SENATE BILL 97109
BY SENATOR Schroeder;
also REPRESENTATIVE Schauer.
CONCERNING THE ADMINISTRATIVE AUTHORITY OF THE DIVISION
OF INSURANCE TO OBTAIN INFORMATION RELATED TO THE FINANCIAL AFFAIRS
OF INSURERS, AND, IN CONNECTION THEREWITH, AMENDING STATUTES REQUIRING
FILING OF INFORMATION WITH THE DIVISION OF INSURANCE AND DEFINING
THE DIVISION'S AUTHORITY WITH REGARD TO FINANCIAL EXAMINATIONS.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. 844113
(4), Colorado Revised Statutes, 1986 Repl. Vol., as amended, is
RECREATED AND REENACTED, WITH AMENDMENTS, to read:
844113. Data from insurance
carriers and selfinsured employers related to workers' compensation
studies related to workers' compensation system
repeal. (4) (a) SELFINSURED
EMPLOYERS SHALL CONTINUE UNDER THE AUTHORITY OF THE EXECUTIVE
DIRECTOR AS PROVIDED IN PART 2 OF THIS ARTICLE.
(b) THE EXECUTIVE DIRECTOR ANNUALLY SHALL
COLLECT DATA FROM SELFINSURED EMPLOYERS COMPARABLE TO THE
DATA COLLECTED FROM INSURERS BY THE COMMISSIONER OF INSURANCE
FOR PURPOSES OF UPDATING THE 1993 COLORADO WORKERS' COMPENSATION
CLOSED CLAIM STUDY. THE GENERAL ASSEMBLY INTENDS THAT THIS DATA
COLLECTION REQUIREMENT BE NO MORE BURDENSOME THAN NECESSARY AND
THAT EACH ELEMENT OF THE DATA COLLECTED AND ALL ELEMENTS OF DATA
BE NO MORE INCLUSIVE THAN THE CORRESPONDING ELEMENT OF DATA AND
ALL ELEMENTS COLLECTED BY THE COMMISSIONER OF INSURANCE. IN ADDITION:
(I) ELEMENTS OF DATA REQUIRED TO BE COLLECTED
PURSUANT TO THIS PARAGRAPH (b) THAT HAVE BEEN PREVIOUSLY REPORTED
BY SELFINSURED EMPLOYERS TO THE EXECUTIVE DIRECTOR SHALL
BE EXTRACTED FROM THE DEPARTMENT'S DATA BASE AND FORWARDED TO
THE COMMISSIONER RATHER THAN REQUIRED TO BE REPORTED PURSUANT
TO THIS SECTION.
(II) DATA SHALL BE COLLECTED ON CLOSED
INDEMNITY CLAIMS ONLY.
(III) DATA SHALL BE COLLECTED ANNUALLY
ON NOVEMBER 15 OF EACH YEAR.
(IV) DATA SHALL BE COLLECTED ON A RANDOMSAMPLE
BASIS. THE NUMBER OF CLAIMS SELECTED FOR DATA COLLECTION SHALL
BE NO GREATER THAN THAT ESTABLISHED BY THE COMMISSIONER FOR PURPOSES
OF THE REPORT PURSUANT TO THIS PARAGRAPH (b).
SECTION 2. 1016107
(2) and (3) (e), Colorado Revised Statutes, 1994 Repl. Vol., are
amended to read:
1016107. Rate regulation
approval of policy forms benefit certificates
evidences of coverage loss ratio guarantees.
(2) No policy of sickness and accident insurance or
subscription certificate or membership certificate or other evidence
of health care coverage shall be delivered or issued for delivery
in this state, nor shall any endorsement, rider, or application
which
THAT becomes a part of any such policy, contract, or evidence
of coverage be used, until the insurer has filed a certification
with the commissioner that such policy, endorsement, rider, or
application conforms, to the best of the insurer's good faith
knowledge and belief, to Colorado law pursuant to section 1016107.2
and a copy
COPIES of the premium
rates or dues
and a copy of
the classification of risks or subscribers pertaining thereto
are filed with the commissioner.
(3) (e) (I) No schedule of charges
or rates for enrollee coverage for health care services, or amendments
thereto, may be used by a health maintenance organization until
a copy of such schedule of charges
or rates, or amendments thereto,
has been filed with the commissioner AT LEAST thirty days prior
to its effective date, except individual group rates which
THAT shall be filed concurrent with or prior to the effective
date.
(II) Such charges
or rates may be established in accordance
with actuarial principles for various categories of enrollees,
if charges or
rates applicable to an enrollee shall not be individually determined
based on the status of such enrollee's health. The charges
or rates shall not be excessive,
inadequate, or unfairly discriminatory. An annual certification,
by a qualified actuary, to the appropriateness of the charges
or rates, based on reasonable assumptions,
shall accompany the filing along with adequate supporting information.
Such supporting information and any other additional background
information regarding the charges
or rates requested by the commissioner
or required by regulation shall not be treated as a public record
subject to part 2 of article 72 of title 24, C.R.S., or section
1016422.
