Approval of forms; definition

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20-1110. Approval of forms; definition

A. Any life or disability insurance policy form, life or disability insurance application form where written application is required and is to be made a part of the policy and printed rider or endorsement form shall not be delivered or issued for delivery in this state by a life or disability insurer unless it has been filed with and approved by the director. The director may also require that proof of death or loss forms shall be filed with and approved by the director.

B. This section shall not apply to policies, riders, endorsements or forms of unique character designed and used for insurance on a particular subject, or that relate to the manner of distribution of benefits or to the reservation of rights and benefits under life or disability insurance policies, and are used at the request of the individual policyholder, contract holder or certificate holder.

C. Every form filing shall be made not less than thirty days in advance of any delivery. The form is approved thirty days after filing unless the director, within the thirty day period, has issued an order affirmatively approving or disapproving the form. The director may extend by not more than an additional fifteen days the period for review of the form, by giving notice of the extension before expiration of the initial thirty day period. The director may at any time, after notice and for cause shown, withdraw the director's approval. This subsection also applies to contracts and policy forms filed with the department under section 20-826, subsection A by a corporation holding a certificate of authority under chapter 4, article 3 of this title. This subsection does not apply to contracts or policy forms issued by a hospital service corporation, medical service corporation or hospital and medical service corporation pursuant to section 20-1063.

D. Any order of the director disapproving the form or withdrawing a previous approval shall state the reasons for the action.

E. A life or disability insurer shall not issue or deliver any advertising matter or sales material to any person in this state until the life or disability insurer files the advertising matter or sales material with the director. This subsection does not require a life or disability insurer to have the prior approval of the director to issue or deliver the advertising matter or sales material. If the director finds that the advertising matter or sales material, in whole or in part, is false, deceptive or misleading, the director may issue an order disapproving the advertising matter or sales material, directing the life or disability insurer to cease and desist from issuing, circulating, displaying or using the advertising matter or sales material within a period of time specified by the director but not less than ten days and imposing any penalties prescribed in this title. At least five days before issuing an order pursuant to this subsection, the director shall provide the life or disability insurer with a written notice of the basis of the order to provide the life or disability insurer with an opportunity to cure the alleged deficiency in the advertising matter or sales material within a single five day period for the particular advertising matter or sales material at issue. The life or disability insurer may appeal the director's order pursuant to title 41, chapter 6, article 10. Except as otherwise provided in this subsection, a life or disability insurer may obtain a stay of the effectiveness of the order as prescribed in section 20-162. If the director certifies in the order and provides a detailed explanation of the reasons in support of the certification that continued use of the advertising matter or sales material poses a threat to the health, safety or welfare of the public, the order may be entered immediately without opportunity for cure and the effectiveness of the order is not stayed pending the hearing on the notice of appeal but the hearing shall be promptly instituted and determined.

F. The director, by order, may exempt from the requirements of this section for so long as the director deems proper any insurance document, advertisement or form as specified in the order, to which, in the director's opinion, this section may not practicably be applied, or the filing and approval of which are, in the director's opinion, not desirable or necessary for the protection of the public.

G. This section shall apply also to any form used by domestic insurers for delivery in a jurisdiction outside this state, if the insurance supervisory official of that jurisdiction informs the director that the form is not subject to approval or disapproval by that official, and on the director's order requiring the form to be submitted to the director for the purpose. The applicable same standards shall apply to these forms as apply to forms for domestic use.

H. For the purposes of this section and sections 20-826, 20-1018 and 20-1057, advertising matter and sales material do not include any of the following materials listed in this subsection, which are not required to be filed:

1. Materials that are designed solely to increase public awareness of an insurer's name, trademarks, service marks, slogan or brand and that do not reference specific products or benefits offered by the insurer.

2. Materials that are designed for and distributed only to large group benefit administrators and their brokers and that are not intended for distribution to group members.

3. Web pages and other materials that are published exclusively to guide current members about use of already purchased products.

4. Social media sites and social media content that do not reference products or benefits offered by the insurer or include a call to action.

5. Web banner advertisements, paid social media posts and online search engine advertisements that either do not link to advertising matter and sales material or, if linked to such content, link only to content that is filed in accordance with this section and that meets one of the following criterion:

(a) Do not reference specific products offered by the insurer.

(b) Are less than one hundred characters.

6. Educational materials that are designed to increase consumers' health insurance literacy and that do not include a call to action or reference a specific insurer, other than as the source or author of the materials.

7. Other materials and advertisements specified by the department in rule or by exemption order.

I. For the purposes of subsections H and J of this section, " insurer" means disability insurer, group disability insurer, blanket disability insurer, fraternal benefit society, prepaid dental plan organization, hospital service corporation, medical service corporation, dental service corporation, optometric service corporation and health care service organization.

J. For the purposes of this section, " call to action" means a statement or other content that invites a consumer to respond by contacting the insurer by phone, letter, e-mail or other electronic communication or attending an event so that the insurer can attempt to sell the individual a product or service.


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