3 CCR 702-1
DEPARTMENT OF REGULATORY AGENCIES Division of Insurance ADMINISTRATIVE PROCEDURES 3 CCR 702-1 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Regulation 1-1-1 ACTUARIAL QUALIFICATIONS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Qualifications Section 5 Continued Qualification Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated pursuant to § § 10-1-108(8) and 10-1-109, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to assure that the consulting actuary, actuary or other person acting in the capacity of an actuary is properly qualified to perform the actuarial duties in a competent and professional manner by establishing qualifications for such persons. The actuarial opinion and other documents included in the scope of this regulation are relied upon for determinations of financial soundness and for the protection of the general public. For these reasons, the qualifications of the person signing the documents must be verified and periodically reevaluated. Section 3 Applicability The provisions of this regulation apply to any and all financial statements, rate filings or other documents which require the signature of a qualified actuary, and which are required to be submitted to the Commissioner.
Section 4 Qualifications Any person acting in the capacity of an actuary, in order to be considered qualified, must fulfill the following requirements:
Code of Colorado Regulations 1 A. In the case of documents relating to property and casualty types of coverage, the person must be:
B. In the case of documents relating to other types of insurance or regulated products, the person must be:
Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders, and/or suspensions or revocation of license. Section 8 Effective Date This regulation shall become effective on June 1, 2012. Section 9 History Originally issued October 31, 1991.
Amended Regulation effective June 1, 2012.
Regulation 1-1-2 PUBLIC ADJUSTER REPRESENTATION AGREEMENTS SUBJECT TO RESCISSION WITHIN 72 HOURS OF SIGNING A SETTLEMENT REPRESENTATION AGREEMENT [Repealed eff. 01/15/2014] Code of Colorado Regulations 2 Regulation 1-1-3 CONCERNING RULES GOVERNING THE FILING OF DECLARATORY JUDGMENT PETITIONS WITH THE COLORADO INSURANCE COMMISSIONER I. BASIS AND PURPOSE Section 24-4-105(11), C.R.S. requires agencies of state government to adopt a regulation providing for the entertainment of petitions for declaratory orders. When the Colorado Insurance Board was in existence the Colorado Division of Insurance (Division) had such a rule. See 3 CCR 702-1, pp. 78-81. However, since the demise of the board in April, 1985, the Division has technically been without such a rule. Accordingly, the Division is adopting the following rule and simultaneously repealing the old board rule found at 3 CCR 702-1, pp. 78-81.
II. AUTHORITY This regulation is promulgated under the authority of § § 10-1-109 and 24-4-105(11), C.R.S.
III. RULE Declaratory Orders.
A. Any person may petition the Commissioner for a declaratory order to terminate controversies or to remove uncertainties as to the applicability to the petitioner of any insurance statute or of any rule or order of the Commissioner.
B. The Commissioner will determine, in his discretion and without notice to petitioner, whether to rule upon any such petition. If the Commissioner determines that he will not rule upon such a petition, the Commissioner shall issue his written order disposing of the same, stating therein his reasons for such action. A copy of such order shall forthwith be transmitted to the petitioner.
C. In determining whether to rule upon a petition filed pursuant to this rule, the Commissioner will consider the following matters, among others:
Code of Colorado Regulations 3 D. Any petition filed pursuant to this rule shall set forth the following:
E. If the Commissioner determines that he will rule on the petition, the following procedures shall apply:
F. The parties to any proceeding pursuant to this rule shall be the Commissioner and the petitioner. Any other person may seek leave of the Commissioner to intervene in such a proceeding, and leave to intervene will be granted at the sole discretion of the Commissioner. A petition to intervene shall set forth the same matters as required by section D. of this rule. Any reference to a Code of Colorado Regulations 4 “petitioner” in this rule also refers to any person who has been granted leave to intervene by the Commissioner.
G. Any declaratory order or other order disposing of a petition pursuant to this rule shall constitute agency action subject to judicial review pursuant to § 24-4-106, C.R.S.
IV. EFFECTIVE DATE The effective date of this Regulation is October 1, 1986. Regulation 1-1-4 CONCERNING THE MAINTENANCE OF OFFICES IN THIS STATE - Repealed Effective 02/01/2012 Regulation 1-1-5 RENUMBERING OF INSURANCE REGULATIONS - Repealed Effective 02/01/2003 Regulation 1-1-6 CONCERNING THE ELEMENTS OF CERTIFICATION FOR CERTAIN FORMS AND CONTRACTS [Repealed eff. 10/01/2013] Regulation 1-1-7 MARKET CONDUCT RECORD RETENTION Section 1. Authority Section 2. Basis And Purpose Section 3. Definitions Section 4. Records Required for Market Conduct Purposes Section 5. Policy Records Section 6. Claim Records Section 7. Licensing Records Section 8. Complaint Records Section 9. Format Of Records Section 10. Location Of Records Section 11. Time Limits To Provide Records And To Respond To Examiners Section 12. Records Usually Required For Examination Section 13. Enforcement Section 14. Severability Section 15. Effective Date Section 16. History Section 1. Authority This regulation is promulgated under the authority of § 10-1-109(1), C.R.S. Code of Colorado Regulations 5 Section 2. Basis And Purpose The purpose of this amended regulation is to clarify definitions and rules that provide for retention and maintenance of records required only for market conduct purposes. Section 3. Definitions A. “Application records” mean any written or electronic application form, any enrollment form, any document used to add coverage under an existing policy, any questionnaire, telephone interview form, paramedical interview form, or any other document used to question or underwrite an applicant for a policy issued by an insurer or for any declination of coverage by an insurer.
B. “Inquiry” means a specific question, comment form or request made in writing to an insurer or its representative by a market conduct examiner authorized or designated by the commissioner.
C. “Examiner” shall have the same meaning as in § 10-1-202, C.R.S.
D. “Claim records” mean:
E. “Complaint” shall have the same meaning as in § 10-3-1104(1)(i), C.R.S.
F. “Declination” or “declination records” mean all written or electronic records concerning a policy for which an application for insurance coverage has been completed and submitted to the insurer or its producer but the insurer has made a determination not to issue a policy or not to add additional coverage when requested. Declined underwriting records shall include an application, any documentation substantiating the decision to decline issuance of a policy, any binder issued without the insurer issuing a policy, any documentation substantiating the decision not to add additional coverage when requested and, if required by law, any declination notification. Notes Code of Colorado Regulations 6 regarding requests for quotations that do not result in a completed application for coverage need not be maintained for purposes of this regulation.
Section 4. Records Required For Market Conduct Purposes A. Every entity subject to the Market Conduct process shall maintain its books, records, documents and other business records in a manner so that the following practices of the entity subject to the Market Conduct process may be readily ascertained during market conduct examinations, including but not limited to, company operations and management, policyholder services, claim's practices, rating, underwriting, marketing, complaint/grievance handling, producer licensing records, and additionally for health insurers/carriers or related entities: network adequacy, utilization review, quality assessment and improvement, and provider credentialing. Records for this regulation regarding market conduct purposes shall be maintained for the current calendar year plus two prior calendar years.
B. Each producer of record, if the carrier does not maintain, shall maintain records for each policy sold, and the records shall contain all work papers and written communications in the producer's possession pertaining to the documented policy.
Section 5. Policy Records A. The following records shall be maintained: A policy record shall be maintained for each policy issued. Policy records shall be maintained so as to show clearly the policy period, basis for rating and any imposition of additional exclusions from or exceptions to coverage. If a policy is terminated, either by the insurer or the policyholder, documentation supporting the termination and account records indicating a return of premiums, if any, shall also be maintained. Policy records need not be segregated from the policy records of other states so long as the records are readily available to market conduct examiners as required under this regulation.
B. Policy records shall include at least the following:
Section 6. Claim Records The claim records shall be maintained so as to show clearly the inception, handling and disposition of each claim. The claim records shall be sufficiently clear and specific so that pertinent events and dates of these events can be reconstructed.
A. The record shall include at least the notification of claim, proof of loss, (or other form of claim submission) claim forms, proof of claim payment check or draft, notes, contract, declaration pages, information on type of coverage, endorsements or riders, work papers, any written communication, any documented or recorded telephone communication related to the handling of a claim, including the investigation, payment or denial of the claim, and any claim manuals or other information necessary for reviewing the claim. Where a particular document pertains to more than one record, insurers may satisfy the requirements of this paragraph by making available, at the site of a market conduct examination, a single copy of each document.
B. Documents in a claim record received from an insured, the insured's agent, a claimant, the department or any other insurer shall bear the initial date of receipt date-stamped by the insurer in a legible form in ink, an electronic format, or some other permanent manner. Unless the company provides the examiners with written procedures to the contrary, the earliest date stamped on a document will be considered the initial date of receipt.
C. If an insurer, as its regular business practice, places the responsibility for handling certain types of claims upon company personnel other than its claims personnel, the insurer need not duplicate its records for maintenance by claims personnel. These claims records shall be maintained as part of the records of the insurer's operations and shall be readily available to examiners. Section 7. Licensing Records Records to be maintained relating to the insurer's compliance with licensing requirements shall include the licensing records of each producer associated with the insurer. Licensing records shall be maintained so as to show clearly the status of the producer at the time the application was taken as well as the dates of the appointment and termination of each producer. A screen print from the NAIC Producer Database (PDB) or the Colorado Division of Insurance Database may serve to provide adequate proof only of an agent's current licensing status.
Section 8. Complaint Records The complaint records required to be maintained under § 10-3-1104(1)(i), C.R.S. shall include, on a calendar year basis, a complaint or grievance log or register, as required by Regulation 6-2-1, in addition to the actual written complaints and any other complaint/grievance logs required by Colorado insurance law. Any codes used shall be provided to the examiners at the time of an examination. Section 9. Format Of Records Code of Colorado Regulations 8 A. Any record required to be maintained by an insurer may be in the form of paper, photograph, magnetic, mechanical or electronic medium; or any process that accurately forms a durable reproduction of the record, so long as the record is capable of duplication to a hard copy that is as legible as the original document. Documents that are produced and sent to an insured by use of a template and an electronic mail list shall be considered to be sufficiently reproduced if the insurer can provide proof of mailing of the document and a copy of the template. Documents that require the signature of the insured or insurer's producer shall be maintained in any format listed above, provided evidence of the signature is preserved in that format.
