Miss. Admin. Code Title 19 — Insurance

MISSISSIPPI DEPARTMENT OF INSURANCE MISSISSIPPI DEPARTMENT OF INSURANCE

Part 1 General

Chapter 9 (F&C 73-1) Use of Investment Income in Ratemaking.

19 Miss. Admin. Code Pt. 1, R. 9.01 Section 1

No rating organization, insurer or group of insurers that transact an insurance business in this State shall file with this Commission any rate schedule, or rate revision, which does not reflect, to the extent prescribed hereinbelow, the investment income of each insurer whose experience is incorporated in the filing.

History

• Source: Miss. Code Ann. §§ 83-2-3; 83-5-1 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 9.02 Section 2

For the purposes of this Regulation, the rate of investment income shall mean the quotient of (1) the net investment gain or loss as shown on line 9A of the Underwriting and Investment exhibit on Page 4, of the appropriate Annual Statement, divided by (2) the cash and invested assets shown as the sum of items one (1) to seven (7) inclusive, on Page 2 of the appropriate Annual Statement or Annual Statements filed with the Mississippi Insurance Department covering the period of time reflected by the statistical data in such rate filing.

History

• Source: Miss. Code Ann. §§ 83-2-3; 83-5-1 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 9.03 Section 3

The amount of investment income allocated to a rate filing shall be determined by multiplying the rate of investment income as determined hereinabove by the sum of (1) reduced by the allowances for acquisition costs, general expense, and taxes in the formula for the premiums which generated the reserve.

History

• Source: Miss. Code Ann. §§ 83-2-3; 83-5-1 (Rev. 2011)

Chapter 12 (81-SIS-3) Proxies, Consents and Authorizations of Domestic Stock Insurers.

19 Miss. Admin. Code Pt. 1, R. 12.01 Statutory Authority

This Regulation is promulgated by the Commissioner of Insurance of the State of Mississippi to implement Sections 83-5-1, 83-5-19 and 83-19-79 through 83-19-97 of the Mississippi Code of 1972, as Amended, and is adopted pursuant to the authority granted to said Commissioner in Sections 83-19-91 and 83-19-97.

History

• Source: Miss. Code Ann. § 83-5-1; 83-5-19; 83-19-79 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.02 Application of Regulation

A. No domestic stock insurer which has any class of equity securities held of record by three hundred or more persons, or any director, officer, or employee of such insurer, or any other person, shall solicit, or permit the use of his name to solicit, by mail or otherwise, any proxy, consent, or authorization in respect of any such class of equity securities in contravention of this Regulation and Schedules A and B hereto annexed and hereby made a part of this Regulation, provided, however, that this Regulation shall not apply to any insurer if ninety-five percent or more of its equity securities is owned or controlled by a parent or an affiliated insurer and the remaining securities are held of record by less than 500 persons. A domestic stock insurer which files with the Securities and Exchange Commission with respect to any class of securities forms of proxies, consents, and authorizations complying with the requirements of the Securities Exchange Act of 1934, as amended, and the applicable regulations promulgated thereunder, shall be exempt from the provisions of this Regulation with respect to such class of securities.

B. Unless proxies, consents or authorizations in respect of any class of equity securities of a domestic insurer subject to Section 1(a) are solicited by or on behalf of the management of such insurer from the holders of record of such securities in accordance with this Regulation and the Schedules hereto prior to any annual or other meeting of such security holders, such insurer shall file with the Commissioner and transmit to every security holder who is entitled to vote in regard to any matter to be acted upon at the meeting and from whom a proxy is not solicited a written information statement containing the information specified in Schedule C hereto annexed.

History

• Source: Miss. Code Ann. § 83-5-1; 83-5-19; 83-19-79 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.03 Definitions

The following definitions apply unless the context otherwise requires:

A. Affiliate. An “affiliate” of, or a person affiliated with a specified person is a person that directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the person specified. Associate. The term “associate” used to indicate a relationship with any person, means:

1. any corporation or organization (other than the issuer or a majority owned subsidiary of the issuer) of which such person is an officer or partner or is, directly or indirectly, the beneficial owner of 10 percent or more of any class of equity securities, 2. any trust or other estate in which such person has substantial beneficial interest or as to which suchperson serves as trustee or in a similar fiduciary capacity, and 3. any relative or spouse of such person, or any relative of such spouse, who has the same home as such person or who is a director or officer of the issuer or any of its parents or subsidiaries.

B. Beneficial Owner. The term “beneficial owner” includes any person who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise has or shares:

1. voting power including the power to vote, or the power to direct voting of, a security, or 2. investment power which includes the power to dispose of, or to direct the disposition of, such security.

C. Control. The term “control” (including the terms “controlling”, “controlled by” and “under common control with”) means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract, or otherwise.

D. Issuer. The term “issuer” means the issuer of the securities in respect of which a proxy is solicited.

E. Last fiscal year. The term “last fiscal year” of the issuer means the last fiscal year of the issuer ending prior to the date of the meeting for which proxies are to be solicited.

F. Officer. The term “officer” means the president, secretary, treasurer, any vice president in charge of a principal business function (such as sales, administration or finance) and any other person who performs similar policy making functions for the insurer.

G. Commissioner. The term “commissioner” means the Commissioner of Insurance of the State of Mississippi.

H. Parent. A “parent” of a specified person is an affiliate controlling such person directly, or indirectly thorough one or more intermediaries.

I. Person. The term “person” means an individual, a corporation, a partnership, an association, a joint stock company, a trust, any unincorporated organization, or a government or political subdivision thereof. As used in this subparagraph, the term “trust” shall include only a trust where the interest or interests of the beneficiary or beneficiaries are evidenced by a security.

J. Proxy statement. The term “proxy statement” means the statement required by Section 5, whether or not contained in a single document.

K. Solicitation.

1. The terms “solicit” and “solicitations” include:

a. any request for a proxy whether or not accompanied by or included in a form of proxy:

b. any request to execute or not to execute, or to revoke, a proxy; or

c. the furnishing of a form of proxy or other communication to security holders under circumstances reasonably calculated to resultin the procurement, withholding or revocation of a proxy.

2. The terms do not apply, however, to the furnishing of a form of proxy to a security holder upon the unsolicited request of such security holder, the performance by the issuer of acts required by Section 9, or the performance by any person of ministerial acts on behalf of a person soliciting a proxy.

History

• Source: Miss. Code Ann. § 83-5-1; 83-5-19; 83-19-79 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.04 Solicitations to Which Regulation Applies

Section 11 of this Regulation shall apply to every solicitation that is subject to Section 2. Sections 3 through 10 and Section 12 of this Regulation shall apply to every solicitation that is subject to Section 2 except the following:

A. Any solicitation made otherwise than on behalf of the issuer where the total number of persons is not more than ten.

B. Any solicitation by a person in respect of securities carried in his name or in the name of his nominee (otherwise than as voting trustee) or held in his custody, if such person:

1. Receives no commission or remuneration for such solicitation, directly or indirectly, other than reimbursement of reasonable expenses;

2. Furnishes promptly to the person solicited a copy of all soliciting material with respect to the same subject matter or meeting received from all persons who shall furnish copies thereof for such purpose and who shall, if requested, defray the reasonable expenses to be incurred in forwarding such material; and

3. In addition, does no more than impartially instruct the person solicited to forward a proxy to the person, if any, to whom the person solicited desires to give a proxy, or impartially request from the person solicited instructions as to the authority to be conferred by the proxy and state that a proxy will be given if no instructions are received by a certain date.

C. Any solicitation by a person in respect of securities of which it is the beneficial owner.

D. Any solicitation through the medium of a newspaper advertisement which informs security holders of a source from which they may obtain copies of a proxy statement, form of proxy and any other soliciting material and does no more than name the issuer, state the reason for the advertisement and identify the proposal or proposals to be acted upon by security holders.

E. Any solicitation which the Commissioner finds for good cause should be exempt from this Regulation or any part thereof.

History

• Source: Miss. Code Ann. § 83-5-1; 83-5-19; 83-19-91; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.05 Information To Be Furnished Security Holders

A. No solicitation subject to this Regulation shall be made unless each person solicited is concurrently furnished or has previously been furnished with a written proxy statement containing the information specified in Schedule A.

B. If the solicitation is made on behalf of the issuer and relates to an annual meeting of security holders at which directors are to be elected, each proxy statement furnished pursuant to paragraph (a) shall be accompanied or preceded by an annual report to security holders as follows:

1. The report shall contain, in comparative columnar form, such financial statements for the last two fiscal years, prepared on a consistent basis, as will in the opinion of the management adequately reflect the financial position of the issuer at the end of each such year and the results of its operations for each such year. Consolidated financial statements of the issuer and its subsidiaries shall be included in the report if they arenecessary to reflect the financial position and

results of operations of the issuer and its subsidiaries, but in such case the individual statements of the issuer may be omitted. TheCommissioner may, upon the request of the issuer, permit the omission of financial statements for the earlier of such two fiscal years upon a showing of good cause therefore.

2. The financial statements for the last two fiscal years required by Subparagraph (b) (1) shall be prepared in a manner acceptable to the Commissioner.

3. The report shall include, in comparative columnar form, a summary of issuer’s operations, or the operations of the issuer and its subsidiaries consolidated, or both as appropriate, for each of the last five fiscal years of the issuer (or the life of the issuer and its predecessors, if less).

Note: subparagraph 7 permits the information required by this subparagraph to be set forth in any form deemed suitable by management.

4. The report shall contain a brief description of the business or businesses done by the issuer and its subsidiaries during the most recent fiscal year which will, in the opinion of management, indicate the general nature and scope of the business of the issuer and its subsidiaries.

5. The report shall identify each of the issuer’s directors and officers and shall indicate the principal occupation or employment of each such person and the name and principal business of any organization by which such person is so employed.

6. The report shall identify the principal market in which securities of any class entitled to vote at the meeting are traded, stating the range of bid and asked quotations for each quarterly period during the issuer’s two most recent fiscal years, and shall set forth each dividend paid during such two year period.

7. Subject to the foregoing requirements, the report may be in any form deemed suitable by management and the information required by subparagraphs (b) (3) through (b) (6) may be presented in an appendix or other separate section of the report, provided that the attention of security holders is called to such presentation.

8. This paragraph (b) shall not apply, however, to solicitations made on behalf of the management before the financial statements are available if solicitation is being made at the time in opposition to the management and if the management’s proxy statement includes an undertaking in bold face type to furnish such annual report to all persons being solicited, at least 20 days before the date of the meeting.

a. Three copies of the report sent to the security holders pursuant to this Section shall be mailed to the Commissioner solely for his information, not later than the date on which such report was first sent or given to

security holders or the date on which preliminary copies of solicitation material are filed pursuant to Section 8, whichever date is later.

b. If the issuer knows that securities of any class entitled to vote at a meeting with respect to which the issuer intends to solicit proxies, consents or authorizations are held of record by a broker, dealer, bank or voting trustee, or their nominees, the issuer shall require of such record holder at least ten days prior to the record date for the meeting of security holders whether other persons are the beneficial owners of such securities and, if so, the number of copied of the proxy and other soliciting material and, in the case of an annual meeting at which directors are to be elected, the number of copies of the annual report to security holders, necessary to supply such material to beneficial owners. The issuer shall supply such record holder in a timely manner with additional copies in such quantities, assembled in such form and at such place, as the record holder may reasonably request in order to address and send one copy of each to each beneficial owner of securities so held and shall, upon the request of such record holder, pay its reasonable expenses for mailing such material to security holders to whom the material is sent.

History

• Source: Miss. Code Ann. §83-5-19; § 83-19-91; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.06 Requirements as To Proxy

A. The form of proxy:

1. shall indicate in bold face type whether or not the proxy is solicited on behalf of the issuers board of directors, and, if not, by whom it is solicited;

2. shall provide a specifically designed blank space for dating the proxy; and,

3. shall identify clearly and impartially each matter or group of related matters intended to be acted upon, whether proposed by the issuer or by security holders. No reference needs to be made to proposals as to which discretionary authority is conferred pursuant to paragraph (c).

B. 1. Means shall be provided in the form of proxy whereby the person solicited is afforded an opportunity to specify by ballot a choice between approval or disapproval of, or abstention with respect to, each matter or group of related matters referred to therein as intended to be acted upon, other than elections to office. A proxy may confer discretionary authority with respect to matters as to which a choice is not so specified provided the form of proxy states in bold face how it is intended to vote the shares represented by the proxy in each such case.

2. A form of proxy which provides for the election of directors and for action on other specified matters shall be prepared so as clearly to provide, by a box or

otherwise, means by which the security holder may withhold authority to vote for any nominee forelection as a director. Any such form of proxy which is executed by the security holder in suchmanner as not to withhold authority to vote for the election of all nominees shall be deemed to grant such authority for all nominees for which a vote is withheld, provided the form of proxy so states in bold face type.

C. A proxy may confer discretionary authority to vote with respect to any of the following matters:

1. Matters which the persons making the solicitation do not know, a reasonable time before the solicitation, are to be presented at the meeting, if a specific statement to that effect is made in the proxy statement or form of proxy;

2. Approval of the minutes of the prior meeting if such approval does not amount to ratification of the action taken at that meeting;

3. The election of any person to any office for which a bona fide nominee is named in the proxy statement and such nominee is unable to serve or for good cause will not serve.

4. Any proposal omitted from the proxy statement and the form of proxy pursuant to Sections 10 or 11.

5. Matters incident to the conduct of the meeting.

D. No proxy shall confer authority to vote for the election of any person to any office for which a bona fide nominee is not named in the proxy statement, or to vote at any annual meeting, other than the next annual meeting (or any adjournment thereof), to be held after the date on which the proxy statement and form of proxy are first sent or given to security holders. A person shall not be deemed to be a bona fide nominee and he shall not be named as such unless he has consented to being named in the proxy statement and to serve if elected.

E. The proxy statement or form of proxy shall provide, subject to reasonable specified conditions, that the securities represented by the proxy will be voted and that where the person solicited specifies by means of a ballot provided pursuant to paragraph (b) a choice with respect to any matter to be acted upon, the securities will be voted in accordance with the specifications so made.

History

• Source: Miss. Code Ann. § 85-5-1; 83-19-91; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.07 Presentation of Information in Proxy Statement

A. The information included in the proxy statement shall be clearly presented and the statements made shall be divided into groups according to subject matter and the various groups of statements shall be preceded by appropriate headings.

B. All proxy statements shall disclose, under an appropriate caption, the date by which proposals of security holders intended to be presented at the next annual meeting must be received by the issuer for inclusion in the issuer’s proxy statement and form of proxy relating to that meeting, such date to be calculated in accordance with the provisions of Section 10(a). If the date of the next annual meeting is subsequently advanced by more than 30 calendar days or delayed by more than 90 calendar days from the date of the annual meeting to which the proxy statement relates, the issuer shall, in a timely manner, inform security holders must be received, by any means reasonably calculated to so inform them.

History

• Source: Miss. Code Ann. § 83-5-19; § 83-19-91; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.08 Material Required To Be Filed

A. Three preliminary copies of the proxy statement and form of proxy and any other soliciting material to be furnished to security holders concurrently therewith (or the information statement pursuant to Schedule C) shall be filed with the Commissioner at least 10 days prior to the date definitive copies of such material are first sent or given to security holders, or such shorter period prior to that date as the Commissioner may authorize upon a showing of good cause therefore.

B. Three preliminary copies of any additional soliciting material relating to the same meeting or subject matter to be furnished to security holders subsequent to the proxy statement shall be filed with the Commissioner at least five days (exclusive of Saturdays, Sundays and holidays) prior to the date copies of such material are first sent or given to security holders, or such shorter period prior to such date as the Commissioner may authorize upon a showing of good cause therefor.

C. Three definitive copies of the proxy statement, form of proxy and all other soliciting material (or the information statement) in the form in which such material is furnished to security holders, shall be filed with, or mailed for filing to, the Commissioner no later than the date such material is first sent or given to any security holder.

D. Copies of replies to inquiries from security holders requesting further information and copies of communications which do no more than request that forms of proxy theretofore solicited be signed and returned need not be filed pursuant to this Section.

E. Notwithstanding the provisions of paragraphs (a) and (b) of this Section and of paragraph (e) of Section 13, copies of soliciting material in the form of speeches, press releases and radio or television scripts may, but need not, be filed with the Commissioner prior to use or publication. Three definitive copies, however, shall be filed with or mailed for filing to the Commissioner as required by paragraph (c) not later than the date such material is

used or published. The provisions of paragraph (a) and (b) of this Section and of paragraph (e) of Section 13 shall apply, however, to any reprints or reproductions of all or any part of such material.

F. Where any proxy statement, form of proxy or other material filed pursuant to this Regulation is amended or revised, one of the copies of such amended or revised material filed pursuant to this Regulation shall be marked to indicate clearly and precisely the changes effected therein.

Rule 12.09: Mailing Communications For Security Holders

If the management of the issuer has made or intends to make any solicitation subject to this Regulation, the issuer shall perform such of the following acts as may be duly requested in writing with respect to the same subject matter or meeting by any security holder who is, or security holders who are, entitled to vote at least one percent of the votes entitled to be voted on such matter and who shall defray the reasonable expenses to be incurred by the issuer in the performance of the act or acts requested.

A. The issuer shall mail or otherwise furnish to such security holder, as promptly as practicable after the receipt of such request:

1. A statement of the approximate number of record owners and, to the extent known to the issuer, the approximate number of beneficial owners of any class of securities, any of whom have been or are to be solicited on behalf of the management, or any group of whom the security holder shall designate:

2. An estimate of the cost of mailing a specified proxy statement, form of proxy or other communication to such owner.

B. 1. Copies of any proxy statement form of proxy or other communication furnished by the security holder shall be mailed by the issuer to such of the security owners specified in subparagraph (a) (1) as the security holder shall designate.

2. Such material furnished by the security holder shall be mailed with reasonable promptness after receipt of the material to be mailed, envelopes or other containers therefore, and postage or payment for postage. The issuer need not, however, mail any such material prior to the first day on which solicitation is made on behalf of the issuer.

3. The issuer shall not be responsible for such proxy statement, form of proxy or other communication.

C. In lieu of performing the acts specified above, the issuer may, at its option, furnish promptly to such security holder a reasonably current list of the names and addresses of

such of the record owners and, to the extent known to the issuer, the beneficial owners as the security holder shall designate and a scheduled of the handling and mailing costs if such schedule has been supplied to the issuer.

History

• Source: Miss. Code Ann. §85-5-19; 83-19-91; § 83-19-97 (Rev. 2011)
• Source: Miss. Code Ann. §83-19-93; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.10 Proposals of Security Holders

A. If any holder or holders of the securities of an issuer (hereafter referred to as the “proponent”) notifies the issuer in writing not less than 90 days before the issuer’s annual meeting of his intention to present a lawful proposal for action at a forthcoming meeting of the issuer’s security holders and at the time of such notice the proponent is entitled to vote at least one percent of the votes entitled to be voted on such proposal, the issuer shall set forth the proposal in its proxy statement and identify it in its form of proxy and provide for the specification of approval or disapproval of such proposal. The proxy statement shall also include the name and address of the proponent.

B. If the issuer opposed any proposal received from a proponent, it shall also, at the request of the proponent, include in its proxy statement a statement of the proponent of not more than 500 words in support of the proposal.

C. The issuer may omit proposal and any statement in support thereof from its proxy statement and form of proxy under any of the following circumstances:

1. The proponent has submitted more than one proposal in connection with a particular meeting.

2. The proposal is more than 500 words in length.

3. The proposal of the supporting statement is contrary to any Section of this Regulation or the schedules hereto, including Section 11, which prohibits false or misleading statements in proxy soliciting materials.

4. The proposal relates to the enforcement of a personal claim or the redness of a personal grievance against the issuer, its management, or any other person.

5. The proposal deals with a matter not significantly related to the issuer’s business; a matter beyond the issuer’s power to effectuate; a matter relating to the conduct of the ordinary business operations of the issuer; or an election to office.

6. The proposal is counter to a proposal to be submitted by the issuer at the meeting; the proposal relates to specific amounts of cash or stock dividends.

7. The proposal is subsequently duplicative of a proposal previously submitted to the issuer by another proponent, which proposal will be included in the management’s proxy material for the meeting.

8. Substantially the same proposal has previously been submitted to security holders in the issuer’s proxy statement and form of proxy relating to any annual or special meeting of security holders held within the preceding five calendar years, and received less than five percent of the total number of votes cast in respect thereof at the time of its most recentsubmission.

D. If the issuer intends to omit any proposal from its proxy statement and/or forms of proxy, it shall notify the proponent in writing of its intention at least ten days before the issuer’s preliminary proxy material is filed pursuant to Section 8(a).

Rule 12.11: False or Misleading Statements

No proxy statement, form of proxy, notice of meeting, information statement, or other communication, written or oral, subject to this Regulation shall contain any statement which, at the time and in the light of the circumstances under which it is made, is false or misleading with respect to any material fact, or which omits to state any material fact necessary in order to make the statements therein not false or misleading or necessary to correct any statement in any earlier communication with respect to the same meeting or subject matter which has become false or misleading.

History

• Source: Miss. Code. Ann.§83-19-97 (Rev. 2011)
• Source: Miss. Code Ann. §83-19-97; 85-5-35 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.12 Prohibition of Certain Solicitations

No person making a solicitation which is subject to this Regulation shall solicit any undated or postdated proxy or any proxy which provides that it shall be deemed to be dated as of any date subsequent to the date on which it is signed by the security holder.

History

• Source: Miss. Code Ann.§83-19-91; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.13 Special Provisions Applicable To Election Contests

A. Solicitations to Which This Section Applies. This Section applies to any solicitation subject to this Regulation by any person or group for the purpose of opposing a solicitation subject to this Regulation by any other person or group with respect to the election or removal of directors at any annual or special meeting of security holders.

B. Participant or Participant in a Solicitation.

1. For the purpose of this Section the terms “participant” and “participant in a solicitation” include: the issuer; any director of the issuer, and any nominee for whose election as a director proxies are solicited; any other person, acting alone

or with one or more other persons, committees or groups, in organizing, directing or financing the solicitation.

2. For the purpose of this Section the terms “participant” and “participant in a solicitation” do not include:

a. a bank, broker or dealer who, in the ordinary course of business, lends money or executes orders for the purchase or sale of securities and who is not otherwise a participant; b. any person or organization retained or employed by a participant to solicit security holders or any person who merely transmits proxy solicitating material or performs ministerial of clerical duties; c. any person employed in the capacity of attorney, accountant, or advertising, public relations or financial adviser, and whose activities are limited to the performance of his duties in the course of such employment; d. any person regularly employed as an officer or employee of the issuer or any of its subsidiaries or affiliates who is not otherwise a participant; or any officer or director of: or, e. any person regularly employed by any other participant, if such officer, director or employee is not otherwise a participant.

C. Filing of Information Required by Schedule B.

1. No solicitation subject to this Section shall be made by any other person other than the issuer unless at least five business days prior thereto, or such shorter period as the Commissioner may authorize upon a showing of good cause therefore, there has been filed with the Commissioner by or on behalf of each participant in such solicitation, a statement in duplicate containing the information specified by Schedule B and a copy of any material proposed to be distributed to security holders in furtherance of such solicitation.

2. Within seven business days after a solicitation subject to this Section is made by the issuer, or such longer period as the Commissioner may authorize upon a showing of good cause therefore, there shall be filed with the Commissioner by or on behalf of each participant in such solicitation other than the issuer, a statement in duplicate containingthe information specified by Schedule B.

3. If any solicitation on behalf of the issuer or any other person has been made, or if proxy material is ready for distribution, prior to a solicitation subject to this Section in opposition thereto, a statement in duplicate containing the information specified in Schedule B shall be filed with the Commissioner by or on behalf of each participant in such prior solicitation, other than the issuer, as soon as reasonably practicable after the commencement of the solicitation in opposition thereto.

4. If, subsequent to the filing of the statements required by paragraphs (a), (b), and (c) of this Section additional persons become participants in a solicitation subject to this Section, there shall be filed with the Commissioner by or on behalf of each such person, a statement in duplicate containing the information specified by Schedule B, within three business days after such person becomes a participant, or such longer period as the Commissioner may authorize upon a showing a good cause therefor.

5. If any material change occurs in the facts reported in any statement filed by or on behalf of any participant, an appropriate amendment to such statement shall be filed promptly with the Commissioner.

6. Each statement and amendment thereto filed pursuant to this paragraph shall be part of the public files of the Commissioner.

D. Solicitations Prior to Furnishing Required Written Proxy Statement.

Notwithstanding the provisions of Section 5(a), a solicitation subject to this Section may be made prior to furnishing security holders a written proxy statement containing the information specified in Schedule A with respect to such solicitation, provided that:

1. The statements required by paragraph (c) are filed by or on behalf of each participant insuch solicitation.

2. No form of proxy is furnished to security holders prior to the time the written proxy statement required by Section 5(a) is furnished to such persons: provided, however, that this paragraph (b) shall not apply where a proxy statement then meeting the requirements of Schedule A has been furnished to security holders.

3. At least the information specified in subparagraph (2) and (3) of the statements required by paragraph (c) to be filed by each participant, or an appropriate summary thereof, are included in each communication sent or given to security holders in connection with the solicitation.

4. A written proxy statement containing the information specified in Schedule A withrespect to a solicitation is sent or given security holders at the earliest practicably date.

E. Solicitations Prior to Furnishing Required Written Proxy Statement— FilingRequirements.

Three copies of any soliciting material proposed to be sent or given to security holders prior to the furnishing of the written proxy statement required by Section 5(a) shall be file with the Commissioner in preliminary form at least seven business days prior to the date definitive copies of such material are first sent or given to such persons, or such shorter period as the Commissioner may authorize upon a showing of good cause therefor.

F. Notwithstanding the provisions of Section 5(b), two copies of any portion of the annual report referred to in Section 5(b) which comments upon or refers to any solicitation subject to this Section, or to any participant in any such solicitation, other than the solicitation by the management, shall be filed with the Commissioner as proxy material subject to this Regulation. Such portion of the report shall be filed with the Commissioner, in preliminary form, at least seven business days prior to the date copies of the report are first sent or given to security holders.

History

• Source: Miss. Code Ann. § 83-19-91; § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.14 Solicitations and Materials Complying With NAIC Model Regulation and Schedules

Notwithstanding the foregoing Sections, the Commissioner may permit the solicitation of proxies, consents, or authorizations, provided that the manner of solicitation and the form of the proxy, proxy statement and other documents used in such solicitation comply with the National Association of Insurance Commissioner’s Model Regulation and the Schedules thereto.

History

• Source: Miss. Code Ann. § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.15 Severability

If any provision of any Section of the Regulation or the application thereof to any insurer or circumstances is held invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application and to this end the provisions of this Regulation are declared to be severable.

History

• Source: Miss. Code Ann. § 83-19-97 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 12.16 Effective Date

This Regulation shall be in full force and in effect on and after ______________, 1981. Promulgated and adopted, This the ____ day of _______________, 1981.

History

• Source: Miss. Code Ann. § 25-43-3.113 (Rev. 2010)

19 Miss. Admin. Code Pt. 1, R. 12.17 Schedule A: Miscellaneous

A. Revocability of Proxy

State whether or not the person giving the proxy has the power to revoke it. If the right of revocation before the proxy is exercised is limited or is subject to compliance with any formal procedure, briefly describe such limitation or procedure.

B. Dissenters’ Rights of Appraisal

Outline briefly any rights of appraisal or similar rights of dissenters with respect to any matter to be acted upon and indicate any statutory procedure required to be followed by dissenting security holders in order to perfect such rights. Where such rights may be exercised only within a limited time after the date of adoption of a proposal, the filing of a charter amendment or other similar act, state whether the person solicited will be notified of such date.

C. Persons Making the Solicitation

1. Solicitations Not Subject to Section 13

a. If the solicitation is made by the issuer, so state. Give the name of any director of the issuer who has informed the issuer in writing that he intends to oppose any action intended to be taken by the issuer and indicate the action which he intends to oppose.

b. If the solicitation is made otherwise than by the issuer, so state and give the names of the persons by whom and on whose behalf it is made.

c. If the solicitation is to be made otherwise than by the use of the mails, describe the methods to be employed. If the solicitation is to be made by specially engaged employees or paid solicitors, state

i. the material features of any contract or agreement for such solicitation and identify the parties, and ii. the cost or anticipated cost thereof.

d. State the names of the persons by whom the cost of solicitation has been or will be borne, directly or indirectly.

2. Solicitations Subject to Section 13

a. State by whom the solicitation is made and describes the methods employed and to be employed to solicit security holders.

b. If regular employees of the issuer or any other participant in a solicitation have been or are to be employed to solicit security holders, describe the class or classes of employees to be so employed, and the manner and nature of their employment for such purpose.

c. If specially engaged employees, representatives or other persons have been or are to be employed to solicit security holders, state;

i. the material features of any contract or arrangement for such solicitation and identify the parties,

ii. the cost or anticipated cost thereof; and iii. the approximate number of such employees or employees of any other person (naming such other person) who will solicit security holders.

d. State the total amount estimated to be spent and the total expenditures to date for or in connection with the solicitation of security holders.

e. State by whom the cost of the solicitation will be borne. If reimbursement will be sought from the issuer, state whether the question of such reimbursement will be submitted to a vote of security holders.

f. If any such solicitation is terminated pursuant to a settlement between the issuer and any other participant in such solicitation, describe the terms of such settlement, including the cost or anticipated cost thereof to the issuer.

D. Interest of Certain Persons in Matters to be Acted Upon

1. Solicitations Not Subject to Section 13. Describe briefly any substantial interest, direct or indirect, of each of the following persons in any matter to be acted upon, other than elections to office:

a. If the solicitation is made on behalf of the issuer, each current director or officer of the issuer.

b. If the solicitation is made otherwise than on behalf of the issuer, any person who would be a participant in a solicitation (except the issuer, or an officer, director, or nominee of the issuer).

c. Each nominee for election as a director of the issuer.

d. Each associate of the foregoing persons.

2. Solicitations Subject to Section 13.

a. Describe briefly any substantial interest, direct or indirect, of each participant (except the issuer) in any matter to be acted upon at the meeting, and include with respect to each participant the information or an adequate summary thereof, required by Items (2)(a), (2)(b), 3, 4(b), 4(c) of Schedule B.

E. Voting Securities and Principal Holders Thereof

1. State as to each class of voting securities of the issuer entitled to be voted at the meeting, the number of shares outstanding and the number of votes to which each class is entitled.

2. Give the date as of which the record of security holders entitled to vote at the meetingwill be determined. If the right to vote is not limited to security holders of record on that date, indicate the conditions under which other security holders may be entitled to votes.

3. If action is to be taken with respect to the election of directors and if the persons solicited have cumulative voting rights:

a. make a statement that they have such rights, b. describe such rights, c. state the conditions precedent to the exercise thereof; and, d. if discretionary authority to cumulative votes is solicited, so indicate.

4. Furnish the following information as of the most recent practicable date, in substantially the tabular form indicated, with respect to: any person or group of persons who is known to be the beneficial owner of more than five percent of any class of securities; and, all directors and nominees, naming them, and directors and officers of the issuer as a group, without naming them.

(1) (2) (3) (4) Title of Class Name of Beneficial Owner Amount and Nature Of Beneficial Ownership Percent of Class

5. If, to the knowledge of the persons on whose behalf the solicitation is made, a change in control of the issuer has occurred since the beginning of its last fiscal year, state the name of the person(s) who acquired control, the amount and the source of the consideration used by such person or persons, the basis of the control, the date and a description of the transaction(s) which resulted in the change of control and the percentage of voting securities of the issuer now beneficially owned directly or indirectly by the person(s) who acquired control; and the identity of the person(s) from whom control was assumed. Describe any arrangements which may at a subsequent date result in a change of control of the issuer.

F. Directors and Executive Officers

If action is to be taken with respect to election of directors, furnish the following information, in tabular form to the extent practicable, with respect to each person nominated for election as a director and each person whose term of office will continue after the meeting. However, if the solicitation is made on behalf of person other than the issuer, the information required need be furnished only as to nominees of the persons making the solicitation.

1. Identification of directors and officers. List the names and ages of all directors and officers of the issuer, and all persons nominated or chosen to become directors or officers; indicate all positions and offices with the issuer held by each such person; state his term of office as director and/or officer and period(s) during which he has served as such; briefly describe any arrangement or understanding between him and any other person or persons (naming such person(s)) pursuant to which he was or is to be selected as a director, officer, or nominee.

The information regarding officers need not be furnished in proxy or information statements provided that such information is furnished in a separate item in the issuer’s annual report to stockholders.

2. Family relationships. State the nature of any family relationship not more remote than first cousin between any director, officer, or person nominated or chosen by the issuer to become a director or officer and also any such family relationship between any such person and any officer or director of any of the issuer’s parents, subsidiaries or other affiliates.

3. Business experience. State the principal occupations and employment during the past five years of each director and each person nominated or chose to become a director or officer and the name and principal business of any corporation or other organization in which such occupations and employment were carried on.

4. Directorships. Indicate other directorships held by each director or person nominated or chosen to become a director.

5. Involvement in certain legal proceedings. Describe any legal proceedings which have occurred during the past five years or which are pending which are material to an evaluation of the ability or integrity of any director, or person nominated to become a director or officer of the issuer.

6. Describe any of the following relationships which exist:

a. If the nominee or director is, or has within the last two full fiscal years been, an officer, director or employee of, or owns, or has within the last two full fiscal years owned,directly or indirectly, in excess of a 1 percent equity interest in any firm, corporation, or other business or professional entity:

i. which has made payments to the issuer or its subsidiaries during the issuer’s last full fiscal year in an aggregate amount in excess of 1 percent of the issuer’s total consolidated gross revenues for its last full fiscal year;

ii. to which the issuer or its subsidiaries were indebted at any time during the issuer’s last fiscal year in an aggregate amount in excess of 1 percent of the issuer’s total consolidated assets at the end of such fiscal year;

iii. to which the issuer or its subsidiaries have made payments during such entity’s last fiscal year or to which the issuer or its subsidiaries propose to make payments during such entity’s current fiscal year in excess of 1 percent of such entity’s consolidated gross revenues for its last full fiscal year;

iv. in order to determine whether payments made or proposed to be made exceed 1 percent of the consolidated gross revenues of any entity other than the issuer for such entity’s last full fiscal year, it is appropriate to rely on information provided by the nominee or director;

v. in calculating payments for property and services, the following may be excluded: payments where the rates or charges involved in the transaction are determined by competitive bids, or the transaction involves the rending of services as a public utility at rates or charges fixed in conformity with law or governmental authority; or,payments which arise solely from the ownership of securities of the issuer and no extra or special benefit not shared on a pro rata basis by all holders of the class of securities is received;

vi. In calculating indebtedness for purposes of subparagraph (ii) above, debt securities which have been publicly offered, admitted to trading on a national securities exchange, or quoted on the automated quotation system of a registered securities association may be excluded.

b. The nominee or director is a member or employee of, or is associated with, a law firm which the issuer has retained in the last two full fiscal years or proposes to retain in the current fiscal year where fees paid or anticipated to be paid by the issuer are material to either the law firm, the issuer, or both.

c. The nominee or director is a director, partner, officer or employee of any investment banking firm which has performed services for the issuer other than as a participating underwriter in a syndicate in the last two full fiscal years or which the issuer proposes to have perform services in the current year; or

d. The nominee or director is a control person of the issuer (other than solely as a director of the issuer).

7. State whether or not the issuer has standing audit, nominating, and compensation committees of the Board of Directors, or committees performing similar functions. If the issuer has such committees, however designated, identify each committee member, state the number of committee meetings held by each such committee during the last fiscal year and describe briefly the functions performed by such committees.

If the issuer has a nominating or similar committee, state whether the committee will consider nominees recommended by shareholders and, if so, describe the procedures to be followed by shareholders in submitting such recommendations.

8. State the total number of meetings of the board of directors (including regularly scheduled and special meetings) which were held during the last full fiscal year. Name each incumbent director who during the last full fiscal year attended fewer than 75 percent of the aggregate the total number of meetings of the board of directors (held during the period for which he has been a director) and the total number of meetings held by all committees of the board on which he served (during the periods that he served).

9. If a director has resigned or declined to stand for re-election to the board of directors since the date of the last annual meeting of shareholders because of a disagreement with the issuer on any matter relating to the issuer’s operations, policies or practices and if the director has furnished the issuer with a letter describing such disagreement and requesting that the matter be disclosed, the issuer shall state the date of resignation or declination to stand for re-election and summarize the director’s description of the disagreement.

If the issuer believes that the description provided by the director is incorrect or incomplete, it may include a brief statement presenting its views of the disagreement.

10. With respect to those classes of voting stock which participated in the election of directors at the most recent meeting at which directors were elected:

a. State the percentage of shares present at the meeting and voting or withholding authority to vote in the election of directors; and disclose in tabular format the percentage of total shares cast for and withheld from the for or, where applicable, cast against, each nominee, which respectively, were voted for and withheld from the vote for, or voted against, such nominee. When groups of classes or series of classes vote together in the election of a director or directors, they shall be treated as a single class for the purpose of the preceding sentence.

b. Instructions.

i. Calculate the percentage of shares present at the meeting and voting withholding authority to vote in the election of directors, referred to in paragraph j(1), by dividing the total shares cast for and withheld from the vote for or, where applicable, voted against, the director in respect of whom the highest aggregate number of shares was cast by the total number of shares outstanding which were eligible to vote as of the record date for the meeting.

ii. No information need be given in response to item 6(j) unless, with respect to any class of voting stock (or group of classes which voted together), 5% or more of the total shares cast for and withheld from the vote for or, where applicable, cast against any nominee were withheld from the vote for or cast against such nominee.

iii. If an issuer elects less than the entire board of directors annually, disclosure is required as to all directors if 5% or more of the total shares cast for and withheld from, the vote for, or, where applicable, cast against any incumbent director were withheld from, or cast against the vote for such director at the meeting at which he was most recently elected.

iv. No information need be given in response to item 6(j) if the issuer has previously furnished to its security holders a report of the results of the most recent meeting of security holders at which directors were elected which includes:

1. a description of each matter voted upon at the meeting and a statement of the percentage of the shares voting which were voted for and against each such matter; and

2. the information which would be called for by this item 6(j).

3. If an issuer has previously furnished such results to its security holders, this fact should be set forth in a letter accompanying the filing of preliminary proxy materials with the Commissioner.

G. Remuneration of Directors and Officers

Furnish the following information if action is to be taken with regard to: the election of directors; any bonus, profit sharing or other remuneration plan, contract, or arrangement in which any director, nominee for election as a director, or officer of the issuer will participate; any pension or retirement plan in which any such person will participate; or, the granting or extension to any such person of any options, warrants or rights to purchase any securities, other than warrants or rights issued to security holders as such,

on a pro rata basis. If the solicitation is made on behalf of persons other than the issuer, the information required need be furnished only as to nominees of the persons making the solicitation and associates of such nominees.

1. Current remuneration. Furnish the information required in the table below, in substantially the tabular form specified, concerning all remuneration of the following persons and groups for services in all capacities to the issuer and its subsidiaries during the issuer’s last fiscal year, or, in specified instances, certain prior fiscal years:

a. Five officers or directors. Each of the five most highly compensated officers or directors of the issuer as to whom the total remuneration required to be disclosed in Columns C1 and C2 below, would exceed $50,000, naming each such person; and

b. All officers and directors. All officers and directors of the issuer as a group, stating the number of persons in the group without naming them.

c. Specified Tabular Format:

(A) (B) (C) (D) (C1) (C2) Name of Individual or Number of person in group Capacities in which served Cash and cash- equivalent forms of remuneration Aggregate of contingent forms of remuneration Salaries, fees, directors’ fees, commissions and bonuses Securities or property, insurance benefits or reimbursement, personal benefits

d. information to be Included: Columns C-1, C-2, and D of the table should contain with respect to each person or group of persons specified in subparagraphs (1)(a) and (2)(b) of paragraph G a dollar amount which reflects the total of all items of remuneration described in the heading to that column including, but not necessarily limited to, those items set forth in the subparagraphs of that column. i. COLUMN C:Include all Cash and Cash Equivalent Forms of Remuneration received during the fiscal year and all such amounts accrued during the fiscal year which, with reasonable certainty, will be distributed or vested in the future. ii. COLUMN C-1: Salaries, Bonuses, Fees, and Commissions: (a) All cash remuneration distributed or accrued in the form of salaries, commissions, bonuses and fees for service rendered. (b) Compensation earned for services performed in the latest fiscal year even if it is deferred for future payment.

(c) Payments received in the latest fiscal year but earned in prior years which were deferred until the latest year, if such amounts were not shown in an earlier proxy statement or annual report to stockholders. iii. COLUMN C-2: Securities, Property, Insurance Benefits or reimbursement, Personal Benefits (Perquisites): (a) Spread between the acquisition price, if any, and fair market price of securities or property acquired under any contract, plan or arrangements. (b) Cost of any life insurance premiums, health insurance premiums and medical reimbursement plans, Premiums for nondiscriminatory plans generally available to all salaried employees are excluded. (c) Personal benefits (perquisites) not directly related to job performance, excluding benefits provided on a nondiscriminatory basis, valued on the basis of cost to the issuer of providing such benefits. (1) If unreasonable effort or expense is required to determine the amounts of personal benefits, they may be omitted if their aggregate value does not exceed $10,000 for each other. (2) If the amount of personal benefits exceeds 10% of the amount of total remuneration or $25,000, whichever is less, the amount and a brief description of the benefits must be disclosed in a footnote. (d) Vested company contributions to thrift, profit sharing, pension, stack purchase and similar plans. iv. COLUMN D: Include all contingent forms of remuneration the distribution, vesting, and measurement of which is subject to future events. Report only amounts relating to the latest fiscal year, not amounts accrued in previous periods. (a) Amount expensed for financial reporting purposes representing nonvested contributions, payments, or accruals under any pension or retirement plans annuities, employment contracts, deferred compensation plans including IRS qualified plans, unless the amount for the individual cannot be separated in which case a footnote is required indicating the percentage which contributions to the plan bear to participants total remuneration. (b) The amount expensed for financial reporting purpose under any incentive compensation plans (long-term income plans), such as stock appreciation rights, stock options, performance share plans, where payout is based on objective standards or stock value.

(1) In subsequent years, if the corporation credits compensation expense for financial reporting purposes as a result of a decline in the value of contingent compensation, Column D may be reduced by a corresponding amount. A footnote explaining such action should be included. (c) The amount expensed for financial reporting purposes for any nonvested contribution payment or accrual to stock purchase plans, profit sharing, and thrift plans whether or not they are qualified under the Internal Revenue Code. (d) Transactions with Third Parties. Item 7(a), among other things, includes transactions between the issuer and a third party when the primary purpose of the transactions is to furnish remuneration to the persons specified in Item 7(a). Other transactions between the issuer and third parties in which person specified in Item 7(a) have an interest, or may realize a benefit, generally are addressed by other disclosure requirements concerning the interest of management and others in certain transactions. Item 7(a) does not require disclosure of remuneration paid to a partnership in which any officer or director was a partner; any such transactions should be disclosed pursuant to these other disclosure requirements, and not as a note to the remuneration table presented pursuant to Item 7(a). (e) Other Permitted Disclosure. The issuer may provide additional disclosure through a footnote to the table, through additional columns, or otherwise, describing the components of aggregate remuneration in such greater detail as is possible.

2. Proposed remuneration.

a. Briefly describe all remuneration payments proposed to be made in the future, pursuant to any existing plan or arrangement to the persons and groups specified in Item 7(a). As to defined benefit or actuarial plans with respect to which amounts are not included in the table, include a separate table showing the estimated annual benefits payable upon retirement to persons in specified remuneration and years-of-service classifications.

b. Information need not be furnished with respect to any group life, health, hospitalization, or medical reimbursement plans which do not discriminate in favor of officers or directors of the issuer and which are available generally to all salaried employees.

3 Remuneration of directors. Describe any standard or special arrangements, stating amounts, by which directors of the issuer are compensated for services as a director.

4. Options, warrants, or rights.

a. Furnish the information required by the following table as to all options to purchase securities from the issuer or its subsidiaries which were granted to or exercised by the persons and groups specified in Item 7(a) since the beginning of the issuer’s last fiscal year, and as to all options held by such persons as of the latest practicable date:

b. The following tabulation shows as to certain directors and officers and as to all directors and officers as a group: i. the amount of options granted since the beginning of the issuer’s last full fiscal year, ii. the amount of shares acquired since that date through the exercise of options, iii. the amount of shares of the same class sold during such period and iv. the amount of shares subject to all unexercised options held as of the most recentpracticable date.

Title of securities Name Name Name All directors and officers as a group Granted—19---to date: Number of shares Average per share option price $ $ $ $ Exercised—19—to date: Number of Shares Aggregate option price of options exercised $ $ $ $ Sales—19—to date:

Number of Shares *** Unexercised at 19--: Number of Shares Average per share option price $ $ $ $ In addition, during the period employees were granted option for.....shares at an average price per share of $.........

***Sales by directors and officers who exercised options during the period 19—to date.

5. Instructions

a. All figures should be adjusted, where applicable, in accordance with the terms of the options to reflect stock splits and to give effect to share dividends.

b. Other tabular presentations are acceptable if they include the necessary data. Tabular presentation may not be needed if only a very few options have been granted.

c. Market value

i. Where the total market value on the granting dates of the securities called for by all options granted during the period specified does not exceed $10,000 for any officer ordirector named in answer to Item 7(a), or $40,000 for all officers and directors as a group, this Item need not be answered with respect to options granted to such person or group. ii. Where the total market value on the dates of purchase of all securities purchased through the exercise of options during the period specified does not exceed $10,000 for any such person or $40,000 for such group, this Item need not be answered with respect to options exercised by such person or group. iii. Where the total market value as of the latest practicable date of the securities called for by all options held at such time does not exceed $10,000 for any such person or $40,000 for such group, this Item need not be answered with respect to options held as of the specified date by such person or group.

d. The term “option” as used in this paragraph includes all options, warrants or rights, other than those issued to security holders as such on a pro rata basis. Where the average price per share iscalled for, the weighted average price per share shall be given.

e. The extension, re-granting or material amendment of options shall be deemed the granting of options within the meaning of this paragraph.

f. If the options relate to more than one class of securities, the information shall be given separately for each such class.

6. Indebtedness of management.

a. State as to each of the following persons who was indebted to the issuer or its subsidiaries at any time since the beginning of the last fiscal year of the registrant, the largest aggregate amount of indebtedness outstanding at any time during such period, the nature of the indebtedness outstanding and the transaction in which it was incurred, the amount thereof outstanding as

of the largest practicable date, and the rate of interest paid or charged thereon:

i. Each director or officer of the issuer;

ii. Each nominee for election as a director; and

iii. Each associate of any such director, officer or nominee.

b. This subparagraph (e) does not apply to: (a) any person whose aggregate indebtedness did not exceed $10,000 or 1 percent of the issuer’s total assets, whichever is less, at any time during the period specified or (b) indebtedness under an insurance policy.

7. Transactions with management.

a. Describe briefly any transaction since the beginning of the issuer’s last fiscal year or any presently proposed transactions, to which the issuer or any of its subsidiaries was or is to be a party, in which any of the following persons had or is to have a direct or indirect material interest, naming such person and stating his relationship to the issuer, the nature of his interest in the transaction and, where practicable, the amount of such interest.

i. Any director or officer of the issuer;

ii. Any nominee for election as a director;

iii. Any security holder who is known to the issuer to own of record or beneficially more than ten percent of any class of issuer’s voting securities; and

iv. Any relative or spouse of any of the foregoing persons, or any relative of such spouse, who has the same home as such person who is a director or officer of any parent or subsidiary of the issuer.

b. Also, describe briefly any material legal proceedings to which any such person is a party adverse to the issuer or any of its subsidiaries or has a material interest adverse to the issuer or any of its subsidiaries.

c. No information need be given in response to this Item 7(f) as to any remuneration or other transaction reported in response to Item 7(a), (b), (c), (d), (e), or as to any transaction with respect to which information may be omitted pursuant to these Items.

d. No information need be given in answer to this Item 7(f) as to any transaction where:

i. The rates or charger involved in the transaction are determined by competitive bids, or at rates or charges fixed in conformity with law or governmental authority;

ii. The transaction involves services as a bank depository of funds, transfer agent, registrar, trustee under a trust indenture, or similar services;

iii. The amount involved in the transaction or series of similar transaction, including all periodic installments in the case of any lease or other agreement providing for periodic payments or installments, does not exceed $40,000; or

iv. The interest of the specified person arises solely from the ownership of securities of the issuer and the specified person receives no extra or special benefit not shared on a pro rata basis by all holders of securities of the class.

e. It should be noted that this item calls for disclosure of indirect, as well as direct, material interests in transactions. A person who has a position or relationship with a firm, corporation, or other entity, which engages in a transaction with the issuer or its subsidiaries may have an indirect interest in such transaction by reason of such position or relationship. However, a person shall be deemed not to have a material indirect interestin a transaction within the meaning of this Item 7(f) where:

i. The interest arises onlyfrom such person’s position as a director of another corporation or organization (other than a partnership) which is a party to the transaction, or ii. from both such position and ownership;

iii. The interest arises only from such person’s position as a limited partner in a partnership in which he and all other persons specified in Item 7(f) had an interest percent; or

iv. The interest of such person arises solely from the holding of an equity interest (including a limited partnership interest but excluding a general partnership interest) or a creditor interest in another person which is a party to the transaction with the issuer or any of its subsidiaries and the transaction is notmaterial to such other person

8 Instructions.

a. In describing any transaction involving the purchase of sale of assets by or to the issuer or any of its subsidiaries, otherwise than in the ordinary course of business, state the cost of the assets to the purchaser and, if acquired by the seller within two years prior to the transaction, the cost thereof to the seller. Indicate the principle followed in determining the issuer’s purchase or sale price and the name of the person making such determination.

b. Information shall be furnished in answer to this Item with respect to transactions not excluded above which involve remuneration from the issuer or its subsidiaries, directly or indirectly, to any of the specified persons for services in any capacity unless the interest of such persons for services in any capacity unless the interest of such persons arises solely from the ownership individually and in the aggregate of less than 10% of any class of equity securities of another corporation furnishing the services to the issuer or itssubsidiaries.

9 Transactions with pension or similar plans.

a. Describe briefly any transactions since the beginning of the issuer’s last fiscal year, or any presently proposed transactions, to which any pension, savings or similar plan provided by the issuer, or any of its parents or subsidiaries was or is to be a party, in which any of the persons specified in Item 7(f) or the issuer or any of its subsidiaries had or is to have a direct or indirect material interest naming such person and stating hisrelationship to the issuer, the nature of his interest in the transaction and, where practicable, the amount of such interest.

b. No information need be given in answer to paragraph (g) with respect to:

i. payments to the plan, or payments to beneficiaries, pursuant to the terms of the plan;

ii. payment of remuneration for services not in excess of 5 percent of the aggregate remuneration received by the specified person during the issuer’s last fiscal year from the issuer and its subsidiaries; or

iii. any interest of the issuer or any of its subsidiaries which arises solelyfrom its general interest in the success of the plan.

10. Instructions.

a. Subparagraph to Item 7(f) shall apply to this Item 7(g).

b. Without limiting the general meaning of the term “transaction”, there shall be included in answer to this item any remuneration received or any loans received or outstanding during this period, or proposed to be received.

H. Matters Related to Accounting

If the solicitation is made on behalf of the issuer and relates to an annual meetingof security holders at which directors are to be elected, or financial statements are included, furnish the following information:

1. If the issuer’s financial statements are not certified by independent public or certified accountants, so state.

2. If the Board of Directors has no audit or similar committee, so state.

3. If the issuer’s financial statements are certified by independent public or certified accountants, so state and provide the following information:

a. The name of the principal accountant selected or being recommended to shareholders for election, approval or ratification for the current year. If no accountant has been elected or recommended, so state and briefly describe the reason therefor.

b. The name of the principal accountant for the fiscal year most recently completed if different from the accountant selected or recommended for the current year or if no accountant has been elected or recommended for the current year.

c. If a change or changes in accountants have taken place since the date of the proxy statement for the most recent annual meeting of shareholders, so state, and if in connection with such change(s) a material disagreement in connection with financial disclosure between the accountant and issuer has occurred, the disagreement shall be described. Prior to filing the preliminary proxy materials with the Commissioner which contains or amends such description, the issuer shall furnish the description of the disagreement to any accountant with whom the disagreement has occurred. If that accountant believes that the description of the disagreement is incorrect or incomplete, he may include a brief statement, not to exceed 200 words, in the proxy statement presenting his view of the disagreement. This statement shall be submitted to the issuer within ten business days of the date the accountant receives the issuer’s description.

d. The proxy statement shall indicate whether or not representatives of the principal accountants for the current year and for the most recently completed fiscal year are expected to be present at the stockholders’ meeting with the opportunity to make a statement if they desire to do so and whether or not

such representatives are expected to be available to respond to appropriate questions.

e. If any change in accountants has taken place since the date of the proxy statement for the most recent annual meeting of shareholders, state whether such change was recommended or approved by:

i. Any audit or similar committee of the Board of Directors, if the issuer has such a committee; or

ii. The Board of Directors, if the issuer has no such committee.

iii. For the fiscal year most recently completed, describe each professional service provided by the principal accountant and state the percentage relationship which the aggregate of the fees for all non-audit services bear to the audit fees, and, except as provided below, state the percentage relationship which the fee for each non-audit service bears to the audit fees. Indicate whether, before each professional service provided by the principal accountant was rendered, it was approved by, and the possible effect on the independence of the accountant was considered by, (1) any audit or similar committee of the Board of Directors and, (2) for any service not approved by an audit or similar committee, the Board of Directors.

4. Instructions.

a. For the purposes of this subsection, all fees for services provided in connection with the audit function (e.g. reviews of quarterly reports) may be computed as part of the audit fees. Indicate which services are reflected in the audit fees computation.

b. If the fee for any non-audit service is less than 3 percent of the audit fees, the percentage relationship need not to be disclosed.

c. Each service should be specifically described. Broad general categories such as “tax matters” or “management advisory services” are not sufficiently specific.

d. Describe the circumstances and give details of any services provided by the issuer’s independent accountant during the latest fiscal year that were furnished at rates or terms that were not customary.

e. Describe any existing direct or indirect understanding or agreement that places a limit on current or future years’ audit fees, including fee arrangements that provide fixed limits on fees that are not subject to reconsideration if

unexpected issues involving accounting or auditing are encountered. Disclosure of fee estimates is not required.

I. Bonus, Profit Sharing and Other Remuneration Plans: Pension and Retirement Plans

If action is to be taken with respect to any bonus, profit sharing or other remuneration plan or any pension or retirement plan, furnish the following information.

1. Describe briefly the material features of the plan, identify each class of persons who will participate therein, indicate the approximate number of persons in each such class and state the basis of such participation.

2. Furnish such information, in addition to that required by this item and Item 7, as may be necessary to describe adequately the provisions already made pursuant to all bonus, profit sharing, pension retirement, stock option, stock purchase, deferred compensation, or other remuneration or incentive plans, now in effect or in effect within the past five years, for each director or officer named in answer to Item 7(a) who may participate in the plan to be acted upon; all present directors and officers of the issuer as a group, if any director or officer may participate in the plan, and all employees, if employees may participate in the plan.

3. If the plan to be acted upon can be amended otherwise than by a vote of stockholders, to increase the cost thereof to the issuer or to alter the allocation of the benefits as between the directors and officers on the one hand and employees on the other, state the nature of the amendments which can be so made.

4. With regard to any bonus, profit sharing or other remuneration plan, on which action is to be taken, furnish the following information.

a. State separately the amounts which would have been distributable under the plan during the last fiscal year of the issuer (1) to directors and officers and (2) to employees if the plan had been in effect.

b. State the name and position with the issuer of each person specified in Item 7(a), who will participate in the plan and the amount which each such person would have received under the plan for the last fiscal year of the issuer if the plan had been in effect.

5. With regard to any pension or retirement plan on which action is to be taken, furnish the following information:

a. State the approximate total amount necessary to fund the plan with respect to past services, the period over which such amount is to be paid and the estimated annual payments necessary to pay the total amount over such period, the estimated annual payment to be made with respect to current

services and the amount of such annual payments to be made for the benefit of directors and employees.

b. State the name and position with the issuer of each person specified in Item 7(a) who will be entitled to participate in the plan, the amount which would have been paid or set aside by the issuer and its subsidiaries for the benefit of such person for the last fiscal year of the issuer if the plan had been in effect, and the amount of the annual benefits estimated to be payable to such person in the event of retirement at normal retirement date.

6. Instructions.

a. If action is to be taken with respect to the amendment or modification of an existing plan, the item shall be answered with respect to the plan as proposed to be amended or modified and shall indicate any material differences from existing plan.

b. The following instructions shall apply to paragraph (b):

i. Information need only be given with respect to benefits received or set aside within the past five years.

ii. Information need not be included as to payments made for, or benefits to be received from, group life or accident insurance, group hospitalization or similar group payments or benefits.

iii. If action is to be taken with respect to any plan in which directors or officers may participate, the information called for by Item 7(d) and shall be furnished for the last five fiscal years of the issuer and any period subsequent to the end of the latest such fiscal year, in aggregate amounts for the entire period for each such person and group. If any named person, or any other director or officer, purchased securities through the exercise of options during such period, state the aggregate amount of securities of that class sold during the period by such named person and by such named person and such other directors and officers as a group. The information called for by this Instruction is in lieu of the information since the beginning of the issuer’s last fiscal year called for by Item 7(d). If employees may participate in the plan to be acted upon, state the aggregate amount of securities called for by all options or options granted to employees during the five-year period and, if the options were other than “restricted” or “qualified” stock options or options granted pursuant to an “employee stock purchase plan”, as the quoted terms are defined in section 422 through 424 of the Internal Revenue Code, state that fact and the weighted average option price per share. The information called for by this instruction may be furnished in the form of the table set forth in Item 7(d).

c. If the plan to be acted upon is set forth in a written document, three copies thereof shall be filed with the Commissioner at the time preliminary copies of the proxy statement and form of proxy are filed.

d. The information called for by subparagraph (e)(1)(c) or (e)(2)(b) of this Item 7 need not be given as to payments made on an actuarial basis pursuant to any group pension plan which provides for fixed benefits in the event of retirement at a specified age or after a specified number of year of service.

J. Options, Warrants, or Rights

If action is to be taken with respect to the granting or extension of any options to purchase securities of the issuer or any subsidiary, furnish the following information:

1. State the title and amount of securities called for or to be called for by such options; the prices, expiration dates and other material conditions upon which the options may be exercised; the consideration received or to be received by the issuer or subsidiary for the granting or extension of the options; the market value of the securities called for or to be called for by the options as of the latest practicable date; and in the case of options, the Federal income tax consequences of the issuance and exercise of such option tothe recipient and to the issuer.

2. State separately the amount of options received by the following persons, naming each such person: each director or officer named in answer to Item 7(a); each nominee for election as a director of the issuer; each associate of such directors, officers, or nominees; and each other person who received by all directors and officers of the issuer as a group, without naming them.

3. Furnish such information, in addition to that required by this item and Item 7, as may be necessary to describe adequately the provision already made pursuant to all bonus, profit sharing pension, retirement, stock option, stock purchase, deferred compensation, or other remuneration or incentive plans, now in effect or in effect within the past five years, for each director or officer named in answer to Item 7(a) who may participate in the plan to be acted upon; all present directors and officers of the issuer as a group, if any director or officer may participate in the plan, and all employees, if employees may participate in the plan.

4. Instructions.

a. For the purpose of this paragraph J, the term option includes any option, warrant or right.

b. Paragraphs (2) and (3) do not apply to warrants or rights to be issued to security holders as such on a pro rata basis.

c. Instruction 6 to paragraph Ishall also apply to paragraph (3) of this item.

d. If the options described in answer to this item are issued pursuant to a plan which is set forth in a written document, three copies thereof shall be filed with the Commissioner at the time preliminary copies of the proxy statement and form of proxy are filed.

K. Authorization of Issuance of Securities Otherwise than for Exchange

If action is to be taken with respect to the authorization or issuance of any securities otherwise than for exchange for outstanding securities of the issuer, furnish the following information:

1. State the title and amount of securities to be authorized or issued.

2. If the securities are other than additional shares of common stock of a class outstanding, furnish a brief summary of the following, if applicable: dividend, voting, liquidation, preemptive, and conversion rights, redemption and sinking fund provisions, interest rate and date of maturity.

3. Describe briefly the transaction in which the securities are to be issued, including a statement as to the nature and approximate amount of consideration received or to be received by the issuer, and the approximate amount devoted to each purpose, as far as is determinable, for which the net proceeds have been or are to be used. If it is impracticable to describe the transaction in which the securities are to e issued, state the reason, indicate the purpose of the authorization of the securities, and state whether further authorization for the issuance of the securities by a vote of security holders will be solicited prior to such issuance.

4. If the securities are to be issued otherwise than in a general public offering for cash, state the reasons for the proposed authorization or issuance and the general effect thereof upon the rights of existing security holders.

L. Modification or Exchange of Securities

If action is to be taken with respect to the modification of any class of securities of the issuer, or the issuance or authorization for the issuance of securities of the issuer in exchange for outstanding securities of the issuer, furnish the following information:

1. If outstanding securities are to be modified, state the title and amount thereof. If securities are to be issued in exchange for outstanding securities, state the title amount of securities to be so issued, the title and amount of outstanding securities to be exchanged therefor and the basis of the exchange.

2. Describe any material differences between the outstanding securities and the modified or new securities.

3. State the reasons for the proposed modification or exchange and the general effect thereof upon the rights of existing security holders.

4. Furnish a brief statement as to arrears in dividends or as to defaults in principal or interest in respect to the outstanding securities which are to be modified or exchanged and such other information as may be appropriate in the particular case to disclose adequately the nature and effect of the proposed action.

5. Outline briefly nay other material features of the proposed modification or exchange. If the plan of the proposed action is set forth in a written document, file copies thereof with the Commissioner at the time the preliminary proxy material is filed.

M. Mergers, Consolidations, Acquisitions, and Similar Matters

Furnish the following information if action is to be taken with respect to any plan for the merger or consolidation of the issuer into or with any other person or of any other person into or with the issuer, the acquisition by the issuer or any of its security holders of securities of another issuer, the acquisition by the issuer of any other going business or of the assets thereof, the sale or other transfer of all or any substantial part of the assets of the issuer, or the liquidation or dissolution of the issuer:

1. Outline briefly the material features of the plan. State the reasons therefor and the general effect thereof upon the rights of existing security holders. If the plan is set forth in a written document, file three copies thereof with the Commissioner at the time preliminary copies of the proxy statement and form of proxy are filed.

2. Furnish the following information as to the issuer and each person which is to be merged into the issuer or into or with which the issuer is to be merged or consolidated or the business or assets or to be acquired or which is the issuer of securities to be acquired by the issuer in exchange for all or a substantial part of its assets or to be acquired by security holders of the issuer. What is required is information essential to an investor’s appraisal of the action proposed to be taken.

a. Describe briefly the business of such person.

b. State the location and describe the general character of the plants and other important physical properties of such person. The description is to be given from an economic and business standpoint, as distinguished from a legal standpoint. Portfolio or investment assets of an issuer need not be enclosed.

c. Furnish a brief statement as to dividends in arrears or defaults in principal or interest in respect of any securities of the issuer or of such person, and as to the effect of the plan thereon and such other information as may be appropriate in the particular case to disclose adequately the nature and effect of the proposed action.

d. Furnish tabulation in columnar form showing the existing and the pro forma capitalization.

e. Furnish in columnar form for each of the last five fiscal years an historical summary of earnings and show per share amounts of net earnings, dividends declared for each year and book value per share at the end of the latest period.

f. Furnish in columnar form for each of the last five fiscal years a combined pro forma summary of earnings, as appropriate in the circumstances, indicating the aggregate and per-share earnings for each such year and the pro forma book value per share at the end of the latest period. If the transaction establishes a new basis of accounting for assets of any of the persons included therein, the pro forma summary of earnings shall be furnished only for the most recent fiscal year and interim period and shall reflect appropriate pro forma adjustments resulting from such new basis of accounting.

g. To the extent material for the exercise of prudent judgment in regard to the matter to be acted upon, furnish the historical and pro forma earnings data specified in (5) and (6) above for interim periods of the current and prior fiscal years, if available.

3. Instructions.

a. Subparagraph (b) of this Item 13 shall not apply if the plan described in answer to paragraph (a) involves only the issuer and one or more of its totally- held subsidiaries.

b. As to each class of securities of the issuer, or of any person specified in paragraph (b), which is admitted to dealing on a national securities exchange or with respect to which a market otherwise exists, and which will be materially affected by the plan, state the high and low sale prices (or, in the absence of trading in a particular period, the range of the bid and asked prices) for each quarterly period within two years. This information may be omitted if the plan involves merely the liquidation or dissolution of the issuer.

N. Financial Statements

1. If action is to be taken with respect to any matter specified in Item 11, 12, 13 above, furnish financial statements of the issuer and its subsidiaries complying with the requirements of Section 4(b)(1), (2) and (3) of the Regulation including schedules of supplementary profit and loss information. Such statements may be omitted with respect to a plan described in answer to Item 13 if the plan involves only the issuer and one or more of its totally-held subsidiaries.

2. If action is to be taken with respect to any matter specified in Item 13(b) furnish for each person specified therein, other than the issuer, financial statements complying with the requirements of Section 4(b)(1), (2) and (3) of the Regulation.

3. The Commissioner may, upon the request of the issuer, permit the omission of any of the statements herein required where such statements are not necessary for the exercise of prudent judgment in regard to any matter to be acted upon, or may permit the filing in substitution therefor of appropriate statements of comparable character. The Commissioner may also require the filing of other statements in addition to, or in substitution for, the statements herein required in any case where such statements for an adequate presentation of the financial statements are required, or whose statements are otherwise material for the exercise of prudent judgment in regard to any matter to be acted upon. In the usual case, financial statements are deemed material to the exercise of prudent judgment where the matter to be acted upon is the authorization or issuance of a material amount of senior securities, but are not deemed material where the matter to be acted upon is the authorization or issuance of common stock, otherwise than in an exchange, merger or consolidation, acquisition or similar transaction.

4. The proxy statement may incorporate by reference any financial statements contained in an annual report sent to security holders with respect to the same meeting as that to which the proxy statement relates, provided such financial statements substantially meet the requirements of this Item.

O. Acquisition or Disposition of Property.

If action is to be taken with respect to the acquisition or disposition of any property, furnish the following information:

1. Describe briefly the general character and location of the property.

2. State the nature and amount of consideration to be paid or received by the issuer or any subsidiary. To the extent practicably, outline briefly the facts bearing upon the question of the fairness of the consideration.

3. State the name and address of the transferor or transferee as the case may be, and the nature of any material relationship of such person to the issuer or an affiliate of the issuer.

4. Outline briefly any other material features of the contract or transaction.

P. Restatement of Accounts

If action is to be taken with respect to the restatement of any asset, capital, or surplus account of the issuer, furnishes the following information:

1. State the nature of the restatement and the date as of which it is to be effective.

2. Outline briefly the reasons for the restatement and for the selection of the particular effective date.

3. State the name and amount of each account (including any reserve accounts) affected by the restatement and the effect of the restatement thereon. Tabular presentationof the amounts shall be made when appropriate, particularly in the case of recapitalization.

4. To the extent practicable, state whether and the extent, if any, to which the restatement will, as of the date thereof, alter the amount available for distribution to the holders of equity securities.

Q. Action with Respect to Reports

If action is to be taken with respect to any report of the issuer or of its directors, officers or committees or any minutes of its stockholders, furnish the following information:

1. State whether or not such action is to constitute approval or disapproval of any of the matters referred to in such reports or minutes.

2. Identify each of such matters which it is intended will be approved or disapproved and furnish the information required by the appropriate item or items of this Schedule with respect to each such matter.

R. Matters Not Required to be Submitted

If action is to be taken with respect to any matter which is not required to be submitted to a vote of security holders, state the nature of such matter, the reasons for submitting it to a vote of security holder and what action is intended to be taken by the management in the event of a negative vote on the matter by the security holders.

S. Amendment of Charter, Bylaws of Other Documents

If action is to be taken with respect to any amendment of the issuer’s charter, bylaws or other documents as to which information is not required above, state briefly the reasons for and general effect of such amendment.

Instruction: Where the matter to be acted upon is the classification of directors, state whether vacancies which occur during the year may be filled by the board of directors to serve only until the next annual meeting or may be so filled for the remainder of the full term.

T. Other Proposed Action

`If action is to be taken with respect to any matter not specifically referred to above, describe briefly the substance of each matter in substantially the same degree of detail as is required by Items 5 to 19, inclusive, above.

U. Vote Required for Approval

As to each matter which is to be submitted to a vote of security holders, other than elections to office or the selection or approval of auditors, state the vote required for its approval.

Rule 12.18Schedule B: Information to Be Included In Statements Filed By Or On Behalf Of a Participant (Other Than the Issuer) In a Proxy Solicitation inan Election Contest

A. Issuer

State the name and address of the Issuer.

B. Identity and Background

1. State the following:

a. Your name and business address.

b. Your present principal occupation or employment and the name, principal business and address of any corporation or other organization in which such employment is carried on.

2. State the following:

a. Your residence address.

b. Information as to all material occupations, positions, offices or employments during the last ten years, giving starting and ending dates of each and the name, principal business and address of any business corporation or other business organization in which each such occupation, position, office or employment was carried on.

3. State whether or not you are or have been a participant in any other proxy contest involving this company or other companies within the past ten years. If so, identify the principals, the subject matter and your relationship to the parties and the outcome.

4. State whether or not, during the past ten years, you have been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors) and, if

so, give dates, nature of conviction, name and location of court, and penalty imposed or other disposition of the case. A negative answer to this sub-item need not be included in the proxy statement or other proxy soliciting material.

C. Interest in Securities of the Issuer

1. State the amount of each class of securities of the issuer which you own beneficially, directly or indirectly.

2. State the amount of each class of securities of the issuer which you own of record but not beneficially.

3. State with respect to all securities of the issuer purchased or sold within the past two years, the dates on which they were purchased or sold and the amount purchased or sold on each such date.

4. If any part of the purchase price or market value of any of the securities specified in paragraph (c) is represented by funds borrowed or otherwise obtained for the purpose of acquiring or holding such securities, so state and indicate the amount of the indebtedness as of the latest practicable date. If such funds were borrowed or obtained otherwise than pursuant to a margin account or bank loan in the regular course of business of a bank, broker or dealer, briefly describe the transaction, and state the names of the parties.

5. State whether or not you are a party to any contracts, arrangements or understandings with any person with respect to any securities of the issuer including but not limited to joint ventures, loan or option arrangements, puts or calls guarantees against losses or guarantees or profits, division of losses or profits, or the giving or withholding of proxies. If so, name the persons with whom such contracts, arrangements, or understandings exist and give the details thereof.

6. State the amount of securities of the issuer owned beneficially directly or indirectly, by each of your associates and the name and address of each such associate.

7. (g) State the amount of each class of securities of any parent, subsidiary or affiliate of the issuer which you own beneficially directly or indirectly.

D. Further Matters.

1. Describe the time and circumstances under which you became a participant in the solicitation and state the nature and extent of your activities or proposed activities as a participant.

2. Describe briefly, and where practicable state the approximate amount of, any material interest, direct or indirect, of yourself and of each of your associates in any material transactions since the beginning of the company’s last fiscal year, or in any material

proposed transactions, to which the company or any of its subsidiaries or affiliates was or is to be a party.

3. State whether or not you or any of your associates have any arrangement or understanding with any person:

a. With respect to any future employment by the issuer or its subsidiaries or affiliates; or

b. With respect to any future transactions to which the issuer or any of its subsidiaries or affiliates will or may be a party.

If so, describe such arrangement or understanding and state the names of the parties thereto.

E. Signature

The statement shall be dated and signed in the following manner:

I certify that the statements made in this statement are true, complete, and correct, to the best of my knowledge and belief.

_______________ _______________________________________________ (Date) (Signature of participant or authorized representative)

Rule 12.19Schedule C: Information Required In Information Statement

Note. Where any item other than Item 5, calls for information with respect to any matter to be acted upon at the meeting, such item need be answered only with respect to proposals to be made by the issuer.

A. Information Required by Items of Schedule 14A

Furnish the information called for by all of the items of Schedule A of the Regulation Regarding Proxies, Consents and Authorization (other than Items 1, 3, and 4 thereof) which would be applicable to any matter to be acted upon at the meeting if proxies were to be solicited in connection with the meeting.

B. Statement That Proxies Are Not Solicited

The following statement shall be set forth on the first page of the information statement in bold face type:

WE ARE NOT ASKING YOU FOR A PROXY AND YOU ARE REQUESTED NOT TO SEND US A PROXY.

C. Date, Time and Place of Meeting

State the date, time and place of the meeting of security holders, unless such information is otherwise disclosed in material furnished to security holders with the information statement.

D. Interest of Certain Persons in or Opposition to Matters to be ActedUpon.

1. Describe briefly any substantial interest, direct or indirect, by security holdings or otherwise, of each of the following persons in any matter to be acted upon, other than elections to office:

a. Each person who has been a director or officer of the issuer at any time since the beginning of the last fiscal year.

b. Each nominee for election as a director of the issuer.

c. Each associate of the foregoing persons.

