Effective – 28 Aug 1998 376.1075. Definitions. — As used in sections 376.1075 to 376.1095, the following terms mean: (1) “Administrator”, “third-party administrator” or “TPA”, a person who directly or indirectly solicits or effects coverage of, underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, or residents of […]
Effective – 28 Aug 1993 376.1077. Administrator to have agreement with insurer, form, contents — termination, how. — 1. No administrator shall act as such without a written agreement between the administrator and the insurer, and such written agreement shall be retained as part of the official records of both the insurer and the administrator […]
Effective – 28 Aug 1993 376.1080. Payments of premiums and claims deemed paid, when. — If an insurer uses the services of an administrator, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured party shall be deemed to have been received by the insurer, and […]
Effective – 28 Aug 1993 376.1082. Records maintained by administrator for insurer — director may examine records — records owned by insurer, transfer allowed, when. — 1. Every administrator shall maintain and make available to the insurer complete books and records of all transactions performed on behalf of the insurer. The books and records shall […]
Effective – 28 Aug 1993 376.1083. Advertising restrictions for administrator. — An administrator may use only such advertising pertaining to the business underwritten by an insurer as has been approved in writing by the insurer in advance of its use. ——– (L. 1993 H.B. 709 § 45)
Effective – 28 Aug 1993 376.1084. Insurer responsible for benefits and underwriting practices — insurer to conduct review of administrator, when. — 1. If an insurer uses the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria and claims payment procedures applicable to such coverage and for […]
Effective – 28 Aug 1993 376.1085. Premiums held in fiduciary capacity, duties — financial records, duties — withdrawals from fiduciary account by agreement only, contents — payment of claims. — 1. All insurance charges or premiums collected by an administrator on behalf of or for an insurer or insurers, and the return of premiums received […]
Effective – 28 Aug 1993 376.1087. Commissions not to be contingent on savings in payment of claims — may be based on premiums collected. — 1. An administrator shall not enter into any agreement or understanding with an insurer in which the effect is to make the amount of the administrator’s commissions, fees or charges […]
Effective – 28 Aug 1993 376.1088. Notice to policyholder of administrator, contents, required — disclosure of receipts to insurer. — 1. When the services of an administrator are used, the administrator shall provide a written notice to, and approved by, the insurer to covered individuals advising them of the identity of, and relationship among, the […]
Effective – 28 Aug 1993 376.1090. Materials delivered to administrator for insured to be promptly delivered. — Any policies, certificates, booklets, termination notices or other written communications delivered by the insurer to the administrator for delivery to insured parties or covered individuals shall be delivered by the administrator promptly after receipt of instructions from the […]
Effective – 28 Aug 1993 376.1092. Certificate of authority, required, application, contents, fee — refusal to issue, when — renewal — bond, required when. — 1. No person shall act as, or offer to act as, or hold himself out to be an administrator in this state without a valid certificate of authority as an […]
Effective – 28 Aug 1993 376.1093. Annual report filed with director, when — contents — filing fee, amount. — 1. Each administrator shall file an annual report for the preceding calendar year with the director on or before March first of each year, or within such extension of time therefor as the director for good […]
Effective – 28 Aug 2007 376.1094. Certificate of authority, suspension or revocation, grounds — civil action, when. — 1. The director shall suspend or revoke the certificate of authority of an administrator if the director finds that the administrator: (1) Is in an unsound financial condition; (2) Is using such methods or practices in the […]
Effective – 28 Aug 1995 376.1095. Rules and regulations, promulgation. — The director shall have the power to promulgate such rules and regulations as are necessary to implement the provisions of sections 376.1075 to 376.1095. No rule or portion of a rule promulgated under the authority of sections 376.1075 to 376.1095 shall become effective unless […]
