excess of that promulgated by the Bureau may be
charged by an insurer on any specific risk if the higher rate is charged in
accordance with rules adopted by the Commissioner. An insurer shall give notice
to the insured that the rates used to calculate the premium for the policy are
greater than those rates that are applicable in the State of North Carolina by
including the following language in the policy on page one of the declarations
page or on a separate page before the declarations page, in at least 14 point
type or in a font size larger than the remainder of the document whichever is
larger, bolded, and all capitalized:
NOTICE: THE PREMIUM THAT WE ARE CHARGING FOR AUTOMOBILE PHYSICAL DAMAGE AND RELATED EXPENSES THAT COVERS THE DAMAGE TO YOUR COVERED VEHICLE(S) EXCEEDS THE PREMIUM BASED UPON THE APPROVED RATES IN NORTH CAROLINA, IN ACCORDANCE WITH G.S. 58‑36‑30(b).
The disclosure statement noted above in this subsection shall be included on any renewal of or endorsement to the policy when the rates charged exceed the approved manual rate. The insurer shall retain consent to rate information for each insured and make this information available to the Commissioner, upon request of the Commissioner. This subsection may also be used to provide motor vehicle liability coverage limits above those required under Article 9A of Chapter 20 of the General Statutes and above those that could be ceded to the North Carolina Reinsurance Facility under Article 37 of this Chapter to persons whose personal excess liability insurance policies require that they maintain specific higher liability coverage limits. Any data obtained by the Commissioner under this subsection is proprietary and confidential and is not a public record under G.S. 132‑1 or G.S. 58‑2‑100."
SECTION 4.(b) G.S. 58‑36‑30(b1) reads as rewritten:
"(b1) This subsection applies only to insurance against loss to residential property with not more than four housing units. A rate in excess of that promulgated by the Bureau may be charged by an insurer on any specific risk if the higher rate is charged in accordance with rules adopted by the Commissioner. An insurer shall give notice to the insured that the rates used to calculate the premium for the policy are greater than those rates that are applicable in the State of North Carolina by including the following language in the policy on page one of the declarations page or on a separate page before the declarations page, in at least 14 point type or in a font size larger than the remainder of the document whichever is larger, bolded, and all capitalized:
NOTICE: IN ACCORDANCE WITH G.S. 58‑36‑30(b1), THE PREMIUM BASED UPON THE APPROVED RATES IN NORTH CAROLINA FOR RESIDENTIAL PROPERTY INSURANCE COVERAGE APPLIED FOR WOULD BE $____. OUR PREMIUM FOR THIS COVERAGE IS $____.
The disclosure statement noted
above in this subsection shall be included on any renewal of or endorsement to
the policy when the rates charged exceed the approved manual rate. for
any subsequent increase above the. The insurer shall retain consent to rate
information for each insured and make this information available to the
Commissioner, upon request of the Commissioner. Any data obtained by the
Commissioner under this subsection is proprietary and confidential and is not a
public record under G.S. 132‑1 or G.S. 58‑2‑100."
SECTION 4.(c) G.S. 58‑36‑30(c) reads as rewritten:
"(c) Any approved rate
under subsection (b) of this section with respect This subsection
applies only to workers' compensation and employers' liability insurance
written in connection therewith shall be furnished to the Bureau.therewith.
A rate in excess of that promulgated by the Bureau may be charged by an insurer
on any specific risk if the higher rate is charged in accordance with rules
adopted by the Commissioner."
SECTION 4.(d) G.S. 58‑36‑30(e) reads as rewritten:
"(e) Each insurer shall
collect the following consent to rate data for nonfleet private
passenger motor vehicle physical damage and homeowners residential property (all
forms excluding HO4 and HO6) with not more than four housing units (all forms, excluding HO4 and HO6) and
transmit the data electronically for each policy to the Commissioner on a semi‑annual
basis in a format prescribed and designated by the Commissioner:
…."