B. The maintenance of records in a computer-based format shall be archival in nature, so as to preclude the alteration of the record after the initial transfer to a computer format. Upon request of an examiner, all records shall be capable of duplication to a hard copy that is as legible as the original document. The records shall be maintained according to written procedures developed and adhered to by the insurer. The written procedures shall be made available to the commissioner's market conduct examiners in accordance with Section 12.
C. Photographs, microfilms or other image-processing reproductions of records shall be equivalent to the originals and may be certified as the same in actions or proceedings before the commissioner unless inconsistent with other Colorado law.
Section 10. Location Of Records A. All records required to be maintained under this regulation shall be kept in a location or locations that will allow the records to be produced for examination within the time period required under Section 11.
B. If required by law or otherwise available, the insurer shall maintain disaster preparedness or disaster recovery procedures that include provisions for the maintenance or reconstruction of original or duplicate records at another location.
Section 11. Time Limits To Provide Records And To Respond To Examiners A. An insurer/carrier shall provide any record requested by any examiner as required by Regulation 1-1-8 or such other time period as mutually agreed upon by the examiner and the insurer/carrier. When the requested record is not or cannot be produced by the insurer/carrier within the specified time period, a violation shall be deemed to have occurred, unless the insurer/carrier can demonstrate to the satisfaction of the commissioner that the requested record cannot reasonably be provided within the specified time period of the request through no fault of its own, its agents or its contracted third party administrator.
B. As a means to facilitate the examination, an insurer/carrier under examination shall provide a written response to an inquiry submitted by an examiner as required by Regulation 1-1-8 or such other time period as mutually agreed upon by the examiner and the insurer/carrier. When the requested response is not provided by the insurer/carrier within the specified time period, a violation shall be deemed to have occurred, unless the insurer/carrier can demonstrate to the satisfaction of the commissioner that the requested response cannot reasonably be provided within the specified time period of the inquiry through no fault of its own, its agents or its contracted third party administrator.
C. Original records, if required to be provided or provided during a market conduct examination, will be returned to the insurer/carrier following the examination. If the records relate to an inquiry made by an examiner, copies of the records shall become a part of the work papers of the examination. § 10-1-205, C.R.S. shall govern the public access to the work papers of the examination. Section 12. Records Usually Required For Examination Code of Colorado Regulations 9 A. Records required for examination usually include, but are not limited to, the following, depending on the line of business;
B. Company operations and management: history and profile, entity oversight (managing general agent, general agent, third party administrator), internal audits, anti-fraud plan if applicable, certificates of authority, disaster recovery plan, and computer systems;
C. Policyholder service: policyholder service (premium/billing notices; policy issuance/insured requested cancellations; correspondence files; reinstatements, policy transactions (cash surrenders, policy loans bank values, extended term, reduced paid up, additional paid up, automatic premium loan, bank drafts and policy changes), late enrollment guidelines, annual policy reports, unearned premiums, assumptions, accelerated benefits, and consumer complaints (complaint register, complaint policies and procedures, complaint records, complaint disposition);
D. Marketing: sales and advertising, producer training materials, producer communications, policy replacements, policy illustrations, accelerated benefit disclosures, outline of coverage, mass marketing policies and procedures, and agency management;
E. Producer licensing: producer records (license, contract or letter of agreement, appointment/termination where applicable), and accounts current;
F. Underwriting and rating practices: annual rate filing, company rating plan and rates, disclosures, producer payments, credits, deviations, schedule rating, IRPM plans, expense/loss cost multipliers, statistical coding/reporting, premium audits, loss reporting, policy forms and filings, underwriting policies, procedures, and manuals, declinations/rejections, cancellations/nonrenewals, rescissions, policyholder records (applications, policy riders, correspondence, policy forms), guaranteed issue, pre-existing conditions and privacy of protected personal information;
G. Claims practices: policies and procedures, claims records, claims paid, claims without payment (denied, rejected, incomplete, closed without payment), total loss settlements (salvage), subrogation, litigation, claim forms, reserves, and statistical coding;
H. Network adequacy: provider manual, provider contracting policies and procedures, provider directories, availability and accessibility standards and monitoring reports related to these standards, management agreements, intermediary contracts, intermediary certifications, provider agreements;
I. Utilization review: utilization review plan, utilization review policies and procedures, annual utilization review certifications, utilization review monthly telephone reports, precertification records, nurse's notes, medical director reviews and appeals of noncertification records;
J. Quality assessment and improvement: quality assessment plan, quality assessment policies and procedures, and quality assessment annual program evaluation; and K. Provider credentialing: credentialing plan, credentialing policies and procedures, and credential records.
Specific records relative to these areas of operations will be requested either through prior written notification, during the pre-examination conference or during the examination. These records shall be made available to the examination staff when the staff arrives at the insurer's office or upon the date specified by the examiner in charge.
Code of Colorado Regulations 10 Additional records requested by the commissioner shall be made available for the examination upon the date specified by the examiner in charge. Appropriate workspace and equipment shall be provided to the examiners to expedite the examiners' review of the records. Section 13. Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in Colorado statutes pertaining to the business of insurance or other laws and specifically Section 10-1-205, C.R.S., which include the imposition of fines, issuance of cease and desist orders and/or suspension or revocation of license.
Section 14. Severability If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the regulation shall not be affected. Section 15. Effective Date This amended regulation shall be effective as of June 1, 2003. Section 16. History Issued as Regulation 1-1-7, effective October 1, 1995.
Repealed and Repromulgated (In Full) Regulation 1-1-7, effective June 1, 2003. Regulation 1-1-8 PENALTIES AND TIMELINES CONCERNING DIVISION INQUIRIES AND DOCUMENT REQUESTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated pursuant to § § 10-1-109, 10-2-104, 10-3-109(3), and 10-16-109, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to prescribe the time period in which all persons and entities shall respond to Colorado Division of Insurance inquiries, including, but not limited to, document and Code of Colorado Regulations 11 information requests during market conduct and financial examinations, investigations of complaints, and any other formal or informal investigation or examination conducted for the purpose of determining compliance with Colorado insurance law. In addition, the purpose of this regulation is to prescribe the penalties for failure to respond to Division inquiries within the timeframes specified in this regulation. Section 3 Applicability This regulation shall apply to all persons and entities over whom the Division has authority, including, but not limited to, producers, insurers, health carriers, as defined by § 10-16-102(8), C.R.S., and insurance agencies for all lines of insurance. This regulation does not apply where a different timeframe for responding to Division inquiries or providing documentation or information is specifically established by Colorado statute or Division regulation.
Section 4 Definitions As used in this regulation:
A. “Complete and accurate response” shall mean a written response that includes all of the information, documents and explanation requested in the Division’s inquiry. If the requested information is not available the response shall include a detailed explanation of why it cannot be provided.
B. “Division” shall mean the Colorado Division of Insurance.
C. “Inquiry” shall mean any written request from the Division to any person, for documents, information or an explanation or response. Inquiries may concern, but are not limited to, market conduct examination request/comment forms, financial examination request/memo forms, information requests arising from complaints received by the Division, compliance reviews, survey requests, rate reviews, filing reviews and any other formal or informal investigation or examination conducted for the purpose of determining compliance with Colorado insurance law. A written Division request may be transmitted electronically, hand delivery or may be sent through the United States Postal System.
D. “Examination Request/Comment Form” and “Examination Request/Memo Form” mean a request for information made during the course of a formal market conduct or financial examination under § § 10-1-201 to 207, C.R.S. or other market conduct actions under § § 10-1-210 to 213, C.R.S., and includes:
E. “Person” shall have the same meaning as in § 10-2-103(8), C.R.S.
F. “Response” means all written information, documentation and/or explanations provided to the Division from the person to whom the inquiry is made.
Section 5 Rules A. Unless another time period is specified by the Division in writing, every person shall provide a complete and accurate response to an Examination Request/Comment Form or Examination Request/Memo Form within ten (10) calendar days from the date on the form. Code of Colorado Regulations 12 B. Except for responses to an Examination Request/Comment Form or Examination Request/Memo Form, and unless another time period is specified by statute, regulation or by the Division either electronically or in another written form, every person shall provide a complete and accurate response to any inquiry from the Division within twenty (20) calendar days from the date of the inquiry.
C. Extension Requests.
D. If a person is represented by legal counsel, said representation does not alter or absolve the person’s obligations to comply with this regulation.
E. The Division will calculate the applicable time periods from the date of the Division’s inquiry as follows:
F. Failure to provide a complete and accurate response to a Division inquiry, failure to request an extension for a specified period in accordance with subsection C. above, or failure to provide a complete and accurate response to a Division inquiry when an extension is not granted, may result in the imposition of a $500.00 civil penalty for an initial violation, and may be increased up to a maximum penalty of $5,000.00 for each subsequent violation, as permitted by § 10-3-109(3), C.R.S.
Section 6 Severability Code of Colorado Regulations 13 If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of the regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation is effective on July 1, 2012.
Section 9 History Originally promulgated as regulation 6-2-2, effective; January 31, 1998. Repealed regulation 6-2-2, re-promulgated as new regulation 1-1-8. Hearing date: April 3, 2003, effective June 2, 2003.
Amended regulation effective February 1, 2009.
Amended regulation effective July 1, 2012.
Regulation 1-1-9 ELECTRONIC RATE FILING AND EXEMPTION TO ELECTRONIC RATE FILING REQUIREMENT DUE TO AN EMERGENCY SITUATION Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Rule Section 5 Severability Section 6 Enforcement Section 7 Effective Date Section 8 History Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109, 10-4-401(5) and 10-16-107(1), C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to prescribe the format for electronic rate filings with the Division of Insurance (Division), and to set forth the circumstances that would be considered an emergency situation exempting carriers from making electronic rate filings. Section 3 Applicability Code of Colorado Regulations 14 The requirements of this regulation shall apply to all insurance companies who file type II rates for property and casualty insurance rate filings subject to Parts 1 through 4 of article 4 of title 10, C.R.S., and for health rate filings subject to Article 16 of Title 10. Section 4 Rule A. The following situations are defined as an emergency situation that would exempt carriers from making electronic rate filings;
B. Except as a result of an event described in section 4.A, an emergency situation does not exist due to an insurer’s failure to have adequate, properly trained staff to file rates electronically.
