40-2255.Accident and sickness insurance; closingblock of business, when.(a) This act shall apply to individual contracts coveringhospital, medical or surgical expenses,providing long-term care coverage, and medicare supplement policies,which are issued, amended, delivered orrenewed on or after the effective date of this actbut shall not apply to any block of long-term care coverage or medicaresupplement business already in force in Kansas on such effective date.
(b) As used in this act:
(1) "Block of business" means a particular individual policy form orcontract providing hospital, medical or surgical expense,long-term care or medicare supplementcoverage issued by acarrier to one or more individuals which includes distinct benefits, servicesand terms.
(2) "Closed block of business" means a block of business which a carrierceases to actively offer or sell to new applicants.
(3) "Carrier" means any insurance company, nonprofit medical and hospitalservice corporation,municipal group-funded pool, fraternal benefit society or healthmaintenance organization, as these terms are defined by the Kansas StatutesAnnotated, that offers any individual hospital, surgical or medical expense,long-term care or medicare supplementpolicy and which is authorized to do business in this state. "Carrier" doesnot include those entities identified above with respect to the sale orissuance of policies or certificates covering only accident, credit, dental,disability income, hospital indemnity,specified disease, vision care, coverage issued as a supplement to liabilityinsurance, insurance arising out of a workers compensation or similar law,automobile medical payment insurance, or insurance under which benefits arepayable with or without regard to fault and which is statutorily required to becontained in any liability insurance policy or equivalent self-insurance.
(4) "Commissioner" means the commissioner of insurance.
(c) No block of business shall be closed by a carrier unless:
(1) The carrier provides written notice of the carrier's decision to closeablock of business to each existing policyholder or contract holder affectedand offers each policyholder or contract holder affected an opportunity topurchase a policy or contractfromany block of business that is not closed and which provides comparablebenefits, services and terms, with no additional underwriting requirement orwaiting period. Each policyholder or contract holder affected by thecarrier's decision to close a block of business shall be permitted to purchasesuch policy or contract during the 30-day period commencing on the dayfollowing the date of the written notice;
(2) the carrier pools the experience of the closed block of business withall appropriate blocks of business that are not closed for the purpose ofdetermining the premium rate of any contract within the closed block, with norate penalty or surcharge beyond that which reflects the experience of thecombined pool; and
(3) if a carrier does not offer or sell any block of business whichprovides comparable benefits, services and terms comparable to the closed blockof business, paragraphs (1) and (2) shall not apply. If ablock of business providing benefits, services and terms comparable to theclosed block of business becomes available within 24 months of the notice tothe commissioner, such block shall be open to any contract holder in accordancewith the provisions of paragraphs (1) and (2). The carriershall provide notice to the commissioner in writing within 30 days of itsdecision to close a block of business or, in the absence of an actual decisionto close a block of business, within 30 days of its determination that a blockof business is within one of the presumptions set forth in subsection (d).
(d) Unless an insurer presents evidence satisfactory to the commissionerthat sucha presumption is or would be incorrect, ablock of business shall be presumed closed if either of the followingcircumstances exist:
(1) There has been an overall reduction in that block of 12% in the numberof in-force contracts for a period of 12 months; or
(2) that block has less than 500 in-force contracts in this state.
The presumption that applies in the circumstances of subsection (d)(2) shallnot apply to a block of business initiated within theprevious 24 months, but notification of that block of business shall beprovided to the commissioner pursuant to subsection (e).
The fact that a block of business does not meet one of the presumptions setforth in this subsection shall not preclude a determination that it is closedas defined in paragraph (2) of subsection (b).
(e) A carrier shall notify the commissioner in writing within 30 days of itsdecision to close a block of business or, in the absence of an actual decisionto close a block of business, within 30 days of its determination that a blockof business is within one of the presumptions set forth in subsection (d).When the carrier decides to close a block of business, the written notice shallfully disclose all information required for compliance with subsection (c).When the carrier determines that a block of business is within a presumption ofsubsection (c), the written notice shall fully disclose all informationrequired for compliance with a presumption of subsection (c). In the case ofeither notice, the carrier shall provide additional information within 15business days after a request by the commissioner.This subsection shall not apply to a carrier which does not have available ablock of business which provides comparable benefits, services and termscomparable to the closed block of business and which has complied with thenotice requirements pursuant to subsection (c)(3).
(f) A carrier shall preserve for a period of not less than five years in anidentified location which is readily accessible for review by the commissioner,all books and records relating to any action taken by a carrier pursuant tosubsection (c).
(g) No carrier shall offer or sell any contract, or provide misleadinginformation about the active or closed status of a block of business, for thepurpose of evading this act.
History: L. 1994, ch. 41, § 1;L. 1994, ch. 280, § 1;L. 2005, ch. 163, § 10; July 1.