SECTION 4.(e) The Commissioner may adopt temporary rules to implement this section.
part V. fast act conforming change
SECTION 5. G.S. 58‑39‑26 reads as rewritten:
"(a) Disclosure Required. – In addition to the notice requirements of G.S. 58‑39‑25, an insurance institution or agent shall provide, to all applicants and policyholders no later than (i) before the initial disclosure of personal information under G.S. 58‑39‑75(11) or (ii) the time of the delivery of the insurance policy or certificate, a clear and conspicuous notice, in written or electronic form, of the insurance institution or agent's policies and practices with respect to:
(1) Disclosing nonpublic personal information to affiliates and nonaffiliated third parties, consistent with section 502 of Public Law 106‑102, including the categories of information that may be disclosed.
(2) Disclosing nonpublic personal information of persons who have ceased to be customers of the financial institution.
(3) Protecting the nonpublic personal information of consumers.
These disclosures shall be made in
accordance with the regulations prescribed under section 505 504 of
Public Law 106‑102.
(b) Information to Be Included. – The disclosure required by subsection (a) of this section shall include:
(1) The policies and practices of the insurance institution or agent with respect to disclosing nonpublic personal information to nonaffiliated third parties, other than agents of the insurance institution or agent, consistent with section 502 of Public Law 106‑102, and including:
a. The categories of persons to whom the information is or may be disclosed, other than the persons to whom the information may be provided under section 502(e) of Public Law 106‑102.
b. The policies and practices of the insurance institution or agent with respect to disclosing of nonpublic personal information of persons who have ceased to be customers of the insurance institution or agent.
(2) The categories of nonpublic personal information that are collected by the insurance institution or agent.
(3) The policies that the insurance institution or agent maintains to protect the confidentiality and security of nonpublic personal information in accordance with section 501 of Public Law 106‑102.
(4) The disclosures required, if any, under section 603(d)(2)(A)(iii) of the Fair Credit Reporting Act.
(c) In the case of a policyholder, the notice required by this section shall be provided not less than annually during the continuation of the policy. As used in this subsection, "annually" means at least once in any period of 12 consecutive months during which the policy is in effect.
(d) Exception to Annual Notice Requirement. – An insurance institution or agent is not required to provide the privacy notice annually as required under subsection (c) of this section if all of the following apply:
(1) The insurance institution or agent provides nonpublic personal information only in accordance with the provisions of sections 502(b)(2) or 502(e) of Public Law 106‑102 or regulations prescribed under section 504(b) of Public Law 106‑102.
(2) The insurance institution or agent has not changed its policies and practices with regard to disclosing nonpublic personal information from the policies and practices that were disclosed in the most recent disclosure sent to consumers in accordance with this section.
If, at any time, subdivision (1) or (2) of this subsection no longer applies to an insurance institution or agent, then the insurance institution or agent shall be required to provide the annual privacy notice required under subsection (c) of this section."
part VI. STREAMLINE EXPEDITED EXTERNAL REVIEW PROCESS
SECTION 6.(a) G.S. 58‑50‑82(a) reads as rewritten:
"(a) Except as provided
in subsection (g) of this section, a covered person may file a request for an
expedited external review with the Commissioner at the time the covered person receives:receives
any of the following:
(1) A noncertification
decision under G.S. 58‑50‑61(f) if:if all of the
following conditions apply:
a. The covered person has a
medical condition where the time frame for completion of an expedited review of
an appeal involving a noncertification set forth in G.S. 58‑50‑61(l)
would be reasonably expected to seriously jeopardize the life or health of the
covered person or would jeopardize the covered person's ability to regain
maximum function; andfunction.
b. The covered person has filed a request for an expedited appeal under G.S. 58‑50‑61(l).
(2) An appeal decision under
G.S. 58‑50‑61(k) or (l) G.S. 58‑58‑61(l)
upholding a noncertification if:if all of the following
conditions apply:
a. The noncertification
appeal decision involves a medical condition of the covered person for which
the time frame for completion of an expedited second‑level grievance
review of a noncertification set forth in G.S. 58‑50‑62(i)
would reasonably be expected to seriously jeopardize the life or health of the
covered person or jeopardize the covered person's ability to regain maximum function;
andfunction.
b. The covered person has
filed a request for an expedited second‑level grievance review of
a noncertification as set forth in G.S. 58-50-61(i); or G.S. 58‑50‑62(i).
