40-2215.Forms and premium rates, filing,duties of commissioner; procedure; rules and regulation, violations,penalties.(a) No individual policy of accident and sickness insurance as definedin K.S.A. 40-2201 and amendments thereto shall be issued or deliveredto any person in thisstate nor shall any application, rider or endorsement be used inconnection therewith, until a copy of the form thereof and of theclassification of risks and the premium rates pertaining thereto, havebeen filed with the commissioner of insurance.
(b) No group or blanket policy or certificate of accident and sicknessinsuranceproviding hospital, medical or surgical expense benefits shall be issued ordelivered to any person in this state, nor shall any application, rider orendorsement be used in connection therewith, until a copy of the form thereofand of the classification of risks and the premium rates pertaining thereto hasbeen filed with the commissioner of insurance.
(c) (1) No such policy shall be issued, nor shall any application,rider or endorsement be used in connection therewith, until the expiration of30 days after it has been filed unless the commissioner gives writtenapproval thereof.
(2) (A) The commissioner shall create a requirementsdocument containing filing requirements for each typeof insurance. Such requirements document shall containa list of all product filing requirements for each type ofinsurance that is required to be filed. For each type ofinsurance, such requirements document shall contain anappropriate citation to each requirement contained inany statute, rule and regulation and publishedbulletins in this state having the force and effect of law.Such requirements document shall be available on theinsurance department internet website.
(B) The commissioner shall update therequirements document referred to insubparagraph (A) no less frequently thanannually. The commissioner shall update therequirements document referred to insubparagraph (A) within 30 days after theeffective date of any change in law, rule andregulation or bulletin published by thecommissioner having the force and effect of lawin this state.
(3) A filer shall submit with each policy form filing adocument indicating the location within the policy formor any supplemental document for informationestablishing compliance with each requirementcontained in the requirements documents referenced insubparagraph (A) of paragraph (2) of this subsection. Afiler shall certify that the policy form, including anyaccompanying supplemental document, meets allrequirements of state law.
(d) (1) Any risk classifications, premium rates, ratingformulae, and all modifications thereof applicable to Kansas residents shallnot establishan unreasonable, excessive or unfairly discriminatory rateor, with respect to group or blanket sickness and accidentpolicies providing hospital, medical or surgical expense benefits issuedpursuant to K.S.A. 40-2209 or 40-2210, and amendmentsthereto, discriminate against any individuals eligible for participation ina group, or establish rating classifications within a group that are based onmedical conditions.In no event shall the rates charged to any group to which thissubsection applies increase by more than 75% during any annual period unlessthe insurer can clearly document a material and significant change in the riskcharacteristics of the group.
(2) All rates forsickness and accident insurance providinghospital, medical or surgical expense benefits coveringKansas residents shall be made in accordance with thefollowing provisions and due consideration shall begiven to:
(A) Past and prospective loss experience;
(B) past and prospective expenses;
(C) adequate contingency reserves; and
(D) all other relevant factors within and withoutthe state.
(3) Nothing in this act is intended to prohibit or discouragereasonable competition or discourage or prohibit uniformity of rates exceptto the extent necessary to accomplish the aforementioned purpose. Thecommissioner is hereby authorized to issue such rules and regulations asare necessary and not inconsistent with this act.
(e) All parties in the filing process shall act in goodfaith and with due diligence in performance of their duties pursuant to thissection.
(f) (1) Within 30 days of receipt of the initial filing, thecommissioner shall review and approve such filing orprovide notice of any deficiency or disapprove the initialfiling. Any notice of deficiency or disapproval shall bein writing and based only on the specific provisions ofapplicable statutes, regulations or bulletins published bythe commissioner having the force and effect of law inthis state and contained in the requirements documentcreated by the commissioner pursuant to subparagraph(A) of paragraph (2) of subsection (c). The notice ofdeficiency or disapproval shall provide specific reasonsfor notice of deficiencies or disapproval. Such reasonsshall contain sufficient detail for the filer to bring thepolicy form into compliance, and shall cite each specificstatute, rule and regulation or bulletin having the forceand effect of law in this state upon which the notice ofdeficiency or disapproval is based. Any notice ofdisapproval provided by the commissioner shall statethat a hearing will be granted within 20 days afterreceipt of a written request therefor by the insurer. Atthe end of the 30 day period, the policy form shall bedeemed approved if the commissioner has taken noaction.