2. Give the names of any director of the issuer who has informed the management in writing that he intends to oppose any action to be taken by the management at the meeting and indicate the action which he intends to oppose.

E. Proposals by Security Holders

If any security holder entitled to vote at the meeting has, not less than 90 days before the issuer’s annual meeting, submitted to the issuer a proposal which is accompanied by notice of his intention to present the proposal for action at the meeting, make a statement to that effect, identify the proposal and indicate the disposition proposed to be made of the proposal by the management at the meeting.

History

• Source: Miss. Code Ann. § 83-19-97 (Rev. 2011)
• Source: Miss. Code Ann. § 83-19-91; § 83-19-97 (Rev. 2011)
• Source: Miss. Code Ann. § 83-19-97 (Rev. 2011)

Chapter 15 Rules of Practice and Procedure before the Mississippi Insurance Department and State Fire Marshal’s Office.

19 Miss. Admin. Code Pt. 1, R. 15.01 Rule 15.01

Statutory Authority Rule 15.02 Purposes Rule 15.03 Applicability Rule 15.04 Definitions Rule 15.05 General Matters; Matters Pertaining to all Proceedings Rule 15.06 Licensing of Producers Rule 15.07 Licensing of Insurers Rule 15.08 Notice Rule 15.09 Hearing and Adjudication Rule 15.10 Orders Rule 15.11 Rules and Rulemaking Rule 15.12 Declaratory Opinions Rule 15.13 Effective Date

19 Miss. Admin. Code Pt. 1, R. 15.01 Statutory Authority

This Regulation is promulgated by the Commissioner of Insurance pursuant to the requirements of Miss. Code Ann. §25-43-5 an in accordance with the Mississippi Administrative Procedures Law. Some provisions of this Regulation are promulgated pursuant to the requirements of Miss. Code Ann. §25-61-5.

History

• Source: Miss. Code Ann. § 25-61-5; § 83-5-1 (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.02 Purposes

Miss. Code Ann. §25-43-5, the “Administrative Procedures Law”, requires each agency of state government to adopt as a rule a description of its organization, stating the general course and

method of its operations and the methods whereby the public may obtain information or make submissions or requests, and adopt rules of practice setting forth the nature and requirements of all formal and informal procedures available, including all requirements respecting the filing of applications for any license and the licensing procedure employed by the agency and the method whereby persons desiring notice pending applications may obtain such notice and request an opportunity to be heard.

The purpose of this Regulation is to comply with the requirements of the Administrative Procedures Law. Some provisions of the Regulation also comply with the requirements of Miss. Code Ann. §25-61-5 of the Mississippi Public Records Act of 1983, as amended.

History

• Source: Miss. Code Ann. § 25-61-5 (Rev. 2021) § 83-5-1 (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.03 Applicability

This Regulation shall be of general applicability and shall apply in all cases except to the extent a statute of the State of Mississippi provides otherwise.

History

• Source: Miss. Code Ann. § 25-61-5 (Rev. 2021)

19 Miss. Admin. Code Pt. 1, R. 15.04 Definitions

A. Department – The Insurance Department of the State of Mississippi.

B. State Fire Marshal’s Office – a division of the Department that is tasked with coordinating and assisting Mississippi fire and law enforcement services in order to protect life and property from fire and related perils.

C. Commissioner – The Insurance Commissioner and State Fire Marshal of the State of Mississippi.

D. Person – Any individual, partnership, corporation, association, reciprocal, exchange, inter-insurer, fraternal benefit society, insurer, company, society, syndicate, business trust, or any public or private organization of any character.

E. Party – Any person named or admitted as a party, or properly seeking and entitled as of right to be admitted as a party, in any Department proceeding.

F. Rule – Any Department statement of general applicability and effect that implements, interprets, or prescribes law or policy, or describes the organization, procedure, or practice of the Department.

G. Rule-Making – The process for the formulation, amendment, or repeal of a rule.

H. Order – The final disposition of the Department in any matter other than rule-making in which the Department is required by law to make its determination and, unless otherwise provided in law, after notice and hearing.

I. Adjudication – A ruling or judgment on a matter that is under the jurisdiction of the Department of Insurance.

J. Hearing – A proceeding for consideration or presentation of evidence, facts and matters for adjudication and decision regarding a matter that is under the jurisdiction of the Department of Insurance.

K. License – Any Department permit, certificate, approval, registration or similar form of permission or record required by law, except a charter, an insurance producer’s certificate of authority. For the purposes of this regulation, a license shall also include any permit, certificate of compliance or license issued by the State Fire Marshal’s Office.

L. Licensing – The Departmental process respecting the grant, denial, renewal, revocation, suspension, probation, withdrawal, or amendment of a license.

M. Application – The request for authority for an action or an issuance by the Commissioner or the Department.

N. Charter – The corporate charter of any corporation formed under the laws of Mississippi for the purpose of becoming an Insurer.

O. Certificate Of Authority – When used with respect to an insurance producer, a certificate issued by the Commissioner pursuant to Miss. Code Ann. Section 83-17-5. When used with respect to a foreign insurer, a certificate issued by the Commissioner pursuant to Miss. Code Ann. §83-21-1.

P. Insurance – A contract of insurance as defined in Miss. Code Ann. §83-5-5.

Q. Insurer – A “company” or “insurance company” as defined in Miss. Code Ann. §83-5-5.

R. Examination – A test, whether oral, written, or both, to determine the capacity of an applicant to be an insurance producer, broker, solicitor or adjuster.

S. Insurance Code – Mississippi Code Annotated, Title 83.

T. Certificate Of Compliance – A certificate issued by the Commissioner in his role as State Fire Marshal that a person or entity has met all necessary requirements and is in acting in accordance with any statute, rule or regulation under the jurisdiction of the State Fire Marshal.

U. Website – The Department hosts a public website wherein Department information, notices, bulletins and regulations, among other documents and information, are posted. The Department’s website address is www.mid.ms.gov .

History

• Source: Miss. Code Ann. §§ 83-5-1, et seq. (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.05 General Matters

A. Description of Department –The Insurance Department generally regulates all insurance companies and their agents doing business in the State of Mississippi. The Department’s responsibilities include, but are not limited, to the following: granting or withholding of charters, issuing certificates of authority; issuing licenses; approving policies, proxies, and advertising material; conducting hearings on rates; and any other matters affecting the regulation of the insurance industry in this state; administering and collecting surplus lines premium taxes; receiving and examining reports and financial statements from all insurance companies authorized to do business in this state; and preparing annual reports of the Insurance Commissioner.

The Commissioner has the further responsibility for the promulgation of rules and regulations concerning the activities of insurance companies and insurance producers engaged in the business of insurance in this State. The Department is composed of several divisions that deal directly with the public including, but not limited to:

• Producer Licensing; • Financial and Market Regulation; • Life and Health Actuarial; • Consumer Services; • Investigations and Consumer Protection; Property and Casualty Rating; • Legal.

The Insurance Department of the State of Mississippi also houses the State Fire Marshal’s Office. The Commissioner of Insurance is by virtue of his office the State Fire Marshal and conducts investigations into all fires of a suspicious nature; ensures compliance with the Mississippi Fire Prevention Code, provides fire safety education, and regulates manufactured housing, liquefied compressed gas, electronic alarms, pyrotechnics and elevators/escalators.

B. Office and Hours -The Office of the Department is located at Suite 1001, 501 N. West Street, Woolfolk State Office Building, in Jackson, Mississippi. The office shall be open during business hours each day, Saturday, Sunday, and holidays excepted. The mailing address of the Department is P. O. Box 79, Jackson, Mississippi 39205, and its telephone number is (601) 359-3569.

C. Custody Of Records – The Commissioner shall have custody of the Seal and records of the Department including the transcripts of testimony and exhibits with all papers and requests filed in proceedings, the minutes of all actions taken by the Department and all of

its findings, determinations, reports, opinions, orders, rules, regulations, and approved forms.

D. Public Records – Except as limited by Miss. Code Ann. §§25-61-9 and 25-61-11, and any other applicable statutory restriction, all public records of the Department are available to the public and may be inspected or copied at the office of the Department.

a. Records Request - A public records request may be made by using the Department’s online public records request system, which can be found at the Department’s website: www.mid.ms.gov , or it may be made by written request or by telephone. If a request is made verbally, the requestor may be asked to also submit a written request.

b. Copies of Records - Copies may be requested and shall be made under the supervision of Department personnel. Records may also be provided by e-mail or by providing scanned copies on a compact disc. The Department may not be able to produce the records in any other type of requested format, such as an electronic format. The Department shall prepare an invoice pursuant to the Public Access Information Fee Schedule located on the Department’s website. The fees shall be collected by the Department in advance of complying with the request pursuant to Miss. Code Ann. §25-61-7.

c. Production Schedule - Pursuant to Miss. Code Ann. §25-61-5, the Public Records Request will be fulfilled within seven (7) working days of the submission of the request. After seven (7) working days, MID will either produce the requested documents, will request an additional seven (7) working days, or another date that is mutually agreed upon by the parties .Denials by the Department for a request for access to or copies of public records shall be in writing and shall contain a statement of the specific reasons for the denial. Some information produced may contain publicly identifiable information or exempted information that is not subject to disclosure. MID will redact that information before producing the public documents as provided in Miss. Code Ann. §§25-61-9 and 25-61-11.

E. Computation Of Time – In computing the time period within which an act must be performed, the first day shall be excluded and the last day shall be included, but if the last day shall fall on a Saturday, Sunday or a legal holiday, then the next business day shall be construed as the last day.

History

• Source: Miss. Code Ann. § 25-61-1, et seq. (Rev. 2021); 83-5-1 (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.06 Licensing of Insurance Producers:

A. License Required - All insurance producers and business entities must be properly licensed before engaging in the business of insurance in this state. All applicants must have complied with the licensing laws prior to receiving a license to engage in the business of insurance in the State of Mississippi.

B. Major Lines of Authority -Insurance producer licenses are issued in the following major lines of authority:

1. Life 2. Accident and Health 3. Property 4. Casualty 5. Variable Life and Variable Annuity, and 6. Personal Lines

C. Limited Lines of Authority - Limited lines producer licenses are issued in the following limited lines of authority:

1. Industrial Fire 2. Surety 3. Title 4. Trip Accident and Baggage 5. Industrial Life and Accident & Health 6. Car Rental 7. Crop Insurance 8. Travel; and 9. Storage

D. Initial and Renewal Applications - License applications and renewal applications shall be made through the Department’s online licensing portal, which may be found at the Department’s website; www.mid.ms.gov .

E. Licensure Period – An insurance producer’s license will continue until such time as the licensure period elapses without timely renewal, or an administrative action is taken by the Department resulting in the revocation of the insurance producer’s license.

F. Continuation of License during Proceeding - When an insurance producer has made a timely and sufficient application for renewal of a license, certificate of authority, with reference to any activity of a continuing nature, the license, certificate of authority does not expire until the administrative action is completed. When a renewal application is denied or an administrative hearing is set to review the licensure status of an insurance producer, or the terms of a certificate of authority are limited, then the license or certificate of authority expires upon the issuance of an Administrative Order by the Commissioner

History

• Source: Miss. Code Ann. §§ 27-15-87 and 27-15-91 (Rev. 2021); 83-17-1, et seq.; 83-17-55, et seq.; 83-17-217 (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.07 Licensing of Insurers

A. Authority and Control – The Department has the sole authority and control over the issuance, grant, denial, refusal, suspension, revocation, expiration, termination, continuance, and renewal of licenses and certificates of authority for all insurers.

B. License Forfeited – Upon the revocation or forfeiture of a license or certificate of authority, said license shall be considered forfeited and no longer valid.

C. Notice and Hearing– Notice and hearing in accordance with this Regulation are required before the suspension or revocation of a license or certificate of authority. Suspension, refusal or revocation of a license or certificate of authority must be for certain statutory causes.

D. License Expiration– The license of an insurer is of a continuing nature, and shall only expire upon the suspension, revocation or forfeiture of an insurer’s license. When administrative action is taken to suspend or revoke an insurer’s license or certificate of authority, then the license or certificate of authority expires the last day for review of any Department Order or at a later date if so fixed by a court.

E. Domestic Insurers – Domestic insurers may become licensed and obtain a certificate of authority by complying with all statutory requirements, including but not limited to those of Title 83, Chapter 19 of the Code of Mississippi, completing and filing with the Department all necessary forms and providing any other information required by the Department. Copies of such forms and instructions regarding required information may be obtained at the Department’s website; www.mid.ms.gov .

F. Foreign Insurers – Foreign insurers may become licensed and obtain a certificate of authority by complying with all statutory requirements, including but not limited to those of Title, 83, Chapter 21 of the Code of Mississippi, and completing and filing with the Department all necessary forms and providing any other information required by the Department. Copies of such forms and instructions regarding required information may be obtained at the Department’s website; www.mid.ms.gov .

G. Non-Admitted And Alien Insurers – Insurers may be considered for placement on the Department’s eligible list of non-admitted insurers by complying with all statutory requirements, including but not limited to Miss. Code Ann. §83-21-17, and completing and filing with the Department all necessary forms and providing any other information required by the Department. Copies of such forms and instructions regarding required information may be obtained at the Department’s website; www.mid.ms.gov .

H. Annual Filings – Admitted insurers must annually complete and file with the Department all necessary forms and any other information required by the Department. Copies of such forms and instructions regarding required information may be obtained at the Department’s website; www.mid.ms.gov .

History

• Source: Miss. Code Ann. § 83-19-1, et seq.; § 83-21-1, et seq. (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.08 Administrative Hearings

A. Notices issued by the Department - Notices shall be effective only when in writing, signed by the Commissioner, his designee, or his attorney.

1. Every notice shall state its effective date.

2. Every notice shall concisely state;

a. Its intent and purpose;

b. The grounds on which it is based; and

c. The provisions of the statutes pursuant to which action is taken or proposed to be taken; but failure to so designate all applicable provisions shall not deprive the Commissioner of the right to rely thereon.

3. A notice may be given by service upon or delivery to the person to be notified or by mailing it, postage prepaid, addressed to such person at his home or at his principal place of business as last on record in the Department, or by electronic delivery with a delivery receipt, if an electronic mail address has been provided.

B. Notice of Hearing – Prior to any hearing regarding an administrative action the Department may be taking against any licensee under the jurisdiction of the Department, the Department shall provide the following notice.

1. Notice of at least twenty (20) days before hearing unless a different time period is specified by law.

2. Notice shall include a statement of the terms or substance of the intended action or a description of the subjects and issues involved, and the time, the place and the manner in which interested persons may present their views thereon.

C. Hearing - In every case of adjudication in cases of a denial, revocation or suspension of any license or certificate of authority, and in cases of rule-making, where rules must be made after a hearing, and in all cases where required by the Insurance Code, a hearing shall be conducted either in-person, or by telephone or videoconference.

D. Right to Counsel – Any person appearing before the Department or any of its representatives shall have the right to be retain their own counsel for representation during the administrative process.

E. Exhibits and Evidence: The parties shall communicate and pre-file documentary evidence and/or exhibits with the Commissioner or the Hearing Officer, if one has been designated, not less than three (3) days prior to the hearing date.

1. Parties shall file exhibits electronically when possible. 2. Absent good cause, exhibits that are not pre-filed will not be admitted into the record. F. Presentation of Evidence– Opportunity shall be afforded all parties to respond and present evidence and argument on all issues involved.

G. Settlement- Nothing in these rules shall prohibit informal disposition by stipulation, settlement, or consent order.

H. Default – If, after proper notice and service, a person fails to appear before the Department for an administrative hearing, a default may be entered against that person, and a final order may be entered by the Commissioner.

I. Record – The record shall include:

1. All pleadings, motions, and intermediate rulings;

2. All evidence received or considered, including on request of any party a transcript of all proceedings or any part;

3. A statement of matters officially noticed;

4. Offers of proof, objections and rulings;

5. Proposed findings and exceptions; and,

6. A final order entered into the matter.

J. Findings of Fact – Findings of fact shall be based exclusively on the evidence received or on matters officially noticed by the Commissioner through his personal knowledge and expertise.

K. Relevant Materials - The Commissioner or his designee has the authority to exclude data or materials deemed to be improper or irrelevant. Formal rules of evidence shall not apply.

L. Court Reporter - The Department does not provide a court reporter for administrative hearings; the Department will make and preserve a record of an administrative hearing through the use of audio or video recording. A party wishing to have a court reporter present for an administrative hearing will need to make their own arrangements to retain a court reporter.

M. Service of Process - Parties shall be served either personally or by mail, postage prepaid, addressed to such person at his home or at his principal place of business as last on record in the Department, or by electronic delivery with a delivery receipt, if an electronic mail address has been provided, with a copy of any notice of hearing, decision or order.

N. Impartiality – Every member of the Department present shall conduct himself in an impartial manner and the presiding official may withdraw if he deems himself disqualified. Any party may file an affidavit of personal bias or disqualification, which shall be ruled upon by the Department, may be granted if it is timely and sufficient, and filed in good faith.

O. Power and Duties of Presiding Official – The presiding officer of the hearing shall be either the Commissioner or his designee, and shall have the power to:

1. Maintain order;

2. Rule on all questions arising during the course of the hearing;

3. Permit discovery by deposition or otherwise;

4. Hold conferences for the settlement or simplification of the issues;

5. Make or recommend findings;

6. Generally, regulate and guide the course of the proceedings.

P. Burden of Proof – the proponent of a rule or order shall have the burden of proof.

Q. Evidence –The Commissioner or his designee has the authority to exclude data or materials deemed to be improper or irrelevant. Irrelevant, immaterial, and unduly repetitious evidence shall be excluded. Any other evidence, oral or documentary, not privileged, may be received if it is a type commonly relied upon by reasonably prudent men in the conduct of their affairs. The Formal Rules of Evidence shall not apply.

R. Objections – Objections to the introductions of evidence may be made and shall be noted of record.

S. Evidence may be Written – When a hearing can be so expedited (and the interests of the parties will not be prejudiced) any part of the evidence may be received in written form.

T. Cross-Examination – Parties shall have the right to conduct such cross-examination as may be required for a full, true disclosure of the facts.

U. Official Notice – Official notice may be taken of judicially cognizable facts and of generally recognized technical or scientific facts peculiarly within the Department’s specialized knowledge. Parties shall be notified of material so noticed (including any staff

memoranda or data). Parties shall be afforded a reasonable opportunity to show the contrary.

V. Continuation of License during Proceeding - When an insurance producer has made a timely and sufficient application for renewal of a license or certificate of authority, with reference to any activity of a continuing nature, the license or certificate of authority does not expire until the administrative action is completed. When a renewal application is denied or an administrative hearing is set to review the licensure status of an insurance producer, or the terms of a certificate of authority are limited, then the license or certificate of authority expires upon the issuance of an Administrative Order by the Commissioner.

Rule 15.09: Administrative Orders

A. Notice and Hearing – Unless otherwise provided in statutory law, any administrative action of the Commissioner shall only be made after notice and hearing to the respondent.

B. Written Orders – Orders of the Commissioner shall be effective only when in writing.

C. Order Formulated Upon Adjudication – There shall be an order formulated upon each adjudication made by the Department or the Commissioner, or his deputy or employee.

D. Effective Date – Each order shall contain its effective date and shall concisely state its intent or purpose and the grounds and pertinent provision of law on which it is based.

E. Publication of Order– An order may be given by service upon or delivery to the person ordered by mail, postage prepaid, addressed to the person at his home or at his principal place of business as last of record in the Department, or by electronic delivery with a delivery receipt, if an electronic mail address has been provided. Furthermore, the Commissioner has the discretion to post said Order on the Department’s website.

Rule 15.10. Bulletins.

The Department may issue Bulletins, which are considered guidance and explanatory in nature, without notice and hearing, and without public participation. Upon adoption of a Bulletin by the Commissioner, the a copy of the Bulletin shall be placed on the Department website, and electronically mailed to all persons who may have made timely request of the Commissioner for notice of adoption of any rule.

History

• Source: Miss. Code Ann. § 25-43-1.106 (Rev. 2021) and § 83-18-21 (Rev. 2022)
• Source: Miss. Code Ann. § 83-5-1 (Rev. 2022)
• Source: Miss. Code Ann. § 83-5-1 (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 15.11 Regulations

A. The Department shall comply with the Mississippi Administrative Procedures Act, Miss. Code Ann. §§25-43-1, et. seq., in the establishment the rules and regulations of the Department.

B. Notice– Prior to adoption, amendment or repeal of any regulation, the Department shall give the following notice.

1. Notice of at least twenty-five (25) days of the intended action is required

2. Notice shall include a statement of the terms or substance of the intended action or a description of the subjects and issues involved, and the time, the place and the manner in which interested persons may present their views thereon.

3. Notice shall be filed with the office of the Secretary of State of the State of Mississippi, placed on the Department website, and electronically mailed to all persons who may have made timely request of the Commissioner for advance notice of rule-making proceedings.

4. Notice may be published in such newspapers of general daily circulation and in such insurance publications as selected by the Department.

C. Emergency Regulations –If the Commissioner finds that an imminent peril to the public health, safety or welfare require adoption of a rule upon fewer than twenty-five (25) days notice and states in writing its reasons for that finding, the Commissioner may proceed without prior notice of hearing or upon an abbreviated notice and hearing that it finds practicable to adopt an emergency rule, pursuant to the provisions provided in Miss. Code Ann., §25-43-3.108.

D. Written Comments – Written comments will be accepted on all proposed regulations, except for emergency or temporary regulations. The Department’s website will provide interested parties with the information on when and how a written comment may be submitted regarding the adoption of the proposed regulation.

E. Oral Hearing - If an oral hearing is held regarding the adoption of a regulation, the following provision, in addition to any statutory requirements, shall apply:

1. The time and place of the public hearing shall be posted on the Department’s website.

2. The public hearing shall be presided over by the Commissioner or his designee.

3. The Commissioner or his designee shall determine all procedural questions not governed by the Administrative Procedures Act, may limit the number of witnesses and to impose such time and presentation limitations as deemed reasonable. Any public hearing held will be a non-adversary, fact-finding

proceeding, and any rule action taken need not be based exclusively on the record of such hearing.

4. Any person interested may attend the hearing, with or without counsel. Any hearing participant may introduce oral testimony through such witnesses as the presiding representative shall permit.

5. The obtaining and use of witnesses is the responsibility of the parties attending the hearing. All witnesses shall be present on their own volition, but any person appearing as a witness may be questioned by any hearing participant and the presiding representative.

6. The Commissioner or his designee have the authority to exclude data or materials deemed to be improper or irrelevant. Formal rules of evidence shall not apply.

F. Written and Oral Comments - All timely written and/or oral comments will be considered before taking any final rule action. All rule actions proposed pursuant to this regulation shall be effective upon the Department’s provision of the final version of the rule or statement of repeal thereof to the office of the Secretary of State. However, no rule shall become effective prior to the time limits imposed by the Administrative Procedures Act. Any party having timely commented adversely to the proposed rule action may seek review of the final rule action in a court of proper jurisdiction.

G. Post-Adoption Actions - Any person aggrieved by any act of the Commissioner with regard to the adoption, amendment or repeal of any rule, may file a petition for review of an adverse ruling within five (5) days after receipt of notice thereof in the case of those interested persons who have made timely requests of the Insurance Department for advance notice of the Insurance Department’s rule-making procedure and ten (10) days for all other interested persons.

History

• Source: Miss. Code Ann. § 25-43-3.101, et seq. (Rev. 2021)

19 Miss. Admin. Code Pt. 1, R. 15.12 Declaratory Opinions

Pursuant to Miss. Code. Ann. §25-43-2.103, any person with a substantial interest in the subject matter may make a written request of an agency for a declaratory opinion as to the applicability to specified circumstances of a statute, rule or order within the primary jurisdiction of the agency.

A. Request for a Declaratory Order –Any request for a declaratory opinion must be made in writing and shall be directed to the Department’s Legal Division. Such petition shall be promptly considered and a prompt disposition shall be made.

B. Response - The Department shall provide a written response to the request for a declaratory opinion to the requesting party within forty-five days of receipt of said

request, providing either a declaratory opinion, an agreement to issue an opinion within ninety days, or decline to issue a declaratory opinion.

Rule 15.13: Effective Date

This Regulation shall become effective thirty (30) days after filing with the Office of the Secretary of State.

History

• Source: Miss. Code Ann. §§25-43-2.103; (Rev. 2021) 83-5-1 (Rev. 2022)
• Source: Miss. Code Ann. § 25-43-3.106 (Rev. 2021)

Chapter 16 (88-105) Advertisements of Medicare Supplement Insurance with Interpretative Guidelines

19 Miss. Admin. Code Pt. 1, R. 16.08 Testimonials or Endorsements by Third Parties

A. Testimonials and endorsements used in advertisements must be genuine, represent the current opinion of the author, be applicable to the policy advertised and be accurately reproduced. The insurer, in using a testimonial or endorsement, makes as its own all of the statement contained therein, and the advertisement, including such statement, is subject to all the provisions of these rules. When a testimonial or endorsement is used more than one year after it was originally given, a confirmation must be obtained.

B. A person shall be deemed a “spokesperson” if the person making the testimonial or endorsement:

1. Has a financial interest in the insurer or a related entity as a stockholder, director, officer, employee or otherwise; or

2. Has been formed by the insurer, is owned or controlled by the insurer, itsemployees, or the person or persons who own or control the insurer; or

3. Has any person in a policy-making position who is affiliated with the insurer in any of the above described capacities; or

4. Is in any way directly or indirectly compensated for making a testimonial or endorsement.

C. The fact of a financial interest or the propriety or representative capacity of a spokesperson shall be disclosed in an advertisement and shall be accomplished in the introductory portion of the testimonial or endorsement in the same form and with equalprominence thereto. If a spokesperson is directly or indirectly compensated for making a testimonial or endorsement, such fact shall be disclosed in the advertisement by language substantially as follows: “Paid Endorsement”. The requirement of thisdisclosure may be fulfilled by use of the phrase “Paid Endorsement” or words of similar import in a type style and size at least equal to that used for the spokesperson’s name or the body of the testimonial or endorsement; whichever is larger. In the case of television or radio advertising, the required disclosure must be accomplished in the introductory portion of the advertisement and must be given prominence.

D. The disclosure requirements of this rule shall not apply where the sole financial interest or compensation of a spokesperson, for all testimonials or endorsements made on behalf of the insurer, consist of the payment of union “scale” wages required by unionrules, and if the payment is actually for such “scale” for TV or radioperformances.

E. An advertisement shall not state or imply that an insurer or a Medicare supplement insurance policy has been approved or endorsed by any individual, group of individuals, society, association or other organizations, unless such is the fact, and unless any proprietary relationship between an organization and the insurer is disclosed. If the entity making the endorsement or testimonial has been formed by the insurer or is owned or controlled by the insurer or the person or persons who own or control the insurer, such fact shall be disclosed in the advertisement. If the insurer or an officer of the insurer formed or controls the association, or holds any policy-making position in the association, that fact must be disclosed.

F. When a testimonial refers to benefits received under a Medicare supplement insurance policy, the specific claim data, including claim number, date of loss, and other pertinent information shall be retained by the insurer for inspection for a period of four years or

until the filing of the next regular report of examination of the insurer, whichever is the longer period of time. The use of testimonials which do not correctly reflect the presentpractices of the insurer or which are not applicable to the policy or benefit being advertised is not permissible.

Rule 16.09Use of Statistics

A. An advertisement relating to the dollar amounts of claims paid, the number of persons insured, or similar statistical information relating to any insurer or policy shall not use irrelevant facts, and shall not be used unless it accurately reflects all of the relevant facts. Such an advertisement shall not imply that such statistics are derived from a policy advertised unless such is the fact, and when applicable to other policies or plans shall specifically so state.

1. An advertisement shall specifically identify the Medicare supplement insurance policy to which statistics relate and, where statistics are given which are applicable to a different policy, it must be stated clearly that the data do not relate to the policy being advertised.

2. An advertisement using statistics which describe an insurer, such as corporate structure, financial standing, age, product lines or relative position in the insurance business, may be irrelevant and, if used at all, must be used with extreme caution because of the potential for misleading the public. As a specific example, an advertisement for Medicare supplement insurance which refers to the amount of life insurance which the company has in force or the amounts paid out in life insurance benefits is not permissible unless the advertisement clearly indicates the amount paid out for each line of insurance.

B. An advertisement shall not represent or imply that claim settlements by the insurer are “liberal” or “generous” or use words of similar import, or state or imply that claim settlements are or will be beyond the actual terms of the contract. An unusual amount paid for a unique claim for the policy advertised is misleading and shall not be used.

C. The source of any statistics used in an advertisement shall be identified in such advertisement.

Rule 16.10Disparaging comparisons and Statements

An advertisement shall not directly or indirectly make unfair or incomplete comparisons of policies or benefits or comparisons of non-comparable policies of other insurers, and shall not disparage competitors, their policies, services or business methods, and shall not disparage or unfairly minimize competing methods of marketing insurance.

A. An advertisement shall not contain statements such as “no red tape” or “here is all you do to receive benefits.”

B. Advertisements which state or imply that competing insurance coverages customarily contain certain exceptions, reductions or limitations not contained in the advertised policies are unacceptable unless such exceptions, reductions, or limitations are contained in a substantial majority of such competing coverages.

C. Advertisements which state or imply that an insurer’s premiums are lower or that its loss ratios are higher because its organizational structure differs from that of competing insurers are unacceptable.

Rule 16.11Jurisdictional Licensing and Status of Insurer

A. An advertisement which is intended to be seen or heard beyond the limits of the jurisdiction in which the insurer is licensed shall not imply licensing beyond those limits.

B. An advertisement shall not create the impression directly or indirectly that the insurer,its financial condition or status; or the payment of its claims; or the merits, desirability or advisability of its policy forms or kinds of plans of insurance are approved, endorsed or accredited by any division or agency of this State or the United States Government.

Rule 16.12Identity of Insurer

A. The name of the actual insurer shall be stated in all of its advertisements. The form number or numbers of the policy advertised shall be state in an advertisement which is an invitation to contract. An advertisement shall not use a trade name, any insurance group designation, name of the parent company of the insurer, name of a particular division of the insurer, service mark, slogan, symbol or other device which with or without disclosing the name of the actual insurer would have the capacity and tendency to mislead or deceive as to the true identity of the insurer.

B. No advertisement shall use any combination of words, symbols or physical materials which by their content, phraseology, shape, color or other characteristics are so similar to combination of words, symbols or physical materials used by agencies of the federal government or of this State, or otherwise appear to be of such nature that it tends to confuse or mislead prospective insureds into believing that the solicitation is in some manner connected with an agency of the municipal, state or federal government.

C. Advertisements, envelopes or stationary which employs words, letters, initials, symbols or other devices which are so similar to those used by governmental agencies or other insurers are not permitted if they may lead the public to believe:

1. that the advertised coverages are somehow provided by or are endorsed by such governmental agencies or such other insurers;

2. that the advertiser is the same as, is connected with or is endorsed by such governmental agencies or such other insurers.

D. No advertisement shall use the name of a state or political subdivision thereof in a policy name or description.

E. No advertisement in the form of envelopes or stationary of any kind may use any name, service mark, slogan, symbol or any device in such a manner that implies that the insurer or the policy advertised, or that any agent who may call upon the consumer in response to the advertisement is connected with a governmental agency, such as the Social Security Administration.

F. No advertisement may incorporate the word “Medicare” in the title of the plan or policy being advertised unless, wherever it appears, said word is qualified by language differentiating it from Medicare. Such an advertisement, however shall not use the phrase “_____________________ Medicare Department of the _____________________ Insurance Company,” or language of similar import.

G. No advertisement shall be used that fails to include the disclaimer to the effect of “Not connected with or endorsed by the U.S. Government or the federal Medicare program.”

H. No advertisement may imply that the reader may lose a right or privilege or benefit under federal, state or local law if he fails to respond to the advertisement.

I. The use of letter, initials, or symbols of the corporate name or trademark that would have the tendency or capacity to mislead or deceive the public as to the true identity of the insurer is prohibited unless the true, correct and complete name of the insurer is in close conjunction and in the same size type as the letter, initials or symbols of the corporate name or trademark.

J. The use of the name of an agency or “___________________ Underwriters” or “____________________ Plan” in type, size and location so as to have the capacity and tendency to mislead or deceive as to the true identity of the insurer is prohibited.

K. The use of an address so as to mislead or deceive as to true identity of the insurer, its locations or licensing status is prohibited.

L. No insurer may use, in the trade name of its insurance policy, any terminology or words so similar to the name of a governmental agency or governmental program as to have the tendency to confuse, deceive or mislead the prospective purchaser.

M. All advertisements used by agents, producers, brokers or solicitors of an insurer must have prior written approval of the insurer before they may be used.

N. An agent who makes contact with a customer, as a result of acquiring that consumer’s name from a lead generating device must disclose such fact in the initial contact with the consumer.

Rule 16.13Group or Quasi-Group Implications

A. An advertisement of a particular policy shall not state or imply that prospective insureds become group or quasi-group members covered under a group policy and as such enjoy special rates or underwriting privileges, unless such is the fact.

B. This rule prohibits the solicitation of a particular class, such as governmental employees, by use of advertisements which state or imply that their occupational status entitles them to reduced rates on a group or other basis when , in fact, the policy being advertised is sold only on an individual basis at regular rates.

Rule 16.14: Introductory, Initial or Special Offers

A. Offers

1. An advertisement of an individual policy shall not directly or by implication represent that a contract or combination of contracts is an introductory, initial or special offer, or that applicants will receive substantial advantages not available at a later date, or that the offer is available only to a specified group of individuals, unless such is the fact. An advertisement shall not contain phrases describing an enrollment period as “special,”“limited,” or similar words or phrases when the insurer uses such enrollment periods as the usual method of advertising Medicare supplement insurance.

2. An enrollment period during which a particular insurance product may be purchased on an individual basis shall not be offered within this State unless there has been a lapse of not less than (6) months between the close of the immediately preceding enrollment period for the same product and the opening of the new enrollment period. The advertisement shall indicate the date by which theapplicant must mail the application, which shall be not less than ten days and not more than forty days from the date that such enrollment period is advertised

for the first time. This rule applies to all advertising media, i.e., mail, newspapers, radio, television, magazines and periodicals, by any one insurer. It is not applicable to solicitation of employees or members of a particular group or association which otherwise would be eligible under specific provisions of the Insurance Code for group, blanket or franchise insurance. The phrase “any one insurer” includes all the affiliated companies of a group of insurance companies under common management or control.

3. This rule prohibits any statement or implication to the effect that only a specific number of policies will be sold, or that a time is fixed for the discontinuance of the sale of the particular policy advertised because of special advantages available in the policy, unless such is the fact.

4. The phrase “a particular insurance product” in Paragraph (2) of this section means an insurance policy which provides substantially different benefits than those contained in any other policy. Different terms of renewability; an increase or decrease in the dollar amounts of benefits; an increase or decrease in any elimination period or waiting period from those available during an enrollment period for another policy shall not be sufficient to constitute the product being offered as a different product eligible for concurrent or overlapping enrollment.

B. An advertisement shall not offer a policy which utilizes a reduced initial premium rate in a manner which overemphasizes the availability and the amount of the initial reduced premium. When an insurer charges an initial premium that differs in amount from the amount of the renewal premium payable on the same mode, the advertisement shall not display the amount of the reduced initial premium either more frequently or more prominently than the renewal premium, and both the initial reduced premium and the renewal premium must be stated in juxtaposition in each portion of the advertisement where the initial reduced premium appears. The term “juxtaposition” means side by side or immediately above or below.

C. Special awards, such as a “safe driver’s award” shall not be used in connectionwith advertisements of Medicare supplement insurance.

Rule 16.15Statements About an Insurer

An advertisement shall not contain statements which are untrue in fact, or by implication misleading, with respect to the assets, corporate structure, financial standing, age or relative position of the insurer in the insurance business. An advertisement shall not contain a recommendation by any commercial rating system unless it clearly indicated the purpose of the recommendation and the limitations of the scope and extent of the recommendation.

Rule 16.16Enforcement Procedures

A. Advertising File: Each insurer shall maintain at its home or principal office a complete file containing every printed, published or prepared advertisement of its individual policies and typical printed, published or prepared advertisements of its blanket, franchise and group policies hereafter disseminated in this or any other state, whether or not licensed in such other state, with a notation attached to each such advertisement which advertised. Such file shall be available for inspection by this Department. All such advertisements shall be maintained in said file for a period of either four years or until the filing of the next regular report of examination of the insurer, whichever is the longer period of time.

B. Certificate of Compliance: Each insurer required to file an Annual Statement which is now or which hereafter becomes subject to the provisions of these rules must file with this Department, with its Annual Statement, a Certificate of Compliance executed by an authorized officer of the insurer wherein it is stated that, to the best of his knowledge, information and belief, the advertisements which were disseminated by the insurer during the preceding statement year complied or were made to comply in all respects with the provisions of these rules and the Insurance Laws of this State as implemented and interpreted by these rules.

Rule 16.17Severability Provision

If any section or portion of a section of these rules, or the applicability thereof to any person or circumstance is held invalid by a court, the remainder of the rules, or the applicability of such provision to other persons or circumstances, shall not be affected thereby.

Rule 16.18Filing Requirements for Advertising

Every insurer, health care service plan or other entity providing Medicare supplement insurance or benefits in this State shall provide a copy of any Medicare supplement advertisement intended for use in this State whether through written, radio or television medium to the Commissioner of Insurance of this State for review and approval by the Commissioner.

This regulation shall become effective thirty (30) days after its adoption and filing with the Mississippi Secretary of State’s Office, as required by law.

Rule 16.19Appendix: Interpretive Guidelines

A. Guideline 1

Disclosure is one of the principal objectives of the rules and this section states specifically that the rules shall assure truthful and adequate disclosure of all material and relevant information. The rules specifically prohibit some previous advertising techniques.

B. Guideline 2

These rules apply to any “advertisement” as that term is defined in Section 3, Subsections A, H, I and J unless otherwise specified in the rules. These rules apply to group, blanket and individual Medicare supplement insurance advertisements. Certain distinctions, however, are applicable to these categories. Among them is the level of conversance with insurance, a factor which is covered by Section 5A of the rules.

C. Guideline 3-A

The scope of the term “advertisement” extends to the use of all media for communications to the general public, to the use of all media for communications to specific members of the general public, and to use of all media for communications by agents, brokers, producers and solicitors.

D. Guideline 3-I

A “brief description of coverage” in an invitation to inquire may consist of an explanation of Medicare benefits, minimum benefits, standards for Medicare supplement policies, and the manner in which the advertised Medicare supplement insurance policy supplements the benefits of Medicare and meets or exceeds the minimum benefit requirements. An invitation to inquire shall not refer to cost or the maximum dollar amount of benefits payable.

As with all Medicare supplement insurance advertisements, an invitation to inquire must not:

1. Employ devices which are designed to create undue anxiety in the minds of the elderly or excite fear of dependence upon relatives or charity;

2. Exaggerate the gaps in Medicare coverage;

3. Exaggerate the value of the benefits available under the advertised policy;

4. Otherwise violate the provisions of these rules.

E. Guideline 4

The rule permits the use of either of the following alternative methods of disclosure:

1. The first alternative provides for the disclosure of exceptions, limitations, reductions and other restrictions conspicuously and in close conjunctions with the statements to which such information relates. This may be accomplished by disclosure in the description of the related benefits or in a paragraph set out in close conjunction with the description of policy benefits.

2. The second alternative provides for the disclosure of exceptions, limitations, reductions and other restrictions not in conjunction with the provisions describing policy benefits but under appropriate captions of such prominence that the information shall not be minimized, rendered obscure or otherwise made to appear unimportant. The phrase “under appropriate captions” means that the title must be accurately descriptive of the captioned material. Appropriate captions include the following: “Exceptions,” “Exclusions,” “Conditions Not Covered,” and “Exceptions and Reductions.” The use of captions such as, or similar to, the following are not acceptable because they do not provide adequate notice of the significance of the material: “Extent of Coverage,” “Only these Exclusions,” or “Minimum Limitations.”

In considering whether an advertisement complies with the disclosure requirements of this rule, the rule must be applied in conjunction with the form and content standards contained in Section 5.

F. Guideline 5-A

The rule must be applied in conjunction with Section 1 and 4 of the rules. The rule refers specifically to “format and content” of the advertisement and the “overall” impression created by the advertisement. This involves factors such as, but not limited to, the size, color and prominence of type used to describe benefits. The word “format” means the arrangement of the text and the captions.

The rule requires distinctly different advertisements for publication in newspapers or magazines of general circulation, as compared to scholarly, technical or business journals and newspapers. Where an advertisement consists of more than one piece of material, each piece of material must, independent of all other pieces of material, conform to the disclosure requirements of this rule.

G. Guideline 5-B

The rule prohibits the use of incomplete statements and words or phrases which have the tendency or capacity to mislead or deceive because of the reader’s unfamiliarity with insurance terminology.

Therefore, words, phrases and illustrations used in an advertisement must be clear and unambiguous if the advertisement uses insurance terminology, sufficient description of a word, phrase or illustration shall be provided by definition or description in the context of

the advertisement. As implied in Guideline 5-A, distinctly different levels of comprehension to the subscribers of various publications may be anticipated.

H. Guideline 6-A(1)

The rule prohibits the use of incomplete statements and words or phrases which create deception by omission or commission. The following examples are illustrations of the prohibitions created by the rule:

1. An advertisement which describes any benefits that vary by age must disclose the fact.

2. An advertisement that uses a phrase such as “no age limit” must disclose that premiums may vary by age or that benefits may vary by age if such is the case.

3. Advertisements, applications, requests for additional information and similar materials are unacceptable if they state or imply that the recipient has been individually selected to be offered insurance, or has had his eligibility for such insurance individually determined in advance, when in fact the advertisement is directed to all persons in a group or to all persons whose names appear on a mailing list.

4. Advertisements for group or franchise group plans which provide a common benefit or a common combination of benefits shall not imply that the insurance coverage is tailored or designed specifically for that group, unless such is the fact.

5. It is unacceptable to use terms such as “enroll” or “join” with reference to a group or blanket insurance coverage when such is not the case.

6. An advertisement, which states or implies immediate coverage is provided, is unacceptable unless suitable administrative procedures exist so that the policy is issued within fifteen working days after the application is received by the insurer.

7. Applications, request forms for additional information, and similar related materials are unacceptable if they resemble paper currency, bonds or stock certificates; or use any name, service mark, slogan, symbol or any device in such a manner that implies that the insurer or the policy advertised is connected with a governmental agency, such as the Social Security Administration or the Department of Health and Human Services.

8. An advertisement which uses the word “plan” without identifying it as a Medicare supplement insurance policy is not permissible.

9. An advertisement which implies in any manner that the prospective insured may realize a profit from obtaining Medicare supplement insurance is not permissible.

10. An advertisement which fails to disclose any waiting or elimination periods is unacceptable.

11. Examples of benefits payable under a policy shall not disclose only maximum benefits unless such maximum benefits are paid for loss from common or probable illnesses or accidents, rather than exceptional or rare illnesses or accidents or periods of confinement for such exceptional or rare accidents or illnesses.

12. When a range of benefit levels is set forth in an advertisement, it must bemade clear that the insured will receive only the benefit level written or printed in the policy selected and issued.

13. Advertisements for policies whose premiums are modest because of their limited amount of benefits shall not describe premiums as “low,” “low-cost,” “budget” or use qualifying words of similar import. This rule also prohibits the use of words such as “only” and “just” in conjunction with statements of premium amounts when used to imply a bargain.

14. An advertisement which exaggerates the effects of statutorily mandated benefits or required policy provisions or which implies that such provisions are unique to the advertised policy is unacceptable. For example, the phrase, “Money Back Guarantee,” is an exaggerated description of the thirty-day right to examine the policy and is not acceptable.

15. An advertisement which implies that a common type of policy or a combination of common benefits is “new,” “unique,” “a bonus,” “a breakthrough,” or is otherwise unusual is unacceptable. Also, the addition of a novel method of premium payment to an otherwise common plan of insurance does not render it “new.”

16. An advertisement may not omit the word “covered” when referring to benefits payable under its policy. Continued reference to “covered” is not necessarily where this fact has been prominently disclosed in the advertisement.

17. An advertisement must state that benefits payable under the policy are based upon Medicare eligible expenses, if such is the case.

18. An advertisement which fails to disclose that the definition of “hospital” does not include a nursing home, convalescent home or extended care facility, as the case may be, is unacceptable.

19. A television, radio, mail or newspaper advertisement or lead generating device which is designed to produce leads either by use of a coupon, a request to write or to call the company, or a subsequent advertisement prior to contact must include

information disclosing that an insurance agent may contact the applicant if such is the fact.

20. Advertisements for policies designed to supplement Medicare shall not employ devices which are designed to create undue anxiety in the minds of the elderly. Such phrases as “here is where most people over 65 learn about the gaps in Medicare,” or “Medicare is great, but . . .” or which otherwise exaggerate the gaps in Medicare coverage are unacceptable. Phrases or devices which unduly excite fear of dependence upon relatives or charity are unacceptable. Phrases or devices which imply that long sicknesses or hospital stays are common among the elderly are unacceptable.

21. An advertisement which is an invitation to contract implying that the coverage is supplemental to Medicare, if it does not explain the manner in which it is supplemental to Medicare coverage, is not acceptable.

22. An advertisement which is an invitation to contract for Medicare supplement insurance is unacceptable if the advertisement:

a. Fails to disclose in clear language which of the Medicare benefits the policy is not designed to supplement or if it otherwise implies that Medicare provides only those benefits which the policy is designed to supplement;

b. Describes the in-patient hospital coverage of Medicare as “Medicare hospital,” or “Medicare Part A” when the policy does not supplement the non-hospital or the psychiatric hospital benefits of Medicare Part A;

c. Fails to describe clearly the operation of the Part or Parts of Medicare which the policy is designed to supplement; or

d. Describes those Medicare benefits not supplemented by the policy in such a way as to minimize their importance relative to the Medicare benefits which are supplemented.

23. Advertisements which indicate that a particular coverage or policy is exclusively for “preferred risks” or a particular segment of the population, or that particular segments of the population are acceptable risks, when such distinctions are not maintained in the issuance of policies, are not acceptable.

24. Any advertisement which contains statements such as “anyone can apply” or “anyone can join” other than with respect to a guaranteed issue policy for which administrative procedures exist to assure that the policy is issued within a reasonable period of time after the application is received by the insurer is unacceptable.

25. Any advertisement which uses any phrase or term such as “here is all you do to apply,” “simply” or “merely” to refer to the act of applying for a policy which is not a guaranteed issue policy is unacceptable unless it refers to the fact that the application is subject to acceptance or approval by the insurer.

26. Advertisements which state or imply that premiums will not be changed in the future are not acceptable unless the advertised policies so provide.

27. An advertisement which does not require the premium to accompany the application must not overemphasize that fact and must make the effective date of that coverage clear.

28. An advertisement which is an invitation to contract which fails to disclose the amount of any deductible and/or the percentage of any co-insurance factor is not acceptable.

I. Guideline 6-A (2)

The rule recognizes that certain words and phrases in advertising may have a tendency to mislead the public as to the extent of benefits under an advertised policy. Consequently, such terms (and those specified in the rules do not represent a comprehensive list but only examples) must be used with caution to avoid any tendency to exaggerate benefits and must not be used unless the statement is literally true in every instance. The use of the following phrases based on such terms or having the same effect must be similarly restricted: “pays hospital, surgical, etc. bills,” “pays dollars to offset the cost of medical care,” “safeguards your standard of living,” “pays full coverage,” “pays complete coverage,” or “pays for financial needs.” Other phrases may or may not be acceptable depending upon the nature of the coverage being advertised.

The rule also prohibits words or phrases which exaggerate the effect of benefit payment on the insured’s general well-being, such as “worry-free savings plan,” “guaranteed savings,” “financial peace of mind,” and “you will never have to worry about hospital bills again.”

Advertisements which are an invitation to contract for policies designed to supplement Medicare benefits are unacceptable if they fail to disclose that no hospital confinement benefits will be payable for that portion of a Medicare benefit period for which Medicare pays all hospital confinement expenses (currently sixty days) other than the initial deductible if the policy so provides. The length of said period must be stated in days.

J. Guideline 6-A(4)

Explanations must not minimize nor describe restrictive provisions in a positive manner. Negative features must be accurately set forth. Any limitation on benefits precluding preexisting conditions must also be restated under a caption concerning exclusions or limitations, notwithstanding that the preexisting condition exclusion has been disclosed

elsewhere in the advertisement. (See Guideline 6-C for additional comments on preexisting conditions.

K. Guideline 6-A(5)

The rule should be applied in conjunction with Section 10. Phrases such as “we cut cost to the bone” or “we deal direct with you so our costs are lower” shall not be used.

L. Guideline 6-B(1)

An advertisement which is an invitation to contract as defined in Section 3J must recite the exceptions, reductions and limitations as required by the rule and in a manner consistent with Section 4.

If an exception, reduction or limitation is important enough to use in a policy, it is sufficient important that its existence in the policy should be referred to in the advertisement regardless of whether it may also be the subject matter of a provision of the Uniform Individual Accident and Sickness Policy Provision Law.

Some advertisements disclose exceptions, reductions and limitations as required, but the advertisement is so lengthy that it obscures the disclosure. Where the length of an advertisement has this effect, special emphasis must be given by changing the format to show the restrictions in a manner which does not minimize, render obscure or otherwise make them appear unimportant. M. Guideline 6-C(1)

The rule implements the objective of Section 6A(4)(a) by requiring in negative terms a description of the effect of a preexisting condition exclusion because such an exclusion is a restriction on coverage. The subdivision also prohibits the use of the phrase “preexisting condition” without an appropriate definition or description of the term and prohibits stating a reduction in the statutory time limit as an affirmative benefit. The words “appropriate definition or description” mean that the term “preexisting condition” must be defined as it is used by the company’s claims department.

N. Guideline 6-C(2)

The phrase “no health questions” or words of similar import shall not be used if the policy excludes preexisting conditions. Use of a phrase as “guaranteed issue,” or “automatic issues,” if the policy excludes preexisting conditions for a certain period, must be accompanied by a statement disclosing that fact in a manner which does not minimize, render obscure or otherwise make it appear unimportant and is otherwise consistent with Section 4.

O. Guideline 6-C(3)

Some states require approval of the application even when the application is not attached to the policy when issued. The rule does not change such a requirement. The text of this guideline should be modified to reflect the rule applicable in the particular state. Guideline 7

P. Guideline 7

Advertisements of cancellable Medicare supplement policies must state that the contract is cancellable or renewable at the option of the company as the case may be. With respect to noncancellable policies and guaranteed renewable policies, the policy provisions, with respect to renewability, must be set forth and defined where appropriate.

The rule also requires a statement of the qualifying conditions which constitute limitations on the permanent nature of the coverage. These customarily fall into three categories: age limits, reservation of a right to increase premiums, and the establishment of aggregate limits. For example, “noncancellable and guaranteed renewable” does not fulfill the requirements of the rule if the policy contains a terminal age ________.” If a guaranteed renewable policy reserves the right to increase premiums, the statement must be expanded into language similar to “guaranteed renewable to age ________” but the company reserves the right to increase premium rates on a class basis.” If the contract contains an aggregate limit after which no further benefits are payable, the above statement must be amplified with the phrase “subject to a maximum aggregate amount of $50,000” or similar language. A Medicare supplement insurance policy may have one or more of the three basic limitations and an advertisement must describe each of those which the policy contains. Over fifty percent of new individual policy issues are guaranteed renewable; therefore, the fact that a policy is guaranteed renewable shall not be exaggerated.

An advertisement for a Medicare supplement insurance policy which provides for age step-rated premium rates based upon the policy year or the insured’s attained age must disclose such rate increases and the times or ages at which such premium increases.

Q. Guideline 8-A

The rule must be applied in conjunction with Section 9 and requires that all such statements must be genuine and not fictitious. Under the rule, the manufacturing, substantive editing or “doctoring up” of a testimonial is clearly prohibited as being false and misleading to the insurance-buying public. However, language which would be unacceptable under these rules must be edited out of a testimonial.

R. Guideline 8-C

The rule requires that either approval or endorsement of a policy by an individual, group or individuals, society, association or other organization be factual and that any proprietary relationship between the sponsoring or endorsing organization and the insurer be disclosed. For example, if the dividend under an association group case is payable to

the association, disclosure of that fact is required. Also, if the insurer or an officer of the insurer formed or controls the association, that fact must be disclosed. This guideline also applies to Section 8E.

S. Guideline 9-A

An advertisement shall specifically indentify the Medicare supplement insurance policy to which statistics relate and, where statistics are given which are applicable to a different policy, it must be stated clearly that the data does not relate to the policy being advertised.

An advertisement which states the dollar amount of claims paid must also indicate the period over which such claims have been paid.

If the term “loss ratio” is used, it shall be properly explained in the context of the advertisement and, unless the state has issued a regulation otherwise defining the term, it shall be calculated on the basis of premiums earned to losses incurred and shall not be on a yearly run-off basis.

T. Guideline 9-C

The rule does not require that statistics for this State be used since statistics as hospital charges and average stays may vary from state to state. When nationwide statistics are used, such fact should be noted, unless the statistics on the particular point are substantially the same in a state to which the advertisement is directed. Statistics may only be used if they are current and credible.

U. Guideline 10

The rule prohibits disparaging, unfair or incomplete comparisons of policies or benefits which would have a tendency to decline or mislead the public. The rule does not preclude the use of comparisons by health maintenance organizations, prepaid health plans and other direct service organizations which describe the difference between their prepaid health benefits coverage and indemnity insurance coverage.

V. Guideline 11-A

The rule prohibits advertisements which imply that an insurer is licensed beyond the limits of those jurisdictions where it is actually licensed. An advertisement which contains testimonials from persons who reside in a state in which the insurer is not licensed or which refers to claims of persons residing in states which the insurer is not licensed implies licensing in those states; and, therefore, is in violation of this rule unless the advertisement states that the insurer is not licensed in those states.

W. Guideline 11-B

Although the rule permits a reference to an insurer being licensed in a state where the advertisement appears, it does not allow exaggeration of the fact of such licensing nor does it permit the suggestion that competing insurers may not be so licensed because, in most states, an insurer must be licensed in the state to which it directs its advertising.

Terms such as “official” or words of similar import, used to describe any policy or application form are not permissible because of the potential for deceiving or misleading the public. This guideline also applies to Section 11C.

X. Guideline 14-A(1)

The rule prohibits advertising representing that a product is offered or an introductory, initial or special offer basis or otherwise which (a) will not be available later; or (b) is available only to certain Individuals, unless such is the fact. This rule prohibits the repetitive use of such advertisements. Where an insurer used enrollment periods as the usual method of advertising these policies, the rule prohibits describing an enrollment period as a special opportunity or offer for the applicant.

Y. Guideline 14-A(2)

The rule restricts the repetitive use of enrollment periods. The requirements of reasonable closing dates and waiting periods between enrollment periods were adopted to eliminate the abuses which formerly existed. This rule does not limit just the use of enrollment periods. It requires that a particular insurance product offered in an enrollment period through any advertising media, including the prepared presentations of agents, cannot be offered again in the State until six (6) months from the close of the enrollment period. Thus, an insurer must choose whether to use enrollment periods or open enrollment for a product. (See Section 14A (4) for the definition of “a particular insurance product.”)

The rule does not prohibit multiple advertising during an enrollment period through any and all media published or transmitted within this State as long as the enrollment periods advertisements have the same expiration date.

The rule does not prohibit the solicitation of members of a group or association for the same product even though there has not been a lapse of six (6) months since the close of a preceding enrollment period which was open to the general public for the same product.

The rule does not require separation by six (6) months of enrollment periods for the same insurance product in this State if the advertising material is directed by an admitted insurer to persons by direct mail on the basis that a common relationship exists with an entity. Examples of such would be a bank and its depositors, a department store to its charge account customers, or an oil company to its credit card holders, and more than one of such organizations is sponsoring such insurance product at different times if providing such insurance under such a rule does not apply to one specific sponsor to the same persons in this State on the basis of their status as customers of that one specific entity only.

Z. Guideline 14-A(4)

The rule defines the meaning of “a particular insurance product” in Section 14A(2) and prohibits advertising of products having minor variations such as different periods or different amounts of daily hospital indemnity benefits, in a succession of enrollment periods.

AA. Guideline 15

The rule is closely related to the requirements of Section 9 concerning the use of statistics. The rule prohibits insurers which have been organized for only a brief period of time advertising that they are “old” and also prohibits emphasizing the size and magnitude of the insurer. Also, the occupations of the persons comprising the insurer’s board of directors or the public’s familiarity with their names or reputations is irrelevant and must not be emphasized. The preponderance of a particular occupation or profession among the board of directors an insurer does not justify the advertisement of a plan of insurance offered to the general public as insurance designed or recommended by members of that occupation or profession. For example, it is unacceptable for an insurance company to advertise a policy offered to the general public as “the physicians’ policy” or “the doctors’ plan” simply because there is a preponderance of physicians or doctors on the board of directors of the insurer. The rule prohibits the use of recommendation of a commercial rating system unless the purpose, meaning and limitations of the recommendation are clearly indicated.

BB. Guideline 16

The text of Subsection A is identical to the text of the first paragraph of the Enforcement Section of previous drafts of the rules except the last sentence of the subsection has been revised to require that the advertising file be maintained either for a period of four years (rather than three as previously) or until the next regular examination of the insurer, whichever is the longer period of time.

CC. Guideline 18

The rule is attached as an example of the text of a rule may be used at the option of the Commissioner in a state which reviews advertisements prior to use. The NAIC takes no position here on the question of whether direct response advertising should be subject to prior review by the Commissioner.

History

• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103; § 83-9-110 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103; § 83-9-110 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-115 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103; § 83-9-110 (Rev. 2011)
• Source: Miss. Code Ann. § 83-9-103 (Rev. 2011)

Chapter 17 (89-101) Guidelines To Be Followed When Lending Institutions Enter Into Agreements with Insurance Companies To Lease Space in Retail Areas.

19 Miss. Admin. Code Pt. 1, R. 17.04 Relationships:

No insurance company, agent, agency or representative of same, shall enter into any contract, lease or other agreement with a lending institution which results in:

A. any activity reasonably leading a person to believe that his credit-worthiness, or that extension of credit or renewal thereof, is conditioned upon the purchase of insurance through a particular insurance company, agent, agency or representative of same:

B. the lending institution or its employees, either directly or indirectly, soliciting insurance for or acting on behalf of an insurance company, agent, agency or representative of same, in the sale or negotiation of insurance.

The dollar amount of rent paid by an insurance company, agent, agency or representative of same, to a lending institution shall be on a strict square footage basis, and shall not be based on a percentage of premium income.

Any compensation, rental fee and/or expense reimbursement paid by the insurance company, agent, agency or representative of same, to the lending institution or its employees must be commercially reasonable considering all material and relevant circumstances and must meet the requirements of all applicable law.

No insurance company, agent, agency or representative of same, may enter into any agreement which requires a lending institution or its employees to provide support services which are prohibited by applicable law. By way of illustration and not limitation, the following support services are specifically prohibited: adjustment and payment of losses; amendment of insurance contracts to keep coverages current; collection of premiums; issuance of policies, certificates and other documents; return of unearned premiums; payment of cash values; and transmittal of applications for insurance contract.

History

• Source: Miss. Code Ann. § 83-5-29 et seq. (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 17.05 Physical Facilities:

The direct or indirect solicitation or transaction of insurance business by an insurance company, agent, agency or representative of same, shall be restricted to the leased area. Accordingly, any insurance company, agent, agency or representative of same, entering into any contract, lease or other agreement with a lending institution shall abide by the following:

A. All signs displayed in connection with the operation of the insurance company, agent, agency or representative of same shall have no indication of any relationship with the lending institution. A sign with the following disclaimer must appear at or directly adjacent to the Leased Area:

“Insurance is offered by (name of Insurance Company, agency or agent). The (name of the Lending Institution) is neither an insurance company nor agency, and the insurance products offered are not FDIC/FSLIC insured.”

Other signs may appear in the general banking area directing interested customers to the designated insurance area. The Commissioner of Insurance may order the removal of any signs or other promotional or advertising materials, the location, size, color or content of which violate the provisions of this regulation.

B. The leased area by an insurance company, agent, agency or representative of same must be situated and individually identified from the other retail area of the lending institution who are conducting normal banking activities from express or implied intimidation or interference with the customers’ free choice regarding the purchase of insurance.

History

• Source: Miss. Code Ann. § 83-5-29 et seq. (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 17.06 Advertising:

Any advertisement, promotional material, sales literature or public announcement of insurance products must be filed with the Mississippi Insurance Department at least thirty (30) days prior to distribution or announcement. If, within thirty (30) days after filing, the Commissioner notifies the insurance company in writing that such filing is disapproved, stating the reason therefor, it will be unlawful for the insurance company to use the filing. Otherwise, the insurance company will be allowed to use any such filing not disapproved within thirty (30) days after filing. Each insurance company shall be responsible for the compliance with this requirement by its agents, agencies and the lending institution which is a party to the lease agreement.

Any use of the name of the lending institution by an insurance company, agent, agency or representative of same in promoting, announcing or advertising its insurance products, other than strictly as an address referencing the location of the insurance company, agent, agency or representative of same, is prohibited. Further, the use of the name of the lending institution in identifying the address of the insurance company, agent, agency or representative of same, cannot be made in such a manner as to indicate any other relationship with the lending institution to the insurance product being advertised. Advertising and sale literature, taken as a whole, shall not be misleading or deceptive such as to cause a reader to reasonably conclude that the insurance product is endorsed or offered by the lending institution.

No insurance company, agent, agency or representative of same shall use a lending institution’s logo in any advertisement, promotional material, sales literature or public announcement of insurance products.

Rule 17.07Severability:

If any provision of any section of this regulation or the application thereof to any circumstance or insurance company, agent, agency or representative of same, nor any other person or entity, is held invalid, such invalidity shall not affect any other provision of that section or application of the regulation which can be given effect without the invalid provision or application, and to this end the provisions of this regulation are declared to be severable.

This regulation shall become effective thirty (30) days after its adoption and filing with the Mississippi Secretary of State’s Office, as required by law.

History

• Source: Miss. Code Ann. § 83-5-29 et seq. (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-1; 83-5-29 to 83-5-51 (Rev. 2011)

Chapter 20 Insurance Holding Company Regulation with Reporting Forms and Instructions.

19 Miss. Admin. Code Pt. 1, R. 20.01 Authority

This regulation is adopted and promulgated pursuant to the authority granted by Miss. Code Ann. Section 83-6-31 (1972), and in accordance with the provisions of Miss Code Ann. Chapter 43, Title 25, and the Mississippi Insurance Department Regulation 19 Miss. Admin. Code, Part 1, Chapter 15, said regulation being the “Rules of Practice and Procedure before the Mississippi Insurance Department”.

History

• Source: Miss. Code Ann. § 83-6-31 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.02 Purpose

The purpose of this regulation is to set forth rules and procedural requirements which the Commissioner deems necessary to carry out the provisions of the Insurance Holding Company System Regulatory Act, Miss. Code Ann. Section 83-6-1 et seq. (Supp. 2013), hereinafter

referred to as “the Act”. The information called for by this regulation is hereby declared to be necessary and appropriate in the public interest and for the protection of the policyholders in this State.

History

• Source: Miss. Code Ann. § 83-6-31 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.03 Severability Clause

If any provision of this regulation, or the application thereof to any person or circumstance, is held invalid, such determination shall not affect other provisions or applications of this regulation which can be given effect without the invalid provision or application, and to that end the provisions of this regulation are severable.

History

• Source: Miss. Code Ann. § 83-5-1 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.04 Forms - General Requirements

A. Forms A, B, C, D, E and F are intended to be guides in the preparation of the statements required by Sections 83-6-24, 83-6-5, 83-6-21, and 83-6-24 of the Act. They are not intended to be blank forms which are to be filled in. These statements filed shall contain the numbers and captions of all items, but the text of the items may be omitted provided the answers thereto are prepared in such a manner as to indicate clearly the scope and coverage of the items. All instructions, whether appearing under the items of the form or elsewhere therein, are to be omitted. Unless expressly provided otherwise, if any item is inapplicable or the answer thereto is in the negative, an appropriate statement to that effect shall be made.

B. One (1) complete copy of each statement including exhibits and all other papers and documents filed as a part thereof, shall be filed with the Commissioner by personal delivery or mail addressed to: Insurance Commissioner of the State of Mississippi, Attention: Commissioner. The copy shall be manually signed in the manner prescribed on the form. If the signature of any person is affixed pursuant to a power of attorney or other similar authority, a copy of such power of attorney or other authority shall also be filed with the statement.

C. If an applicant requests a hearing on a consolidated bases under Section 83-6-24(4)(d) of the Act, in addition to filing the Form A with the commissioner, the applicant shall file a copy of Form A with the National Association of Insurance Commissioners (NAIC) in electronic form.

D. Statements should be prepared electronically. Statements shall be easily readable and suitable for review and reproduction. Debits in credit categories and credits in debit categories shall be designated so as to be clearly distinguishable as such on photocopies. Statements shall be in the English language and monetary values shall be stated in United States currency. If any exhibit or other paper or document filed with the statement is in a foreign language, it shall be accompanied by a translation into the English language and

any monetary value shown in a foreign currency normally shall be converted into United States currency.

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-21; 83-6-24; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.05 Forms - Incorporation by Reference, Summaries and Omissions

A. Information required by any item of Form A, Form B, Form C, Form D, Form E or Form F may be incorporated by reference in answer or partial answer to any other item. Information contained in any financial statement, annual report, proxy statement, statement filed with a governmental authority, or any other document may be incorporated by reference in answer or partial answer to any item of Form A, Form B, Form C, Form D, Form E or Form F provided such document or paper is filed as an exhibit to the statement. Excerpts of documents may be filed as exhibits if the documents are extensive. Documents currently on file with the Commissioner which were filed within three years need not be attached as exhibits. References to information contained in exhibits or in documents already on file shall clearly identify the material and shall specifically indicate that such material is to be incorporated by reference in answer to the item. Matter shall not be incorporated by reference in any case where such incorporation would render the statement incomplete, unclear or confusing.

B. Where an item requires a summary or outline of the provisions of any document, only a brief statement shall be made as to the pertinent provisions of the document. In addition to such statement, the summary or outline may incorporate by reference particular parts of any exhibit or document currently on file with the Commissioner which was filed within three years and may be qualified in its entirety by such reference. In any case where two or more documents required to be filed as exhibits are substantially identical in all material respects except as to the parties thereto, the dates of execution, or other details, a copy of only one of such documents need be filed with a schedule identifying the omitted documents and setting forth the material details in which such documents differ from the documents a copy of which is filed.

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-21; 83-6-24; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.06 Forms - Information Unknown or Unavailable and Extension of Time to Furnish

If it is impractical to furnish any required information, document or report at the time it is required to be filed, there may be filed with the Commissioner as a separate document a statement:

A. Identifying the information, document or report in question;

B. Stating why the filing thereof at the time required is impractical; and,

C. Requesting an extension of time for filing the information, document or report to a specified date. The request for extension shall be deemed granted unless the Commissioner within 60 days after receipt thereof enters an order denying the request.

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-21; 83-6-24 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.07 Forms - Additional Information and Exhibits

In addition to the information expressly required to be included in Form A, Form B, Form C, Form D, Form E and Form F, there shall be added such further material information, if any, as may be necessary to make the information contained therein not misleading. The person filing may also file such exhibits as it may desire in addition to those expressly required by the statement. Such exhibits shall be so marked as to indicate clearly the subject matters to which they refer. Changes to Forms A, B, C, D, E or F shall include on the top of the cover page the phrase: “Change No. (insert number) to” and shall indicate the date of the change and not the date of the original filing.

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-21; 83-6-24; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.08 Definitions

A. “Executive officer” means chief executive officer, chief operating officer, chief financial officer, treasurer, secretary, controller, and any other individual performing functions corresponding to those performed by the foregoing officers under whatever title.

B. “Ultimate controlling person” means that person which is not controlled by any other person.

C. Unless the context otherwise requires, other terms found in those regulations and in Section 83-6-1 of the Act are used as defined in the Act. Other nomenclature or terminology is according to the Industry Code or industry usage if not defined by the Code.

History

• Source: Miss. Code Ann. §§ 83-6-1; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.09 Subsidiaries of Domestic Insurers

The authority to invest in subsidiaries under Section 83-6-2(2) of the Act is in addition to any authority to invest in subsidiaries which may be contained in any other provision of the Insurance Code.

History

• Source: Miss. Code Ann. § 83-6-2 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.10 Acquisition of Control - Statement Filing (Form A)

A person required to file a statement pursuant to Section 83-6-24 of the Act shall furnish the required information on Form A, hereby made a part of this regulation. Such person shall also furnish the required information on Form E, hereby made a part of this regulation and described in Rule 20.14 of this regulation.

History

• Source: Miss. Code Ann. § 83-6-24; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.11 Amendments to Form A

The applicant shall promptly advise the Commissioner of any changes in the information so furnished on Form A arising subsequent to the date upon which such information was furnished but prior to the Commissioner’s disposition of the application.

History

• Source: Miss. Code Ann. § 83-5-1 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.12 Acquisition

If the person being acquired is deemed to be a “domestic insurer” solely because of the provisions of Section 83-6-24 of the Act, the name of the domestic insurer on the cover page should be indicated as follows:

“ABC Insurance Company, a subsidiary of XYZ Holding Company”.

Where a Section 83-6-24 insurer is being acquired, references to “the insurer” contained in Form A shall refer to both the domestic subsidiary insurer and the person being acquired.

History

• Source: Miss. Code Ann. §§ 83-6-24; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.13 Pre-Acquisition Notification

If a domestic insurer, including any person controlling domestic insurer, is proposing a merger or acquisition pursuant to Section 83-6-24(1) of the Act, that person shall file a pre-acquisition notification form, Form E, which was developed pursuant to Section 83-6-24 of the Act.

Additionally, if a non-domiciliary insurer licensed to do business in this state is proposing a merger or acquisition pursuant to Section 83-6-24 of the Act, that person shall file a pre- acquisition notification form, Form E. No pre-acquisition notification form need be filed if the acquisition is beyond the scope of Subsection 2(b) of Section 4, Senate Bill 2298, 2017 Regular Legislative Session.

In addition to the information required by Form E, the commissioner may wish to require an expert opinion as to the competitive impact of the proposed acquisition.

History

• Source: Miss. Code Ann. § 83-6-24 (Rev. 2011); Senate Bill 2298, 2017 Regular Legislative Session

19 Miss. Admin. Code Pt. 1, R. 20.14 Annual Registration of Insurers - Statement Filing (Form B)

An insurer required to file a registration statement pursuant to Section 83-6-5 of the Act shall file such statement on an annual basis and shall furnish the required information on Form B, hereby made a part of this regulation.

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.15 Summary of Registration - Statement Filing (Form C)

An insurer required to file an annual registration statement pursuant to Section 83-6-3 is also required to furnish information required on Form C, hereby made a part of these regulations. An insurer shall file a copy of Form C in each state in which the insurer is authorized to do business, if requested by the Commissioner of that state.

History

• Source: Miss. Code Ann. §§ 83-6-3 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.16 Amendments to Form B

A. An amendment to Form B shall be filed within 15 days after the end of any month in which there is a material change to the information provided in the annual registration statement.

B. Amendments shall be filed in the Form B format with only those items which are being amended reported. Each such amendment shall include at the top of the cover page “Amendment No. (insert number) to Form B for (insert Year)” and shall indicate the date of the change and not the date of the original filings.

History

• Source: Miss. Code Ann. § 83-5-1 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.17 Alternative and Consolidated Registration

A. Any authorized insurer may file a registration statement on behalf of any affiliated insurer or insurers which are required to register under Section 83-6-3 of the Act. A registration statement may include information not required by the Act regarding any insurer in the insurance holding company system even if such insurer is not authorized to do business in this State. In lieu of filing a registration statement on Form B, the authorized insurer may file a copy of the registration statement or similar report which it is required to file in its State of domicile, provided:

1. the statement or report contains substantially similar information required to be furnished on Form B; and

2. the filing insurer is the principal insurance company in the insurance holding company system.

B. The question of whether the filing insurer is the principal insurance company in the insurance holding company system is a question of fact and an insurer filing a registration statement or report in lieu of Form B on behalf of an affiliated insurer, shall set forth a brief statement of facts which will substantiate the filing insurer’s claim that it, in fact, is the principal insurer in the insurance holding company system.

C. With the prior approval of the Commissioner, an unauthorized insurer may follow any of the procedures which could be done by an authorized insurer under paragraph (a) above.

D. Any insurer may take advantage of the provisions of Section 83-6-13 of the Act without obtaining the prior approval of the Commissioner. The Commissioner, however, reserves the right to require individual filings if he deems such filings necessary in the interest of clarity, ease of administration or the public good.

History

• Source: Miss. Code Ann. §§ 83-6-13; 83-6-31 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.18 Disclaimers and Termination of Registration

A. A disclaimer of affiliation or a request for termination of registration claiming that a person does not, or will not upon the taking of some proposed action, control another person (hereinafter referred to as the “subject”) shall contain the following information:

1. the number of authorized, issued and outstanding voting securities of the subject;

2. with respect to the person whose control is denied and all affiliates of such person, the number and percentage of shares of the subject’s voting securities which are held of record or known to be beneficially owned, and the number of such shares concerning which there is a right to acquire, directly or indirectly;

3. all material relationships and bases for affiliation between the subject and the person whose control is denied and all affiliates of such person;

4. A statement explaining why such person should not be considered to control the subject.

B. A request for termination of registration shall be deemed to have been granted unless the Commissioner, within 30 days after he receives the request, notifies the registrant otherwise.