C. The Division will only accept electronic filings submitted through SERFF (System for Electronic Rate and Form Filing). Information regarding SERFF can be located at www.SERFF.com. Section 5 Severability If any provision of this regulation or application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 6 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 7 Effective Date This regulation shall be effective April 1, 2013.
Section 8 History New Colorado Regulation 1-1-9 effective February 1, 2008. Amended Regulation 1-1-9 effective April 1, 2013.
Regulation 1-2-1 CONCERNING PRODUCER FIDUCIARY RESPONSIBILITIES Section 1. Authority Section 2. Scope and Purpose Section 3. Applicability Section 4. Rule Section 5. Enforcement Code of Colorado Regulations 15 Section 6. Severability Section 7. Effective Date Section 8. History Section 1. Authority This regulation is promulgated under the authority of § § 10-1-109, 10-2-104, 10-2-704, and 10-3-1110 Colorado Revised Statutes (C.R.S.)
Section 2. Scope and Purpose The purpose of this regulation is to clarify the responsibility of insurance producers to treat each insurance policy and premiums handled thereon as a separate account of their insureds unless specific authorization has been obtained from insureds to commingle multiple obligations and funds. Section 3. Applicability This regulation shall apply to all insurance producers and agencies over whom the Division of Insurance has authority.
Section 4. Rule A. No insurance premium or refund received by an insurance producer or agency by reason of the application for, issuance or termination of any particular policy may be credited to any other obligation owed by the insured to such producer, agency or other insurer unless specific written authorization has been obtained from the insured to so credit, or a blanket authorization has been obtained from the insured to handle all policies and obligations from one account.
B. Upon receipt, the insurance producer or agency shall treat all premiums and returned premiums in a fiduciary capacity, including but not limited to the following:
Section 5. Enforcement Code of Colorado Regulations 16 Noncompliance with this regulation, whether defined or reasonably implied, may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders and/or suspensions or revocation of license. Section 6. Severability If any of the provisions of this regulation or the application thereof to any person or circumstances is for any reason held invalid or unenforceable, this regulation shall be construed as if not containing such provisions and the validity, legality and enforceability of the remaining provisions of this regulation shall not be affected or impaired in any way.
Section 7. Effective Date This regulation is effective January 1, 2009.
Section 8. History Originally promulgated in 1978 as 78-12 Amended Regulation in 1980 Re-codified as Regulation 1-2-1 in 1992 Repealed and repromulgated January 1, 2009.
Regulation 1-2-4 CONTINUING EDUCATION REQUIREMENTS FOR LICENSED INSURANCE PRODUCERS, INCLUDING PUBLIC ADJUSTERS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This amended regulation is promulgated and adopted by the Commissioner of Insurance under the authority of § § 10-1-109, 10-2-104, 10-2-301 and 10-19-113.7, C.R.S. Section 2 Scope and Purpose Code of Colorado Regulations 17 This regulation establishes continuing education requirements for persons licensed to sell certain types of insurance, including public adjusters. Additionally, this regulation establishes the procedures for filing course completion information by the course providers.
This regulation sets forth:
A. The basic requirements for such training and the standards for the courses and programs that qualify for approval by the Commissioner;
B. The procedures and standards that the Commissioner will use in approving the courses;
C. The required record keeping and procedures for certification of satisfactory completion of the continuing education requirement; and D. The sanctions for noncompliance with this regulation. Section 3 Applicability This regulation shall apply to all individuals licensed as insurance producers, including public adjusters, in Colorado, with the exception of those individuals licensed to write only one or more of the following lines: travel ticket selling, title, limited lines credit insurance, and crop hail. This regulation shall also apply to all providers of continuing insurance education in Colorado. The requirements of this regulation apply to any Colorado resident licensed to solicit and sell insurance in this state and to public adjusters. Pursuant to § 10-2-301(3)(b), C.R.S., this section shall not apply to any person holding a limited or restricted license if that license is in good standing with the Division of Insurance and no complaints have been filed against the licensee. Section 4 Definitions A. "Approved course" is a course offered for continuing education credit that is approved by the Division of Insurance.
B. "Credit hour" is a value assigned to an approved course.
C. "Carryover credit hour" is a credit hour earned over and above the twenty-four (24) hours of continuing education required during the one hundred twenty (120) days before the licensing continuation date, which may be applied to the next continuing education period. If a producer chooses to complete continuing education courses in the period prior to their first continuation, these credits are not eligible for carry over.
D. "Classroom course" is at least sixty (60) minutes of participation in an approved course in a classroom. Not more than ten (10) minutes of any sixty (60) minute period may be used for breaks, roll taking, or administrative instructions. Classroom course includes a course offered by live video conference or webcast if the technology allows for communication between and among the participants and instructor and the participant’s attendance and participation is monitored.
E. "Competency examination" is a closed book examination taken and passed by a producer without assistance and personally monitored by a disinterested third party.
F. "Continuing Education Administrator" shall mean Pearson VUE whose mailing address is 3131 South Vaughn Way, Suite 205, Aurora, Colorado 80014.
G. "Disinterested third party" is someone who is not:
Code of Colorado Regulations 18
H. "Insurance producer" or "Producer" shall have the same meaning as defined in § 10-2-103(6), C.R.S.
I. "Public adjuster" shall have the same meaning as defined in § 10-2-103(8.5), C.R.S.
J. "Qualified instructor" means a person who has demonstrated competency in the subject matter of an approved course through one of the following means:
K. "Self-study course" is a course that involves book study, video study, computer based training or other means of training and education where a qualified instructor is not present. Self-study courses must include an examination and the examination is subject to the requirements of a competency examination.
L. "Sponsor" means the person or entity primarily responsible for conducting the course and maintaining records of successful course completion. A sponsor may be an institution, organization or instructor.
Section 5 Rules A. Required Hours/Certification Every producer who is licensed in Colorado and not otherwise specifically exempted in this regulation shall complete twenty-four (24) credit hours of approved courses biennially after the producer’s initial renewal. At least eighteen (18) of the twenty-four (24) credit hours shall be in approved courses for the type of license for which the producer is licensed. At least three (3) of the twenty-four (24) hours of continuing education shall be for courses in ethics. All producers licensed to sell property or personal lines insurance must complete three (3) hours of continuing education on homeowner’s insurance coverage. A maximum of six (6) of the twenty-four (24) credit hours shall be in approved courses on subjects designated by the Commissioner whenever the Commissioner determines that continuing education in such subjects is needed to protect insurance consumers. Those individuals licensed as reinsurance intermediary brokers must complete the required continuing education through professional seminars or curriculum within Code of Colorado Regulations 19 the reinsurance field. Producers may accumulate no more than twelve (12) carryover credit hours during the one hundred twenty (120) days before the licensing continuation date, which may be applied to the next continuing education period.
B. Implementation of Health Maintenance Organization and Nonprofit Hospital Medical-Surgical and Health Service Corporation Producers Continuing Education Requirement There will be no new licenses issued for these lines on or after January 1, 2002. All producers who currently hold the health maintenance organization and/or nonprofit hospital medical-surgical and health service producer licenses will not be required to complete twenty-four (24) hours of continuing education for compliance periods beginning after January 1, 2002.
C. Approved Courses
Code of Colorado Regulations 20
Affidavits must be submitted the day of the examination. Sponsors must clearly identify the time frame required for submission and provide the affidavit form prior to testing. The test completion date is the date the individual took and successfully passed the examination, providing the affidavit is received by the sponsor and the sponsor was paid.
D. Record Keeping
E. Advertisement of Qualified Courses
Code of Colorado Regulations 23
Section 6 Severability If any provision of this regulation or its application to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation is effective January 1, 2014.
Section 9 History New November 2, 1992; Effective January 1, 1993.
Amended October 15, 1994; Effective January 1, 1995: Sections amended 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12.
Amended April 3, 1998; Effective June 2, 1998. Sections added: 6. Sections amended: 1, 2, 3, 4, 5, 7, 8, 10, and 13.
Amended November 1, 2000. Effective January 1, 2001. Sections amended 2, 5, and 7. Section 10 deleted. Subsequent sections renumbered.
Emergency Regulation effective January 1, 2002. Sections amended 1, 2, 3, 4, 5, 6, 7, 8, 12, and 13. Amended Regulation effective April 1, 2002. Sections amended 1, 2, 3, 4, 5, 6, 7, 8, 12, and 13. Amended Regulation effective February 1, 2003. Sections Amended 1, 3, 5, 8, 12 and 13. Amended Regulation effective September 30, 2004. Sections Amended 2 and 5. Amended Regulation effective February 1, 2005. Sections 5, 7,10 and 12. Amended Regulation effective January 1, 2006. Sections 5.b., 7.B., 12, and 13. Amended Regulation effective January 1, 2007. Sections 4E, 5A(2), 5C1(c), 5C1(d), 5C1(e), 5C1(e), 5C2(b)(iii), 5C2(b)(iiiv), 5C2(b)(ix), 8.
Emergency Regulation 12-E-01 effective July 1, 2012.
Amended Regulation effective October 15, 2012. Sections 1, 2, 3, 4, 5, and 7. Amended Regulation effective January 1, 2014.
Code of Colorado Regulations 24 Regulation 1-2-5 INSURANCE PRODUCER PRELICENSING EDUCATION REQUIREMENTS FOR RESIDENTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 General Requirements Section 6 Course Approval Section 7 Course Hour Requirements Section 8 Certification of Satisfactory Completion Section 9 Period of Validity for Prelicensing Course Certificates Section 10 Exemptions from Prelicensing education Section 11 Compliance Section 12 Enforcement Section 13 Severability Section 14 Further Information and Submittals Section 15 Effective Date Section 16 History Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109, 10-2-104, and 10-2-201(2), C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to set forth the prelicensing education required for all applicants for a resident insurance producer license issued by the State of Colorado. The regulation also sets forth the method for submission and approval of prelicensure education courses. Section 3 Applicability The requirements of this regulation shall apply to all applicants for a resident insurance producer license issued by the State of Colorado who are subject to the prelicensure education requirements set forth in § 10-2-201, C.R.S. The requirements of this regulation shall also apply to providers of prelicensure education in Colorado.
