HSB 167

This bill relates to insurance policy terms and public policy considerations. The bill prohibits a policy or policy form (form) in connection with a group accident or health insurance policy (group policy) that is issued in this state from containing a provision that is unjust, unfair, inequitable, misleading, deceptive, encourages misrepresentation, or that is otherwise contrary to public policy (contrary to policy). The bill makes it unlawful for a carrier to issue a policy or to use a form in connection with any group policy after notice from the commissioner of insurance (commissioner) that the policy or form violates the prohibition. A carrier has days after receipt of the notice to request a hearing to contest the commissioner’s notice. The hearing shall be conducted pursuant to Code chapter 17A and if it results in a decision that affirms the commissioner’s notice, the decision shall be provided to the carrier in writing and specify the reasons for the decision. A group policy of insurance against loss or expense from sickness, or from the bodily injury or death by accident of the insured (accident and health policy), shall not be issued or delivered in this state by a carrier until a copy of the policy has been filed with, and approved by, the commissioner. _____ of the policy form has been filed with, and approved by, the commissioner. A filing shall be deemed approved unless disapproved by the commissioner within days. If upon review of a form the commissioner finds that the benefits provided are unreasonable in relation to the premium charged, or that the form contains a provision contrary to public policy, the commissioner shall provide notice to the carrier that advises the carrier as detailed in the bill. The carrier has days after receipt of the notice to request a hearing, to be conducted pursuant to Code chapter 17A. The division permits the commissioner, after opportunity for hearing, to withdraw the commissioner’s previous approval of a form in circumstances detailed in the bill. A carrier is prohibited from issuing a form, or from using a form in connection with any group policy, on or after the effective date of the commissioner’s withdrawal of the previous approval. If a hearing results in a decision to withdraw a previous approval, the decision shall be provided to the carrier in writing.