History

• Source: Miss. Code Ann. § 83-5-1 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.19 Transactions Subject to Prior Notice - Notice Filing (Form D)

A. An insurer required to give notice of a proposed transaction pursuant to Section 83-6-21 of the Act shall furnish the required information on Form D, hereby made a part of this regulation.

B. Agreements for cost sharing services and management services shall at a minimum and as applicable:

1. Identify the person providing services and the nature of such services;

2. Set forth the methods to allocate costs;

3. Require timely settlement, not less frequently than on a quarterly basis, and compliance with the requirements in the Accounting Practices and Procedures Manual.

4. Prohibit advancement of funds by the insurer to the affiliate except to pay for services defined in the agreement;

5. State that the insurer will maintain oversight for functions provided to the insurer by the affiliate and that the insurer will monitor services annually for quality assurance;

6. Define records and data of the insurer to include all records and data developed or maintained under or related to the agreement that are otherwise the property of the insurer, in whatever form maintained, including, but not limited to, claims and claim files, policyholder lists, application files, litigation files, premium records, rate books, underwriting manuals, personnel records, financial records or similar records within the possession, custody or control of the affiliate;

7. Specify that all records and data of the insurer are and remain the property of the insurer and

i. Are subject to control of the insurer;

ii. Are identifiable, and

iii. Are segregated from all other persons’ records and data or are readily capable of segregation at no additional cost to the insurer;

8. State that all funds and invested assets of the insurer are the exclusive property of the insurer, held for the benefit of the insurer and are subject to the control of the insurer;

9. Include standards for termination of the agreement with and without cause;

10. Include provisions for indemnification of the insurer in the event of gross negligence or willful misconduct on the part of the affiliate providing the

services and for any actions by the affiliate that violate provisions of the agreement required in Rules 20.19(B)(11); 20.19(B)(12); 20.19(B)(13); 20.19(B)(14) and 20.19(B)(15) of this regulation;

11. Specify that, if the insurer is placed in supervision, seizure, conservatorship or receivership pursuant to the Insurer Rehabilitation and Liquidation Act, Section 83-34-1, et seq.

i. All of the rights of the insurer under the agreement extend to the receiver or commissioner to the extent permitted by law;

ii. All records and data of the insurer shall be identifiable and segregated from all other persons’ records and data or readily capable of segregation at no additional cost to the receiver or the commissioner;

iii. A complete set of records and data of the insurer will immediately be made available to the receiver or the commissioner, shall be made available in a usable format and shall be turned over to the receiver or commissioner immediately upon the receiver or the commissioner’s request; and the cost to transfer data to the receiver or the commissioner shall be fair and reasonable; and,

iv. The affiliated person(s) will make available all employees essential to the operations of the insurer and the services associated therewith for the immediate continued performance of the essential services ordered or directed by the receiver or commissioner;

12. Specify that the affiliate has no automatic right to terminate the agreement if the insurer is placed into supervision, seizure, conservatorship or receivership pursuant to the Insurer Rehabilitation and Liquidation Act, Section 83-34-1, et seq.; and,

13. Specify that the affiliate will continue to maintain any systems, programs, or other infrastructure, notwithstanding supervision, seizure, conservatorship or receivership pursuant to the Insurer Rehabilitation and Liquidation Act, Sections 83-34-1, et seq., as ordered or directed by the receiver or commissioner. Performance of the essential services will continue to be provided without regard to pre-receivership unpaid fees, so long as the affiliate continues to receive timely payment for post-receivership services rendered, and unless released by the receiver, commissioner or supervising court;

14. Specify that the affiliate will continue to maintain any systems, programs or other infrastructure, notwithstanding supervision, seizure, conservatorship or receivership pursuant to the Insurer Rehabilitation and Liquidation Act, Sections 83-34-1, et seq., and will make them available to the receiver or

commissioner as ordered or directed by the receiver or commissioner for so long as the affiliate continues to receive timely payment for post-receivership services rendered, and unless released by the receiver, commissioner or supervising court; and

15. Specify that, in furtherance of the cooperation between the receiver and the affected guaranty association(s) and subject to the receiver’s authority over the insurer, if the insurer is placed into supervision, seizure, conservatorship or receivership pursuant to the Insurer Rehabilitation and Liquidation Act, Sections 83-34-1, et seq., and portions of the insurer’s policies or contracts are eligible for coverage by one or more guaranty associations, the affiliate's commitments under Rules 20.19(B)(11), 20.19(B)(12), 20.19(B)(13) and 20.19(B)(14) of this regulation will extend to such guaranty association(s).

History

• Source: Miss. Code Ann. §§ 83-6-21; 83-6-31 (Supp. 2022)

19 Miss. Admin. Code Pt. 1, R. 20.20 Enterprise Risk Report

The ultimate controlling person of an insurer required to file an enterprise risk report pursuant to Section 83-6-5(5) of the Act shall furnish the required information on Form F, hereby made a part of these regulations.

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.21 Extraordinary Dividends and Other Distributions

A. Requests for approval of extraordinary dividends or any other extraordinary distribution to shareholders shall include the following:

1. The amount of the proposed dividend;

2. The date established for payment of the dividend;

3. A statement as to whether the dividend is to be in cash or other property and, if in property, a description thereof, its cost, and its fair market value together with an explanation of the basis for valuation;

4. A copy of the calculations determining that the proposed dividend is extraordinary. The work paper shall include the following information:

i. The amounts, dates and form of payment of all dividends or distributions (including regular dividends but excluding distributions of the insurers own securities) paid within the period of twelve (12) consecutive months ending on the date fixed for payment of the proposed dividend for which approval is sought and commencing on the day after the same day of the same month in the last preceding year.

ii. Surplus as regards policyholders (total capital and surplus) as of the 31st day of December next preceding;

iii. If the insurer is a life insurer, the net gain from operations for the 12- month period ending the 31 st day of December next preceding;

iv. If the insurer is not a life insurer, the net income less realized capital gains for the 12-month period ending the 31st day of December next preceding and the two preceding 12-months periods; and

v. If the insurer is not a life insurer, the dividends paid to stockholders excluding distributions of the insurer’s own securities in the preceding two calendar years.

5. A balance sheet and statement of income for the period intervening from the last annual statement filed with the Commissioner and the end of the month preceding the month in which the request for dividend approval is submitted; and

6. A brief statement as to the effect of the proposed dividend upon the insurer’s surplus and the reasonableness of surplus in relation to the insurer’s outstanding liabilities and the adequacy of surplus relative to the insurer’s financial needs.

B. Subject to Section 83-6-25, each registered insurer shall report to the commissioner all dividends and other distributions to shareholders within fifteen (15) business days following the declaration thereof, including the same information required by Subsection A(4).

History

• Source: Miss. Code Ann. §§ 83-6-5; 83-6-31 (Supp. 2013)

19 Miss. Admin. Code Pt. 1, R. 20.22 Group Capital Calculation

A. Where an insurance holding company system has previously filed the annual group capital calculation at least once, the lead state commissioner has the discretion to exempt the ultimate controlling person from filing the annual group capital calculation if the lead state commissioner makes a determination based upon that filing that the insurance holding company system meets all of the following criteria:

1. Has annual direct written and unaffiliated assumed premium (including International direct and assumed premium), but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of less than $1,000,000,000;

2. Has no insurers within its holding company structure that are domiciled outside of the United States or one of its territories;

3. Has no banking, depository or other financial entity that is subject to an identified regulatory capital framework within its holding company structure;

4. The holding company system attests that there are no material changes in the transactions between insurers and non-insurers in the group that have occurred since the last filing of the annual group capital; and

5. The non-insurers within the holding company system do not pose a material financial risk to the insurer’s ability to honor policyholder obligations.

B. Where an insurance holding company system has previously filed the annual group capital calculation at least once, the lead state commissioner has the discretion to accept in lieu of the group capital calculation a limited group capital filing if:

1. The insurance holding company system has annual direct written and unaffiliated assumed premium (including international direct and assumed premium), but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of less than $1,000,000,000; and all of the following additional criteria are met:

i. Has no insurers within its holding company structure that are domiciled outside of the United States or one of its territories;

ii. Does not include a banking, depository or other financial entity that is subject to an identified regulatory capital framework; and

iii. The holding company system attests that there are no material changes in transactions between insurers and non-insurers in the group that have occurred since the last filing of the report to the lead state commissioner and the non-insurers within the holding company system do not pose a material financial risk to the insurers ability to honor policyholder obligations.

C. For an insurance holding company that has previously met an exemption with respect to the group capital calculation pursuant Rules 20.22(A) and 20.22(B) of this regulation, the lead state commissioner may require at any time the ultimate controlling person to file an annual group capital calculation, completed in accordance with the NAIC Group Capital Calculation Instructions, if any of the following criteria are met:

1. Any insurer within the insurance holding company system is in a Risk-Based Capital action level event as set forth in Miss Code Ann. §§83-5-405 through 83-5-411, or a similar standard for a non-U.S. insurer; or

2. Any insurer within the insurance holding company system meets one or more of the standards of an insurer deemed to be in hazardous financial condition as defined in 19 Miss. Admin. Code, Pt. 1, Rules 39.03 and 39.04; or

3. Any insurer within the insurance holding company system otherwise exhibits qualities of a troubled insurer as determined by the lead state commissioner based on unique circumstances including, but not limited to, the type and volume of business written, ownership and organizational structure, federal agency requests, and international supervisor requests.

D. A non-U.S. jurisdiction is considered to “recognize and accept” the group capital calculation if it satisfies the following criteria:

1. With respect to Miss. Code Ann. §83-6-5(5)(n)(4).

i. The non-U.S. jurisdiction recognizes the U.S. state regulatory approach to group supervision and group capital, by providing confirmation by a competent regulatory authority, in such jurisdiction, that insurers and insurance groups whose lead state is accredited by the NAIC under the NAIC Accreditation Program shall be subject only to worldwide prudential insurance group supervision including worldwide group governance, solvency and capital, and reporting, as applicable, by the lead state and will not be subject to group supervision, including worldwide group governance, solvency and capital, and reporting, at the level of the worldwide parent undertaking of the insurance or reinsurance group by the non-U.S. jurisdiction; or

ii. Where no U.S. insurance groups operate in the non-U.S. jurisdiction, that non-U.S. jurisdiction indicates formally in writing to the lead state with a copy to the International Association of Insurance Supervisors that the group capital calculation is an acceptable international capital standard. This will serve as the documentation otherwise required in Rule 20.22(1)(a)

2. The non-U.S. jurisdiction provides confirmation by a competent regulatory authority in such jurisdiction that information regarding insurers and their parent, subsidiary, or affiliated entities, if applicable, shall be provided to the

lead state commissioner in accordance with a memorandum of understanding or similar document between the commissioner and such jurisdiction, including but not limited to the International Association of Insurance Supervisors Multilateral Memorandum of Understanding or other multilateral memoranda of understanding coordinated by the NAIC. The commissioner shall determine, in consultation with the NAIC Committee Process, if the requirements of the information sharing agreements are in force.

E. A list of non-U.S. jurisdictions that “recognize and accept” the group capital calculation will be published through the NAIC Committee Process:

1. A list of jurisdictions that “recognize and accept” the group capital calculation pursuant to Miss. Code Ann §83-6-5(5)(b)(i)(4), is published through the NAIC Committee Process to assist the lead state commissioner in determining which insurers shall file an annual group capital calculation. The list will clarify those situations in which a jurisdiction is exempted from filing under Miss. Code Ann §83-6-5(5)(b)(i)(4). To assist with a determination under Miss. Code Ann §83-6-5(5)(b)(ii), the list will also identify whether a jurisdiction that is exempted under either Miss. Code Ann §83-6-5(5)(b)(i)(3) and Miss. Code Ann §83-6-5(5)(b)(i)(4) requires a group capital filing for any U.S. based insurance group’s operations in that non-U.S. jurisdiction.

2. For a non-U.S. jurisdiction where no U.S. insurance groups operate, the confirmation provided to meet the requirement of Rule 20.22(D(1)(b)(ii) will serve as support for recommendation to be published as a jurisdiction that “recognizes and accepts” the group capital calculation through the NAIC Committee Process.

3. If the lead state commissioner makes a determination pursuant to Miss. Code Ann §83-6-5(5)(b)(i)(4) that differs from the NAIC List, the lead state commissioner shall provide thoroughly documented justification to the NAIC and other states.

4. Upon determination by the lead state commissioner that a non-U.S. jurisdiction no longer meets one or more of the requirements to “recognize and accept” the group capital calculation, the lead state commissioner may provide a recommendation to the NAIC that the non-U.S. jurisdiction be removed from the list of jurisdictions that “recognize and accepts” the group capital calculation.

19 Miss. Admin. Code Pt. 1, R. 20.23 Adequacy of Surplus

The factors set forth in Section 83-6-23 of the Act are not intended to be an exhaustive list. In determining the adequacy and reasonableness of an insurer’s surplus no single factor is necessarily controlling. The Commissioner, instead, will consider the net effect of all of these factors plus other factors bearing on the financial condition of the insurer. In comparing the surplus maintained by other insurers, the Commissioner will consider the extent to which each of these factors varies from company to company and in determining the quality and liquidity of investments in subsidiaries, the Commissioner will consider the individual subsidiary and may discount or disallow its valuation to the extent that the individual investments so warrant.

All new and renewal reinsurance transactions entered into after on and after July 1, 2017, shall conform to the requirements of this Regulation, as amended.

History

• Source: Miss. Code Ann. § 83-6-23 (Rev. 2022) Rule 20. 24 Effective date
• Source: Miss. Code Ann. §§ 25-43-3.112; 83-5-1 (Rev. 2022)

19 Miss. Admin. Code Pt. 1, R. 20.25 Form A - Statement Regarding the Acquisition of Control of or Merger with a Domestic Insurer FORM A

STATEMENT REGARDING THE ACQUISITION OF CONTROL OF OR MERGER WITH A DOMESTIC INSURER

____________________________________ Name of Domestic Insurer

BY

____________________________________ Name of Acquiring Person (Applicant)

Filed with the Insurance Department of

_____________________________________________________ (State of domicile of insurer being acquired)

Dated: ____________________, 20 __________

Name, Title, address and telephone number of Individual to Whom Notices and Correspondence Concerning this Statement should be Addressed: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

ITEM 1. INSURER AND METHOD OF ACQUISITION

State the name and address of the domestic insurer to which this application relates and a brief description of how control is to be acquired.

ITEM 2. IDENTITY AND BACKGROUND OF THE APPLICANT

A. State the name and address of the applicant seeking to acquire control over the insurer.

B. If the applicant is not an individual, state the nature of its business operations for the past five years or for such lesser period as such person and any predecessors thereof shall have been in existence. Briefly describe the business intended to be done by the applicant and the applicant’s subsidiaries.

C. Furnish a chart or listing clearly presenting the identities of the inter-relationships among the applicant and all affiliates of the applicant. Indicate in such chart or listing the percentage of voting securities of each such person which is owned or controlled by the

applicant or by any other such person. If control of any person is maintained other than by the ownership or control of voting securities, indicate the basis of such control. As to each person specified in such chart or listing indicate the type of organization (e.g. corporation, trust, partnership) and the state or other jurisdiction of domicile. If court proceedings involving a reorganization or liquidation are pending with respect to any such person, indicate which person, and set forth the title of the court, nature of proceedings and the date when commenced.

ITEM 3. IDENTITY AND BACKGROUND OF INDIVIDUALS ASSOCIATED WITH THE APPLICANT

On the biographical affidavit, include a third party background check, and state the following with respect to (1) the applicant if (s)he is an individual or (2) all persons who are directors, executive officers or owners of 10% or more of the voting securities of the applicant if the applicant is not an individual.

A. Name and business address;

B. Present principal business activity, occupation or employment including position and office held and the name, principal business and address of any corporation or other organization in which such employment is carried on;

C. Material occupations, positions, offices or employment during the last five years, giving the starting and ending dates of each and the name, principal business and address of any business corporation or other organization in which each such occupation, position, office or employment was carried on; if any such occupation, position, office or employment required licensing by or registration with any federal, state or municipal governmental agency, indicate such fact, the current status of such licensing or registration, and an explanation of any surrender, revocation, suspension or disciplinary proceedings in connection therewith.

D. Whether or not such person has ever been convicted in a criminal proceeding (excluding minor traffic violations) during the last ten years and, if so, give the date, nature of conviction, name and location of court, and penalty imposed or other disposition of the case.

ITEM 4. NATURE, SOURCE AND AMOUNT OF CONSIDERATION

A. Describe the nature, source and amount of funds or other considerations used or to be used in effecting the merger or other acquisition of control. If any part of the same is represented or is to be represented by funds or other consideration borrowed or otherwise obtained for the purpose of acquiring, holding or trading securities, furnish a description of the transaction, the names of the parties thereto, the relationship, if any, between the borrower and the lender, the amounts borrowed or to be borrowed, and copies of all agreements, promissory notes and security arrangements relating thereto.

B. Explain the criteria used in determining the nature and amount of such consideration.

C. If the source of the consideration is a loan made in the lender’s ordinary course of business and if the applicant wishes the identity of the lender to remain confidential, he must specifically request that the identity be kept confidential.

ITEM 5. FUTURE PLANS OF INSURER

Describe any plans or proposals which the applicant may have to declare an extraordinary dividend, to liquidate such insurer, to sell its assets to or merge it with any person or persons or to make any other material change in its business operations or corporate structure or management.

ITEM 6. VOTING SECURITIES TO BE ACQUIRED

State the number of shares of the insurer’s voting securities which the applicant, its affiliates and any person listed in Item 3 plan to acquire, and the terms of the offer, request, invitation, agreement or acquisition, and a statement as to the method by which the fairness of the proposal was arrived at.

ITEM 7. OWNERSHIP OF VOTING SECURITIES

State the amount of each class of any voting security of the insurer which is beneficially owned or concerning which there is a right to acquire beneficial ownership by the applicant, its affiliates or any person listed in Item 3.

ITEM 8. CONTRACTS, ARRANGEMENTS, OR UNDERSTANDINGS WITH RESPECT TO VOTING SECURITIES OF THE INSURER

Give a full description of any contracts, arrangements or understandings with respect to any voting security of the insurer in which the applicant, its affiliates or any person listed in Item 3 is involved, including but not limited to transfer of any of the securities, joint ventures, loan or option arrangements, puts or calls, guarantees of loans, guarantees against loss or guarantees of profits, division of losses or profits, or the giving or withholding of proxies. Such description shall identify the persons with whom such contracts, arrangements or understandings have been entered into.

ITEM 9. RECENT PURCHASERS OF VOTING SECURITIES

Describe any purchases of any voting securities of the insurer by the applicant, its affiliates or any person listed in Item 3 during the 12 calendar months preceding the filing of this Statement. Include in such description the dates of purchase, the names of the purchasers, and the consideration paid or agreed to be paid therefor. State whether any such shares so purchased are hypothecated.

ITEM 10. RECENT RECOMMENDATIONS TO PURCHASE

Describe any recommendations to purchase any voting security of the insurer made by the applicant, its affiliates or any person listed in Item 3, or by anyone based upon interviews or at the suggestion of the applicant, its affiliates or any person listed in Item 3 during the 12 calendar months preceding the filing of this statement.

ITEM 11. AGREEMENTS WITH BROKER-DEALERS

Describe the terms of any agreement, contract or understanding made with any broker-dealer as to solicitation of voting securities of the insurer for tender and the amount of any fees, commissions or other compensation to be paid to broker-dealers with regard thereto.

ITEM 12. FINANCIAL STATEMENTS AND EXHIBITS

A. Financial statements, exhibits, and three-year financial projections of insurer(s) shall be attached to this statement as an appendix, but list under this item the financial statements and exhibits so attached.

B. The financial statements shall include the annual financial statements of the persons identified in Item 2(c) for the preceding five fiscal years (or for such lesser period as such applicant and its affiliates and any predecessors thereof shall have been in existence), and similar information covering the period from the end of such person’s last fiscal year, if such information is available. Such statements may be prepared on either an individual basis, or, unless the Commissioner otherwise requires, on a consolidated basis if such consolidated statements are prepared in the usual course of business.

The annual financial statements of the applicant shall be accompanied by the certificate of an independent public accountant to the effect that such statements present fairly the financial position of the applicant and the results of its operations for the year then ended, in conformity with generally accepted accounting principles or with requirements of insurance or other accounting principles prescribed or permitted under law. If the applicant is an insurer which is actively engaged in the business of insurance, the financial statements need not be certified, provided they are based on the Annual Statement of such person filed with the insurance department of the person’s domiciliary state and are in accordance with the requirements of insurance or other accounting principles prescribed or permitted under the law and regulations of such state.

C. File as exhibits copies of all tender offers for, requests or invitations for, tenders of, exchange offers for, and agreements to acquire or exchange any voting securities of the insurer and (if distributed) of additional soliciting material relating thereto, any proposed employment, consultation, advisory or management contracts concerning the insurer, annual reports to the stockholders of the insurer and the applicant for the last two fiscal years, and any additional documents or papers required by Form A or Regulation Sections 4 and 6.

ITEM 13. AGREEMENT REQUIREMENTS FOR ENTERPRISE RISK MANAGEMENT

Applicant agrees to provide, to the best of its knowledge and belief, the information required by Form F within fifteen (15) days after the end of the month in which the acquisition of control occurs.

ITEM 14. SIGNATURE AND CERTIFICATION

Signature and certification required as follows:

SIGNATURE

Pursuant to the requirements of Section 83-6-24 of the Act ________________ has caused this

application to be duly signed on its behalf in the City of ____________________ and State

of _______________________ on the _______ of ________ 20_______.

(SEAL)__________________________ Name of applicant Attest: BY______________________________ (Name) (Title) _________________________________ (Signature of Officer)

_________________________________ (Title)

CERTIFICATION

The undersigned deposes and says that (s)he has duly executed the attached application dated

________________, 20, for and on behalf of _________________________

_____________________________________________________________ ; that (s)he is the (Name of applicant)

_______________________________________________of such company and that (s)he is an (Title of Officer)

authorized to execute and file such instrument. Deponent further says that (s)he is familiar with such instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief.

(Signature) ________________________________________

(Type or print name beneath) _________________________________________

Rule 20.26: Form B - Insurance Holding Company System Annual Registration Statement

FORM B

INSURANCE HOLDING COMPANY SYSTEM ANNUAL REGISTRATION STATEMENT

Filed with the Insurance Department of the State of ____________________

BY

__________________________ (Name of Registrant)

On Behalf of Following Insurance Companies:

Name Address ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Date: __________, 20

Name, Title, Address and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

ITEM 1. IDENTITY AND CONTROL OF REGISTRANT

Furnish the exact name of each insurer registering or being registered (hereinafter called “the Registrant”), the home office address and principal executive offices of each; the date on which each Registrant became part of the insurance holding company system; and the method(s) by which control of each Registrant was acquired and is maintained.

ITEM 2. ORGANIZATIONAL CHART

Furnish a chart or listing clearly presenting the identities of and interrelationships among all affiliated persons within the insurance holding company system. The chart or listing should show the percentage of each class of voting securities of each affiliate which is owned, directly or indirectly, by another affiliate. If control of any person within the system is maintained other than by the ownership or control of voting securities, indicate the basis of such control. As to

each person specified in such chart or listing indicate the type of organization (e.g.,- corporation, trust, partnership) and the state or other jurisdiction of domicile.

ITEM 3. THE ULTIMATE CONTROLLING PERSON

As to the ultimate controlling person in the insurance holding company system furnish the following information:

A. Name.

B. Home office address.

C. Principal executive office address.

D. The organizational structure of the person, i.e., corporation, partnership, individual, trust, etc.

E. The principal business of the person.

F. The name and address of any person who holds or owns 10% or more of any class of voting security, the class of such security, the number of shares held of record or known to be beneficially owned, and the percentage of class so held or owned.

G. If court proceedings involving a reorganization or liquidation are pending, indicate the title and location of the court, the nature of proceedings and the date when commenced.

ITEM 4. BIOGRAPHICAL INFORMATION

If the ultimate controlling person is a corporation, an organization, a limited liability company, or other legal entity, furnish the following information for the directors and executive officers of the ultimate controlling person: the individual’s name and address, his or her principal occupation and all offices and positions held during the past five years, and any conviction of crimes other than minor traffic violations. If the ultimate controlling person is an individual, furnish the individual’s name and address, his or her principal occupation and all offices and positions held during the past five years, and any conviction of crimes other than minor traffic violations.

ITEM 5. TRANSACTIONS AND AGREEMENTS

Briefly describe the following agreements in force, and transactions currently outstanding or which have occurred during the last calendar year between the Registrant and its affiliates:

A. Loans, other investments, or purchases, sales or exchanges of securities of the affiliates by the Registrant or of the Registrant by its affiliates:

B. Purchases, sales or exchanges of assets;

C. Transactions not in the ordinary course of business;

D. Guarantees or undertakings for the benefit of an affiliate which result in an actual contingent exposure of the Registrant’s assets to liability, other than insurance contracts entered into in the ordinary course of the Registrant’s business;

E. All management agreements, service contracts and all cost-sharing arrangements;

F. Reinsurance agreements;

G. Dividends and other distributions to shareholders;

H. Consolidated tax allocation agreements; and

I. Any pledge of the Registrant’s stock and/or of the stock of any subsidiary or controlling affiliate, for a loan made to any member of the insurance holding company system.

No information need be disclosed if such information is not material for purposes of Sections 83- 6-3 through 83-6-19 of the Act.

Sales, purchases, exchanges, loans or extensions of credit, investments or guarantees involving one-half of 1% or less of the Registrant’s admitted assets as of the 31st day of December next preceding shall not be deemed material.

The description shall be in a manner as to permit the proper evaluation thereof by the Commissioner, and shall include at least the following: the nature and purpose of the transaction, the nature and amounts of any payments or transfers of assets between the parties, the identity of all parties to such transaction, and relationship of the affiliated parties to the Registrant.

ITEM 6. LITIGATION OR ADMINSTATIVE PROCEEDINGS

A brief description of any litigation or administrative proceedings of the following types, either then pending or concluded within the preceding fiscal year, to which the ultimate controlling person or any of its directors or executive officers was a party or of which the property of any such person is or was the subject; give the names of the parties and the court or agency in which such litigation or proceeding is or was pending;

A. Criminal prosecutions or administrative proceedings by any government agency or authority which may be relevant to the trustworthiness of any party thereto; and

B. Proceedings which may have a material effect upon the solvency or capital structure of the ultimate holding company including, but not necessarily limited to, bankruptcy, receivership or other corporate reorganizations.

ITEM 7. STATEMENT REGARDING PLAN OR SERIES OF TRANSACTIONS

The insurer shall furnish a statement that transactions entered into since the filing of the prior year’s annual registration statement are not part of a plan or series of like transactions, the purpose of which is to avoid statutory threshold amounts and the review that might otherwise occur.

ITEM 8. FINANCIAL STATEMENTS AND EXHIBITS

A. Financial statements and exhibits should be attached to this statement as an appendix, but list under this item the financial statements and exhibits so attached.

B. If the ultimate controlling person is a corporation, an organization, a limited liability company, or other legal entity, the financial statements shall include the annual financial statements of the ultimate controlling person in the insurance holding company system as of the end of the person’s latest fiscal year.

If at the time of the initial registration, the annual financial statements for the latest fiscal year are not available, annual statements for the previous fiscal year may be filed and similar financial information shall be filed for any subsequent period to the extent such information is available. Such financial statements may be prepared on either an individual basis, or unless the Commissioner otherwise requires, on a consolidated basis if such consolidated statements are prepared in the usual course of business.

Other than with respect to the foregoing, such financial statements shall be filed in a standard form and format adopted by the National Association of Insurance Commissioners, unless an alternative form is accepted by the Commissioner. Documentation and financial statements filed with the Securities and Exchange Commission or audited GAAP financial statements shall be deemed to be an appropriate form and format.

Unless the Commissioner otherwise permits, the annual financial statements shall be accompanied by the certificate of an independent public accountant to the effect that such statements present fairly the financial position of the ultimate controlling person and the results of its operations for the year then ended, in conformity with generally accepted accounting principles or with requirements of insurance or other accounting principles prescribed or permitted under law. If the ultimate controlling person is an insurer which is actively engaged in the business of insurance, the annual financial statements need not be certified, provided they are based on the Annual Statement of such insurer filed with the insurance department of the insurer’s domiciliary State and are in accordance with requirements of insurance or other accounting principles prescribed or permitted under the law and regulations of such state.

Any ultimate controlling person who is an individual may file personal financial statements that are reviewed rather than audited by an independent public accountant. The review shall be conducted in accordance with standards for review of personal financial statements published in the Personal Financial Statements Guide by the

American Institute of Certified Public Accountants. Personal financial statements shall be accompanies by the independent public accountant’s Standard Review Report stating that the accountant is not aware of any material modifications that should be made to the financial statements in order for the statements to be in conformity with generally accepted accounting principles.

C. Exhibits shall include copies of the latest annual reports to shareholders of the ultimate controlling person and proxy material used by the ultimate controlling person; and any additional documents or papers required by Form B or Regulation Sections 20.04 and 20.06.

ITEM 9. FORM C REQUIRED

A Form C Summary of Changes to Registration Statement, must be prepared and filed with this Form B.

ITEM 10: SIGNATURE AND CERTIFICATION

Signature and certification required as follows:

SIGNATURE

Pursuant to the requirements of Section 83-6-5, the Registrant has caused this annual registration statement to be duly signed on its behalf in the City of _________________ and State of _______________________ on the _______ day of _, 20.

(SEAL)__________________________ Name of Registrant

BY______________________________ (Name) (Title) Attest:

_________________________________ (Signature of Officer)

_________________________________ (Title) CERTIFICATION

The undersigned deposes and says that (s)he has duly executed the attached annual registration statement dated ________________, 20, for and on behalf of _______________________________; that (s)he is the (Name of company)

_______________________________ of such company and that (s)he is authorized to execute (Title of Officer)

and file such instrument. Deponent further says that (s)he is familiar with such instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief.

(Signature) ____________________________

History

• Source: Miss. Code Ann. § 83-6-23 (Rev. 2011)
• Source: Miss. Code Ann. § 83-6-5 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.27 Form C - Summary of Registration Statement

FORM C SUMMARY OF REGISTRATION STATEMENT

Filed with the Insurance Department of the State of ____________________

BY

__________________________ (Name of Registrant)

On Behalf of Following Insurance Companies

Name Address

---

Date: __________, 20

Name, Title, Address and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed:

---

Furnish a brief description of all items in the current annual registration statement which represent changes from the prior year’s annual registration statement. The description shall be in a manner as to permit the proper evaluation thereof by the Commissioner, and shall include specific references to Item numbers in the annual registration statement and to the terms contained therein.

Changes occurring under Item 2 of Form B insofar as changes in the percentage of each class of voting securities held by each affiliate is concerned, need only be included where such changes are ones which result in ownership or holdings of 10% or more of voting securities, loss or transfer of control, or acquisition or loss of partnership interest.

Changes occurring under Item 4 of Form B need only be included where an individual is, for the first time, made a director or executive officer of the ultimate controlling person; a director or executive officer terminates his or her responsibilities with the ultimate controlling person; or in the event an individual is named president of the ultimate controlling person.

If a transaction disclosed on the prior year’s annual registration statement has been changed, the nature of such change shall be included. If a transaction disclosed on the prior year’s annual registration statement has been effectuated, furnish the mode of completion and any flow of funds between affiliates resulting from the transaction.

The insurer shall furnish a statement that transactions entered into since the filing of the prior year’s annual registration statement are not part of a plan or series of like transactions whose purpose it is to avoid statutory threshold amounts and the review that might otherwise occur.

SIGNATURE AND CERTIFICATION

Signature and certification required as follows:

Pursuant to the requirements of Section 83-6-3, Registrant has caused this annual registration

statement to be duly signed on its behalf of the City of ____________________ and State

of _______________________ on the _______ day of _, 20.

(SEAL)__________________________ Name of Applicant

BY______________________________ (Name) (Title) Attest: _________________________________ (Signature of Officer)

_________________________________ (Title)

CERTIFICATION

The undersigned deposes and says that (s)he has duly executed the attached annual registration

statement dated ___________________, 20, for and on behalf of

__________________________________________________________; that (s)he is the (Name of applicant)

_______________________________ such company and that (s)he is authorized to execute (Title of Officer)

and file such instrument. Deponent further says that (s)he is familiar with such instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief.

(Signature) ____________________________

History

• Source: Miss. Code Ann. § 83-6-3 (Rev. 2011)

19 Miss. Admin. Code Pt. 1, R. 20.28 Form D - Prior Notice of a Transaction

FORM D PRIOR NOTICE OF A TRANSACTION

Filed with the Insurance Department of the State of ____________________

BY

__________________________________________ (Name of Registrant)

On Behalf of Following Insurance Companies

Name Address

---

Date: __________, 20

Name, Title, Address and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

ITEM 1. IDENTITY OF PARTIES TO TRANSACTION

Furnish the following information for each of the parties to the transaction:

(a) Name.

(b) Home office address.

(c) Principal executive office address.

(d) The organizational structure, i.e. corporation, partnership, individual, trust, etc.

(e) A description of the nature of the parties’ business operations.

(f) Relationship, if any, of other parties to the transaction to the insurer filing the notice, including any ownership or debtor/creditor interest by any other parties to the

transaction in the insurer seeking approval, or by the insurer filing the notice in the affiliated parties.

(g) Where the transaction is with a non-affiliate, the name(s) of the affiliate(s) which will receive, in whole or in substantial part, the proceeds of the transaction.

ITEM 2. DESCRIPTION OF THE TRANSACTION

Furnish the following information for each transaction for which notice is being given:

(a) A statement as to whether notice is being given under Section 83-6-21 (2)(a)(b)(c)(d) (e) (f) or (g) of the Act.

(b) A statement of the nature of the transaction.

(c) A statement of how the transaction meets the “fair and reasonable” standard of Section 83-6-21(1)(a); and

(d) The proposed effective date of the transaction.

ITEM 3. SALES, PURCHASES, EXCHANGES, LOANS, EXTENSIONS OF CREDIT, GUARANTEES OR INVESTMENTS

Furnish a brief description of the amount and source of funds, securities, property or other consideration for the sale, purchase, exchange, loan, extension of credit, guarantee, or investment, whether any provision exists for purchase by the insurer filing notice, by any party to the transaction, or by any affiliate of the insurer filing notice, a description of the terms of any securities being received, if any, and a description of any other agreements relating to the transaction such as contracts or agreements for services, consulting agreements and the like. If the transaction involves other than cash, furnish a description of the consideration, its cost and its fair market value, together with an explanation of the basis for evaluation.

If the transaction involves a loan, extension of credit or a guarantee, furnish a description of the maximum amount which the insurer will be obligated to make available under such loan, extension of credit or guarantee, the date on which the credit or guarantee will terminate, and any provisions for the accrual of or deferral of interest.

If the transaction involves an investment, guarantee or other arrangement, state the time period during which the investment, guarantee or other arrangement will remain in effect, together with any provisions for extensions or renewals of such investments, guarantees or arrangements. Furnish a brief statement as to the effect of the transaction upon the insurer’s surplus.

No notice need be given if the maximum amount which can at any time be outstanding or for which the insurer can be legally obligated under the loan, extension of credit or guarantee is less than, (a) in the case of non-life insurer’s, the lesser of 3% of the insurer’s admitted assets or 25%

of surplus as regards policyholders or, (b) in the case of life insurers, 3% of the insurer’s admitted assets, each as of the 31st day of December next preceding.

ITEM 4. LOANS OR EXTENSIONS OF CREDIT TO A NON-AFFILIATE

If the transaction involves a loan or extension of credit to any person who is not an affiliate, furnish a brief description of the agreement or understanding whereby the proceeds of the proposed transaction, in whole or in substantial part, are to be used to make loans or extensions of credit to, to purchase the assets of, or to make investments in, any affiliate of the insurer making such loans or extensions of credit, and specify in what manner the proceeds are to be used to loan to, extend credit to, purchase assets of or make investments in any affiliate. Describe the amount and source of duns, securities, property or other consideration for the loan or extension of credit and, if the transaction is one involving consideration other than cash, a description of its cost and its fair market value together with an explanation of the basis for evaluation. Furnish a brief statement as to the effect of the transaction upon the insurer’s surplus.

No notice need be given if the loan or extension of credit is one which equals less than, in the case of non-life insurers, the lesser or 3% of the insurer’s admitted assets or 25% of surplus as regards policyholders or, with respect to life insurers, 3% of the insurer’s admitted assets, each as of the 31st day of December next preceding.

ITEM 5. REINSURANCE

If the transaction is a reinsurance agreement or modification thereto, as described by Section 83- 6-21(2)(c) of the Act, or a reinsurance pooling agreement or modification thereto as described by Section 83-6-21(c), furnish a description of the known and/or estimated amount of liability to be ceded and/or assumed in each calendar year, the period of time during which the agreement will be in effect, and a statement whether an agreement or understanding exists between the insurer and non-affiliate to the effect that any portion of the assets constituting the consideration for the agreement will be transferred to one or more of the insurer’s affiliates. Furnish a brief description of the consideration involved in the transaction, and a brief statement as to the effect of the transaction upon the insurer’s surplus.

No notice need be given for reinsurance agreements or modifications thereto if the reinsurance premium or a change in the insurer’s liabilities, or the projected reinsurance premium or change in the insurer’s liabilities in any of the next three years, in connection with the reinsurance agreement or modification thereto is less than 5% of the insurer’s surplus as regards policyholders, as of the 31st day of December next preceding. Notice shall be given for all reinsurance pooling agreements including modifications thereto.

ITEM 6. MANAGEMENT AGREEMENTS, SERVICE AGREEMENTS AND COST- SHARING ARRANGEMENTS.

For management agreements and services agreements, furnish:

(a) a brief description of the managerial responsibilities, or services to be performed.

(b) a brief description of the agreement, including a statement of its duration, together with brief descriptions of the basis for compensation and the terms under which payment or compensation is to be made.

For cost-sharing arrangements, furnish:

(a) a brief description of the purpose of the agreement.

(b) a description of the period of time during which the agreement is to be in effect.

(c) a brief description of each party’s expenses or costs covered by the agreement.

(d) a brief description of the accounting basis to be used in calculating each party’s costs under the agreement.

(e) a brief statement as to the effect of the transaction upon the insurer’s policyholder surplus;

(f) A statement regarding the cost allocation methods that specifies whether proposed charges are based on “cost or market”. If market based, rationale for using market instead of cost, including justification for the company’s determination that amounts are fair and reasonable; and

(g) A statement regarding compliance with the NAIC Accounting Practices and Procedure Manual regarding expense allocation.

ITEM 7. SIGNATURE AND CERTIFICATION

Signature and certification required as follows:

SIGNATURE: ________________________________________________________________

Pursuant to the requirements of Section 83-6-21 of the Act, ____________________ has caused

this notice to be duly signed on its behalf in the City of _______________________ and State of

______________________ on the _______ day of _______________, 20.

(SEAL)__________________________ Name of Applicant BY______________________________ (Name) (Title)

Attest: _________________________________ (Signature of Officer)

_________________________________ (Title)

CERTIFICATION

The undersigned deposes and says that (s)he has duly executed the attached annual registration statement dated ________________, 20, for and on behalf of

_________________________________________; that (s)he is the (Name of Applicant)

_____________________________________ of such company and that (s)he is authorized to (Title of Officer)

execute and file such statement. Deponent further says that (s)he is familiar with such instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief.

(Signature) ____________________________

(Type or print name beneath) ____________________________

Rule 20.29: Form E – Pre-Acquisition Notification Form

FORM E

PRE-ACQUISITION NOTIFICATION FORM REGARDING THE POTENTIAL COMPETITIVE IMPACT OF A PROPOSED MERGER OR ACQUISITION BY A NON-DOMICILIARY INSURER DOING BUSINESS IN THIS STATE OR BY A DOMESTIC INSURER

______________________________ Name of Applicant

______________________________ Name of Other Person Involved in Merger or Acquisition

Filed with the Insurance Department of

---

Dated:____________, 20

Name, title, address and telephone number of person completing this statement:

---

---

---

---

ITEM 1. NAME AND ADDRESS

State the names and addresses of the persons who hereby provide notice of their involvement in a pending acquisition or change in corporate control.

ITEM 2. NAME AND ADDRESSES OF AFFILIATED COMPANIES

State the names and addresses of the person affiliated with those listed in Item 1. Describe their affiliations.

ITEM 3. NATURE AND PURPOSE OF THE PROPOSED MERGER OR ACQUISITION

State the nature and purpose of the proposed merger or acquisition.

ITEM 4. NATURE OF BUSINESS

State the nature of the business performed by each of the persons identified in response to Item 1 and Item 2.

ITEM 5. MARKET AND MARKET SHARE

State specifically what market and market share in each relevant insurance market the persons identified in Item 1 and Item 2 currently enjoy in this state. Provide historical market and market share data for each person identified in Item 1 and Item 2 for the past five years and identify the source of such data. Provide a determination as to whether the proposed acquisition or merger, if consummated, would violate the competitive standards of the state as stated in Section 4 of Senate Bill 2298, 2017 Regular Legislative Session. If the proposed acquisition or merger would violate competitive standards, provide justification of why the acquisition or merger would not substantially lessen competition or create a monopoly in the state.

For purposes of this question, market means direct written insurance premium in this state for a line of business as contained in the annual statement required to be filed by insurers licensed to do business in this state.

Miss. Code Ann. § 83-6-24 (Supp. 2013); Senate Bill 2298, 2017 Regular Legislative Session

Rule 20.30: Form F – Enterprise Risk Report

FORM F

ENTERPRISE RISK REPORT

Filed with the Insurance Department of the State of _________________________

By

____________________________________ Name of Registrant/Applicant

On Behalf of/Related to Following Insurance Companies

Name Address

---

---

---

---

Date:_________, 20

Name, Title, Address and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed:

---

---

---

ITEM 1. ENTERPRISE RISK

The Registrant/Applicant, to the best of its knowledge and belief, shall provide information regarding the following areas that could produce enterprise risk as defined in Miss. Code Ann. § 83-6-5(5), provided such information is not disclosed in the Insurance Holding Company System Annual Registration Statement filed on behalf of itself or another insurer for which it is the ultimate controlling person: • Any material developments regarding strategy, internal audit findings, compliance or risk management affecting the insurance holding company system;

• Acquisition or disposal of insurance entities and reallocating of existing financial or insurance entities within the insurance holding company system;

• Any changes of shareholders of the insurance holding company system exceeding ten percent (10%) or more of voting securities;

• Developments in various investigations, regulatory activities or litigation that may have a significant bearing or impact on the insurance holding company system;

• Business plan of the insurance holding company system and summarized strategies for next 12 months;

• Identification of material concerns of the insurance holding company system raised by supervisory college, if any, in last year;

• Identification of insurance holding company system capital resources and material distribution patterns;

• Identification of any negative movement or discussions with rating agencies which may have caused, or may cause, potential negative movement in the credit ratings and individual insurer financial strength ratings assessment of the insurance holding company system (including both the rating score and outlook);

• Information on corporate or parental guarantees throughout the holding company and the expected source of liquidity should such guarantees be called upon; and

• Identification of any material activity or development of the insurance holding company system that, in the opinion of senior management, could adversely affect the insurance holding company system.

The Registrant/Applicant may attach the appropriate form most recently filed with the U.S. Securities and Exchange Commission, provided the Registrant/Applicant includes specific references to those areas listed in Item 1 for which the form provides responsive information. If the Registrant/Applicant is not domiciled in the U.S., it may attach its most recent public audited financial statement filed in its country of domicile, provided the Registrant/Applicant includes specific references to those areas listed in Item 1 for which the financial statement provides responsive information.

ITEM 2: OBLIGATION TO REPORT

If the Registrant/Applicant has not disclosed any information pursuant to Item 1, the Registrant/Applicant shall include a statement affirming that, to the best of its knowledge and belief, it has not identified enterprise risk subject to disclosure pursuant to Item 1.

Miss. Code Ann. § 83-6-5 (Supp. 2013)

History

• Source: Miss. Code Ann. § 83-6-21 (Rev. 2011)

Chapter 22 Credit for Reinsurance.

19 Miss. Admin. Code Pt. 1, R. 22.20 Form CR-F Form CR-F – PART 1 Assumed Reinsurance as of December 31, Current Year (000 Omitted)

1 2 3 4 5 Reinsurance On 9 10 11 12 13 14 15

Com pany Code or ID Num ber

Name of Reinsured

Domicil iary Jurisdic tion

Assume d Premiu m

Paid Losses and Loss Adjust ment Expens es

Known Case Losses and LAE

Cols. 6 + 7

Conting ent Commis sions Payable

Assum ed Premi ums Receiv able

Unear ned Premi um

Funds Held By or Deposi ted With Reinsu red Compa nies

Letter s of Credit Posted Amount of Assets Pledged or Compens ating Balances to Secure Letters of Credit

Amou nt of Assets Pledge d or Collat eral Held in Trust ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. .............

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19 Miss. Admin. Code Pt. 1, R. 9999999 Totals

Form CR-F – PART 2 Ceded Reinsurance as of December 31, Current Year (000 Omitted)

1 2 3 4 5 6 Reinsurance Recoverable On Reinsurance Payable 18 19

Co mpa ny

Cod e or ID Nu mbe r

Name of Reinsur er

Domi ciliar y Juris dictio n Reins uranc e Contr acts Cedin g 75% or More of Direc t Premi ums Writt en

Reins uranc e Prem iums Cede d

Pai d Los ses

Pai d LA E

Kno wn Cas e Loss Res erve s

Kno wn Cas e LAE Res erve s

IBN R Loss Res erve s

IBN R LAE Res erve s

Une arne d Pre miu ms

Conti ngent Com missi ons

Col s. 7 thro ugh

Tot als

Ced ed Bal ance s Pay able

Othe r Amo unts Due to Rein sure rs

Net Amo unt Reco verab le From Reins urers Cols. 15 – [16 + 17]

Fund s Held by Comp any Unde r Reins uranc e Treat ies ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ ............

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Rule 22.21. Form CR-S

Form CR-S – PART 1 – SECTION 1 Reinsurance Assumed Life Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or Disability Contingencies, and Related Benefits Listed by Reinsured Company as of December 31, Current Year

Compa ny Code or ID Numbe r

Effect ive Date

Name of Reinsured

Location

Type of Reinsura nce Assumed

Amount of In Force at End of Year

Reserve

Premiu ms

Reinsura nce Payable on Paid and Unpaid Losses

Modified Coinsura nce Reserve

Funds Withhel d Under Coinsura nce .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. 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Totals

Form CR-S – PART 1 – SECTION 2 Reinsurance Assumed Accident and Health Insurance Listed by Reinsured Company as of December 31, Current Year

Comp any Code or ID Numb er

Effecti ve Date

Name of Reinsured

Domiciliary Jurisdiction

Type of Reinsura nce Assumed

Premiu ms

Unearne d Premiu ms

Reserve Liability Other Than For Unearne d Premiu ms

Reinsuran ce Payable on Paid and Unpaid Losses

Modified Coinsura nce Reserve

Funds Withheld Under Coinsura nce .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... .................... ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ ................ .................... .................... .................... .................... .................... .................... .................... .................... .................... 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Totals

Form CR-S – PART 2 Reinsurance Recoverable on Paid and Unpaid Losses Listed by Reinsuring Company as of December 31, Current Year

Compan y Code or ID Number

Effective Date

Name of Company

Location

Paid Losses

Unpaid Losses ................. ................. ................. ................. ................. ................. ................. ................. ................. ............... ............... ............... ............... ............... ............... ............... ............... ............... .................. .................. .................. .................. .................. .................. .................. .................. .................. ..................................................................... ..................................................................... ..................................................................... ..................................................................... ..................................................................... ..................................................................... ..................................................................... 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Totals—Life, Annuity and Accident and Health

Form CR-S – PART 3 – SECTION 1 Reinsurance Ceded Life Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or Disability Contingencies, and Related Benefits Listed by Reinsuring Company as of December 31, Current Year

Comp any Code or ID Numb er

Effecti ve Date

Name of Company

Location

Type of Reinsur ance Ceded

Reserve Credit Taken

Outstanding Surplus Relief

Modifie d Coinsu rance Reserv e

Funds Withhe ld Under Coinsu rance Amoun t in Force at End of Year

Curre nt Year

Prior Year

Premi ums

Curre nt Year

Prior Year ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................................ ........................................ ........................................ ....................... ....................... ........................ ........................ ............... ............... .................. .................. .................. .................. ................. ................. ................. ............... ............... ....................... ....................... ....................... ....................... ...................

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Form CR-S – PART 3 – SECTION 2 Reinsurance Ceded Accident and Health Insurance Listed by Reinsuring Company as of December 31, Current Year

Comp any Code or ID Numb er

Effect ive Date

Name of Company

Location

Typ e

Premiu ms

Unearn ed Premiu ms (Estima ted)

Reserve Credit Taken Other than for Unearne d Premiu ms

Outstanding Surplus Relief

Modified Coinsura nce Reserve

Funds Withheld Under Coinsuranc e

Current Year

Prior Year .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. .................. ..................

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................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................ ................................

History

• Source: Miss. Code Ann. § 83-19-157 (Rev. 2011)
• Source: Miss. Code Ann. § 83-19-157 (Rev. 2011)

Chapter 34 (2007-1) Mississippi Homeowner Insurance Policyholder Bill of Rights.

19 Miss. Admin. Code Pt. 1, R. 24 months

Personal

Liability Coverage

Medical payments coverage

Building, Ordinance or Law coverage

Named Windstorm Deductible

Percentage of Deductible

n/a

History

• Source: Miss. Code Ann. § 83-5-29 (Rev. 2011)

Chapter 42 Non-Admitted Policy Fee Account Regulation

19 Miss. Admin. Code Pt. 1, R. 45.02 Purpose

The purpose of this Regulation is to implement a more efficient, reasonable and competitive property and casualty insurance market and regulatory environment that benefits Mississippi consumers by establishing a Flexible Rating System applicable to certain lines of business as specified below.

Rule 45.03: Scope.

The Flexible Rating System set forth in this Regulation shall be allowed for any residential or commercial earthquake policies, residential or commercial flood insurance policies that are not written through the National Flood Insurance Program, commercial liability and cybersecurity coverages, whether the insurance policies/coverages are endorsed to, or otherwise made a part of, another kind of insurance policy, or sold as a stand-alone policy.

This Regulation shall not apply to workers’ compensation insurance, medical malpractice insurance, assigned risk/residual market plans or the Mississippi Windstorm Underwriting Association.

Rate service organizations, as defined in Miss. Code Ann. § 83-2-1(d), shall not be eligible to submit filings pursuant to the Flexible Rating System as set forth in this Regulation.

History

• Source: Miss. Code Ann. Sections 83-5-1; 83-2-1 et seq. (Rev. 2011).
• Source: Miss. Code Ann. Sections 83-5-1; 83-2-1 et seq. (Rev. 2011).

19 Miss. Admin. Code Pt. 1, R. 45.04 Definition of Flexible Rating System

For purposes of this Regulation, the term “Flexible Rating System” shall mean a proposed rate plan filed with MID pursuant to Section 83-2-1 et seq., which allows for an automatic ability on the part of the insurer to raise in the aggregate or lower in the aggregate rates by 15% without the need for approval by MID so long as the change is within the overall approved +/- 15% range.

History

• Source: Miss. Code Ann. Sections 83-5-1; 83-2-1 et seq. (Rev. 2011).

19 Miss. Admin. Code Pt. 1, R. 45.05 Filing Requirements

A Flexible Rating System filing made pursuant to this Regulation shall be in compliance with all applicable provisions in Section 83-2-1 et seq., and shall include the rate, rating plans and rating systems used by the insurer. Supporting actuarial data shall accompany every filing and shall be in sufficient detail to justify the rate.

At the point that aggregate rate changes by the insurer under the Flexible Rating System approved by MID total either an aggregate increase of 15%, or an aggregate decrease of 15%, a new rate filing shall be required pursuant to the provisions of Section 83-2-1 et seq. prior to making any further rate adjustments. There is no annual reset for the 15% flexible rating band.

History

• Source: Miss. Code Ann. Sections 83-5-1; 83-2-1 et seq. (Rev. 2011).

19 Miss. Admin. Code Pt. 1, R. 45.06 Notice to Department

An insurer shall notify MID of any change in rates implemented under the Flexible Rating System within thirty (30) days after the effective date of the change. The notice must include the name of the insurer and the average percentage change in rates statewide and by zone or territory. Any rate change made pursuant to the Flexible Rating System may only be applied to a policy at the beginning of the policy period.

Should the Commissioner determine that any change in rates implemented pursuant to this Regulation is excessive, inadequate or unfairly discriminatory, he shall disapprove the change in rates pursuant to the procedure provided in Section 83-2-11(2)(b).

No more than one (1) rate adjustment may be made by an insurer during a twelve (12) month period pursuant to the Flexible Rating System set forth in this Regulation; however, upon written application by the insurer, the Commissioner may authorize more than one (1) rate adjustment during any twelve (12) month period, subject to the percentage limitations prescribed herein,

History

• Source: Miss. Code Ann. Sections 83-5-1; 83-2-3; 83-2-7; 83-2-11(2)(b) (Rev. 2011).

19 Miss. Admin. Code Pt. 1, R. 45.07 Policy Forms

With respect to policy form filings for coverages subject to this Regulation, insurers must comply with Section 83-2-7 prior to the use of any policy form.

History

• Source: Miss. Code Ann. Sections 83-5-1; 83-2-7 (Rev. 2011).

19 Miss. Admin. Code Pt. 1, R. 45.08 Rating Modification on Individual Commercial Risks

Insurers are still allowed to follow established procedures allowing for a debit or credit to be recognized regarding the special characteristics of an individual commercial risk which may not fully be reflected in the basic company premium or rates. Filings of this nature are distinct from filings made under the Flexible Rating System as set forth in this Regulation, as Flexible Rating System filings are applicable to all policies within the subject line of insurance, whereas the rating modification referenced within this section is applicable only to an individual risk.

Rule 45.09. Severability.

If any provision of any section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application, and to this end, the provisions of the Regulation are declared to be severable.

History

• Source: Miss. Code Ann. Section 83-5-1 (Rev. 2011).
• Source: Miss. Code Ann. Section 83-5-1 (Rev. 2011).

19 Miss. Admin. Code Pt. 1, R. 45.10 Effective Date

The effective date of this Regulation shall be thirty days after filing for final adoption with the Office of the Secretary of State. Filings made on and after this date may contain a Flexible Rating System component.

History

• Source: Miss. Code Ann. Sections 25-43-3.113(2)(b)(i) (Rev. 2018); 83-5-1; 83-2-3; 83-2-7 (Rev. 2011).

Part 2 Life Insurance

Chapter 3 (LA&H 73-5) Minimum Burial Rate Schedule (and Supplement)

19 Miss. Admin. Code Pt. 2, R. 3.02 Effective Date

These rules and regulations shall become effective November 6, 1973.

PROMULGATED AND ADOPTED, THIS THE 6TH day of November, 1973.

Rule 3.03: Minimum Burial Rate Schedule Age $150 Benefit $300 Benefit $450 Benefit 1 week to 5 years, inclusive .10 .20 .30 6 years to 15 years, inclusive .15 .30 .45 16 years to 20 years, inclusive .20 .40 .60 21 years to 44 years, inclusive .25 .50 .75 45 years to 55 years, inclusive .30 .60 .90 56 years to 60 years, inclusive .50 1.00 1.50 61 years to 65 years, .75 1.50 2.25

inclusive 66 years to 70 years, inclusive 1.00 2.00 3.00 71 years to 75 years, inclusive 1.50 3.00 4.50 76years to 80 years, inclusive 2.00 4.00 6.00 81 years to 85 years, inclusive 5.00 10.00 15.00

Rule 3.04: Supplement

TO: All Persons and Associations Operating Under the Burial Insurance Laws ofthe State of Mississippi

FROM: Evelyn Gandy Commissioner of Insurance

The Insurance Department has been asked by a number of burial association owners to give consideration to several changes and modifications which they desire and purpose to have made to the rules and regulations which were issued and mailed to you from this office on November 6, 1973. Careful study and thorough consideration have been given to these subjects which are more fully reviewed and discussed as follows:

A. Minimum Rate Schedule- Nothing contain in our regulation of November 6, 1973, was intended to convey the impression that the Commissioner of Insurance had established a mandatory standard rate to be used by any association whose policyholders services, funeral benefits and plan of operation under the revised law justify the charging of a higher premium. Instead, this schedule merely lists and sets forth the lowest or minimum rate which would be approved by the Insurance Department for any association.

Our study shows that a substantial number of associations are presently using this minimum rate and can justify its continued usage. Further, no advantage has been found for this or any other so-called minimum rate schedule except the doubtful value of possibly discouraging willful intent to twist business from one association to another. The Insurance Department holds the view that any such unethical practice can and will be properly dealt with under other related insurance statuses.

In view of the foregoing, notice is hereby given that no change has been approved or made in the afore-mentioned minimum rate schedule which has been long-established and accepted by both the Insurance Department and burial insurance industry for many years. However, we emphasize again that each association has the option of using this minimum rate or a higher rate provided that proper justification for whichever rate is proposed is submitted to the Insurance Department.

B. Standard Provisions- A large number of associations have submitted new policy forms which have completely failed to incorporate or include the new standard provisions which are an absolutely mandatory requirement of the revised burial law after January 1, 1974. For your information and guidance in this regard, we enclose a copy of the required standard provisions which must appear in every burial policy written on and after January 1, 1974.

There is only one exception or change which will be permitted in the Standard Provisions, and this relates to Section 8. If you wish your policy to provide for a 50% pay-off, Section 8 should read:

“If death and/or burial occurs more than fifty (50) miles from any location of the funeral home named herein and should the beneficiary therefore deem it impractical for the association to service this contract, the association shall pay in cash to the member not less than fifty percent (50%) of the face value of the certificate to which the member is entitled or the full return of the premium paid by the member, not to exceed three-fourths percent (3/4%) of the face value of the certificate, whichever amount is larger. If death and/or burial occurs within fifty (50) miles of any location of the funeral home named herein, and the member desires to use a funeral home other than the funeral home named in this contract, the association’s liability shall be the full return of the premium paid by the member not to exceed the face value of the certificate.”

If you wish your policy to provide for a 100% pay-off, then Section 8 should read:

“If death and/or burial occurs more than fifty (50) miles from any location of the funeral home named herein and should the member therefore deem it impractical for the association to service this contract, the association shall pay in cash to the member not less than one-hundred percent (100%) of the face value of the certificate to which the member is entitled, which shall be in full settlement of the claim. If death and/or burial occurs within fifty (50) miles of any location of the funeral home named herein, and the member desires to use a funeral home other than the funeral home named in this contract, the association’s liability shall be the full return of the premiums paid by the member not to exceed the face value of the certificate.”

No burial association will be authorized to issue a burial policy on and after January 1, 1974, unless and until it has previously submitted and received the approval of the Commissioner of Insurance of its policy forms and rates which conform and comply with the rules and regulations of our Order dated November 6, 1973, and the above-mentioned authorized changes.

Ordered this the 30th day of November, 1973.

Rule 3.05: Standard Provisions for Burial Policies

House Bill 424, Mississippi Laws of 1973, requires that all burial policies issued from and after January 1, 1974, contain the following Standard Provisions.

STANDARD PROVISIONS

A. The association will not be responsible for casket or any other funeral supplies or expenses contracted for by anyone unless authorized by the association, subject to minimum cash settlement hereinafter provided.

B. When this policy has been maintained in force for not less than two (2) consecutive months, there will be a grace period of thirty (30) days for the payment of anysubsequent premium, and during such period of grace, the funeral benefit provided herein shall continue in force, provided all other conditions and stipulations herein contained shall have been complied with by such member or members.

C. This contract shall lapse, and the association shall not be liable for any benefits hereunder, when any premium payment on same is more than thirty (30) days in arrears, and in such event all premiums paid hereon shall be forfeited to the association.

D. If the contract is allowed to lapse, it may be reinstated by furnishing the association with satisfactory evidence that all members named hereon are in good health, and by the payment of the premiums required by the association, provided the policy is not over six (6) months in arrears. Acceptance of premium as of date of lapse shall reinstate the contract as of date premium is applied on lapse period.

E. No agent has the power on behalf of the association to modify this contract or to extend the time for payment of premium, the entire contract being that contained herein together with the application thereof.

F. The association reserves the right to investigate within one (1) year from date of application all statements made in the application as to age or condition of health, and should any of the statements made therein be found to be false, the association’s liability shall be limited to the return of all premiums paid hereon, and the policyholders shall forfeit all rights to the funeral benefits. All applicants must be in good health when this contract is delivered.

G. This contract shall be incontestable after one (1) year, except for nonpayment of premiums.

H. If death and/or burial occurs more than fifty (50) miles from any location of the funeral home named herein and should the beneficiary therefore deem it impractical shall pay in cash to the member not less than fifty percent (50%) of the face value of the certificate to which the member is entitled or the full return of the premium paid by the member, not to

exceed three-fourths percent (3/4%) of the face value of the certificate, whichever amount is larger. Provided, however, if premium rates of not less than ten percent (10%) in excess of the rates described herein are requested by the association and approved by the commissioner, the standard provisions contained in this paragraph may provide for a cash settlement up to one hundred percent (100%) of the face value of the contract. If death and/or burial occurs within fifty (50) miles of any location of the funeral home named herein, and the member desires to use a funeral home other than the funeral home named in this contract, the association’s liability shall be the full return of the premium paid by the member not to exceed the face value of the certificate.

I. There shall be no liability to any person or persons insured hereunder if death should occur through self-destruction or suicide, whether sane or insane, within one (1) year from date of issuance of this contract, or within one (1) year from the date of the date of any reinstatement. In the event of death by suicide or self-destruction, no return of premium shall be due under this contract.

History

• Source: Miss. Code Ann. § 24-43-3.113 (Rev. 2010)
• Source: Miss. Code Ann. § 83-37-35 (Rev. 2011)
• Source: Miss. Code Ann. § 83-37-35 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-37-13; 83-37-35 (Rev. 2011)

Chapter 7 (84-104) Mississippi’s Regulation Permitting the Use of Smoker/Non- Smoker Mortality Tables When Determining Minimum Reserve Liabilities and Nonforfeiture Benefits.

19 Miss. Admin. Code Pt. 2, R. 1958 CET Male and Smoker and Non-Smoker Mortality Rates

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

2.21 2.28 2.35 2.39 2.40 2.49 2.60 2.71 2.78 2.80

4.50 4.89 5.30 5.79 6.32 8.67 9.52 10.43 11.47 12.62

89.15 96.85 105.50 115.21 125.91 116.00 124.38 133.69 144.04 155.27

2.39 2.37 2.38 2.38 2.39 2.80 2.79 2.82 2.83 2.86

6.90 7.58 8.32 9.19 10.19 13.88 15.28 16.74 18.41 20.20

137.48 149.85 162.86 176.44 190.61 167.18 179.66 192.47 205.47 218.69

2.39 2.40 2.41 2.42 2.44 2.87 2.90 2.93 2.98 3.04

11.34 12.66 14.18 15.94 17.86 22.14 24.25 26.57 29.06 31.75

205.48 221.10 237.59 255.15 274.14 232.21 246.04 260.27 275.09 290.81

2.46 2.48 2.50 2.54 2.58 3.12 3.20 3.28 3.42 3.55

19.99 22.31 24.88 27.68 30.78 34.74 37.97 41.44 45.28 49.40

295.09 318.28 344.76 375.41 411.29 307.91 329.34 353.76 381.94 414.87

2.63 2.70 2.79 2.90 3.03 3.72 3.94 4.23 4.58 4.98

34.24 38.12 42.39 47.16 52.22 53.87 58.75 63.96 69.62 75.80

456.61 520.73 634.95 868.60 1000.00 456.61 520.73 634.95 868.60 1000.00

3.18 3.36 3.61 3.89 4.17 5.45 6.01 6.55 7.22 7.92

57.64 63.36 69.32 75.49 82.04 82.25 88.83 95.43 102.05 108.82

Rule 7.10: Table 3:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1958 CSO Male ALB Smoker and Non-Smoker Mortality Rates

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

1.49 1.56 1.62 1.64 1.65 1.79 1.90 1.99 2.04 2.05

3.61 3.92 4.26 4.65 5.08 6.99 7.67 8.42 9.26 10.19

71.43 77.70 84.73 92.54 101.07 92.30 99.08 106.60 114.87 123.73

1.63 1.62 1.63 1.63 1.64 2.05 2.05 2.07 2.09 2.11

5.57 6.11 6.73 7.45 8.28 11.21 12.31 13.52 14.85 16.28

110.24 119.97 130.15 140.77 151.89 133.07 142.76 152.65 162.70 172.94

1.64 1.65 1.66 1.68 1.70 2.13 2.16 2.20 2.26 2.33

9.23 10.32 11.58 13.00 14.55 17.83 19.54 21.39 23.37 25.56

163.55 175.83 188.84 202.78 217.99 183.42 194.16 205.28 216.94 229.45

1.72 1.74 1.77 1.81 1.85 2.41 2.48 2.57 2.68 2.79

16.26 18.14 20.20 22.47 24.99 27.95 30.53 33.33 36.39 39.69

234.77 253.59 275.19 300.25 330.53 243.99 261.37 281.25 304.28 332.14

1.91 1.99 2.09 2.21 2.35 2.94 3.14 3.38 3.67 4.01

27.81 30.94 34.41 38.19 42.21 43.28 47.15 51.32 55.86 60.72

370.65 433.49 549.25 750.84 1000.00 370.65 433.49 549.25 750.84 1000.00

2.51 2.69 2.88 3.10 3.33 4.40 4.88 5.29 5.82 6.88

45.49 50.97 55.63 60.51 65.76 65.72 70.73 75.85 81.00 86.35

Rule 7.11: Table 4:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1958 CET Male ALB smoker and Non-Smoker Mortality Rates

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

2.24 2.31 2.37 2.39 2.40 2.54 2.65 2.74 2.79 2.80

4.69 5.09 5.54 6.05 6.61 9.09 9.97 10.95 12.04 13.25

92.82 100.95 110.08 120.23 131.31 119.93 128.73 138.49 149.22 160.72

2.38 2.37 2.38 2.38 2.39 2.80 2.80 2.82 2.84 2.86

7.24 7.95 8.75 9.69 10.76 14.58 16.00 17.57 19.30 21.16

143.21 155.83 169.05 182.84 197.26 172.85 185.43 198.28 211.32 224.62

2.39 2.40 2.41 2.43 2.45 2.88 2.91 2.95 3.01 3.08

12.00 13.42 15.05 16.89 18.92 23.18 25.40 27.80 30.39 33.22

212.40 228.32 245.19 263.26 282.95 238.22 252.16 266.57 281.70 297.91

2.47 2.49 2.52 2.56 2.60 3.16 3.24 3.35 3.48 3.63

21.14 23.58 26.26 29.21 32.48 36.33 39.67 43.32 47.29 51.58

304.68 329.01 356.89 389.20 428.08 316.68 339.14 364.82 394.52 430.28

2.66 2.74 2.84 2.96 3.10 3.83 4.08 4.40 4.78 5.21

36.15 40.21 44.72 49.63 54.86 56.24 61.28 66.70 72.60 78.90

479.19 557.74 697.43 883.86 1000.00 479.19 557.74 697.43 883.86 1000.00

3.28 3.49 3.75 4.03 4.33 5.73 6.28 6.88 7.57 8.29

60.42 66.24 72.29 78.64 85.44 85.40 91.98 98.57 105.25 112.20

Rule 7.12:Table 5:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CSO Female Smoker and Non-Smoker Mortality Rates: Age Nearest Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

0.84 0.88 0.92 0.95 0.98 0.94 0.99 1.04 1.09 1.13

2.99 3.19 3.41 3.65 3.90 4.61 4.95 5.31 5.68 6.08

37.32 42.04 47.11 52.53 58.45 46.64 51.92 57.46 63.23 69.41

1.01 1.02 1.04 1.05 1.08 1.16 1.18 1.21 1.23 1.27

4.19 4.50 4.85 5.26 5.68 6.54 7.00 7.52 8.13 8.75

65.12 72.76 81.59 91.76 103.03 76.26 84.00 92.84 102.87 114.65

1.09 1.12 1.14 1.17 1.20 1.29 1.34 1.38 1.42 1.48

6.13 6.59 7.05 7.49 7.96 9.40 10.05 10.67 11.25 11.85

115.38 128.58 142.71 157.61 173.51 126.42 139.79 152.67 167.23 181.07

1.24 1.27 1.31 1.35 1.42 1.55 1.61 1.68 1.75 1.86

8.51 9.16 9.98 11.01 12.23 12.51 13.36 14.39 15.78 17.33

190.39 208.58 228.60 251.40 279.31 197.01 214.00 232.54 253.55 279.31

1.47 1.56 1.67 1.79 1.93 1.94 2.09 2.28 2.49 2.73

13.55 14.97 16.41 17.86 19.41 19.07 20.79 22.58 24.20 26.02

317.32 375.74 474.97 655.85 1000.00 317.32 375.74 474.97 655.85 1000.00

2.08 2.26 2.44 2.62 2.80 3.00 3.33 3.64 3.96 4.28

21.21 23.34 25.99 29.22 33.02 27.95 30.45 33.55 37.33 41.74

Rule 7.13: Table 6:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CSO Male Smoker and Non-Smoker Mortality Rates: Age Nearest Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

1.29 1.43 1.54 1.60 1.66 1.65 1.87 2.05 2.16 2.26

3.32 3.59 3.88 4.19 4.54 6.27 6.83 7.44 8.08 8.80

58.80 65.06 71.64 78.47 85.72 83.77 91.10 98.52 105.91 113.49

1.68 1.67 1.64 1.61 1.57 2.31 2.33 2.30 2.26 2.21

4.91 5.35 5.86 6.43 7.09 9.56 10.44 11.42 12.54 13.80

93.67 102.52 112.52 123.79 136.11 121.59 130.41 140.20 151.03 162.49

1.52 1.48 1.46 1.44 1.44 2.14 2.08 2.06 2.04 2.06

7.82 8.63 9.49 10.42 11.47 15.14 16.59 18.09 19.69 21.35

149.20 162.80 176.79 190.89 205.29 174.20 185.78 197.06 209.37 221.52

1.44 1.47 1.50 1.55 1.61 2.10 2.17 2.24 2.35 2.48

12.64 13.94 15.42 17.11 19.02 23.19 25.26 27.59 30.23 33.14

220.19 235.84 252.75 271.63 295.65 233.69 246.12 259.33 276.30 298.15

1.69 1.77 1.88 2.00 2.14 2.63 2.81 3.04 3.30 3.60

21.13 23.40 25.86 28.50 31.38 36.29 39.57 43.01 46.55 50.32

329.96 384.55 480.20 657.98 1000.00 329.96 384.55 480.20 657.98 1000.00

2.29 2.47 2.65 2.86 3.07 3.94 4.34 4.75 5.22 5.71

34.63 38.91 42.56 47.44 52.92 54.48 59.09 64.33 70.23 76.66

Rule 7.14: Table 7:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CET Female Smoker and Non-Smoker Mortality Rates: Age Nearest Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

1.59 1.63 1.67 1.70 1.73 1.69 1.74 1.79 1.84 1.88

3.89 4.15 4.43 4.75 5.07 5.99 6.44 6.90 7.38 7.90

48.52 54.65 61.24 68.29 75.99 60.63 67.50 74.70 82.20 90.23

1.76 1.77 1.79 1.80 1.83 1.91 1.93 1.96 1.98 2.02

5.45 5.85 6.31 6.84 7.38 8.50 9.10 9.78 10.57 11.38

84.66 94.59 106.07 119.29 133.94 99.14 109.20 120.69 133.73 149.05

1.84 1.87 1.89 1.92 1.95 2.04 2.09 2.13 2.17 2.23

7.97 8.57 9.17 9.74 10.35 12.22 13.07 13.87 14.63 15.41

149.99 167.15 185.52 204.89 225.56 164.35 181.73 198.47 217.40 235.39

1.99 2.02 2.06 2.10 2.17 2.30 2.36 2.43 2.50 2.61

11.06 11.91 12.97 14.31 15.90 16.26 17.37 18.71 20.51 22.53

247.51 271.15 197.18 326.82 363.10 256.11 278.20 302.30 329.62 363.10

2.22 2.31 2.42 2.54 2.68 2.69 2.84 3.03 3.24 3.55

17.62 19.46 21.33 23.22 25.23 24.79 27.03 29.35 31.46 33.83

412.52 488.46 617.46 852.61 1000.00 412.52 488.46 617.46 852.61 1000.00

2.83 3.01 3.19 3.41 3.64 3.90 4.33 4.73 5.15 5.55

27.56 30.34 33.79 37.99 42.93 36.34 39.59 43.62 48.53 54.26

Rule 7.15: Table 8:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CET Male Smoker and Non-Smoker Mortality Rates: Age Nearest Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

2.04 2.18 2.29 2.35 2.41 2.40 2.62 2.80 2.91 3.01

4.32 4.67 5.04 5.45 5.90 8.15 8.88 9.67 10.50 11.44

76.44 84.58 93.13 102.01 111.44 108.90 118.43 128.08 137.68 147.54

2.43 2.42 2.39 2.36 2.32 3.06 3.08 3.05 3.01 2.96

6.38 6.96 7.62 8.36 9.22 12.43 13.57 14.85 16.30 17.94

121.77 133.28 146.28 160.93 176.94 158.07 169.53 182.26 196.34 211.24

2.27 2.23 2.21 2.19 2.19 2.89 2.83 2.91 2.79 2.81

10.17 11.22 12.34 16.55 14.91 19.68 21.57 23.52 25.60 27.76

193.96 211.64 229.83 248.16 266.88 226.46 241.51 256.18 272.18 287.98

2.19 2.22 2.25 2.30 2.36 2.85 2.92 2.99 3.10 3.23

16.43 18.12 20.05 22.24 24.73 30.15 32.84 35.87 39.30 43.08

286.25 306.59 328.58 353.12 384.35 303.80 319.96 337.19 359.19 387.60

2.44 2.52 2.63 2.75 2.89 3.42 3.65 3.95 4.29 4.68

27.47 30.42 33.62 37.05 40.79 47.18 51.44 55.91 60.52 65.42

428.95 499.92 624.26 855.37 1000.00 428.95 499.92 624.26 855.37 1000.00

3.04 3.22 3.45 3.72 3.99 5.12 5.64 6.18 6.79 7.42

45.02 49.80 55.33 61.67 68.80 70.82 76.82 83.63 91.30 99.66

Rule 7.16: Table 9:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CSO Female Smoker and Non-Smoker Mortality Rates: Age Last Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

0.86 0.90 0.93 0.96 0.99 0.96 1.01 1.06 1.11 1.14

3.09 3.30 3.53 3.77 4.04 4.78 5.13 5.49 5.88 6.31

39.64 44.52 49.75 55.41 61.68 49.22 54.62 60.26 66.22 72.71

1.01 1.03 1.04 1.06 1.08 1.17 1.19 1.22 1.25 1.28

4.34 4.67 5.05 5.47 5.90 6.77 7.26 7.82 8.44 9.07

68.81 77.01 86.46 97.12 108.87 79.98 88.23 97.61 108.44 120.18

1.10 1.13 1.15 1.18 1.22 1.31 1.36 1.40 1.45 1.51

6.36 6.82 7.27 7.72 8.23 9.72 10.36 10.96 11.55 12.18

121.58 135.16 149.59 164.88 181.15 132.65 145.75 159.35 173.52 188.25

1.25 1.29 1.33 1.38 1.44 1.58 1.64 1.71 1.80 1.90

8.83 9.57 10.49 11.62 12.89 12.93 13.87 15.08 16.55 18.19

198.53 217.42 238.53 262.35 295.23 204.58 222.16 241.66 264.56 295.23

1.51 1.61 1.73 1.86 2.00 2.01 2.18 2.38 2.61 2.86

14.26 15.68 17.13 18.63 20.30 19.92 21.68 23.38 25.10 26.97

341.02 413.88 537.24 743.96 1000.00 341.02 413.88 537.24 743.96 1000.00

2.17 2.35 2.53 2.71 2.89 3.16 3.48 3.80 4.12 4.44

22.26 24.65 27.58 31.09 35.13 29.13 31.98 35.41 39.49 44.14

Rule 7.17: Table 10:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CSO Male Smoker and Non-Smoker Mortality Rates: Age Last Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

1.36 1.48 1.57 1.63 1.67 1.76 1.96 2.10 2.21 2.28

3.45 3.73 4.03 4.36 4.72 6.55 7.13 7.76 8.44 9.18

61.84 68.24 74.93 81.95 89.52 87.27 94.63 102.02 109.49 117.30

1.68 1.66 1.63 1.59 1.55 2.32 2.32 2.28 2.24 2.18

5.13 5.60 6.14 6.76 7.45 10.00 10.93 11.98 13.17 14.47

97.88 107.25 117.82 129.54 142.18 125.71 134.96 145.21 156.29 167.83

1.50 1.47 1.45 1.44 1.44 2.11 2.07 2.05 2.05 2.08

8.22 9.06 9.95 10.94 12.05 15.86 17.33 18.88 20.51 22.26

155.45 169.18 183.16 197.33 211.89 179.44 190.84 202.54 214.73 226.85

1.45 1.48 1.52 1.58 1.65 2.13 2.20 2.29 2.41 2.55

13.29 14.67 16.26 18.06 20.06 24.21 26.41 28.89 31.66 34.69

227.05 243.16 260.82 281.75 309.83 239.08 251.80 266.55 285.47 311.27

1.73 1.82 1.94 2.07 2.21 2.72 2.92 3.17 3.45 3.77

22.25 24.62 27.16 29.92 32.98 37.90 41.26 44.74 48.39 52.35

351.86 420.99 541.00 745.15 1000.00 351.86 420.99 541.00 745.15 1000.00

2.38 2.56 2.75 2.96 3.19 4.14 4.54 4.98 5.46 5.99

36.44 40.39 44.95 50.11 55.78 56.72 61.63 67.18 73.33 80.07

Rule 7.18: Table 11:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CET Female Smoker and Non-Smoker Mortality Rates: Age Last Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

1.61 1.65 1.68 1.71 1.74 1.71 1.76 1.81 1.86 1.89

4.02 4.29 4.59 4.90 5.25 6.21 6.67 7.14 7.64 8.20

51.53 57.88 64.68 72.03 80.18 63.99 71.01 78.34 86.09 94.52

1.76 1.78 1.79 1.81 1.83 1.92 1.94 1.97 2.00 2.03

5.64 6.07 6.57 7.11 7.67 8.80 9.44 10.17 10.97 11.79

89.45 100.11 112.40 126.26 141.53 103.97 114.70 126.89 140.97 156.23

1.85 1.88 1.90 1.93 1.97 2.06 2.11 2.15 2.20 2.26

8.27 2.87 9.45 10.04 10.70 12.64 16.47 14.24 15.02 15.83

158.05 175.71 194.47 214.34 235.50 172.45 189.48 207.16 225.58 244.73

2.00 2.04 2.08 2.13 2.19 2.33 2.39 2.46 2.55 2.65

11.48 12.44 13.64 15.11 16.76 16.81 18.03 19.60 21.52 23.65

258.09 282.65 310.09 342.36 383.80 265.95 288.81 314.16 343.93 383.80

2.26 2.36 2.48 2.61 2.75 2.76 2.93 3.13 3.39 3.72

18.54 20.38 22.27 24.22 26.39 25.90 28.18 30.39 32.63 35.06

443.33 538.04 698.41 967.15 1000.00 443.33 538.04 698.41 967.15 1000.00

2.92 3.10 3.29 3.52 3.76 4.11 4.52 4.94 5.36 5.77

28.94 32.05 35.85 40.42 45.67 37.93 41.57 46.03 51.34 57.38

Rule 7.19: Table 12:

Mississippi Model Regulation Permitting Smokers/Nonsmokers Mortality Tables For Use In Determining Minimum Reserve Liabilities and Nonforfeiture Benefits:

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

19 Miss. Admin. Code Pt. 2, R. 1980 CET Male Smoker and Non-Smoker Mortality Rates: Age Last Birthday

AGE Non- Smoker Smoker AGE Non- Smoker Smoker AGE Non- smoker Smoker

2.11 2.23 2.32 2.38 2.42 2.51 2.71 2.85 2.96 3.03

4.49 4.85 5.24 5.67 6.14 8.52 9.27 10.09 10.97 11.93

80.39 88.71 97.41 106.54 116.38 113.45 123.02 132.63 142.34 152.49

2.43 2.41 2.38 2.34 2.30 3.07 3.07 3.03 2.99 2.93

6.67 7.28 7.98 8.79 9.69 13.00 14.21 15.57 17.12 18.81

127.24 139.43 153.17 168.40 184.83 163.42 175.45 188.77 203.18 218.18

2.25 2.22 2.20 2.19 2.19 2.86 2.82 2.80 2.80 2.83

10.69 11.78 12.94 14.22 15.67 20.62 22.53 24.54 26.66 28.94

202.09 219.93 238.11 256.53 275.46 233.27 248.09 263.30 279.15 294.91

2.20 2.23 2.27 2.33 2.40 2.88 2.95 3.04 3.16 3.32

17.28 19.07 21.14 23.48 26.08 31.47 34.33 37.56 41.16 45.10

295.17 316.11 339.07 366.28 402.78 310.80 327.34 346.52 371.11 404.65

2.48 2.57 2.69 2.82 2.96 3.54 3.80 4.12 4.49 4.90

28.93 32.01 35.31 38.90 42.87 49.27 53.64 58.16 62.91 68.06

457.42 547.29 703.30 968.70 1000.00 457.42 547.29 703.30 968.70 1000.00

3.13 3.33 3.58 3.85 4.15 5.38 5.90 6.47 7.10 7.79

47.37 52.51 58.44 65.14 72.51 73.74 80.12 87.33 95.33 104.09

History

• Source: Miss. Code Ann. § 83-7-25 (Rev 2011)

Chapter 18 Suitability in Annuity Transactions Regulation. (2/11/2013)

19 Miss. Admin. Code Pt. 2, R. 18.01 Purpose

A. The purpose of this regulation is to require producers, as defined in this regulation, to act in the best interest of the consumer when making a recommendation of an annuity and to require insurers to establish a system to supervise recommendations to set forth standards and procedures for recommendations to consumers that result in transactions involving annuity products so that the insurance needs and financial objectives of consumers at the time of the transaction are appropriately addressed.