(3) A second‑level
grievance review decision under G.S. 58-60-62(h) or (i) G.S. 58‑50‑62(h)
or G.S. 58‑50‑62(i) upholding a noncertification:noncertification
if all of the following conditions apply:
a. If the covered person has
a medical condition where the time frame for completion of a standard external
review under G.S. 58‑50‑80 would reasonably be expected to
seriously jeopardize the life or health of the covered person or jeopardize the
covered person's ability to regain maximum function; orfunction.
b. If the second‑level grievance concerns a noncertification of an admission, availability of care, continued stay, or health care service for which the covered person received emergency services, but has not been discharged from a facility."
SECTION 6.(b) G.S. 58‑50‑82(b) reads as rewritten:
"(b) Within two days after receiving a request for an expedited external review, the Commissioner shall complete all of the following:
(1) Notify the insurer that made the noncertification, noncertification appeal decision, or second‑level grievance review decision which is the subject of the request that the request has been received and provide a copy of the request. The Commissioner shall also request any information from the insurer necessary to make the preliminary review set forth in G.S. 58‑50‑80(b)(2) and require the insurer to deliver the information not later than one day after the request was made.
(2) Determine whether the
request is eligible for external review and, if it is eligible, determine
whether it is eligible for expedited review.review.
(3) If the request is eligible for external review and the covered person's treating provider requesting the service that is the subject of the external review has certified the request on a form prescribed by the Commissioner, then one of the following shall apply:
a. For a request made
pursuant to subdivision (a)(1) of this section that the Commissioner has
determined meets the reviewability requirements set forth in G.S. 58 50
80(b)(2), determine, based on medical advice from a medical professional who is
not affiliated with the organization that will be assigned to conduct the
external review of the request, whether section, the request should
shall be reviewed on an expedited basis because the time frame for
completion of an expedited review under G.S. 58‑50‑61(l) would
reasonably be expected to seriously jeopardize the life or health of the
covered person or would jeopardize the covered person's ability to regain
maximum function. The Commissioner shall then inform the covered person,
the covered person's provider who performed or requested the service, and the
insurer whether the Commissioner has accepted the covered person's request for
an expedited external review. If the Commissioner has accepted the covered
person's request for an expedited external review, then the Commissioner shall,
in accordance with G.S. 58‑50‑80, assign an organization to
conduct the review within the appropriate time frame. If the Commissioner has
not accepted the covered person's request for an expedited external review,
then the covered person shall be informed by the Commissioner that the
covered person must exhaust, at a minimum, the insurer's internal appeal
process under G.S. 58-50-61(l) before making another request for an external
review with the Commissioner.notified.
b. For a request made
pursuant to subdivision (a)(2) of this section that the Commissioner
has determined meets the reviewability requirements set forth in G.S. 58 50
80(b)(2), the Commissioner shall determine, based on medical advice from a
medical professional who is not affiliated with the organization that will be
assigned to conduct the external review of the request, whether section,
the request should shall be reviewed on an expedited basis
because the time frame for completion of an expedited review under G.S. 58‑50‑62
would reasonably be expected to seriously jeopardize the life or health of the
covered person or would jeopardize the covered person's ability to regain
maximum function. The Commissioner shall then inform the covered person,
the covered person's provider who performed or requested the service, and the
insurer whether the Commissioner has accepted the covered person's request for
an expedited external review. If the Commissioner has accepted the covered
person's request for an expedited external review, then the Commissioner shall,
in accordance with G.S. 58‑50‑80, assign an organization to
conduct the review within the appropriate time frame. If the Commissioner has
not accepted the covered person's request for an expedited external review,
then the covered person shall be informed by the Commissioner that the
covered person must exhaust the insurer's internal grievance process under G.S.
