Current through 11/5/2024 election
Section 10-20-119 - Prohibited advertisement of association article in insurance sales - notice to owners, certificate holders, and enrollees(1) A person, including a member insurer and any agent or affiliate of a member insurer, shall not make, publish, disseminate, circulate, or place before the public, or cause directly or indirectly to be made, published, disseminated, circulated, or placed before the public, in any newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio station or television station, or in any other way, any advertisement, announcement, or statement, written or oral, that uses the existence of the life and health insurance protection association for the purpose of sales, solicitation, or inducement to purchase any form of insurance or other coverage covered by this article 20. However, this section does not apply to the association or any other entity that does not sell or solicit insurance or coverage by a health maintenance organization.(2) The association shall prepare a summary document, in compliance with subsection (3) of this section, describing the general purposes and current limitations of this article 20. The association shall submit the summary document to the commissioner for approval. Sixty days after receiving approval from the commissioner, each member insurer, when delivering a policy or contract as described in section 10-20-104 (2)(a) to an owner, a certificate holder, or an enrollee, shall deliver the summary document concurrently with or before delivering the policy or contract unless subsection (4) of this section applies. The member insurer shall also make the summary document available upon request by an owner, a certificate holder, or an enrollee. The distribution, delivery, or contents or interpretation of the summary document does not mean that either the policy or the contract or the owner, certificate holder, or enrollee will be covered in the event of impairment or insolvency of a member insurer. The association shall revise the summary document as necessary based on amendments to this article 20 or as other circumstances may require. Failure to receive this summary document does not give an owner, a certificate holder, an insured, or an enrollee any rights other than those stated in this article 20.(3) The summary document prepared pursuant to subsection (2) of this section must contain a clear and conspicuous disclaimer on its face. The commissioner shall establish the form and content of the disclaimer. The disclaimer must: (a) State the name and address of the association and the division of insurance;(b) Prominently warn the owner, certificate holder, or enrollee that the association may not cover the policy or contract or, if coverage is available, the policy or contract may be subject to substantial limitations and exclusions and is conditioned on the continued residence in the state by the owner, insured, certificate holder, or enrollee;(c) State that the member insurer and its agents are prohibited by law from using the existence of the association for the purpose of sales, solicitation, or inducement to purchase any form of insurance or health maintenance organization coverage;(d) Emphasize that the owner, certificate holder, or enrollee should not rely on coverage by the association when selecting a member insurer; and(e) Provide other information as directed by the commissioner.(4) A member insurer or agent of a member insurer shall not deliver a policy or contract that is described in section 10-20-104 (2)(a) but excluded under section 10-20-104 (2)(b)(I) from coverage under this article 20 unless the member insurer or agent, before or at the time of delivery, gives the owner, certificate holder, or enrollee a separate written notice that clearly and conspicuously discloses that the policy or contract is not covered by the association. The commissioner shall specify the form and content of the notice.Amended by 2023 Ch. 195,§ 15, eff. 5/15/2023.L. 91: Entire article added, p. 1280, § 1, effective July 1.