Rule 120-2-49-.12 - Underwriting Provisions(1) The written agreement between the administrator and an insurer shall make provision with respect to the underwriting or other standards pertaining to the business underwritten by such insurer. The written agreement between the administrator and a self-insurer shall make provision with respect to any underwriting requirements or other standards pertaining to the benefit coverage to be provided.(2) As to the administration of coverage insured by an insurance company, the insurance company, and not the administrator, shall be responsible for determining the benefits, rates, underwriting criteria, and claims payment procedures applicable to such coverage and for securing reinsurance, if any.(3) No administrator shall place any insurance or reinsurance coverage on behalf of a plan sponsor with an insurer that is not authorized or approved to do business in Georgia.(4) No administrator shall have the authority to move the coverage of a group or subgroup to a new insurer unless such action is at the request of the current insurer or the group policyholder following notice of termination of the group coverage by the insurer or group policyholder, and the new insurer must hold a Certificate of Authority to do business in Georgia.(5) Any insured individual whose group insurance coverage terminates, regardless of the situs of the group policy, shall be entitled to conversion rights as required under O.C.G.A. §§ 33-24-21.1 and 120-2-10-.11 of the Rules and Regulations of the Office of Commissioner of Insurance, or as provided in the group insurance policy, if more favorable.(6) Where group insurance coverage is discontinued and replaced, the individual insureds shall be entitled to all takeover rights provided under Rule 120-2-10-.10 of the Rules and Regulations of the Office of Commissioner of Insurance.Ga. Comp. R. & Regs. R. 120-2-49-.12
O.C.G.A. Secs. 33-2-9, 33-23-100et seq., 33-23-104, 33-23-105.
Original Rule entitled "Underwriting Provisions" adopted. F. May 19, 1993; eff. June 8, 1993.Amended: F. June 10, 1997; eff. June 30, 1997.Repealed: New Rule of same title adopted. F. Dec. 9, 2005; eff. Dec. 29, 2005.