(2) In addition to the statutes, regulations orbulletins described in paragraph (2) ofsubsection (c), the commissioner may disapprovea filing or provide a notice of deficiency for anyform for which the commissioner determinesthat the benefits provided therein areunreasonable in relation to the premiumcharged; or if such form contains any provisionswhich are unjust, unfair, inequitable,misleading, deceptive or encouragemisrepresentation of such policy. Any notice ofdisapproval provided by the commissionerpursuant to this paragraph shall state that ahearing will be granted within 20 days afterreceipt of a written request therefor by theinsurer.
(3) If the insurer has received a disapproval ornotice of deficiency or disapproval regarding apolicy form, it shall be unlawful for an insurerto issue such policy form or use such policyform in connection with any policy until thatpolicy form has received a later approval by thecommissioner.
(4) Within 30 days of receipt of thecommissioner's notice of deficiency ordisapproval, a filer may resubmit a policy form that corrects any deficienciesor resubmit adisapproved policy form and a revisedcertification. Any policy form not resubmitted tothe commissioner within 30 days of the noticeof deficiency shall be deemed withdrawn. Anydisapproved policy form not resubmitted to thecommissioner within 30 days of the notice ofdisapproval shall be deemed disapproved.
(5) (A) Within 30 days of receipt of aresubmitted filing and certification, thecommissioner shall review the resubmittedfiling and certification, and shall approve ordisapprove such resubmitted filing andcertification. Any notice of disapprovalpertaining to the resubmitted filing andcertification shall be in writing and provide adetailed description of the reasons for thedisapproval in sufficient detail for the filer tobring the policy form into compliance. Thenotice of disapproval shall cite each specificstatute, rule and regulation or bulletin having theforce and effect of law in this state upon whichthe disapproval is based. No further extensionof time may be taken unless the filer hasintroduced new provisions in the resubmittedfiling and certification or the filer has materiallymodified any substantive provisions of thepolicy form, in which case the commissionermay extend the time for review by an additional30 days. At the end of this 30 day review period,the policy form shall be deemed approved if thecommissioner has taken no action.
(B) (i) Subject to clause (ii) of thissubparagraph, the commissioner may notdisapprove a resubmitted policy form forreasons other than those initially set forth in theoriginal notice of deficiencies or disapprovalsent pursuant to paragraph (1) of this subsection.
(ii) The commissioner may disapprove aresubmitted policy form for reasons other thanthose initially set forth in the original notice ofdeficiencies or disapproval sent pursuant to thissubsection if:
(a) The filer has introduced newprovisions in the resubmitted policyform and certification;
(b) the filer has materially modified anysubstantive provisions of the policyform;
(c) there has been a change in any statute, rule and regulation or publishedbulletin in this state having the forceand effect of law; or
(d) there has been reviewer error andthe written disapproval fails to state aspecific provision of applicable statute,regulation or bulletin published by thecommissioner having the force andeffect of law in this state that isnecessary to have the policy formconform to the requirements of law.
(6) At the end of the review period, the policyform shall be deemed approved if thecommissioner has taken no action.
(7) Notwithstanding any other provision in thissection, the commissioner may return a grosslyinadequate filing to the filer without triggeringany of the time deadlines set forth in thissection. For purposes of this paragraph, the term"grossly inadequate filing" means a filing thatfails to provide key information, including state-specific information,regarding a product, policyor rate, or that demonstrates an insufficientunderstanding of what is required to complywith state statutes or regulations.
(g) Except in cases of a material error or omission in apolicy form that has been approved or deemed approvedpursuant to the provisions of this act, the commissionershall not:
(1) Retroactively disapprove that filing; or
(2) with respect to those policy forms, examine thefiler during a routine or targeted market conductexamination for compliance with any later-enactedpolicy form filing requirements.
(h) If a rate filing or marketing material is required tobe filed or approved by state law for a specific policyform, the time frames for review, approval ordisapproval, resubmission, and re-review of those ratefilings or marketing materials shall be the same asthose provided for in subsection (f) for the review ofpolicy forms.
(i) For purposes of this section:
(1) "Accident and sickness carrier" means anentity licensed to offer accident and sicknessinsurance in this state, or subject to theinsurance laws and regulations of this state, orsubject to the jurisdiction of the commissioner,that contracts or offers to contract to provide,deliver, arrange for, pay for or reimburse anyof the costs of health care services or any insurer that provides policies ofsupplemental,disability income, medicare supplement orlong-term care insurance.