B. Nothing herein shall be construed to create or imply a private cause of action for a violation of this regulation or to subject a producer to civil liability under the best interest standard of care outlined in Rule 18.06 of this regulation or under standards governing the conduct of a fiduciary or a fiduciary relationship.

Rule 18.02. Scope

This regulation shall apply to any sale or recommendation of an annuity.

Rule 18.03. Authority

This regulation is issued under the authority of Miss. Code Ann. §§83-5-29 through 83-5-51.

Rule 18.04. Exemptions

Unless otherwise specifically included, this regulation shall not apply to recommendations involving:

A. Direct response solicitations where there is no recommendation based on information collected from the consumer pursuant to this regulation;

B. Contracts used to fund:

(1) An employee pension or welfare benefit plan that is covered by the Employee Retirement and Income Security Act (ERISA);

(2) A plan described by Sections 401(a), 401(k), 403(b), 408(k) or 408(p) of the Internal Revenue Code (IRC), as amended, if established or maintained by an employer;

(3) A government or church plan defined in Section 414 of the IRC, a government or church welfare benefit plan, or a deferred compensation plan of a state or local government or tax exempt organization under Section 457 of the IRC;

(4) A nonqualified deferred compensation arrangement established or maintained by an employer or plan sponsor;

C. Settlements of or assumptions of liabilities associated with personal injury litigation or any dispute or claim resolution process; or

D. Formal prepaid funeral contracts.

Rule 18.05. Definitions

A. “Annuity” means an annuity that is an insurance product under State law that is individually solicited, whether the product is classified as an individual or group annuity.

B. “Cash compensation” means any discount, concession, fee, service fee, commission, sales, charge, loan, override, or cash benefit received by a producer in connection with the recommendation or sale of an annuity from an insurer, intermediary, or directly from the consumer.

C. “Consumer profile information” means information that is reasonably appropriate to determine whether a recommendation addresses the consumer’s financial situation, insurance needs and financial objectives, including, at a minimum, the following:

(1) Age;

(2) Actual income;

(3) Financial situation and needs, including debts and other obligations;

(4) Financial experience;

(5) Insurance needs;

(6) Financial objectives;

(7) Intended use of the annuity;

(8) Financial time horizon;

(9) Existing assets or financial products, including investment, annuity and insurance holdings;

(10) Liquidity needs;

(11) Liquid net worth;

(12) Risk tolerance, including but not limited to, willingness to accept non- guaranteed elements in the annuity;

(13) Financial resources used to fund the annuity; and

(14) Tax status.

D. “Continuing Education credit hour” or “CE credit hour” means one hour of continuing education credit as defined in Miss. Code Ann. §§ 83-17-251 to 83-17- 261, Miss. Code Ann. § 83-17-415, Miss. Code Ann. § 83-17-513.

E. “Continuing Education provider” or CE provider” means an individual or entity that is approved to offer continuing education courses pursuant to Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, Miss. Code Ann. § 83-17-513.

F. “FINRA” means the Financial Industry Regulatory Authority or a succeeding agency.

G. “Insurer” means a company required to be licensed under the laws of this state to provide insurance products, including annuities.

H. “Intermediary” means an entity contracted directly with an insurer or with another entity contracted with an insurer to facilitate the sale of the insurer’s annuities by producers.

I. (1) “Material conflict of interest” means a financial interest of the producer in the sale of any annuity that a reasonable person would expect to influence the impartiality of a recommendation.

(2) “Material conflict of interest” does not include cash compensation or non- cash compensation.

J. “Non-cash compensation” means any form of compensation that is not cash compensation, including, but not limited to, health insurance, office rent, office support and retirement benefits.

K. “Non-guaranteed elements” means the premiums, credited interest rates (including any bonus), benefits, values, dividends, non-interest based credits, charges or elements of formula used to determine any of these, that are subject to company discretion and are not guaranteed at issue. An element is considered non-guaranteed if any of the underlying non-guaranteed elements are used in its calculations.

L. “Producer” means a person or entity required to be licensed under the laws of this state to sell, solicit or negotiate insurance, including annuities. For purposes of this regulation, “producer” includes an insurer where no producer is involved.

M. (1) “Recommendation” means advice provided by a producer to an individual consumer that was intended to result or does result in a purchase, exchange or replacement of an annuity in accordance with that advice.

(2) Recommendation does not include general communication to the public, generalized customer services assistance or administrative support, general educational information and tools, prospectuses, or other product and sales material.

N. “Replacement” means a transaction in which a new annuity is to be purchased, and it is known or should be known to the proposing producer, or to the proposing insurer whether or not a producer is involved, that by reason of the transaction, an existing annuity or other insurance policy has been or is to be any of the following:

(1) Lapsed, forfeited, surrendered or partially surrendered, assigned to the replacing insurer or otherwise terminated;

(2) Converted to reduced paid-up insurance, continued as extended term insurance, or otherwise reduced in value by the use of nonforfeiture benefits or other policy values;

(3) Amended so as to effect either a reduction in benefits or in the term for which coverage would otherwise remain in force or for which benefits would be paid;

(4) Reissued with any reduction in cash value; or

(5) Used in a financed purchase.

O. “SEC” means the United States Securities and Exchange Commission.

Rule 18.06. Duties of Insurers and Producers

A. Best Interest Obligations. A producer, when making a recommendation of an annuity, shall act in the best interest of the consumer under the circumstances known at the time the recommendation is made without placing the producer’s or the insurer’s financial interest ahead of the consumer’s interest. A producer has acted in the best interest of the consumer if they have satisfied the following obligations regarding care, disclosure, conflict of interest and documentation:

(1) (a) Care Obligation. The producer, in making a recommendation shall exercise reasonable diligence, care and skill to:

(i) Know the consumer’s financial situation, insurance needs and financial objectives:

(ii) Understand the available recommendation options after making a reasonable inquiry into options available to the producer;

(iii) Have a reasonable basis to believe the recommended option effectively addresses the consumer’s financial situation, insurance needs and financial objectives over the life of the product, as evaluated in light of the consumer profile information; and

(iv) Communicate the basis or bases of the recommendation.

(b) The requirements under Subparagraph (a) of this paragraph include making reasonable efforts to obtain consumer profile information from the consumer prior to the recommendation of annuity.

(c) The requirements under Subparagraph (a) of this paragraph require a producer to consider the types of produces the producer is authorized and licensed to recommend or sell that address the consumer’s financial situation, insurance needs and financial objectives. This does not require analysis or consideration of any product outside the authority and license of the producer or other possible alternative products or strategies available in the market at the time of the recommendation. Producers shall be held to standards applicable to producers with similar authority and licensure.

(d) The requirements under this subsection do not create a fiduciary obligation or relationship and only create a regulatory obligation as established in this regulation.

(e) The consumer profile information, characteristics of the insurer, and product costs, rates, benefits and features are those factors generally relevant in making a determination whether an annuity effectively addresses the consumer’s financial situation, insurance needs and financial objectives, but the level of importance of each factor under the care obligation of this paragraph may vary depending on the facts and circumstances of a particular case. However, each factor may not be considered in isolation.

(f) The requirements under Subparagraph (a) of this paragraph include having a reasonable basis to believe the consumer would benefit from certain features of the annuity, such as annuitization, death or living benefit or other insurance-related features.

(g) The requirements under Subparagraph (a) of this paragraph apply to the particular annuity as a whole and the underlying subaccounts to which funds are allocated at the time of purchase or exchange of an annuity, and riders and similar producer enhancements, if any.

(h) The requirements under Subparagraph (a) of this paragraph do not mean the annuity with the lowest one-time or multiple-occurrence compensation structure shall necessarily be recommended.

(i) The requirements under Subparagraph (a) of this paragraph do not mean the producer has ongoing monitoring obligations under the care obligation under this paragraph, although such an obligation may be separately owed under the terms of a fiduciary, consulting, investment advising or financial planning agreement between the consumer and the producer.

(j) In the case of an exchange or replacement of an annuity, the producer shall consider the whole transaction, which includes taking into consideration whether:

(i) The consumer will incur a surrender charge, be subject to the commencement of a new surrender period, lose existing benefits, such as death, living or other contractual benefits, or be subject to increased fees, investment advisory fees or charges for riders and similar product enhancements;

(ii) The replacing producer product would substantially benefit the consumer in comparison to the replaced product over the life of the product, and

(iii) The consumer has had another annuity exchange or replacement and, in particular, an exchange or replacement within the preceding 60 months.

(k) Nothing in this regulation should be construed to require a producer to obtain any license other than a producer license with the appropriate line of authority to sell, solicit or negotiate insurance in this state, including but not limited to any securities license, in order to fulfill the duties and obligations contained in this regulation, provided the producer does not give advice or provide services that are otherwise subject to securities law or engage in any other activity requiring other professional licenses.

(2) Disclosure obligation

(a) Prior to the recommendation or sale of an annuity, the producer shall prominently disclose to the consumer on a form substantially similar to Appendix A:

(i) A description of the scope and terms of the relationship with the consumer and the role of the producer in the transaction;

(ii) An affirmative statement on whether the producer is licensed and authorized to sell the following products:

(I) Fixed annuities;

(II) Fixed indexed annuities;

(III) Variable annuities;

(IV) Life insurance;

(V) Mutual funds;

(VI) Stocks and bonds, and

(VII) Certificates of deposit;

(iii) An affirmative statement describing the insurers the producer is authorized, contracted (or appointed), or otherwise able to sell insurance products for, using the following descriptions:

(I) From one insurer;

(II) From two or more insurers, or

(III) From two or more insurers although primarily contracted with one insurer.

(iv) A description of the sources and types of cash compensation and non-cash compensation to be received by the producer, including whether the producer is to be compensated for the sale of a recommended annuity by commission as part of premium or other remuneration received from the reinsurer, intermediary or other producer or by fee as a result of a contract for advice or consulting services, and

(v) A notice of the consumer’s right to request additional information regarding cash compensation described in Subparagraph (b) of this paragraph.

(b) Upon request of the consumer or the consumer’s designated representative, the producer shall disclose:

(i) A reasonable estimate of the amount of cash compensation to be received by the producer, which may be stated as a range of amounts or percentages; and

(ii) Whether the case compensation is a one-time or multiple occurrence amount, and if a multiple occurrence amount, the frequency and amount of the occurrence, which may be stated as a range of amounts or percentages; and

(c) Prior to or at the time of the recommendation or sale of an annuity, the producer shall have a reasonable basis to believe the consumer has been informed of various features of the annuity, such as the potential surrender period and surrender charge; potential tax penalty if the consumer sells, exchanges, surrenders or annuitizes the annuity, mortality and expense fees, investment advisory fees, any annual fees, potential charges for and features of riders or other options of the annuity, limitations on interest returns, potential changes in non- guaranteed elements of the annuity, insurance and investment components and market risk.

(3) Conflict of interest obligation. A producer shall identify and avoid or reasonably manage and disclose material conflicts of interest, including material conflicts of interest related to an ownership interest.

(4) Documentation obligation. A producer shall at the time of recommendation or sale:

(a) Make a written record of any recommendation and the basis for the recommendation subject to this regulation;

(b) Obtain a consumer signed statement on a form substantially similar to Rule 18.13 (Appendix B) documenting:

(i) A customer’s refusal to provide the consumer profile information, if any, and

(ii) A customer’s understanding of the ramifications of not providing his or her consumer profile information or providing insufficient consumer profile information, and

(c) Obtain a consumer agreed statement on a form substantially similar to Rule 18.14 (Appendix C) acknowledging the annuity transaction is not recommended if a customer decides to enter into an annuity transaction that is not based on the producer’s recommendation.

(5) Application of the best interest obligation. Any requirement applicable to a producer under this subsection shall apply to every producer who has exercised material control or influence in the making of a recommendation and has received direct compensation as a result of the recommendation or sale, regardless of whether the producer has had any direct contact with the consumer. Activities such as providing or delivering marketing or educational materials, product wholesaling or other back office product support, and general supervision of a producer do not, in and of themselves, constitute material control or influence.

B. Transactions not based on a recommendation.

(1) Except as provided under Paragraph (2), a producer shall have no obligation to a consumer under Subsection (a)(1) related to any annuity if:

(a) No recommendation is made;

(b) A recommendation was made and was later found to have been prepared based on materially inaccurate information provided by the consumer;

(c) A consumer refuses to provide relevant consumer profile information and the annuity transaction is not recommended, or

(d) A consumer decides to enter into an annuity transaction that is not based on a recommendation of the producer.

(2) An insurer’s issuance of an annuity subject to Paragraph (1) shall be reasonable under all the circumstances actually known to the insurer at the time the annuity is issued.

C. Supervision system.

(1) Except as permitted under subsection B, an insurer shall not issue an annuity recommended to a consumer unless there is a reasonable basis to believe the annuity would effectively address the particular consumer’s financial situation, insurance needs and financial objectives based on the consumer’s consumer profile information.

(2) An insurer shall establish and maintain a supervision system that is reasonably designed to achieve the insurer’s and its producers’ compliance with this regulation, including, but not limited to, the following:

(a) The insurer shall establish and maintain reasonable procedures to inform its producers of the requirements of this regulation and shall

incorporate the requirements of this regulation into relevant producer training manuals;

(b) The insurer shall establish and maintain standards for producer product training and shall establish and maintain reasonable procedures to require its producers to comply with the requirements of Rule 18.07 of this regulation;

(c) The insurer shall provide product-specific training and training materials which explain all material features of its annuity products to its producers;

(d) The insurer shall establish and maintain procedures for the review of each recommendation prior to issuance of an annuity that are designed to ensure there is a reasonable basis to determine that the recommended annuity would effectively address the particular consumer’s financial situation, insurance needs and financial objectives. Such review procedures may apply a screening system for the purpose of identifying selected transactions for additional review and may be accomplished electronically or through other means including, but not limited to, physical review. Such an electronic or other system may be designed to require additional review only of those transactions identified for additional review by their selection criteria;

(e) The insurer shall establish and maintain reasonable procedures to detect recommendations that are not in compliance with Subsections A, B, D, and E. This may include, but is not limited to, confirmation of the consumer’s consumer profile information, systematic customer surveys, producer and consumer interviews, confirmation letters, producer statements or attestations and programs of internal monitoring. Nothing in this subparagraph prevents an insurer from complying with this subparagraph by applying sampling procedures, or by forming the consumer profile information or other required information under this section after issuance or delivery of the annuity.

(f) The insurer shall establish and maintain reasonable procedures to assess, prior to or upon issuance or delivery of an annuity, whether a producer has provided to the consumer the information required to be provided under this section;

(g) The insurer shall establish and maintain reasonable procedures to identify and address suspicious consumer refusals to provide consumer profile information;

(h) The insurer shall establish and maintain reasonable procedures to identify and eliminate any sales contests, sale quotas, bonuses, and non-cash compensation that are based on the sales of specific annuities within a limited period of time. The requirements of this subparagraph are not intended to prohibit the receipt of health insurance, office rent, office support, retirement benefits or other employee benefits by employees as long as those benefits are not based upon the volume of sales of a specific annuity within a limited period of time; and

(i) The insurer shall annually provide a written report to senior management, including to the senior manager responsible for audit functions, which details a review, with appropriate testing, reasonably designed to determine the effectiveness of the supervision system, the exceptions found, and corrective action taken or recommended, if any.

(3) (a) Nothing in this subsection restricts an insurer from contracting for performance of a function (including maintenance of procedures) required under this subsection. An insurer is responsible for taking appropriate corrective action and may be subject to sanctions and penalties pursuant to Rule 18.08 of this regulation regardless of whether the insurer contracts for performance of a function and regardless of the insurer’s compliance with Subparagraph (b) of this paragraph.

(b) An insurer’s supervision system under this subsection shall include supervision of contractual performance under this subsection. This includes, but is not limited to, the following:

(i) Monitoring and, as appropriate, conducting audits to assure that the contracted function is properly performed; and

(ii) Annually obtaining a certification from a senior manager who has responsibility for the contracted function that the manager has a reasonable basis to represent, and does represent, that the function is properly performed.

(4) An insurer is not required to include in its system of supervision:

(a) A producer’s recommendation to consumers of products other than the annuities offered by the insurer, or

(b) Consideration of or comparison to options available to the producer or compensation relating to those options other than annuities or other products offered by the insurer.

D. Prohibited Practices. Neither a producer nor an insurer shall dissuade, or attempt to dissuade, a consumer from:

(1) Truthfully responding to an insurer’s request for confirmation of the consumer profile information;

(2) Filing a complaint; or

(3) Cooperating with the investigation of a complaint.

E. Safe Harbor.

(1) Recommendations and sales of annuities made in compliance with comparable standards shall satisfy the requirements under this regulation. This subsection applies to all recommendations and sales of annuities made by financial professionals in compliance with business rules, controls and procedures that satisfy a comparable standard even if such standard would not otherwise apply to the product or recommendation at issue. However, nothing in this subsection shall limit the insurance commissioner’s ability to investigate and enforce the provisions of this regulation.

(2) Nothing in Paragraph (1) shall limit the insurer’s obligation to comply with Rule 18.06(C)(1) of this regulation, although the insurer may base its analysis on information received from either the financial professional or the entity supervising the financial professional.

(3) For paragraph (1) to apply, an insurer shall:

(a) Monitor the relevant conduct of the financial professional seeking to rely on Paragraph (1) or the entity responsible for supervising the financial professional, such as the financial professional’s broker-dealer or an investment adviser registered under federal securities laws using information collected in the normal course of an insurer’s business; and,

(b) Provide to the entity responsible for supervising the financial professional seeking to rely on Paragraph (1) such as the financial professional’s broker-dealer or investment adviser registered under federal securities laws, information and reports that are reasonably appropriate to assist such entity to maintain its supervisory system.

(4) For purposes of this subsection, “financial professional” means a producer that is regulated and acting as:

(a) A broker-dealer registered under federal securities laws or a registered representative of a broker-dealer.

(b) An investment adviser registered under federal securities laws or an investment adviser representative associated with the federal registered investment adviser; or

(c) A plan fiduciary under Section 3(21) of the Employee Retirement Income Security Act of 1974 (ERISA) or fiduciary under Section 4975(a)(3) of the Internal Revenue Code (IRC) or any amendments or successor statutes thereto.

(5) For purposes of this subsection, “comparable standards” means:

(a) With respect to broker-dealers and registered representatives of broker-dealers, applicable SEC and FINRA rules pertaining to best interest obligations and supervision of annuity recommendations and sales, including, but not limited to, Regulation Best Interest and any amendments or successor regulations thereto.

(b) With respect to investment advisers registered under federal securities laws or investment adviser representatives, the fiduciary duties and all other requirements imposed on such investment advisers or investment adviser representatives by contract or under the Investment Advisers Act of 1940, including but not limited to, the Form ADV and interpretations, and

(c) With respect to plan fiduciaries or fiduciaries, means the duties, obligations, prohibitions, and all other requirements attendant to such status under ERISA or the IRC and any amendments or successor statutes thereto.

Rule 18.07. Insurance Producer Training

A. An insurance producer shall not solicit the sale of an annuity product unless the insurance producer has adequate knowledge of the product to recommend the annuity and the insurance producer is in compliance with the insurer’s standards for product training. An insurance producer may rely on insurer-provided product-specific training standards and materials to comply with this Rule.

B. (1) (a) An insurance producer who engages in the sale of annuity products shall complete a one-time four (4) credit training course approved

by the Department and provided by the Department approved education provider.

(b) Insurance producers who hold a life insurance line of authority on the effective date of this regulation and who desire to sell annuities shall complete the requirements of this subsection within six (6) months after the effective date of this regulation. Individuals who obtain a life insurance line of authority on or after the effective date of this regulation may not engage in the sale of annuities until the annuity training course required under this subsection has been completed.

(2) The minimum length of the training required under this subsection shall be sufficient to qualify for at least four (4) CE credit hours, but may be longer.

(3) The training required under this subsection shall include information on the following topics:

(a) The types of annuities and various classifications of annuities;

(b) Identification of the parties to an annuity;

(c) How product specific annuity contract provisions features affect consumers;

(d) The application of income taxation of qualified and non-qualified annuities;

(e) The primary uses of annuities; and

(f) Appropriate standard of conduct, sales practices, replacement and disclosure requirements.

(4) Providers of courses intended to comply with this subsection shall cover all topics listed in the prescribed outline and shall not present any marketing information or provide training on sales techniques or provide specific information about a particular insurer’s products. Additional topics may be offered in conjunction with and in addition to the required outline.

(5) A provider of an annuity training course intended to comply with this subsection shall register as a CE provider in this State and comply with the rules and guidelines applicable to insurance producer continuing education courses as set forth in Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, Miss. Code Ann. § 83-17-513.

(6) A producer who has completed an annuity training course approved by the Department prior to January 1, 2022, shall, within six (6) months after January 1, 2022, complete either:

(a) A new four (4) credit training course approved by the Department after January 1, 2022; or

(b) An additional one-time one (1) credit training course approved by the Department and provided by the Department approved education provider on appropriate sales practices, replacement and disclosure requirements under this amended regulation.

(7) Annuity training courses may be conducted and completed by classroom or self-study methods in accordance with Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, and Miss. Code Ann. § 83-17- 513.

(8) Providers of annuity training shall comply with the reporting requirements and shall issue certificates of completion in accordance with Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, and Miss. Code Ann. § 83-17-513.

(9) The satisfaction of the training requirements of another State that are substantially similar to the provisions of this subsection shall be deemed to satisfy the training requirements of this subsection in this state.

(10) The satisfaction of the components of the training requirements of any course or courses with components substantially similar to the provisions of this subsection shall be deemed to satisfy the training requirements of this subsection in this state.

(11) An insurer shall verify that an insurance producer has completed the annuity training course required under this subsection before allowing the producer to sell an annuity product for that insurer. An insurer may satisfy its responsibility under this subsection by obtaining certificates of completion of the training course or obtaining reports provided by commissioner-sponsored database systems or vendors or from a reasonably reliable commercial database vendor that has a reporting arrangement with approved insurance education providers.

Rule 18.08. Compliance Mitigation; Penalties

A. An insurer is responsible for compliance with this regulation. If a violation occurs, either because of the action or inaction of the insurer or its insurance producer, the commissioner may order:

(1) An insurer to take reasonably appropriate corrective action for any consumer harmed by a failure to comply with this regulation by the insurer, an entity contracted to perform the insurer’s supervisory duties or by the insurance producer;

(2) A general agency, independent agency or the insurance producer to take reasonably appropriate corrective action for any consumer harmed by the insurance producer’s violation of this regulation; and

(3) Appropriate penalties and sanctions.

B. Any applicable penalty under Miss. Code Ann. §§ 83-5-29 through 83-5-51 for a violation of this regulation may be reduced or eliminated, as determined by the commissioner, if corrective action for the consumer was taken promptly after a violation was discovered or the violation was not part of a pattern or practice.

C. The authority to enforce compliance with this regulation is vested exclusively with the commissioner.

Rule 18.09. Recordkeeping

A. Insurers, general agents, independent agencies and insurance producers shall maintain or be able to make available to the commissioner records of the information collected from the consumer, disclosures made to the consumer, including summaries of oral disclosures, and other information used in making the recommendations that were the basis for insurance transactions for five (5) years after the insurance transaction is completed by the insurer. An insurer is permitted, but shall not be required, to maintain documentation on behalf of an insurance producer.

B. Records required to be maintained by this regulation may be maintained in paper, photographic, micro-process, magnetic, mechanical or electronic media or by any process that accurately reproduces the actual document.

Rule 18.10. Severability

If any provision of these sections or the application thereof to any person or circumstance is held invalid for any reason, the invalidity shall not affect the other provisions or any other application

of these sections which can be given effect without the invalid provisions or application. To this end all provisions of these sections are declared to be severable.

Rule 18.11. Effective Date

This Amended Regulation shall become effective on January 1, 2022, and shall apply to acts or practices committed on or after July 1, 2022.

_____________________________ MIKE CHANEY COMMISSIONER OF INSURANCE

Rule 18:12 - APPENDIX A

INSURANCE AGENT (PRODUCER) DISCLOSURE FOR ANNUITIES Do Not Sign Unless You Have Read and Understand the Information in this Form

Date: ________________________

I. INSURANCE AGENT (PRODUCER) INFORMATION (“Me”, “I”, “My”)

First Name: _________________________________________ Last Name: _________________________________________

Business\Agency Name: ___________________________________ Website: ________________________________________________

Business Mailing Address:____________________________________________________________________

Business Telephone Number:____________________________________________________

Email Address:_______________________________________________________________

National Producer Number in MS:________________________________________________

II. CUSTOMER INFORMATION (“You”, “Your”)

First Name: _______________________________________ Last Name: ________________________________________

What Types of Products Can I Sell You? I am licensed to sell annuities to You in accordance with state law. If I recommend that You buy an annuity, it means I believe that it effectively meets Your financial situation, insurance needs, and financial objectives. Other financial products, such as life insurance or stocks, bonds and mutual funds, also may meet Your needs.

I offer the following products:

Fixed or Fixed Indexed Annuities Variable Annuities Life Insurance

I need a separate license to provide advice about or to sell non-insurance financial products. I have checked below any noninsurance financial products that I am licensed and authorized to provide advice about or to sell.

Mutual Funds Stocks/Bonds Certificates of Deposits

Whose Annuities Can I Sell to You?

I am authorized to sell: Annuities from Only One (1) Insurer

Annuities from Two or More Insurers Annuities from Two or More Insurers although I primarily sell annuities from:_________________________

How I’m Paid for My Work: It’s important for You to understand how I’m paid for my work. Depending on the particular annuity You purchase, I may be paid a commission or a fee. Commissions are generally paid to Me by the insurance company while fees are generally paid to Me by the consumer. If You have questions about how I’m paid, please ask Me.

Depending on the particular annuity You buy, I will or may be paid cash compensation as follows:

Commission, which is usually paid by the insurance company or other sources. If other sources, describe: __________________.

Fees (such as a fixed amount, an hourly rate, or a percentage of your payment), which are usually paid directly by the customer.

Other, describe:_______________________________________________________________

If You have questions about the above compensation I will be paid for this transaction, please ask me.

I may also receive other indirect compensation resulting from this transaction (sometimes called “non- cash” compensation), such as health or retirement benefits, office rent and support, or other incentives from the insurance company or other sources.

By signing below, You acknowledge that You have read and understand the information provided to You in this document.

________________________________________________ Customer Signature

________________________________________________ Date

________________________________________________ Agent (Producer) Signature

________________________________________________ Date

Rule 18:13 – APPENDIX B

CONSUMER REFUSAL TO PROVIDE INFORMATION Do Not Sign Unless You Have Read and Understand the Information in this Form

Why are You being given this form?

You’re buying a financial product – an annuity.

To recommend a product that effectively meets Your needs, objectives and situation, the agent, broker, or company needs information about You, Your financial situation, insurance needs and financial objectives.

If You sign this form, it means You have not given the agent, broker, or company some or all the information needed to decide if the annuity effectively meets Your needs, objectives and situation. You may lose protections under the Insurance Code of [this state] if You sign this form or provide inaccurate information.

Statement of Purchaser:

I REFUSE to provide this information at this time. I have chosen to provide LIMITED information at this time.

________________________________________________ Customer Signature

________________________________________________ Date

Rule 18:14 – APPENDIX C

Consumer Decision to Purchase an Annuity NOT Based on a Recommendation

Do Not Sign This Form Unless You Have Read and Understand It.

Why are You being given this form? You are buying a financial product – an annuity.

To recommend a product that effectively meets your needs, objectives and situation, the agent, broker, or company has the responsibility to learn about You, your financial situation, insurance needs and financial objectives.

If You sign this form, it means You know that you’re buying an annuity that was not recommended.

Statement of Purchaser:

I understand that I am buying an annuity, but the agent, broker or company did not recommend that I buy it. If I buy it without a recommendation, I understand I may lose protections under the Insurance Code of [this state].

________________________________________________ Customer Signature

________________________________________________ Date

________________________________________________ Agent/Producer Signature

History

• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)

Chapter 18 Suitability In Annuity Transactions Model Regulation

19 Miss. Admin. Code Pt. 2, R. 18.01 Purpose

A. The purpose of this regulation is to require producers, as defined in this regulation, to act in the best interest of the consumer when making a recommendation of an annuity and to require insurers to establish a system to supervise recommendations to set forth standards and procedures for recommendations to consumers that result in transactions involving annuity products so that the insurance needs and financial objectives of consumers at the time of the transaction are appropriately addressed.

B. Nothing herein shall be construed to create or imply a private cause of action for a violation of this regulation or to subject a producer to civil liability under the best interest standard of care outlined in Rule 18.06 of this regulation or under standards governing the conduct of a fiduciary or a fiduciary relationship.

Rule 18.02. Scope

This regulation shall apply to any sale or recommendation of an annuity.

Rule 18.03. Authority

This regulation is issued under the authority of Miss. Code Ann. §§83-5-29 through 83-5-51.

Rule 18.04. Exemptions

Unless otherwise specifically included, this regulation shall not apply to recommendations involving:

A. Direct response solicitations where there is no recommendation based on information collected from the consumer pursuant to this regulation;

B. Contracts used to fund:

1. An employee pension or welfare benefit plan that is covered by the Employee Retirement and Income Security Act (ERISA);

2. A plan described by Sections 401(a), 401(k), 403(b), 408(k) or 408(p) of the Internal Revenue Code (IRC), as amended, if established or maintained by an employer;

3. A government or church plan defined in Section 414 of the IRC, a government or church welfare benefit plan, or a deferred compensation plan of a state or local government or tax exempt organization under Section 457 of the IRC;

4. A nonqualified deferred compensation arrangement established or maintained by an employer or plan sponsor;

C. Settlements of or assumptions of liabilities associated with personal injury litigation or any dispute or claim resolution process; or

D. Formal prepaid funeral contracts.

Rule 18.05. Definitions

A. “Annuity” means an annuity that is an insurance product under State law that is individually solicited, whether the product is classified as an individual or group annuity.

B. “Cash compensation” means any discount, concession, fee, service fee, commission, sales, charge, loan, override, or cash benefit received by a producer in connection with the recommendation or sale of an annuity from an insurer, intermediary, or directly from the consumer.

C. “Consumer profile information” means information that is reasonably appropriate to determine whether a recommendation addresses the consumer’s financial situation, insurance needs and financial objectives, including, at a minimum, the following:

(15) Age;

(16) Actual income;

(17) Financial situation and needs, including debts and other obligations;

(18) Financial experience;

(19) Insurance needs;

(20) Financial objectives;

(21) Intended use of the annuity;

(22) Financial time horizon;

(23) Existing assets or financial products, including investment, annuity and insurance holdings;

(24) Liquidity needs;

(25) Liquid net worth;

(26) Risk tolerance, including but not limited to, willingness to accept non- guaranteed elements in the annuity;

(27) Financial resources used to fund the annuity; and

(28) Tax status.

D. “Continuing Education credit hour” or “CE credit hour” means one hour of continuing education credit as defined in Miss. Code Ann. §§ 83-17-251 to 83-17- 261, Miss. Code Ann. § 83-17-415, Miss. Code Ann. § 83-17-513.

E. “Continuing Education provider” or CE provider” means an individual or entity that is approved to offer continuing education courses pursuant to Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, Miss. Code Ann. § 83-17-513.

F. “FINRA” means the Financial Industry Regulatory Authority or a succeeding agency.

G. “Insurer” means a company required to be licensed under the laws of this state to provide insurance products, including annuities.

H. “Intermediary” means an entity contracted directly with an insurer or with another entity contracted with an insurer to facilitate the sale of the insurer’s annuities by producers.

I. (1) “Material conflict of interest” means a financial interest of the producer in the sale of any annuity that a reasonable person would expect to influence the impartiality of a recommendation.

(2) “Material conflict of interest” does not include cash compensation or non- cash compensation.

J. “Non-cash compensation” means any form of compensation that is not cash compensation, including, but not limited to, health insurance, office rent, office support and retirement benefits.

K. “Non-guaranteed elements” means the premiums, credited interest rates (including any bonus), benefits, values, dividends, non-interest based credits, charges or elements of formula used to determine any of these, that are subject to company discretion and are not guaranteed at issue. An element is considered non-guaranteed if any of the underlying non-guaranteed elements are used in its calculations.

L. “Producer” means a person or entity required to be licensed under the laws of this state to sell, solicit or negotiate insurance, including annuities. For purposes of this regulation, “producer” includes an insurer where no producer is involved.

M. (1) “Recommendation” means advice provided by a producer to an individual consumer that was intended to result or does result in a purchase, exchange or replacement of an annuity in accordance with that advice.

(2) Recommendation does not include general communication to the public, generalized customer services assistance or administrative support, general educational information and tools, prospectuses, or other product and sales material.

N. “Replacement” means a transaction in which a new annuity is to be purchased, and it is known or should be known to the proposing producer, or to the proposing insurer whether or not a producer is involved, that by reason of the transaction, an existing annuity or other insurance policy has been or is to be any of the following:

(1) Lapsed, forfeited, surrendered or partially surrendered, assigned to the replacing insurer or otherwise terminated;

(2) Converted to reduced paid-up insurance, continued as extended term insurance, or otherwise reduced in value by the use of nonforfeiture benefits or other policy values;

(3) Amended so as to effect either a reduction in benefits or in the term for which coverage would otherwise remain in force or for which benefits would be paid;

(4) Reissued with any reduction in cash value; or

(5) Used in a financed purchase.

O. “SEC” means the United States Securities and Exchange Commission.

Rule 18.06. Duties of Insurers and Producers

A. Best Interest Obligations. A producer, when making a recommendation of an annuity, shall act in the best interest of the consumer under the circumstances known at the time the recommendation is made without placing the producer’s or the insurer’s financial interest ahead of the consumer’s interest. A producer has acted in the best interest of the consumer if they have satisfied the following obligations regarding care, disclosure, conflict of interest and documentation:

(1) (a) Care Obligation. The producer, in making a recommendation shall exercise reasonable diligence, care and skill to:

(i) Know the consumer’s financial situation, insurance needs and financial objectives:

(ii) Understand the available recommendation options after making a reasonable inquiry into options available to the producer;

(iii) Have a reasonable basis to believe the recommended option effectively addresses the consumer’s financial situation, insurance needs and financial objectives over the life of the product, as evaluated in light of the consumer profile information; and

(iv) Communicate the basis or bases of the recommendation.

(b) The requirements under Subparagraph (a) of this paragraph include making reasonable efforts to obtain consumer profile information from the consumer prior to the recommendation of an annuity.

(c) The requirements under Subparagraph (a) of this paragraph require a producer to consider the types of products the producer is authorized and licensed to recommend or sell that address the consumer’s financial situation, insurance needs and financial objectives. This does not require analysis or consideration of any product outside the authority and license of the producer or other possible alternative products or strategies available in the market at the time of the recommendation. Producers shall be held to standards applicable to producers with similar authority and licensure.

(d) The requirements under this subsection do not create a fiduciary obligation or relationship and only create a regulatory obligation as established in this regulation.

(e) The consumer profile information, characteristics of the insurer, and product costs, rates, benefits and features are those factors generally relevant in making a determination whether an annuity effectively addresses the consumer’s financial situation, insurance needs and financial objectives, but the level of importance of each factor under the care obligation of this paragraph may vary depending on the facts and circumstances of a particular case. However, each factor may not be considered in isolation.

(f) The requirements under Subparagraph (a) of this paragraph include having a reasonable basis to believe the consumer would benefit from certain features of the annuity, such as annuitization, death or living benefit or other insurance-related features.

(g) The requirements under Subparagraph (a) of this paragraph apply to the particular annuity as a whole and the underlying subaccounts to which funds are allocated at the time of purchase or exchange of an annuity, and riders and similar producer enhancements, if any.

(h) The requirements under Subparagraph (a) of this paragraph do not mean the annuity with the lowest one-time or multiple-occurrence compensation structure shall necessarily be recommended.

(i)The requirements under Subparagraph (a) of this paragraph do not mean the producer has ongoing monitoring obligations under the care obligation under this paragraph, although such an obligation may be separately owed under the terms of a fiduciary, consulting, investment advising or financial planning agreement between the consumer and the producer.

(j) In the case of an exchange or replacement of an annuity, the producer shall consider the whole transaction, which includes taking into consideration whether:

(i) The consumer will incur a surrender charge, be subject to the commencement of a new surrender period, lose existing benefits, such as death, living or other contractual benefits, or be subject to increased fees, investment advisory fees or charges for riders and similar product enhancements;

(ii) The replacing producer product would substantially benefit the consumer in comparison to the replaced product over the life of the product, and

(iii) The consumer has had another annuity exchange or replacement and, in particular, an exchange or replacement within the preceding 60 months.

(k) Nothing in this regulation should be construed to require a producer to obtain any license other than a producer license with the appropriate line of authority to sell, solicit or negotiate insurance in this state, including but not limited to any securities license, in order to fulfill the duties and obligations contained in this regulation, provided the producer does not give advice or provide services that are otherwise subject to securities law or engage in any other activity requiring other professional licenses.

(2) Disclosure obligation

(a) Prior to the recommendation or sale of an annuity, the producer shall prominently disclose to the consumer on a form substantially similar to Appendix A:

(i) A description of the scope and terms of the relationship with the consumer and the role of the producer in the transaction;

(ii) An affirmative statement on whether the producer is licensed and authorized to sell the following products:

(I) Fixed annuities;

(II) Fixed indexed annuities;

(III) Variable annuities;

(IV) Life insurance;

(V) Mutual funds;

(VI) Stocks and bonds, and

(VII) Certificates of deposit;

(iii) An affirmative statement describing the insurers the producer is authorized, contracted (or appointed), or otherwise able to sell insurance products for, using the following descriptions:

(I) From one insurer;

(II) From two or more insurers, or

(III) From two or more insurers although primarily contracted with one insurer.

(iv) A description of the sources and types of cash compensation and non- cash compensation to be received by the producer, including whether the producer is to be compensated for the sale of a recommended annuity by commission as part of premium or other remuneration received from the reinsurer, intermediary or other producer or by fee as a result of a contract for advice or consulting services, and

(v) A notice of the consumer’s right to request additional information regarding cash compensation described in Subparagraph (b) of this paragraph.

(b) Upon request of the consumer or the consumer’s designated representative, the producer shall disclose:

(i) A reasonable estimate of the amount of cash compensation to be received by the producer, which may be stated as a range of amounts or percentages; and

(ii) Whether the case compensation is a one-time or multiple occurrence amount, and if a multiple occurrence amount, the frequency and amount of the occurrence, which may be stated as a range of amounts or percentages; and

(c) Prior to or at the time of the recommendation or sale of an annuity, the producer shall have a reasonable basis to believe the consumer has been informed of various features of the annuity, such as the potential surrender period and surrender charge; potential tax penalty if the consumer sells, exchanges, surrenders or annuitizes the annuity, mortality and expense fees, investment advisory fees, any annual fees, potential charges for and features of riders or other options of the annuity, limitations on interest returns, potential changes in non-guaranteed elements of the annuity, insurance and investment components and market risk.

(3) Conflict of interest obligation. A producer shall identify and avoid or reasonably manage and disclose material conflicts of interest, including material conflicts of interest related to an ownership interest.

(4) Documentation obligation. A producer shall at the time of recommendation or sale:

(a) Make a written record of any recommendation and the basis for the recommendation subject to this regulation;

(b) Obtain a consumer signed statement on a form substantially similar to Rule 18.13 (Appendix B) documenting:

(i) A customer’s refusal to provide the consumer profile information, if any, and

(ii) A customer’s understanding of the ramifications of not providing his or her consumer profile information or providing insufficient consumer profile information, and

(c) Obtain a consumer agreed statement on a form substantially similar to Rule 18.14 (Appendix C) acknowledging the annuity transaction is not recommended if a customer decides to enter into an annuity transaction that is not based on the producer’s recommendation.

(5) Application of the best interest obligation. Any requirement applicable to a producer under this subsection shall apply to every producer who has exercised material control or influence in the making of a recommendation and has received direct compensation as a result of the recommendation or sale, regardless of whether the producer has had any direct contact with the consumer. Activities such as providing or delivering marketing or educational materials, product wholesaling or other back office product support, and general supervision of a producer do not, in and of themselves, constitute material control or influence.

B. Transactions not based on a recommendation.

(1) Except as provided under Paragraph (2), a producer shall have no obligation to a consumer under Subsection (a)(1) related to any annuity if:

(a) No recommendation is made;

(b) A recommendation was made and was later found to have been prepared based on materially inaccurate information provided by the consumer;

(c) A consumer refuses to provide relevant consumer profile information and the annuity transaction is not recommended, or

(d) A consumer decides to enter into an annuity transaction that is not based on a recommendation of the producer.

(2) An insurer’s issuance of an annuity subject to Paragraph (1) shall be reasonable under all the circumstances actually known to the insurer at the time the annuity is issued.

C. Supervision system.

(1) Except as permitted under subsection B, an insurer shall not issue an annuity recommended to a consumer unless there is a reasonable basis to believe the annuity would effectively address the particular consumer’s financial situation, insurance needs and financial objectives based on the consumer’s consumer profile information.

(2) An insurer shall establish and maintain a supervision system that is reasonably designed to achieve the insurer’s and its producers’ compliance with this regulation, including, but not limited to, the following:

(a) The insurer shall establish and maintain reasonable procedures to inform its producers of the requirements of this regulation and shall incorporate the requirements of this regulation into relevant producer training manuals;

(b) The insurer shall establish and maintain standards for producer product training and shall establish and maintain reasonable procedures to require its producers to comply with the requirements of Rule 18.07 of this regulation;

(c) The insurer shall provide product-specific training and training materials which explain all material features of its annuity products to its producers;

(d) The insurer shall establish and maintain procedures for the review of each recommendation prior to issuance of an annuity that are designed to ensure there is a reasonable basis to determine that the recommended annuity would effectively address the particular consumer’s financial situation, insurance needs and financial objectives. Such review procedures may apply a screening system for the purpose of identifying selected transactions for additional review and may be accomplished electronically or through other means including, but not limited to, physical review. Such an electronic or other system may be designed to require additional review only of those transactions identified for additional review by their selection criteria;

(e) The insurer shall establish and maintain reasonable procedures to detect recommendations that are not in compliance with Subsections A, B, D, and E. This may include, but is not limited to, confirmation of the consumer’s consumer profile information, systematic customer surveys, producer and consumer interviews, confirmation letters, producer statements or attestations and programs of internal monitoring. Nothing in this subparagraph prevents an insurer from complying with this subparagraph by applying sampling procedures, or by forming the

consumer profile information or other required information under this section after issuance or delivery of the annuity.

(f) The insurer shall establish and maintain reasonable procedures to assess, prior to or upon issuance or delivery of an annuity, whether a producer has provided to the consumer the information required to be provided under this section;

(g) The insurer shall establish and maintain reasonable procedures to identify and address suspicious consumer refusals to provide consumer profile information;

(h) The insurer shall establish and maintain reasonable procedures to identify and eliminate any sales contests, sale quotas, bonuses, and non-cash compensation that are based on the sales of specific annuities within a limited period of time. The requirements of this subparagraph are not intended to prohibit the receipt of health insurance, office rent, office support, retirement benefits or other employee benefits by employees as long as those benefits are not based upon the volume of sales of a specific annuity within a limited period of time; and

(i) The insurer shall annually provide a written report to senior management, including to the senior manager responsible for audit functions, which details a review, with appropriate testing, reasonably designed to determine the effectiveness of the supervision system, the exceptions found, and corrective action taken or recommended, if any.

(3) (a) Nothing in this subsection restricts an insurer from contracting for performance of a function (including maintenance of procedures) required under this subsection. An insurer is responsible for taking appropriate corrective action and may be subject to sanctions and penalties pursuant to Rule 18.08 of this regulation regardless of whether the insurer contracts for performance of a function and regardless of the insurer’s compliance with Subparagraph (b) of this paragraph.

(b) An insurer’s supervision system under this subsection shall include supervision of contractual performance under this subsection. This includes, but is not limited to, the following:

(i) Monitoring and, as appropriate, conducting audits to assure that the contracted function is properly performed; and

(iii) Annually obtaining a certification from a senior manager who has responsibility for the contracted function that the manager has a

reasonable basis to represent, and does represent, that the function is properly performed.

(4) An insurer is not required to include in its system of supervision:

(c) A producer’s recommendation to consumers of products other than the annuities offered by the insurer, or

(d) Consideration of or comparison to options available to the producer or compensation relating to those options other than annuities or other products offered by the insurer.

D. Prohibited Practices. Neither a producer nor an insurer shall dissuade, or attempt to dissuade, a consumer from:

(1) Truthfully responding to an insurer’s request for confirmation of the consumer profile information;

(2) Filing a complaint; or

(3) Cooperating with the investigation of a complaint.

E. Safe Harbor.

(1) Recommendations and sales of annuities made in compliance with comparable standards shall satisfy the requirements under this regulation. This subsection applies to all recommendations and sales of annuities made by financial professionals in compliance with business rules, controls and procedures that satisfy a comparable standard even if such standard would not otherwise apply to the product or recommendation at issue. However, nothing in this subsection shall limit the insurance commissioner’s ability to investigate and enforce the provisions of this regulation.

(2) Nothing in Paragraph (1) shall limit the insurer’s obligation to comply with Rule 18.06(C)(1) of this regulation, although the insurer may base its analysis on information received from either the financial professional or the entity supervising the financial professional.

(3) For paragraph (1) to apply, an insurer shall:

(a) Monitor the relevant conduct of the financial professional seeking to rely on Paragraph (1) or the entity responsible for supervising the financial professional, such as the financial professional’s broker- dealer or an investment adviser registered under federal securities laws

using information collected in the normal course of an insurer’s business; and,

(b) Provide to the entity responsible for supervising the financial professional seeking to rely on Paragraph (1) such as the financial professional’s broker-dealer or investment adviser registered under federal securities laws, information and reports that are reasonably appropriate to assist such entity to maintain its supervisory system.

(4) For purposes of this subsection, “financial professional” means a producer that is regulated and acting as:

(a) A broker-dealer registered under federal securities laws or a registered representative of a broker-dealer.

(b) An investment adviser registered under federal securities laws or an investment adviser representative associated with the federal registered investment adviser; or

(c) A plan fiduciary under Section 3(21) of the Employee Retirement Income Security Act of 1974 (ERISA) or fiduciary under Section 4975(a)(3) of the Internal Revenue Code (IRC) or any amendments or successor statutes thereto.

(5) For purposes of this subsection, “comparable standards” means:

(a) With respect to broker-dealers and registered representatives of broker-dealers, applicable SEC and FINRA rules pertaining to best interest obligations and supervision of annuity recommendations and sales, including, but not limited to, Regulation Best Interest and any amendments or successor regulations thereto.

(b) With respect to investment advisers registered under federal securities laws or investment adviser representatives, the fiduciary duties and all other requirements imposed on such investment advisers or investment adviser representatives by contract or under the Investment Advisers Act of 1940, including but not limited to, the Form ADV and interpretations, and

(c) With respect to plan fiduciaries or fiduciaries, means the duties, obligations, prohibitions, and all other requirements attendant to such status under ERISA or the IRC and any amendments or successor statutes thereto.

Rule 18.07. Insurance Producer Training

A. An insurance producer shall not solicit the sale of an annuity product unless the insurance producer has adequate knowledge of the product to recommend the annuity and the insurance producer is in compliance with the insurer’s standards for product training. An insurance producer may rely on insurer-provided product-specific training standards and materials to comply with this Rule.

B. (1) (a) An insurance producer who engages in the sale of annuity products shall complete a one-time four (4) credit training course approved by the Department and provided by the Department approved education provider.

(b) Insurance producers who hold a life insurance line of authority on the effective date of this regulation and who desire to sell annuities shall complete the requirements of this subsection within six (6) months after the effective date of this regulation. Individuals who obtain a life insurance line of authority on or after the effective date of this regulation may not engage in the sale of annuities until the annuity training course required under this subsection has been completed.

(2) The minimum length of the training required under this subsection shall be sufficient to qualify for at least four (4) CE credit hours, but may be longer.

(3) The training required under this subsection shall include information on the following topics:

(a) The types of annuities and various classifications of annuities;

(b) Identification of the parties to an annuity;

(c) How product specific annuity contract provisions features affect consumers;

(d) The application of income taxation of qualified and non-qualified annuities;

(e) The primary uses of annuities; and

(f) Appropriate standard of conduct, sales practices, replacement and disclosure requirements.

(4) Providers of courses intended to comply with this subsection shall cover all topics listed in the prescribed outline and shall not present any

marketing information or provide training on sales techniques or provide specific information about a particular insurer’s products. Additional topics may be offered in conjunction with and in addition to the required outline.

(5) A provider of an annuity training course intended to comply with this subsection shall register as a CE provider in this State and comply with the rules and guidelines applicable to insurance producer continuing education courses as set forth in Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, Miss. Code Ann. § 83-17-513.

(6) A producer who has completed an annuity training course approved by the Department prior to January 1, 2022, shall, within six (6) months after January 1, 2022, complete either:

(a) A new four (4) credit training course approved by the Department after January 1, 2022; or

(b) An additional one-time one (1) credit training course approved by the Department and provided by the Department approved education provider on appropriate sales practices, replacement and disclosure requirements under this amended regulation.

(7) Annuity training courses may be conducted and completed by classroom or self-study methods in accordance with Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, and Miss. Code Ann. § 83-17- 513.

(8) Providers of annuity training shall comply with the reporting requirements and shall issue certificates of completion in accordance with Miss. Code Ann. §§ 83-17-251 to 83-17-261, Miss. Code Ann. § 83-17-415, and Miss. Code Ann. § 83-17-513.

(9) The satisfaction of the training requirements of another State that are substantially similar to the provisions of this subsection shall be deemed to satisfy the training requirements of this subsection in this state.

(10) The satisfaction of the components of the training requirements of any course or courses with components substantially similar to the provisions of this subsection shall be deemed to satisfy the training requirements of this subsection in this state.

(11) An insurer shall verify that an insurance producer has completed the annuity training course required under this subsection before allowing the producer to sell an annuity product for that insurer. An insurer may satisfy its responsibility under this subsection by obtaining certificates of

completion of the training course or obtaining reports provided by commissioner-sponsored database systems or vendors or from a reasonably reliable commercial database vendor that has a reporting arrangement with approved insurance education providers.

Rule 18.08. Compliance Mitigation; Penalties

A. An insurer is responsible for compliance with this regulation. If a violation occurs, either because of the action or inaction of the insurer or its insurance producer, the commissioner may order:

(1) An insurer to take reasonably appropriate corrective action for any consumer harmed by a failure to comply with this regulation by the insurer, an entity contracted to perform the insurer’s supervisory duties or by the insurance producer;

(2) A general agency, independent agency or the insurance producer to take reasonably appropriate corrective action for any consumer harmed by the insurance producer’s violation of this regulation; and

(3) Appropriate penalties and sanctions.

B. Any applicable penalty under Miss. Code Ann. §§ 83-5-29 through 83-5-51 for a violation of this regulation may be reduced or eliminated, as determined by the commissioner, if corrective action for the consumer was taken promptly after a violation was discovered or the violation was not part of a pattern or practice.

C. The authority to enforce compliance with this regulation is vested exclusively with the commissioner.

Rule 18.09. Recordkeeping

A. Insurers, general agents, independent agencies and insurance producers shall maintain or be able to make available to the commissioner records of the information collected from the consumer, disclosures made to the consumer, including summaries of oral disclosures, and other information used in making the recommendations that were the basis for insurance transactions for five (5) years after the insurance transaction is completed by the insurer. An insurer is permitted, but shall not be required, to maintain documentation on behalf of an insurance producer.

B. Records required to be maintained by this regulation may be maintained in paper, photographic, micro-process, magnetic, mechanical or electronic media or by any process that accurately reproduces the actual document.

Rule 18.10. Severability

If any provision of these sections or the application thereof to any person or circumstance is held invalid for any reason, the invalidity shall not affect the other provisions or any other application of these sections which can be given effect without the invalid provisions or application. To this end all provisions of these sections are declared to be severable.

Rule 18.11. Effective Date

This Amended Regulation shall become effective on January 1, 2022, and shall apply to acts or practices committed on or after the effective date July 1, 2022.

_____________________________ MIKE CHANEY COMMISSIONER OF INSURANCE

Rule 18:12 - APPENDIX A

INSURANCE AGENT (PRODUCER) DISCLOSURE FOR ANNUITIES Do Not Sign Unless You Have Read and Understand the Information in this Form

Date: ________________________

III. INSURANCE AGENT (PRODUCER) INFORMATION (“Me”, “I”, “My”)

First Name: _________________________________________ Last Name: _________________________________________

Business\Agency Name: ___________________________________ Website: ________________________________________________

Business Mailing Address:____________________________________________________________________

Business Telephone Number:____________________________________________________

Email Address:_______________________________________________________________

National Producer Number in MS:________________________________________________

IV. CUSTOMER INFORMATION (“You”, “Your”)

First Name: _______________________________________ Last Name: ________________________________________

What Types of Products Can I Sell You? I am licensed to sell annuities to You in accordance with state law. If I recommend that You buy an annuity, it means I believe that it effectively meets Your financial situation, insurance needs, and financial objectives. Other financial products, such as life insurance or stocks, bonds and mutual funds, also may meet Your needs.

I offer the following products:

Fixed or Fixed Indexed Annuities Variable Annuities Life Insurance

I need a separate license to provide advice about or to sell non-insurance financial products. I have checked below any noninsurance financial products that I am licensed and authorized to provide advice about or to sell.

Mutual Funds Stocks/Bonds Certificates of Deposits

Whose Annuities Can I Sell to You?

I am authorized to sell: Annuities from Only One (1) Insurer

Annuities from Two or More Insurers Annuities from Two or More Insurers although I primarily sell annuities from:_________________________

How I’m Paid for My Work: It’s important for You to understand how I’m paid for my work. Depending on the particular annuity You purchase, I may be paid a commission or a fee. Commissions are generally paid to Me by the insurance company while fees are generally paid to Me by the consumer. If You have questions about how I’m paid, please ask Me.

Depending on the particular annuity You buy, I will or may be paid cash compensation as follows: Commission, which is usually paid by the insurance company or other sources. If other sources, describe: __________________.

Fees (such as a fixed amount, an hourly rate, or a percentage of your payment), which are usually paid directly by the customer.

Other, describe:_______________________________________________________________

If You have questions about the above compensation I will be paid for this transaction, please ask me.

I may also receive other indirect compensation resulting from this transaction (sometimes called “non- cash” compensation), such as health or retirement benefits, office rent and support, or other incentives from the insurance company or other sources.

By signing below, You acknowledge that You have read and understand the information provided to You in this document.

________________________________________________ Customer Signature

________________________________________________ Date

________________________________________________ Agent (Producer) Signature

________________________________________________ Date

Rule 18:13 – APPENDIX B

CONSUMER REFUSAL TO PROVIDE INFORMATION Do Not Sign Unless You Have Read and Understand the Information in this Form

Why are You being given this form?

You’re buying a financial product – an annuity.

To recommend a product that effectively meets Your needs, objectives and situation, the agent, broker, or company needs information about You, Your financial situation, insurance needs and financial objectives.

If You sign this form, it means You have not given the agent, broker, or company some or all the information needed to decide if the annuity effectively meets Your needs, objectives and situation. You may lose protections under the Insurance Code of [this state] if You sign this form or provide inaccurate information.

Statement of Purchaser:

I REFUSE to provide this information at this time. I have chosen to provide LIMITED information at this time.

________________________________________________ Customer Signature

________________________________________________ Date

Rule 18:14 – APPENDIX C

Consumer Decision to Purchase an Annuity NOT Based on a Recommendation

Do Not Sign This Form Unless You Have Read and Understand It.

Why are You being given this form? You are buying a financial product – an annuity.

To recommend a product that effectively meets your needs, objectives and situation, the agent, broker, or company has the responsibility to learn about You, your financial situation, insurance needs and financial objectives.

If You sign this form, it means You know that you’re buying an annuity that was not recommended.

Statement of Purchaser:

I understand that I am buying an annuity, but the agent, broker or company did not recommend that I buy it. If I buy it without a recommendation, I understand I may lose protections under the Insurance Code of [this state].

________________________________________________ Customer Signature

________________________________________________ Date

________________________________________________ Agent/Producer Signature

History

• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)
• Source: Miss. Code Ann. §§ 83-5-29 to 83-5-51 (Rev. 2011)

Part 3 Accident, Health, and Medicare Supplement Insurance

Chapter 10 Regulation to Implement The Medicare Supplement Insurance Minimum Standards Model Act.

19 Miss. Admin. Code Pt. 3, R. 10.02 Authority

This regulation is issued pursuant to the authority vested in the commissioner under Miss. Code Ann. §83-9-103 and §83-9-105.

History

• Source: Miss Code Ann §§83-9-103; 83-9-105 (Rev. 2011)

19 Miss. Admin. Code Pt. 3, R. 10.03 Applicability and Scope

A. Except as otherwise specifically provided in Rules 10.07, 10.13, 10.14, 10.17 and 10.22, this regulation shall apply to:

1. All Medicare supplement policies delivered or issued for delivery in this state on or after the effective date of this regulation; and

2. All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued for delivery in this state.

B. This regulation shall not apply to a policy or contract of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees, or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations.

History

• Source: Miss Code Ann §§83-9-102; 83-9-103 (Rev. 2011)

19 Miss. Admin. Code Pt. 3, R. 10.04 Definitions

For purposes of this regulation: A. “Applicant” means: 1. In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits, and

2. In the case of a group Medicare supplement policy, the proposed certificate holder.

B. “Bankruptcy” means when a Medicare Advantage organization that is not an issuer has filed, or has had filed against it, a petition for declaration of bankruptcy and has ceased doing business in the state.

C. “Certificate” means any certificate delivered or issued for delivery in this state under a group Medicare supplement policy.

D. “Certificate form” means the form on which the certificate is delivered or issued for delivery by the issuer.

E. “Continuous period of creditable coverage” means the period during which an individual was covered by creditable coverage, if during the period of the coverage the individual had no breaks in coverage greater than sixty-three (63) days.

F. 1. “Creditable coverage” means, with respect to an individual, coverage of the individual provided under any of the following:

a. A group health plan;

b. Health insurance coverage;

c. Part A or Part B of Title XVIII of the Social Security Act (Medicare);

d. Title XIX of the Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928;

e. Chapter 55 of Title 10 United States Code (CHAMPUS);

f. A medical care program of the Indian Health Service or of a tribal organization;

g. A state health benefits risk pool;

h. A health plan offered under chapter 89 of Title 5 United States Code (Federal Employees Health Benefits Program);

i. A public health plan as defined in federal regulation; and

j. A health benefit plan under Section 5(e) of the Peace Corps Act (22 United States Code 2504(e)).

2. “Creditable coverage” shall not include one or more, or any combination of, the following:

a. Coverage only for accident or disability income insurance, or any combination thereof;

b. Coverage issued as a supplement to liability insurance;

c. Liability insurance, including general liability insurance and automobile liability insurance;

d. Workers’ compensation or similar insurance;

e. Automobile medical payment insurance;

f. Credit-only insurance;

g. Coverage for on-site medical clinics; and

h. Other similar insurance coverage, specified in federal regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.

3. “Creditable coverage” shall not include the following benefits if they are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of the plan:

a. Limited scope dental or vision benefits;

b. Benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof; and

c. Such other similar, limited benefits as are specified in federal regulations.

4. “Creditable coverage” shall not include the following benefits if offered as independent, non-coordinated benefits:

a. Coverage only for a specified disease or illness; and

b. Hospital indemnity or other fixed indemnity insurance.

5. “Creditable coverage” shall not include the following if it is offered as a separate policy, certificate or contract of insurance:

a. Medicare supplemental health insurance as defined under section 1882(g)(1) of the Social Security Act;

b. Coverage supplemental to the coverage provided under chapter 55 of title 10, United States Code; and

c. Similar supplemental coverage provided to coverage under a group health plan.

G. “Employee welfare benefit plan” means a plan, fund or program of employee benefits as defined in 29 U.S.C. Section 1002 (Employee Retirement Income Security Act).

H. “Insolvency” means when an issuer, licensed to transact the business of insurance in this state, has had a final order of liquidation entered against it with a finding of insolvency by a court of competent jurisdiction in the issuer’s state of domicile, and as further defined in Miss. Code Ann. § 83-24-7(k).

I. “Issuer” includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state Medicare supplement policies or certificates.

J. “Medicare” means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

K. “Medicare Advantage plan” means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

1. Coordinated care plans that provide health care services, including but not limited to health maintenance organization plans (with or without a point-of- service option), plans offered by provider-sponsored organizations, and preferred provider organization plans;

2. Medical savings account plans coupled with a contribution into a Medicare Advantage plan medical savings account; and

3. Medicare Advantage private fee-for-service plans.

L. “Medicare supplement policy” means a group or individual policy of [accident and sickness] insurance or a subscriber contract [of hospital and medical service associations or health maintenance organizations], other than a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act (42 U.S.C. Section 1395 et. seq.) or an issued policy under a demonstration project specified in 42 U.S.C. § 1395ss(g)(1), which is advertised, marketed or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical or surgical expenses of persons eligible for Medicare. “Medicare supplement policy” does not include Medicare Advantage plans established under Medicare Part C, Outpatient Prescription Drug plans established under Medicare Part D, or any Health Care Prepayment Plan (HCPP) that provides benefits pursuant to an agreement under §1833(a)(1)(A) of the Social Security Act.

M. "Pre-Standardized Medicare supplement benefit plan," "Pre-Standardized benefit plan" or "Pre- Standardized plan" means a group or individual policy of Medicare supplement insurance issued prior to July 1, 1992.

N. "1990 Standardized Medicare supplement benefit plan," "1990 Standardized benefit plan" or "1990 plan" means a group or individual policy of Medicare supplement insurance issued on or after July 1, 1992 and with an effective date for coverage prior to June 1, 2010.

O. “2010 Standardized Medicare supplement benefit plan," "2010 Standardized benefit plan" or "2010 plan" means a group or individual policy of Medicare supplement insurance with an effective date for coverage on or after June 1, 2010.

P. “Policy form” means the form on which the policy is delivered or issued for delivery by the issuer.

Q. “Secretary” means the Secretary of the United States Department of Health and Human Services.

Rule 10.05: Policy Definitions and Terms

No policy or certificate may be advertised, solicited or issued for delivery in this state as a Medicare supplement policy or certificate unless the policy or certificate contains definitions or terms which conform to the requirements of this section.

A. “Accident,” “accidental injury,” or “accidental means” shall be defined to employ “result” language and shall not include words that establish an accidental means test or use words such as “external, violent, visible wounds” or similar words of description or characterization.

1. The definition shall not be more restrictive than the following: “Injury or injuries for which benefits are provided means accidental bodily injury sustained by the insured person which is the direct result of an accident, independent of disease or bodily infirmity or any other cause, and occurs while insurance coverage is in force.”

2. The definition may provide that injuries shall not include injuries for which benefits are provided or available under any workers’ compensation, employer’s liability or similar law, or motor vehicle no-fault plan, unless prohibited by law.

B. “Benefit period” or “Medicare benefit period” shall not be defined more restrictively than as defined in the Medicare program.

C. “Convalescent nursing home,” “extended care facility,” or “skilled nursing facility” shall not be defined more restrictively than as defined in the Medicare program.

D. “Health care expenses” means, for purposes of Rule 10.14, expenses of health maintenance organizations associated with the delivery of health care services, which expenses are analogous to incurred losses of insurers.

E. “Hospital” may be defined in relation to its status, facilities and available services or to reflect its accreditation by the Joint Commission on Accreditation of Hospitals, but not more restrictively than as defined in the Medicare program.

F. “Medicare” shall be defined in the policy and certificate. Medicare may be substantially defined as “The Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965 as Then Constituted or Later Amended,” or “Title I, Part I of Public Law 89-97, as Enacted by the Eighty-Ninth Congress of the United States of America and popularly known as the Health Insurance for the Aged Act, as then constituted and any later amendments or substitutes thereof,” or words of similar import.

G. “Medicare eligible expenses” shall mean expenses of the kinds covered by Medicare Parts A and B, to the extent recognized as reasonable and medically necessary by Medicare.