58 50 62 before making another request for an external review with the
Commissioner.notified.
c. For a request made
pursuant to sub‑subdivision (a)(3)a. of this section that the
Commissioner has determined meets the reviewability requirements set forth in
G.S. 58 50 80(b)(2), the Commissioner shall determine, based on medical advice
from a medical professional who is not affiliated with the organization that
will be assigned to conduct the external review of the request, whether section,
the request should shall be reviewed on an expedited basis
because the time frame for completion of a standard external review under
G.S. 58‑50‑80 would reasonably be expected to seriously
jeopardize the life or health of the covered person or would jeopardize the
covered person's ability to regain maximum function. The Commissioner shall then
inform the covered person, the covered person's provider who performed or
requested the service, and the insurer whether the review will be conducted
using an expedited or standard time frame and shall, in accordance with
G.S. 58‑50‑80, assign an organization to conduct the review
within the appropriate time frame.
d. For a request made
pursuant to sub subdivision (a)(3)b. of this section, that the Commissioner
has determined meets the reviewability requirements set forth in G.S. 58 50
80(b)(2), the Commissioner shall, in accordance with G.S. 58 50 80, assign an
organization to conduct the expedited review and inform the covered person, the
covered person's provider who performed or requested the service, and the
insurer of its decision.the Commissioner shall, in accordance with G.S. 58‑50‑80,
assign an organization to conduct the expedited review and inform the covered
person, the covered person's provider who performed or requested the service,
and the insurer of its decision."
SECTION 6.(c) G.S. 58‑50‑89 reads as rewritten:
"§ 58‑50‑89. Hold
harmless for Commissioner, medical professionals, Commissioner and
independent review organizations.
Neither the The Commissioner, a
medical professional rendering advice to the Commissioner under G.S.
58-50-82(b)(2), an independent review organization, nor shall or a
clinical peer reviewer working on behalf of an independent review organization
shall not be liable for damages to any person for any opinions rendered
during or upon completion of an external review conducted under this Part,
unless the opinion was rendered in bad faith or involved gross
negligence."
SECTION 6.(d) Subsections (a) and (b) of this section become effective October 1, 2019, and apply to requests for expedited review submitted on or after that date.
Part vii. bail Bondsman Changes
SECTION 7.(a) G.S. 58‑71‑1 is amended by adding a new subdivision to read:
"(6a) Premium. – An amount of money paid in exchange for a bail bondsman's services in writing a bail bond."
SECTION 7.(b) G.S. 58‑71‑45 reads as rewritten:
"§ 58‑71‑45. Terms of licenses.
A license issued to a bail bondsman
or to a runner authorizes the licensee to act in that capacity until the
license is lapsed, suspended or revoked. Upon the suspension or
revocation of a license, the The licensee shall return the license
to the Commissioner. Commissioner within 10 working days of the
lapse, suspension, or revocation of the license. A license of a bail
bondsman and a license of a runner shall be renewed in accordance with
G.S. 58‑71‑75. After notifying the Commissioner in writing, a
professional bondsman who employs a runner may cancel the runner's authority to
act for the professional bondsman."
SECTION 7.(c) G.S. 58‑71‑165(a) reads as rewritten:
"(a) Each professional
bail bondsman shall file with the Commissioner a written report in a form
prescribed by the Commissioner regarding all bail bonds on which the bondsman
is liable as of the first day of each month showing (i) each individual bonded,
(ii) the date the bond was given, (iii) the principal sum of the bond, (iv) the
State or local official to whom given, and court file or docket
number for the principal's court obligation, (v) the fee charged for the
bonding service in each instance.instance, and (vi) the certificate
seal number for each bond issued."
SECTION 7.(d) G.S. 58‑71‑167 reads as rewritten:
"§ 58‑71‑167. Portion of bond premium payments deferred.
(a) In any case where the
agreement between principal and surety calls for some portion of the bond
premium payments to be deferred or paid after the defendant has been released
from custody, a written memorandum of agreement between the principal and
surety shall be kept on file by the surety with a copy provided to the principal,
upon request. principal. The memorandum shall contain the following
information:
(1) The amount of the premium payment deferred or not yet paid at the time the defendant is released from jail.