(2) "Commissioner" means the commissionerof insurance.
(3) "Health care services" means services forthe diagnosis, prevention, treatment, cure orrelief of a health condition, illness or disease.
(4) "Policy form" means any policy, contract,certificate, rider, endorsement, evidence ofcoverage of any amendments thereto that arerequired by law to be filed with thecommissioner for approval prior to their saleor issuance for sale in this state.
(5) "Supplemental documents" means anydocuments required to be filed in support ofpolicy forms that may or may not be subject toapproval.
(6) "Type of insurance" means any hospital ormedical expense policy, health, hospital ormedical service corporation contract, and aplan provided by a municipal group-fundedpool, or a health maintenance organizationcontract offered by an employer or anycertificate issued under any such policies,contracts or plans, policies or certificatescovering only accident, credit, dental,disability income, long-term care, hospitalindemnity, medicare supplement, specifieddisease, vision care, coverage issued as asupplement to liability insurance.
(j) This section shall apply to any individual or grouppolicy form issued by an accident and health carrierrequired to be filed with the commissioner for reviewor approval.
(k) Violations of subsection (d) shall betreated asviolations of theunfair trade practices act and subject to the penalties prescribed by K.S.A.40-2407 and 40-2411 and amendments thereto.
(l) Hearings under this section shall be conducted inaccordancewith the provisions of the Kansas administrative procedure act.
40-2215.Forms and premium rates, filing,duties of commissioner; procedure; rules and regulation, violations,penalties.(a) No individual policy of accident and sickness insurance as definedin K.S.A. 40-2201 and amendments thereto shall be issued or deliveredto any person in thisstate nor shall any application, rider or endorsement be used inconnection therewith, until a copy of the form thereof and of theclassification of risks and the premium rates pertaining thereto, havebeen filed with the commissioner of insurance.
(b) No group or blanket policy or certificate of accident and sicknessinsuranceproviding hospital, medical or surgical expense benefits shall be issued ordelivered to any person in this state, nor shall any application, rider orendorsement be used in connection therewith, until a copy of the form thereofand of the classification of risks and the premium rates pertaining thereto hasbeen filed with the commissioner of insurance.
(c) (1) No such policy shall be issued, nor shall any application,rider or endorsement be used in connection therewith, until the expiration of30 days after it has been filed unless the commissioner gives writtenapproval thereof.
(2) (A) The commissioner shall create a requirementsdocument containing filing requirements for each typeof insurance. Such requirements document shall containa list of all product filing requirements for each type ofinsurance that is required to be filed. For each type ofinsurance, such requirements document shall contain anappropriate citation to each requirement contained inany statute, rule and regulation and publishedbulletins in this state having the force and effect of law.Such requirements document shall be available on theinsurance department internet website.
(B) The commissioner shall update therequirements document referred to insubparagraph (A) no less frequently thanannually. The commissioner shall update therequirements document referred to insubparagraph (A) within 30 days after theeffective date of any change in law, rule andregulation or bulletin published by thecommissioner having the force and effect of lawin this state.
(3) A filer shall submit with each policy form filing adocument indicating the location within the policy formor any supplemental document for informationestablishing compliance with each requirementcontained in the requirements documents referenced insubparagraph (A) of paragraph (2) of this subsection. Afiler shall certify that the policy form, including anyaccompanying supplemental document, meets allrequirements of state law.
(d) (1) Any risk classifications, premium rates, ratingformulae, and all modifications thereof applicable to Kansas residents shallnot establishan unreasonable, excessive or unfairly discriminatory rateor, with respect to group or blanket sickness and accidentpolicies providing hospital, medical or surgical expense benefits issuedpursuant to K.S.A. 40-2209 or 40-2210, and amendmentsthereto, discriminate against any individuals eligible for participation ina group, or establish rating classifications within a group that are based onmedical conditions.In no event shall the rates charged to any group to which thissubsection applies increase by more than 75% during any annual period unlessthe insurer can clearly document a material and significant change in the riskcharacteristics of the group.
(2) All rates forsickness and accident insurance providinghospital, medical or surgical expense benefits coveringKansas residents shall be made in accordance with thefollowing provisions and due consideration shall begiven to:
(A) Past and prospective loss experience;
(B) past and prospective expenses;
(C) adequate contingency reserves; and
(D) all other relevant factors within and withoutthe state.