H. “Physician” shall not be defined more restrictively than as defined in the Medicare program.

I. “Sickness” shall not be defined to be more restrictive than the following: “Sickness means illness or disease of an insured person which first manifests itself after the effective date of insurance and while the insurance is in force.” The definition may be further modified to exclude sicknesses or diseases for which benefits are provided under any workers’ compensation, occupational disease, employer’s liability or similar law.

Rule 10.06: Policy Provisions

A. Except for permitted preexisting condition clauses as described in Rules 10.07A(1), 10.08A(1), and 10.08.1A(1) of this regulation, no policy or certificate may be advertised, solicited or issued for delivery in this state as a Medicare supplement policy if the policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of Medicare.

B. No Medicare supplement policy or certificate may use waivers to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.

C. No Medicare supplement policy or certificate in force in the state shall contain benefits that duplicate benefits provided by Medicare.

D. 1. Subject to Rules 10.07A(4), (5) and (7), and 10.08A(4) and (5) of this regulation, a Medicare supplement policy with benefits for outpatient prescription drugs in existence prior to January 1, 2006 shall be renewed for current policyholders who do not enroll in Part D at the option of the policyholder.

2. A Medicare supplement policy with benefits for outpatient prescription drugs shall not be issued after December 31, 2005.

3. After December 31, 2005, a Medicare supplement policy with benefits for outpatient prescription drugs may not be renewed after the policyholder enrolls in Medicare Part D unless:

a. The policy is modified to eliminate outpatient prescription coverage for expenses of outpatient prescription drugs incurred after the effective date of the individual’s coverage under a Part D plan and;

b. Premiums are adjusted to reflect the elimination of outpatient prescription drug coverage at the time of Medicare Part D enrollment, accounting for any claims paid, if applicable.

Rule 10.07: Minimum Benefit Standards for Pre-Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued For Delivery Prior To July 1, 1992

No policy or certificate may be advertised, solicited or issued for delivery in this state as a Medicare supplement policy or certificate unless it meets or exceeds the following minimum standards. These are minimum standards and do not preclude the inclusion of other provisions or benefits which are not inconsistent with these standards.

A. General Standards. The following standards apply to Medicare supplement policies and certificates and are in addition to all other requirements of this regulation.

1. A Medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.

2. A Medicare supplement policy or certificate shall not indemnify against losses resulting from sickness on a different basis than losses resulting from accidents.

3. A Medicare supplement policy or certificate shall provide that benefits designed to cover cost sharing amounts under Medicare will be changed automatically to coincide with any changes in the applicable Medicare deductible, co-payment, or coinsurance amounts. Premiums may be modified to correspond with such changes.

4. A “non-cancellable,” “guaranteed renewable,” or “non-cancellable and guaranteed renewable” Medicare supplement policy shall not:

a. Provide for termination of coverage of a spouse solely because of the occurrence of an event specified for termination of coverage of the insured, other than the nonpayment of premium; or

b. Be cancelled or non-renewed by the issuer solely on the grounds of deterioration of health.

5. a. Except as authorized by the commissioner of this state, an issuer shall neither cancel nor non-renew a Medicare supplement policy or certificate for any reason other than nonpayment of premium or material misrepresentation.

b. If a group Medicare supplement insurance policy is terminated by the group policyholder and not replaced as provided in Paragraph (5)(d), the issuer shall offer certificate holders an individual Medicare supplement policy. The issuer shall offer the certificate holder at least the following choices:

i. An individual Medicare supplement policy currently offered by the issuer having comparable benefits to those contained in the terminated group Medicare supplement policy; and

ii. An individual Medicare supplement policy which provides only such benefits as are required to meet the minimum standards as defined in Rule 10.08.1B of this regulation.

c. If membership in a group is terminated, the issuer shall:

i. Offer the certificate holder the conversion opportunities described in Subparagraph (b); or

ii. At the option of the group policyholder, offer the certificate holder continuation of coverage under the group policy.

d. If a group Medicare supplement policy is replaced by another group Medicare supplement policy purchased by the same policyholder, the issuer of the replacement policy shall offer coverage to all persons covered under the old group policy on its date of termination. Coverage under the new group policy shall not result in any exclusion for preexisting conditions that would have been covered under the group policy being replaced.

6. Termination of a Medicare supplement policy or certificate shall be without prejudice to any continuous loss which commenced while the policy was in force, but the extension of benefits beyond the period during which the policy was in force may be predicated upon the continuous total disability of the insured, limited to the duration of the policy benefit period, if any, or to payment of the maximum benefits. Receipt of Medicare Part D benefits will not be considered in determining a continuous loss.

7. If a Medicare supplement policy eliminates an outpatient prescription drug benefit as a result of requirements imposed by the Medicare Prescription Drug,

Improvement, and Modernization Act of 2003, the modified policy shall be deemed to satisfy the guaranteed renewal requirements of this subsection.

B. Minimum Benefit Standards.

1. Coverage of Part A Medicare eligible expenses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period;

2. Coverage for either all or none of the Medicare Part A inpatient hospital deductible amount;

3. Coverage of Part A Medicare eligible expenses incurred as daily hospital charges during use of Medicare’s lifetime hospital inpatient reserve days;

4. Upon exhaustion of all Medicare hospital inpatient coverage including the lifetime reserve days, coverage of ninety percent (90%) of all Medicare Part A eligible expenses for hospitalization not covered by Medicare subject to a lifetime maximum benefit of an additional 365 days;

5. Coverage under Medicare Part A for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in accordance with federal regulations or already paid for under Part B;

6. Coverage for the coinsurance amount of Medicare eligible expenses under Part B regardless of hospital confinement, subject to a maximum calendar year out-of- pocket amount equal to the Medicare Part B deductible [$185];

7. Effective January 1, 1990, coverage under Medicare Part B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations), unless replaced in accordance with federal regulations or already paid for under Part A, subject to the Medicare deductible amount.

Rule 10.08: Benefit Standards for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued For Delivery After July 1, 1992 With An Effective Date For Coverage Prior To June 1, 2010

The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state on or after July 1, 1992 and with an effective date for coverage prior to June 1, 2010. No policy or certificate may be advertised, solicited,

delivered or issued for delivery in this state as a Medicare supplement policy or certificate unless it complies with these benefit standards.

A. General Standards. The following standards apply to Medicare supplement policies and certificates and are in addition to all other requirements of this regulation.

1. A Medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate may not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.

2. A Medicare supplement policy or certificate shall not indemnify against losses resulting from sickness on a different basis than losses resulting from accidents.

3. A Medicare supplement policy or certificate shall provide that benefits designed to cover cost sharing amounts under Medicare will be changed automatically to coincide with any changes in the applicable Medicare deductible, co-payment, or coinsurance amounts. Premiums may be modified to correspond with such changes.

4. No Medicare supplement policy or certificate shall provide for termination of coverage of a spouse solely because of the occurrence of an event specified for termination of coverage of the insured, other than the nonpayment of premium.

5. Each Medicare supplement policy shall be guaranteed renewable.

a. The issuer shall not cancel or non-renew the policy solely on the ground of health status of the individual.

b. The issuer shall not cancel or non-renew the policy for any reason other than nonpayment of premium or material misrepresentation.

c. If the Medicare supplement policy is terminated by the group policyholder and is not replaced as provided under Rule 10.08A(5)(e), the issuer shall offer certificate holders an individual Medicare supplement policy which (at the option of the certificate holder)

i. Provides for continuation of the benefits contained in the group policy, or

ii. Provides for benefits that otherwise meet the requirements of this subsection.

d. If an individual is a certificate holder in a group Medicare supplement policy and the individual terminates membership in the group, the issuer shall:

i. Offer the certificate holder the conversion opportunity described in Rule 10.08A(5)(c), or

ii. At the option of the group policyholder, offer the certificate holder continuation of coverage under the group policy.

e. If a group Medicare supplement policy is replaced by another group Medicare supplement policy purchased by the same policyholder, the issuer of the replacement policy shall offer coverage to all persons covered under the old group policy on its date of termination. Coverage under the new policy shall not result in any exclusion for preexisting conditions that would have been covered under the group policy being replaced.

f. If a Medicare supplement policy eliminates an outpatient prescription drug benefit as a result of requirements imposed by the Medicare Prescription Drug, Improvement and Modernization Act of 2003, the modified policy shall be deemed to satisfy the guaranteed renewal requirements of this paragraph.

6. Termination of a Medicare supplement policy or certificate shall be without prejudice to any continuous loss which commenced while the policy was in force, but the extension of benefits beyond the period during which the policy was in force may be conditioned upon the continuous total disability of the insured, limited to the duration of the policy benefit period, if any, or payment of the maximum benefits. Receipt of Medicare Part D benefits will not be considered in determining a continuous loss.

7. a. A Medicare supplement policy or certificate shall provide that benefits and premiums under the policy or certificate shall be suspended at the request of the policyholder or certificate holder for the period (not to exceed twenty-four (24) months) in which the policyholder or certificate holder has applied for and is determined to be entitled to medical assistance under Title XIX of the Social Security Act, but only if the policyholder or certificate holder notifies the issuer of the policy or certificate within ninety (90) days after the date the individual becomes entitled to assistance.

b. If suspension occurs and if the policyholder or certificate holder loses entitlement to medical assistance, the policy or certificate shall be automatically reinstituted (effective as of the date of termination of entitlement) as of the termination of entitlement if the policyholder or

certificate holder provides notice of loss of entitlement within ninety (90) days after the date of loss and pays the premium attributable to the period, effective as of the date of termination of entitlement.

c. Each Medicare supplement policy shall provide that benefits and premiums under the policy shall be suspended (for any period that may be provided by federal regulation) at the request of the policyholder if the policyholder is entitled to benefits under Section 226 (b) of the Social Security Act and is covered under a group health plan (as defined in Section 1862 (b)(1)(A)(v) of the Social Security Act). If suspension occurs and if the policyholder or certificate holder loses coverage under the group health plan, the policy shall be automatically reinstituted (effective as of the date of loss of coverage) if the policyholder provides notice of loss of coverage within ninety (90) days after the date of the loss and pays the premium attributable to the period effective as of the date of termination of enrollment in the group health plan.

d. Reinstitution of coverages as described in Subparagraphs (b) and (c):

i. Shall not provide for any waiting period with respect to treatment of preexisting conditions;

ii. Shall provide for resumption of coverage that is substantially equivalent to coverage in effect before the date of suspension. If the suspended Medicare supplement policy provided coverage for outpatient prescription drugs, reinstitution of the policy for Medicare Part D enrollees shall be without coverage for outpatient prescription drugs and shall otherwise provide substantially equivalent coverage to the coverage in effect before the date of suspension; and

iii. Shall provide for classification of premiums on terms at least as favorable to the policyholder or certificate holder as the premium classification terms that would have applied to the policyholder or certificate holder had the coverage not been suspended.

8. If an issuer makes a written offer to the Medicare Supplement policyholders or certificate holders of one or more of its plans, to exchange during a specified period from his or her 1990 Standardized plan (as described in Rule 10.09 of this regulation) to a 2010 Standardized plan (as described in Rule 10.09.1 of this regulation), the offer and subsequent exchange shall comply with the following requirements:

a. An issuer need not provide justification to the commissioner if the insured replaces a 1990 Standardized policy or certificate with an issue

age rated 2010 Standardized policy or certificate at the insured’s original issue age and duration. If an insured’s policy or certificate to be replaced is priced on an issue age rate schedule at the time of such offer, the rate charged to the insured for the new exchanged policy shall recognize the policy reserve buildup, due to the pre- funding inherent in the use of an issue age rate basis, for the benefit of the insured. The method proposed to be used by an issuer must be filed with the commissioner according to the state’s rate filing procedure.

b. The rating class of the new policy or certificate shall be the class closest to the insured’s class of the replaced coverage.

c. An issuer may not apply new pre-existing condition limitations or a new incontestability period to the new policy for those benefits contained in the exchanged 1990 Standardized policy or certificate of the insured, but may apply pre-existing condition limitations of no more than six (6) months to any added benefits contained in the new 2010 Standardized policy or certificate not contained in the exchanged policy.

d. The new policy or certificate shall be offered to all policyholders or certificate holders within a given plan, except where the offer or issue would be in violation of state or federal law.

B. Standards for Basic (Core) Benefits Common to Benefit Plans A to J.

Every issuer shall make available a policy or certificate including only the following basic “core” package of benefits to each prospective insured. An issuer may make available to prospective insureds any of the other Medicare Supplement Insurance Benefit Plans in addition to the basic core package, but not in lieu of it.

1. Coverage of Part A Medicare eligible expenses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period;

2. Coverage of Part A Medicare eligible expenses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used;

3. Upon exhaustion of the Medicare hospital inpatient coverage, including the lifetime reserve days, coverage of one hundred percent (100%) of the Medicare Part A eligible expenses for hospitalization paid at the applicable prospective payment system (PPS) rate, or other appropriate Medicare standard of payment, subject to a lifetime maximum benefit of an additional 365 days. The provider

shall accept the issuer’s payment as payment in full and may not bill the insured for any balance;

4. Coverage under Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in accordance with federal regulations;

5. Coverage for the coinsurance amount, or in the case of hospital outpatient department services paid under a prospective payment system, the co-payment amount, of Medicare eligible expenses under Part B regardless of hospital confinement, subject to the Medicare Part B deductible;

C. Standards for Additional Benefits. The following additional benefits shall be included in Medicare Supplement Benefit Plans “B” through “J” only as provided by Rule 10.09 of this regulation.

1. Medicare Part A Deductible: Coverage for all of the Medicare Part A inpatient hospital deductible amount per benefit period.

2. Skilled Nursing Facility Care: Coverage for the actual billed charges up to the coinsurance amount from the 21st day through the 100th day in a Medicare benefit period for post-hospital skilled nursing facility care eligible under Medicare Part A.

3. Medicare Part B Deductible: Coverage for all of the Medicare Part B deductible amount per calendar year regardless of hospital confinement.

4. Eighty Percent (80%) of the Medicare Part B Excess Charges: Coverage for eighty percent (80%) of the difference between the actual Medicare Part B charge as billed, not to exceed any charge limitation established by the Medicare program or state law, and the Medicare-approved Part B charge.

5. One Hundred Percent (100%) of the Medicare Part B Excess Charges: Coverage for all of the difference between the actual Medicare Part B charge as billed, not to exceed any charge limitation established by the Medicare program or state law, and the Medicare-approved Part B charge.

6. Basic Outpatient Prescription Drug Benefit: Coverage for fifty percent (50%) of outpatient prescription drug charges, after a $250 calendar year deductible, to a maximum of $1,250 in benefits received by the insured per calendar year, to the extent not covered by Medicare. The outpatient prescription drug benefit may be included for sale or issuance in a Medicare supplement policy until January 1, 2006.

7. Extended Outpatient Prescription Drug Benefit: Coverage for fifty percent (50%) of outpatient prescription drug charges, after a $250 calendar year deductible to a maximum of $3,000 in benefits received by the insured per calendar year, to the extent not covered by Medicare. The outpatient prescription drug benefit may be included for sale or issuance in a Medicare supplement policy until January 1, 2006.

8. Medically Necessary Emergency Care in a Foreign Country: Coverage to the extent not covered by Medicare for eighty percent (80%) of the billed charges for Medicare- eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first sixty (60) consecutive days of each trip outside the United States, subject to a calendar year deductible of $250, and a lifetime maximum benefit of $50,000. For purposes of this benefit, “emergency care” shall mean care needed immediately because of an injury or an illness of sudden and unexpected onset.

9. a. Preventive Medical Care Benefit: Coverage for the following preventive health services not covered by Medicare:

i. An annual clinical preventive medical history and physical examination that may include tests and services from Subparagraph (b) and patient education to address preventive health care measures;

ii. Preventive screening tests or preventive services, the selection and frequency of which is determined to be medically appropriate by the attending physician.

b. Reimbursement shall be for the actual charges up to one hundred percent (100%) of the Medicare-approved amount for each service, as if Medicare were to cover the service as identified in American Medical Association Current Procedural Terminology (AMA CPT) codes, to a maximum of $120 annually under this benefit. This benefit shall not include payment for any procedure covered by Medicare.

10. At-Home Recovery Benefit: Coverage for services to provide short term, at-home assistance with activities of daily living for those recovering from an illness, injury or surgery.

a. For purposes of this benefit, the following definitions shall apply:

i. “Activities of daily living” include, but are not limited to bathing, dressing, personal hygiene, transferring, eating, ambulating, assistance with drugs that are normally self-administered, and changing bandages or other dressings.

ii. “Care provider” means a duly qualified or licensed home health aide or homemaker, personal care aide or nurse provided through a licensed home health care agency or referred by a licensed referral agency or licensed nurse’s registry.

iii. “Home” shall mean any place used by the insured as a place of residence, provided that the place would qualify as a residence for home health care services covered by Medicare. A hospital or skilled nursing facility shall not be considered the insured’s place of residence.

iv. “At-home recovery visit” means the period of a visit required to provide at home recovery care, without limit on the duration of the visit, except each consecutive four (4) hours in a twenty-four-hour period of services provided by a care provider is one visit.

b. Coverage Requirements and Limitations.

i. At-home recovery services provided must be primarily services which assist in activities of daily living.

ii. The insured’s attending physician must certify that the specific type and frequency of at-home recovery services are necessary because of a condition for which a home care plan of treatment was approved by Medicare.

iii. Coverage is limited to:

(I) No more than the number and type of at-home recovery visits certified as necessary by the insured’s attending physician. The total number of at-home recovery visits shall not exceed the number of Medicare approved home health care visits under a Medicare approved home care plan of treatment;

(II) The actual charges for each visit up to a maximum reimbursement of $40 per visit;

(III) $1,600 per calendar year;

(IV) Seven (7) visits in any one week; (V)Care furnished on a visiting basis in the insured’s home; (VI) Services provided by a care provider as defined in this section;

(VII) At-home recovery visits while the insured is covered under the policy or certificate and not otherwise excluded;

(VIII) At-home recovery visits received during the period the insured is receiving Medicare approved home care services or no more than eight (8) weeks after the service date of the last Medicare approved home health care visit.

c. Coverage is excluded for:

i. Home care visits paid for by Medicare or other government programs; and

ii. Care provided by family members, unpaid volunteers or providers who are not care providers.

D. Standards for Plans K and L.

1. Standardized Medicare supplement benefit plan “K” shall consist of the following:

a. Coverage of one hundred percent (100%) of the Part A hospital coinsurance amount for each day used from the 61st through the 90th day in any Medicare benefit period;

b. Coverage of one hundred percent (100%) of the Part A hospital coinsurance amount for each Medicare lifetime inpatient reserve day used from the 91st through the 150th day in any Medicare benefit period;

c. Upon exhaustion of the Medicare hospital inpatient coverage, including the lifetime reserve days, coverage of one hundred percent (100%) of the Medicare Part A eligible expenses for hospitalization paid at the applicable prospective payment system (PPS) rate, or other appropriate

Medicare standard of payment, subject to a lifetime maximum benefit of an additional 365 days. The provider shall accept the issuer’s payment as payment in full and may not bill the insured for any balance;

d. Medicare Part A Deductible: Coverage for fifty percent (50%) of the Medicare Part A inpatient hospital deductible amount per benefit period until the out-of-pocket limitation is met as described in Subparagraph (j);

e. Skilled Nursing Facility Care: Coverage for fifty percent (50%) of the coinsurance amount for each day used from the 21st day through the 100th day in a Medicare benefit period for post-hospital skilled nursing facility care eligible under Medicare Part A until the out-of-pocket limitation is met as described in Subparagraph (j);

f. Hospice Care: Coverage for fifty percent (50%) of cost sharing for all Part A Medicare eligible expenses and respite care until the out-of-pocket limitation is met as described in Subparagraph (j);

g. Coverage for fifty percent (50%), under Medicare Part A or B, of the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in accordance with federal regulations until the out- of-pocket limitation is met as described in Subparagraph (j);

h. Except for coverage provided in Subparagraph (i) below, coverage for fifty percent (50%) of the cost sharing otherwise applicable under Medicare Part B after the policyholder pays the Part B deductible until the out-of-pocket limitation is met as described in Subparagraph (j) below;

i. Coverage of one hundred percent (100%) of the cost sharing for Medicare Part B preventive services after the policyholder pays the Part B deductible; and

j. Coverage of one hundred percent (100%) of all cost sharing under Medicare Parts A and B for the balance of the calendar year after the individual has reached the out-of-pocket limitation on annual expenditures under Medicare Parts A and B of $4000 in 2006, indexed each year by the appropriate inflation adjustment specified by the Secretary of the U.S. Department of Health and Human Services.

2. Standardized Medicare supplement benefit plan “L” shall consist of the following:

a. The benefits described in Paragraphs (1)(a), (b), (c) and (i);

b. The benefit described in Paragraphs (1)(d), (e), (f), (g) and (h), but substituting seventy-five percent (75%) for fifty percent (50%); and

c. The benefit described in Paragraph (1)(j), but substituting $2000 for $4000.

Rule 10.08.1: Benefit Standards For 2010 Standardized Medicare Supplement Benefit Plan Policies Or Certificates Issued For Delivery With An Effective Date For Coverage On Or After June 1, 2010

The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state with an effective date for delivery on or after June 1, 2010. No policy or certificate may be advertised, solicited, delivered, or issued for delivery in this state as a Medicare supplement policy or certificate unless it complies with these benefit standards. No issuer may offer any [1990 Standardized Medicare supplement benefit plan] for sale on or after June 1, 2010. Benefit standards applicable to Medicare supplement policies and certificates issued with an effective date for coverage prior to June 1, 2010 remain subject to the requirements of Miss. Code Ann. §83-9-101 to 115, and this regulation.

A. General Standards. The following standards apply to Medicare supplement policies and certificates and are in addition to all other requirements of this regulation.

1. A Medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate may not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.

2. A Medicare supplement policy or certificate shall not indemnify against losses resulting from sickness on a different basis than losses resulting from accidents.

3. A Medicare supplement policy or certificate shall provide that benefits designed to cover cost sharing amounts under Medicare will be changed automatically to coincide with any changes in the applicable Medicare deductible, co-payment, or coinsurance amounts. Premiums may be modified to correspond with such changes.

4. No Medicare supplement policy or certificate shall provide for termination of coverage of a spouse solely because of the occurrence of an event specified for termination of coverage of the insured, other than the nonpayment of premium.

5. Each Medicare supplement policy shall be guaranteed renewable.

a. The issuer shall not cancel or non-renew the policy solely on the ground of health status of the individual.

b. The issuer shall not cancel or non-renew the policy for any reason other than nonpayment of premium or material misrepresentation.

c. If the Medicare supplement policy is terminated by the group policyholder and is not replaced as provided under Rule 10.08.1A(5)(e) of this regulation, the issuer shall offer certificate holders an individual Medicare supplement policy which (at the option of the certificate holder):

i. Provides for continuation of the benefits contained in the group policy; or

ii. Provides for benefits that otherwise meet the requirements of this Subsection.

d. If an individual is a certificate holder in a group Medicare supplement policy and the individual terminates membership in the group, the issuer shall

i. Offer the certificate holder the conversion opportunity described in Rule 10.08.1A(5)(c) of this regulation; or

ii. At the option of the group policyholder, offer the certificate holder continuation of coverage under the group policy.

e. If a group Medicare supplement policy is replaced by another group Medicare supplement policy purchased by the same policyholder, the issuer of the replacement policy shall offer coverage to all persons covered under the old group policy on its date of termination. Coverage under the new policy shall not result in any exclusion for preexisting conditions that would have been covered under the group policy being replaced.

6. Termination of a Medicare supplement policy or certificate shall be without prejudice to any continuous loss which commenced while the policy was in force, but the extension of benefits beyond the period during which the policy was in force may be conditioned upon the continuous total disability of the insured, limited to the duration of the policy benefit period, if any, or payment of the maximum benefits. Receipt of Medicare Part D benefits will not be considered in determining a continuous loss.

7. a. A Medicare supplement policy or certificate shall provide that benefits and premiums under the policy or certificate shall be suspended at the request of the policyholder or certificate holder for the period (not to exceed twenty-four (24) months) in which the policyholder or certificate holder has applied for and is determined to be entitled to medical assistance under Title XIX of the Social Security Act, but only if the policyholder or certificate holder notifies the issuer of the policy or certificate within ninety (90) days after the date the individual becomes entitled to assistance.

b. If suspension occurs and if the policyholder or certificate holder loses entitlement to medical assistance, the policy or certificate shall be automatically reinstituted (effective as of the date of termination of entitlement) as of the termination of entitlement if the policyholder or certificate holder provides notice of loss of entitlement within ninety (90) days after the date of loss and pays the premium attributable to the period, effective as of the date of termination of entitlement.

c. Each Medicare supplement policy shall provide that benefits and premiums under the policy shall be suspended (for any period that may be provided by federal regulation) at the request of the policyholder if the policyholder is entitled to benefits under Section 226 (b) of the Social Security Act and is covered under a group health plan (as defined in Section 1862 (b)(1)(A)(v) of the Social Security Act). If suspension occurs and if the policyholder or certificate holder loses coverage under the group health plan, the policy shall be automatically reinstituted (effective as of the date of loss of coverage) if the policyholder provides notice of loss of coverage within ninety (90) days after the date of the loss and pays the premium attributable to the period, effective as of the date of termination of enrollment in the group health plan.

d. Reinstitution of coverages as described in Subparagraphs (b) and (c):

i. Shall not provide for any waiting period with respect to treatment of preexisting conditions;

ii. Shall provide for resumption of coverage that is substantially equivalent to coverage in effect before the date of suspension; and

iii. Shall provide for classification of premiums on terms at least as favorable to the policyholder or certificate holder as the premium classification terms that would have applied to the policyholder or certificate holder had the coverage not been suspended.

B. Standards for Basic (Core) Benefits Common to Medicare Supplement Insurance Benefit Plans A, B, C, D, F, F with High Deductible, G, M and N. Every issuer of Medicare supplement insurance benefit plans shall make available a policy or certificate including

only the following basic “core” package of benefits to each prospective insured. An issuer may make available to prospective insureds any of the other Medicare Supplement Insurance Benefit Plans in addition to the basic core package, but not in lieu of it.

1. Coverage of Part A Medicare eligible expenses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare benefit period;

2. Coverage of Part A Medicare eligible expenses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used;

3. Upon exhaustion of the Medicare hospital inpatient coverage, including the lifetime reserve days, coverage of one hundred percent (100%) of the Medicare Part A eligible expenses for hospitalization paid at the applicable prospective payment system (PPS) rate, or other appropriate Medicare standard of payment, subject to a lifetime maximum benefit of an additional 365 days. The provider shall accept the issuer’s payment as payment in full and may not bill the insured for any balance;

4. Coverage under Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in accordance with federal regulations;

5. Coverage for the coinsurance amount, or in the case of hospital outpatient department services paid under a prospective payment system, the co-payment amount, of Medicare eligible expenses under Part B regardless of hospital confinement, subject to the Medicare Part B deductible;

6. Hospice Care: Coverage of cost sharing for all Part A Medicare eligible hospice care and respite care expenses.

C. Standards for Additional Benefits. The following additional benefits shall be included in Medicare supplement benefit Plans B, C, D, F, F with High Deductible, G, M, and N as provided by Section 9.1 of this regulation.

1. Medicare Part A Deductible: Coverage for one hundred percent (100%) of the Medicare Part A inpatient hospital deductible amount per benefit period.

2. Medicare Part A Deductible: Coverage for fifty percent (50%) of the Medicare Part A inpatient hospital deductible amount per benefit period.

3. Skilled Nursing Facility Care: Coverage for the actual billed charges up to the coinsurance amount from the 21st day through the 100th day in a Medicare benefit period for post-hospital skilled nursing facility care eligible under Medicare Part A.

4. Medicare Part B Deductible: Coverage for one hundred percent (100%) of the Medicare Part B deductible amount per calendar year regardless of hospital confinement.

5. One Hundred Percent (100%) of the Medicare Part B Excess Charges: Coverage for all of the difference between the actual Medicare Part B charges as billed, not to exceed any charge limitation established by the Medicare program or state law, and the Medicare-approved Part B charge.

6. Medically Necessary Emergency Care in a Foreign Country: Coverage to the extent not covered by Medicare for eighty percent (80%) of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first sixty (60) consecutive days of each trip outside the United States, subject to a calendar year deductible of $250, and a lifetime maximum benefit of $50,000. For purposes of this benefit, “emergency care” shall mean care needed immediately because of an injury or an illness of sudden and unexpected onset.

Rule 10.09: Standard Medicare Supplement Benefit Plans For 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery after July 1, 1992 and with an Effective Date for Coverage Prior to June 1, 2010

A. An issuer shall make available to each prospective policyholder and certificate holder a policy form or certificate form containing only the basic core benefits, as defined in Rule 10.08B of this regulation.

B. No groups, packages or combinations of Medicare supplement benefits other than those listed in this section shall be offered for sale in this state, except as may be permitted in Rule10.09G and in Rule 10.10 of this regulation.

C. Benefit plans shall be uniform in structure, language, designation and format to the standard benefit plans “A” through “L” listed in this subsection and conform to the definitions in Rule 10.04 of this regulation. Each benefit shall be structured in accordance

with the format provided in Rules 10.08B and 10.08C,or 10.08D and list the benefits in the order shown in this subsection. For purposes of this section, “structure, language, and format” means style, arrangement and overall content of a benefit.

D. An issuer may use, in addition to the benefit plan designations required in Subsection C, other designations to the extent permitted by law.

E. Make-up of benefit plans:

1. Standardized Medicare supplement benefit plan “A” shall be limited to the basic (core) benefits common to all benefit plans, as defined in Rule 10.08B of this regulation.

2. Standardized Medicare supplement benefit plan “B” shall include only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible as defined in Rule 10.08C(1).

3. Standardized Medicare supplement benefit plan “C” shall include only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, Medicare Part B deductible and medically necessary emergency care in a foreign country as defined in Rules 10.08C(1), (2), (3) and (8) respectively.

4. Standardized Medicare supplement benefit plan “D” shall include only the following: The core benefit (as defined in Rule 10.08B of this regulation), plus the Medicare Part A deductible, skilled nursing facility care, medically necessary emergency care in an foreign country and the at-home recovery benefit as defined in Rules 10.08C(1), (2), (8) and (10) respectively.

5. Standardized Medicare supplement benefit plan “E” shall include only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, medically necessary emergency care in a foreign country and preventive medical care as defined in Rule 10.08C(1), (2), (8) and (9) respectively.

6. Standardized Medicare supplement benefit plan “F” shall include only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, the skilled nursing facility care, the Part B deductible, one hundred percent (100%) of the Medicare Part B excess charges, and medically necessary emergency care in a foreign country as defined in Rule 10.08C(1), (2), (3), (5) and (8) respectively.

7. Standardized Medicare supplement benefit high deductible plan “F” shall include only the following: 100% of covered expenses following the payment of the annual high deductible plan “F” deductible. The covered expenses include the core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A

deductible, skilled nursing facility care, the Medicare Part B deductible, one hundred percent (100%) of the Medicare Part B excess charges, and medically necessary emergency care in a foreign country as defined in Rule 10.08C(1), (2), (3), (5) and (8) respectively. The annual high deductible plan “F” deductible shall consist of out-of-pocket expenses, other than premiums, for services covered by the Medicare supplement plan “F” policy, and shall be in addition to any other specific benefit deductibles. The annual high deductible Plan “F” deductible shall be $1500 for 1998 and 1999, and shall be based on the calendar year. It shall be adjusted annually thereafter by the Secretary to reflect the change in the Consumer Price Index for all urban consumers for the twelve-month period ending with August of the preceding year, and rounded to the nearest multiple of $10.

8. Standardized Medicare supplement benefit plan “G” shall include only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, eighty percent (80%) of the Medicare Part B excess charges, medically necessary emergency care in a foreign country, and the at-home recovery benefit as defined in Rules 10.08C(1), (2), (4), (8) and (10) respectively.

9. Standardized Medicare supplement benefit plan “H” shall consist of only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, basic prescription drug benefit and medically necessary emergency care in a foreign country as defined in Rules 10.08C(1), (2), (6) and (8) respectively. The outpatient prescription drug benefit shall not be included in a Medicare supplement policy sold after December 31, 2005.

10. Standardized Medicare supplement benefit plan “I” shall consist of only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, one hundred percent (100%) of the Medicare Part B excess charges, basic prescription drug benefit, medically necessary emergency care in a foreign country and at-home recovery benefit as defined in Rules 10.08C(1), (2), (5), (6), (8) and (10) respectively. The outpatient prescription drug benefit shall not be included in a Medicare supplement policy sold after December 31, 2005.

11. Standardized Medicare supplement benefit plan “J” shall consist of only the following: The core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, Medicare Part B deductible, one hundred percent (100%) of the Medicare Part B excess charges, extended prescription drug benefit, medically necessary emergency care in a foreign country, preventive medical care and at- home recovery benefit as defined in Rules 10.08C(1), (2), (3), (5), (7), (8), (9) and (10) respectively. The outpatient prescription drug benefit shall not be included in a Medicare supplement policy sold after December 31, 2005.

12. Standardized Medicare supplement benefit high deductible plan “J” shall consist of only the following: 100% of covered expenses following the payment of the annual high deductible plan “J” deductible. The covered expenses include the core benefit as defined in Rule 10.08B of this regulation, plus the Medicare Part A deductible, skilled nursing facility care, Medicare Part B deductible, one hundred percent (100%) of the Medicare Part B excess charges, extended outpatient prescription drug benefit, medically necessary emergency care in a foreign country, preventive medical care benefit and at-home recovery benefit as defined in Rules 10.08C(1), (2), (3), (5), (7), (8), (9) and (10) respectively. The annual high deductible plan “J” deductible shall consist of out-of-pocket expenses, other than premiums, for services covered by the Medicare supplement plan “J” policy, and shall be in addition to any other specific benefit deductibles. The annual deductible shall be $1500 for 1998 and 1999, and shall be based on a calendar year. It shall be adjusted annually thereafter by the Secretary to reflect the change in the Consumer Price Index for all urban consumers for the twelve-month period ending with August of the preceding year, and rounded to the nearest multiple of $10. The outpatient prescription drug benefit shall not be included in a Medicare supplement policy sold after December 31, 2005.

F. Make-up of two Medicare supplement plans mandated by The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA);

1. Standardized Medicare supplement benefit plan “K” shall consist of only those benefits described in Rule 10.08 D(1).

2. Standardized Medicare supplement benefit plan “L” shall consist of only those benefits described in Rule 10.08 D(2).

G. New or Innovative Benefits: An issuer may, with the prior approval of the commissioner, offer policies or certificates with new or innovative benefits in addition to the benefits provided in a policy or certificate that otherwise complies with the applicable standards. The new or innovative benefits may include benefits that are appropriate to Medicare supplement insurance, new or innovative, not otherwise available, cost-effective, and offered in a manner that is consistent with the goal of simplification of Medicare supplement policies. After December 31, 2005, the innovative benefit shall not include an outpatient prescription drug benefit.

Rule 10.09.1: Standard Medicare Supplement Benefit Plans for 2010 Standardized Supplement Benefit Plan Policies or Certificates Issued for Delivery Effective Date for Coverage on or After June 10, 2010

The following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state with an effective date for coverage on or after June 1, 2010. No policy or certificate may be advertised, solicited, delivered or issued for delivery in

this state as a Medicare supplement policy or certificate unless it complies with these benefit

plan standards. Benefit plan standards applicable to Medicare supplement policies and certificates with an effective date for coverage before June 1, 2010 remain subject to the requirements of Miss. Code Ann. § 83-9-101 to 115, and this regulation.

A. 1. An issuer shall make available to each prospective policyholder and certificate holder a policy form or certificate form containing only the basic (core) benefits, as defined in Rule 10.08.1B of this regulation.

2. If an issuer makes available any of the additional benefits described in Rule 10.08.1C, or offers standardized benefit Plans K or L (as described in Rules 10.09.1E(8) and (9) of this regulation), then the issuer shall make available to each prospective policyholder and certificate holder, in addition to a policy form or certificate form with only the basic (core) benefits as described in subsection A(1) above, a policy form or certificate form containing either standardized benefit Plan C (as described in Rule 10.09.1E(3) of this regulation) or standardized benefit Plan F (as described in Rule 10.09.1E(5) of this regulation).

B. No groups, packages or combinations of Medicare supplement benefits other than those listed in this Section shall be offered for sale in this state, except as may be permitted in Rule 10.09.1F and in Rule 10.0 of this regulation.

C. Benefit plans shall be uniform in structure, language, designation and format to the standard benefit plans listed in this Subsection and conform to the definitions in Rule 10.0 4 of this regulation. Each benefit shall be structured in accordance with the format provided in Rules 10.08.1B and 10.08.1C of this regulation; or, in the case of plans K or L, in Rule 10.09.1E(8) or (9) of this regulation and list the benefits in the order shown. For purposes of this Section, “structure, language, and format” means style, arrangement and overall content of a benefit.

D. In addition to the benefit plan designations required in Subsection C of this section, an issuer may use other designations to the extent permitted by law.

E. Make‐up of 2010 Standardized Benefit Plans:

1. Standardized Medicare supplement benefit Plan A shall include only the following: The basic (core) benefits as defined in Rule 10.08.1B of this regulation.

2. Standardized Medicare supplement benefit Plan B shall include only the following: The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus one hundred percent (100%) of the Medicare Part A deductible as defined in Rule 10.08.1C(1) of this regulation.

3. Standardized Medicare supplement benefit Plan C shall include only the following: The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus one hundred percent (100%) of the Medicare Part A deductible, skilled nursing facility care, one hundred percent (100%) of the Medicare Part B deductible, and medically necessary emergency care in a foreign country as defined in Rules 10.08.1C(1), (3), (4), and (6) of this regulation, respectively.

4. Standardized Medicare supplement benefit Plan D shall include only the following: The basic (core) benefit (as defined in Rule 10.08.1B of this regulation), plus one hundred percent (100%) of the Medicare Part A deductible, skilled nursing facility care, and medically necessary emergency care in an foreign country as defined in Rule 10.08.1C(1), (3), and (6) of this regulation, respectively.

5. Standardized Medicare supplement [regular] Plan F shall include only the following: The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus one hundred percent (100%) of the Medicare Part A deductible, the skilled nursing facility care, one hundred percent (100%) of the Medicare Part B deductible, one hundred percent (100%) of the Medicare Part B excess charges, and medically necessary emergency care in a foreign country as defined in Rule 10.08.1C(1), (3), (4), (5), and (6), respectively.

6. Standardized Medicare supplement Plan F with High Deductible shall include only the following: one hundred percent (100%) of covered expenses following the payment of the annual deductible set forth in Subparagraph (b).

a. The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus one hundred percent (100%) of the Medicare Part A deductible, skilled nursing facility care, one hundred percent (100%) of the Medicare Part B deductible, one hundred percent (100%) of the Medicare Part B excess charges, and medically necessary emergency care in a foreign country as defined in Rule 10.08.1C(1), (3), (4), (5), and (6) of this regulation, respectively.

b. The annual deductible in Plan F with High Deductible shall consist of out-of-pocket expenses, other than premiums, for services covered by [regular] Plan F, and shall be in addition to any other specific benefit deductibles. The basis for the deductible shall be $1,500 and shall be adjusted annually from 1999 by the Secretary of the U.S. Department of Health and Human Services to reflect the change in the Consumer Price Index for all urban consumers for the twelve-month period ending with August of the preceding year, and rounded to the nearest multiple of ten dollars ($10).

7. Standardized Medicare supplement benefit Plan G shall include only the following: The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus one hundred percent (100%) of the Medicare Part A deductible, skilled nursing facility care, one hundred percent (100%) of the Medicare Part B excess charges, and medically necessary emergency care in a foreign country as defined in Rule 10.08.1C(1), (3), (5), and (6), respectively.

8. Standardized Medicare supplement Plan K is mandated by The Medicare Prescription Drug, Improvement and Modernization Act of 2003, and shall include only the following:

a. Part A Hospital Coinsurance 61st through 90th days: Coverage of one hundred percent (100%) of the Part A hospital coinsurance amount for each day used from the 61st through the 90th day in any Medicare benefit period;

b. Part A Hospital Coinsurance, 91st through 150th days: Coverage of one hundred percent (100%) of the Part A hospital coinsurance amount for each Medicare lifetime inpatient reserve day used from the 91st through the 150th day in any Medicare benefit period;

c. Part A Hospitalization After 150 Days: Upon exhaustion of the Medicare hospital inpatient coverage, including the lifetime reserve days, coverage of one hundred percent (100%) of the Medicare Part A eligible expenses for hospitalization paid at the applicable prospective payment system (PPS) rate, or other appropriate Medicare standard of payment, subject to a lifetime maximum benefit of an additional 365 days. The provider shall accept the issuer’s payment as payment in full and may not bill the insured for any balance;

d. Medicare Part A Deductible: Coverage for fifty percent (50%)

of the Medicare Part A inpatient hospital deductible amount per benefit period until the out‐of‐pocket limitation is met as described in Subparagraph (j);

e. Skilled Nursing Facility Care: Coverage for fifty percent (50%) of the coinsurance amount for each day used from the 21st day through the 100th day in a Medicare benefit period for post‐hospital skilled nursing facility care eligible under Medicare Part A until the out‐of‐pocket limitation is met as described in Subparagraph (j);

f. Hospice Care: Coverage for fifty percent (50%) of cost sharing for all Part A Medicare eligible expenses and respite care until the out‐of‐pocket limitation is met as described in Subparagraph (j);

g. Blood: Coverage for fifty percent (50%), under Medicare Part A or B, of the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in accordance with federal regulations until the out‐of‐pocket limitation is met as described in Subparagraph (j);

h. Part B Cost Sharing: Except for coverage provided in Subparagraph (i), coverage for fifty percent (50%) of the cost sharing otherwise applicable under Medicare Part B after the policyholder pays the Part B deductible until the out‐of‐pocket limitation is met as described in Subparagraph (j);

i. Part B Preventive Services: Coverage of one hundred percent (100%) of the cost sharing for Medicare Part B preventive services after the policyholder pays the Part B deductible; and

j. Cost Sharing After Out‐of‐Pocket Limits: Coverage of one hundred percent (100%) of all cost sharing under Medicare Parts A and B for the balance of the calendar year after the individual has reached the out‐of‐ pocket limitation on annual expenditures under Medicare Parts A and B of $4000 in 2006, indexed each year by the appropriate inflation adjustment specified by the Secretary of the U.S. Department of Health and Human Services.

9. Standardized Medicare supplement Plan L is mandated by The Medicare Prescription Drug, Improvement and Modernization Act of 2003, and shall include only the following:

a. The benefits described in Paragraphs 9.1E (8) (a), (b), (c) and (i);

b. The benefit described in Paragraphs 9.1E (8)(d), (e), (f), (g) and (h), but substituting seventy‐five percent (75%) for fifty percent (50%); and

c. The benefit described in Paragraph 9.1E(8)(j), but substituting $2000 for $4000.

10. Standardized Medicare supplement Plan M shall include only the following: The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus fifty percent (50%) of the Medicare Part A deductible, skilled nursing facility care, and medically necessary emergency care in a foreign country as defined in Rules 10.08.1C(2), (3) and (6) of this regulation, respectively.

11. Standardized Medicare supplement Plan N shall include only the following: The basic (core) benefit as defined in Rule 10.08.1B of this regulation, plus one hundred percent (100%) of the Medicare Part A deductible, skilled nursing facility care, and medically necessary emergency care in a foreign country as defined in Rules 10.08.1C(1), (3) and (6) of this regulation, respectively, with co‐ payments in the following amounts:

a. The lesser of twenty dollars ($20) or the Medicare Part B coinsurance or co‐payment for each covered health care provider office visit (including visits to medical specialists); and

b. The lesser of fifty dollars ($50) or the Medicare Part B coinsurance or co‐ payment for each covered emergency room visit, however, this co‐ payment shall be waived if the insured is admitted to any hospital and the emergency visit is subsequently covered as a Medicare Part A expense.

F. New or Innovative Benefits: An issuer may, with the prior approval of the commissioner, offer policies or certificates with new or innovative benefits, in addition to the standardized benefits provided in a policy or certificate that otherwise complies with the applicable standards. The new or innovative benefits shall include only benefits that are appropriate to Medicare supplement insurance, are new or innovative, are not otherwise available, and are cost-effective. Approval of new or innovative benefits must not adversely impact the goal of Medicare supplement simplification. New or innovative benefits shall not include an outpatient prescription drug benefit. New or innovative benefits shall not be used to change or reduce benefits, including a change of any cost-sharing provision, in any standardized plan.

History

• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)

19 Miss. Admin. Code Pt. 3, R. 10.09.2 Rule 10.09.2

Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare on or After January 1, 2020.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the following standards are applicable to all Medicare supplement policies or certificates delivered or issued for delivery in this state to individuals newly eligible for Medicare on or after January 1, 2020. No policy or certificate that provides coverage of the Medicare Part B deductible may be advertised, solicited, delivered or issued for delivery in this state as a Medicare supplement policy or certificate to individuals newly eligible for Medicare on or after January 1, 2020. All policies must comply with the following benefit standards. Benefit plan standards applicable to Medicare supplement policies and certificates issued to individuals eligible for Medicare before January 1, 2020, remain subject to the requirements of Miss. Code Ann. § 83-9-101 to 115, and this regulation.

A. Benefit Requirements. The standards and requirements of Rule 10.09.1 shall apply to all Medicare supplement policies or certificates delivered or issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020, with the following exceptions:

1. Standardized Medicare supplement benefit Plan C is redesignated as Plan D and shall provide the benefits contained in Rule 10.09.1E(3) of this regulation but shall not provide coverage for one hundred percent (100%) or any portion of the Medicare Part B deductible.

2. Standardized Medicare supplement benefit Plan F is redesignated as Plan G and shall provide the benefits contained in Rule 10.09.1E(5) of this regulation but shall not provide coverage for one hundred percent (100%) or any portion of the Medicare Part B deductible.

3. Standardized Medicare supplement benefit plans C, F, and F with High Deductible may not be offered to individuals newly eligible for Medicare on or after January 1, 2020.

4. Standardized Medicare supplement benefit Plan F With High Deductible is redesignated as Plan G With High Deductible and shall provide the benefits contained in Rule 10.09.1E(6) of this regulation but shall not provide coverage for one hundred percent (100%) or any portion of the Medicare Part B deductible; provided further that, the Medicare Part B deductible paid by the beneficiary shall be considered an out-of- pocket expense in meeting the annual high deductible.

5. The reference to Plans C or F contained in Rule 10.09.1A(2) is deemed a reference to Plans D or G for purposes of this section.

B. Applicability to Certain Individuals. This Rule 10.09.2, applies to only individuals that are newly eligible for Medicare on or after January 1, 2020:

1. By reason of attaining age 65 on or after January 1, 2020; or

2. By reason of entitlement to benefits under part A pursuant to Section 226(b) or 226A of the Social Security Act, or who is deemed to be eligible for benefits under Section 226(a) of the Social Security Act on or after January 1, 2020.

C. Guaranteed Issue for Eligible Persons. For purposes of Rule 10.12E, in the case of any individual newly eligible for Medicare on or after January 1, 2020, any reference to a Medicare supplement policy C or F (including F With High Deductible) shall be deemed to be a reference to Medicare supplement policy D or G (including G With High Deductible), respectively, that meet the requirements of this Rule 10.09.2A.

D. Applicability to Waivered States. In the case of a State described in Section 1882(p)(6) of the Social Security Act (“waivered” alternative simplification states) MACRA prohibits the coverage of the Medicare Part B deductible for any Medicare supplement policy sold or issued to an individual that is newly eligible for Medicare on or after January 1, 2020.

E. Offer of Redesignated Plans to Individuals Other Than Newly Eligible. On or after January 1, 2020, the standardized benefit plans described in Subparagraph A(4), above may be offered to any individual who was eligible for Medicare prior to January 1, 2020, in addition to the standardized plans described in Rule 10.09.1E of this regulation.

Rule 10.10: Medicare Select Policies and Certificates

A. 1. This section shall apply to Medicare Select policies and certificates, as defined in this section.

2. No policy or certificate may be advertised as a Medicare Select policy or certificate unless it meets the requirements of this section.

B. For the purposes of this section:

1. “Complaint” means any dissatisfaction expressed by an individual concerning a Medicare Select issuer or its network providers.

2. “Grievance” means dissatisfaction expressed in writing by an individual insured under a Medicare Select policy or certificate with the administration, claims practices, or provision of services concerning a Medicare Select issuer or its network providers.

3. “Medicare Select issuer” means an issuer offering, or seeking to offer, a Medicare Select policy or certificate.

4. “Medicare Select policy” or “Medicare Select certificate” mean respectively a Medicare supplement policy or certificate that contains restricted network provisions.

5. “Network provider” means a provider of health care, or a group of providers of health care, which has entered into a written agreement with the issuer to provide benefits insured under a Medicare Select policy.

6. “Restricted network provision” means any provision which conditions the payment of benefits, in whole or in part, on the use of network providers.

7. “Service area” means the geographic area approved by the commissioner within which an issuer is authorized to offer a Medicare Select policy.

C. The commissioner may authorize an issuer to offer a Medicare Select policy or certificate, pursuant to this section and Section 4358 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 if the commissioner finds that the issuer has satisfied all of the requirements of this regulation.

D. A Medicare Select issuer shall not issue a Medicare Select policy or certificate in this state until its plan of operation has been approved by the commissioner.

E. A Medicare Select issuer shall file a proposed plan of operation with the commissioner in a format prescribed by the commissioner. The plan of operation shall contain at least the following information:

1. Evidence that all covered services that are subject to restricted network

provisions are available and accessible through network providers, including a demonstration that:

a. Services can be provided by network providers with reasonable promptness with respect to geographic location, hours of operation and after-hour care. The hours of operation and availability of after-hour care shall reflect usual practice in the local area. Geographic availability shall reflect the usual travel times within the community.

b. The number of network providers in the service area is sufficient, with respect to current and expected policyholders, either:

i. To deliver adequately all services that are subject to a restricted network provision; or

ii. To make appropriate referrals.

c. There are written agreements with network providers describing specific responsibilities.

d. Emergency care is available twenty-four (24) hours per day and seven (7) days per week.

e. In the case of covered services that are subject to a restricted network provision and are provided on a prepaid basis, there are written agreements with network providers prohibiting the providers from billing or otherwise seeking reimbursement from or recourse against any individual insured under a Medicare Select policy or certificate. This paragraph shall not apply to supplemental charges or coinsurance amounts as stated in the Medicare Select policy or certificate.

2. A statement or map providing a clear description of the service area. 3. A description of the grievance procedure to be utilized. 4. A description of the quality assurance program, including:

a. The formal organizational structure;

b. The written criteria for selection, retention and removal of network providers; and

c. The procedures for evaluating quality of care provided by network providers, and the process to initiate corrective action when warranted.

5. A list and description, by specialty, of the network providers.

6. Copies of the written information proposed to be used by the issuer to comply with Subsection I.

7. Any other information requested by the commissioner.

F. 1. A Medicare Select issuer shall file any proposed changes to the plan of operation, except for changes to the list of network providers, with the commissioner prior to implementing the changes. Changes shall be considered approved by the commissioner after thirty (30) days unless specifically disapproved. 2. An updated list of network providers shall be filed with the commissioner at least quarterly.

G. A Medicare Select policy or certificate shall not restrict payment for covered services provided by non-network providers if:

1. The services are for symptoms requiring emergency care or are immediately required for an unforeseen illness, injury or a condition; and

2. It is not reasonable to obtain services through a network provider.

H. A Medicare Select policy or certificate shall provide payment for full coverage under the policy for covered services that are not available through network providers.

I. A Medicare Select issuer shall make full and fair disclosure in writing of the provisions, restrictions and limitations of the Medicare Select policy or certificate to each applicant. This disclosure shall include at least the following:

1. An outline of coverage sufficient to permit the applicant to compare the coverage and premiums of the Medicare Select policy or certificate with:

a. Other Medicare supplement policies or certificates offered by the issuer; and

b. Other Medicare Select policies or certificates.

2. A description (including address, phone number and hours of operation) of the network providers, including primary care physicians, specialty physicians, hospitals and other providers.

3. A description of the restricted network provisions, including payments for coinsurance and deductibles when providers other than network providers are utilized. Except to the extent specified in the policy or certificate, expenses incurred when using out-of-network providers do not count toward the out-of- pocket annual limit contained in plans K and L.

4. A description of coverage for emergency and urgently needed care and other out- of- service area coverage.

5. A description of limitations on referrals to restricted network providers and to other providers.

6. A description of the policyholder’s rights to purchase any other Medicare supplement policy or certificate otherwise offered by the issuer.

7. A description of the Medicare Select issuer’s quality assurance program and grievance procedure.

J. Prior to the sale of a Medicare Select policy or certificate, a Medicare Select issuer shall obtain from the applicant a signed and dated form stating that the applicant has received the information provided pursuant to Subsection I of this section and that the applicant understands the restrictions of the Medicare Select policy or certificate.

K. A Medicare Select issuer shall have and use procedures for hearing complaints and resolving written grievances from the subscribers. The procedures shall be aimed at mutual agreement for settlement and may include arbitration procedures.

1. The grievance procedure shall be described in the policy and certificates and in the outline of coverage.

2. At the time the policy or certificate is issued, the issuer shall provide detailed information to the policyholder describing how a grievance may be registered with the issuer.

3. Grievances shall be considered in a timely manner and shall be transmitted to appropriate decision-makers who have authority to fully investigate the issue and take corrective action.

4. If a grievance is found to be valid, corrective action shall be taken promptly.

5. All concerned parties shall be notified about the results of a grievance.

6. The issuer shall report no later than each March 31st to the commissioner regarding its grievance procedure. The report shall be in a format prescribed by the commissioner and shall contain the number of grievances filed in the past year and a summary of the subject, nature and resolution of such grievances.

L. At the time of initial purchase, a Medicare Select issuer shall make available to each applicant for a Medicare Select policy or certificate the opportunity to purchase any Medicare supplement policy or certificate otherwise offered by the issuer.

M. 1. At the request of an individual insured under a Medicare Select policy or certificate, a Medicare Select issuer shall make available to the individual insured the opportunity to purchase a Medicare supplement policy or certificate offered by the issuer which has comparable or lesser benefits and which does not contain a restricted network provision. The issuer shall make the policies or certificates available without requiring evidence of insurability after the Medicare Select policy or certificate has been in force for six (6) months.

2. For the purposes of this subsection, a Medicare supplement policy or certificate will be considered to have comparable or lesser benefits unless it contains one or more significant benefits not included in the Medicare Select policy or certificate being replaced. For the purposes of this paragraph, a significant benefit means coverage for the Medicare Part A deductible, coverage for at-home recovery services or coverage for Part B excess charges.

N. Medicare Select policies and certificates shall provide for continuation of coverage in the event the Secretary of Health and Human Services determines that Medicare Select policies and certificates issued pursuant to this section should be discontinued due to either the failure of the Medicare Select Program to be reauthorized under law or its substantial amendment.

1. Each Medicare Select issuer shall make available to each individual insured under a Medicare Select policy or certificate the opportunity to purchase any Medicare supplement policy or certificate offered by the issuer which has comparable or lesser benefits and which does not contain a restricted network provision. The issuer shall make the policies and certificates available without requiring evidence of insurability.

2. For the purposes of this subsection, a Medicare supplement policy or certificate will be considered to have comparable or lesser benefits unless it contains one or more significant benefits not included in the Medicare Select policy or certificate being replaced. For the purposes of this paragraph, a significant benefit means coverage for the Medicare Part A deductible, coverage for at-home recovery services or coverage for Part B excess charges.

O. A Medicare Select issuer shall comply with reasonable requests for data made by state or federal agencies, including the United States Department of Health and Human Services, for the purpose of evaluating the Medicare Select Program.

Rule 10.11: Open Enrollment

A. An issuer shall not deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in this state, nor discriminate in the pricing of a policy or certificate because of the health status, claims experience, receipt of health care, or medical condition of an applicant in the case of an application for a policy or certificate that is submitted prior to or during the six (6) month period beginning with the latter of the first day: of the first month in which an individual is both sixty-five years of age or older and is enrolled for benefits under Medicare Part B Each Medicare supplement policy and certificate currently available from an insurer shall be made available to all applicants who qualify under this subsection without regard to age.

B. 1. If an applicant qualifies under Subsection A and submits an application during the time period referenced in Subsection A and, as of the date of application, has had a continuous period of creditable coverage of at least six (6) months, the issuer shall not exclude benefits based on

a preexisting condition.

2. If the applicant qualifies under Subsection A and submits an application during the time period referenced in Subsection A and, as of the date of application, has had a continuous period of creditable coverage that is less than six (6) months, the issuer shall reduce the period of any preexisting condition exclusion by the aggregate of the period of creditable coverage applicable to the applicant as of the enrollment date. The Secretary shall specify the manner of the reduction under this subsection.

C. Except as provided in Subsection B and Sections Rules 10.12 and 10.23, Subsection A shall not be construed as preventing the exclusion of benefits under a policy, during the first six (6) months, based on a preexisting condition for which the policyholder or certificate holder received treatment or was otherwise diagnosed during the six (6) months before the coverage became effective.

Rule 10.12: Guaranteed Issue for Eligible Persons

A. Guaranteed Issue.

1. Eligible persons are those individuals described in Subsection B who seek to enroll under the policy during the period specified in Subsection C, and who submit evidence of the date of termination, disenrollment, or Medicare Part D enrollment with the application for a Medicare supplement policy.

2. With respect to eligible persons, an issuer shall not deny or condition the issuance or effectiveness of a Medicare supplement policy described in Subsection E that is offered and is available for issuance to new enrollees by the issuer, shall not discriminate in the pricing of such a Medicare supplement policy because of health status, claims experience, receipt of health care, or medical condition, and shall not impose an exclusion of benefits based on a preexisting condition under such a Medicare supplement policy.

B. Eligible Persons. An eligible person is an individual described in any of the following paragraphs:

1. The individual is enrolled under an employee welfare benefit plan that provides health benefits that supplement the benefits under Medicare; and the plan terminates, or the plan ceases to provide all such supplemental health benefits to the individual;

2. The individual is enrolled with a Medicare Advantage organization under a Medicare Advantage plan under part C of Medicare, and any of the following circumstances apply, or the individual is 65 years of age or older and is enrolled with a Program of All-Inclusive Care for the Elderly (PACE) provider under Section 1894 of the Social Security Act, and there are circumstances similar to those described below that would permit discontinuance of the individual’s enrollment with such provider if such individual were enrolled in a Medicare Advantage plan:

a. The certification of the organization or plan has been terminated;

b. The organization has terminated or otherwise discontinued providing the plan in the area in which the individual resides;

c. The individual is no longer eligible to elect the plan because of a change in the individual’s place of residence or other change in circumstances specified by the Secretary, but not including termination of the individual’s enrollment on the basis described in Section 1851(g)(3)(B) of the federal Social Security Act (where the individual has not paid premiums on a timely basis or has engaged in disruptive behavior as specified in standards under Section 1856), or the plan is terminated for all individuals within a residence area;

d. The individual demonstrates, in accordance with guidelines established by the Secretary, that:

i. The organization offering the plan substantially violated a material provision of the organization’s contract under this part in relation to the individual, including the failure to provide an enrollee on a timely basis medically necessary care for which benefits are available under the plan or the failure to provide such covered care in accordance with applicable quality standards; or

ii. The organization, or agent or other entity acting on the organization’s behalf, materially misrepresented the plan’s provisions in marketing the plan to the individual; or

e. The individual meets such other exceptional conditions as the Secretary may provide.

3. a. The individual is enrolled with:

i. An eligible organization under a contract under Section 1876 of the Social Security Act (Medicare cost);

ii. A similar organization operating under demonstration project authority, effective for periods before April 1, 1999;

iii. An organization under an agreement under Section 1833(a)(1)(A) of the Social Security Act (health care prepayment plan); or iv. An organization under a Medicare Select policy; and b. The enrollment ceases under the same circumstances that would permit discontinuance of an individual’s election of coverage under Rule 10.12B (2).

4. The individual is enrolled under a Medicare supplement policy and the enrollment ceases because:

a. i. Of the insolvency of the issuer or bankruptcy of the non-issuer organization; or

ii. Of other involuntary termination of coverage or enrollment under the policy;

b. The issuer of the policy substantially violated a material provision of the policy; or

c. The issuer, or an agent or other entity acting on the issuer's behalf, materially misrepresented the policy’s provisions in marketing the policy to the individual;

5. a. The individual was enrolled under a Medicare supplement policy and terminates enrollment and subsequently enrolls, for the first time, with any Medicare Advantage organization under a Medicare Advantage plan under part C of Medicare, any eligible organization under a contract under Section 1876 of the Social Security Act (Medicare cost), any similar organization operating under demonstration project authority, any PACE provider under Section 1894 of the Social Security Act or a Medicare Select policy; and

b. The subsequent enrollment under subparagraph (a) is terminated by the enrollee during any period within the first twelve (12) months of such subsequent enrollment (during which the enrollee is permitted to terminate such subsequent enrollment under Section 1851(e) of the federal Social Security Act); or

6. The individual, upon first becoming eligible for benefits under part A of Medicare at age 65, enrolls in a Medicare Advantage plan under part C of Medicare, or with a PACE provider under Section 1894 of the Social Security Act, and disenrolls from the plan or program by not later than twelve (12) months after the effective date of enrollment.

7. The individual enrolls in a Medicare Part D plan during the initial enrollment period and, at the time of enrollment in Part D, was enrolled under a Medicare supplement policy that covers outpatient prescription drugs and the individual terminates enrollment in the Medicare supplement policy and submits evidence of enrollment in Medicare Part D along with the application for a policy described in Subsection E(4).

C. Guaranteed Issue Time Periods.

1. In the case of an individual described in Subsection B(1), the guaranteed issue period begins on the later of: (i) the date the individual receives a notice of termination or cessation of all supplemental health benefits (or, if a notice is not received, notice that a claim has been denied because of a termination or cessation); or (ii) the date that the applicable coverage terminates or ceases; and ends sixty-three (63) days thereafter;

2. In the case of an individual described in Subsection B(2), B(3), B(5) or B(6) whose enrollment is terminated involuntarily, the guaranteed issue period begins on the date that the individual receives a notice of termination and ends sixty- three (63) days after the date the applicable coverage is terminated;

3. In the case of an individual described in Subsection B(4)(a), the guaranteed issue period begins on the earlier of: (i) the date that the individual receives a notice of termination, a notice of the issuer’s bankruptcy or insolvency, or other such similar notice if any, and (ii) the date that the applicable coverage is terminated, and ends on the date that is sixty-three (63) days after the date the coverage is terminated;

4. In the case of an individual described in Subsection B(2), B(4)(b), B(4)(c), B(5) or B(6) who disenrolls voluntarily, the guaranteed issue period begins on the date that is sixty (60) days before the effective date of the disenrollment and ends on the date that is sixty-three (63) days after the effective date;

5. In the case of an individual described in Subsection B(7), the guaranteed issue period begins on the date the individual receives notice pursuant to Section 1882(v)(2)(B) of the Social Security Act from the Medicare supplement issuer during the sixty-day period immediately preceding the initial Part D enrollment period and ends on the date that is sixty- three (63) days after the effective date of the individual’s coverage under Medicare Part D; and

6. In the case of an individual described in Subsection B but not described in the preceding provisions of this Subsection, the guaranteed issue period begins on the effective date of disenrollment and ends on the date that is sixty-three (63) days after the effective date.

D. Extended Medigap Access for Interrupted Trial Periods.

1. In the case of an individual described in Subsection B(5) (or deemed to be so described, pursuant to this paragraph) whose enrollment with an organization or provider described in Subsection B(5)(a) is involuntarily terminated within the first twelve (12) months of enrollment, and who, without an intervening enrollment, enrolls with another such organization or provider, the subsequent enrollment shall be deemed to be an initial enrollment described in Rule 10.12B(5);

2. In the case of an individual described in Subsection B(6) (or deemed to be so described, pursuant to this paragraph) whose enrollment with a plan or in a program described in Subsection B(6) is involuntarily terminated within the first twelve (12) months of enrollment, and who, without an intervening enrollment, enrolls in another such plan or program, the subsequent enrollment shall be deemed to be an initial enrollment described in Rule 10.12B(6); and

3. For purposes of Subsections B(5) and B(6), no enrollment of an individual with an organization or provider described in Subsection B(5)(a), or with a plan or in a program described in Subsection B(6), may be deemed to be an initial enrollment under this paragraph after the two-year period beginning on the date on which the individual first enrolled with such an organization, provider, plan or program.

E. Products to Which Eligible Persons are Entitled. The Medicare supplement policy to which eligible persons are entitled under:

1. Rule 10.12B(1), (2), (3) and (4) is a Medicare supplement policy which has a benefit package classified as Plan A, B, C, F (including F with a high deductible), K or L offered by any

issuer.

2. a. Subject to Subparagraph (b), Rule 10.12B(5) is the same Medicare supplement policy in which the individual was most recently previously enrolled, if available from the same issuer, or, if not so available, a policy described in Paragraph (1);

b. After December 31, 2005, if the individual was most recently enrolled in a Medicare supplement policy with an outpatient prescription drug benefit, a Medicare supplement policy described in this subparagraph is:

i. The policy available from the same issuer but modified to remove outpatient prescription drug coverage; or

ii. At the election of the policyholder, an A, B, C, F (including F with a high deductible), K or L policy that is offered by any issuer;

3. Rule 10.12B(6) shall include any Medicare supplement policy offered by any issuer;

4. Rule 10.12B(7) is a Medicare supplement policy that has a benefit package classified as Plan A, B, C, F (including F with a high deductible), K or L, and that is offered and is available for issuance to new enrollees by the same issuer that issued the individual’s Medicare supplement policy with outpatient prescription drug coverage.

F. Notification provisions.

1. At the time of an event described in Subsection B of this section because of which an individual loses coverage or benefits due to the termination of a contract or agreement, policy, or plan, the organization that terminates the contract or agreement, the issuer terminating the policy, or the administrator of the plan being terminated, respectively, shall notify the individual of his or her rights under this section, and of the obligations of issuers of Medicare supplement policies under Subsection A. Such notice shall be communicated contemporaneously with the notification of termination.

2. At the time of an event described in Subsection B of this section because of which an individual ceases enrollment under a contract or agreement, policy, or plan, the organization that offers the contract or agreement, regardless of the basis for the cessation of enrollment, the issuer offering the policy, or the administrator of the plan, respectively, shall notify the individual of his or her rights under this section, and of the obligations of issuers of Medicare supplement policies under Rule 10.12A. Such notice shall be communicated within ten working days of the issuer receiving notification of disenrollment.

Rule 10.13: Standards for Claims Payment

A. An issuer shall comply with Section 1882(c)(3) of the Social Security Act (as enacted by section 4081(b)(2)(C) of the Omnibus Budget Reconciliation Act of 1987 (OBRA) 1987, Pub. L. No. 100- 203) by:

1. Accepting a notice from a Medicare carrier on dually assigned claims submitted by participating physicians and suppliers as a claim for benefits in place of any other claim form otherwise required and making a payment determination on the basis of the information contained in that notice;

2. Notifying the participating physician or supplier and the beneficiary of the payment determination;

3. Paying the participating physician or supplier directly;

4. Furnishing, at the time of enrollment, each enrollee with a card listing the policy name, number and a central mailing address to which notices from a Medicare carrier may be sent;

5. Paying user fees for claim notices that are transmitted electronically or otherwise; and

6. Providing to the Secretary of Health and Human Services, at least annually, a central mailing address to which all claims may be sent by Medicare carriers.

B. Compliance with the requirements set forth in Subsection A above shall be certified on the Medicare supplement insurance experience reporting form.

Rule 10.14: Loss Ratio Standards and Refund or Credit Of Premium

A. Loss Ratio Standards.

1. a. A Medicare Supplement policy form or certificate form shall not be delivered or issued for delivery unless the policy form or certificate form can be expected, as estimated for the entire period for which rates are computed to provide coverage, to return to policyholders and certificate holders in the form of aggregate benefits (not including anticipated refunds or credits) provided under the policy form or certificate form:

i. At least seventy-five percent (75%) of the aggregate amount of premiums earned in the case of group policies; or

ii. At least sixty-five percent (65%) of the aggregate amount of premiums earned in the case of individual policies;

b. Calculated on the basis of incurred claims experience or incurred health care expenses where coverage is provided by a health maintenance organization on a service rather than reimbursement basis and earned premiums for the period and in accordance with accepted actuarial principles and practices. Incurred health care expenses where coverage is provided by a health maintenance organization shall not include:

i. Home office and overhead costs;

ii. Advertising costs;

iii. Commissions and other acquisition costs;

iv. Taxes;

v. Capital costs;

vi. Administrative costs;and vii. Claims processing costs. 2. All filings of rates and rating schedules shall demonstrate that expected claims in relation to premiums comply with the requirements of this section when combined with actual experience to date. Filings of rate revisions shall also demonstrate that the anticipated loss ratio over the entire future period for which the revised rates are computed to provide coverage can be expected to meet the appropriate loss ratio standards.

3. For purposes of applying Subsection A(1) of this section and Subsection C(3) of Rule 10.15 only, policies issued as a result of solicitations of individuals through the mails or by mass media advertising (including both print and broadcast advertising) shall be deemed to be individual policies.

4. For policies issued prior to July 1, 1992, expected claims in relation to premiums shall meet:

a. The originally filed anticipated loss ratio when combined with the actual experience since inception;

b. The appropriate loss ratio requirement from Subsection A(1)(a)(i) and (ii) when combined with actual experience beginning with April 26, 1996 to date; and

c. The appropriate loss ratio requirement from Subsection A(1)(a)(i) and (ii) over the entire future period for which the rates are computed to provide coverage.

B. Refund or Credit Calculation.

1. An issuer shall collect and file with the commissioner by May 31 of each year the data contained in the applicable reporting form contained in Appendix A for each type in a standard Medicare supplement benefit plan.

2. If on the basis of the experience as reported the benchmark ratio since inception (ratio 1) exceeds the adjusted experience ratio since inception (ratio 3), then a refund or credit calculation is required. The refund calculation shall be done on a statewide basis for each type in a standard Medicare supplement benefit plan. For purposes of the refund or credit calculation, experience on policies issued within the reporting year shall be excluded.

3. For the purposes of this section, policies or certificates issued prior to July 1, 1992, the issuer shall make the refund or credit calculation separately for all individual policies (including all group policies subject to an individual loss ratio standard when issued) combined and all other group policies combined for experience after April 26, 1996. The first report shall be due by May 31, 1998.

4. A refund or credit shall be made only when the benchmark loss ratio exceeds the adjusted experience loss ratio and the amount to be refunded or credited exceeds a de minimis level. The refund shall include interest from the end of the calendar year to the date of the refund or credit at a rate specified by the Secretary of Health and Human Services, but in no event shall it be less than the average rate of interest for thirteen-week Treasury notes. A refund or credit against premiums due shall be made by September 30 following the experience year upon which the refund or credit is based.

C. Annual filing of Premium Rates.

An issuer of Medicare supplement policies and certificates issued before or after the effective date of this regulation, in this state shall file annually its rates, rating schedule and supporting documentation including ratios of incurred losses to earned premiums by policy duration for approval by the commissioner in accordance with the filing requirements and procedures prescribed by the commissioner. The supporting documentation shall also demonstrate in accordance with actuarial standards of practice using reasonable assumptions that the appropriate loss ratio standards can be expected to be met over the entire period for which rates are computed. The demonstration shall exclude active life reserves. An expected third-year loss ratio which is greater than or equal to the applicable percentage shall be demonstrated for policies or certificates in force less than three (3) years.

As soon as practicable, but prior to the effective date of enhancements in Medicare benefits, every issuer of Medicare supplement policies or certificates in this state shall file with the commissioner, in accordance with the applicable filing procedures of this state:

1. a. Appropriate premium adjustments necessary to produce loss ratios as

anticipated for the current premium for the applicable policies or certificates. The supporting documents necessary to justify the adjustment shall accompany the filing.

b. An issuer shall make premium adjustments necessary to produce an expected loss ratio under the policy or certificate to conform to minimum loss ratio standards for Medicare supplement policies and which are expected to result in a loss ratio at least as great as that originally anticipated in the rates used to produce current premiums by the issuer for the Medicare supplement policies or certificates. No premium adjustment which would modify the loss ratio experience under the policy other than the adjustments described herein shall be made with respect to a policy at any time other than upon its renewal date or anniversary date.

c. If an issuer fails to make premium adjustments acceptable to the commissioner, the commissioner may order premium adjustments, refunds or premium credits deemed necessary to achieve the loss ratio required by this section.

2. Any appropriate riders, endorsements or policy forms needed to accomplish the Medicare supplement policy or certificate modifications necessary to eliminate benefit duplications with Medicare. The riders, endorsements or policy forms shall provide a clear description of the Medicare supplement benefits provided by the policy or certificate.

D. Public Hearings.

The commissioner may conduct a public hearing to gather information concerning a request by an issuer for an increase in a rate for a policy form or certificate form issued before or after the effective date of this regulation, if the experience of the form for the previous reporting period is not in compliance with the applicable loss ratio standard. The determination of compliance is made without consideration of any refund or credit for the reporting period. Public notice of the hearing shall be furnished in a manner deemed appropriate by the commissioner.

Rule 10.15: Filing and Approval of Policies and Certificates and Premium Rates

A. An issuer shall not deliver or issue for delivery a policy or certificate to a resident of this state unless the policy form or certificate form has been filed with and approved by the commissioner in accordance with filing requirements and procedures prescribed by the commissioner.