SECTION 3. 1016416
(1), Colorado Revised Statutes, 1994 Repl. Vol., is amended to
read:
1016416. Examination.
(1) The commissioner may make an examination of the
affairs of any health maintenance organization and providers with
whom such organization has contracts, agreements, or other arrangements
pursuant to its health care plan as often as the commissioner
deems it necessary for the protection of the interests of the
people of this state but not less frequently than once every three
FIVE years.
SECTION 4. 103209,
Colorado Revised Statutes, 1994 Repl. Vol., as amended, is amended
BY THE ADDITION OF A NEW SUBSECTION to read:
103209. Tax on premiums
collected exemptions penalties.
(5) FOR THE PURPOSE OF AUDITING A COMPANY'S TAX STATEMENT,
THE COMMISSIONER OR THE COMMISSIONER'S DESIGNEE HAS THE POWER
TO EXAMINE ANY BOOKS, PAPERS, RECORDS, AGREEMENTS, OR MEMORANDA
BEARING UPON THE MATTERS REQUIRED TO BE INCLUDED IN THE TAX STATEMENT.
SUCH BOOKS, PAPERS, RECORDS, AGREEMENTS, OR MEMORANDA SHALL BE
MADE AVAILABLE UPON REQUEST TO THE COMMISSIONER'S OFFICE.
SECTION 5. 1031004
(1), Colorado Revised Statutes, 1994 Repl. Vol., is amended, and
the said 1031004 is further amended BY THE ADDITION
OF A NEW SUBSECTION, to read:
1031004. Defense of action
by unauthorized insurer. (1) Before
any unauthorized foreign or alien insurer files or causes to be
filed any pleading in any action, suit, or proceeding instituted
against it, such unauthorized insurer shall either deposit, with
the clerk of the court in which such action, suit, or proceeding
is pending, cash or securities, or file with such clerk a bond
with good and sufficient sureties, to be approved by the court,
in an amount to be fixed by the court sufficient to secure the
payment of any final judgment which may be rendered in such action,
or procure a certificate of authority to transact the business
of insurance in this state, UNLESS ONE OR MORE OF THE FOLLOWING
IS APPLICABLE:
(a) THE INSURER MAKES A SHOWING SATISFACTORY
TO THE COURT AND THE COMMISSIONER THAT THERE ARE, IN THIS STATE
OR IN ANOTHER STATE, CASH, SECURITIES, BOND, OR OTHER ASSETS SUFFICIENT
AND AVAILABLE TO SECURE THE PAYMENT OF ANY FINAL JUDGMENT WHICH
MAY BE RENDERED IN THE ACTION, SUIT, OR PROCEEDING OR THAT THE
INSURANCE WAS PLACED LAWFULLY IN THE JURISDICTION IN WHICH THE
TRANSACTION TOOK PLACE AND WHICH WAS NOT AN UNLAWFUL PLACEMENT
UNDER THE LAWS OF THIS STATE.
(b) AT THE TIME THE INSURER FILES ANY
PLEADING IN ANY ACTION, SUIT, OR PROCEEDING INSTITUTED AGAINST
IT, THE INSURER IS LISTED ON THE APPROVED NONADMITTED INSURERS
LIST PREPARED BY THE COMMISSIONER PURSUANT TO SUBSECTION (1) OF
SECTION 105108;
(c) WITH RESPECT TO A CONTRACT OF REINSURANCE,
THE REINSURER HAS COMPLIED WITH THE PROVISIONS OF THIS TITLE,
NECESSARY TO PERMIT THE CEDING INSURER TO TAKE CREDIT ON ITS FINANCIAL
STATEMENT FOR THE REINSURANCE PURSUANT TO SUBSECTIONS (5) AND
(6) OF SECTION 103118; OR
(1.5) IF AN INSURER OR REINSURER ASSERTS
AN EXEMPTION UNDER PARAGRAPHS (a), (b), OR (c) OF SUBSECTION (1)
OF THIS SECTION, SUCH INSURER OR REINSURER SHALL NOTIFY THE COURT
OF THE BASIS ON WHICH THE EXEMPTION IS SOUGHT AND SHALL FILE A
COPY OF THE ASSERTION WITH THE COMMISSIONER OF INSURANCE.
SECTION 6. Effective
date applicability. This act shall take effect
upon passage and shall apply to acts occurring on or after said
date.
SECTION 7. Safety
clause. The general assembly hereby finds, determines, and
declares that this act is necessary for the immediate preservation
of the public peace, health, and safety.
____________________________ ____________________________
Tom Norton Charles E. Berry
PRESIDENT OF SPEAKER OF THE HOUSE
THE SENATE OF REPRESENTATIVES
____________________________ ____________________________
Joan M. Albi Judith M. Rodrigue
SECRETARY OF CHIEF CLERK OF THE HOUSE
THE SENATE OF REPRESENTATIVES
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE OF COLORADO