(3) Nothing in this act is intended to prohibit or discouragereasonable competition or discourage or prohibit uniformity of rates exceptto the extent necessary to accomplish the aforementioned purpose. Thecommissioner is hereby authorized to issue such rules and regulations asare necessary and not inconsistent with this act.
(e) All parties in the filing process shall act in goodfaith and with due diligence in performance of their duties pursuant to thissection.
(f) (1) Within 30 days of receipt of the initial filing, thecommissioner shall review and approve such filing orprovide notice of any deficiency or disapprove the initialfiling. Any notice of deficiency or disapproval shall bein writing and based only on the specific provisions ofapplicable statutes, regulations or bulletins published bythe commissioner having the force and effect of law inthis state and contained in the requirements documentcreated by the commissioner pursuant to subparagraph(A) of paragraph (2) of subsection (c). The notice ofdeficiency or disapproval shall provide specific reasonsfor notice of deficiencies or disapproval. Such reasonsshall contain sufficient detail for the filer to bring thepolicy form into compliance, and shall cite each specificstatute, rule and regulation or bulletin having the forceand effect of law in this state upon which the notice ofdeficiency or disapproval is based. Any notice ofdisapproval provided by the commissioner shall statethat a hearing will be granted within 20 days afterreceipt of a written request therefor by the insurer. Atthe end of the 30 day period, the policy form shall bedeemed approved if the commissioner has taken noaction.
(2) In addition to the statutes, regulations orbulletins described in paragraph (2) ofsubsection (c), the commissioner may disapprovea filing or provide a notice of deficiency for anyform for which the commissioner determinesthat the benefits provided therein areunreasonable in relation to the premiumcharged; or if such form contains any provisionswhich are unjust, unfair, inequitable,misleading, deceptive or encouragemisrepresentation of such policy. Any notice ofdisapproval provided by the commissionerpursuant to this paragraph shall state that ahearing will be granted within 20 days afterreceipt of a written request therefor by theinsurer.
(3) If the insurer has received a disapproval ornotice of deficiency or disapproval regarding apolicy form, it shall be unlawful for an insurerto issue such policy form or use such policyform in connection with any policy until thatpolicy form has received a later approval by thecommissioner.
(4) Within 30 days of receipt of thecommissioner's notice of deficiency ordisapproval, a filer may resubmit a policy form that corrects any deficienciesor resubmit adisapproved policy form and a revisedcertification. Any policy form not resubmitted tothe commissioner within 30 days of the noticeof deficiency shall be deemed withdrawn. Anydisapproved policy form not resubmitted to thecommissioner within 30 days of the notice ofdisapproval shall be deemed disapproved.
(5) (A) Within 30 days of receipt of aresubmitted filing and certification, thecommissioner shall review the resubmittedfiling and certification, and shall approve ordisapprove such resubmitted filing andcertification. Any notice of disapprovalpertaining to the resubmitted filing andcertification shall be in writing and provide adetailed description of the reasons for thedisapproval in sufficient detail for the filer tobring the policy form into compliance. Thenotice of disapproval shall cite each specificstatute, rule and regulation or bulletin having theforce and effect of law in this state upon whichthe disapproval is based. No further extensionof time may be taken unless the filer hasintroduced new provisions in the resubmittedfiling and certification or the filer has materiallymodified any substantive provisions of thepolicy form, in which case the commissionermay extend the time for review by an additional30 days. At the end of this 30 day review period,the policy form shall be deemed approved if thecommissioner has taken no action.
(B) (i) Subject to clause (ii) of thissubparagraph, the commissioner may notdisapprove a resubmitted policy form forreasons other than those initially set forth in theoriginal notice of deficiencies or disapprovalsent pursuant to paragraph (1) of this subsection.
(ii) The commissioner may disapprove aresubmitted policy form for reasons other thanthose initially set forth in the original notice ofdeficiencies or disapproval sent pursuant to thissubsection if:
(a) The filer has introduced newprovisions in the resubmitted policyform and certification;
(b) the filer has materially modified anysubstantive provisions of the policyform;
(c) there has been a change in any statute, rule and regulation or publishedbulletin in this state having the forceand effect of law; or
(d) there has been reviewer error andthe written disapproval fails to state aspecific provision of applicable statute,regulation or bulletin published by thecommissioner having the force andeffect of law in this state that isnecessary to have the policy formconform to the requirements of law.