B. An issuer shall file any riders or amendments to policy or certificate forms to delete outpatient prescription drug benefits as required by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 only with the commissioner in the state in which the policy or certificate was issued.

C. An issuer shall not use or change premium rates for a Medicare supplement policy or certificate unless the rates, rating schedule and supporting documentation have been filed with and approved by the commissioner in accordance with the filing requirements and procedures prescribed by the commissioner.

D. 1. Except as provided in Paragraph (2) of this subsection, an issuer shall not file for approval more than one form of a policy or certificate of each type for each standard Medicare supplement benefit plan.

2. An issuer may offer, with the approval of the commissioner, up to four (4) additional policy forms or certificate forms of the same type for the same standard Medicare supplement benefit plan, one for each of the following cases:

a. The inclusion of new or innovative benefits;

b.

The addition of either direct response or agent marketing methods;

c.

The addition of either guaranteed issue or underwritten coverage;

d.

The offering of coverage to individuals eligible for Medicare by reason of disability.

For th policy,

e purposes of this section, a “type” means an individual policy, a group an individual Medicare Select policy, or a group Medicare Select policy.

E. 1. Except as provided in Paragraph (1)(a), an issuer shall continue to make available

for purchase any policy form or certificate form issued after the effective date of this regulation that has been approved by the commissioner. A policy form or certificate form shall not be considered to be available for purchase unless the issuer has actively offered it for sale in the previous twelve (12) months.

a. An issuer may discontinue the availability of a policy form or certificate form if the issuer provides to the commissioner in writing its decision at least thirty (30) days prior to discontinuing the availability of the form of the policy or certificate. After receipt of the notice by the commissioner, the issuer shall no longer offer for sale the policy form or certificate form in this state.

b. An issuer that discontinues the availability of a policy form or certificate form pursuant to Subparagraph (a) shall not file for approval a new policy form or certificate form of the same type for the same standard Medicare supplement benefit plan as the discontinued form for a period of five (5) years after the issuer provides notice to the commissioner of the discontinuance. The period of discontinuance may be reduced if the commissioner determines that a shorter period is appropriate.

2. The sale or other transfer of Medicare supplement business to another issuer shall be considered a discontinuance for the purposes of this subsection.

3. A change in the rating structure or methodology shall be considered discontinuance under Paragraph (1) unless the issuer complies with the following requirements:

a. The issuer provides an actuarial memorandum, in a form and manner prescribed by the commissioner, describing the manner in which the revised rating methodology and resultant rates differ from the existing rating methodology and existing rates.

b. The issuer does not subsequently put into effect a change of rates or rating factors that would cause the percentage differential between the discontinued and subsequent rates as described in the actuarial memorandum to change. The commissioner may approve a change to the differential that is in the public interest.

F. 1. Except as provided in Paragraph (2), the experience of all policy forms or

certificate forms of the same type in a standard Medicare supplement benefit plan shall be combined for purposes of the refund or credit calculation prescribed in Rule 10.14 of this regulation.

2. Forms assumed under an assumption reinsurance agreement shall not be combined with the experience of other forms for purposes of the refund or credit calculation.

Rule 10.16: Permitted Compensation Arrangements

A. An issuer or other entity may provide commission or other compensation to an agent or other representative for the sale of a Medicare supplement policy or certificate only if the first year commission or other first year compensation is no more than 200 percent of the commission or other compensation paid for selling or servicing the policy or certificate in the second year or period.

B. The commission or other compensation provided in subsequent (renewal) years must be the same as that provided in the second year or period and must be provided for no fewer than five (5) renewal years.

C. No issuer or other entity shall provide compensation to its agents or other producers and no agent or producer shall receive compensation greater than the renewal compensation payable by the replacing issuer on renewal policies or certificates if an existing policy or certificate is replaced.

D. For purposes of this section, “compensation” includes pecuniary or non-pecuniary remuneration of any kind relating to the sale or renewal of the policy or certificate including but not limited to bonuses, gifts, prizes, awards and finders fees.

Rule 10.17: Required Disclosure Provisions

A. General Rules.

1. Medicare supplement policies and certificates shall include a renewal or continuation provision. The language or specifications of the provision shall be consistent with the type of contract issued. The provision shall be appropriately captioned and shall appear on the first page of the policy, and shall include any reservation by the issuer of the right to change premiums and any automatic renewal premium increases based on the policyholder’s age.

2. Except for riders or endorsements by which the issuer effectuates a request made in writing by the insured, exercises a specifically reserved right under a Medicare supplement policy,

or is required to reduce or eliminate benefits to avoid duplication of Medicare benefits, all riders or endorsements added to a Medicare supplement policy after date of issue or at reinstatement or renewal which reduce or eliminate benefits or coverage in the policy shall require a signed acceptance by the insured. After the date of policy or certificate issue, any rider or endorsement which increases benefits or coverage with a concomitant increase in premium during the policy term shall be agreed to in writing signed by the insured, unless the benefits are required by the minimum standards for Medicare supplement policies, or if the increased benefits or coverage is required by law. Where a separate additional premium is charged for benefits provided in connection with riders or endorsements, the premium charge shall be set forth in the policy.

3. Medicare supplement policies or certificates shall not provide for the payment of benefits based on standards described as “usual and customary,” “reasonable and customary” or words of similar import.

4. If a Medicare supplement policy or certificate contains any limitations with respect to preexisting conditions, such limitations shall appear as a separate paragraph of the policy and be labeled as “Preexisting Condition Limitations.”

5. Medicare supplement policies and certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance that the policyholder or certificate holder shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the insured person is not satisfied for any reason.

6. a. Issuers of accident and sickness policies or certificates which provide hospital or medical expense coverage on an expense incurred or indemnity basis to persons eligible for Medicare shall provide to those applicants a Guide to Health Insurance for People with Medicare in the form developed jointly by the National Association of Insurance Commissioners and CMS and in a type size no smaller than 12 point type. Delivery of the Guide shall be made whether or not the policies or certificates are advertised, solicited or issued as Medicare supplement policies or certificates as defined in this regulation. Except in the case of direct response issuers, delivery of the Guide shall be made to the applicant at the time of application and acknowledgement of receipt of the Guide shall be obtained by the issuer. Direct response issuers shall deliver the Guide to the applicant upon request but not later than at the time the policy is delivered.

b. For the purposes of this section, “form” means the language, format, type size, type proportional spacing, bold character, and line spacing.

B. Notice Requirements.

1. As soon as practicable, but no later than thirty (30) days prior to the annual effective date of any Medicare benefit changes, an issuer shall notify its policyholders and certificate holders of modifications it has made to Medicare supplement insurance policies or certificates in a format acceptable to the commissioner. The notice shall:

a. Include a description of revisions to the Medicare program and a description of each modification made to the coverage provided under the Medicare supplement policy or certificate, and

b. Inform each policyholder or certificate holder as to when any premium adjustment is to be made due to changes in Medicare.

2. The notice of benefit modifications and any premium adjustments shall be in outline form and in clear and simple terms so as to facilitate comprehension.

3. The notices shall not contain or be accompanied by any solicitation. C. MMA Notice Requirements. Issuers shall comply with any notice requirements of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

D. Outline of Coverage Requirements for Medicare Supplement Policies. 1. Issuers shall provide an outline of coverage to all applicants at the time application is presented to the prospective applicant and, except for direct response policies, shall obtain an acknowledgement of receipt of the outline from the applicant; and

2. If an outline of coverage is provided at the time of application and the Medicare supplement policy or certificate is issued on a basis which would require revision of the outline, a substitute outline of coverage properly describing the policy or certificate shall accompany the policy or certificate when it is delivered and contain the following statement, in no less than twelve (12) point type, immediately above the company name:

NOTICE: Read this outline of coverage carefully. It is not identical to the outline of coverage provided upon application and the coverage originally applied for has not been issued.”

3. The outline of coverage provided to applicants pursuant to this section consists of four parts: a cover page, premium information, disclosure pages, and charts displaying the features of each benefit plan offered by the issuer. The outline of coverage shall be in the language and format prescribed below in no less than twelve (12) point type. All plans shall be shown on the cover page, and the plans that are offered by the issuer shall be prominently identified. Premium information for plans that are offered shall be shown on the cover page or immediately following the cover page and shall be prominently displayed. The premium and mode shall be stated for all plans that are offered to the prospective applicant. All possible premiums for the prospective applicant shall be illustrated

4. The following items shall be included in the outline of coverage in the order prescribed below:

Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1,

A B C D F F* G

K L M N

Basic, including 100% Part B coinsurance

Basic, including 100% Part B coinsurance

Basic, including 100% Part B coinsurance

Basic, including 100% Part B coinsurance

Basic, including 100% Part B coinsurance*

Basic, including 100% Part B coinsurance

Hospitalization and preventive care paid at 100%; other basic benefits paid at 50%

Hospitalization and preventive care paid at 100%; other basic benefits paid at 75%

Basic, including 100% Part B coinsurance Basic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER

Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance

50% Skilled Nursing Facility Coinsurance 75% Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance

Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible

50% Part A Deductible 75% Part A Deductible 50% Part A Deductible Part A Deductible

Part B Deductible

Part B Deductible

Part B Excess (100%) Part B Excess (100%)

Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency

Foreign Travel Emergency Foreign Travel Emergency

Out-of-pocket limit $[5560]; paid at 100% after limit reached Out-of-pocket limit $[2780]; paid at 100% after limit reached

This chart shows the benefits included in each of the standard Medicare supplement plans. Every company must make Plan “A” available. Some plans may not be available in your state.

Basic Benefits:

Hospitalization –Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. Medical Expenses –Part B coinsurance (generally 20% of Medicare‐approved expenses) or co‐ payments for hospital outpatient services. Plans K, L and N require insureds to pay a portion of Part B coinsurance or co‐payments. Blood –First three pints of blood each year. Hospice— Part A coinsurance

.

*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$2300] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$2300] Out-of- pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible

PREMIUM INFORMATION [Boldface Type]

We [insert issuer’s name] can only raise your premium if we raise the premium for all policies like yours in this State. [If the premium is based on the increasing age of the insured, include information specifying when premiums will change.]

READ YOUR POLICY VERY CAREFULLY [Boldface Type]

This is only an outline describing your policy’s most important features. The policy is your insurance contract. You must read the policy itself to understand all of the rights and duties of both you and your insurance company.

RIGHT TO RETURN POLICY [Boldface Type]

If you find that you are not satisfied with your policy, you may return it to [insert issuer’s address]. If you send the policy back to us within 30 days after you receive it, we will treat the policy as if it had never been issued and return all of your payments.

POLICY REPLACEMENT [Boldface Type]

If you are replacing another health insurance policy, do NOT cancel it until you have actually received your new policy and are sure you want to keep it. NOTICE [Boldface Type] This policy may not fully cover all of your medical costs.

[for agents:] Neither [insert company’s name] nor its agents are connected with Medicare.

[for direct response:] [insert company’s name] is not connected with Medicare.

This outline of coverage does not give all the details of Medicare coverage. Contact your local Social Security Office or consult Medicare and You for more details.

COMPLETE ANSWERS ARE VERY IMPORTANT [Boldface Type]

When you fill out the application for the new policy, be sure to answer truthfully and completely all

questions about your medical and health history. The company may cancel your policy and refuse to pay any claims if you leave out or falsify important medical information. [If the policy or certificate is guaranteed issue, this paragraph need not appear.]

Review the application carefully before you sign it. Be certain that all information has been properly recorded.

[Include for each plan prominently identified in the cover page, a chart showing the services, Medicare payments, plan payments and insured payments for each plan, using the same language, in the same order, using uniform layout and format as shown in the charts below. No more than four plans may be shown on one chart. For purposes of illustration, charts for each plan are included in this regulation. An issuer may use additional benefit plan designations on these charts pursuant to Rule 10.09.1D of this regulation.]

[Include an explanation of any innovative benefits on the cover page and in the chart, in a manner approved by the commissioner.]

PLAN A

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

61st thru 90th day

91st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used:

—Additional 365 days

—Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$0

$[ 341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$[1364](Part A deductible) $0

$0

$0**

All costs SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility Within 30 days after leaving the hospital

First 20 days

st thru 100th day

st day and after

All approved amounts

All but $[170.50] a day

$0

$0

$0

$0

$0

Up to $[170.50] a day

All costs

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY

BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0

HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness.

All but very limited co-payment/ coinsurance for out- patient drugs and inpatient respite care

Medicare co-payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN A

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

• Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

Generally 80%

$0

Generally 20%

$[185] (Part B deductible)

$0 Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$0

20%

$0

$[185] (Part B deductible)

$0

CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

20%

$0

$[185] (Part B deductible)

$0

PLAN B

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY

HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

st thru 90th day

st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used:

—Additional 365 days

—Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1364](Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$0

$0

$0

$0**

All costs SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility within 30 days after leaving the hospital

First 20 days

st thru 100 th day

101st day and after

All approved amounts

All but $[170.50] a day

$0

$0

$0

$0

$0

Up to $[170.50] a day

All costs

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY

BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0 HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness

All but very limited co-payment/ coinsurance for out- patient drugs and inpatient respite care

Medicare co- payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN B

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

• Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

Generally 80%

$0

Generally 20%

$[185] (Part B deductible)

$0 Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs

BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$0

20%

$0

$[185] (Part B deductible)

$0 CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

20%

$0

$[185] (Part B deductible

0% $0

PLAN C

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies First 60 days

st thru 90th day

st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used:

Additional 365 days —Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1364](Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$0

$0

$0

$0**

All costs

SKILLED NURSING FACILITY CARE*

You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare‐approved facility within 30 days after leaving the hospital

First 20 days

st thru 100th day

101st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0 HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness.

All but very limited co- payment/ coinsurance for out- patient drugs and inpatient respite care

Medicare co-payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN C

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

• Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment, First $[185] of Medicare

Approved Amounts* Remainder of Medicare Approved Amounts

$0

Generally 80%

$[185] (Part B deductible)

Generally 20%

$0

$0 Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$[185] (Part B deductible)

20%

$0

$0

$0 CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PLAN C PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$[185](Part B deductible)

20%

$0

$0

$0

OTHER BENEFITS—NOT COVERED BY MEDICARE

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY FOREIGN TRAVEL— NOT COVERED BY MEDICARE Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA First $250 each calendar year

Remainder of Charges

$0

$0

$0

80% to a lifetime maxi-mum benefit of $50,000

$250

20% and amounts over the $50,000 lifetime maximum

PLAN D

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

61st thru 90th day

91st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used:

Additional 365 days —Beyond the additional 365 days

All but $[1364] All but $[341] a day

All but $[682] a day

$0

$0

$[1364] (Part A deductible)

$[341] a day

$[682] a day $0

100% of Medicare eligible expenses

$0

$0

$0

$0

$0**

All costs

SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital First 20 days

st thru 100th day

101st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0 HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness

All but very limited co- payment/ coinsurance for out- patient drugs and inpatient respite care

Medicare co-payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN D

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

• Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY

MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment, First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

Generally 80%

$0

Generally 20%

$[185] (Part B deductible)

$0 Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$0

20%

$0

$[185] (Part B deductible)

$0 CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PLAN D

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

20%

$0

$[185] (Part B deductible)

$0

PLAN D

OTHER BENEFITS – NOT COVERED BY MEDICARE

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY FOREIGN TRAVEL— NOT COVERED BY MEDICARE Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA First $250 each calendar year

Remainder of charges

$0

$0

$0

80% to a lifetime maximum benefit of $50,000

$250

20% and amounts over the $50,000 lifetime maximum

PLAN F or HIGH DEDUCTIBLE PLAN F

MEDICARE (PART A) – HOSPITAL SERVICES – PER BENEFIT PERIOD

A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

[**This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$2300] deductible. Benefits from the high deductible plan F will not begin until out- of-pocket expenses are [$2300]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.]

SERVICES

MEDICARE PAYS [AFTER YOU PAY $[2300] DEDUCTIBLE,] PLAN PAYS [IN ADDITION TO $[2300] DEDUCTIBLE,] YOU PAY HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies First 60 days

61st thru 90 th day

91st day and after: —While using 60 Lifetime reserve days

Once lifetime reserve days are used: —Additional 365 days

Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1364] (Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$0

$0

$0

$0***

All costs

PLAN F or HIGH DEDUCTIBLE PLAN F

MEDICARE (PART A) – HOSPITAL SERVICES – PER BENEFIT PERIOD (cont.)

SERVICES

MEDICARE PAYS [AFTER YOU PAY $[2300] DEDUCTIBLE,] PLAN PAYS [IN ADDITION TO $[2300] DEDUCTIBLE,] YOU PAY SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility within 30 days after leaving the hospital

First 20 days

21st thru 100th day

st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0 HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness.

All but very limited co-payment/ coinsurance for out- patient drugs and inpatient respite care

Medicare co- payment/co- insurance

$0

*** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN F or HIGH DEDUCTIBLE PLAN F

MEDICARE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR

*Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

[**This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$2300] deductible. Benefits from the high deductible plan F will not begin until out- of-pocket expenses are [$2300]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.]

SERVICES

MEDICARE PAYS [AFTER YOU PAY $[2300] DEDUCTIBLE,] PLAN PAYS [IN ADDITION TO $[2300] DEDUCTIBLE,] YOU PAY

MEDICAL EXPENSES IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, Such as physician’s Services, inpatient and Outpatient medical and Surgical services and Supplies, physical and Speech therapy, Diagnostic tests, Durable medical Equipment, First $[185] of Medicare Approved amounts*

Remainder of Medicare Approved amounts

$0

Generally 80%

$[185] (Part B deductible) Generally 20%

$0

$0

PART B EXCESS CHARGES (Above Medicare Approved Amounts)

$0

100%

$0 BLOOD First 3 pints

Next $[185] of Medicare Approved amounts*

Remainder of Medicare Approved amounts

$0

$0

80%

All costs

$[185] (Part B deductible)

20%

$0

$0

$0 CLINICAL LABORATORY SERVICES—- TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PLAN F or HIGH DEDUCTIBLE PLAN F

PARTS A & B

SERVICES

MEDICARE PAYS AFTER YOU PAY $[2300] DEDUCTIBLE,** PLAN PAYS IN ADDITION TO $[2300] DEDUCTIBLE,**

YOU PAY HOME HEALTH CARE Medicare Approved Services - Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare — Approved Amounts

100%

$0

80%

$0

$[185] (Part B deductible)

20%

$0

$0

$0

OTHER BENEFITS - NOT COVERED BY MEDICARE

SERVICES

MEDICARE PAYS AFTER YOU PAY $[2300] DEDUCTIBLE,* * PLAN PAYS IN ADDITION TO $[2300] DEDUCTIBLE, ** YOU PAY FOREIGN TRAVEL - NOT COVERED BY MEDICARE Medically necessary Emergency care services Beginning during the first 60 days of each trip outside the USA

First $250 each calendar year

Remainder of charges

$0

$0

$0

80% to a lifetime maximum benefit of $50,000

$250

20% and amounts over the $50,000 lifetime maximum

PLAN G or HIGH DEDUCTIBLE PLAN G

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY

HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies First 60 days

61st thru 90th day

91st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used:

—Additional 365 days

—Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1364] (Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$0

$0

$0

$0**

All costs SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital First 20 days

st thru 100th day

101st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness

All but very limited co- payment/ coinsurance for out-patient drugs and inpatient respite care

Medicare co-payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN G or HIGH DEDUCTIBLE PLAN G

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

• Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

Generally 80%

$0

Generally 20%

$185 ( Unless Part B deductible has been met)

$0 Part B Excess Charges (Above Medicare Approved Amounts)

$0

100%

$0 BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$0

20%

$0

$185(Unless Part B Deductible has been met)

$0 CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PLAN G or HIGH DEDUCTIBLE PLAN G

PARTS A & B

SERVICES MEDICARE PAYS [AFTER YOU PAY $2,300 DEDUCTIBLE] PLAN PAYS [IN ADDITION TO $2,300 DEDUCTIBLE] YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

20%

$0

$185 (Unless Part B Deductible has been met)

$0

OTHER BENEFITS—NOT COVERED BY MEDICARE

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY FOREIGN TRAVEL— NOT COVERED BY MEDICARE Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA

First $250 each calendar year

Remainder of Charges

$0

$0

$0

80% to a lifetime maximum benefit of $50,000

$250

20% and amounts over the $50,000 lifetime maximum

PLAN K

• You will pay half the cost-sharing of some covered services until you reach the annual out-of- pocket limit of $[5560] each calendar year. The amounts that count toward your annual limit are noted with diamonds (♦) in the chart below. Once you reach the annual limit, the plan pays 100% of your Medicare co-payment and coinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

** A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY* HOSPITALIZATION** Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

st thru 90th day

91st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used: —Additional 365 days

—Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[682](50% of Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$[682](50% of Part A deductible)♦

$0

$0

$0***

All costs

PLAN K MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD (cont.)

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY* SKILLED NURSING FACILITY CARE** You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility Within 30 days after leaving the hospital

First 20 days

st thru 100th day

101st day and after

All approved amounts.

All but $[170.50] a day

$0

$0

Up to $[85.25] a day (50% of Part A Coinsurance)

$0

$0

Up to $[85.25] a day (50% of Part A Coinsurance)♦

All costs BLOOD First 3 pints

Additional amounts

$0

100%

50%

$0

50%♦

$0 HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness.

All but very limited co-payment/ coinsurance for outpatient drugs and inpatient respite care

50% of co-payment/ coinsurance

50% of Medicare co- payment/coinsurance ♦

*** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN K

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

**** Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY* MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment,

First $[185] of Medicare Approved Amounts****

Preventive Benefits for Medicare covered services

Remainder of Medicare Approved Amounts

$0

Generally 7580% or more of Medicare approved amounts

Generally 80%

$0

Remainder of Medicare approved amounts

Generally 10%

$[185] (Part B deductible)**** ♦

All costs above Medicare approved amounts

Generally 10% ♦ Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs (and they do not count toward annual out- of-pocket limit of [$5560])*

BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts****

Remainder of Medicare Approved Amounts

$0

$0

Generally 80%

50%

$0

Generally 10%

50%♦

$[185] (Part B deductible)**** ♦

Generally 10% ♦ CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0 (continued) * This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $[5560] per year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.

PLAN K

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY* HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*****

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

10%

$0

$[185] (Part B deductible) ♦

10%♦

****Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.

PLAN L

• You will pay one-fourth of the cost-sharing of some covered services until you reach the annual out-of-pocket limit of $[2780] each calendar year. The amounts that count toward your annual limit are noted with diamonds (♦) in the chart below. Once you reach the annual limit, the plan pays 100% of your Medicare copayment and coinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider that exceed Medicare- approved amounts (these are called “Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.

MEDICARE (PART A) – HOSPITAL SERVICES – PER BENEFIT PERIOD

** A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY* HOSPITALIZATION ** Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

st day thru 90 th day

st day and after:

• While using 60 lifetime reserve days

• Once lifetime reserve days are used

• Additional 365 days

• Beyond additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1023] (75% of Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$[1023] (75% of Part A deductible) ♦

$0

$0

$0***

All costs

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY SKILLED NURSING FACILITY CARE*** You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility within 30 days after leaving the hospital

First 20 days

st thru 100 th day

st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[127.88] a day (75% of Part A Coinsurance) $0

$0

Up to $[127.88] a day (75% of Part A Coinsurance) ♦ All costs BLOOD First 3 pints

Additional amounts

$0

100%

75%

$0

25%♦

$0 HOSPICE CARE You must meet Medicare's requirements, including a doctor's certification of terminal illness.

All but very limited co-payment/ coinsurance for outpatient drugs and inpatient respite care

75% of co- payment/ coinsurance

25% of co- payment/ coinsurance ♦

*** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid

PLAN L

MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR

**** Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY*

MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment

First $[185] of Medicare Approved Amounts****

Preventive Benefits for Medicare covered services

Remainder of Medicare Approved Amounts

$0

Generally 80% or more of Medicare approved amounts

Generally 80%

$0

Remainder of Medicare approved amounts

Generally 15%

$[185] (Part B deductible)**** ♦

All costs above Medicare approved amounts

Generally 5% ♦ Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs (and they do not count toward annual out- of- pocket limit of [$2780])*

BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts****

Remainder of Medicare Approved Amounts

$0

$0

Generally 80%

75%

$0

Generally 15%

25%♦

$[185] (Part B deductible) ♦

Generally 5%♦ CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

• This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $[2780] per year. However, this limit does NOT include charges from your provider that exceed Medicare- approved amounts (these are called “Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.

PLAN L

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY* HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*****

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

15%

$0

$[185] (Part B deductible) ♦

5% ♦

*****Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare

PLAN M

MEDICARE (PART A) – HOSPITAL SERVICES – PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

st thru 90th day

st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used: —Additional 365 days

—Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[682](50% of Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$[682](50% of Part A deductible)

$0

$0

$0**

All costs

SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital First 20 days

21st thru 100th day

101st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPICE CARE You must meet Medicare’s requirements, including a doctor’s certification of terminal illness

All but very limited co-payment/ coinsurance for outpatient drugs and inpatient respite care

Medicare co- payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN M

MEDICARE (PART B) – MEDICAL SERVICES – PER CALENDAR YEAR

• Once you have been billed $[185] of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY MEDICAL EXPENSES— IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment

—First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

Generally 80%

$0

Generally 20%

$[185] (Part B deductible)

$0 Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$0

20%

$0

$[185] (Part B deductible)

$0 CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PLAN M

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

20%

$0

$[185](PartB deductible)

$0

OTHER BENEFITS—NOT COVERED BY MEDICARE

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY FOREIGN TRAVEL— NOT COVERED BY MEDICARE Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA

First $250 each calendar year

Remainder of Charges

$0

$0

$0

80% to a lifetime maxi-mum benefit of $50,000

$250

20% and amounts over the $50,000 lifetime maximum

PLAN N

MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD

• A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies

First 60 days

st thru 90th day

st day and after: —While using 60 lifetime reserve days

—Once lifetime reserve days are used: —Additional 365 days

—Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1364](Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$0

$0

$0

$0**

All costs

SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility within 30 days after leaving the hospital

First 20 days

st thru 100th day

101st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs BLOOD First 3 pints

Additional amounts

$0

100%

3 pints

$0

$0

$0

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPICE CARE You must meet Medicare’s requirements, including a doctor’s certification of terminal illness

All but very limited co-payment/ coinsurance for outpatient drugs and inpatient respite care

Medicare co- payment/ coinsurance

$0

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

PLAN N

MEDICARE (PART A) – HOSPITAL SERVICES – PER BENEFIT PERIOD

*A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOSPITALIZATION* Semiprivate room and board; general nursing and miscellaneous services and supplies

First 60 days

st thru 90 th day

st day and after

-While using 60 lifetime reserve days

-Once lifetime reserve days are used.

---Additional 365 days

---Beyond the additional 365 days

All but $[1364]

All but $[341] a day

All but $[682] a day

$0

$0

$[1364] (Part A deductible)

$[341] a day

$[682] a day

100% of Medicare eligible expenses

$0

$0

$0

$0

$0

All costs

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY

SKILLED NURSING FACILITY CARE* You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare- approved facility within 30 days after leaving the hospital

First 20 days

st thru 100 th day

st day and after

All approved amounts

All but $[170.50] a day

$0

$0

Up to $[170.50] a day

$0

$0

$0

All costs

BLOOD

First 3 pints

Additional Amounts

$0

100%

Three pints

$0

$0

$0 HOSPICE CARE You must meet Medicare’s requirements, including a doctor’s certification of terminal illness

All but very limited co- payment coinsurance for outpatient drugs and inpatient respite care

Medicare co- payment/coninsurance

$0

**NOTICE: when your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits”. During this time the hospital is prohibited from billing you for the balance based on any difference between the billed charges and the amount Medicare would have paid.

PLAN N

MEDICARE (PART B) – MEDICAL SERVICES – PER CALENDAR YEAR

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY MEDICAL EXPENSES –IN OR OUT OF THE HOPSITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician’s services, impatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment.

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

Generally 80%

$0

Balances, other than up to [$20] per office visit and up to [$50] per emergency room visit. The co- payment of up to [$50] is waived if the insured is admitted to any hospital and the emergency visit is covered as a Medicare Part A expense.

$[185] (Part B deductible)

Up to [$20] per office visit and up to [$50] per emergency room visit. The co-payment of up to [$50] is waived if the insured is admitted to any hospital and the emergency visit is covered as a Medicare Party A expense. Part B Excess Charges (Above Medicare Approved Amounts)

$0

$0

All costs BLOOD First 3 pints

Next $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

$0

$0

80%

All costs

$0

20%

$0

$[185] (Part B deductible)

$0 CLINICAL LABORATORY SERVICES—TESTS FOR DIAGNOSTIC SERVICES

100%

$0

$0

PLAN N

PARTS A & B

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY HOME HEALTH CARE MEDICARE APPROVED SERVICES

Medically necessary skilled care services and medical supplies

—Durable medical equipment

First $[185] of Medicare Approved Amounts*

Remainder of Medicare Approved Amounts

100%

$0

80%

$0

$0

20%

$0

$[185] (Part B deductible)

$0

PLAN N

OTHER BENEFITS—NOT COVERED BY MEDICARE

SERVICES MEDICARE PAYS PLAN PAYS YOU PAY FOREIGN TRAVEL— NOT COVERED BY MEDICARE Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA

First $250 each calendar year

Remainder of Charges

$0

$0

$0

80% to a lifetime maximum benefit of $50,000

$250

20% and amounts over the $50,000 lifetime maximum

E. Notice Regarding Policies or Certificates Which Are Not Medicare Supplement Policies.

1. Any accident and sickness insurance policy or certificate, other than a Medicare supplement policy, a policy issued pursuant to a contract under Section 1876 of the Federal Social Security Act (42 U.S.C. § 1395 et seq.), disability income policy; or other policy identified in Rule 10.03B of this regulation, issued for delivery in this state to persons eligible for Medicare shall notify insureds under the policy that the policy is not a Medicare supplement policy or certificate. The notice shall either be printed or attached to the first page of the outline of coverage delivered to insureds under the policy, or if no outline of coverage is delivered, to the first page of the policy, or certificate delivered to insureds. The notice shall be in no less than twelve (12) point type and shall contain the following language:

“THIS [POLICY OR CERTIFICATE] IS NOT A MEDICARE SUPPLEMENT [POLICY OR CONTRACT]. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare available from the company.”

2. Applications provided to persons eligible for Medicare for the health insurance policies or certificates described in Subsection D(1) shall disclose, using the applicable statement in Appendix C, the extent to which the policy duplicates Medicare. The disclosure statement shall be provided as a part of, or together with, the application for the policy or certificate.

Rule 10.18: Requirements for Application Forms And Replacement Coverage

A. Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant currently has Medicare supplement, Medicare Advantage, Medicaid coverage, or another health insurance policy or certificate in force or whether a Medicare supplement policy or certificate is intended to replace any other accident and sickness policy or certificate presently in force. A supplementary application or other form to be signed by the applicant and agent containing such questions and statements may be used.

[Statements]

1. You do not need more than one Medicare supplement policy.

2. If you purchase this policy, you may want to evaluate your existing health coverage and decide if you need multiple coverages.

3. You may be eligible for benefits under Medicaid and may not need a Medicare

supplement policy.

4. If, after purchasing this policy, you become eligible for Medicaid, the benefits and premiums under your Medicare supplement policy can be suspended, if requested, during your entitlement to benefits under Medicaid for 24 months. You must request this suspension within 90 days of becoming eligible for Medicaid. If you are no longer entitled to Medicaid, your suspended Medicare supplement policy (or, if that is no longer available, a substantially equivalent policy) will be reinstituted if requested within 90 days of losing Medicaid eligibility. If the Medicare supplement policy provided coverage for outpatient prescription drugs and you enrolled in Medicare Part D while your policy was suspended, the reinstituted policy will not have outpatient prescription drug coverage, but will otherwise be substantially equivalent to your coverage before the date of the suspension.

5. If you are eligible for, and have enrolled in a Medicare supplement policy by reason of disability and you later become covered by an employer or union-based group health plan, the benefits and premiums under your Medicare supplement policy can be suspended, if requested, while you are covered under the employer or union- based group health plan. If you suspend your Medicare supplement policy under these circumstances, and later lose your employer or union-based group health plan, your suspended Medicare supplement policy (or, if that is no longer available, a substantially equivalent policy) will be reinstituted if requested within 90 days of losing your employer or union-based group health plan. If the Medicare supplement policy provided coverage for outpatient prescription drugs and you enrolled in Medicare Part D while your policy was suspended, the reinstituted policy will not have outpatient prescription drug coverage, but will otherwise be substantially equivalent to your coverage before the date of the suspension.

6. Counseling services may be available in your state to provide advice concerning your purchase of Medicare supplement insurance and concerning medical assistance through the state Medicaid program, including benefits as a Qualified Medicare Beneficiary (QMB) and a Specified Low-Income Medicare Beneficiary (SLMB).

[Questions]

If you lost or are losing other health insurance coverage and received a notice from your prior insurer saying you were eligible for guaranteed issue of a Medicare supplement insurance policy, or that you had certain rights to buy such a policy, you may be guaranteed acceptance in one or more of our Medicare supplement plans. Please include a copy of the notice from your prior insurer with your application. PLEASE ANSWER ALL QUESTIONS. [Please mark Yes or No below with an “X”]

To the best of your knowledge, (1) (a) Did you turn age 65 in the last 6 months?

Yes No

(b) Did you enroll in Medicare Part B in the last 6 months?

Yes No

(c) If yes, what is the effective date?

(2) Are you covered for medical assistance through the state Medicaid program?

[NOTE TO APPLICANT: If you are participating in a “Spend-Down Program” and have not met your “Share of Cost,” please answer NO to this question.]

Yes No

If yes;

(a) Will Medicaid pay your premiums for this Medicare supplement policy?

Yes No

(b) Do you receive any benefits from Medicaid OTHER THAN payments toward your Medicare Part B premium?

Yes No

(3) (a) If you had coverage from any Medicare plan other than original Medicare within the past 63 days (for example, a Medicare Advantage plan, or a Medicare HMO or PPO), fill in your start and end dates below. If you are still covered under this plan, leave “END” blank.

START

/ / END / /

(b) If you are still covered under the Medicare plan, do you intend to replace your current coverage with this new Medicare supplement policy?

Yes No

(c) Was this your first time in this type of Medicare plan?

Yes No

(d) Did you drop a Medicare supplement policy to enroll in the Medicare plan?

Yes No

(4) (a) Do you have another Medicare supplement policy in force?

Yes No

(b) If so, with what company, and what plan do you have [optional for Direct Mailers]?

(c) If so, do you intend to replace your current Medicare supplement policy with this policy?

Yes No

(5) Have you had coverage under any other health insurance within the past 63 days? (For example, an employer, union, or individual plan)

Yes No

(a) If so, with what company and what kind of policy?

(b) What are your dates of coverage under the other policy?

START / / END / /

(If you are still covered under the other policy, leave “END” blank.)

B. Agents shall list any other health insurance policies they have sold to the applicant.

1. List policies sold which are still in force.

2. List policies sold in the past five (5) years that are no longer in force.

C. In the case of a direct response issuer, a copy of the application or supplemental form, signed by the applicant, and acknowledged by the insurer, shall be returned to the applicant by the insurer upon delivery of the policy.

D. Upon determining that a sale will involve replacement of Medicare supplement coverage, any issuer, other than a direct response issuer, or its agent, shall furnish the applicant, prior

to issuance or delivery of the Medicare supplement policy or certificate, a notice regarding replacement of Medicare supplement coverage. One copy of the notice signed by the applicant and the agent, except where the coverage is sold without an agent, shall be provided to the applicant and an additional signed copy shall be retained by the issuer. A direct response issuer shall deliver to the applicant at the time of the issuance of the policy the notice regarding replacement of Medicare supplement coverage.

E. The notice required by Subsection D above for an issuer shall be provided in substantially the following form in no less than twelve (12) point type:

NOTICE TO APPLICANT REGARDING REPLACEMENT OF MEDICARE SUPPLEMENT INSRUANCE OR MEDICARE ADVANTAGE

[Insurance company’s name and address]

SAVE THIS NOTICE! IT MAY BE IMPORTANT TO YOU IN THE FUTURE

According to [your application] [information you have furnished], you intend to terminate existing Medicare supplement or Medicare Advantage insurance and replace it with a policy to be issued by [Company Name] Insurance Company. Your new policy will provide thirty (30) days within which you may decide without cost whether you desire to keep the policy.

You should review this new coverage carefully. Compare it with all accident and sickness coverage you now have. If, after due consideration, you find that purchase of this Medicare supplement coverage is a wise decision, you should terminate your present Medicare supplement or Medicare Advantage coverage. You should evaluate the need for other accident and sickness coverage you have that may duplicate this policy.

STATEMENT TO APPLICANT BY ISSUER, AGENT [BROKER OR OTHER REPRESENTATIVE]:

I have reviewed your current medical or health insurance coverage. To the best of my knowledge, this Medicare supplement policy will not duplicate your existing Medicare supplement or, if applicable, Medicare Advantage coverage because you intend to terminate your existing Medicare supplement coverage or leave your Medicare Advantage plan. The replacement policy is being purchased for the following reason (check one):

Additional benefits.

No change in benefits, but lower premiums.

Fewer benefits and lower premiums.

My plan has outpatient prescription drug coverage and I am enrolling in Part D.

____ Disenrollment from a Medicare Advantage plan. Please explain reason for disenrollment. [optional only for Direct Mailers. ]

Other. (please specify)

1. Note: If the issuer of the Medicare supplement policy being applied for does not, or is otherwise prohibited from imposing pre‐existing condition limitations, please skip to statement 2 below. Health conditions that you may presently have (preexisting conditions) may not be immediately or fully covered under the new policy. This could result in denial or delay of a claim for benefits under the new policy, whereas a similar claim might have been payable under your present policy.

2. State law provides that your replacement policy or certificate may not contain new preexisting conditions, waiting periods, elimination periods or probationary periods. The insurer will waive any time periods applicable to preexisting conditions, waiting periods, elimination periods, or probationary periods in the new policy (or coverage) for similar benefits to the extent such time was spent (depleted) under the original policy.

3. If, you still wish to terminate your present policy and replace it with new coverage, be certain to truthfully and completely answer all questions on the application concerning your medical and health history. Failure to include all material medical information on an application may provide a basis for the company to deny any future claims and to refund your premium as though your policy had never been in force. After the application has been completed and before you sign it, review it carefully to be certain that all information has been properly recorded. [If the policy or certificate is guaranteed issue, this paragraph need not appear.]

Do not cancel your present policy until you have received your new policy and are sure that you want to keep it.

(Signature of Agent, Broker or Other Representative)* [Typed Name and Address of Issuer, Agent or Broker]

(Applicant’s Signature

(Date) *Signature not required for direct response sales.

F. Paragraphs 1 and 2 of the replacement notice (applicable to preexisting conditions) may be deleted by an issuer if the replacement does not involve application of a new preexisting condition limitation.

Rule 10.19: Filing Requirements For Advertising

An issuer shall provide a copy of any Medicare supplement advertisement intended for use in this state whether through written, radio or television medium to the Commissioner of Insurance of this state for review or approval by the commissioner to the extent it may be required under state law.

Rule 10.20: Standards for Marketing

A. An issuer, directly or through its producers, shall:

1. Establish marketing procedures to assure that any comparison of policies by its agents or other producers will be fair and accurate.

2. Establish marketing procedures to assure excessive insurance is not sold or issued.

3. Display prominently by type, stamp or other appropriate means, on the first page of the policy the following:

“Notice to buyer: This policy may not cover all of your medical expenses.”

4. Inquire and otherwise make every reasonable effort to identify whether a prospective applicant or enrollee for Medicare supplement insurance already has accident and sickness insurance and the types and amounts of any such insurance.

5. Establish auditable procedures for verifying compliance with this Subsection A. B. In addition to the practices prohibited in Miss. Code Ann. § 83-5-29, et seq., the following acts and practices are prohibited:

6. Twisting. Knowingly making any misleading representation or incomplete or fraudulent comparison of any insurance policies or insurers for the purpose of inducing, or tending to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on, or convert an insurance policy or to take out a policy of insurance with another insurer.

7. High pressure tactics. Employing any method of marketing having the effect of or tending to induce the purchase of insurance through force, fright, threat, whether explicit or implied, or undue pressure to purchase or recommend the purchase of insurance.

8. Cold lead advertising. Making use directly or indirectly of any method of marketing which fails to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contact will be made by an insurance agent or insurance company.

C. The terms “Medicare Supplement,” “Medigap,” “Medicare Wrap-Around” and words of similar import shall not be used unless the policy is issued in compliance with this regulation.

Rule 10.21: Appropriateness of Recommended Purchase and Excessive Insurance

A. In recommending the purchase or replacement of any Medicare supplement policy or certificate an agent shall make reasonable efforts to determine the appropriateness of a recommended purchase or replacement.

B. Any sale of a Medicare supplement policy or certificate that will provide an individual more than one Medicare supplement policy or certificate is prohibited.

C. An issuer shall not issue a Medicare supplement policy or certificate to an individual enrolled in Medicare Part C unless the effective date of the coverage is after the termination date of the individual’s Part C coverage

Rule 10.22: Reporting Of Multiple Policies

A. On or before March 1 of each year, an issuer shall report the following information for every individual resident of this state for which the issuer has in force more than one Medicare supplement policy or certificate:

1. Policy and certificate number; and

2. Date of issuance.

B. The items set forth above must be grouped by individual policyholder.

Editor’s Note: Appendix B contains a reporting form for compliance with this section.

Rule 10.23: Prohibition against Preexisting Conditions, Waiting Periods, Elimination Periods And Probationary Periods in Replacement Policies or Certificates

A. If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate, the replacing issuer shall waive any time periods applicable to preexisting conditions, waiting periods, elimination periods and probationary periods in the new Medicare supplement policy or certificate for similar benefits to the extent such time was spent under the original policy.

B. If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate which has been in effect for at least six (6) months, the replacing policy shall not provide any time period applicable to preexisting conditions, waiting periods, elimination periods and probationary periods for benefits similar to those contained in the original policy or certificate.

Rule 10.24: Prohibition Against use of Genetic Information and Requests for Genetic Testing

This Section applies to all policies with policy years beginning on or after May 21, 2009.

A. An issuer of a Medicare supplement policy or certificate;

1. Shall not deny or condition the issuance or effectiveness of the policy or certificate (including the imposition of any exclusion of benefits under the policy based on a pre- existing condition) on the basis of the genetic information with respect to such individual; and

2. Shall not discriminate in the pricing of the policy or certificate (including the adjustment of premium rates) of an individual on the basis of the genetic information with respect to such individual.

B. Nothing in Subsection A shall be construed to limit the ability of an issuer, to the extent otherwise permitted by law, from

1. Denying or conditioning the issuance or effectiveness of the policy or certificate or increasing the premium for a group based on the manifestation of a disease or disorder of an insured or applicant; or

2. Increasing the premium for any policy issued to an individual based on the manifestation of a disease or disorder of an individual who is covered under the policy (in such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members and to further increase the premium for the group).

C. An issuer of a Medicare supplement policy or certificate shall not request or require an individual or a family member of such individual to undergo a genetic test.

D. Subsection C shall not be construed to preclude an issuer of a Medicare supplement policy or certificate from obtaining and using the results of a genetic test in making a determination regarding payment (as defined for the purposes of applying the regulations promulgated under part C of title XI and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) and consistent with Subsection A.

E. For purposes of carrying out Subsection D, an issuer of a Medicare supplement policy or certificate may request only the minimum amount of information necessary to accomplish the intended purpose.

F. Notwithstanding Subsection C, an issuer of a Medicare supplement policy may request, but not require, that an individual or a family member of such individual undergo a genetic test if each of the following conditions is met:

1. The request is made pursuant to research that complies with Part 46 of Title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.

2. The issuer clearly indicates to each individual, or in the case of a minor child, to the legal guardian of such child, to whom the request is made that

a. Compliance with the request is voluntary; and

b. Non-compliance will have no effect on enrollment status or premium or contribution amounts.

3. No genetic information collected or acquired under this Subsection shall be used for underwriting, determination of eligibility to enroll or maintain enrollment status, premium rates, or the issuance, renewal, or replacement of a policy or certificate.

4. The issuer notifies the Secretary in writing that the issuer is conducting activities pursuant to the exception provided for under this Subsection, including a description of the activities conducted.

5. The issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this Subsection.

G. An issuer of a Medicare supplement policy or certificate shall not request, require, or purchase genetic information for underwriting purposes.

H. An issuer of a Medicare supplement policy or certificate shall not request, require, or purchase genetic information with respect to any individual prior to such individual’s enrollment under the policy in connection with such enrollment.

I. If an issuer of a Medicare supplement policy or certificate obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of Subsection H if such request, requirement, or purchase is not in violation of Subsection G.

J. For the purposes of this Section only:

1. “Issuer of a Medicare supplement policy or certificate” includes third-party administrator, or other person acting for or on behalf of such issuer.

2. “Family member” means, with respect to an individual, any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of such individual.

3. “Genetic information” means, with respect to any individual, information about such individual’s genetic tests, the genetic tests of family members of such individual, and the manifestation of a disease or disorder in family members of such individual. Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual. Any reference to genetic information concerning an individual or family member of an individual who is a pregnant woman, includes genetic information of any fetus carried by such pregnant woman, or with respect to an individual or family member utilizing reproductive technology, includes genetic information of any embryo legally held by an individual or family member. The term “genetic information” does not include information about the sex or age of any individual.

4. “Genetic services” means a genetic test, genetic counseling (including obtaining, interpreting, or assessing genetic information), or genetic education.

5. “Genetic test” means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detect genotypes, mutations, or chromosomal changes. The term “genetic test” does not mean an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes; or an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.

6. “Underwriting purposes” means,

a. Rules for, or determination of, eligibility (including enrollment and continued eligibility) for benefits under the policy;

b. The computation of premium or contribution amounts under the policy;

c. The application of any pre-existing condition exclusion under the policy; and

d. Other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.

Rule 10.25: Separability

If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the regulation and the application of such provision to other persons or circumstances shall not be affected thereby

Rule 10.26: Effective Date

This regulation and its amendments shall be effective on June 30, 2009 and after January 1, 2020.

Life Years Exposed Since Inception Tolerance

10,000 + 0.0% 5,000 ·9,999 5.0% 2,500 ·4,999 7.5% 1,000 ·2,499

10.0% 500.999 15.0% Ifless than 500, no credibility.

Rule 10.27: Appendix A- Reporting Form for Calculation of Loss Ratios APPENDIX A

MEDICARE SUPPLEMENT REFUND CALCULATION FORM FOR CALENDAR YEAR. _

TYPEl SMSBP2

For the State of Company Name----------- NAIC Group Code NAIC Company Code ------------------ Address Person Completing Exhibit _ Title Telephone Number------ ---

Line

(a) Earned Premiums (b) Incurred Claims4 L Current Year's Experience

a. Total (all policy years)

b. Current year's issuess

c. Net (for reporting purposes= 1a-1b

2. Past Years' Experience (allpolicv years)

3. Total Experience (Net Current Year+ Past Year)

4. Refunds Last Year (Excluding Interest)

5. Previous Since Inception (Excluding Interest)

6. Refunds Since Inception (Excluding Interest)

Benchmark Ratio Since Inception (see worksheet for Ratio I)

8. Experienced Ratio Since Inception (Ratio 2J

Total Actual Incurred Qlaims line 3, CQl. b2 Total Earned Prem. (line 3, col. a)-Refunds Since Inception Qine 6)

9. Life Years Exposed Since Inception If the Experienced Ratio is less than the Benchmark Ratio, and there are more than 500 life years exposure, then proceed to calculation of refund.

Tolerance Permitted (obtained from credibility table)

M e d

. care s upp

Jement C re d

" billty T a bl e

1 Individual, Group, Individual Medicare Select, or Group Medicare Select Only. 2 "SMSBP" = Standardized Medicare Supplement Benefit Plan ·Use "P" for pre-standardized plans. 3 Includes Modal Loadings and Fees Charged 4 Excludes Active Life Reserves 5 This is to be used as "Issue Year Earned Premium" for Year 1 of next year's "Worksheet for Calculation of Benchmark Ratios" ·

RATIO SINCE INCEPTION FOR GROUP POLICIES FOR CALENDAR YEAR.

TYPE

SMSBP

---------------------------- For the State of Company Name------------------ NAIC Group Code NAIC Company Code----- - - -- Address Person Completing Exhibit-------- Title Telephone Number----- ------

(a)3 (b)4 (c) (d)

(e) <D

(g) (h) (i) (j) (o)s

Year Earned Premium

Factor

(b)x(c) Cumulative Loss Ratio

(d)x(e)

Factor

(b)x(g) Cumulative Loss Ratio

(h)x(i) Policy Yea1· Loss Ratio

2.770

0.507

0.000

0.000

0.46 ·

4.175

0.567

0.000

0.000

0.63 '

4.175

0.567

1.194

0.759

0.75

4.175

0.567

2.245

0.771

0.77

4.175

0.567

3.170

0.782

0.80

4.175

0.567

3.998

0.792

0.82

4.175

0.567

4.754

0.802

0.84

4.175

0.567

5.445

0.811

0.87

4:175

0.567

6.075

0.818

0.88

4.175

0.567

6.650

0.824

0.88

4.175

0.567

7.176

0.828

0.88

4.175

0.567

7.655

0.831

0.88

4.175

0.567

8.093

0.834

0.89

4.175

0.567

8.493

0.837

0.89 15+6

4.175

0.567

8.684

0.838

0.89 To.tal:

(k):

(1):

(m):

(n):

Benchmark Ratio Since Inception: (l + n)/(k + m):

1Individual, Group, Individual Medicare Select, or Group Medicare Select Only. 2 "SMSBP" = Standardized Medicare Supplement Benefit Plan · Use "P" for pre·standardized plans 3 Year 1is the cunent calendar year·1. Year 2 is the current calendar year·2 (etc.) (Example: If the current year is 1991, then: Year 1is 1990; Yea1·2 is 1989, etc.)

For the calendar year on the appropriate line in column (a), the premium earned during that year for policies issued in that year.

These loss ratios are not explicitly used in computing the benchmark loss ratios. They are the loss ratios, on a policy year basis, which result in the cumulative loss ratios displayed on this worksheet. They are shown here for informational purposes only.

To include the earned premium for all years prior to as well as the 15 th year prior to the current year.

Benchmark Ratio Since Inception: (l + n)/(k + m):

Individual, Group, Individual Medicare Select, or Group Medicare Select Only.

“SMSBP” = Standardized Medicare Supplement Benefit Plan - Use “P” for pre-standardized plans

Year 1 is the current calendar year - 1. Year 2 is the current calendar year - 2 (etc.) (Example: If the current year is 1991, then: Year 1 is 1990; Year 2 is 1989, etc.)

For the calendar year on the appropriate line in column (a), the premium earned during that year for policies issued in that year.

These loss ratios are not explicitly used in computing the benchmark loss ratios. They are the loss ratios, on a policy year basis, which result in the cumulative loss ratios displayed on this worksheet. They are shown here for informational purposes only.

To include the earned premium for all years prior to as well as the 15 th year prior to the current year.

Rule 10.28: Appendix B- Form for Reporting Duplicate Policies

APPENDIX B

FORM FOR REPORTING MEDICARE SUPPLEMENT POLICIES

Company Name:

Address:

Phone Number:

Due March 1, annually

The purpose of this form is to report the following information on each resident of this state who has in force more than one Medicare supplement policy or certificate. The information is to be grouped by individual policyholder.

Policy and Date of Certificate # Issuance

Signature

Name and Title (please type)

Rule 10.29: Disclosure Statements Appendix C

Date

DISCLOSURE STATEMENTS

Instructions for Use of the Disclosure Statements for Health Insurance Policies Sold to Medicare Beneficiaries that Duplicate Medicare

1. Section 1882 (d) of the federal Social Security Act [42 U.S.C. 1395ss] prohibits the sale of a health insurance policy (the term policy includes certificate) to Medicare beneficiaries that duplicates Medicare benefits unless it will pay benefits without regard to a beneficiary’s other health coverage and it includes the prescribed disclosure statement on or together with the application for the policy. 2. All types of health insurance policies that duplicate Medicare shall include one of the attached disclosure statements, according to the particular policy type involved, on the application or together with the application. The disclosure statement may not vary from the attached statements in terms of language or format (type size, type proportional spacing, bold character, line spacing, and usage of boxes around text). 3. State and federal law prohibits insurers from selling a Medicare supplement policy to a person that already has a Medicare supplement policy except as a replacement policy. 4. Property/casualty and life insurance policies are not considered health insurance. 5. Disability income policies are not considered to provide benefits that duplicate Medicare. 6. Long‐term care insurance policies that coordinate with Medicare and other health insurance are not considered to provide benefits that duplicate Medicare. 7. The federal law does not preempt state laws that are more stringent than the federal requirements. 8. The federal law does not preempt existing state form filing requirements. 9. Section 1882 of the federal Social Security Act was amended in Subsection (d)(3)(A) to allow for alternative disclosure statements. The disclosure statements already in Appendix C remain. Carriers may use either disclosure statement with the requisite insurance product. However, carriers should use either the original disclosure statements or the alternative disclosure statements and not use both simultaneously.

History

• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83-9-115(Rev. 2011)
• Source:Miss Code Ann §25-43-3.113(Rev. 2010)
• Source: Miss Code Ann §83-9-107(Rev. 2011)
• Source: Miss Code Ann §83-9-103(Rev. 2011)
• Source: Miss Code Ann §83‐9‐103(Rev. 2011)

Chapter 17 Large Group Health Insurance Claims Data Reporting

19 Miss. Admin. Code Pt. 3, R. 17.01 Authority

This regulation is adopted and promulgated pursuant to the authority granted by Miss. Code Ann. § 83-5-1, §§ 83-9-1 et seq., §§ 83-41-401 et seq. and in accordance with the provisions of the Administrative Procedures Act found at Miss Code Ann. § 25-43-1 et seq.

(Rev. 2011).

History

• Source: Miss. Code Ann. §§ 25-43-1 et seq.; § 83-5-1; §§ 83-9-1 et seq., § 83-41-401, et seq.

19 Miss. Admin. Code Pt. 3, R. 17.02 Purpose and Scope

A. Purpose. The purpose of this regulation is to establish requirements for companies who offer fully insured, comprehensive, major medical health insurance products on the remittance of certain claims data to large employer groups as defined by Mississippi Insurance Department Bulletin 2016-9, entitled, “Clarification on How and When Employees Must be Counted for the Purposes of Determining Group Health Plan Size.”

B. Scope. This regulation shall apply to all health carriers that offer managed care plans.

History

• Source: Miss. Code Ann. § 83-5-1; §§ 83-9-1 et seq., § 83-41-405; § 83-41-413 (Rev. 2011).

19 Miss. Admin. Code Pt. 3, R. 17.03 Claims Data Reporting

A. Upon request by a large employer group (“group”) or the group’s agent or broker, the group’s health carrier shall make available the currently available summary health information, aggregate paid claims, and premium data accumulated for the current and the immediately preceding policy periods. The company shall make this data available within ten (10) business days of the request.

B. The company may condition the remittance of the data on both the execution of an agreement for immunity from civil liability and a certification of compliance with the federal rules concerning privacy of individually identifiable health information found in 45 C.F.R. Section 164.504(f)(2).

C. All group claims data reports provided pursuant to this regulation shall include all data available to the company as of the date of the request and shall include the following information:

1. The net claims paid by month during the current and the immediately preceding policy period. 2. The monthly enrollment by employee only, employee and spouse, employee and child(ren), and the employee and family during the current and the immediately preceding policy period. 3. The amount of any claims reserve established by the insurance company against future claims under the policy, to the extent the company maintains claims reserves on a group policyholder basis. 4. Claims over twenty-five thousand dollars ($25,000.00) including claim identifier, the date of occurrence, the amount of claims paid and those unpaid or outstanding, and claimant health condition or diagnosis during the current and the immediately preceding policy period. The data shall provide a unique identifying number or code for the claimant.

D. Nothing in this section shall be construed to prohibit a plan and group from negotiating the release of additional information not described in this regulation.

E. The provisions of this regulation shall not be construed to authorize the disclosure of the identity of a particular employee covered under the group policy, nor the disclosure of any individual employee’s particular health insurance claim, condition, diagnosis, or prognosis, which would violate federal or state law. Nothing in this regulation shall be construed to require an insurer to provide information protected as confidential by the Health Insurance Portability and Accountability Act of 1996 or any other provision of federal law.

Rule 17.04: Severability

If any section or portion of a section of this regulation or the application thereof to any person or circumstance is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of this regulation which can be given effect without the invalid provision or application, and to this end the provisions of this regulation are declared to be severable.

Rule 17.05: Effective Date

This regulation shall become effective thirty (30) days after filing for final adoption with the Office of the Secretary of State.

Title 19, Part 3, Chapter 18: Managed Care Plan Certification Regulation

Rule 18.01. Title

This Regulation shall be known and may be cited as the Managed Care Plan Certification Regulation and is promulgated by the Commissioner of Insurance pursuant to the authority granted to him by Title 83, the Mississippi Insurance Code; the requirements of Miss. Code Ann. §§ 25-43-1.101, et seq., the Mississippi Administrative Procedures Law; and the requirements of Miss. Code Ann. §§ 83-41-401, et seq., the Mississippi Patient Protection Act of 1995.

The purpose of this Regulation is to establish a process for certifying managed care plans pursuant to the provisions of Miss. Code Ann. §§ 83-41-401 et seq., also known as the Mississippi Patient Protection Act of 1995. Additionally, it furthers the goals of the Managed Care Plan Network Adequacy Regulation, Title 19, Part 3, Chapter 14, by requiring that managed care plans have adequate networks in order to be certified by the Mississippi Insurance Department.

For purposes of this Regulation, the term “managed care entities” as used herein, shall include a “health carrier” as that term is defined in Rule 14.03 of Title 19, Part 3, Chapter 14. Any term defined in Rule 14.03 of Title 19, Part 3, Chapter 14 will have the same meaning in this Chapter 18. Further, any terms defined in Miss. Code Ann. § 83-41-403 (Rev. 2022) shall have the same meaning in this Chapter 18.

This Regulation shall apply to all managed care plans, managed care entities and managed care contractors; provided, however, the Regulation shall not apply to the Mississippi State Employee Health Plan or to any managed care plan regulated by the Mississippi Division of Medicaid.

A. Beginning January 1, 2025, managed care entities shall file with the Commissioner sample contract forms proposed for use with its participating providers and intermediaries.

B. By June 1 of each calendar year, managed care entities shall submit to the Commissioner, in an electronic format (such as Excel) that is readily useable by the Department, a complete list, effective January 1 of that calendar year, of: (1) the names of its Participating Providers; (2) each Participating Provider’s most closely- affiliated type as provided for in Rule 14.05; (3) the complete practice location address for each Participating Provider; and (4) contact information for each Participating Provider.

C. By June 1 of each calendar year, managed care entities shall submit to the Commissioner, in electronic format (such as Excel) that is readily useable by the Department, a complete list, effective January 1 of that calendar year, of: (1) the names of its covered persons; and (2) the complete residential addresses of each covered person.

D. By June 1 of each calendar year, managed care entities shall submit to the Commissioner a certification attestation in the following format: “I attest that [managed care entity] has complied with the Managed Care Plan Network Adequacy Regulation and the Managed Care Plan Certification Regulation promulgated by the Mississippi Department of Insurance.” If a managed care entity is unable to meet compliance with any rules in those Regulations, including, but not limited to, Rule 14.05(B), Rule 14.05(C) and Rule 14.05(D), such attestation shall include reasons why the carrier contends it was unable to meet such standards and why the Commissioner should give special consideration to the reasons asserted for lack of compliance.

E. By June 1 of each calendar year, managed care entities shall submit to the Commissioner a complete, detailed description of their measures to provide covered persons, in easily understandable language, written information on the terms and conditions of coverage, including:

(1) coverage provisions;

(2) benefits;

(3) limitations;

(4) exclusions and restrictions on the use of any providers of care;

(5) a summary of utilization review and quality assurance policies;

(6) enrollee financial responsibility for copayments, deductions, and payment for out-of-plan services and supplies;

(7) the managed care entity’s policies, in circumstances where the managed care entity has an insufficient number or type of participating providers/facilities to provide a covered benefit consistent with the geographic access standards set forth in the Managed Care Network Adequacy Regulation, Section 14.05(B), or fails to provide a covered benefit consistent with the geographic access standards set forth in Section 14.05(B), to ensure covered persons obtain the covered benefit at no greater cost to the covered person than if the benefit were obtained from participating providers, and to ensure in such situations, the provision of covered persons with reasonable reimbursement for the covered persons travel, lodging, and incidental expenses as set forth in the Managed Care Network Adequacy Regulation, Rule 14.05(C);

(8) a summary of the managed care entity’s credentialing criteria and process and policies relating to the credentialing criteria;

(9) the managed care entity’s procedures for ensuring a provider may request a copy of the provider’s individual profile if economic or practice profiles, or both, are used in the credentialing process;

(10) the managed care entity’s procedures for ensuring a provider is aware that the provider may request to review the reasons for denial or termination with regard to a provider’s application that has been denied or where the provider’s contract is terminated;

(11) the managed care entity’s procedure/policy to ensure adherence with all applicable state and federal laws designed to protect the confidentiality of medical records; and

(12) the managed care entity’s procedures to ensure interested healthcare providers within the geographic area of the managed care entity’s network are given an opportunity to apply for participation.

A. Based on the information managed care entities must submit pursuant to this Regulation and the Managed Care Network Adequacy Regulation, the Commissioner shall review such information and if found sufficient, the Commissioner shall issue an annual certification of each managed care plan. Such certification shall allow the managed care entity’s continued operation of the managed care plan except that such

certification shall always be subject to reconsideration should the Commissioner determine, in his or her sole discretion, that the managed care entity has not in fact complied with the requirements of this Regulation.

B. If the Commissioner determines that a managed care entity has not sufficiently complied with any provision of the Managed Care Network Adequacy Regulation or this Regulation, the Commissioner may institute a corrective action that shall be followed by the managed care entity, may deny certification of the managed care entity’s plan, or may use any of the Commissioner’s other enforcement powers to obtain the managed care entity’s compliance.

C. If the Commissioner determines that a managed care entity’s network does not sufficiently comply with the Managed Care Network Adequacy Regulation or this Regulation, the Commissioner shall afford a managed care entity a hearing, consistent with Mississippi Department of Insurance regulations, upon a managed care entity’s request made within twenty (20) days of notification of the Commissioner’s determination, before such determination becomes final.

The Commissioner, at any time, may review a managed care entity’s compliance with this Regulation or the Managed Care Plan Network Adequacy Regulation, request information from the managed care entity necessary to investigate the managed care entity’s compliance, and order the corrective measures the Commissioner, in his or her sole discretion, deems necessary. The Commissioner may retain outside consultants to assist in such review if the Commissioner determines such is appropriate, and the fees and costs of such consultants’ services shall be paid by the managed care entity to the consultants pursuant to Miss. Code Ann. § 83-41-407.

Rule 18.08. Confidentiality

A managed care entity or managed care contractor may designate material submitted to the Commissioner pursuant to this regulation as confidential and exempt from disclosure to the public under the Mississippi Public Records Act if the health carrier deems the material to meet the criteria set forth in Miss. Code Ann. § 25-61-9(1).

Rule 18.09. Penalties

A violation of this Regulation shall be subject to the penalty provisions set forth in Miss. Code Ann. § 83-5-17, as well as other penalty provisions under applicable law.

If any provision of this Regulation, or the application of the provision to any person or circumstance shall be held invalid, the remainder of the Regulation, and the application of the provision to persons or circumstances other than those to which it is held invalid, shall not be affected.

This Regulation shall be effective thirty (30) days after final adoption with the Office of the Secretary of State. All provider and intermediary contracts in effect on the effective date of this Regulation, or which are issued or put inforce on or after the effective date of this Regulation, shall comply with this Regulation no later than January 1, 2025. The Commissioner may extend this deadline for an additional period not to exceed six (6) months if the managed care entity demonstrates good cause for an extension.

Title 19, Part 3, Chapter 19: Minimum Standards for Utilization Review Agents Regulation

Table of Contents Rule 19.01. Title Rule 19.02 Purpose Rule 19.03 Definitions Rule 19.04 Applicability and Scope Rule 19.05 Definitions Rule 19.06 Application for Certification Rule 19.07 Renewal of Certification Rule 19.08 Denial or Revocation of Certification and Penalty Rule 19.09 Utilization Review Standards Rule 19.10 Appeals of Determinations Not to Certify Rule 19.11 Computation of Time Rule 19.12 Urgent Prior Authorization Requests; Access to Physicians Rule 19.13 Notification for Adverse Determinations / Form

History

• Source: Miss. Code Ann. § 83-5-1, §§ 83-9-1 et seq., §§ 83-41-401 et seq. (Rev. 2011).
• Source: Miss. Code Ann. § 83-5-1 (Rev. 2011).
• Source: Miss. Code Ann. § 25-43-3.112; § 25-43-3.113 (Rev. 2018).
• Source: Miss. Code Ann. §§ 25-43-1.101, et seq.; § 83-5-1; §§ 83-41-401, et seq. (Rev. 2022) Rule 18.02. Purpose
• Source: Miss. Code Ann. § 83-41-405; § 83-41-413 (Rev. 2022) Rule 18.03. Definitions
• Source: Miss. Code Ann. § 83-41-403; § 83-41-405; § 83-41-413 (Rev. 2022) Rule 18.04. Applicability and Scope
• Source: Miss. Code Ann. § 83-41-405; § 83-41-413 (Rev. 2022) Rule 18.05. Filing Requirements and State Administration
• Source: Miss. Code Ann. § 83-41-405; § 83-41-413 (Rev. 2022) Rule 18.06. Certification and Enforcement
• Source: Miss. Code Ann. § 83-41-405; § 83-41-413 (Rev. 2022) Rule 18.07. Ongoing Compliance
• Source: Miss. Code Ann. § 83-41-405; § 83-41-407; § 83-41-411, and § 83-41-413 (Rev. 2022)
• Source: Miss. Code Ann. § 25-61-9; § 83-41-43 (Rev. 2022)
• Source: Miss. Code Ann. § 83-5-17; § 83-41-405; § 83-41-413 (Rev. 2022) Rule 18.10. Severability
• Source: Miss. Code Ann. § 83-5-1; § 83-41-413 (Rev. 2022) Rule 18.11. Effective Date
• Source: Miss. Code Ann. § 25-43-3.112 (Rev. 2022)

19 Miss. Admin. Code Pt. 3, R. 19.14 Qualifications of persons reviewing appeals Rule 19.15

Change of patient status to emergency status after submission of prior authorization request Rule 19.16 Length of Approvals Rule 19.17 Approvals for chronic conditions Rule 19.18 Continuity of Prior Approvals Rule 19.19 Revocations of prior authorizations Rule 19.20 Standardized electronic prior authorizations Rule 19.21 Reports to the Department Rule 19.22 Prior Authorization Statistics Rule 1923. Enforcement and administration Rule 19.24 Penalties Rule 19.25 Severability Rule 19.2623 Effective Date

19 Miss. Admin. Code Pt. 3, R. 19.01 Rule 19.01

Title This Regulation shall be known and may be cited as the Utilization Review Regulation and is promulgated by the Commissioner of Insurance pursuant to the authority granted to him by Title 83, the Mississippi Insurance Code; the requirements of Miss. Code Ann. §§ 25-43-1.101 et seq., the Mississippi Administrative Procedures Law; and the requirements of Miss. Code Ann. §§ 83- 5-901 through 83-5-937, the Mississippi Prior Authorization Reform Act.

§§ 83-5-901 through 83-5-937. Rule 19.02. Purpose The purpose of these rules and regulations is to promote the delivery of quality health care in a cost effective manner; foster greater coordination between payors and providers conducting utilization review activities; protect patients, business and providers by ensuring that private review agents are qualified to perform utilization activities and to make informed decisions on the appropriateness of medical care; and to ensure that private review agents maintain the confidentiality of medical records.

Rule 19.03 Definitions Unless otherwise defined herein, any term defined in Miss. Code Ann. §§ 83-5-901 through 83-5- 937 shall have the same meaning in this Regulation.

History

• Source: Miss. Code Ann. §§ 25-43-1.101, et seq.; § 83-5-1; § 41-83-1, et seq.: Miss. Code Ann.
• Source: Miss. Code Ann. §41-83-1, et seq. (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.

19 Miss. Admin. Code Pt. 3, R. 19.04 Applicability and Scope

This Regulation shall apply to every health insurance issuer and all health benefit plans, as both terms are defined in Miss. Code Ann. § 83-9-6.3, and all private review agents and utilization

review plans, as both terms are defined in Miss. Code Ann. § 41-83-1, with the exception of employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 or health care provided pursuant to the Workers' Compensation Act. This act does not diminish the duties and responsibilities under other federal or state law or rules promulgated under those laws applicable to a health insurer, health insurance issuer, health benefit plan, private review agent or utilization review plan, including, but not limited to, the requirement of a certificate in accordance with Miss. Code Ann §41-83-3. For simplification, when the term “health insurance issuer” is used alone in these Regulations, the term also includes health benefit plans, private review agents and utilization review plans unless otherwise explicitly stated. (1) In the State of Mississippi, every health insurance plan or every insurer proposing to issue or deliver a health insurance policy or contract or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of those benefits; every health insurer proposing to issue or deliver in this state a group or blanket health insurance policy or administer a health benefit program which provides for the coverage of hospital and medical benefits and the utilization review of such benefits shall: a. Have a certificate in accordance with these regulations; b. Contract with a private review agent that has a certificate in accordance with these regulations. (2) Notwithstanding any provisions of these regulations, for claims where medical necessity of the provision of a covered benefit is disputed, an insurer that does not meet the requirements of this section shall pay any person or hospital entitled to reimbursement under the policy or contract.

Rule 19.05 Definitions (1) Adverse determination: A determination by a health insurance issuer that, based on the information provided, a request for a benefit under the health insurance issuer's health benefit plan upon application of any utilization review technique does not meet the health insurance issuer's requirements for medical necessity, appropriateness, health care setting, level of care, or effectiveness or is determined to be experimental or investigational and the requested benefit is therefore denied, reduced, or terminated or payment is not provided or made, in whole or in part, for the benefit; the denial, reduction, or termination of or failure to provide or make payment, in whole or in part, for a benefit based on a determination by a health insurance issuer that a preexisting condition was present before the effective date of coverage; or a rescission of coverage determination, which does not include a

cancellation or discontinuance of coverage that is attributable to a failure to timely pay required premiums or contributions toward the cost of coverage.

(2) Appeal: A formal request, either orally or in writing, to reconsider an adverse determination.

(3) Approval: A determination by a health insurance issuer that a health care service has been reviewed and, based on the information provided, satisfies the health insurance issuer's requirements for medical necessity and appropriateness. (4) Attending Physician: The physician with primary responsibility for the care provided to a patient in a hospital or other health care facility. (5) Certificate: A certificate of registration granted by the Mississippi Insurance Department to a private review agent, and is not transferable. Any valid and active certificate issued by the Mississippi Department of Health prior to July 1, 2024, shall be honored by the Mississippi Department of Insurance until such time as the expiration or revocation of said certificate. (6) Certification: A determination by a utilization review organization that an admission, extension of stay, or other medical service has been reviewed and based on the information provided, qualifies as medically necessary and appropriate under the medical review requirements of the applicable health benefit plan. (7) Certification Number: The number assigned to each certified private review agent. This number is not transferable. (8) Certified Private Review Agent: A private review agent who meets all the criteria for certification as set forth in these rules and regulations, has paid all current fees, and has been assigned a certification number. (9) Chronic Condition. A medical condition that is medically complex, life threatening, long-term, or substantially disabling, including, but not limited to, chemotherapy for the treatment of cancer. Treatment for a chronic condition may include a recurring health care service or maintenance medication. (10) Commissioner. The Commissioner of Insurance. (11) Clinical review criteria: The written screening procedures, decision abstracts, clinical protocols and practice guidelines used by a health insurance issuer to determine the necessity and appropriateness of health care services.