Section 4 Definitions Code of Colorado Regulations 25 A. "Course Provider" means the person or entity approved by the Division to offer prelicensing education courses for Colorado resident insurance producers.
B. "Division" means the Colorado Division of Insurance.
C. "Insurance Producer" shall have the same meaning as set forth in § 10-2-103(6), C.R.S.
D. "License" shall have the same meaning as set forth in § 10-2-103(7), C.R.S.
E. "Line of Authority" shall mean the specific type of insurance as authorized in § 10-2-407, C.R.S.
F. "NAIC" shall mean the National Association of Insurance Commissioners.
G. "Resident" shall have the meaning as set forth in § 10-2-405, C.R.S. Section 5 General Requirements Any person applying for a Colorado resident insurance producer license, other than those exempt pursuant to § 10-2-202, C.R.S., must successfully complete prelicensing education before taking the state producer license examination. The prelicensing education required by this regulation shall be satisfied by the successful completion of course(s), with hours totaling those required by Section 7 of this regulation. Course(s) must be approved for prelicensing for the particular line of authority by the Division. Only successful completion of courses approved by the Division will satisfy the requirements of the regulation.
Section 6 Course Approval A. Prior to being offered or advertised, any prelicensing course or program must be approved by the Division. Any change in the course or program must be approved by the Division prior to being implemented. Any full-time program of prelicensure education operated by a company with a qualified home office located in Colorado will not be required to submit courses for review and certification by the Commissioner. Course approval requests must be accompanied by the following:
Code of Colorado Regulations 26
B. Prelicensing courses may consist either of classroom study or self-study (including online courses). Evaluation of any proposed course shall be based upon the substance of the course and not its method of delivery. During the consideration of approval for a self-study course or program, the Division will take into account the specific method used to verify that a student satisfactorily completed the course or program. One of the following methods shall be used in measuring satisfactory completion of a course or program:
C. The curriculum of the following designation programs satisfy the prelicensure education requirements of § 10-2-201, C.R.S., as follows:
Section 8 Certification of Satisfactory Completion A. A certificate of completion shall be issued by the approved Course Provider to each person satisfactorily completing the course.
B. The certificate of completion shall contain the student's full name, residential address, name of the approved course, beginning date, date of completion, name of the approved Course Provider, the original or electronic signature of the instructor and any other information that the Division deems necessary.
C. The certificate of completion must have been earned prior to sitting for the state license examination. Proof of course completion must be transmitted electronically to the Division or its vendor. Such electronic transmission will satisfy the applicant’s responsibility to transmit the certificate to the Division.
Section 9 Period of Validity for Prelicensing Course Certificates Prelicensing certificates of completion shall be valid for a period of one (1) year from the date of completion. Prelicensing certificates of completion that are more than one (1) year old will not be accepted by the Division and students will be required to take an approved prelicensing course. Section 10 Exemption from Prelicensing education An individual who was previously licensed for the same line(s) of authority in a reciprocal state is exempt from prelicensing education. Such individual shall be required to certify knowledge of Colorado law applicable to insurance producers on a form approved by the Division. This exemption is only available if Code of Colorado Regulations 28 the person is currently licensed in the other state or if the application is received within ninety (90) days of the cancellation of the applicant’s previous home state license and if the prior home state issues a certification that, at the time of cancellation, the applicant was in good standing in that state or the state’s producer database records, maintained by the NAIC, its affiliates or subsidiaries, indicates that the insurance producer is or was licensed in good standing for the line(s) of authority requested. Section 11 Compliance The Division or its designee may conduct audits of producers, course providers, sponsoring organizations, or qualified instructors to verify that the approved courses are administered as filed with the Division of Insurance and to determine compliance with § 10-2-203, C.R.S., and this regulation. Noncompliance with this regulation or the applicable provisions of Title 10 by institutions, instructors, or organizations conducting approved courses may result in termination of course approval. Section 12 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 13 Severability If any provision of this Regulation or the application thereof to any person or circumstance is for any reason held to be invalid the remainder of the regulation shall not be affected. Section 14 Further Information and Submittals Any submittals or questions should be directed to:
Licensing Administrator Colorado Division of Insurance 1560 Broadway, Suite 850 Denver, Colorado 80202 Phone (303) 894-7499 Section 15 Effective Date This regulation is effective October 15, 2012.
Section 16 History Original Regulation 1-2-5, Effective January 1, 1995.
Emergency Regulation 01-E-4, Effective January 1, 2002 Temporary Regulation 02-E-2, Effective April 1, 2002 Code of Colorado Regulations 29 Amended Regulation 1-2-5, Effective May 1, 2002.
Amended Regulation 1-2-5, Effective March 31, 2007.
Amended Regulation 1-2-5, Effective February 1, 2008.
Emergency Regulation 12-E-09, Effective July 1, 2012.
Repealed and Repromulgated Regulation 1-2-5, Effective October 15, 2012. Regulation 1-2-6 CONCERNING REINSURANCE INTERMEDIARIES Section 1. Authority Section 2. Basis And Purpose Section 3. Reinsurance Intermediary License Section 4. Filing Requirements For Licensure As A Reinsurance Intermediary -- Producer Section 5. Filing Requirements For Licensure As A Reinsurance Intermediary -- Manager Section 6. Severability Section 7. Effective Date Section 8. History Section 1. Authority This regulation is promulgated under the authority of § §10-2-104, 10-2-912, and 10-2-1101, C.R.S. Section 2. Basis And Purpose In accordance with the provisions of Part 9, of Article 2 of Title 10, reinsurance intermediaries are required to be licensed by the Division of Insurance prior to doing business in Colorado. The purpose of this regulation is to specify the filing requirements for licensure. Section 3. Reinsurance Intermediary License Reinsurance intermediary licenses shall be perpetual licenses that are subject to payment of a continuation fee and filing the continuation forms approved by the Commissioner ninety (90) days prior to the month of continuation. Issuance of the Reinsurance Intermediary License is not dependent upon licensure as an insurance producer under §10-2-401. C.R.S. Section 4. Filing Requirements For Licensure As A Reinsurance Intermediary -- Producer A. Any person, firm, association, or corporation initially applying to be a reinsurance intermediary - producer must submit the following information to the Colorado Division of Insurance:
B. Ninety (90) days prior to the month a license is due to be continued the Commissioner shall notify the reinsurance intermediary - producer, at the last known address, of the requirements necessary to continue the license. Any person, firm, association, or corporation applying to continue a reinsurance intermediary - producer license shall submit the following:
Section 5. Filing Requirements For Licensure As A Reinsurance Intermediary -- Manager A. Any person, firm, association or corporation initially applying to be a reinsurance intermediary - manager must submit the following to the Colorado Division of Insurance:
Code of Colorado Regulations 31
Prior Calendar Year aggregate Written liability Errors & Omissions Policy Limits limits $0 - 10,000,000 $1,000,000 $10,000,000 - 25,000,000 $2,500,000 $25,000,000 and above $5,000,000
B. Ninety (90) days prior to the end of the month a license is due to be continued the Commissioner shall notify the reinsurance intermediary - manager, at the last known address, of the requirements necessary to continue the license. Any person, firm, association or corporation applying to renew a reinsurance intermediary - manager license shall submit the following:
Section 6. Severability If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Code of Colorado Regulations 32 Section 7. Effective Date The effective date of this regulation is May 1, 2003.
Section 8. History Originally effective December 31, 1995.
Amended and effective May 1, 2003.
Regulation 1-2-7 Concerning Managing General Agents Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 General Provisions Section 5 Independent Audit Section 6 Annual Filing Section 7 Fiduciary Accounting Section 8 Severability Section 9 Enforcement Section 10 Effective Date Section 11 History Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109 and 10-2-1008, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to clarify standards and procedures contained in the Managing General Agents Act.
Section 3 Applicability This regulation shall apply to a managing general agent as defined in § 10-2-1002(2)(a), C.R.S., and to any insurer as defined in § 10-2-1002(1), C.R.S., that contracts with any person, firm, association, or corporation acting in the capacity of a managing general agent (MGA) as that term is defined in § 10-2- 1002(2)(a), C.R.S.
Section 4 General Provisions A. All persons, firms, associations, or corporations who meet the definition of a managing general agent in § 10-2-1002(2)(a), C.R.S., must be licensed in Colorado as an insurance producer and must have a contract with the insurer(s) for which they are acting as a managing general agent. Code of Colorado Regulations 33 B. Each insurer must notify the Commissioner in writing, on forms acceptable to the Commissioner of Insurance, of those persons, firms, associations or corporations they designate as managing general agents.
C. Those persons, firms, associations, or corporations meeting the requirements of § 10-2-1002(2)(a), C.R.S., and who adjust or pay claims in excess of $10,000 shall be considered a managing general agent for the purpose of this regulation.
D. The amount of the bond required by § 10-2-1003(3), C.R.S., for the protection of the insurer, shall be a minimum of $100,000 or ten percent (10%) of the managing general agent’s total annual written premium nationwide for each insurer for which it acts as an MGA for the prior calendar year, not to exceed $500,000 for each insurer. The bond shall be kept on file with each insurer with which the managing general agent has a contract.
E. The contract required by § 10-2-1004, C.R.S., between the MGA and the insurer shall contain a provision that the MGA may use only advertising material pertaining to the business issued by an insurer that has been approved in writing by the insurer in advance of its use. Section 5 Independent Audit A. The insurer shall have on file an independent audited annual financial statement. If the MGA has been in existence for less than one (1) year, the MGA shall file financial statements, certified by an officer of the MGA and prepared in accordance with GAAP, each month during the calendar year.
B. An audited financial/annual report prepared on a consolidated basis shall include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:
Section 8 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 9 Enforcement Non compliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition Code of Colorado Regulations 34 of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 10 Effective Date This amended regulation shall become effective October 1, 2012 Section 11 History Originally effective June 1, 1994 Amended and effective April 1, 2000 Amended effective May 1, 2003 Amended effective October 1, 2012 Regulation 1-2-9 FEES CHARGED BY PRODUCERS Section 1. Authority Section 2. Basis and Purpose Section 3. Rules Section 4. Enforcement Section 5. Severability Section 6. Effective Date Section 7. History Section 1. Authority This regulation is promulgated under the authority of §10-1-109, C.R.S. Section 2. Basis and Purpose The purpose of this regulation is to implement rules which prohibit producers from charging insurance applicants and policyholders certain fees for which they are already compensated through commissions and to clarify which fees may be charged.