(6) At the end of the review period, the policyform shall be deemed approved if thecommissioner has taken no action.
(7) Notwithstanding any other provision in thissection, the commissioner may return a grosslyinadequate filing to the filer without triggeringany of the time deadlines set forth in thissection. For purposes of this paragraph, the term"grossly inadequate filing" means a filing thatfails to provide key information, including state-specific information,regarding a product, policyor rate, or that demonstrates an insufficientunderstanding of what is required to complywith state statutes or regulations.
(g) Except in cases of a material error or omission in apolicy form that has been approved or deemed approvedpursuant to the provisions of this act, the commissionershall not:
(1) Retroactively disapprove that filing; or
(2) with respect to those policy forms, examine thefiler during a routine or targeted market conductexamination for compliance with any later-enactedpolicy form filing requirements.
(h) If a rate filing or marketing material is required tobe filed or approved by state law for a specific policyform, the time frames for review, approval ordisapproval, resubmission, and re-review of those ratefilings or marketing materials shall be the same asthose provided for in subsection (f) for the review ofpolicy forms.
(i) For purposes of this section:
(1) "Accident and sickness carrier" means anentity licensed to offer accident and sicknessinsurance in this state, or subject to theinsurance laws and regulations of this state, orsubject to the jurisdiction of the commissioner,that contracts or offers to contract to provide,deliver, arrange for, pay for or reimburse anyof the costs of health care services or any insurer that provides policies ofsupplemental,disability income, medicare supplement orlong-term care insurance.
(2) "Commissioner" means the commissionerof insurance.
(3) "Health care services" means services forthe diagnosis, prevention, treatment, cure orrelief of a health condition, illness or disease.
(4) "Policy form" means any policy, contract,certificate, rider, endorsement, evidence ofcoverage of any amendments thereto that arerequired by law to be filed with thecommissioner for approval prior to their saleor issuance for sale in this state.
(5) "Supplemental documents" means anydocuments required to be filed in support ofpolicy forms that may or may not be subject toapproval.
(6) "Type of insurance" means any hospital ormedical expense policy, health, hospital ormedical service corporation contract, and aplan provided by a municipal group-fundedpool, or a health maintenance organizationcontract offered by an employer or anycertificate issued under any such policies,contracts or plans, policies or certificatescovering only accident, credit, dental,disability income, long-term care, hospitalindemnity, medicare supplement, specifieddisease, vision care, coverage issued as asupplement to liability insurance.
(j) This section shall apply to any individual or grouppolicy form issued by an accident and health carrierrequired to be filed with the commissioner for reviewor approval.
(k) Violations of subsection (d) shall betreated asviolations of theunfair trade practices act and subject to the penalties prescribed by K.S.A.40-2407 and 40-2411 and amendments thereto.
(l) Hearings under this section shall be conducted inaccordancewith the provisions of the Kansas administrative procedure act.
40-2215.Forms and premium rates, filing,duties of commissioner; procedure; rules and regulation, violations,penalties.(a) No individual policy of accident and sickness insurance as definedin K.S.A. 40-2201 and amendments thereto shall be issued or deliveredto any person in thisstate nor shall any application, rider or endorsement be used inconnection therewith, until a copy of the form thereof and of theclassification of risks and the premium rates pertaining thereto, havebeen filed with the commissioner of insurance.
(b) No group or blanket policy or certificate of accident and sicknessinsuranceproviding hospital, medical or surgical expense benefits shall be issued ordelivered to any person in this state, nor shall any application, rider orendorsement be used in connection therewith, until a copy of the form thereofand of the classification of risks and the premium rates pertaining thereto hasbeen filed with the commissioner of insurance.
(c) (1) No such policy shall be issued, nor shall any application,rider or endorsement be used in connection therewith, until the expiration of30 days after it has been filed unless the commissioner gives writtenapproval thereof.
(2) (A) The commissioner shall create a requirementsdocument containing filing requirements for each typeof insurance. Such requirements document shall containa list of all product filing requirements for each type ofinsurance that is required to be filed. For each type ofinsurance, such requirements document shall contain anappropriate citation to each requirement contained inany statute, rule and regulation and publishedbulletins in this state having the force and effect of law.Such requirements document shall be available on theinsurance department internet website.