(12) Concurrent Review: Utilization review conducted during a patient's hospital stay or course of treatment. (13) Consulting Physician: A Medical Doctor, Doctor of Osteopathy, Dentist, Psychologist, Podiatrist or Chiropractor who possess the degree of skill ordinarily possessed and used by members of his or her profession in good standing, and actively engaged in the same type of practice and relevant specialty. The medical and osteopathy specialist shall be certified by the Boards within the American Board of Medical Specialists or the American Board of Osteopathy. (14) Department: The Mississippi Insurance Department. (15) Emergency medical condition: A medical condition manifesting itself by acute symptoms of sufficient severity, including, but not limited to, severe pain, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in: a. Placing the health of the individual or, with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy; b. Serious impairment to bodily functions; or c. Serious dysfunction of any bodily organ or part. (16) Emergency services: Health care items and services furnished or required to evaluate and treat an emergency medical condition. (17) Enrollee: The individual who has elected to contract for, or participate in, a health benefit plan for their self and/or their dependents. (18) Expedited Appeal: A request for additional review of a utilization review organization's determination not to certify an admission, extension of stay, or other medical service. An expedited appeal request may be called a reconsideration request by some utilization review organizations. (19) Health care professional: A physician, a registered professional nurse or other individual appropriately licensed or registered to provide health care services (20) Health care provider: Any physician, hospital, ambulatory surgery center, or other person or facility that is licensed or otherwise authorized to deliver health care services. (21) Health care service. Any services or level of services included in the

furnishing to an individual of medical care or the hospitalization incident to the furnishing of such care, as well as the furnishing to any person of any other services for the purpose of preventing, alleviating, curing, or healing human illness or injury, including behavioral health, mental health, home health and pharmaceutical services and products. (22) Health insurance issuer: Shall have the meaning given to that term in Miss. Code Ann. §83-9-6.3, and all private review agents and utilization review plans, as both terms are defined in Miss. Code Ann. §41-83-1, with the exception of employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 or health care provided pursuant to the Workers' Compensation Act. (23) Hospital: An institution which is primarily engaged in providing to inpatients and outpatients, by or under the supervision of physicians, diagnostic services and therapeutic services for medical diagnosis, treatment and care of injured, disabled or sick persons, or rehabilitation services for the rehabilitation of injured, disabled or sick persons, and also, means a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment and illness, disease, injury or deformity, or a place devoted primarily to providing obstetrical or other medical, surgical or nursing care of individuals, whether or not any such place be organized or operated for profit and whether any such place be publicly or privately owned. The term "Hospital" does not include convalescent or boarding homes, children's homes, homes for the aged or other like establishments where room and board only are provided, nor does it include offices or clinics where patients are not regularly kept as bed patients. The term ”Hospital” includes Rural Emergency Hospitals which are licensed as such through the Mississippi Department of Health. (24) Medically Necessary: A health care professional exercising prudent clinical judgment would provide care to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease or its symptoms and that are: a. In accordance with generally accepted standards of medical practice; and b. Clinically appropriate in terms of type, frequency, extent, site and duration and are considered effective for the patient's illness, injury or disease; and not primarily for the convenience of the patient, treating physician, other health care professional, caregiver, family member or other interested party, but focused on what is best for the patient's health outcome.

(25) Patient: The intended recipient of the proposed health care, his/her representative, and/or the enrollee. (26) Physician: Any person with a valid doctor of medicine, doctor of osteopathy or doctor of podiatry degree. (27) Physician Advisor: A physician representing the claim administrator/utilization review organization who provides advice on whether to certify an admission, extension of stay, or other medical service as being medically necessary and appropriate. (28) Private Review Agent: A non-hospital affiliated person or entity performing utilization review on behalf of: a. An employer or employees in the State of Mississippi; or b. A third party that provides or administers hospital and medical benefits to citizens of this state, including: a health maintenance organization issued a certificate of authority under and by virtue of the laws of the State of Mississippi, or a health insurer, nonprofit health service plan, health insurance service organization, or preferred provider organization or other entity offering health insurance policies, contracts or benefits in this state. (29) Prior authorization: The process by which a health insurance issuer determines the medical necessity and medical appropriateness of an otherwise covered health care service before the rendering of such health care service. "Prior authorization" includes any health insurance issuer's requirement that an enrollee, health care professional or health care provider notify the health insurance issuer before, at the time of, or concurrent to providing a health care service. (30) Provider Utilization Review Representative: The person(s) in a physician's office or hospital designated by the physician or hospital to provide the necessary information to complete the review process. (31) Review Criteria: The written policies, decision rules, medical protocols, or guides used by the utilization review organization to determine certification [e.g., Appropriateness Evaluation Protocol (AEP) and Intensity of Service, Severity of Illness, Discharge, and Appropriateness Screens (ISD-A)]. (32) Urgent health care service: A health care service with respect to which the application of the time periods for making a non-expedited prior authorization that in the opinion of a treating health care professional or

health care provider with knowledge of the enrollee's medical condition: a. Could seriously jeopardize the life or health of the enrollee or the ability of the enrollee to regain maximum function; b. Could subject the enrollee to severe pain that cannot be adequately managed without the care or treatment that is the subject of the utilization review; or c. Could lead to likely onset of an emergency medical condition if the service is not rendered during the time period to render a prior authorization determination for an urgent medical service. (33) Urgent health care service: For the purposes of this regulation, urgent health care service does not include emergency services. (34) Utilization Review: A system for reviewing the appropriate and efficient allocation of hospital resources and medical services given or proposed to be given to a patient or group of patients. More specifically, utilization review refers to pre-service determination of the medical necessity or appropriateness of services to be rendered in a hospital setting either on an inpatient or outpatient basis, when such determination results in approval or denial of payment for the services. It includes both prospective and concurrent review and may include retrospective review under certain circumstances. (35) Utilization Review Plan: A description of the utilization review procedures of a private review agent.

History

• Source: Miss. Code Ann. §41-83-1, et seq. (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §41-83-1, et seq. (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5-937.

19 Miss. Admin. Code Pt. 3, R. 19.06 Rule 19.06

Application for Certification (1) A private review agent who approves or denies payment or who recommends approval or denial of payment for hospital or medical services or whose review results in approval or denial of payment for hospital or medical services on a case by case basis, may not conduct utilization review in this state unless the Mississippi Department of Insurance has granted the private review agent a certificate. Any valid and active certificate issued by the Mississippi Department of Health prior to July 1, 2024, shall be honored by the Mississippi Department of Insurance until such time as the expiration or revocation of said certificate.

(2) The Mississippi Insurance Department shall issue a certificate to any applicant that has met all the requirements and all applicable regulations of the Department.

(3) A certificate is not transferable. When there is a change of ownership of the Certified Organization, a new application will be required and a new number will be issued.

(4) Any information required by the Department with respect to customers, patients or utilization review procedures of a private review agent shall be held in confidence and not disclosed to the public.

(5) A Private Review Agent applying for a certificate shall submit the following documentation to the Department:

a. A completed application, signed and verified by the applicant; b. A fee of $1,500.00, made payable to Mississippi Insurance Department, either by business check, money order, or by electronic means; and c. A utilization review plan which shall include all of the following components used by the private review agent to approve or deny payment or recommend approval or denial of payment in advance for proposed or delivered inpatient or outpatient care or retrospectively approve or deny under certain circumstances:

1. Elements of review for:

i) Preadmission

ii) Admission

iii) Preauthorization

iv) Second Surgical Opinion

2. Discharge Planning

i) Concurrent Review

ii) Retrospective Review

iii) Readmission Review

3. Procedures for review, including:

i) Any form used during the review process;

ii) Time frames that shall be met during the review; and

iii) A written protocol describing every aspect of the review process;

iv) A description and examples of review criteria to be used for the review;

v) The provisions, procedures, and time frames by which patients, physicians, and hospitals may seek reconsideration or appeal of adverse decisions by the private review agent, including:

(a) A written protocol describing the appeals procedure;

(b) Any form which shall be completed during the appeals procedure;

(c) Time frames that shall be met during the appeal procedure; and

(d) The names and qualifications of personnel making final appeal determinations;

(i) The number, type, and qualification or qualifications of the personnel either employed or under contract to perform the utilization review; (ii) The policies and procedures to ensure that a representative of the private review agent is accessible to patients and providers five (5) days a week during normal business hours in this state, 9 A.M. to 5 P.M.; and that a free telephone number be provided with adequate lines available and staffed. The procedure for handling after-hours inquiries shall be specified. (iii)The policies and procedures to ensure that all applicable state and federal laws to protect the confidentiality of individual medical records are followed; (iv) A copy of the materials designed to inform applicable patients and providers of the requirements of the utilization review plan; and (v) A list (names and addresses) of the third party payors for which the private review agent is performing utilization review in this state. vi) Compliance with statutory prior authorization requirements as set forth in Miss. Code Ann. §§ 83-5-901 through 83-5-937.

Rule 19.07. Renewal of Certification. (1) A certificate expires on the second anniversary of its effective date unless certification has been renewed for a two (2) year term.

(2) Before the certification expires, the certified private review agent may renew its certification for an additional two (2) year term, if the certified private review agent:

a. Is otherwise entitled to be certified;

b. Pays to the Department the renewal fee of $1,500.00, either by business check, money order, or by electronic means; and

c. Submits to the Department:

i. A renewal application on the form that the Commissioner requires;

ii. An update of information as required under Rule 19.06;

iii. An annual report.

(3) The Department shall renew the certification of each certified private review agent, if the requirements of these regulations are met.

History

• Source: Miss. Code Ann. §41-83-1, et seq. (rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83- 5-937.
• Source: Miss. Code Ann. §41-83-7 (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5-937.

19 Miss. Admin. Code Pt. 3, R. 19.08 Rule 19.08

Denial or Revocation of Certification and Penalty (1) The Commissioner shall deny a certificate to an applicant if the Department finds that the applicant does not:

a. Have available the services of a sufficient number of registered nurses, that are supervised by appropriate physicians to efficiently carry out its utilization review activities;

i. Meet any applicable provisions of these rules and regulations relating to the qualifications of private review agents or the performance of utilization review the Department adopts relating to the qualifications of private review agents or the performance of utilization review;

ii. Have policies and procedures which protect the confidentiality of medical records in accordance with applicable state and federal laws; or

iii. Make itself accessible to patients and providers five (5) working days a week during normal business hours in this state, or

iv. Does not comply with prior authorization standards as provided in Miss. Code Ann. §§ 83-5-901 through 83-5-937.

(2) The Commissioner may revoke the certification of a private review agent if the Department finds that the agent:

a. Does not comply with performance assurances;

b. Violates any provision of these rules and regulations;

c. Fails to substantially meet the standards and qualifications adopted by the Commissioner;

d. Does not comply with prior authorization standards as provided in Miss. Code Ann. §§ 83-5-901 through 83-5-937; or

e. Fails to comply with the regulations adopted by the Department.

(3) Before denying or revoking a certificate, the Commissioner shall comply with the process for Administrative Hearings as provided in 19 Miss. Admin. Code, Part 1, Rule 15.08 and Rule 15.09, “Rules of Practice and Procedure before the Mississippi Insurance Department and State Fire Marshal’s Office”.

(4) A private review agent may not disclose or publish individual medical records or any other confidential medical information obtained in the performance of utilization review activities without the patient's authorization or an order of a county, circuit or chancery court of Mississippi or a U. S. District Court. It is provided, however, that nothing in these regulations shall prohibit private review agents from providing information to the third party with whom the private review agent is under contract or acting on behalf of.

Rule 19.09. Utilization Review Standards

(1) Responsibility for Obtaining Certification

a. In the absence of any contractual agreement to the contrary, the enrollee is responsible for notifying the private review agent in a timely manner and obtaining certification for health care services, if required by the health benefit plan. A private review agent shall allow any licensed health care provider, or responsible patient representative, including a family member, to assist in fulfilling that responsibility.

b. To ensure confidentiality, a private review agent must, when contacting a health care provider’s office or facility, or hospital, provide its certification number, the caller's name, and professional qualification to the designated utilization review representative in the health care provider’s office or facility, or hospital.

(2) Information Upon Which Utilization Review is Conducted

a. When conducting routine prospective and concurrent utilization review, the private review agent shall collect only the information necessary to certify the admission, procedure or treatment and length of stay.

b. A private review agent should not routinely expect hospitals and physicians to supply numerically codified diagnoses or procedures. The private review agent may ask for such coding, since if it is known, its inclusion in the data collected increases the effectiveness of the communication.

c. The private review agent shall not routinely request copies of medical records on all patients reviewed. During prospective and concurrent review, copies of medical records should only be required when a difficulty develops in certifying the medical necessity or appropriateness of the admission or extension of stay. In those cases, only the necessary or pertinent sections of the record should be required.

d. Private review agents may request copies of medical records retrospectively for a number of purposes, including auditing the services provided, quality assurance, and evaluation of compliance with the terms of the health benefit plan or Utilization Review provisions. With the exception of the reviewing of records associated with an appeal or with an investigation of data discrepancies and unless otherwise provided for by contract or law, health care providers should be reimbursed the reasonable direct costs of duplicating requested records for retrospective review. e. Private review agents must comply with prior authorization standards as established by Miss. Code Ann. §§ 83-5-901 through 83-5-937.

(3) Except as otherwise provided in these standards, a private review agent should limit its initial data requirements to the following elements:

a. Patient Information

i. Name

ii. Address

iii. Date of Birth

iv. Sex

v. Social Security Number or Patient ID Number

vi. Name of Carrier or Plan

vii. Plan ID Number

b. Enrollee Information i. Name ii. Address iii. Social Security Number or Employee ID Number iv. Relation to Patient v. Employer vi. Health Benefit Plan vii. Group Number/Plan ID Number viii. Other Coverage Available (Workers’ Comp., Medicare, etc.) c. Attending Physician/Practitioner Information i. Name ii. Address iii. Phone Number iv. Degree v. Specialty/Certification Status vi. Tax ID or Other ID Number d. Diagnosis/Treatment Information i. Primary Diagnosis ii. Secondary Diagnosis iii. Proposed Procedure(s) or Treatment(s) iv. Surgical Assistant Requirement v. Anesthesia Requirement

vi. Proposed Admission or Service Date(s) vii. Proposed Procedure Date viii. Proposed Length of Stay e. Clinical Information. Sufficient information for support of appropriateness and level of service proposed f. Facility Information i. Type (such as in-patient, out-patient, rehab, etc.) ii. Status (DRG exempt status, as needed) iii. Name iv. Address v. Phone Number vi. Tax ID or Other ID Number g. Concurrent (Continued Stay) Review Information i. Clinical Contact Person ii. Additional Days/Services Proposed iii. Reasons for Extension iv. Diagnosis (same/changed) v. Clinical Information (Sufficient to support, as above) h. Admissions to Facilities Other Than Acute Medical/Surgical Hospitals i. History of Present Illness ii. Patient Treatment Plan and Goals iii. Prognosis iv. Staff Qualifications v. 24 Hour Availability of Staff i. Compliance with prior authorization standards as established by Miss. Code Ann. §§

83-5-901 through 83-5-937. (4) Special Situations

a. Additional information may be required for other specific review functions such as discharge planning or catastrophic case management. Second opinion information may also be required, when applicable, sufficient to support benefit plan requirements. b. Information in addition to that described in this section may be requested by the private review agent or voluntarily submitted by the provider, when there is significant lack of agreement between the private review agent and health care provider regarding the appropriateness of certification during the review or appeal process. "Significant lack of agreement" means that the private review agent has: i. Tentatively determined, through its professional staff, that a service cannot be certified; ii. Referred the case to a physician for review; and iii. Talked to or attempted to talk to the attending physician for further information. c. A private review agent should share all clinical and demographic information on individual patients among its various divisions (e.g., certification, discharge planning, case management) to avoid duplicate requests for information from enrollee or providers. (5) Procedures For Review Determination

a. Each private review agent shall have written procedures to ensure that reviews are conducted in a timely manner and as expeditiously as the enrollee’s condition requires.

b. Each private review agent shall make utilization reviews of prior authorization after obtaining all necessary information within pursuant to the timeframes establish in Rule 19.09(6) for nonurgent circumstances and Rule 19.09(7) for urgent circumstances, unless a longer minimum time frame is required under federal law for the health insurance issuer and the health care service at issue. Collection of the necessary information may necessitate a discussion with the attending physician or, based on the requirements of the health benefit plan, may involve a completed second opinion review.

c. A private review agent may review ongoing inpatient stays, but shall not routinely conduct daily review on all such stays. The frequency of the review for extension

of the initial determination should vary based on the severity or complexity of the patient's condition or on necessary treatment and discharge planning activity. Routine concurrent review generally should not be necessary earlier than 24 hours prior to the lapse of the certified length of stay.

d. Each private review agent shall have in place written procedures for providing notification of its determination regarding certification, recertification, or extensions of previously authorized length of stay in accordance with the following:

i. When an initial determination is made to certify, notification shall be provided promptly either by telephone or in writing, via letter or electronic mail, to the attending physician. The notification shall be transmitted in writing to the hospital and attending physician, as well as to the enrollee or patient, within two working days. ii. A determination to certify resulting from concurrent review shall be transmitted to the attending physician by telephone or in writing within one working day of receipt of all information necessary to complete the review process or prior to the end of the current certified period. iii. If a private review agent transmits written confirmation of certification for continued hospitalization, that notification shall include the number of extended days, the new total number of days approved, and the date of admission. iv. When a determination is made not to certify a hospital or surgery facility admission or extension of a hospital stay or other service requiring review determination, the attending physician shall be notified by telephone within one working day and a written notification should be sent within one working day to the hospital, attending physician and the enrollee or patient. The written notification shall include the principal reason(s) for the determination and the way to initiate an appeal of the determination if the enrollee, patient, or their representative so chooses. Reasons for a determination not to certify shall include, among other things, the lack of adequate information to certify after a reasonable attempt has been made to contact the attending physician. (6) Utilization review of prior authorizations in nonurgent circumstances. If a health insurance issuer requires prior authorization of a health care service, the health insurance issuer must make an approval or adverse determination and notify the enrollee, the enrollee's health care professional, and the enrollee's health care provider of the approval or adverse determination as expeditiously as the enrollee's condition requires but no later

than seven (7) calendar days after obtaining all necessary information to make the approval or adverse determination, unless a longer minimum time frame is required under federal law for the health insurance issuer and the health care service at issue. As used in this section, "necessary information" includes the results of any face-to-face clinical evaluation, second opinion or other clinical information that is directly applicable to the requested service that may be required. Notwithstanding the foregoing provisions of this section, health insurance issuers must comply with the requirements of Miss. Code Ann. § 83-9-6.3 to respond by two (2) business days for prior authorization requests for pharmaceutical services and products.

(7) Utilization review of prior authorizations in urgent circumstances.

a. If requested by a treating health care provider or health care professional for an enrollee, a health insurance issuer must render an approval or adverse determination concerning urgent health care services and notify the enrollee, the enrollee's health care professional and the enrollee's health care provider of that approval or adverse determination as expeditiously as the enrollee's condition requires but no later than forty-eight (48) hours after receiving all information needed to complete the review of the requested health care services, unless a longer minimum time frame is required under federal law for the health insurance issuer and the urgent health care service at issue.

b. To facilitate the rendering of a prior authorization determination in conformance with this section, a health insurance issuer must establish a mechanism to ensure health care professionals have access to appropriately trained and licensed clinical personnel who have access to physicians for consultation, designated by the plan to make such determinations for prior authorization concerning urgent care services.

(8) Notwithstanding language to the contrary elsewhere contained herein, if a licensed physician certifies in writing to an insurer within seventy-two (72) hours of an admission that the insured person admitted was in need of immediate hospital care for emergency services, such shall constitute a prima facie case of the medical necessity of the admission. To overcome this, the entity requesting the utilization review and/or the private review agent must show by clear and convincing evidence that the admitted person was not in need of immediate hospital care.

(9) Private review agents shall have in place written procedures to address the failure of a health care provider, patient, or their representative to provide the necessary information for review. If the patient or provider will not release the necessary information to the Utilization Review Organization, the Utilization Review Organization may deny certification in accordance with its own policy or that of the health benefit plan.

Rule 19.10. Appeals of Determinations Not to Certify (1) Each private review agent shall have in place procedures for appeals of determinations not to certify an admission, procedure, service or extension of stay. The right to appeal shall be available to the patient or enrollee, and to the attending physician on behalf of the patient. The procedures for appeals shall include, at a minimum, the following statement: a. Any person aggrieved by a final decision of the department or a private review agent in a contested case under this act shall have the right of judicial appeal to the chancery court of the county of the residence of the aggrieved person. b. Notwithstanding any provision of this act, the insured shall have the express right to pursue any legal remedies he may have in a court of competent jurisdiction.

(2) If a prior review agent has clear and convincing evidence that a health care professional or health care provider has knowingly and willingly submitted false or fraudulent requests for prior authorization to the health insurance issuer, the issuer shall notify and provide that the information in the manner as provided in Subsection (3) of this Section to the Commissioner of Insurance. (3) If a health insurance issuer intends either to implement a new prior authorization requirement or restriction or amend an existing requirement or restriction, the health insurance issuer shall provide contracted health care professionals and contracted health care providers of enrollees written notice of the new or amended requirement or amendment no less than sixty (60) days before the requirement or restriction is implemented. Written notice may take the form of a conspicuous notice posted on the health insurance issuer’s public website or portal for contracted health care professionals and contracted health care providers. A health insurance issuer shall provide email notices to health care professionals or health care providers if the health care professional or health care provider has requested to receive the notice through email. The health insurance issuer shall ensure that the new or amended requirement is not implemented unless the health insurance issuer’s website has been updated to reflect the new or amended requirement or restriction. Written notice of a new, amended, or restricted prior authorization requirement, as required by Miss. Code Ann. §83-5-909(6), may be provided less than sixty (60) days in advance if a health insurance issuer determines and contemporaneously notifies the department in writing and submitted to priorauthoriztion.notice@mid.ms.gov : (a) The health insurance issuer has identified fraudulent or abusive practices related to the health care service; (b) The health care service is unavailable or scarce which necessitates the use of an alternative health care service; (c) The health care service is newly introduced to the health care market and a delay in providing coverage for the health care service and would not be in the best interests of enrollees;

(d) The health care service is the subject of a clinical trial authorized by the United States Food and Drug Administration; or (e) Changes to the health care service or its availability are otherwise required by law to be made by the health insurance issuer in less than sixty (60) days.

Rule 19.11. Computation of Time (1) Utilization review of prior authorizations in nonurgent circumstances. If a health insurance issuer requires prior authorization of a health care service, the health insurance issuer must make an approval or adverse determination and notify the enrollee, the enrollee's health care professional, and the enrollee's health care provider of the approval or adverse determination as expeditiously as the enrollee's condition requires but no later than seven (7) calendar days after obtaining all necessary information to make the approval or adverse determination, unless a longer minimum time frame is required under federal law for the health insurance issuer and the health care service at issue. As used in this section, "necessary information" includes the results of any face-to-face clinical evaluation, second opinion or other clinical information that is directly applicable to the requested service that may be required. Notwithstanding the foregoing provisions of this section, health insurance issuers must comply with the requirements of Miss. Code Ann. § 83-9-6.3 to respond by two (2) business days for prior authorization requests for pharmaceutical services and products.

(2) Utilization review of prior authorizations in urgent circumstances.

a. If requested by a treating health care provider or health care professional for an enrollee, a health insurance issuer must render an approval or adverse determination concerning urgent health care services and notify the enrollee, the enrollee's health care professional and the enrollee's health care provider of that approval or adverse determination as expeditiously as the enrollee's condition requires but no later than forty-eight (48) hours after receiving all information needed to complete the review of the requested health care services, unless a longer minimum time frame is required under federal law for the health insurance issuer and the urgent health care service at issue.

b. To facilitate the rendering of a prior authorization determination in conformance with this section, a health insurance issuer must establish a mechanism to ensure health care professionals have access to appropriately trained and licensed clinical personnel who have access to physicians for consultation, designated by the plan to make such determinations for prior authorization concerning urgent care services.

(3) Notwithstanding language to the contrary elsewhere contained herein, if a licensed physician certifies in writing to an insurer within seventy-two (72) hours of an admission

that the insured person admitted was in need of immediate hospital care for emergency services, such shall constitute a prima facie case of the medical necessity of the admission. To overcome this, the entity requesting the utilization review and/or the private review agent must show by clear and convincing evidence that the admitted person was not in need of immediate hospital care.

(4) Notwithstanding the foregoing provisions of this Rule, health insurance issuers must comply with the requirements of Miss. Code Ann. § 83-9-6.2 to respond by two (2) business days for prior authorization requests for pharmaceutical services and products.

Rule 19.12. Urgent Prior Authorization Requests; Access to Physicians. To facilitate an Urgent Prior Authorization request in a timely manner as required by statute and this Rule, a health insurance issuer must establish a policy to ensure Health Care Professionals, defined as a physician, registered professional nurse or other individual appropriately licensed or registered to provide health care services, have access to appropriately trained and licensed clinical personnel who have access to physicians for consultation, designated by the plan to make such determinations for prior authorization concerning urgent care services. This policy must include the following: (1) Identification of the physicians available for consultation for each designated health service that requires prior authorization and contact information for those physicians.

(2) Time frame for physicians to respond to Health Care Professionals or other clinical personnel.

(3) Identification of the trained and licensed clinical personnel available for consultation for each designated health service that requires prior authorization and a method to contact said licensed clinical personnel. Identification may be made by providing the job title of the licensed clinical personnel.

(4) The expertise required by the consulting physicians, which should take into consideration the physician’s specialty and experience as determined by the health care services requiring Urgent Prior Authorization. This policy is separate from the requirement of use of physicians qualified to review appeals. Such policy shall be submitted to the Department upon request.

Rule 19.13. Notification for Adverse Determinations / Form When a provider or facility makes a request for prior authorization, should a health insurance issuer make an adverse determination, the health insurance issuer shall include in writing the

following in the notification to the enrollee, the enrollee's health care professional, and the enrollee's health care provider: (1) The reasons for the adverse determination and related evidence-based criteria, including a description of any missing or insufficient documentation; (2) The right to appeal the adverse determination; (3) Instructions on how to file the appeal; and (4) Additional documentation necessary to support the appeal. A decision may be provided orally, but subsequent written notice must also be provided within twenty-four (24) hours of the oral decision. A denial must include the department and credentials of the individual who has the authorizing authority to approve or deny the request, including a phone number to contact the authorizing authority and a notice regarding the enrollee’s appeal rights and process. A health insurance issuer, when sending a notice to a covered person of a denial of a request for prior authorization made under this section, shall include with such notice the following statement in bold and in twelve (12) point font: THE STATEMENT BELOW IS REQUIRED BY MISSISSIPPI INSURANCE DEPARTMENT REGULATION ACTIONS YOU CAN TAKE AND HOW TO GET HELP You, or someone on your behalf, recently requested approval from your health insurance plan for a health care service or item. Your health insurance plan denied the request. You have the right to ask your health insurance plan to change this decision. This is called an internal appeal. If the request is not approved after an internal appeal, your request may be eligible for a review by an independent third party. This is called an external review. The independent third party may change your health insurance plan’s decision, or it may confirm your health insurance plan’s decision. Please read carefully the information your health insurance plan has provided with this insert. This information explains the reason(s) for the health insurance plan’s decision, as well as how to ask for an internal appeal or external review, including any deadlines and timing. You should also feel free to contact your health insurance plan or the Mississippi Insurance Department to help you understand your rights and answer any questions. Contact information for both your health insurance plan and the Department is included in the information your health insurance plan has provided.

Rule 19.14. Qualifications of persons reviewing appeals

1. A health insurance issuer must ensure that all appeals are reviewed by a physician when the request is by a physician or a representative of a physician. The physician must:

a. Possess a current and valid nonrestricted license to practice medicine in any United States jurisdiction;

b. Be certified by the board(s) of the American Board of Medical Specialists or the American Board of Osteopathy within the relevant specialty of a physician who typically manages the medical condition or disease;

c. Be knowledgeable of, and have experience providing, the health care services under appeal;

d. Not have been directly involved in making the adverse determination; and

e. Consider all known clinical aspects of the health care service under review, including, but not limited to, a review of all pertinent medical records provided to the health insurance issuer by the enrollee's health care professional or health care provider and any medical literature provided to the health insurance issuer by the health care professional or health care provider.

Rule 19.15. Change of patient status to emergency status after submission of prior authorization request. Notwithstanding language to the contrary elsewhere contained herein, if a licensed physician certifies in writing to an insurer within seventy-two (72) hours of an admission that the insured person admitted was in need of immediate hospital care for emergency services, such shall constitute a prima facie case of the medical necessity of the admission. To overcome this, the entity requesting the utilization review and/or the private review agent must show by clear and convincing evidence that the admitted person was not in need of immediate hospital care.

Rule 19.16. Length of Approvals. (1) A prior authorization approval shall be valid for the lesser of six (6) months after the date the health care professional or provider receives the prior authorization approval or the length of treatment as determined by the patient’s health care professional or the renewal of the policy or plan, and the approval period shall be effective regardless of any changes, including any changes in dosage for a prescription drug prescribed by the health care professional. Notwithstanding the foregoing, a health insurer and an enrollee or his/her health care professional may extend a prior authorization approval for a longer period by agreement. All dosage increases must be based on established evidentiary standards, and nothing in this section shall prohibit a health insurance

issuer from having safety edits in place. This provision shall not apply to the prescription of benzodiazepines or Schedule II narcotic drugs, such as opioids. (2) Nothing in this provision shall require a policy or plan to cover any care, treatment, or services for any health condition that the terms of coverage otherwise completely exclude from the policy’s or plan’s covered benefits without regard for whether the care, treatment or services are medically necessary.

Rule 19.17. Approvals for chronic conditions. (1) If a health insurance issuer requires a prior authorization for a recurring health care service or maintenance medication for the treatment of a chronic or long-term condition, including, but not limited to, chemotherapy for the treatment of cancer, the approval shall remain valid for the lesser of twelve (12) months from the date the health care professional or health care provider receives the prior authorization approval or the length of the treatment as determined by the patient's health care professional. Notwithstanding the foregoing, a health insurer and an enrollee or his or her health care professional may extend a prior authorization approval for a longer period, by agreement. This section shall not apply to the prescription of benzodiazepines or Schedule II narcotic drugs, such as opioids. (2) Nothing in this section shall require a policy or plan to cover any care, treatment or services for any health condition that the terms of coverage otherwise completely exclude from the policy's or plan's covered benefits without regard for whether the care, treatment, or services are medically necessary.

Rule 19.18. Continuity of Prior Approvals. (1) On receipt of information documenting a prior authorization approval from the enrollee or from the enrollee's health care professional or health care provider, a health insurance issuer shall honor a prior authorization granted to an enrollee from a previous health insurance issuer for at least the initial ninety (90) days of an enrollee's coverage under a new health plan, subject to the terms of the member's coverage agreement. (2) During the time period described in subsection (1) of this rule, a health insurance issuer may perform its own review to grant a prior authorization approval subject to the terms of the member's coverage agreement. (3) If there is a change in coverage or approval criteria for a previously authorized health care service, the change in coverage or approval criteria does not affect an enrollee who received prior authorization approval before the effective date of the change for the remainder of the enrollee's plan year. (4) Except to the extent required by medical exceptions processes for prescription drugs, nothing in this rule shall require a policy or plan to cover any care, treatment or services for any health condition that the terms of coverage otherwise completely exclude from the policy's or plan's

covered benefits without regard for whether the care, treatment or services are medically necessary.

Rule 19.19. Revocations of prior authorizations. (1) A health insurance issuer may not revoke or further limit, condition or restrict a previously issued prior authorization approval while it remains valid under this act. (2) Notwithstanding any other provision of law, if a claim is properly coded and submitted timely to a health insurance issuer, the health insurance issuer shall make payment according to the terms of coverage on claims for health care services for which prior authorization was required and approval received before the rendering of health care services, unless one (1) of the following occurs: (a) It is timely determined that the enrollee's health care professional or health care provider knowingly and without exercising prudent clinical judgment provided health care services that required prior authorization from the health insurance issuer or its contracted private review agent without first obtaining prior authorization for those health care services; (b) It is timely determined that the health care services claimed were not performed; (c) It is timely determined that the health care services rendered were contrary to the instructions of the health insurance issuer or its contracted private review agent or delegated reviewer if contact was made between those parties before the service being rendered; (d) It is timely determined that the enrollee receiving such health care services was not an enrollee of the health care plan; or (e) The approval was based upon a material misrepresentation by the enrollee, health care professional, or health care provider; as used in this paragraph, "material" means a fact or situation that is not merely technical in nature and results or could result in a substantial change in the situation. (3) Nothing in this section shall preclude a private review agent or a health insurance issuer from performing post-service reviews of health care claims for purposes of payment integrity or for the prevention of fraud, waste, or abuse.

History

• Source: Miss. Code Ann. §41-83-1, et. seq. (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §41-83-1, et. seq. (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§41-83-1, et. seq; §83-9-6.2; Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §41-83-1, et. seq Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §41-83-1, et. seq.; Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §41-83-1, et. seq.; Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §41-83-21 (Rev. 2023); Miss. Code Ann. §§ 83-5-901 through 83-5- 937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.

19 Miss. Admin. Code Pt. 3, R. 19.20 Standardized electronic prior authorizations

(1) By January 1, 2025, all health insurance issuer or designee utilization review organization shall make available a standardized electronic prior authorization request transaction process using an internet webpage, internet webpage portal, or similar electronic, internet, and web-based system.

(2) Not later than January 1, 2027, all health care professionals and health care providers shall be required to use the standardized electronic prior authorization request transaction process made available as required by subsection (1) of Rule 19.20. (3) Not later than January 1, 2027, all health insurance issuers or designee utilization review organization shall comply with the Centers for Medicare & Medicaid Services, CMS-0057-F, Prior Authorization and Interoperability Final Rule (2024), regarding automation of prior authorization application programming interfaces.

Rule 19.21. Reports to the Department (1) By June 1, 2025, and each June 1 after that date, a health insurance issuer shall report to the department, on a form issued by the department, the following aggregated trend data, de- identified of protected health information, related to the insurer's practices and experience for the prior plan year for health care services submitted for payment: (a) The number of prior authorization requests; (b) The number of prior authorization requests denied; (c) The number of prior authorization appeals received; (d) The number of adverse determinations reversed on appeal; (e) Of the total number of prior authorization requests, the number of prior authorization requests that were not submitted electronically; (f) The ten (10) health care services that were most frequently denied through prior authorization; (g) The ten (10) reasons prior authorization requests were most frequently denied; (h) The number of claims for health care services that were examined through a post- service utilization review process; (i) The number and percentage of claims for health care services denied through post- service utilization review; and (j) The ten (10) health care services that were most frequently denied as a result of post- service utilization reviews. (k) Any prior authorization requirements that have been removed. (2) All reports required by this section shall be considered public records under the Mississippi Public Records Act of 1983 and the Department shall make all reports freely available to requestors and post all reports to its public website without redactions.

Rule 19.22. Prior Authorization Statistics

Pursuant to Miss. Code Ann. §83-5-909(7), health insurance issuers using prior authorization shall make statistics available regarding prior authorization approvals and denials on their website in a readily accessible format. Following each calendar year, the statistics must be updated annually, by March 31, and include all of the following information: (1) A list of all health care services, including medications, that are subject to prior authorization;

(2) The percentage of standard prior authorization requests that were approved, aggregated for all items and services;

(3) The percentage of standard prior authorization requests that were denied, aggregated for all items and services;

(4) The percentage of prior authorization requests that were approved after appeal, aggregated for all items and services;

(5) The percentage of prior authorization requests for which the timeframe for review was extended, and the request was approved, aggregated for all items and services;

(6) The percentage of expedited prior authorization requests that were approved, aggregated for all items and services;

(7) The percentage of expedited prior authorization requests that were denied, aggregated for all items and services;

(8) The average and median time that elapsed between the submission of a request and a determination by the payer, plan or health insurance issuer, for standard prior authorization, aggregated for all items and services;

(9) The average and median time that elapsed between the submission of a request and a decision by the payer, plan or health insurance issuer, for expedited prior authorizations, aggregated for all items and services

Rule 19.23. Enforcement and administration The Department may issue a cease-and-desist order or require a private review agent or health insurance issuer to submit a plan of correction for violation of Miss. Code Ann. §§ 83-5-901 through 83-5-937. The Department may impose upon a private review agent, health benefit plan or health insurance issuer an administrative fine not to exceed Ten Thousand Dollars ($10,000.00) per violation for failure to submit a requested plan of correction, failure to comply with its plan of correction, or repeated violations of this act. All hearings related to the enforcement and administration of this act shall be in accordance with 19 Miss. Admin. Code Part 1, Ch. 15, as may be amended from time to time. All fines collected by the Department under this section shall be deposited into the State General Fund.

Upon receipt of a complaint by any person or his or her treating physician who has evidence that his or her health insurance issuer or health benefit plan is in violation of the provisions contained in Miss. Code Ann. §§ 83-5-901 through 83-5-937, these regulations, the Department shall review all complaints received and investigate all complaints that it deems a potential violation in accordance with normal Department policies and procedures and in a fair, efficient ant timely manner

Rule 19.24. Penalties (1) A failure by a health insurance issuer to comply with the deadlines and other requirements specified in this act shall result in any health care services subject to review to be automatically deemed authorized by the health insurance issuer or its contracted private review agent. (2) A private review agent, health benefit plan or health insurance issuer. The failure of a private review agent, health benefit plan or health insurance issuer to comply with the provisions of Miss. Code Ann. §§ 83-5-901 through 83-5-937 or the provisions of this Regulation shall subject said entity to the penalty provisions as provided in Miss. Code Ann. § 83-5-933.

Rule 19. 25. Severability If any provision of this Regulation, or the application of the provision to any person or circumstance shall be held invalid, the remainder of the Regulation, and the application of the provision to persons or circumstances other than those to which it is held invalid, shall not be affected.

Rule 19.26. Effective Date This Regulation shall be effective on and after January 1, 2025.

History

• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. §§ 83-5-901 through 83-5-937.
• Source: Miss. Code Ann. § 83-5-1; § 83-41-413 (Rev. 2022).
• Source: Miss. Code Ann. § 25-43-3.108 (Rev. 2022); Miss. Code Ann. §§ 83-5-901 through 83- 5-937.

Part 4 Automobile Insurance

Chapter 1 A (79-1) Automobile Club Service Contracts Pursuant To The Provisions Of Miss. Code Ann. §§81-11-201 Through 83-11-247.

19 Miss. Admin. Code Pt. 4, R. 1.01 Automobile Club Service Contracts

TO: ALL COMPANIES WRITING AUTOMOBILE CLUB SERVICE CONTRACTS PURSUANT TO THE PROVISIONS OF SECTIONS 83-11-201 THROUGH 83-11-247 OF THE MISSISSIPPI CODE OF 1972, ANNOTATED.

WHEREAS, it has come to the attention of the Department of Insurance and the Commissioner of Insurance that certain automobile clubs and automobile club agents have, because of certain company-agent problems committed acts that are either misleading or confusing to the automobile club buying public in revealing to the named club member the identity of the automobile club holding the member’s automobile club service contract, and

WHEREAS, following a detailed study of the automobile club service contract field in the State of Mississippi, it has been decided that some automobile clubs and automobile club agents are involved in the practice of “twisting” to the detriment of the automobile club buying public of the State of Mississippi.

THEREFORE, it is the considered opinion of the Insurance Commissioner of the State of Mississippi that certain voluntarily steps be taken by the automobile clubs doing business in this state to help remedy this problem, and,

THAT the Commissioner of Insurance suggests that all automobile clubs doing business in this state initiate a program wherein all agents presently in the employ of, or hired from this day forward, be employed through the use of a written contract setting forth all of the conditions and responsibilities of such employment and that each and every agent’s contract contain the following standard provisions in the words in which the same appear in this letter, to wit:

“It is agreed, in the event of the termination of this employment by either party with or without cause, that for a period of one (1) year after the date of such termination, if such employee shall go into business alone or in conjunction with one or more persons or in the employ of any person, partnership, association, corporation, automobile club or other legal entity where the business of such employment shall be the same or similar to that of the company, that such employee shall not;

(1) Solicit any active or paid up members or holders of service contracts of the company;

(2) Loan to, pay off or pay on any active membership or service contract of the company.

(3) Transmit or reveal any information, written or oral, concerning the active or paid up membership or service contract of the company, or its method of operation, or the types of benefits offered by the company or use same for himself or others in the same or similar employment.

Further, members or service contract holders shall be regarded or defined as; All persons, and each and every one thereof, for whom the company performs services in the course of its business, are and shall be the members or service contract holders of the company , as well after the termination of, as at all times during, the employment of the employee, not withstanding that some or all of said persons may have been induced to give their patronage to the company by the solicitation of the employee, or of someone on his behalf, either during the usual hours of employment of the employee or otherwise, and not withstanding that all or some of such persons may have previously been customers of the employee or others.”

WHEREFORE, it is requested that all automobile clubs doing business in this state announce to the Commissioner of Insurance, within ten (10) working days of this writing, their intention to either comply with or resist this request, and if such automobile club refuses to voluntarily comply with this request to state their reasons for same. Full compliance of this request will be effective thirty (30) days from the date of this writing.

IT IS, THEREFORE, the hope of the Commissioner of Insurance that all automobile clubs doing business in this state will comply with this request so that the automobile club buying public of this state will be protected from the practices mentioned herein and that it will not be necessary to promulgate any further rules or regulations in the furtherance of the purposes stated herein. The Department of Insurance and the Commissioner of Insurance earnestly solicit the cooperation of all concerned.

Dated: February 12, 1979.

History

• Source: Miss. Code Ann. §§_83-11-201 through 83—11-247 (Rev. 2011)

Chapter 2 (2002-1) Non-Stacking Uninsured Motorist Insurance Coverage.

19 Miss. Admin. Code Pt. 4, R. 3.01 Purposes of Plan

The purposes of the Plan are to make automobile bodily injury, property damage, and medical payment liability insurance available to vehicles registered with the Mississippi Division of Motor Vehicles, subject to the conditions hereinafter stated and in the Mississippi Plan of Operation (hereinafter the “Plan of Operation”) and the Mississippi Automobile Insurance Plan of Rules and Rates (hereinafter the “Plan Manual”). The Plan may issue private passenger motor vehicle policies, and commercial motor vehicle policies in the name of the Plan. Such policies shall be recognized as if issued by an insurance company authorized to issue insurance in this state. The Plan shall also establish procedures for the sharing of premium, losses, costs, and expenses generated by the Personal Automobile Insurance Procedure (hereinafter “PAIP”) among all subscriber companies writing voluntary private passenger non-fleet (hereinafter “PPNF”) and the Commercial Automobile Procedure (hereinafter “CAIP”) among all subscriber companies writing voluntary other than private passenger (hereinafter “OTPP”) policies in the State of Mississippi. Copies of the Plan of Operation or Plan Manual may be obtained at www.aipso.com/ms or by calling 1-800-301-6477.

History

• Source: Miss. Code Ann. §§83-5-1 (Rev. 2011); 63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.02 Effective Date

The Plan became effective in February of 1949 when all companies licensed to write direct automobile bodily injury liability insurance in the state have subscribed thereto. The requirements in this Regulation shall become effective upon adoption. No company which is licensed to write only reinsurance shall be a subscriber to this plan.

History

• Source: Miss. Code Ann. §25-43-3.102 (Rev. 2010).

19 Miss. Admin. Code Pt. 4, R. 3.03 Residents and Non-Residents

A. Except as may be otherwise provided, the Plan shall be available to residents and non- residents of the state only with respect to automobiles that are registered in the state, except that non-residents who are members of the United States military forces shall be eligible with respect to automobiles registered in other states provided such military non- residents are stationed in this state at the time application is made and are otherwise eligible for insurance under the Plan.

B. A motor vehicle registered in Mississippi, and principally garaged in another state shall be subject to the rates, additional charges, rating rules and policy forms applicable under the Automobile Insurance Plan of the state of principal garaging, and such applicants shall be assigned to companies licensed to write and writing automobile liability insurance in that state.

C. When a vehicle registered in Mississippi is principally garaged in another state whose Automobile Insurance Plan does not provide for physical damage coverage such risk shall be subject to whichever of the following will produce the higher dollar amount:

1. The rates applicable to the Mississippi territory determined by the address shown on the registration, and otherwise subject to all of the provisions of this Plan, or

2. The rules, rates, minimum premiums, classifications in force and rating plans applicable in the state and territory where the vehicle is principally garaged, and otherwise subject to all of the provisions of this Plan.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.04 Administration

The Plan shall be administered by a Governing Committee and a Manager. The Governing Committee (hereinafter referred to as “the Committee”) must be approved by the Commissioner of Insurance and shall consist of nine voting members, who are Plan Subscriber Companies, two non-voting members who are licensed Mississippi resident property and casualty insurance producers and two ex officio non-voting members.

A. Subscriber Companies shall be chosen from each of the following classes of insurers:

1. Six Subscribers from the American Property Casualty Insurers Association (APCIA);

2. Three Subscribers from the Non-Affiliated Insurance Companies (NAF)

When the APCIA or NAF are unable to appoint one or more subscriber companies to serve on the Governing Committee, the vacant seat shall be opened up to any subscriber company for that term only. The company to fill the vacancy for that term only will be chosen by a process to be determined by the Governing Committee. At the end of the term, the seat will be resumed by a representative from the respective class of company.

Each voting member serving on the Committee shall designate a representative to act on its behalf. This representative shall be either (1) a salaried employee or officer of the named subscriber company or (2) a salaried employee of officer of another subscriber company from a group of companies under the same management as the named subscriber company. A salaried employee or officer of the holding company of the named subscriber company may also be designated as the representative.

B. Two non-voting members shall be chosen from a list of all licensed Mississippi resident property and casualty insurance producers.

C. The Commissioner of Insurance shall appoint two persons, who are employed by the Mississippi Insurance Department, to serve as ex officio non-voting members.

Prior to the biennial meeting, the Manager shall poll the nonaffiliated companies to determine those companies desiring to serve on the Committee and then conduct a mail ballot prior to the annual meeting for the nonaffiliated companies to elect their representatives. Nonaffiliated company representatives shall be selected on a weighted vote basis by all nonaffiliated company insurers. Each nonaffiliated company shall cast a proportionate vote based on that company’s respective Voluntary Private Passenger Nonfleet Liability Direct Written Premiums and Voluntary Other than Private Passenger Liability and Physical Damage Net Direct Written Premiums written in the state for the calendar year ending December 31 of the second prior year by nonaffiliated companies as reported to AIPSO by statistical agents.

Biennially, on a date fixed by the Committee, each respective group of insurers heretofore described shall elect its representative to the Committee to serve for a period of one year or until a successor is elected. Forty-five (45) days’ notice of such meeting shall be given in writing to all subscribers and members to the Plan. The subscriber companies and members may be present or represented by proxy at such meetings and voting by proxy shall be permitted.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2013).

19 Miss. Admin. Code Pt. 4, R. 3.05 Duties of Governing Committee

The Committee shall meet as often as may be required to perform the general duties of administration of the Plan. A majority of the filled voting members’ seats of the Committee shall constitute a quorum.

The Committee shall be empowered to appoint a Manager, budget expenses, levy assessments, disburse funds and perform all duties essential to the proper administration of the Plan.

Upon request, the Committee shall furnish to any subscribers to the Plan, a written report of operations annually in such form and detail as the Committee may determine. The annual report shall be available on the Plan website. In addition, hardcopies of the report may be available by contacting the Plan.

Rule 3. Subscriber Participation

A. The Plan shall establish a procedure to perform all such policy holder and claim handling services as may be necessary to administer the PAIP.

B. The Plan shall distribute CAIP applications to the CAIP servicing carriers for servicing of eligible risks.

C. Company groups under the same ownership may elect to be treated as one company to receive assessments, and for PAIP and CAIP participation ratios.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).
• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.07 Cost of Administration

Each company subscribing to the Plan shall pay a minimum annual fee and assessments as provided in the Plan of Operation, each for liability and for physical damage insurance.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.08 Eligibility

A. To be eligible for bodily injury, property damage, medical payments, and physical damage coverage’s, the applicant must meet the following criteria:

1. As a prerequisite to consideration for coverage through the Plan, an applicant must certify, in the prescribed application form, that he has attempted, within 60 days prior to the date of application, to obtain automobile insurance in the State and that he has been unable to obtain such insurance.

2. An applicant so certifying shall be considered for coverage through the Plan upon making application in good faith to the Plan. An applicant shall be considered in good faith if he reports all information of a material nature, and does not willfully make incorrect or misleading statements, in the prescribed application form, or does not come within any of the prohibitions or exclusions specified in the Plan of Operation or Plan Manual.

B. An applicant shall not be entitled to physical damage insurance nor shall the Plan or CAIP servicing carrier be required to afford or continue to afford physical damage insurance under the exclusions specified in the Plan of Operation or Plan Manual.

C. Medical payments insurance shall be available to an applicant, but only in conjunction with the same policy written in accordance with this Plan affording bodily injury and property damage coverage for a four-wheel vehicle classified and rated as a private passenger automobile.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.09 Extent of Coverage

A. The Plan or CAIP servicing carrier shall be required to write a policy or binder at a minimum for the limits in the Financial Responsibility law of the State.

B. Notwithstanding paragraph A, upon request of any applicant, the Plan or CAIP servicing carrier shall provide limits adequate to comply with the provisions of the Financial Responsibility Law of any state in which the motor vehicle will be operated, but applicable only while the motor vehicle is being operated in that state/province.

C. Upon request of the insured, a standard loss payable clause for the benefit of a lien-holder shall be included in the policy.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.10 Application for Assignment

The application for insurance under the Plan must be submitted to the Plan on a prescribed form accompanied by the appropriate premium as specified in the Plan of Operation. If the applicant is ineligible for coverage, the deposit shall be returned. No coverage will be in effect if the premium remittance which accompanies the application is justifiably dishonored by the financial institution. Producers may not deduct commission from the premium submitted with the application. The producer must compute the premium for each risk and show the computed premium on the application. If computation is not shown, the application will be returned. The Plan will not estimate a premium.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.11 Designation of Company and Effective Date of Coverage

Upon receipt of the application for insurance properly completed and the deposit specified in the Plan of Operation, and if the application form shows that the applicant is eligible for coverage, the Plan shall so advise the applicant and producer of record and shall state in such notice the date when the coverage shall become effective. The Plan shall give written notice to the CAIP

servicing carrier of the name of the applicant, the producer of record, the coverage to be afforded and the effective date of coverage.

If for any reason, the applicant refuses to accept the policy, the Plan or CAIP servicing carrier shall retain the premium as allowed in the Plan of Operation or Plan Manual.

The Plan shall forward to the CAIP servicing carrier, a copy of the application form, the notice of the effective date of coverage, and the deposit, same to be credited by the CAIP servicing carrier against the policy premium.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.12 Assignment Period

The Plan or CAIP servicing carrier shall write the applicant for a period of three consecutive years, except in the event a financial responsibility filing is required, the Plan or CAIP servicing carrier shall carry the risk for the period of Financial Responsibility Filing, but in no event in excess of 5 years. The Plan or CAIP servicing carrier shall not extend or offer to renew a policy beyond the fifth year. If an insured is unable to obtain insurance at the end of the 3 year period, reapplication for insurance may be made to the Plan. Such reapplication shall be considered as a new application.

In the case of non-resident military personnel, the Plan or CAIP servicing carrier, shall not be required to renew if at the time of renewal the insured is stationed in another state and his/her automobile is not registered in Mississippi.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.13 Notice to Applicant

For private passenger risks and risks serviced by a CAIP servicing carrier, issuance of the original or renewal policy and the making of Financial Responsibility filings shall all be done in accordance with the applicable provisions of the Plan of Operation or Plan Manual.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.14 Rule 3.14

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.15 Rates

A. All risks placed through the Plan shall be subject to the rules, rates, surcharges, minimum premiums and classifications filed on behalf of all companies subscribing to this Plan by AIPSO and approved by the Mississippi Department of Insurance. The rate applicable to

any risk placed through the plan shall be determined in accordance with the applicable provisions as set forth in the Plan Manual.

B. For the purposes of such filings, each company subscribing to this Plan is a subscriber to the AIPSO and authorizes the Mississippi Insurance Department to accept such filings on its behalf.

C. All of the statistical data required to develop the appropriate rate shall be furnished to AIPSO by each company subscribing to this Plan or by a statistical agency designated by such company.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.15.01 Standard Policy Coverage

A. Personal Auto Policy

Coverage for private passenger automobiles, as defined in the Plan of Operation and Plan Manual, which have four wheels and are owned or hired under a long-term contract by an individual or by husband and wife who are residents in the same household and written on a specified car basis; for private passenger automobiles owned or hired under a long- term contract by relatives other than husband and wife or resident individuals and for motorcycles or similar type motor vehicles or motor homes; and for named non-owner risks, shall be provided uniform coverage equivalent to the coverage of the Edition of the Insurance Service Office, Inc. (ISO) Personal Auto Policy and the ISO and Automobile Insurance Plan endorsements which have been approved by the Mississippi Insurance Department for use with Plan business.

B. CAIP Commercial Policy

Commercial risks shall be provided uniform coverage, equivalent to the coverage of the ISO Commercial Auto Coverage Part Program and the ISO and Automobile Insurance Plan endorsements which have been approved by the Mississippi Insurance Department for use with Plan business.

Policies issued under the provisions of the Mississippi Commercial Automobile Part of the Plan of Operation shall indicate that they have been issued on behalf of the Plan.

Any required filings of policy or endorsement forms shall be made on behalf of all companies subscribing to this Plan by AIPSO. For the purposes of such filings, each company subscribing to the Plan is a subscriber to AIPSO.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004); 83-5-1 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.16 Cancellations

A. Cancellation at Request of Insured.

If for any reason the insured requests a cancellation, the Plan or CAIP servicing carrier shall retain the earned premium for the period of coverage and 10% of the pro rata unearned policy premium, or the minimum policy premium as contained in the Plan Manual, whichever is greater, and return the balance to the insured except in the cases indicated in the Plan of Operation or Plan Manual where the return premium shall be computed pro rata.

B. Cancellation by the Plan or by the CAIP Servicing Carrier

The Plan, or CAIP servicing carrier which has issued a policy or binder under this Plan, shall have the right to cancel the insurance by giving appropriate notice as required in the policy or binder only for the reasons specified in the Plan of Operation unless otherwise specified by law.

Nothing herein shall be deemed to affect the Plan’s or the CAIP servicing carrier's right to rescind a policy for fraud or misrepresentation or if the insured's premium remittance which accompanies the application is justifiably dishonored by the financial institution, or to invoke other remedies provided by law.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.17 Right of Appeal

The Committee may hear any appeal from an applicant, insured, producer, or insurer on a matter pertaining to the proper administration of the Plan. Each Notice of Cancellation or denial of insurance under the provisions of the Plan shall contain or be accompanied by a statement that the insured or applicant has a right to appeal to the Committee within thirty (30) days from the date of cancellation, or denial of insurance. The action of the Committee may be appealed to the Commissioner of Insurance within thirty (30) days from the date of action by the Committee.

The Plan shall promptly notify the company, the insured or the applicant, and the producer of record, of the disposition of the appeal, which notification in the case of refusal to sustain a cancellation shall include notice that upon payment of the deposit premium to the company a policy or binder will be issued.

An appeal shall not operate as stay of cancellation, provided, however, that if either the Committee or the Commissioner of Insurance refuses to sustain the cancellation, the company which issued the policy or binder shall, within two working days after receipt of the deposit premium, provided such deposit premium is received within thirty (30) days after determination of the appeal, issue a new policy or binder effective for a period of one year from the date of issuance of such new policy or binder. The balance of the premium shall be payable as provided in the Plan of Operation Personal Automobile Part and the Plan of Operation Commercial Automobile Part.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.18 Re-eligibility

An applicant denied insurance under the Plan or cancelled by the Plan or CAIP servicing carrier may reapply to the Plan as provided in the Plan of Operation.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.19 Commission

Unless other arrangements have been made with the Insurance Department the compensation under the Plan shall be a percentage as provided in the Plan of Operation. On any risk rated and domiciled outside of this state, the licensed producer may be paid only that portion of the producer's commission which is permissible under the laws of the state in which the risk is rated and domiciled.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.20 Amendment of Plan

Subject to the approval of the Commissioner of Insurance, the Plan may be amended by the Committee by a majority vote taken at a Committee meeting or teleconference or by mail vote.

In the event a mail vote is conducted, the mail ballot containing any proposed amendment shall be mailed to the Committee not less than ten (10) days prior to the final date fixed for voting thereon. If a Committee member does not respond on or by the final voting date, its vote shall be considered affirmative on the proposed amendment.

History

• Source: Miss. Code Ann. §63-15-65 (Rev. 2004).

19 Miss. Admin. Code Pt. 4, R. 3.21 Separability

If any provision of this regulation or its application to any person or circumstance is for any reason held to be invalid by any court of law, the remainder of the regulation and its application to other persons or circumstances shall not be affected.

History

• Source: Miss. Code Ann. §83-5-1 (Rev. 2011).

19 Miss. Admin. Code Pt. 4, R. 3.22 Examination Oversight

The Commissioner or any of his appointed examiners may conduct an examination of the Plan under the procedures set forth under Miss. Code Ann. §83-5-201, et. seq. (as amended) as often as the Commissioner, in his or her sole discretion, deems appropriate. The cost of such examination shall be borne in full by the Plan.

History

• Source: Miss. Code Ann. §§63-15-65 (Rev. 2004); 83-5-1 (Rev. 2011); 83-5-201 through 83-5-

19 Miss. Admin. Code Pt. 4, R. 215 Rule 215

(Rev. 2011).

Part 4, Chapter 4: Regulation of Vehicle Service Contracts

Rule 4.01: Authority and Purpose

A. This regulation is adopted and promulgated pursuant to the authority granted by Miss. Code Ann. § 83-65-101, et seq. (Rev. 2011), Regulation of Vehicle Service Contracts, and in accordance with the provisions of The Mississippi Administrative Procedures Law, Miss. Code Ann. § 25-43-1.101, et seq., and the Mississippi Insurance Department Regulation found at Miss. Admin. Code, Part 1, Chapter 15, which regulation is entitled, “Rules of Practice and Procedure Before the Mississippi Insurance Department.”

B. The purpose of this regulation is to set forth rules and procedural requirements which the Commissioner of Insurance deems necessary for consistent regulation of vehicle service contracts, companies and entities engaged in the marketing and selling of these contracts in the State of Mississippi, and to ensure that there is clear guidance concerning the rules of the Mississippi Insurance Department pertaining to the regulation of vehicle service contracts.

Admin. Code Part 1, Chapter 15.

Rule 4.02.: Scope

A. This regulation shall apply to all entities, individuals, and persons engaged in the selling and marketing of vehicle service contracts as defined in Miss. Code Ann. § 83-65-103. However, in accordance with Miss. Code Ann. § 83-65-101, this regulation shall not apply to motor vehicle manufacturers' warranties.

B. Vehicle service contracts, including the marketing, sale, offering for sale, insurance, making, proposing to make, and administration of vehicle service contracts by providers, sellers, and other persons, are governed exclusively by Miss. Code Ann. § 83-65-101, et seq. Other statutes are not applicable to Vehicle Service Contracts except as specifically provided in Miss. Code Ann. § 83-65-101, et seq. C.

Rule 4.03: Licensing

Except for the filing requirements in Miss. Code Ann. § 83-65-101, et seq., providers, sellers, and other persons marketing, selling, or offering to sell vehicle service contracts are exempt from any licensing or registration requirements of Title 83 of the Mississippi Code.

Rule 4.04: Cancellation

A. Cancellation by Service Contract Holder

1. Cancellation by a Service Contract Holder shall require the Service Contract Provider to permit the Service Contract Holder to return the vehicle service contract within twenty (20) days of the date the vehicle service contract was mailed to the Service Contract Holder, within ten (10) days of delivery if the vehicle service contract was delivered to the Service Contract Holder at the time of sale, or within a longer time period permitted under the vehicle service contract. Upon return of the vehicle service contract to the Service Contract Provider within the applicable time period, if no claim has been made under the vehicle service contract prior to its return to the Service Contract Provider, the vehicle service contract will be voided, and the Service Contract Provider will refund to the Service Contract Holder, or credit to the account of the Service Contract Holder, the full purchase price of the vehicle service contract. The right to void the vehicle service contract provided in this subsection is not transferrable, applies only to the original Service Contract Holder, and is allowed only when no claim has been made prior to its return to the Service Contract Provider. A ten percent (10%) penalty per month shall be added to a refund that is not paid or credited within forty-five (45) days after return of the vehicle service contract to the Service Contract Provider.

2. Subsequent to the time period specified in subsection (1), or if a claim has been made under the vehicle service contract within that time period, a Service Contract Holder may cancel the vehicle service contract, and the Service Contract Provider shall refund to the Service Contract Holder one hundred percent (100%) of the unearned pro rata purchase price of the vehicle service contract, less the amount of any claims paid. A reasonable administrative fee may be charged by the Service Contract Provider not to exceed ten percent (10%) of the gross service contract provider fee paid by the Service Contract Holder.

B Cancellation by Service Contract Provider

1. Cancellation by the Service Contract Provider shall only occur in instances of nonpayment of the provider fee, a material misrepresentation by the Service Contract Holder to the Service Contract Provider, or a substantial breach of duties by the Service Contract Holder relating to the covered product or its use.

2. In the event of cancellation by a Service Contract Provider for reason other than nonpayment of the provider fee, the Service Contract Provider shall refund to the Service Contract Holder one hundred percent (100%) of the unearned pro rata purchase price of the vehicle service contract, less the amount of any claims paid. A reasonable administrative fee may be charged by the Service Contract Provider not to exceed ten percent (10%) of the gross provider fee paid by the Service Contract Holder.

Rule 4.05: Severability

If any section or portion of a section of this regulation, or the application thereof to any person or circumstance, is held to be invalid by a court of competent jurisdiction, such determination shall not affect any other provision or application of this regulation which can be given effect without the invalid provision or application. To this end the provisions of this regulation are severable.

Rule 4.06: Effective Date This Regulation shall become effective thirty (30) days after filing in the Office of the Secretary of State.

History

• Source: Miss. Code Ann. §§ 83-65-101, et seq. and 25-43-1.101, et seq. (Rev. 2011) and Miss.
• Source: Miss. Code Ann. § 83-65-101, et seq. (Rev. 2011).
• Source: Miss. Code Ann. § 83-65-101, et seq. (Rev. 2011).
• Source: Miss. Code Ann. § 83-65-101, et seq. (Rev. 2011).
• Source: Miss. Code Ann. § 83-65-101, et seq. (Rev. 2011).
• Source: Miss Code Ann. §§ 83-65-101, et seq. and 25-43.3.113 (Rev. 2011).

Part 5 Non-Auto Property & Casualty Insurance

Chapter 6 Pet Insurance Regulation

19 Miss. Admin. Code Pt. 5, R. 7.05 Grant Allocations

1. In the counties the SMH program is made available, grant applications will be awarded through a lottery process. 2. The Commissioner of Insurance may establish projects as needed to establish a sustainable distribution system of the SMH program grants in the geographic area within Hancock, Harrison, Jackson, Pearl River, Stone, and George Counties.

2. Applicants shall report any funds received or anticipated from insurance, disaster relief, or other sources to ensure that the grant only covers actual costs.

3. SMF Funds cannot be used for payment of deductible or co-insurance requirements on any covered claim by any insurer.

4. Insurers shall not reduce settlement payments based on the payment of an SMH grant.

Rule 7.07. Contractor Eligibility Requirements. To be eligible to work on the SMH program as a Contractor, the Contractor must meet all of the following program requirements and must maintain a current copy of all certificates, licenses, and proof of insurance coverages with the program office: 1. The Contractor must hold a valid roofers license or residential home builder's license without limitation, which may be designated as "unlimited", or its successor issued by the Mississippi State Board of Contractors. If the Contractor is a general partnership, limited partnership, corporation, limited liability company, or not-for-profit, the qualifying representative representing the contractor must at all times be the same person designated as the contractor's qualifying representative on the face of that contractor's license. The Contractor must be free from all disciplinary action by the Board. 2. The Contractor must hold any other valid state or jurisdictional business license or work permit required by law in Mississippi. 3. The Contractor and each subcontractor used must independently provide proof of insurance with the following minimum coverages: a. General Liability policy with $1,000,000 per occurrence; $1,000,000 personal and advertising injury; $2,000,000 aggregate; and $2,000,000 products/completed operations aggregate; b. Automobile Liability covering owned, non-owned, and hired automobiles with $1,000,000 per occurrence; c. Employer Liability with $1,000,000 per accident; $1,000,000 disease policy limit; and $1,000,000 disease each employee; d. Umbrella Liability with $1,000,000 each occurrence and aggregate; and e. Contractors Errors & Omission Liability with $100,000 each occurrence and aggregate. 4. The Contractor and each subcontractor used must independently comply with all state and federal Workman’s Compensation laws. 5. Contractor must successfully complete FORTIFIED Roof Contractor for High Wind and Hail and Hurricane training AND FORTIFIED Professional for High Wind and Hail and Hurricane training provided by the Insurance Institute for Business and Home Safety (IBHS) or its successor and provide a certificate of successful completion of the training. The training may be offered as separate courses and the contractor is responsible for paying all fees associated with the training. 6. Contractor must agree to the terms and successfully register with the State of Mississippi MAGIC application and receive direct deposit of payment for

FORTIFIED work performed under this program. An entity may register as a vendor at the following link: https://www.dfa.ms.gov/vendors. 7. Contractor must maintain internet access and a valid email address on file with the SMH program and remain active in MAGIC while working on the program. 8. Contractor must maintain an active email address for the communication with the program. 9. Contractors must agree to follow SMH program procedures, rules and regulations as established by the Commissioner of Insurance. 10. Contractor must avoid any conflicts of interest in any work performed on projects funded by SMH, and as more particularly defined in Rule 7.08 of this Regulation.

1. Contractors may not have a financial interest in any project for which they perform work toward a FORTIFIED designation other than for payment on behalf of the homeowner by the SMH program for work performed. 2. Contractors cannot be the Evaluator for a FORTIFIED designation on any project funded by the SMH program. 3. It is the Contractor's responsibility to report to the SMH program any potential conflicts of interest before work commences on any job funded by the program.

To be eligible to work on the SMH program as an Evaluator, the Evaluator must meet all program eligibility requirements, must submit and maintain a copy of all current certificates and licenses, and comply with the following: 1. The certification as a FORTIFIED Home Evaluator for Hurricane and High Wind and Hail certificate or its successor. Evaluator must be in good standing with the IBHS and maintain an active 2. Evaluator must possess a Mississippi Business license and any other necessary business license to perform the work required. 3. Evaluator must be registered with Mississippi Secretary of State. 4. Evaluator must be in compliance with all regulatory and tax laws regulating businesses in this state. 5. Evaluator must avoid any conflicts of interest in any work performed on projects funded by SMH, and as more particularly defined in Rule 7.10 of this Regulation.

7. Evaluator must maintain an active email address for the communication with the program.

8. Evaluators may not have a financial interest in any project for which they inspect for designation purposes for the SMH program (SMH). 2. Evaluators cannot be a contractor or supplier of any materials and/or products or systems installed in any home that they inspection for designation purposes for the SMH program. 3. Evaluators cannot be a sales agent for any home being designated for the SMH program. 4. Evaluators have a duty to inform the SMH program of any potential conflicts of interest.

Once a Grant Round is opened, grant applications may be submitted online at the following link: www.mid.ms.gov. Contractor eligibility submissions may be submitted online at the following link: www.mid.ms.gov. Evaluator eligibility submissions may be submitted online at the following link: www.mid.ms.gov. All information regarding the acceptance of any application or submission will be provided by either SMH or its TPA.

The MID will issue a Bulletin at the time of each Grant Round advising applicants of the submission rules, timeframes, criteria, and geographical area subject to the round. Once a Bulletin is issued, a copy will be uploaded to the Strengthen Mississippi Homes webpage at www.mid.ms.gov and also onto MID’s Administrative Procedures Bulletin webpage at https://www.mid.ms.gov/mississippi-insurance-department/legal/bulletins/.

If any rule or portion of a rule or its applicability to any person or circumstance is held invalid by any court, the remainder of this chapter or the applicability of the provision to other persons or circumstances shall not be affected.

History

• Source: Miss. Code Ann. §83-1-191 (Rev. 2022) Rule 7.06. Coordination with Other Funding Sources.
• Source: Miss. Code Ann. §83-1-191 (Rev. 2022)
• Source: Miss. Code Ann. §83-1-191 (Rev. 2022) Rule 7.08. Contractor Conflict of Interest.
• Source: Miss. Code Ann. §83-1-191 (Rev. 2022) Rule 7.09. Evaluator Eligibility Requirements.
• Source: Miss. Code Ann. §83-1-191 and § 83-5-1 (Rev. 2022) Rule 7.10. Evaluator Conflict of Interest.
• Source: Miss. Code Ann. §83-1-191 (Rev. 2022) Rule 7.11. Online Submissions.
• Source: Miss. Code Ann. §83-1-191 (Rev. 2022) Rule 7.12. Notice of Grant Rounds.
• Source: Miss. Code Ann. §83-1-191 (Rev. 2022) Rule 7.13. Severability.
• Source: Miss. Code Ann. §25-43-1.103 (Rev. 2018) Rule 7.12. Effective Date This chapter shall become in effect and apply to grant applications on and after January 1, 2025.
• Source: Miss. Code Ann. §25-43-1.106 (Rev. 2018)

Part 6 Insurance Agents, Solicitors, and Adjustors

19 Miss. Admin. Code Pt. 6 Insurance Agents, Solicitors, and Adjustors

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Title 19: Insurance

Part 6: Insurance Agents, Solicitors, and Adjustors

Part 6 Chapter 1: (F&C 61-2) Order To All Fire And Casualty Insurance Agents

Rule 1.01: Fire and Casualty Agents; Revocation of License

Notice is hereby given that any fire and casualty agent licensed by the Mississippi Department of Insurance shall be subject to hearing for revocation of license upon proper showing that such agent has (1) collected monies from an insured in excess of the filed rate of the company in which the business is placed; or (2) has failed to remit promptly to an insured any dividend accruing under a policy; or (3) has failed to refund within a reasonable time any unearned premiums due the insured.

So Ordered This 15 th Day Of June, 1961.

Source: Miss. Code Ann. §83-17-71 (Rev. 2011)

Part 6 Chapter 2: (F&C 71-1) Agent’s Commissions; Countersignature, Incorporated Agencies

Rule 2.01: Commission to be Paid Only to Licensed Agents

WHEREAS, it has come to the attention of the Department that certain incorporated agencies have stockholders who are not licensed insurance agents or solicitors; and

WHEREAS, the insurance laws of this State, including but not limited to Section 5674, 5710 and 5711 of the Miss. Code of 1942, Recompiled, and the rules and regulations of the Insurance Department, particularly Regulation No. F & C 18 dated September 5, 1963, as clarified by Regulation No. F & C 19, prohibit the dividing of commissions with anyone other than a licensed agent or solicitor; and

WHEREAS, the payment of dividends to stockholders who are not licensed agents or solicitors violates the aforesaid law and regulations,

IT IS HEREBY ORDERED that no commission accruing to incorporated agencies through the sale of insurance shall be divided or paid, directly or indirectly, to anyone other than a licensed agent or solicitor. Nothing herein shall be construed to prevent payment of operating expenses, salaries and professional fees for services actually rendered in the usual and customary course of agency business commensurate with such services rendered. This order does not prohibit the division of commissions with duly licensed or resident agents as set out under Sections 5674, 5710 and 5711 of the Miss. Code of1942, Recompiled. Any incorporated agency willfully violating this regulation will be subject to revocation, suspension, or non-renewal of license. No insurance agent or solicitor shall knowingly participate in the division of any commission prohibited herein, earned by him in whole or in part, but shall report to the Insurance Department

2

such attempt to evade this regulation. Any licensed agent or solicitor knowingly participating in divisions and not reporting same shall place his own license in jeopardy.

The form attached hereto is made a part hereof as if fully set out herein and is required to be executed by and filed with all new and renewal applications for an incorporated agency licensed from and after the effective date of this regulation.

This regulation does not prevent the dividing of corporate income derived from sources other than the commissions on the sale of insurance.

Signed and effective immediately, this 31 st day of December, 1971.

Source: Miss. Code Ann. §83-17-7 (Rev. 2011)

Part 6 Chapter 3: (LA&H 73-2) Temporary Agents for Industrial Life, Health, and Accident Coverage

Rule 3.01: Temporary Licenses for Industrial Life, Health and Accident Agents

WHEREAS, it has been shown that need and justification do exist for modification of the captioned Orders in the instance of the so-called “debit system”, in order to insure an uninterrupted service to the policyholders by the collection of weekly and monthly premiums on industrial life, health and accident insurance, notice is hereby given that, effective July 1, 1973, said Orders are revised to the following extent:

Temporary licenses, not to exceed a period of sixty (60) days, will be granted to industrial life, health and accident agents who are responsible for the weekly or monthly collecting of premiums and servicing of accounts pertaining to such industrial life, health and accident business; subject to the following conditions:

A. The insurance company requesting temporary license for such agent has an established basic training program for its agents which has been approved by the Mississippi Insurance Department.

B. No additional insurance shall be sold by such agents during the period they are operating under such temporary license unless they are accompanied and supervised in such sales program by a permanently licensed agent for the insurance company, and such supervision shall be deemed to constitute a part of the company’s training program.

C. The percentage of such agents successfully passing the qualifying examination when given by the Insurance Department shall not fall below seventy-five percent(75%) in any given year.

So Ordered This The 1 st Day Of June, 1973.

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TO: Industrial Life, Health & Accident Insurance Companies

In Re: Temporary Agents for Industrial Life, Health and Accident Coverage

Dear Sirs:

In the period since issuance of my Order dated June 1, 1973, a number of inquiries have been directed to this office to determine if it is expected, or required, that in instances where new business is being solicited and sold during the period of the sixty (60) days temporary license, applications for such new business should be signed by both the temporary agent and his accompanying agent-supervisor.

In the interest of maintaining uniformity, it is my judgment that the applications for new business developed during this sixty day period should be signed by the temporary agent and also countersigned by his agent-supervisor. Such procedure will serve good purpose; firstly, it will enable the company to properly credit commissions to the appropriate agent account; secondly, it will preclude any questions being raised whether or not the company and its agents are complying with the provisions of the above-mentioned Order.

Source: Miss. Code Ann. §83-17-71 (Rev. 2011)

Part 6 Chapter 4: (LA&H 74-2) Unlawful Participation of Unlicensed Persons in the Life, Health and Accident Insurance Business.