40-2255.Accident and sickness insurance; closingblock of business, when.(a) This act shall apply to individual contracts coveringhospital, medical or surgical expenses,providing long-term care coverage, and medicare supplement policies,which are issued, amended, delivered orrenewed on or after the effective date of this actbut shall not apply to any block of long-term care coverage or medicaresupplement business already in force in Kansas on such effective date.
(b) As used in this act:
(1) "Block of business" means a particular individual policy form orcontract providing hospital, medical or surgical expense,long-term care or medicare supplementcoverage issued by acarrier to one or more individuals which includes distinct benefits, servicesand terms.
(2) "Closed block of business" means a block of business which a carrierceases to actively offer or sell to new applicants.
(3) "Carrier" means any insurance company, nonprofit medical and hospitalservice corporation,municipal group-funded pool, fraternal benefit society or healthmaintenance organization, as these terms are defined by the Kansas StatutesAnnotated, that offers any individual hospital, surgical or medical expense,long-term care or medicare supplementpolicy and which is authorized to do business in this state. "Carrier" doesnot include those entities identified above with respect to the sale orissuance of policies or certificates covering only accident, credit, dental,disability income, hospital indemnity,specified disease, vision care, coverage issued as a supplement to liabilityinsurance, insurance arising out of a workers compensation or similar law,automobile medical payment insurance, or insurance under which benefits arepayable with or without regard to fault and which is statutorily required to becontained in any liability insurance policy or equivalent self-insurance.
(4) "Commissioner" means the commissioner of insurance.
(c) No block of business shall be closed by a carrier unless:
(1) The carrier provides written notice of the carrier's decision to closeablock of business to each existing policyholder or contract holder affectedand offers each policyholder or contract holder affected an opportunity topurchase a policy or contractfromany block of business that is not closed and which provides comparablebenefits, services and terms, with no additional underwriting requirement orwaiting period. Each policyholder or contract holder affected by thecarrier's decision to close a block of business shall be permitted to purchasesuch policy or contract during the 30-day period commencing on the dayfollowing the date of the written notice;
(2) the carrier pools the experience of the closed block of business withall appropriate blocks of business that are not closed for the purpose ofdetermining the premium rate of any contract within the closed block, with norate penalty or surcharge beyond that which reflects the experience of thecombined pool; and
(3) if a carrier does not offer or sell any block of business whichprovides comparable benefits, services and terms comparable to the closed blockof business, paragraphs (1) and (2) shall not apply. If ablock of business providing benefits, services and terms comparable to theclosed block of business becomes available within 24 months of the notice tothe commissioner, such block shall be open to any contract holder in accordancewith the provisions of paragraphs (1) and (2). The carriershall provide notice to the commissioner in writing within 30 days of itsdecision to close a block of business or, in the absence of an actual decisionto close a block of business, within 30 days of its determination that a blockof business is within one of the presumptions set forth in subsection (d).
(d) Unless an insurer presents evidence satisfactory to the commissionerthat sucha presumption is or would be incorrect, ablock of business shall be presumed closed if either of the followingcircumstances exist:
(1) There has been an overall reduction in that block of 12% in the numberof in-force contracts for a period of 12 months; or
(2) that block has less than 500 in-force contracts in this state.
The presumption that applies in the circumstances of subsection (d)(2) shallnot apply to a block of business initiated within theprevious 24 months, but notification of that block of business shall beprovided to the commissioner pursuant to subsection (e).
The fact that a block of business does not meet one of the presumptions setforth in this subsection shall not preclude a determination that it is closedas defined in paragraph (2) of subsection (b).
(e) A carrier shall notify the commissioner in writing within 30 days of itsdecision to close a block of business or, in the absence of an actual decisionto close a block of business, within 30 days of its determination that a blockof business is within one of the presumptions set forth in subsection (d).When the carrier decides to close a block of business, the written notice shallfully disclose all information required for compliance with subsection (c).When the carrier determines that a block of business is within a presumption ofsubsection (c), the written notice shall fully disclose all informationrequired for compliance with a presumption of subsection (c). In the case ofeither notice, the carrier shall provide additional information within 15business days after a request by the commissioner.This subsection shall not apply to a carrier which does not have available ablock of business which provides comparable benefits, services and termscomparable to the closed block of business and which has complied with thenotice requirements pursuant to subsection (c)(3).
(f) A carrier shall preserve for a period of not less than five years in anidentified location which is readily accessible for review by the commissioner,all books and records relating to any action taken by a carrier pursuant tosubsection (c).
(g) No carrier shall offer or sell any contract, or provide misleadinginformation about the active or closed status of a block of business, for thepurpose of evading this act.
History: L. 1994, ch. 41, § 1;L. 1994, ch. 280, § 1;L. 2005, ch. 163, § 10; July 1.