Section 3. Rules A. Fees Prohibited Agreements between the insurer and insurance producers include a commission schedule which lists the producer's compensation for soliciting and acquiring insurance business. Insurers subsequently include these commissions and/or other acquisition expenses in their comprehensive rate filings and must justify these expenses to the Commissioner of Insurance. If insurance producers charge a separate fee in addition to those included as commissions in the insurers' rate filings, then premiums charged to the policyholders could be considered excessive.
Code of Colorado Regulations 35 Therefore, insurance producers are prohibited from charging separate fees in addition to those contemplated in the rate filing and included in their commissions for the solicitation and procurement of insurance products and for servicing existing insurance policyholders. These services may include, but are not limited to: inspections; quoting premiums; issuing policies; signing policies; examining and mailing policies, applications and daily reports; compiling figures for accounts current and mailing billing notices; correspondence and other bookkeeping and clerical work; issuing certificates of insurance and endorsements; issuing proof of insurance cards and notices (SR-22's); making copies of insurance documents; and taking loss information. Insurance producers are also prohibited from charging fees for purchasing new computer equipment, extending business hours, adding new sales facilities, or other overhead expenses associated with the solicitation or procurement of insurance products or the servicing of existing insurance policyholders.
The prohibition in this section shall not apply to insurance wholesale intermediaries; however, insurance wholesale intermediaries must advise the insurance producer, as the representative of the consumer, in writing, that “the cost of the insurance coverage provided herein includes a fee to a wholesale intermediary in addition to the premium charges.” For the purpose of this regulation a wholesale intermediary is a person or organization that deals directly with a licensed retail producer and not with a consumer.
Insurance producers may not condition the placement of insurance upon the provision of other services for which fees may be charged.
B. Fees Allowed Insurance producers may charge fees for specific services which are beyond the scope of services pertaining to acquiring and/or maintaining specific insurance policies, including, but not necessarily limited to, risk management services, financial planning, investment counseling, qualified retirement plan design or administration, estate planning, third party employee benefit plans, or any other service for which the insurance producer does not receive a commission from an insurance company. Such fees may be charged only under the following circumstances:
C. Maintenance of Records The insurance producer shall retain a copy of the disclosure statement for not less than three (3) years after completion of services and a copy shall be available to the commissioner upon request.
Section 4. Enforcement Noncompliance with this regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines and/or suspension or revocation of an insurance producer's license.
Section 5. Severability Code of Colorado Regulations 36 If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the regulation and the application of such provision shall not be affected.
Section 6. Effective Date The effective date of this regulation is September 1, 2003. Section 7. History Issued As New Regulation Effective June 1, 1994.
Regulation Amended, Effective September 1, 2003.
Regulation 1-2-10 CONCERNING THE REGULATION OF INSURANCE PRODUCERS, INCLUDING PUBLIC ADJUSTERS, AND AUTHORIZED INSURERS BY THE COLORADO DIVISION OF INSURANCE Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 License Examination Section 6 Insurance Producer License Section 7 List of Contractually Authorized Producers Section 8 Designation of Responsible Producer and Agency Registration of Producers Section 9 Producer Registration of Assumed (Trade) Name Section 10 Insurer Reporting Requirements Concerning Termination of Insurance Producer by an Insurer for Cause Section 11 Producer Reporting Requirements for Administrative and Criminal Prosecutions Section 12 Fees Section 13 Severability Section 14 Enforcement Section 15 Effective Date Section 16 History Section 1 Authority This regulation is promulgated, and adopted by the Commissioner of Insurance, under the authority of § § 10-1-109, 10-2-104, 10-2-407, 10-2-413, 10-2-417 and 10-16-414, C.R.S. Code of Colorado Regulations 37 Section 2 Scope and Purpose This regulation sets forth the terms and conditions for licensing insurance producers, including public adjusters, and regulates certain requirements of insurers, agencies, producers and entities acting as public adjusters. This regulation also establishes the fees required by §10-2-413, C.R.S. Nothing in this regulation shall change or modify any provisions of a Colorado motor vehicle insurance plan as may be adopted by the Commissioner under the authority of §10-4-412, C.R.S. Section 3 Applicability This regulation shall apply to all resident and nonresident producers, including public adjusters, business entities acting as public adjusters, agencies, and insurers licensed and authorized to conduct insurance business in the state of Colorado.
Section 4 Definitions A. "Credit" means credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection insurance, or any form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation and is designated by the Commissioner as limited line credit insurance.
B. "Crop insurance" is insurance providing protection against damage to crops from unfavorable weather conditions, fire or lightning, flood, hail, insect infestation, disease or other yield-reducing conditions or periods provided by the private insurance market, or that is subsidized by the Federal Crop Insurance Corporation, including multi-peril crop insurance.
C. "Division" shall mean the Colorado Division of Insurance.
D. "Insurance agency" or "business entity" shall have the same meaning as defined in §10-2-103(5), C.R.S.
E. "Insurance producer" or "producer", shall have the same meaning as defined in §10-2-103(6), C.R.S.
F. "Insurer" for the purpose of this regulation, shall have the same meaning as § 10-1-202(6), C.R.S., and shall include Health Maintenance Organizations (HMO) and nonprofit hospital, medical- surgical, and health service corporations.
G. "License" for the purpose of this regulation, shall mean any type of license regulated by the Colorado Division of Insurance.
H. "Person" shall have the same meaning as defined in §10-2-103(8), C.R.S.
I. "Public adjuster" shall have the same meaning as defined in 10-2-103(8.5), C.R.S.
J. "Travel" means insurance coverage for trip cancellation, trip interruption, baggage, life, sickness and accident, disability, and personal effects when limited to a specific trip and sold in connection with transportation provided by a common carrier.
Section 5 License Examination A. Applicants shall pass the examination as approved by the Commissioner for each license type and authority that is subject to an examination requirement. Procedures for registering for the examination shall be published in the Candidate Handbook available from the test administrator Code of Colorado Regulations 38 or the Division, 1560 Broadway, Suite 850, Denver, Colorado 80202. The candidate shall pay a fee to the test administrator for administering the examination, plus the license fee shown in Section 13 of this regulation.
B. Nonresident producers may not be subject to examination pursuant to §10-2-403, C.R.S.
C. Resident producers applying for, renewing, or continuing the Variable Life and Variable Annuity Products line of authority, in addition to holding the life authority, must furnish evidence that they have passed the test to be registered and are currently registered with a Financial Industry Regulatory Authority (FINRA) member firm, broker or dealer with a FINRA membership. Nonresident producers applying for, renewing or continuing the Variable Life and Variable Annuity Producers line of authority must meet the requirements of their resident state and have a current registration with a FINRA member firm, broker or dealer with a FINRA membership. Section 6 Insurance Producer, including Public Adjuster, License A. Initial Application
B. Continuation of Producer License
Code of Colorado Regulations 39
C. Reinstatement Due To Failure to Continue License
D. Amending Licenses
E. Letter of Certification
Code of Colorado Regulations 40
F. Letter of Clearance
G. Temporary License The Commissioner may issue a temporary license to an individual or agency under special circumstances as outlined in §10-2-410, C.R.S. Any request for a temporary license shall be in writing and sent to the attention of the licensing section at the Division. Section 7 List of Contractually Authorized Producers Insurers are reminded that they must comply with the provisions of § § 10-2-416.5 and 10-16-414 C.R.S., which requires them to maintain a current list of producers contractually authorized to accept applications on behalf of the insurer. Additionally, bail bond insurers must comply with § § 10-2-415.5 and 10-2-415.7, C.R.S., and Division of Insurance Regulation 1-2-16.
Section 8 Designation of Responsible Producer, Responsible Public Adjuster and Agency Registration of Producers A. Pursuant to §10-2-404(2) (a) through (f), C.R.S., each agency must designate and register the following:
Code of Colorado Regulations 41
B. Pursuant to §10-2-417(1)(c), C.R.S., a business entity acting as a public adjuster must be licensed and must designate a licensed public adjuster who is responsible for the business entity’s compliance with the insurance laws and rules of Colorado.
C. The insurance agency or business entity shall, within ten (10) days, notify the Commissioner of any change relative to the insurance agency or business entity name, officers, directors, partners, or owners; to report a merger; or that the insurance agency or business entity has ceased doing business in Colorado. The procedures for reporting this information shall be included in the Candidate Handbook.
Section 9 Producer Registration of Assumed (Trade) Name Each producer shall register with the Commissioner in writing the use of any assumed or fictitious name under which the producer conducts business prior to using the assumed name. The Commissioner will not accept registration of any name that is similar or identical to the name of any producer whose license was suspended or revoked. Producers are reminded that they must provide written notice to the Commissioner of any change in or discontinuance of the use of any name. Section 10 Insurer Reporting Requirements Concerning Termination of Insurance Producer by an Insurer for Cause A. Section 10-2-416, C.R.S. imposes penalties including revocation of the certificate of authority if:
B. The information required to be reported to the Commissioner may be communicated by letter, addressed to the Investigations Section of the Division. In the caption section of the letter refer to "Section 10-2-416, C.R.S. NOTIFICATION." Also include in the letter the date of termination, the name of the producer, the reason for termination and any documents that were used to support the action.
C. For notifications involving information the insurer has regarding knowledge the producer was found by a court, government body, or self-regulatory organization authorized by law to have engaged in any of the prohibited activities in Article 2 or Article 3 of Title 10, C.R.S., the insurer shall provide any documents or information pertaining to those activities. Section 11 Producer Reporting Requirements for Administrative and Criminal Prosecutions Code of Colorado Regulations 42 A. Pursuant to §10-2-801(3) and (4), C.R.S., it is the responsibility of the producer or business entity to report to the Commissioner any administrative action taken in another jurisdiction or by another governmental agency in this state within thirty (30) days after the final disposition of the matter. This report must include a copy of the order, consent to order, or other relevant documents.