(2) The method and schedule of payment to be made by the defendant to the bondsman, which shall include the dates of payment and amount to be paid on each date.
(3) That the principal is,
upon the principal's request, is entitled to a copy of the
memorandum.
(b) The memorandum must be
signed by the defendant and the bondsman, or one of the bondsman's agents, and dated
at the time the agreement is made. Any subsequent modifications of the
memorandum must be in writing, signed, dated, and kept on file by the surety,
with a copy provided to the principal, upon request.principal."
Part viii. CLARIFY RULE‑MAKING AUTHORITY FOR state FIRE AND RESCUE COMMISSION
SECTION 8. G.S. 58‑78‑5(a) is amended by adding a new subdivision to read:
"(a) The Commission shall have the following powers and duties:
…
(17) To adopt, modify, or repeal any rules and regulations necessary for the purpose of carrying out the provisions of this Article."
part ix. Prepaid health plan licensing act clarifying and technical changes
SECTION 9.(a) G.S. 58‑93‑20(c) reads as rewritten:
"(c) Any person that is already a licensed health organization in this State under this Chapter shall be recognized as a PHP under this Article and shall be issued a PHP license upon the licensed health organization's demonstration to the Commissioner of its compliance with this Article. A licensed health organization shall not be required to file a PHP application, pay a PHP application fee, or provide the notice required by subsection (d) of this section as a condition of receipt of a PHP license. Unless otherwise exempted, a licensed health organization shall be subject to the remaining requirements of this Article, including deposit, minimum capital and surplus, and working capital requirements."
SECTION 9.(b) G.S. 58‑93‑30 reads as rewritten:
"§ 58‑93‑30. Fees.
The Commissioner shall establish
charge an application fee not to exceed of two
thousand dollars ($2,000) for entities filing an application to be licensed as
a PHP under this Article. The Commissioner shall establish charge an
annual PHP license continuation fee not to exceed of five
thousand dollars ($5,000). The PHP license shall continue in full force and
effect subject to timely payment of the annual PHP license continuation fee in
accordance with G.S. 58‑6‑7(c) and subject to any other
provisions of this Chapter applicable to PHPs."
SECTION 9.(c) G.S. 58‑93‑60 reads as rewritten:
"§ 58‑93‑60. Examinations.
The Commissioner may make an examination of the affairs of any PHP as often as the Commissioner determines it to be necessary for the protection of the interests of the enrollees or the State but not less frequently than once every five years. The Commissioner shall notify DHHS prior to any examination of a PHP and shall provide DHHS with the results of an examination in accordance with G.S. 58‑93‑5(e). Examinations shall otherwise be conducted under G.S. 58‑2‑131 through G.S. 58‑2‑134."
SECTION 9.(d) G.S. 58‑93‑90 reads as rewritten:
"§ 58‑93‑90. Rehabilitation or liquidation of PHP.
(a) Any rehabilitation or liquidation of a PHP shall be deemed to be the rehabilitation or liquidation of an insurance company and shall be conducted under the supervision of the Commissioner pursuant to Article 30 of this Chapter. The Commissioner may apply for an order directing the rehabilitation or liquidation of a PHP upon one or more grounds set out in Article 30 of this Chapter or when it is the opinion of the Commissioner that the continued operation of the PHP would be hazardous either to the enrollees or to the State. Priority shall be given to DHHS's claims over all other claims in G.S. 58‑30‑220, except for claims in G.S. 58‑30‑220(1).
(b) To the greatest extent possible, the Commissioner shall provide notice to DHHS prior to seeking an application for an order to rehabilitate or liquidate a PHP under this section. If prior notice is not possible, the Commissioner shall provide the notice to DHHS as soon as possible after seeking the order."
SECTION 9.(e) G.S. 58‑93‑95(a) reads as rewritten:
"(a) When the
Commissioner has cause to believe that grounds for the denial of an application
for a license exist, or that grounds for the suspension or revocation of a
license exist, notification shall be given to the PHP in writing. writing
and a copy of the notice shall be provided to DHHS. This notice shall
specifically state the grounds for denial, suspension, or revocation and shall
set a date for a hearing on the matter at least 30 days after notice is
given."