(B) The commissioner shall update therequirements document referred to insubparagraph (A) no less frequently thanannually. The commissioner shall update therequirements document referred to insubparagraph (A) within 30 days after theeffective date of any change in law, rule andregulation or bulletin published by thecommissioner having the force and effect of lawin this state.
(3) A filer shall submit with each policy form filing adocument indicating the location within the policy formor any supplemental document for informationestablishing compliance with each requirementcontained in the requirements documents referenced insubparagraph (A) of paragraph (2) of this subsection. Afiler shall certify that the policy form, including anyaccompanying supplemental document, meets allrequirements of state law.
(d) (1) Any risk classifications, premium rates, ratingformulae, and all modifications thereof applicable to Kansas residents shallnot establishan unreasonable, excessive or unfairly discriminatory rateor, with respect to group or blanket sickness and accidentpolicies providing hospital, medical or surgical expense benefits issuedpursuant to K.S.A. 40-2209 or 40-2210, and amendmentsthereto, discriminate against any individuals eligible for participation ina group, or establish rating classifications within a group that are based onmedical conditions.In no event shall the rates charged to any group to which thissubsection applies increase by more than 75% during any annual period unlessthe insurer can clearly document a material and significant change in the riskcharacteristics of the group.
(2) All rates forsickness and accident insurance providinghospital, medical or surgical expense benefits coveringKansas residents shall be made in accordance with thefollowing provisions and due consideration shall begiven to:
(A) Past and prospective loss experience;
(B) past and prospective expenses;
(C) adequate contingency reserves; and
(D) all other relevant factors within and withoutthe state.
(3) Nothing in this act is intended to prohibit or discouragereasonable competition or discourage or prohibit uniformity of rates exceptto the extent necessary to accomplish the aforementioned purpose. Thecommissioner is hereby authorized to issue such rules and regulations asare necessary and not inconsistent with this act.
(e) All parties in the filing process shall act in goodfaith and with due diligence in performance of their duties pursuant to thissection.
(f) (1) Within 30 days of receipt of the initial filing, thecommissioner shall review and approve such filing orprovide notice of any deficiency or disapprove the initialfiling. Any notice of deficiency or disapproval shall bein writing and based only on the specific provisions ofapplicable statutes, regulations or bulletins published bythe commissioner having the force and effect of law inthis state and contained in the requirements documentcreated by the commissioner pursuant to subparagraph(A) of paragraph (2) of subsection (c). The notice ofdeficiency or disapproval shall provide specific reasonsfor notice of deficiencies or disapproval. Such reasonsshall contain sufficient detail for the filer to bring thepolicy form into compliance, and shall cite each specificstatute, rule and regulation or bulletin having the forceand effect of law in this state upon which the notice ofdeficiency or disapproval is based. Any notice ofdisapproval provided by the commissioner shall statethat a hearing will be granted within 20 days afterreceipt of a written request therefor by the insurer. Atthe end of the 30 day period, the policy form shall bedeemed approved if the commissioner has taken noaction.
(2) In addition to the statutes, regulations orbulletins described in paragraph (2) ofsubsection (c), the commissioner may disapprovea filing or provide a notice of deficiency for anyform for which the commissioner determinesthat the benefits provided therein areunreasonable in relation to the premiumcharged; or if such form contains any provisionswhich are unjust, unfair, inequitable,misleading, deceptive or encouragemisrepresentation of such policy. Any notice ofdisapproval provided by the commissionerpursuant to this paragraph shall state that ahearing will be granted within 20 days afterreceipt of a written request therefor by theinsurer.
(3) If the insurer has received a disapproval ornotice of deficiency or disapproval regarding apolicy form, it shall be unlawful for an insurerto issue such policy form or use such policyform in connection with any policy until thatpolicy form has received a later approval by thecommissioner.
(4) Within 30 days of receipt of thecommissioner's notice of deficiency ordisapproval, a filer may resubmit a policy form that corrects any deficienciesor resubmit adisapproved policy form and a revisedcertification. Any policy form not resubmitted tothe commissioner within 30 days of the noticeof deficiency shall be deemed withdrawn. Anydisapproved policy form not resubmitted to thecommissioner within 30 days of the notice ofdisapproval shall be deemed disapproved.