B. In the event of criminal prosecution in any jurisdiction, the producer or business entity must report this to the Commissioner within thirty (30) days after the initial pre-trial hearing. The report to the Commissioner must include a copy of the initial complaint, the order resulting from the hearing, and any other relevant documents.
Section 12 Fees Standard fees for producers shall be as follows:
Resident $288.00 Nonresident $428.00 Resident Continuation $32.00 per authority Nonresident Continuation $60.00 per authority All fees paid pursuant to this regulation are non-refundable. Fees are payable by electronic cash or credit card. If fees are paid electronically, and the check is refused by the bank for any reason or the credit card is declined for any reason, the producer’s license will not be valid. Section 13 Severability If any provision of this regulation or the application to any person or circumstance is for any reason held to be invalid, the remainder of the Regulation shall not be affected. Section 14 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 15 Effective Date This regulation shall be effective January 1, 2014.
Section 16 History Code of Colorado Regulations 43 Original Regulation 1-2-10, effective January 1, 1995.
Emergency Regulation 96-E-2, effective July 1, 1996.
Emergency Regulation 96 E 3, effective September 29, 1996. Amended Regulation 1-2-10, effective December 30, 1996. Amended Regulation 1-2-10, effective November 11, 1997. Amended Regulation 1-2-10, effective January 1, 2000.
Amended Regulation 1-2-10, effective January 1, 2001.
Emergency Regulation 1-2-10, effective January 1, 2002. Amended Regulation 1-2-10, effective April 1, 2002.
Amended Regulation 1-2-10, effective February 1, 2003.
Amended Emergency Regulation 05-E-2, effective June 1, 2005. Amended Regulation 1-2-10, effective December 1, 2005.
Amended Regulation 1-2-10, effective July 1, 2008.
Amended Regulation 1-2-10, effective February 1, 2009.
Amended Regulation 1-2-10, effective July 1, 2009 Amended Regulation 1-2-10, effective January 1, 2010 Emergency Regulation 12-E-02, effective July 1, 2012 Amended Regulation 1-2-10, effective October 15, 2012.
Amended Regulation 1-2-10, effective January 1, 2014 Regulation 1-2-11 STANDARDS AND APPROVAL FOR REQUIRED EDUCATION COURSES FOR PRODUCERS TO BE APPOINTED BY A BAIL INURANCE COMPANY Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Prelicensure Education Requirements Section 6 Course Approval Section 7 Proof of Satisfactory Completion Code of Colorado Regulations 44 Section 8 Provider Records Section 9 Compliance Section 10 Severability Section 11 Enforcement Section 12 Further Information and Submittals Section 13 Effective Date Section 14 History Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109, and 10-2-104, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to specify the requirements, procedures and standards necessary to implement the education requirements mandated by § 10-2-415.5(2)(c), C.R.S. including the certification and filing of courses in bail recovery pursuant to § 10-2-415.5(2)(c)(I)(B), C.R.S which comply with the Peace Officer Standards and Training Board (P.O.S.T.) curriculum established by P.O.S.T. pursuant to § 24-31-303(1)(h), C.R.S.
Section 3 Applicability The requirements and provisions of this regulation apply to bail insurance companies, insurance producers attempting to obtain appointments with bail insurance companies and course providers. Section 4 Definitions A. "Course" means an education class designed to satisfy the hourly requirements for one or more of the required areas listed in Section 5 below.
B. "Division" means the Colorado Division of Insurance.
C. "Provider" means the person or entity primarily responsible for conducting the course and maintaining records of successful course completion. A provider may be an individual, organization, or insurance company.
Section 5 Education Requirements Section 10-2-415.5, C.R.S. specifies that that an insurance producer must complete certain required education prior to obtaining an appointment with a bail insurance company. The education required is as follows:
A. Eight clock hours regarding bail bonding which shall consist of:
B. Sixteen clock hours of training in bail recovery practices. This required education is in addition to and does not substitute for or otherwise reduce the ongoing continuing education required by § 10-2-301, C.R.S.
Section 6 Course Approval A. Prior to being offered or advertised, a course that fulfills all or a portion of the eight clock hours described in Section 5.A. must be approved by the Division. Any change in the course must be approved by the Division prior to being implemented. Course approval requests must be accompanied by the following:
B. Education courses may consist either of classroom study or self-study (including online courses). Evaluation of any proposed course shall be based upon the substance of the course and not its method of delivery. During the consideration of approval for a self-study course, the Division will take into account the specific method used to verify that a student satisfactorily completed the course. One of the following methods shall be used in measuring satisfactory completion of a course:
C. Prior to being offered or advertised, a course that fulfills the sixteen clock hours described in Section 5.B. must be certified by the Provider as complying with the requirements of P.O.S.T. and filed with the Division for listing as an approved course. Course approval requests must be accompanied by the following:
Section 7 Proof of Satisfactory Completion A. Proof of satisfactory completion shall be issued by the approved Provider to each person satisfactorily completing a course within seven (7) days of course completion.
B. The certificate of completion shall contain the student's full name, residential address, name of the approved course, beginning date, date of completion, name of the approved Provider, the original or electronic signature of the instructor and any other information that the Division deems necessary.
Section 8 Provider Records A. Providers must maintain adequate records to verify the attendance and successful course completion for all students enrolled in a course.
B. Attendance and completion records must be retained for a five-year period following the date of completion of the course. These records must be available for audit by the Division. Section 9 Compliance The Division or its designee may conduct audits of producers, course providers, or qualified instructors to verify that the approved courses are administered as filed with the Division and to determine compliance with § 10-2-415.5, C.R.S., and this regulation.
Noncompliance with this regulation or the applicable provisions of Title 10 by persons conducting approved courses may result in termination of course approval. Section 10 Severability If any provision of this Regulation or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of the regulation shall not be affected thereby. Section 11 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Code of Colorado Regulations 47 Section 12 Further Information and Submittals Any submittals or questions should be directed to:
Compliance/Investigations Section Colorado Division of Insurance 1560 Broadway, Suite 850 Denver, Colorado 80202 303-894-7499 Section 13 Effective Date This amended regulation shall become effective October 15, 2012. Section 14 History Original Regulation 1-2-11, Effective August 30, 1995.
Emergency Regulation 96-E-1, Effective July 1, 1996.
Amended Regulation 1-2-11, Effective October 1, 1996.
Emergency Regulation 99-E-1, Effective January 1, 1999. Amended Regulation 1-2-11, Effective March 31, 1999.
Amended Regulation 1-2-11, Effective November 1, 1999.
Amended Regulation 1-2-11, Effective March 31, 2007.
Amended Regulation 1-2-11, Effective February 1, 2009.
Emergency Regulation 12-E-04, Effective July 1, 2012.
Repealed and Repromulgated Regulation 1-2-11, Effective October 15, 2012. Regulation 1-2-12 CONCERNING PUBLIC INSURANCE ADJUSTERS [Repealed eff. 01/15/2014] Regulation 1-2-13 CASH-BONDING AGENT AND PROFESSIONAL CASH-BAIL AGENT PROVISIONS FOR RELEASE OF QUALIFICATION BOND Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Procedures for Release of Qualification Bond Code of Colorado Regulations 48 Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner under the authority of § 10-1-109, C.R.S.
Section 2 Scope and Purpose Pursuant to § 12-7-103, C.R.S. as effective until July 1, 2012, Cash-Bonding Agents and Professional Cash-Bail Agents were required to post a cash qualification bond in the amount of $50,000 to secure payment of defaulted bonds and to pay any final, non-appealable judgment for failure to return collateral, including costs and attorney's fees, if awarded. This regulation sets forth the terms and conditions for release of the qualification bond for those Cash-Bonding Agents and Professional Cash-Bail Agents whose license expired, was cancelled, surrendered, revoked other otherwise inactivated prior to July 1, 2012.
Section 3 Applicability This regulation shall apply to any individual formerly licensed as a Cash-Bonding Agent or a Professional Cash-Bail Agent whose license expired, was cancelled, surrendered, revoked or otherwise inactivated prior to July 1, 2012, who is not registered with the Division as a Cash-Bonding Agent or a Professional Cash-Bail Agent under Article 23 of Title 10, C.R.S. which is effective on July 1, 2012, and who seeks the release of their qualification bond.
Section 4 Definitions A. "Commissioner" means the office of the Commissioner of Insurance as established in § 10-1-104(1), C.R.S. Reference to the Commissioner in this Regulation means any past, present, or future Commissioner who holds said office.
B. "Division" means the Colorado Division of Insurance.
C. "Inactivation date" means the date that the Cash-Bonding Agent or a Professional Cash-Bail Agent license was cancelled, surrendered, revoked other otherwise inactivated.
D. "Licensee" means a person licensed under Article 7 of Title 12 as a Cash-Bonding Agent or a Professional Cash-Bail Agent E. "Qualification bond" means the bond required by § 12-7-102, C.R.S. as effective until July 1, 2012. Section 5 Procedures for Release of the Qualification Bond The Division will consider release of the Qualification bond in the following situations:
1. On or after the seventh anniversary of the inactivation date of the license of the Cash-Bonding Agent or a Professional Cash-Bail Agent.
Code of Colorado Regulations 49 2. Upon request of the heir of a deceased Licensee: The Division will release the bond upon the later of the date on which any liability covered by the bond is satisfied or the third anniversary of the death of the Licensee.
3. Upon request of a former Licensee within the seven year period specified in paragraph 1 of this Section 5 if:
4. The Division will conduct an investigation upon receipt of a request for release that contains all of the required information in paragraphs 2 or 3 above. This investigation may involve, but is not limited to, verifying the information in the request, requesting additional information from the Licensee and verifying information with any Colorado courts.
5. Upon completion of the Division’s investigation, the Division will send the Licensee a settlement agreement, in which the Licensee agrees that if any bail bond liability continues to exist notwithstanding the execution of the affidavits, that the Licensee will be liable and satisfy any such bail bond liability should it arise. The settlement agreement will also require the Licensee to attest that all collateral that had been taken for any and all bonds posted under the qualification Code of Colorado Regulations 50 bond to which the Licensee seeks to release, has been returned to all rightful defendants or third party indemnitor(s) unless rightfully used pursuant to § 12-7-108(10)(a) and (b), C.R.S.