40-2255.Accident and sickness insurance; closingblock of business, when.(a) This act shall apply to individual contracts coveringhospital, medical or surgical expenses,providing long-term care coverage, and medicare supplement policies,which are issued, amended, delivered orrenewed on or after the effective date of this actbut shall not apply to any block of long-term care coverage or medicaresupplement business already in force in Kansas on such effective date.
(b) As used in this act:
(1) "Block of business" means a particular individual policy form orcontract providing hospital, medical or surgical expense,long-term care or medicare supplementcoverage issued by acarrier to one or more individuals which includes distinct benefits, servicesand terms.
(2) "Closed block of business" means a block of business which a carrierceases to actively offer or sell to new applicants.
(3) "Carrier" means any insurance company, nonprofit medical and hospitalservice corporation,municipal group-funded pool, fraternal benefit society or healthmaintenance organization, as these terms are defined by the Kansas StatutesAnnotated, that offers any individual hospital, surgical or medical expense,long-term care or medicare supplementpolicy and which is authorized to do business in this state. "Carrier" doesnot include those entities identified above with respect to the sale orissuance of policies or certificates covering only accident, credit, dental,disability income, hospital indemnity,specified disease, vision care, coverage issued as a supplement to liabilityinsurance, insurance arising out of a workers compensation or similar law,automobile medical payment insurance, or insurance under which benefits arepayable with or without regard to fault and which is statutorily required to becontained in any liability insurance policy or equivalent self-insurance.
(4) "Commissioner" means the commissioner of insurance.
(c) No block of business shall be closed by a carrier unless:
(1) The carrier provides written notice of the carrier's decision to closeablock of business to each existing policyholder or contract holder affectedand offers each policyholder or contract holder affected an opportunity topurchase a policy or contractfromany block of business that is not closed and which provides comparablebenefits, services and terms, with no additional underwriting requirement orwaiting period. Each policyholder or contract holder affected by thecarrier's decision to close a block of business shall be permitted to purchasesuch policy or contract during the 30-day period commencing on the dayfollowing the date of the written notice;
(2) the carrier pools the experience of the closed block of business withall appropriate blocks of business that are not closed for the purpose ofdetermining the premium rate of any contract within the closed block, with norate penalty or surcharge beyond that which reflects the experience of thecombined pool; and
(3) if a carrier does not offer or sell any block of business whichprovides comparable benefits, services and terms comparable to the closed blockof business, paragraphs (1) and (2) shall not apply. If ablock of business providing benefits, services and terms comparable to theclosed block of business becomes available within 24 months of the notice tothe commissioner, such block shall be open to any contract holder in accordancewith the provisions of paragraphs (1) and (2). The carriershall provide notice to the commissioner in writing within 30 days of itsdecision to close a block of business or, in the absence of an actual decisionto close a block of business, within 30 days of its determination that a blockof business is within one of the presumptions set forth in subsection (d).
(d) Unless an insurer presents evidence satisfactory to the commissionerthat sucha presumption is or would be incorrect, ablock of business shall be presumed closed if either of the followingcircumstances exist:
(1) There has been an overall reduction in that block of 12% in the numberof in-force contracts for a period of 12 months; or
(2) that block has less than 500 in-force contracts in this state.
The presumption that applies in the circumstances of subsection (d)(2) shallnot apply to a block of business initiated within theprevious 24 months, but notification of that block of business shall beprovided to the commissioner pursuant to subsection (e).
The fact that a block of business does not meet one of the presumptions setforth in this subsection shall not preclude a determination that it is closedas defined in paragraph (2) of subsection (b).
(e) A carrier shall notify the commissioner in writing within 30 days of itsdecision to close a block of business or, in the absence of an actual decisionto close a block of business, within 30 days of its determination that a blockof business is within one of the presumptions set forth in subsection (d).When the carrier decides to close a block of business, the written notice shallfully disclose all information required for compliance with subsection (c).When the carrier determines that a block of business is within a presumption ofsubsection (c), the written notice shall fully disclose all informationrequired for compliance with a presumption of subsection (c). In the case ofeither notice, the carrier shall provide additional information within 15business days after a request by the commissioner.This subsection shall not apply to a carrier which does not have available ablock of business which provides comparable benefits, services and termscomparable to the closed block of business and which has complied with thenotice requirements pursuant to subsection (c)(3).
(f) A carrier shall preserve for a period of not less than five years in anidentified location which is readily accessible for review by the commissioner,all books and records relating to any action taken by a carrier pursuant tosubsection (c).
(g) No carrier shall offer or sell any contract, or provide misleadinginformation about the active or closed status of a block of business, for thepurpose of evading this act.
History: L. 1994, ch. 41, § 1;L. 1994, ch. 280, § 1;L. 2005, ch. 163, § 10; July 1.