(5) (A) Within 30 days of receipt of aresubmitted filing and certification, thecommissioner shall review the resubmittedfiling and certification, and shall approve ordisapprove such resubmitted filing andcertification. Any notice of disapprovalpertaining to the resubmitted filing andcertification shall be in writing and provide adetailed description of the reasons for thedisapproval in sufficient detail for the filer tobring the policy form into compliance. Thenotice of disapproval shall cite each specificstatute, rule and regulation or bulletin having theforce and effect of law in this state upon whichthe disapproval is based. No further extensionof time may be taken unless the filer hasintroduced new provisions in the resubmittedfiling and certification or the filer has materiallymodified any substantive provisions of thepolicy form, in which case the commissionermay extend the time for review by an additional30 days. At the end of this 30 day review period,the policy form shall be deemed approved if thecommissioner has taken no action.
(B) (i) Subject to clause (ii) of thissubparagraph, the commissioner may notdisapprove a resubmitted policy form forreasons other than those initially set forth in theoriginal notice of deficiencies or disapprovalsent pursuant to paragraph (1) of this subsection.
(ii) The commissioner may disapprove aresubmitted policy form for reasons other thanthose initially set forth in the original notice ofdeficiencies or disapproval sent pursuant to thissubsection if:
(a) The filer has introduced newprovisions in the resubmitted policyform and certification;
(b) the filer has materially modified anysubstantive provisions of the policyform;
(c) there has been a change in any statute, rule and regulation or publishedbulletin in this state having the forceand effect of law; or
(d) there has been reviewer error andthe written disapproval fails to state aspecific provision of applicable statute,regulation or bulletin published by thecommissioner having the force andeffect of law in this state that isnecessary to have the policy formconform to the requirements of law.
(6) At the end of the review period, the policyform shall be deemed approved if thecommissioner has taken no action.
(7) Notwithstanding any other provision in thissection, the commissioner may return a grosslyinadequate filing to the filer without triggeringany of the time deadlines set forth in thissection. For purposes of this paragraph, the term"grossly inadequate filing" means a filing thatfails to provide key information, including state-specific information,regarding a product, policyor rate, or that demonstrates an insufficientunderstanding of what is required to complywith state statutes or regulations.
(g) Except in cases of a material error or omission in apolicy form that has been approved or deemed approvedpursuant to the provisions of this act, the commissionershall not:
(1) Retroactively disapprove that filing; or
(2) with respect to those policy forms, examine thefiler during a routine or targeted market conductexamination for compliance with any later-enactedpolicy form filing requirements.
(h) If a rate filing or marketing material is required tobe filed or approved by state law for a specific policyform, the time frames for review, approval ordisapproval, resubmission, and re-review of those ratefilings or marketing materials shall be the same asthose provided for in subsection (f) for the review ofpolicy forms.
(i) For purposes of this section:
(1) "Accident and sickness carrier" means anentity licensed to offer accident and sicknessinsurance in this state, or subject to theinsurance laws and regulations of this state, orsubject to the jurisdiction of the commissioner,that contracts or offers to contract to provide,deliver, arrange for, pay for or reimburse anyof the costs of health care services or any insurer that provides policies ofsupplemental,disability income, medicare supplement orlong-term care insurance.
(2) "Commissioner" means the commissionerof insurance.
(3) "Health care services" means services forthe diagnosis, prevention, treatment, cure orrelief of a health condition, illness or disease.
(4) "Policy form" means any policy, contract,certificate, rider, endorsement, evidence ofcoverage of any amendments thereto that arerequired by law to be filed with thecommissioner for approval prior to their saleor issuance for sale in this state.
(5) "Supplemental documents" means anydocuments required to be filed in support ofpolicy forms that may or may not be subject toapproval.
(6) "Type of insurance" means any hospital ormedical expense policy, health, hospital ormedical service corporation contract, and aplan provided by a municipal group-fundedpool, or a health maintenance organizationcontract offered by an employer or anycertificate issued under any such policies,contracts or plans, policies or certificatescovering only accident, credit, dental,disability income, long-term care, hospitalindemnity, medicare supplement, specifieddisease, vision care, coverage issued as asupplement to liability insurance.
(j) This section shall apply to any individual or grouppolicy form issued by an accident and health carrierrequired to be filed with the commissioner for reviewor approval.
(k) Violations of subsection (d) shall betreated asviolations of theunfair trade practices act and subject to the penalties prescribed by K.S.A.40-2407 and 40-2411 and amendments thereto.
(l) Hearings under this section shall be conducted inaccordancewith the provisions of the Kansas administrative procedure act.