6. Upon receipt of the signed settlement agreement, and upon confirmation that all such other procedures have been satisfied, the Commissioner, in his or her sole discretion, may order a release on the hold of the qualification bond.
Section 6 Severability If any provision of this regulation or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation shall become effective October 15, 2012. Section 9 History Original Regulation 1-2-10, effective January 1, 1995 Emergency Regulation 96-E-2, effective July 1, 1996 Emergency Regulation 96 E 3, effective September 29, 1996 Amended Regulation 1-2-10, effective December 30, 1996 Amended Regulation 1-2-10, effective November 11, 1997 Amended Regulation 1-2-10, effective January 1, 2000 Amended Regulation 1-2-10, effective January 1, 2001 Emergency Regulation 1-2-10, effective January 1, 2002 Amended Regulation 1-2-10, effective April 1, 2002 Amended Regulation 1-2-10, effective February 1, 2003 Amended Emergency Regulation 05-E-2, effective June 1, 2005 Amended Regulation 1-2-10, effective December 1, 2005 Amended Regulation 1-2-10, effective July 1, 2008 Amended Regulation 1-2-10, effective February 1, 2009 Amended Regulation 1-2-10, effective July 1, 2009 Code of Colorado Regulations 51 Amended Regulation 1-2-10, effective January 1, 2010 Emergency Regulation 12-E-10, effective July 1, 2012 Repealed and Repromulgated Regulation, effective October 15, 2012 Regulation 1-2-14 CONCERNING RECORD KEEPING AND REPORTING REQUIREMENTS FOR INSURANCE PRODUCERS AUTHORIZED TO WRITE BAIL BONDS, AND THE FORMAT OF THE REQUIRED DISCLOSURE STATEMENT Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of § § 10-1-109, 10-2-104, and 10-2-705, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to establish the requirements to file the annual report required by § 10- 2-415.6, C.R.S; set forth the format of the Disclosure Form required by § 10-2-705(2), C.R.S.; and describe additional documents that must be retained by insurance producers pursuant to § 10-2-705(5), C.R.S.
Section 3 Applicability This regulation shall apply to insurance producers who are authorized to write bail bonds in the state of Colorado.
Section 4 Definitions As used in this regulation, and unless the context requires otherwise:
A. "Bail insurance company" shall have the same meaning as defined in § 10-1-102(3.5), C.R.S.
B. "Disclosure Statement" means the form contained in Appendix A of this regulation.
C. "Division" means the Colorado Division of Insurance. Code of Colorado Regulations 52 D. "Reporting Year" means the period of time from July 1 through June 30 of the following year. For example, July 1, 2012 through June 30, 2013.
E. "Transaction" a bail transaction occurs at the earliest of the issuance or execution of any of the documents listed in § 10-2-705, C.R.S., the payment of premium or the taking of collateral. Section 5 Rules A. Annual Report
B. Disclosure Statement
C. Records Required to be Maintained
Section 8 Effective Date This regulation is effective October 15, 2012.
Section 9 History Originally issued as Emergency Regulation 04-E-6, effective July 1, 2004. Emergency Regulation 04-E-8, effective July 23, 2004.
Emergency Regulation 04-E-11, effective October 21, 2004. Regulation 1-2-14, effective December 1, 2004.
Regulation 1-2-14, effective November 1, 2009.
Emergency Regulation 12-E-05,effective July 1, 2012.
Repealed and Repromulgated Regulation 1-2-14, effective October 15, 2012. APPENDIX A DISCLOSURE STATEMENT Code of Colorado Regulations 54 Code of Colorado Regulations 55 Regulation 1-2-15 Repealed Effective 10/15/2012.
Regulation 1-2-16 Insurance Producer Appointment and Termination Requirements for Bail Insurance Companies and Credentials Required by § 10-2-418(2), C.R.S. Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated pursuant to § § 10-1-109 and 10-2-104, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to establish the requirements for the appointment and termination of insurance producers by bail insurance companies authorized to do business in Colorado pursuant to the statutory provisions of § § 10-2-415.5 and 10-2-415.7, C.R.S. Section 3 Applicability This regulation shall apply to insurance producers and bail insurance companies that are authorized to write bail bonds in the State of Colorado.
Section 4 Definitions A. "Bail insurance company" shall have the same meaning as in § 10-1-102(3.5), C.R.S.
B. "Credentials" shall mean the paper document produced by the Division and provided to an insurance producer as required by § 10-2-418(2), C.R.S.
C. "Division" shall mean the Colorado Division of Insurance Section 5 Rules A. Initial Insurance producer appointments pursuant to § 10-2-415.5, C.R.S.
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B. Appointment renewals pursuant to § 10-2-415.5, C.R.S.
C. Insurance producer appointment terminations pursuant to § 10-2-415.7, C.R.S.
D. Credentials
Code of Colorado Regulations 57
E. Contractual agreements between insurance producers and bail insurance companies Bail insurance companies shall have a written contractual agreement directly with the insurance producer. No insurance producer shall claim to be representative of, or an agent of a bail insurance company, or accept applications or complete bail bond documents, unless the bail insurance producer has a written contract directly with the bail insurance company authorizing the insurance producer to act in the capacity of the agent for the bail insurance company and appointing the agent to act in that capacity.
Section 6 Severability If any provision of this regulation or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of the regulation and the application for such provision to other persons or circumstances shall not be affected.
Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation is effective October 15, 2012 Code of Colorado Regulations 58 Section 9 History Emergency Regulation 04 E7, effective October 5, 2005 New Regulation 1-2-16, effective February 1, 2005 Emergency Regulation 05 E1, effective June 1, 2005 Amended Regulation 1-2-16, effective December 1, 2005 Amended Regulation 1-2-16, effective November 1, 2009 Emergency Regulation 12-E-07, effective July 1, 2012 Repealed and Repromulgated Regulation 1-2-16, effective October 15, 2012 Regulation 1-2-17 STANDARD COMPENSATION DISCLOSURE FOR HEALTH INSURANCE PRODUCERS Section 1. Authority Section 2. Scope and Purpose Section 3. Applicability Section 4. Definitions Section 5. Rule Section 6. Severability Section 7. Enforcement Section 8. Further Information and Submittals Section 9. Effective Date Section 10. History Section 1. Authority This regulation is promulgated under the authority of § 10-1-109, C.R.S. Section 2. Scope and Purpose A. Pursuant to § 10-16-133(5), C.R.S., effective January 1, 2009, insurance producers, who sell health care insurance shall disclose to the person purchasing the policy that the insurance producer will receive a commission.
B. This regulation establishes the required disclosure of the standard compensation schedule of the producer to the consumer.
Section 3. Applicability Code of Colorado Regulations 59 The requirements and provisions of this regulation apply to all producers who sell health insurance. This regulation does not apply to sales under Medicare Advantage (also known as Medicare Part C) , Medicare Part D Prescription Drug Benefit programs, travel insurance, disability income insurance, credit insurance or long term care insurance.
Section 4. Definitions For purposes of this regulation, and unless the context requires otherwise:
A. “Additional Compensation” is when the producer provides additional services on behalf of an insurance company. For example, the producer may perform some underwriting or administrative services, such as policy issuance, for which additional compensation beyond standard compensation or contingent commission is appropriate. These services are not originally contemplated in an insurance company’s standard or contingent commission payments.
B. “Contingent Compensation” is the incentive commission for insurance producers to meet pre- established goals for profitability, retention and/or growth standards across all of the policies they place with an insurance company for a specific year.
C. “Health care insurance” shall have the same meaning as “health coverage plan” , as defined in § 10- 16-102 (22.5), C.R.S.
D. “Sale” of insurance shall be as defined by § 10-2-103 (10), C.R.S. A sale means the exchange a contract of insurance for money or its equivalent on behalf of an insurance company.
E. “Standard Compensation” is the set amount or percentage commission the insurance company pays the insurance producer for selling their insurance policy. Standard compensation does not include renewal commissions.
Section 5. Rule A. Effective January 1, 2009 all producers who sell health care insurance shall disclose his or her standard compensation. The standard compensation may be disclosed as a percentage or fixed amount, depending on how the commission is paid.
B. The standard compensation shall be disclosed when the health producer finalizes the sale of health insurance.
C. The producer disclosure requirements apply only to a new policy. The producer shall maintain written certification that he or she has provided the required disclosure to a policyholder. This may be in the form of Certificate of Mailing or Hand Delivery signed by the producer or a copy of an email to the policyholder. The Colorado Division of Insurance will not provide or approve forms used by producers for disclosure. The written certification of delivery or copy of the email to the policyholder must be retained by the producer pursuant to Regulation 1-1-7 for the current calendar year and two prior years.
D. In some instances, a producer may sell a product for an insurer but will not be compensated by that insurer. The compensation may come from the insurer’s parent or other affiliate, or from a third party. The source of the producer’s standard compensation must be disclosed.
E. Contingent or additional compensation is not considered standard compensation and therefore need not be disclosed.
Section 6. Severability Code of Colorado Regulations 60 If any provision of this regulation or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of the regulation shall not be affected thereby. Section 7. Enforcement Noncompliance with this Regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders, and/or suspensions or revocations of licenses. Among others, the penalties provided for in § 10-3-1108, C.R.S. may be applied. Section 8. Further Information and Submittals Any submittals or questions should be directed to:
Regulation 1-2-18 USE OF SENIOR-SPECIFIC CERTIFICATIONS AND PROFESSIONAL DESIGNATIONS IN THE SALE OF LIFE INSURANCE AND ANNUITIES Section 1. Authority Section 2. Scope and Purpose Section 3. Applicability Section 4. Definitions Section 5. Prohibited Use of Senior-Specific Certifications and Professional Designations Section 6. Severability Section 7. Enforcement Section 8. Effective Date Section 9. History Code of Colorado Regulations 61 Section 1. Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of § § 10-1-109 and 10-3-1110, C.R.S.
Section 2. Scope and Purpose The purpose of this regulation is to set forth standards to protect consumers from misleading and fraudulent marketing practices with respect to the use of senior-specific certifications and professional designations in the solicitation, sale or purchase of, or advice made in connection with, a life insurance or annuity product.