SECTION 9.(f) G.S. 58‑93‑120(16) reads as rewritten:
"(16) G.S. 58‑7‑26,
Asset or reduction from liability for reinsurance ceded by a domestic insurer
to an assuming insurer not meeting the requirements of G.S. 58‑7‑121.G.S. 58‑7‑21."
part x. CLARIFY WHEN APPLICATION SENT TO NORTH CAROLINA SELF‑INSURANCE SECURITY ASSOCIATION
SECTION 10. G.S. 97‑170(b) reads as rewritten:
"(b) An applicant for a
license as a self‑insurer shall file with the Commissioner the
information required by subsection (d) of this section on a form prescribed by
the Commissioner at least 90 days before the proposed licensing date. No
application is complete until the Commissioner has received all required
information. A copy of the application must shall also be filed
with the North Carolina Self‑Insurance Security Association at least
90 days before the proposed licensing date.at the same time the
application is filed with the Commissioner."
part XI. MEDICARE SUPPLEMENT CHANGES
SECTION 11.(a) G.S. 58‑54‑45 reads as rewritten:
"§ 58‑54‑45. By reason of disability.
(a) In For Persons
Whose Eligibility for Medicare Occurred Before January 1, 2020. – In addition
to any rule adopted under this Article that is directly or indirectly related
to open enrollment, an insurer shall at least make standardized Medicare
Supplement Plan A available to persons eligible for Medicare by reason of
disability before age 65 and also standardized Plan C or F if marketing either
Plan to persons eligible for Medicare before January 1, 2020, due to
age. This action shall be taken without regard to medical condition, claims
experience, or health status. To be eligible, a person must submit an
application during the six‑month period beginning with the first month
the person first enrolls in Medicare Part B. For those persons that are
retroactively enrolled in Medicare Part B due to a retroactive eligibility
decision made by the Social Security Administration, the application must be
submitted within a six‑month period beginning with the month in which the
person receives notification of the retroactive eligibility decision.
(a1) For Persons Whose Eligibility for Medicare Occurs on or After January 1, 2020. – In addition to any rule adopted under this Article that is directly or indirectly related to open enrollment, an insurer shall at least make standardized Medicare Supplement Plan A available to persons eligible for Medicare by reason of disability before age 65 and also standardized Plan D or G if marketing either Plan to persons eligible for Medicare on or after January 1, 2020, due to age. This action shall be taken without regard to medical condition, claims experience, or health status. To be eligible, a person must submit an application during the six‑month period beginning with the first month the person first enrolls in Medicare Part B. For those persons that are retroactively enrolled in Medicare Part B due to a retroactive eligibility decision made by the Social Security Administration, the application must be submitted within a six‑month period beginning with the month in which the person receives notification of the retroactive eligibility decision.
(b) Persons eligible for
Medicare by reason of disability before age 65 who are enrolled in a managed
care plan and whose coverage under the managed care plan is terminated through
cancellation, nonrenewal, or disenrollment have the guaranteed right to
purchase Medicare Supplement Plans A and C A, D, or G from any
insurer within 63 days after the date of termination or disenrollment.
(c) An insurer may develop premium rates specific to the disabled population. No insurer shall discriminate in the pricing of the Medicare supplement plans referred to in this section because of the health status, claims experience, receipt of health care, or medical condition of an applicant where an application for the plan is submitted during an open enrollment or is submitted within 63 days after the managed care plan is terminated. The rates and any applicable rating factors for the Medicare supplement plans referred to in this section shall be filed with and approved by the Commissioner."
SECTION 11.(b) This section becomes effective January 1, 2020.
part XII. Effective Date
SECTION 12. Except as otherwise provided, this act is effective when it becomes law.
In the General Assembly read three times and ratified this the 18th day of July, 2019.
s/ Carl Ford
Presiding Officer of the Senate
s/ Tim Moore
Speaker of the House of Representatives
s/ Roy Cooper
Governor
Approved 12:14 p.m. this 26th day of July, 2019