Section 3. Applicability This regulation shall apply to any solicitation, sale or purchase of, or advice made in connection with, a life insurance or annuity product by an insurance producer. Section 4. Definitions For the purposes of this regulation, “insurance producer” shall have the same meaning as contained in § 10-2-103(6), C.R.S.
Section 5. Prohibited Use of Senior-Specific Certifications and Professional Designations A. Prohibited Uses
B. There is a rebuttable presumption that a certifying or designating organization is not disqualified solely for purposes of subsection A(2)(d) of this section five when the certification or designation issued from the organization does not primarily apply to sales or marketing and when the organization or the certification or designation in question has been accredited by:
C. In determining whether a combination of words or an acronym standing for a combination of words constitutes a certification or professional designation indicating or implying that a person has special certification or training in advising or service seniors, factors to be considered shall include:
D. Definitions
Section 6. Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7. Enforcement Code of Colorado Regulations 63 Noncompliance with this Regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders, and/or suspensions or revocation of license. Among others, the penalties provided for in §10-3-1108, C.R.S. may be applied. Section 8. Effective Date This regulation shall become effective on June 1, 2009. Section 9. History New regulation effective June 1, 2009.
Regulation 1-2-19 CONTRACT AND RECORD RETENTION RULES FOR PUBLIC ADJUSTERS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Contract and Disclosure Statement Between Public Adjuster and Insured Section 6 Financial Responsibility Section 7 Record Retention Section 8 Severability Section 9 Enforcement Section 10 Effective Date Section 11 History Appendix A Public Adjusters Surety Bond Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of § § 10-1-109 and 10-2-417, C.R.S.
Section 2 Scope and Purpose This regulation sets forth the requirements and standards for contracts between a public adjuster and an Insured. This regulation also sets forth the requirements for the retention of records by public adjusters and the securing of evidence of the financial responsibility of a public adjuster through a surety bond executed and issued by an insurer.
Section 3 Applicability This regulation shall apply to all resident and nonresident public adjusters licensed in the state of Colorado.
Code of Colorado Regulations 64 Section 4 Definitions For purposes of this regulation, and unless the context requires otherwise:
A. "Business entity" shall have the same meaning as defined in §10-2-103(5), C.R.S.
B. "Commissioner" means the Commissioner of Insurance for the state of Colorado.
C. "Division" means the Colorado Division of Insurance.
D. "Erroneous act" means, for the purposes of this regulation, shall include, but not be limited to, a violation of Articles 2 or 3 of Title 10 of the Colorado Revised Statutes and Division of Insurance Regulations.
E. "Home state" means, for the purposes of this regulation, the District of Columbia and any state or territory of the United States in which the public adjuster’s principal place of residence or principal place of business is located. If neither the state in which the public adjuster maintains his or her principal place of residence nor the state in which the public adjuster maintains his or her principal place of business has a substantially similar law governing public adjusters, the public adjuster may declare another state in which he or she becomes licensed and acts as a public adjuster to be the "home state."
F. "Person" shall have the same meaning as defined in § 10-2-103(8), C.R.S.
G. "Public adjuster" shall have the same meaning as defined in § 10-2-103(8.5), C.R.S. Section 5 Contract and Disclosure Statement between Public Adjuster and Insured A. Public adjusters shall ensure that all contracts for their services are in writing and contain the following:
Code of Colorado Regulations 65
B. The contract may specify that the public adjuster may be named as a co-payee on an insurer’s payment of a claim.
C. If the insurer, within seventy-two (72) hours after the date on which the loss is reported to the insurer, either pays or commits in writing to pay to the insured the policy limit of the policy, the public adjuster shall:
D. A public adjuster contract shall not contain any contract term or clause that:
E. Prior to the signing of the contract the public adjuster shall provide the insured with a separate disclosure document regarding the claim process and the contract that states:
F. The contracts and disclosure statement shall be executed in duplicate to provide an original contract and disclosure statement to the public adjuster and an original contract and disclosure statement to the insured. The public adjuster’s original contract and disclosure statement shall be available at all times for inspection by the Commissioner or his or her designee.
G. The public adjuster shall provide the insurer a notification letter, which has been signed by the insured, authorizing the public adjuster to represent the insured’s interest. The letter shall be accompanied by a copy of the signed public adjuster contract.
H. The public adjuster shall give the insured written notice of the insured’s rights as provided in the Colorado Consumer Protection Act, Title 6 of the Colorado Revised Statutes.
I. The insured has the right to rescind the contract within seventy-two (72) hours of the contract being signed. The rescission shall be in writing, addressed to the public adjuster, at the address in the contract, and the insurer, and placed in the mail or delivered to the public adjuster within seventy- two (72) hours.
J. If the insured exercises the right to rescind the contract, anything of value given by the insured under the contract will be returned to the insured within fifteen (15) business days following the receipt by the public adjuster of the cancellation notice.
Section 6 Financial Responsibility Code of Colorado Regulations 67 A. A business entity acting as a public adjuster, as described at § 10-2-103(8.5), C.R.S., is required to obtain a public adjuster license and shall comply with § 10-2-417(2), C.R.S., by securing a surety bond in the format attached hereto as Appendix A.
B. Effective January 1, 2014, all persons and business entities originally licensed as a public adjuster pursuant to § 10-2-417,C.R.S (2012) must secure a surety bond in the format attached hereto as Appendix A, which is executed and issued by an insurer authorized to issue surety bonds in this state in order to satisfy the financial responsibility requirements of § 10-2-417(2), C.R.S. Effective January 1, 2014, a failure on the part of a person or business entity originally licensed as a public adjuster pursuant to § 10-2-417, C.R.S. (2012), to secure a surety bond in the format attached hereto as Appendix A shall result in the summary suspension of the public adjuster licensee.
C. Prior to receiving a public adjuster license, a person or business entity applying for the public adjuster license must secure a surety bond in the format attached hereto as Appendix A, which is executed and issued by an insurer authorized to issue surety bonds in this state in order to satisfy the financial responsibility requirements of § 10-2-417(2), C.R.S. A failure on the part of the person or business entity to secure the surety bond in the format attached hereto as Appendix A shall result in the denial of the license application.
D. The original surety bond and power of attorney required pursuant to Section 6.B., above shall be mailed or delivered to the Commissioner of Insurance on or before January 2, 2014.
E. The original surety bond and power of attorney required pursuant to Section 6.C. above shall be submitted, to the Division of Insurance, with the application for licensure. Section 7 Record Retention A. A public adjuster shall maintain a complete record of each transaction as a public adjuster. The records required by this section shall be retained for five (5) years from the date of contract or upon completion of contract, whichever is longer. The records required by this section include the following:
Code of Colorado Regulations 68
Section 10 Effective Date This regulation shall be effective January 1, 2014.
Section 11 History Original Regulation 1-2-19, effective January 1, 2014.
APPENDIX A Code of Colorado Regulations 69 _________________________________________________________________________ Editor’s Notes History Regulation 1-1-2 eff. 12/01/2007.
Regulation 08-E-1 emer. rule eff. 01/01/2008.
Regulations 1-1-9; 1-2-5 eff. 2/1/2008.
Code of Colorado Regulations 70 Regulation 08-E-3 emer. rule eff. 06/01/2008.
Regulation 1-2-10 eff. 07/01/2008.
Regulation 1-2-1 eff. 01/01/2009.
Regulation 08-E-7 emer. rule eff. 01/01/2009.
Regulations 1-1-8, 1-2-10, 1-2-11 eff. 02/01/2009.
Regulation 1-2-17 eff. 03/02/2009.
Regulation 1-2-18 eff. 06/01/2009.
Regulation 1-2-10 eff. 07/01/2009.
Regulation 1-2-13 eff. 10/01/2009.
Regulations 1-2-14, 1-2-16 eff. 11/01/2009.
Regulation 09-E-05 emer. rule eff. 12/03/2009; expired 03/03/2010. Regulation 1-2-10 eff. 01/01/2010.
Regulation 1-1-6 eff. 01/01/2012.
Regulation 1-1-4 Repealed eff. 02/01/2012.
Regulation 1-1-1 eff. 06/01/2012.
Regulation 1-1-8 eff. 07/01/2012.
Regulations 12-E-01, 12-E-09, 12-E-02, 12-E-04, 12-E-10, 12-E-05, 12-E-07 emer. rule eff. 07/01/2012; regulation 1-2-15 repealed emer. rule eff. 07/01/2012.
Regulation 1-2-7 eff. 10/01/2012.
Regulations 1-2-4 – 1-2-5, 1-2-10 – 1-2-11, 1-2-13 – 1-2-14, 1-2-16 eff. 10/15/2012; regulation 1-2-15 repealed eff. 10/15/2012.
Regulation 1-1-9 eff. 04/01/2013.
Regulation 1-1-6 emer. rule repealed eff. 06/28/2013.
Regulation 1-1-6 repealed eff. 10/01/2013.
Regulations 1-2-4, 1-2-10, 1-2-19 eff. 01/01/2014.
Regulations 1-1-2, 1-2-12 repealed eff. 01/15/2014.
Annotations Code of Colorado Regulations 71 Insurer's response did not substantially address the DOI’s first letter of inquiry against insurer thus triggering a violation of regulation. Colo. Div. of Ins. v. Auto-Owner's Ins. Co., Colo. App. 08CA0960 (2009).
Emergency Regulation 09-E-05 (eff. 12/03/2009) superseded and replaced Regulation 1-2-13 (eff. 10/01/2009). Upon expiration of the emergency regulation, the regulation was removed from the CCR. However, prior to expiration of the emergency regulation, the Denver District Court (Case No. 2009 CV 11706, Quesada v. Morrison ) temporarily enjoined the enforcement of Emergency Regulation 09-E-05 and ordered that the prior governing regulation, 1-2-13, remain in effect. The Court later granted the parties’ stipulated motion to dismiss, effective upon the expiration of Emergency Regulation 09-E-05 on 03/03/2010. Per agency request, prior Regulation 1-2-13, eff. 10/01/2009, has been restored to its place in 3 CCR 702-1, in order to effectuate the intent of the Court and the parties that the prior regulation be reinstated upon the expiration of Emergency Regulation 09-E-05. Code of Colorado Regulations 72