Rule 4.01: Requirement of Licensure to Sell, Solicit or Negotiate Life, Health and Accident Insurance

WHEREAS, Section 83-17-1, Mississippi Code of 1972, provides that every person who solicits insurance on behalf of any insurance company or who takes or transmits, other than for himself an application for insurance, or a policy of insurance or who advertises or otherwise gives notice that he will receive or transmit the same, or who shall receive or deliver a policy of insurance of any such company or receive, collect or transmit any premium of insurance, or do or perform any other act or thing in the making or consummation of any contract of insurance, for or with any insurance company, other than for himself, whether any of such acts shall be done at the instance, or request, or by the employment of such insurance company, or of, or by any broker or any other person shall be held to be the agent of the company for which the act is done or the risk is taken as to all the duties and liabilities imposed by law, and a criminal penalty is provided for any violation of such prohibitions; and

WHEREAS, Section 83-17-101, Mississippi Code of 1972, defines an agent as one who acts in any manner, directly or indirectly, in the solicitation of, negotiation for, or procurement or making of a contract of life, health or accident insurance, or making of an annuity contract, including hospital services association agents or agents within the meaning of said act, and are required to obtain a license and certificate of authority in order to be lawfully able to do any of such acts and the doing of any such acts without such license constitutes a criminal offense against the State of Mississippi; and

4

WHEREAS, Section 83-17-105,Mississippi Code of 1972, prohibits any insurance company or agent from paying, directly or indirectly, any commission or any other valuable consideration to any person for services as an insurance agent unless such person holds a valid and current agent’s license and certificate of authority, and prohibits any unlicensed person from accepting any such commission or any other valuable consideration and makes both the payment of such and the receipt of such a criminal offense against the State of Mississippi; and

WHEREAS, Section 83-17-7, Mississippi Code of 1972, makes it unlawful for any insurance company or agent to pay, directly or indirectly, any commission, brokerage, or other valuable consideration, on account of any policy or policies written on risks in this State, to any person, agent, firm, or corporation not duly licensed as an insurance agent in this State; and

WHEREAS, there is no provision in the statutes of this State for the licensing of any corporate agency/or partnership as an agent pertaining to life and health and accident insurance, although there is a provision for the licensing of a corporate agency in the fire and casualty lines; and

WHEREAS, it has come to the attention of the Commissioner of Insurance that certain insurance companies and licensed agents have participated in the solicitation of insurance through the means of certain trusts, administrators, or other like unauthorized and unlicensed media; and

WHEREAS, it has come to the attention of the Commissioner of Insurance that certain insurance companies and agents are alleged to have made unlawful payments to certain individuals and associations, being neither insurance companies nor agents, or certain valuable considerations have been given in return for the sponsorship of certain insurance programs by such individuals or associations; and

WHEREAS, it has come to the attention of the Commissioner of Insurance that certain corporate insurance agencies duly licensed as fire and casualty agencies are alleged to have solicited and participated otherwise in the sale of life, health and accident insurance in violation of the statutes of this State;

THEREFORE, all insurance companies and agents licensed and holding certificates of authority to do business in this State are hereby notified that any and all of such acts should be terminated immediately and that hereafter any violations of the foregoing statutes, directly or indirectly, under any guise or pretense whatsoever, will, after investigation and proof of guilt, result in the revocation of the certificate of authority and license of any insurance company or agent participating in any of such acts, either directly or indirectly, whatsoever the guise or pretense thereof.

All insurance companies authorized to write life, health and accident business in this State are directed to bring this regulation to the attention of all their agents and other personnel having any responsibility in the solicitation, sale or issuance of life, health and accident policies.

Source: Miss. Code Ann. §83-17-1, et seq. (Rev. 2011)

5

Part 6 Chapter 5: (85-101) Special Permanent License for Industrial Life, Health and Accident Insurance.

Rule 5.01: Authority

These rules and regulations are promulgated by the Commissioner of Insurance of the State of Mississippi to implement Sections 83-5- 1, 83-17-107, 83-17-109, 83-17-129 and 83-19- 31(A)(5), Mississippi Code of 1972, as amended, and are being adopted pursuant to the authority granted the Commissioner of Insurance by Section 8-17-129, Mississippi Code of 1972, as Amended, and in accordance with Sections 25-43-1, et seq., Mississippi Code of 1972, as Amended known as the Mississippi Administrative Procedures Law.

In consideration of the foregoing, I George Dale, Commissioner of Insurance of the State of Mississippi do hereby promulgate and adopt the following rules and regulation with an effective date of December 1, 1985 and compliance with the applicable statutes.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011)

Rule 5.02: Purpose

The purposes of these rules and regulations are to establish pre-license requirements for applicants applying for a permanent privilege license to offer for sale and the selling of industrial life, accident and health insurance contracts within this State and to improve the competency of such applicants.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011)

Rule 5.03: Applicability

These rules and regulations shall apply to all resident and non-resident individuals who apply for a permanent agent’s privilege license to engage in the sale of industrial life, health and accident insurance.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011 )

Rule 5.04: Pre-License Requirements

A prospective licensee for a permanent industrial life, health and accident license must meet the following pre-license requirements before an application for an examination can be submitted to the Home Service Life Insurers Council.

A permanent Industrial Life, Health and Accident License Study Guide as approved by the Mississippi Insurance Department, including any amendments, revisions, additions or modifications made to such Guide after the effective date of this regulation will be provided to the prospective licensee by the Home Service Life Insurers Council. Prospective licensee must

6

complete under the direction of a licensed industrial life, accident and health company five (5) hours of instruction utilizing the herein-described study guide in preparation for the examination.

The licensed industrial company must declare on the application for examination that the applicant has completed the requirements as set forth above before an examination can be administered.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011)

Rule 5.05: Definition of Special License

Any agent who sells industrial life, health and accident policies (as defined by Section 83-19-31, Mississippi Code of 1972, as Amended), where benefits are equal to or less than $5,000 per policy for life insurance and disability benefits are equal to or less than $60.00 per week may be eligible for this license.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011)

Rule 5.06: Administration Procedures and Examination Schedule

Administration procedures and examination schedule for a License to write Permanent Industrial Life, Health and Accident Insurance administered by The Home Service Life Insurers Council:

A. Upon request, the Home Service Life Insurers Council will provide study materials to applicants to satisfy pre-license requirements.

B. Applicants for examination will be mailed to the Secretary of the Home Service Life Insurers Council.

C. The Secretary will notify a member of HSLIC that an examination has been requested and will set examination dates and notify the applicant of the date and place of examination.

D. Any member of the Home Service Life Insurers Council may administer the examination and report such results to the Mississippi Department of Insurance on the forms prescribed and provided, including amendments, revisions or modifications made thereto, for such purpose.

E. Examinations will be administered every Monday at 1:00 P.M. except holidays.

F. A member company cannot administer an examination to an applicant who is its prospective employee unless there are other applicants who are prospective employeeso f other companies present also for the examination.

G. Only members of the Home Service Life Insurers Council will be allowed to administer the examination.

7

H. The Secretary of the Home Service Life Insurers Council will be responsible for coordinating the examination procedures and schedule for examinations.

I. Examinations will be chosen by the member company from those approved by the Mississippi Department of Insurance.

J. The Home Service Life Insurers Council understands that the passage of this examination does not constitute the automatic issuance of the above license and that the applicant must satisfy any other requirements as set forth by the Mississippi Department of Insurance and that the Mississippi Department of Insurance ahs the sole discretion for the issuance of the above license.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011)

Rule 5.07: Separability

If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of these rules and regulations and the application of such provision to other persons or circumstances shall not be affected thereby.

Source: Miss. Code Ann. §83-17-53 (Rev. 2011)

Rule 5.08: Effective Date

These rules and regulations shall be effective from and after December 1, 1985.

Promulgated And Adopted this the 23 rd day of October, 1985.

Source: Miss. Code Ann. § 25-43-3, 113 (Rev. 2010)

Part 6 Chapter 6: (88-103) Compensation In Connection With Credit Insurance With Interpretative Guidelines. REPEAL. Effective 12/29/2014.

Part 6 Chapter 7: (95-101) Regulation Regarding Professional Bail Agent’s Fines and Penalties.

Rule 7.01: Statutory Authority

This regulation is promulgated by the Commissioner of Insurance of the State of Mississippi to implement Miss. Code Ann . §§ 83-39-1 et seq. (Supp. 1994), and is being adopted pursuant to the authority granted the Commissioner of Insurance by Miss. Code Ann. §83-39-3 (3) (Supp. 1994), and in accordance with Miss. Code Ann. §25-43-1 (Rev. 1991), known as the Mississippi Administrative Procedures law and Regulation No. 88-101 known as Rules & Procedures before the Mississippi Insurance Department.

8

Source: Miss. Code Ann. §83-39-3 (Rev. 2011)

Rule 7.02: Purpose

The purpose of this regulation is to promulgate rules and regulations necessary for the enforcement of this chapter by establishing fines and penalties.

Source: Miss. Code Ann. §83-39-1, et seq. (Rev. 2011)

Rule 7.03: Applicability

This regulation shall apply to those terms defined in Miss. Code Ann . §83-39-1 (Supp. 1994).

A. Any person, individual or corporation as defined in Miss. Code Ann . §83-39-1 (Supp. 1994), found in violation of Miss. Code Ann. §§83-39-3, 83-39-5, 83-39-13, 83-39-15, 83-39-25 (Supp. 1994) and or their subsections may be fined up to One Thousand Dollars ($1,000.00) per violation and/or their license refused, suspended, revoked or the renewal thereof refused.

B. Any person, individual or corporation as defined in Miss. Code Ann. §83-39-1 (Supp. 1994), found in violation of Miss. Code Ann. §83-39-7(Supp. 1994) by allowing Revocation Orders to be sent to the Mississippi Insurance Department may be fined as per the following schedule:

1. First order up to $500.00 fine.

2. Second order within twelve (12) months of first order up to $1,000.00 fine.

3. Third order within twelve (12) months of the first order up to $5000.00 fine and or up to six (6) month license suspension.

4. Fourth order within twelve (12) months of first order, the permanent revocation of the professional bail agent’s license and/or up to $10,000.00 fine.

C. Any violation not covered under B herein may carry a fine of up to One Thousand Dollars (1,000.00) per violation and/or license suspension.

D. Any applicant not able to prove “Good Moral Character” required under Miss. Code Ann. §83-39-9 (Supp. 1994), may have his/her license denied, suspended, revoked or refused at renewal under of Miss. Code Ann. §83-39-5 (a) (Supp. 1994).

E. Any “repeated” violation other than forfeitures on Revocation Orders within a twelve (12) month period may have the following penalty:

1. Second offense within a twelve (12) month period up to $5,000.00 per violation.

9

2. Third offense within a twelve (12) month period up to $5,000.00 and/or license suspension.

3. Fourth offense within a twelve (12) month period up to $5,000.00 and/or permanent revocation of license.

Source: Miss. Code Ann. §83-39-1, et seq. (Rev. 2011)

Rule 7.04: Severability

If any provision of this regulation or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of these rules and regulations and the application of such provision to other persons or circumstances shall not be affected thereby.

Source: Miss. Code Ann. §83-39-1, et seq. (Rev. 2011)

Rule 7.05: Effective Date

These rules and regulations shall become effective 30 days from and after its adoption and filing with the Secretary of State’s office.

Source: Miss. Code Ann. §25-43-3.113 (Rev. 2010 )

Part 7 State Fire Marshal

Chapter 5 Rules and Regulations for the Uniform Standards Code for the Factory-Built Homes Law Regulation MH- 5 Rule 5.01: Promulgation and Purpose Rule 5.01.1: General

19 Miss. Admin. Code Pt. 7, R. 13 Rule 13

¼” x 26 ¼” Pad 2.395 square feet ID#4148 4 or 20” x 20” Pad 2.777 square feet ID#1055 7

TABLE IV - MAXIMUM PIER LOAD

Type ABS Pad Configuration ABS Pad Area (in square inches) Soil Bearing Capacity PSF (in pounds)

Remarks

1-16 x 16 w/1 or w/2 CMUs

Max: 5340 #

1-18.5 x 18.5 w/1 CMU

Max: 5600 #

1-18.5 x 18.5 w/2 CMUs

Max: 7125 #

2-13.13 x 26.13 w/1 CMU

Max: 6400 #

1-18.5 x 18.5 w/1 CMU ID# SPA 264-1-1

Max: 7125 #

1-20 x 20 w/1 CMU

Max: 5600 #

1-20 x 20 w/2 CMUs

Max: 8333 # All pad sizes shown are nominal dimensions and may vary up to 1/8 inch.

C. Pier foundations shall be installed directly under each I-beam of the Factory-Built home. If the Factory-Built home installation instructions are not available for a used home, piers for single section homes are to be placed under each longitudinal I-beam not to exceed 8 ft. on center spacing for homes that are 14 ft. wide or less when using a minimum soil bearing capacity of 2,000 psf. End piers shall be placed no more than two (2) feet and no less than one (1) foot from the end of each I-beam.

D. For used homes, having no manufacturers installation instructions, of widths over 14 ft, piers shall be placed under each I-beam no further apart than 6 ft. on centers, when using a minimum soil bearing capacity of 2,000 psf. End piers shall be placed no more than two (2) feet and no less than one (1) foot from the end of each I-beam.

Rule 5.06.7: Pier Construction

Rule 5.06.7-1: Single Stacked Piers

Except for corner piers, support piers less than 36 inches high, shall be constructed of single stacked masonry units, placed with the open cells in the vertical position when placed upon the pier footing. The frame piers must be installed so that the long sides are at right angles to the supported I-beam. (See Figure 9 and Table V). Perimeter piers shall be single tiered and placed parallel to the sidewall under the rim joist.

Figure 9. Single block pier construction.

Table V Pier Construction

Pier Location Pier Height, inches Configuration

Frame Piers

Less than 36 inches

Single stacked blocks with long side perpendicular to frame I-beam

Between 36 and 67 inches

Double Stacked Interlocked blocks

Between 68 and 80 inches

Double stacked interlocked, filled with mortar, reinforced

Corner Piers

All Heights

Double Stacked Interlocked blocks

History

• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).

19 Miss. Admin. Code Pt. 7, R. 54 Perimeter Piers

inches or less Single stacked blocks with long side parallel to the perimeter rail (rim joist)

Marriage Line Piers

19 Miss. Admin. Code Pt. 7, R. 54 Rule 54

inches or less Single stacked blocks with long side perpendicular to the marriage line

Rule 5.06.7-2: Pier Caps

All piers must have a full-size cap covering the top of the pier. A solid concrete 2”x8”x16” or 4”x8”x16” block or a 2”x8”x16” pressure treated wood plate shall be placed on top of the pier to serve as a cap. All caps must be of the same length and width as the piers on which they rest. When split caps are used on double stack piers, the caps must be installed with a long dimension across the joint in the blocks below. Additional full-size pressure treated or hardwood plates not less than 1 x 8 x 16 inch may be used but the additional plates shall not exceed 4 inches in total height.

Rule 5.06.7-3: Shims

A. The I-beam shall be cushioned with treated wood or hardwood or other approved shims (wedges). The shims (wedges) shall be used in pairs, installed in opposite directions and be fitted and driven tightly between the pressure-treated wood plate and the I-beam of the home.

B. One shim at least 4”x6” nominal shall be placed on each side of the main frame on single tiered piers (see Figure 7).

C. Two shims shall be placed on each side of the I-beam on double tiered piers (see Figure 8).

D. Shims shall not occupy more than 1 inch of vertical space between the top plate and the I- beam.

E. Shims shall be used in pairs and driven tight.

Rule 5.06.7-4: Removal of Organic Material

All grass, debris and other organic materials shall be removed before footing or pier foundations are installed. The minimum I-beam support pier foundation shall be a 16-inch x 16-inch x 4- inch solid concrete pad, pre-cast, poured-in-place, or ABS pads.

Rule 5.06.7-5: Protection from Frost Heave

Where the soil is subject to frost heave from freezing and thawing, the footings for support piers must extend below the frost line (no less than two (2) inches from the top of the ground).

Rule 5.06.7-6: Corner Piers

All used single wide home corner piers, regardless of the length of the home and wind zone, shall be double tiered units at least 16” x 16” consisting of interlocking masonry units and shall be fully capped as shown in Figure 10. Two 8 x16 x4 inch concrete cap blocks or two 2x8x16 inch treated wood plates may be used on a double tiered pier provided that the joint between the blocks or plates is perpendicular to the joint between the open cell concrete blocks and is also perpendicular to the I-beam. The corner piers shall be placed not more than 2 ft. and not less than 1 ft. from the end of each I-beam.

Corner piers on the outer I-beams of each half of a used multi-section home factory-built home are required to be double blocked regardless of height (see Figure 11). Corner piers on the inner I-beams of each half of the multi section factory-built home may be single blocked unless the pier height is 36 inches or higher.

The placement and construction of corner piers on all new factory-built homes must be done according to the manufacturer’s installation instructions. The installer is required to submit, with the Property Locator/Certificate of Installation, a copy of the manufacturer’s installation instruction pertaining to the construction of corner piers, if double blocking is not required.

Rule 5.06.7-7: Double Tiered Pier Heights

A. Piers 36 inches to 67 inches high shall be double-tiered units at least 16x16 inches consisting of interlocking masonry units and shall be fully capped with a 2 inch or 4-inch-thick solid masonry unit two (2) 2”x8”x16” pressure treated wood plates. (See Figure 11 and Table V).

Figure 10. Double Block Pier Construction.

Figure 11. Corner Piers Under the Outside and Inside Frames of a Multi-Section Home

B. All support piers between 68-80 inches high, for used Factory-Built homes, shall be constructed in accordance with the provisions of Rule 5.06.7-7(A), provided the piers shall be filled with grout and reinforced with four (4) continuous No. 5 steel bars. One steel bar shall be placed in each corner of the grouted space of the piers. Footings for piers of these heights shall be poured in place and shall be a minimum twelve (12) inches thick with a least a 28-day compressive strength of 3,000 pounds per square inch (psi) and shall be required to contain proper reinforcing rebar. The footing reinforcing rebars shall extend a minimum of six (6) inches above the surface of the poured in place footing and match the spacing of the open cells of the masonry concrete blocks. However, it is recommended to consult with a local concrete

supplier or local building code office for determining periods of cure time required before setting up a Factory-Built home on the poured concrete footings. For all new Factory-Built homes, the pier construction requirements, for piers in this height range, shall be in compliance with the manufacturer’s installation instructions.

C . The maximum pier height shall be no more than 80 inches unless designed and approved by a registered engineer or a higher height/different design is required by the National Flood Insurance Program (NFIP) floodplain management criteria.

Rule 5.06.7-8: Cast-In-Place Concrete Piers

Cast-in-place concrete piers meeting the same size and height limitations of Rule 5.06.7-1 through 5.06.7-7 above, may be substituted for piers constructed of masonry units.

Rule 5.06.7-9: Pier Footings

A. Every pier shall be supported by a footing. All I-beam support piers and marriage line support piers shall be constructed on footings of solid concrete not less than 16 x 16 inches that consist of a 4-inch-thick concrete pad, precast, ABS, or poured in place concrete slab, unless other footing types and sizes are allowed. All footings are to be placed on stable undisturbed soil or properly compacted fill material. The fill material must be compacted to 90 percent of maximum relative density to adequately provide the proper load bearing capacity for the support pier footings.

B. Perimeter pier footings are required to be a 4”x 8”x 16” concrete pads or equivalent size ABS pads.

C. Prepare the surface of the footing making sure the top surface of the footing upon which the pier will be installed is level, flat and smooth.

D. Poured-in-place concrete runners used as footings for a new Factory-Built shall meet the guidelines of the manufacturer’s installation instructions. For all used Factory-Built homes the concrete runners shall be eight (8) to twelve (12) inches thick with a 28-day compressive strength of 3,000 pounds per square inch (psi) and shall be required to contain proper reinforcing steel. For 3000 psi concrete, it is generally recommended to wait at least 28 days before applying significant weight, as this is the standard curing time for concrete to reach its full strength and achieve optimal durability. However, it is recommended to consult with a local concrete supplier or local building code office for determining accurate periods of cure time required before setting up a Factory-Built home on the poured concrete slab or runners.

E. If an existing concrete slab is to be used as the foundation of the home and the thickness

and the existence of reinforcing steel cannot be readily determined, all I-beam support piers shall be required to be placed on solid concrete footings, 4 x 16 x 16 inches, or equivalent size ABS pads. In addition, the top elevation of the existing concrete slab shall be a minimum of 4 inches higher than the existing grade of the soil around the slab.

Rule 5.06.7-10: Marriage Line Piers

Marriage line piers shall be constructed to the same requirements as all other main frame support pier requirements (see Table V). Marriage line piers, less than 54 inches in height, shall be single tiered, on footings and placed perpendicular to the line of the mated sections of the home. All wide openings along the length of the marriage line are required to have support piers at each side of the opening. Typical marriage line openings are cathedral openings and passageway openings which are 48 inches and larger. Marriage lines shall also have support piers at each ridge beam column location and within 2 ft. of each end of the home.

Rule 5.06.8: Pier Spacing and Placement

A. For proper pier spacing and placement for all new Factory-Built homes, the piers shall be located in accordance with the Factory-Built home manufacturer’s installation instructions.

B. If the Factory-Built home manufacturer installation instructions are not available for a used home, piers for single section homes are to be placed under each I-beam not to exceed 8 ft. on center spacing for homes that are 14 ft. wide or less. For single section homes that exceed 14 ft in width, piers shall not exceed 6 ft. on center spacings for the minimum soil bearing capacity of 2,000 psf. If the soil bearing capacity is determined to be less than 2000 psf, the support piers shall not exceed 4 ft on center spacings. Note: End piers shall be placed no more than two (2) feet and no less than one (1) foot from the end of each I-beam.

C. The pier spacing under each longitudinal I-beam for all used Factory-Built homes (single wide or multi-section) having a Wind Zone II classifications shall be no greater than 6 ft. on center.

D. Piers for all used multi-section homes are to be placed under each I-beam not to exceed 6 ft. on center spacing. For used multi-section homes, piers are to be placed under the center marriage line no less than one (1) foot from each end, under ridge beam support columns, and under both sides of an opening at the marriage line that is greater than 12 ft in width. All marriage wall support piers shall be placed perpendicular to the mate line of the two sections of the home.

Rule 5.06.8-1: Placement of Door and Window Support Piers

For all new and used Factory-Built homes, all exterior entry doors shall have piers or a manufacturer’s approved support device on each side of the opening. All doors and windows over 48 inches wide shall be properly blocked under each side of the opening (footings for these support piers may be 8”x 16” x 4” concrete pads or equivalent). If an obstruction (electrical, mechanical, plumbing or other device) is directly under one side of the opening, the blocks on that side may be offset a maximum of 6 inches in either direction of the obstruction. Factory installed outriggers and cross members may replace support piers directly below exterior door or window openings less than 48 inches in width, provided the floor rim joist has not been compromised or damaged.

Source. Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024). Rule 5.06.8-2: Placement of End Frame Support Piers

Where practical for all new and used Factory-Built homes, the end frame (corner) support piers (including the marriage line end piers) must be placed no less than 1 ft. from the ends of each I- beam but shall not be placed more than 2 ft. from the end of each I-beam. When the location and spacing of wheels and axles, or other structural members of the home frames, or undercarriages prevent spacing of piers on 8 or 6 ft. centers, the spacing shall be as near the 8 or 6 ft. maximum spacing as practicable in the area of the obstruction.

Rule 5.06.8-3: Placement of Piers Under Concentrated Loads

Piers shall be placed under other concentrated loads such as porch posts, bay window overhangs, and masonry faced fireplaces or floor overhangs. Factory-Built Homes that exceed 16 ft., per floor, in width shall have perimeter piers under the sidewalls every 6 ft. and at each corner. The data plate of the Factory-Built home must be reviewed by the installer/transporter to determine if additional perimeter pier installations are required.

Rule 5.06.8-4: Placement of Perimeter Support Piers

Perimeter piers, if required around the entire exterior walls of the home, shall be placed under the intersection of a floor rim joist and a transverse floor joist. If the structural integrity of the rim joist, at or near the locations of door and window locations has been compromised by water damage and/or by insects, it shall be required that a 4 inch x 4 inch treated wood brace be placed so that it spans a minimum of two (2) or more structurally sound floor joists that will accept placement of the perimeter piers along the length of the 4x4 inch brace (see Figure 12).

Figure 12. Bracing for Perimeter Piers Under a Damaged Rim Joist Rule 5.06.8-5: Piers for Homes Installed In Designated Flood Area

For all Factory Built homes placed in sites that have a potential for flooding, special elevations and anchoring techniques may be required. Consult an engineer and the LAHJ (local building official, etc.) to make sure that the design and construction of the foundation system of the home conform to applicable federal, state, and local codes and regulations.

All piers and foundation support for Factory-Built homes installed in a designated flood prone area shall comply with the design requirements set forth in Appendix H of the publication, “Protecting Manufactured Homes from Floods and Other Hazards”, published by the Federal Emergency Management Agency (FEMA P-85, Second Edition/November 2009).

Rule 5.06.9: Installation Instructions for ABS Pads

A. The purpose of this section is to emphasize that the ground under the ABS pads must be leveled, evenly compacted, and cleared of all vegetation and debris before the placement of the pads and all pads are to be installed flat side down, ribbed side up.

B. The maximum deflection in a single pad is 3/8 of an inch measured from the highest point to the lowest point of the top. If the ABS pad deflects more than 3/8” when installed with home’s dead load applied, it is an indication that a) the pier spacing is incorrect resulting in the

improper weight distribution on the support pier and/or; b) the soil pad was not properly compacted resulting in the support pier settling due to the improper load bearing capacity of the soil.

C. Installation Instructions for ABS Pads.

1. All pads are to be installed flat side down, ribbed side up.

2. The ground under the pads should be level and smooth with all vegetation removed. Pads are not to be placed on natural grade unless otherwise permitted by the local building authority.

3. Pier and pad spacing will be determined by the Factory-Built home manufacturer's written set up instructions.

4. The open cells between the ribbings on the upper side of the pads may be filled with soil or sand after installation to prevent any accumulation of stagnant water in the pads.

5. ABS pads can be used in multi-stack orientations to create a larger pad area and provide for wider pier spacing as shown in Figure 13 (consult manufacturer’s listing for proper uses).

6. A pocket penetrometer may be used to determine the actual soil bearing value. If soil testing equipment is not available, an assumed soil bearing capacity value of 2,000 lbs./square foot (psf) may be used.

7. All pad sizes shown are nominal dimensions and may vary to 1/8 of an inch.

8. The maximum deflection in a single ABS pad is 3/8 of an inch measured from the highest point to the lowest point of the top face of the pad. (Please review Table VI and Figure 14). Deflections of the ABS pads with the home’s dead load applied results from improper pier spacings, uneven soil or poorly compacted soil.

TABLE VI – SIZE AND LOAD

PAD SIZE PAD AREA 1000 LB. SOIL 2000 LB. SOIL 3000 LB. SOIL 16” X 16” 256 sq. in. 1,780 lbs. 3,560 lbs. 5,333 lbs. 18.5” X 18.5” 342 sq. in. 2,375 lbs. 4,750 lbs. 7,125 lbs. 20” X 20” 400 sq. in. 2,750 lbs. 5,500 lbs. 8,250 lbs.

a. Any configuration of ABS pad sizes above may be used to replace a home manufacturer’s recommended concrete pad.

b. The maximum load at any intermediate solid value may be determined as the average of the next lower and next higher soil values given in the above table.

c. Pad sizes shown are nominal dimensions and may vary up to 1/8 inch.

d. Pad loads are the same when using single stack or double stack blocks.

Figure 13. Example of an ABS multi-stack pad assembly for a 26”x 26” configuration.

Figure 14. Maximum allowable deflection in a single ABS pad

Rule 5.06.10: Anchors and Tie downs

Factory-Built homes with provisions for installation of anchor and tie down systems, including instructions, in accordance with Federal Manufactured Home Construction & Safety Standards, Section 24 CFR 3280.306 and Federal Manufactured Home Installation Standards 24 CFR 3285.402 and shall be installed in accordance with the manufacturer's instructions. Factory- Built homes not provided with such installation instructions, or Factory-Built homes not provided with instructions for the zone (wind or non- wind) in which they are being installed shall comply with the following:

Rule 5.06.10-1: Single-wide Factory-Built Homes

A. The number of anchors with tie downs for used single wide (10 ft., 12 ft., 14 ft., or 16 ft.) Factory-Built homes shall comply with Tables VII, Table VIII and Table IX.

B. All used Factory-Built homes shall be tied down in accordance with Tables VII, Table VIII and Table IX unless the anchoring system is designed and approved by a registered professional engineer (as per manufacturer's installation instructions).

C. Single section Factory-Built homes shall have diagonal, vertical and longitudinal tie downs and anchors in accordance with Tables VII, Table VIII and Table IX unless the manufacturer's installation instructions are utilized.

TABLE VII - MINIMUM NUMBER OF ANCHORS WITH TIEDOWNS (TIES) FOR WIND ZONE I

Length of Factory-Built home, excluding draw bar (ft.) Number of vertical ties on each side Number of diagonal ties on each side 2,5 Singlewide Number of Longitudinal ties on each end 2,4 Doublewide Number of Longitudinal ties on, each end of each half 2,4 Doublewide Number of Marriage Line Anchor and Ties

Total required Anchors per home Singlewide

Total Required Anchors per Home; Doublewide

0-40 0 4 1 1 2 10 14 41-60 0 6 1 1 3 14 19 61-84 0 8 1 1 4 18 24 (See Figure 15 A)

TABLE VIII - MINIMUM NUMBER OF ANCHORS WITH TIEDOWNS FOR WIND ZONE II

Length of Factory-Built home, excluding draw bar (ft.) Number of vertical ties on each side 2,3

Number of diagonal ties on each side 2,3 Singlewide Number of Longitudinal ties on each end 2,4 Doublewide Number of Longitudinal ties on each end of each half 2,4 Doublewide Number of Marriage Line Anchors and Ties Total required anchors per home Singlewide

Total Required Anchors per Home; Doublewide

0-40 5 5 2 2 2 16 22 41-60 7 7 2 2 3 20 27 61-84 9 9 2 2 4 24 32 (See Figure 15 B)

TABLE IX - MINIMUM NUMBER OF ANCHORS WITH TIEDOWNS FOR WIND ZONE III

Length of Factory-Built home, excluding draw bar (ft.) Number of vertical ties on each side 2,3

Number of diagonal ties on, each side

Singlewide Number of Longitudinal ties on each end 2,4 Doublewide Number of Longitudinal ties on each end of each half 2,4 Doublewide Number of Marriage Line Anchors and Ties Total Required Anchors per Home Singlewide

Total Required Anchors per Home Doublewide

0-40 6 6 3 3 2 18 26 41-60 8 8 3 3 3 22 31 61-84 10 10 3 3 4 26 36 (See Figure 15 C)

These tables are based on a minimum working load per tie down of 3,150 lbs. with a 50 % overload (4,725 lbs. total).

The Federal Manufactured home construction and safety standards require all Factory-Built homes designed for and located in wind Zone II and III to have diagonal anchors and tie downs installed at each vertical tie location and longitudinal anchors and tie downs installed on each end of the home.

Some older Wind Zone II and III Factory-Built homes may have a reduced number of vertical (over-the-top) tie down straps at the existing location. Installer must document, with photographs, the existing set-up before demobilizing home for transport and submit the

photograph with the Property Locator/Certificate of Inspection. The home must be returned to the original set-up conditions at the secondary location.

The Federal Manufactured Home Installation Standards 24 CFR 3285.402 (3) require all Factory-built homes, regardless of wind zone, to be stabilized in the longitudinal direction on each end of the home. The number of longitudinal anchors required in the above tables, is not dependent on pier height.

If the maximum support pier height exceeds 24 inches, an additional diagonal tie must be added, per side, for every additional 12 inches of pier height or any portion thereof for singlewide and doublewide Wind Zone I homes only

Figure 15 A. Number of Anchors Required for Varying Lengths of Homes for Wind Zone I

Figure 15 B. Number of Anchors Required for Varying Lengths of Homes for Wind Zone II.

Figure 15 C. Number of Anchors Required for Varying Length of Homes for Wind Zone III.

Some manufactured homes may have brackets welded to the bottom of the frame I-beam similar to that shown in Figure 16. These brackets are factory installed longitudinal brackets and are required to have a tie down strap and anchor installed or the installation of manufacturer approved equivalent longitudinal stabilizing devices. If the home does not have factory installed longitudinal brackets, an alternative method for installing the required longitudinal anchor and tie down strap is shown in Figure 17.

History

• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024);

19 Miss. Admin. Code Pt. 7, R. 24 CFR Part 3285 Subpart E, (b) -- Anchorage Against Wind

Figure 16. Longitudinal brackets factory installed on the frame I-beam.

Figure 17. Alternative Longitudinal Anchor Installation

Rule 5.06.10-2: Multi-Sectional Factory-Built Homes

A. All used multi-sectional Factory-Built homes shall have diagonal tie downs and anchors as required above for double-wide Factory-Built homes as listed in Tables VII, Table VIII and Table IX above.

B.The installation of anchors and diagonal tie downs will be required along the marriage line on all used multi-section Factory-Built homes unless the manufacturer’s installation manual for the home is available and specifies that stabilizing devices (caps, plates, rods, etc.) are optional.

C.All new multi-sectional Factory-Built homes are to be secured at the marriage line with straps and anchors to the specifications in the manufacturer’s installation manual or at the locations designated on the home. In addition to marriage line tie down straps specified by the manufacturer, marriage line anchors and tie down straps must be attached within two (2) feet of each end of each section of the Factory-Built home. If the manufacturer installed marriage line bracket has been modified or compromised, an industry approved replacement bracket shall be installed by the installer/transporter.

D.All used multi-section homes shall be lagged and sealed together in accordance with the manufacturer’s installation instructions, if available. The maximum allowed gap at the marriage line along the length and at the ends of the home shall be one (1) inch or less in width. If no manufacturer’s installation instructions are available, the instructions provided in this regulation (see Figure 18) shall be followed. For all new Factory-Built homes, the connections along the marriage line and any filler material used to reduce the gap must be in compliance with the manufacturers installation manual.

E. Holes in bottom board fabric from installation of lag screws at the marriage line must be properly patched with the bottom board fabric patches, mastic and staples.

Figure 18. Multi-section Factory-Built Home Fastening and Sealing

F. All new multi-section homes that have been constructed with a tag unit are to be installed according to the manufacturer’s installation instructions. The HUD label on this unit is required to be recorded on the Property Locator/Certificate of Installation.

G. If a used multi-section homes has a tag unit, the required support pier spacings and anchor locations for the unit are shown in Figure 19a and Figure 19b. The HUD label on this unit is required to be recorded on the Property Locator/Certificate of Installation.

Figure 19a. Typical Support Pier Placement and Spacing for a Tag Unit.

Figure 19b. Typical Anchor Locations and Spacings for a Tag Unit. Rule 5.06.10-3: Proprietary Ground (Pan) Foundation Stabilizing Systems

A proprietary ground foundation stabilizing systems (herein referred to as pan foundation systems) are designed to provide an alternative to conventional ground anchors and straps for stabilizing the Factory-Built home against wind loads. These systems can eliminate the need for most anchors in a Wind Zone I area and eliminate the need for diagonal frame ties and stabilizing plates on vertical anchors in Wind Zone II and III areas. The base of the system (pan) is a flat metal plate or concave metal pan set with the top surface of the plate/pan at or slightly below the level of the concrete slab or dirt foundation, respectively.

The pan foundation systems can provide resistance against lateral and longitudinal wind loads with the addition of metal tubes called “transverse” and “longitudinal” bars, respectively. A generalized installation of a pan foundation system is shown in Figure 20.

Figure 20. Typical installation of a Ground (Pan) Foundation System

Pan foundation systems are required to be installed, according to the instructions provided by the manufacturer of each individual system. The systems are designed to operate in conjunction with each other and must be placed as evenly as possible from the end of the support beams and on opposing corners. Pier height and roof pitch limit the use of these systems in certain applications.

In Wind Zone I areas, effective November 3, 2025, the installation of the pan system will be required to meet the following guidelines for vertical anchor installation (see Table X-A):

TABLE X-A VERTICAL ANCHORING REQUIREMENTS FOR WIND ZONE I HOMES

4:12 Roof Pitch 5:12 Roof Pitch 6:12/7:12 Roof Pitch

Home Section Size Home Width Home Length Anchors per Side Home Length Anchors per Side Home Length Anchors per Side 12 ‘ Up to 63’ 3 Up to 55’ 4 Up to 45’ 4 140” + 64’ – 90’ 4 56’ – 74’ 5 46’ – 62’ 5 75’ – 90’ 6 63’ – 73’ 6 79’ – 90’ 7 Singlewide 14’ – 18’ Up to 73’ 3 Up to 58’ 4 Up to 47’ 4 156”to 210” 74’ to 90’ 4 59’ -78’ 5 48'-64' 5 79’ – 90’ 6 65'-81' 6 82'-90' 7

20’ Up to 90’ 2 up to 90' 3 up to 90' 4 (2) 118” 2 Doublewide Up to 85’ 3 24’ – 32’ Up to 90’ 2 up to 90' 2 up to 90' 4 (2) 140” to (2) 186”

36’ – 48’ 2 2 2 Triple-wide (3) 140” to (3) 186” up to 90' 2 up to 90' 2 up to 90' 2

In Wind Zone I areas, the transverse bar and one (1) longitudinal bar are required on each pan foundation system. For Wind Zone II and Wind Zone III areas, the transverse bar and two (2) longitudinal bars are required on each system. Factory Built Homes exceeding seventy-six (76) feet in length may require the addition of a third pan foundation system (see Figure 21). The pan foundation system manufacturers’ installation instructions should be referred to for proper placement of any additional systems and required anchors and tie downs.

Figure 21. Anchor and Pan Foundation System Installation Locations for Varying Roof Pitch

T a b l e X-B a n d T a b l e X-C p r o v i d e t h e i n f o r m a t i o n f o r t h e u s e o f p a n f o u n d a t i o n s s y s t e m s o n n e w a n d u s e d h o m e s i n W i n d Z o n e I , W i n d Z o n e I I a n d W i n d Z o n e I I I a r e a s . It is required that the name of the manufacturer of the pan- type foundation system be indicated on the Property Locator/Certificate of Installation form. In addition, the vertical anchor requirements (Table X-A) will be required to be implemented into the set-up of the home.

TABLE X-B

MINIMUM NUMBER OF PAN SYSTEMS, STABILIZING BAR AND ANCHOR REQUIREMENTS FOR WIND ZONE I

HOMES

Length of Factory- Built home, excluding draw bar (ft.) Number of Pan Systems (each section)

Number of Transverse Bars (each Pan) Number of Longitudinal Bars (each pan)

Number of Anchors Required Singlewide, Doublewide, Triple wide

0-40 2 1 1 See Table X-A 41-60 2 1 1 “ 61-76 2 1 1 “ 80 + 3 1 1 “

TABLE X-C

MINIMUM NUMBER OF PAN SYSTEMS, STABILIZING BAR AND ANCHOR

REQUIREMENTS FOR WIND ZONE II

AND WIND ZONE III HOMES

Length of Factory- Built home, excluding draw bar (ft.) Number of Pan Systems (each section)

Number of Transverse Bars (each pan) Number of Longitudinal Bars (each pan)

Number of Anchors Required Singlewide, Doublewide, Triple

wide **** 0-40 2 1 2 See Table X-A 41-60 2 1 2 “ 61-76 2 1 2 “ 80 + 3 1 2 “

Pan foundation systems must not be used when any single support pier height exceeds 48 inches.

A minimum of two (2) pan foundation systems are required under a home and are to be placed under the main frame member at a distance no farther from the end of the home than ¼ the length of the home. If a third pan foundation system is required by the manufacturer of the system, it must be placed halfway between the two (2) pan foundation systems and may be installed on either section (front or rear half) of the home.

All pan foundation systems shall have the proper number of longitudinal bars per the Wind Zone designation of the home.

Anchoring requirements for Wind Zone II and Wind Zone III Factory Built homes shall comply with the anchor manufacturer’s installation instructions for the pan foundation system that is installed.

Prior to the selection and use of the pan foundation system, it is the responsibility of the installer/transporter to check with the LAHJ to determine if any restrictions have been placed on the use of these types of foundation systems.

Rule 5.06.10-4: Anchor Tie Down Spacing and Sizes

The following specifications are the minimum standards for all tie down spacing and sizes.

A. Wherever feasible, over-the-top tie down straps shall be attached to the anchor head tie down strap tensioning bolts at the anchor located directly beneath them.

B. All vertical side wall and shear wall tie down brackets existing on the home must be

properly strapped and anchored. Any vertical side wall brackets not used for installing anchors and straps for the proper installation of the home must have manufacturers documentation that excludes these brackets from use.

C. Vertical side wall brackets which are not required to have anchor and strap installed are not to be folded up or compromised in any manner.

D. Figure 22 shows the use of a radius clip (made from a short piece of frame strap) to protect the strap loop that passes through the slot in the side wall bracket. Figure 23 shows an alternate method (looped)for installing the anchor straps to a vertical side wall bracket. The open end of the strap (as shown in Figure 23) must not exceed six (6) inches in length. Any length of the open end of the strap exceeding the 6 inches will require the installation of a crimp seal on the open-end strap crimped to the vertical tie down strap.

Figure 22. Use of a radius clip inside vertical sidewall and shear wall bracket slots.

Figure 23. Alternate (looped) method for installing anchor straps in vertical sidewall brackets.

E. On all new factory-built homes, any other method of attaching tie down straps to the wall bracket (looped) will require approval by the manufacturer and will require documentation submitted to the Division with the Property Locator/Certificate of Installation prior to the inspection.

F . All tie down straps, cables and devices must be tested and approved by the manufacturer of the materials. All tie down straps shall be fastened to ground anchors and drawn tight with slotted tensioning bolts or other such tensioning devices listed with the ground anchor. Tie down straps must not be over-tightened.

G . All tie down straps and devices must be attached to the Factory-Built home in accordance with the manufacturer’s instructions for the specific types of straps and devices. All tie- down straps and devices must be tested and approved. Straps must be type I, finished B, grade 1 steel strapping, 1 ¼” wide and 0.035” thick conforming with Federal Specifications strapping steel and seals FS QQ-S-781H-1974.

H. Tie down straps shall not be kinked, bent or otherwise abnormally stressed when installed at an angle to the frame I-beam. Straps must not be in contact with the support piers.

I. If the angle between the frame strap to the outer I-beam and the ground is greater than 45 degrees, a “Cross Strapping” method must be used as shown in Figure 24A and 24B. It requires

an additional anchor tensioning bolt connected to a frame strap attached to the opposite outer frame I-beam for Wind Zone I installations (note dotted line in Figure 24A). Connect the strap to the top inside location on the opposite frame I-beam and wrap the strap completely around the I-beam. Position the strap directly over the lapped strap and in line with the anchor head. With the anchor and stabilizer device properly installed in the ground, insert the strap into the second slotted tensioning bolt in the anchor head, turning the bolt a minimum of 4-5 turns to remove slack from the frame strap. The first frame strap to the outer I-beam is to remain in place to provide additional tie down strength. If one of the tensioning bolts is connected to a vertical sidewall strap, typical for Wind Zone II or III installations (note dotted lines in Figure 24B), remove the strap from the near I-beam and install a longer strap to the opposing I beam.

Figure 24A. “Cross Strapping” Wind Zone I Figure 24 B. “Cross Strapping” Wind Zone II and Wind Zone III Installation

J. All tie down straps must be properly attached to the frame I-beam and the anchor head according to the manufacturer’s installation instruction and must be properly tensioned. Figures 25 and 26 illustrate the correct strap installation methods for use with double slot strap buckles and/or clips, respectively. According to manufacturer specifications, the winding of the strap on the anchor head bolt must contain a minimum of four to five complete turns.

Figure 25. Installing Frame Tie Strap Using a Double Slot Strap Buckle

Figure 26. Installing Frame Tie Strap Using a Hook Clip

K. Splices in the anchor straps must be installed in accordance with the manufacturer’s instructions for straps and devices. If manufacturer instructions for splicing anchor straps are not available, the following instructions will apply. The ends of the straps must overlap to a

minimum of six (6) inches and a maximum of twelve (12) inches. Two (2) crimp seals must be installed in the overlap of the strap ends and each crimp seal must be double crimped, as shown in Figure 27.

Figure 27. Tie Down Strap Splice Details

L. Tie down strap materials shall be capable of resisting an allowable working load of 3,150 lbs. with no more than 2% elongation and shall withstand a 50% overload [4,725 lbs. total]. Tie downs exposed to weathering shall be resistant to weathering deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 oz. per square foot of surface coated. Type I, Class B, Grade I, steel strapping 1 1/4 inches wide and 0.035 inch thick, conforming to Federal Specifications QQ S 781 F, is judged to conform to this section.

M. Materials used for tie down straps must terminate with D-rings bolts, or other fastening devices, which will not cause distortion of the band or reduce its breaking strength of 4,725 lb. Please note that tie down straps should be double wrapped (double looped) at top of the I- beam, returning to the anchor from this position, not from the bottom of the I-beam.

N. Connection of the cable frame tie to the I-beam (or other shape) main structural frame member should be by a 5/8-inch drop forged closed eye bolted through a hole drilled in the center of the I-beam web. A washer, or equivalent, shall be used so that the beam is sufficiently reinforced around the hole. If steel strap ties are used, care should be exercised to ensure that minimum bending radius is adhered to so that the breaking strength of the strap is not reduced.

O. Frame ties shall connect the anchor and the steel I-beam (or other shape) main structural frame member which run lengthwise under the Factory-Built home. Frame ties shall never be connected to any of the steel outrigger beams which fasten to and intersect the main I beam at right angles.

Rule 5.06.11: Anchors

Devices used to anchor Factory Built homes shall meet the requirements listed in the following Rules.

Rule 5.06.11-1: Soil Classification of Anchors

All ground anchors must be installed in the soil types for which they are tested and approved. It should be noted that soil types may vary across a home installation site. Prior to installing any ground anchor, it is the responsibility of the installer/transporter to determine the soil class at the installation site and to ensure that the proper class of anchor is installed for the existing type of soil. The acceptable method for the determination of the soil classification is by a soil test probe (see Figure 5). The soil classifications shown in Table I are the accepted standards of this Regulation and are to be used for the purpose of determining the design loads, specifications and holding power of anchors and tie down devices for installation of all Factory-Built homes in the State of Mississippi.

Rule 5.06.11-2: Determining the Soil Class of Anchors

The use of a soil test probe shall be required in the determination of the soil classification at the installation site for the proper soil class anchor that can be used. A minimum of 6 readings (one at each of the four corners of the home, within two feet of the corners, one at the front center of the home and one at the rear center of the home) shall be required in order to properly choose the anchoring device required for the home. Results of the soil test probe may be averaged and used to determine anchor types based on the anchor manufacturer’s installation and/or user manual requirements. However, all of the soil test probe torque values and the depth readings obtained at the installation site, including the computed average reading, shall be recorded on the Property Locator/Certificate of Installation to confirm the determined soil class for anchor selection.

Rule 5.06.11-3: Preferred Soil Class Anchor

If no soil test probe measurements have been obtained for the determination of the soil classification at the installation site, it is preferred that a soil class type C-4 rated anchor shall be used. C-4 rated anchors shall have a minimum auger diameter of 6 inches and shall be installed to their full depth. When the condition of the soil (including ground density, composition, moisture content and compaction) will not allow the C-4 rated anchors to be installed to their full depth, the C-4 rated anchor that could not be installed shall be left in place.

A soil test probe shall be employed to obtain readings to determine the appropriate soil class anchor installed adjacent to the failed C-4 anchor. All ground anchors used shall be capable of withstanding 4,750 lbs. of pull (in a vertical or diagonal direction) without failure.

In difficult soil conditions, the anchor manufacturers shall be contacted for a recommendation

of an alternate type of soil class anchor (approved by the manufactured housing industry) to be used.

Rule 5.06.11-4: Proper Installation of Ground Anchors and Tie Down Straps

A. Ground anchors and tie down straps shall be aligned close to the location of the support piers, but not in the center of the pier, as that will interfere with frame ties.

B. All anchors shall be installed in a vertical position or with the anchor rod in direct alignment with the force of the loading.

C. Anchors to reinforced concrete slabs must be strength comparable to that presented above. If a Factory-Built home is to be placed on a monolithic concrete slab, the ground anchors may be replaced with anchor bolts imbedded in the concrete slab. The location of the anchor bolt in relation to the longitudinal support I-beam will be the same as the ground anchors.

D. Other anchors which can withstand 4,750 lbs. of pull without failure may be approved by the Factory-Built Home Division of the State Fire Marshal's Office as equivalent to above specifications.

E. All ground anchors installed in a vertical position having frame tie connections shall have approved stabilizer plates, stabilizer caps, concrete collar, or other approved stabilizer devices installed to resist horizontal movement. The stabilizer device must be installed according to the manufacturer instructions, and the top of the device must be flush with the surface of the soil. If a concrete cap is used it must be a minimum of 10” in diameter and 18” deep. Exception: Stabilizer plates are not required with coral anchors or at centerline or marriage line locations.

F. Anchors must be installed to full depth with the bottom of the anchor head within one (1) inch of the soil’s surface.

G. The "Standard Method of Test for Manufactured Home Anchors, Parts A and B" is described in the Federal Manufactured Home Construction and Safety Standards, 24 CFR Section 3280.401.

H. Previously installed anchors, extracted from the initial installation site, shall not be used in the installation of the Factory – Built home at a new location.

I. The use of any alternate systems of anchoring, not approved by HUD, may be used if the installer provides proof that the manufacturer of the home has provided written approval of the use of such systems and that the written approval is provided with the submittal of the Property Locator/Certificate of Inspection Form.

J. All ground anchors, tie down devices, and ground foundation systems must be installed according to the manufacturer’s installation instructions for their respective ground anchors, tie

down devices and ground stabilization devices.

K. Rock anchors can only be used in solid rock.

Rule 5.07: Official Notices and Bulletins All manufacturers, retailers, developers, installers/transporters shall maintain any and all official notes and/or bulletins issued by the Factory-Built Home Division for three (3) years from the date of issuance. If so, required by this Factory-Built Home Division, all manufacturers, retailers, developers and installers/transporters shall display official notices and bulletins in plain view for the public. Exception: Any official notices and bulletins marked as permanent records or DO NOT DESTROY.

Rule 5.08: Severability If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision of application, and to this end the provisions of the Regulation are declared to be severable.

Rule 5-09: Effective Date

The amended version of this regulation shall supersede prior versions and shall become effective on July 1, 2026.

History

• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024).
• Source: Miss. Code Ann. §§ 75-49-1, et seq.; 75-49-11 (Supp. 2024)

Chapter 8 General L.C. Gas Regulations

19 Miss. Admin. Code Pt. 7, R. 8.01 Transfer of Liquids

When an LP-Gas container is used for motor fuel, farm implements, portable containers or similar service and cannot be serviced due to excessive vapor pressure in the fuel container, vapor pressure may be reduced to facilitate fueling by venting to the atmosphere, provided the liquid transfer is located not less than 50 feet from the nearest important building and in an open area without undue hazard to any building or surrounding property and there is no open flame or other source of ignition in the area. Passenger-carrying vehicles shall not be fueled in this manner while passengers are on board.

History

• Source: Miss. Code Ann. §§75-57-1, et seq. (Rev. 2009)

19 Miss. Admin. Code Pt. 7, R. 8.02 Appliances

8.02.1 Room Heaters. Unvented room heaters may be installed in residential sleeping quarters and bathrooms provided the aggregate input rating does not exceed 20 BTU’s per hour per cubic foot of room or space in which it is installed.

8.02.2 Heating Appliances In Stationary Mobile Homes. Vented or Non-vented type circulating room heaters may be installed in stationary mobile homes for use with LP-Gas as follows:

A. The appliance must be listed for use with LP-Gas by the American Gas Association or othernationally recognized testing laboratory. B. The appliance must be installed in accordance with NFPA-54 provisions for combustionand circulating air. C. A clayback heater cannot be used; however a heater with a cool-type cabinet may be used.

History

• Source: Miss. Code Ann. §§75-57-1, et seq. (Rev. 2009)
• Source: Miss. Code Ann. §§75-57-1, et seq. (Rev. 2009)

19 Miss. Admin. Code Pt. 7, R. 8.03 Effective Date

This regulation will become effective thirty (30) days after the Final Rule is filed.

History

• Source:Miss. Code Ann. §25-43-3.113, et seq. (Rev. 2010)

Chapter 9 (2011-2) Handling of Liquefied Compressed Gas Containers

19 Miss. Admin. Code Pt. 7, R. 9.03 Scope

This Regulation shall apply to all liquefied petroleum gas dealers, their agents and employees, any installer or other person who installs, connects, alters, extends, changes or repairs any liquefied compressed gas system, container, or appliance whatsoever, and also any person who installs connects, changes, extends, alters or repairs any piping or fitting connected with or attached to any liquefied compressed gas system or appliance. For purposes of this regulation, these persons are sometimes referred to as “dealers and installers”.

History

• Source: Miss. Code Ann. § 75-57-3 and §75-57-105 (Supp. 2024)

19 Miss. Admin. Code Pt. 7, R. 9.04 Requirements

A. In order to promote the public safety by avoiding the contamination of ASME containers and by assuring the proper reconditioning of service valves and containers, all dealers shall be required to mark, label, or otherwise designate liquefied petroleum gas containers in such a manner as to easily identify such containers as being owned by the particular dealer. No dealer shall sell, install, fill, refill, deliver or permit to be delivered, or use in any manner any ASME liquefied petroleum gas container unless such container is owned by such dealer or its use is authorized by the owner of such container.

B. No liquefied petroleum gas dealer or installer, including its agents and employees, may dismantle, disconnect, evacuate, repair, deface, fill, or refill a container belonging to another dealer unless:

1. Prior written permission shall have been granted by the dealer who owns the container;

2. Prior written permission shall have been granted by the owner or lessee of the premises where the container is located, except the owner or lessee may not grant permission to fill or refill a container. Written notification to the dealer who owns the container is required prior to any actions that break into or modify the liquified compressed gas system;

3. The action is taken at the discretion of the authority having jurisdiction as defined in NFPA Pamphlet 58; or

4. The action is taken under a declared state of emergency.

C. Nothing in this section shall be construed as abrogating the right of the consumer to terminate a rental contract on a container with the dealer/owner, in accordance with the terms and provisions of said rental contract.

History

• Source: Miss. Code Ann. §75-57-105 (Supp. 2024)

19 Miss. Admin. Code Pt. 7, R. 9.06 Violations and Penalties

Failure of a liquefied petroleum gas dealer or installer to comply with the provisions of this regulation shall be considered a violation of the Liquefied Compressed Gas Equipment Inspection Law of Mississippi, as codified in Miss. Code Ann. §§75-57-1, et. seq., and may result in a monetary penalty and/or revocation of the dealer’s liquefied compressed gas permit.

History

• Source: Miss. Code Ann. §75-57-105 and § 75-57-109 (Supp. 2024)

19 Miss. Admin. Code Pt. 7, R. 9.07 Severability

If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application, and to this end the provisions of the Regulation are declared to be severable.

History

• Source: Miss. Code Ann. §75-57-105 (Supp. 2024); §45-11-101, et seq.(Supp. 2024)

19 Miss. Admin. Code Pt. 7, R. 9.08 Effective Date

This amended version of the regulation shall supersede prior versions and become effective thirty (30) days from the filing for final adoption with the Secretary of State.

Part 7, Chapter 10. Rules Regarding the Mississippi Fire Standard and Firefighter Protection Act.

Rule 10.01: Purpose

The purpose of this Regulation is to set forth the rules and regulations governing the testing, certification, marking, and sale of fire standard compliant cigarettes in the State of Mississippi.

Rule 10.02: Authority

This Regulation is promulgated by the Commissioner of Insurance, through his power as State Fire Marshal, as required pursuant to the provision of the Mississippi Fire Safety Standard and Firefighter Protection Act ("Act") Senate Bill 2249, 2009 Regular Session, as approved by the Governor of Mississippi, as well as the provisions of Mississippi Department of Insurance Regulation No. 88-101, said regulation being the Rules of Practice and Procedure before the Mississippi Insurance Department, of which the State Fire Marshal's Office is a division.

Rule 10.03: Scope

This Regulation shall apply to individuals and companies who sell or offer to sell cigarettes in the State of Mississippi.

This Regulation and the Act shall supersede any existing county or municipal ordinance, rule or regulation. Any such rules and regulations shall be null, void and of no effect. Further, no county or municipality shall enact any new ordinance, rule or regulation regulating companies and persons subject to licensure pursuant to this Regulation and the Act.

Rule 10.04: Definitions

As used in this Regulation, the following terms shall be defined as follows:

A. "Agent" means any person authorized by the commissioner to purchase and affix stamps on packages of cigarettes.

B. "Commissioner" means the Chairman of the State Tax Commission of the State of Mississippi, and his authorized agents and employees.

C. "State Fire Marshal" means the Commissioner of Insurance and State Fire Marshal of the State of Mississippi, and his authorized agents and employees.

D. "Cigarette" means:

1. Any roll of tobacco wrapped in paper or in any substance not containing tobacco; or

2. Any roll of tobacco wrapped in any substance containing tobacco which, because of its appearance, the type of tobacco used in the filler, or its packaging and labeling, is likely to be offered to, or purchased by, consumers as a cigarette as described in subparagraph (i) above.

E. "Manufacturer" means:

1. Any entity which manufactures or otherwise produces cigarettes or causes cigarettes to be manufactured or produced anywhere that such manufacturer intends to be sold in this state, including cigarettes intended to be sold in the United States through an importer; or

2. Any entity that becomes a successor of an entity described in subparagraph (i) of this paragraph.

F. "Quality control and quality assurance program" means the laboratory procedures implemented to ensure that operator bias, systematic and nonsystematic methodological errors, and equipment-related problems do not affect the results of the testing. Such a program ensures that the testing repeatability remains within the required repeatability values stated in subsection (1)(f) of Section 45-12-5 for all test trials used to certify cigarettes in accordance with this chapter.

G. "Repeatability" means the range of values within which the repeat results of cigarette test trials from a single laboratory will fall ninety-five percent (95%) of the time.

H. "Retail dealer" means any person, other than a manufacturer or wholesale dealer, engaged in selling cigarettes or tobacco products.

I. "Sale" means any transfer of title or possession or both, exchange or barter, conditional or otherwise, in any manner or by any means whatever or any agreement therefore. In addition to cash and credit sales, the giving of cigarettes as samples, prizes or gifts, and the exchanging of cigarettes for any consideration other than money, are considered sales.

J. "Sell" means to sell, or to offer or agree to do the same.

K. "Wholesale dealer" means any person, other than a manufacturer, who sells cigarettes or tobacco products to retail dealers or other persons for purposes of resale, and any person who owns, operates or maintains one or more cigarette or tobacco product vending machines in, at or upon premises owned or occupied by any other person.

A. Except as provided in subsection (7) of this section, no cigarettes may be sold or offered for sale in this state or offered for sale or sold to persons located in this state unless the cigarettes have been tested in accordance with the test method and meet the performance standard specified in this section, a written certification has been filed by the manufacturer with the State Fire Marshal in accordance with Section 45-12-7, and the cigarettes have been marked in accordance with Section 45-12-9.

1. Testing of cigarettes shall be conducted in accordance with the American Society of Testing and Materials (ASTM) Standard E2187-04, "Standard Test Method for Measuring the Ignition Strength of Cigarettes."

2. Testing shall be conducted on ten (10) layers of filter paper.

3. No more than twenty-five percent (25%) of the cigarettes tested in a test trial in accordance with this section shall exhibit full-length burns. Forty (40) replicate tests shall comprise a complete test trial for each cigarette tested.

4. The performance standard required by this section shall only be applied to a complete test trial.

5. Written certifications shall be based upon testing conducted by a laboratory that has been accredited pursuant to Standard ISO/IEC 17025 of the International Organization for Standardization (ISO), or other comparable accreditation standard required by the State Fire Marshal.

6. Laboratories conducting testing in accordance with this section shall implement a quality control and quality assurance program that includes a procedure that will determine the repeatability of the testing results. The repeatability value shall be no greater than nineteen percent (19%).

7. This section does not require additional testing if cigarettes are tested consistent with this chapter for any other purpose.

8. Testing performed or sponsored by the State Fire Marshal to determine a cigarette's compliance with the performance standard required shall be conducted in accordance with this section.

B. Each cigarette listed in a certification submitted pursuant to Section 45-12-7 that uses lowered permeability bands in the cigarette paper to achieve compliance with the performance standard set forth in this section shall have at least two (2) nominally identical bands on the paper surrounding the tobacco column. At least one (1) complete band shall be located at least fifteen (15) millimeters from the lighting end of the cigarette. For cigarettes on which the bands are positioned by design, there shall be at least two (2) bands fully located at least fifteen (15) millimeters from the lighting end and ten (10) millimeters from the filter end of the tobacco column, or ten (10) millimeters from the labeled end of the tobacco column for nonfiltered cigarettes.

C. A manufacturer of a cigarette that the State Fire Marshal determines cannot be tested in accordance with the test method prescribed in paragraph (1) of subsection (A) shall propose a test method and performance standard for the cigarette to the State Fire Marshal. Upon approval of the proposed test method and a determination by the State Fire Marshal that the performance standard proposed by the manufacturer is equivalent to the performance standard prescribed in paragraph (3) of subsection (A), the manufacturer may employ such test method and performance standard to certify such cigarette pursuant to Section 45-12-7. If the State Fire Marshal determines that another state has enacted reduced cigarette ignition propensity standards that include a test method and performance standard that are the same as those contained in this section, and the State Fire Marshal finds that the officials responsible for implementing those requirements have approved the proposed alternative test method and performance standard for a particular cigarette proposed by a manufacturer as meeting the fire safety standards of that state's law or regulation under a legal provision comparable to this section, then the State Fire Marshal shall authorize that manufacturer to employ the alternative test method and performance standard to certify that cigarette for sale in this state, unless the State Fire Marshal demonstrates a reasonable basis why the alternative test should not be accepted under this section. All other applicable requirements of this section shall apply to the manufacturer.

D. Each manufacturer shall maintain copies of the reports of all tests conducted on all cigarettes offered for sale for a period of three (3) years, and shall make copies of these reports available to the State Fire Marshal and the Attorney General upon written request. Any manufacturer who fails to make copies of these reports available within sixty (60) days of receiving a written request shall be subject to a civil penalty not to exceed Ten Thousand Dollars ($ 10,000.00) for each day after the sixtieth day that the manufacturer does not make such copies available.

E. The State Fire Marshal may promulgate a subsequent ASTM Standard Test Method for Measuring the Ignition Strength of Cigarettes upon a finding that such subsequent method does not result in a change in the percentage of full-length burns exhibited by any tested cigarette when compared to the percentage of full-length burns the same cigarette would exhibit when tested in accordance with ASTM Standard E2187-04 and the performance standard in paragraph (3) of subsection (A).

F. The State Fire Marshal shall review the effectiveness of this section and report every three (3) years to the Legislature his findings and, if appropriate, recommendations for legislation to improve the effectiveness of this chapter. The report and legislative recommendations shall be submitted no later than June 30 following the conclusion of each three-year period.

G. The requirements of subsection (A) shall not prohibit:

1. Wholesale or retail dealers from selling their existing inventory of cigarettes on or after July 1, 2010, if the wholesale or retail dealer can establish that state tax stamps were affixed to the cigarettes prior to July 1, 2010, and the wholesale or retail dealer can establish that the inventory was purchased prior to July 1, 2010, in comparable quantity to the inventory purchased during the same period of the prior year; or

2. The sale of cigarettes solely for the purpose of consumer testing. For purposes of this subsection, the term "consumer testing" means an assessment of cigarettes that is conducted by a manufacturer (or under the control and direction of a manufacturer), for the purpose of evaluating consumer acceptance of such cigarettes, utilizing only the quantity of cigarettes that is reasonably necessary for such assessment.

H. This regulation shall be so interpreted and construed as to effectuate its general purpose to make uniform this chapter with the laws of those states that have enacted reduced cigarette ignition propensity laws as of July 1, 2010.

Rule 10.06: Certification and product change

A. Each manufacturer shall submit, in a form made available by the State Fire Marshal, a written certification attesting that:

1. Each cigarette listed in the certification has been tested in accordance with Section 45-12-5; and

2. Each cigarette listed in the certification meets the performance standard set forth in Section 45-12-5.

B. Each cigarette listed in the certification shall be described with the following information:

1. Brand, or trade name on the package;

2. Style, such as light or ultra light;

3. Length in millimeters;

4. Circumference in millimeters;

5. Flavor, such as menthol or chocolate, if applicable;

6. Filter or nonfilter;

7. Package description, such as soft pack or box;

8. Marking pursuant to Section 45-12-9;

9. The name, address and telephone number of the laboratory, if different than the manufacturer that conducted the test; and

10. The date that the testing occurred.

C. The State Fire Marshal shall make certifications available to the Attorney General for purposes consistent with this chapter and the commissioner for the purposes of ensuring compliance with this section.

D. For each brand family of cigarettes listed for certification, a manufacturer shall pay a fee of One Thousand Dollars ($ 1,000.00) to the State Fire Marshal. The fee paid shall apply to all cigarettes within the brand family certified and shall include any new cigarette certified within the brand family during the three-year certification period.

E. If a manufacturer has certified a cigarette pursuant to this section, and thereafter makes any change to such cigarette that is likely to alter its compliance with the reduced cigarette ignition propensity standards required by this section, that cigarette shall not be sold or offered for sale in this state until the manufacturer retests the cigarette in accordance with the testing standards set forth in Section 45-12-5 and maintains records of that retesting as required by Section 45-12-5. Any altered cigarette which does not meet the performance standard set forth in Section 45-12-5 may not be sold in this state.

F. Each brand family of cigarettes certified under this section shall be recertified every three (3) years from the original certification date.

1. To continue to sell a cigarette brand that has been certified under this regulation the manufacturer of that cigarette must, within three (3) years of the certification date, apply for recertification in a form made available by the State Fire Marshal,

which may be accessed at http://www.mid.ms.gov/ attesting that each cigarette listed for recertification meets the standards necessary for initial certification.

2. For each brand family of cigarettes listed for recertification, a manufacturer shall pay a fee of One Thousand Dollars ($ 1,000.00) to the State Fire Marshal. The fee paid shall apply to all cigarettes within the brand family certified and shall include any new cigarette certified within the brand family during the three-year recertification period.

Rule 10.07: Marking of cigarette packaging

A. Cigarettes that are certified by a manufacturer in accordance with Section 45-12-7 shall be marked to indicate compliance with the requirements of Section 45-12-5. The marking shall be in eight-point type or larger and consist of the letters "FSC," which signifies Fire Standard Compliant, permanently printed, stamped, engraved or embossed on the package at or near the UPC Code.

B. A manufacturer shall use only one (1) marking, and shall apply this marking uniformly for all packages, including, but not limited to, packs, cartons, and cases, and brands marketed by that manufacturer.

C. Manufacturers certifying cigarettes in accordance with Section 45-12-7 shall provide a copy of the certifications to all wholesale dealers and agents to which they sell cigarettes. Wholesale dealers, agents and retail dealers shall permit the State Fire Marshal, the commissioner, the Attorney General and their employees to inspect markings of cigarette packaging marked in accordance with this section.

Rule 10.08: Violations and Penalties

The Commissioner shall have the ability to issue penalties due to violations of the Act or Regulation, as more specifically stated in this Section.

A. The following are violations that will result in administrative action by the Commissioner:

1. A manufacturer, wholesale dealer, agent or any other person or entity who knowingly sells or offers to sell cigarettes, other than through retail sale, in violation of Section 45-12-5, shall be subject to a civil penalty not to exceed One Hundred Dollars ($ 100.00) for each pack of such cigarettes sold or offered for sale, provided that in no case shall the penalty against any such person or entity exceed One Hundred Thousand Dollars ($ 100,000.00) during any thirty-day period.

2. A retail dealer who knowingly sells or offers to sell cigarettes in violation of Section 45-12-5 shall be subject to a civil penalty not to exceed One Hundred Dollars ($ 100.00) for each pack of such cigarettes sold or offered for sale, provided that in no case shall the penalty against any retail dealer exceed Twenty- five Thousand Dollars ($ 25,000.00) for sales or offers to sale during any thirty- day period.

3. In addition to any penalty prescribed by law, any corporation, partnership, sole proprietor, limited partnership or association engaged in the manufacture of cigarettes that knowingly makes a false certification pursuant to Section 45-12-7 shall be subject to a civil penalty of at least Seventy-five Thousand Dollars ($ 75,000.00) and not to exceed Two Hundred Fifty Thousand Dollars ($ 250,000.00) for each such false certification.

4. Any person violating any other provision in this section shall be liable for a civil penalty for a first offense not to exceed One Thousand Dollars ($ 1,000.00), and for a subsequent offense shall be liable for a civil penalty not to exceed Five Thousand Dollars ($ 5,000.00), for each such violation.

B. Whenever any law enforcement personnel or duly authorized representative of the State Fire Marshal shall discover any cigarettes (a) for which no certification has been filed as required by Section 45-12-7, or (b) that have not been marked as required by Section 45- 12-9, such personnel is hereby authorized and empowered to seize and take possession of such cigarettes.

1. Cigarettes seized pursuant to this section shall be destroyed; provided, however, that prior to the destruction of any cigarette seized pursuant to these provisions, the true holder of the trademark rights in the cigarette brand shall be permitted to inspect the cigarette.

i. The true holder of trademark right in the cigarette brand of the products to be destroyed shall have twenty (25) days from the date of notice to the holder of trademark right to inspect the products prior to the cigarettes being destroyed.

C. In addition to any other remedy provided by law, the Attorney General may file an action in the circuit court of the county in which such alleged violation of this chapter occurred, including petitioning (a) for preliminary or permanent injunctive relief against any manufacturer, importer, wholesale dealer, retail dealer, agent or any other person or entity to enjoin such entity from selling, offering to sell, or affixing tax stamps to any cigarette that does not comply with the requirements of this chapter, or (b) to recover any costs or damages suffered by the state because of a violation of this chapter, including enforcement costs relating to the specific violation and attorney's fees. Each violation of this chapter or of rules or regulations adopted under this chapter constitutes a separate civil violation for which the State Fire Marshal or Attorney General may obtain relief.

Upon obtaining judgment for injunctive relief under this section, the State Fire Marshal or Attorney General shall provide a copy of the judgment to all wholesale dealers and agents to which the cigarette has been sold.

D. Notice and Hearing

1. Before any fines are issued, the State Fire Marshal shall give the manufacturer, wholesale dealer, agent, retailer or any other person or entity in violation at least twenty-five (25) days written notice of his intention to hold a hearing on this matter. Service shall be by certified mail, return receipt, or by personal service.

2. The hearing shall be conducted pursuant to the Department's Rules of Practice and Procedure before the Mississippi Insurance Department, Regulation 88-101.

3. When a hearing is to be held before the State Fire Marshal, the State Fire Marshal shall give written notice thereof to the manufacturer, wholesale dealer, agent, retailer or any other person or entity allegedly in violation. The notice shall set forth the reason for the hearing, the questions or issues to be decided by the State Fire Marshal at such hearing, and the time for and place where the hearing will be held. All such notices shall be mailed to all parties whose rights may be affected by such hearing by registered or certified mail, addressed to their last known address, or via personal service.

4. All parties whose rights may be affected at any hearing before the State Fire Marshal shall have the right to appear personally and by counsel, to cross- examine witnesses appearing against them, and to produce evidence and witnesses in their own behalf. The State Fire Marshal shall make and keep a record of each such hearing and shall provide a transcript thereof to any interested party upon such party’s written request and at the party’s expense. The State Fire Marshal will provide a transcript to the requesting party AFTER receiving payment for the transcript. Testimony taken at all hearings shall be taken either stenographically or by machine.

5. If any party who is notified of a hearing as outlined herein fails to appear at such hearing, either in person or by counsel, the State Fire Marshal may make any decision and take any action he deems necessary or appropriate with respect to any issues or questions scheduled for the hearing. In accordance with the applicable Mississippi law and this Regulation, the defaulting party shall have no right to appeal such a decision of the State Fire Marshal.

6. All decisions of the State Fire Marshal with respect to the hearings provided for in this section shall be incorporated into orders of the State Fire Marshal. All such orders shall be made available during normal office hours for inspection by interested persons.

7. It shall be the duty of the sheriffs and constables of the counties of this state and of any employee of the State Fire Marshal, when so directed by the State Fire Marshal, to execute any summons, citation, or subpoena which the State Fire Marshal may cause to be issued and to make his return thereof to the State Fire Marshal. The sheriffs and constables so serving and returning same shall be paid for so doing the same fees provided for such services in circuit court. Any person who appears before the State Fire Marshal or a duly designated employee of his department in response to a summons, citation, or subpoena shall be paid the same witness fee and mileage allowance as witnesses in the circuit court. In case of failure or refusal on the part of any person to comply with any summons, citation, or subpoena issued and served as above authorized or in the case of the refusal of any person to testify or answer to any matter regarding which he may be lawfully interrogated or the refusal of any person to produce his record books and accounts relating to any matter regarding which he may be lawfully interrogated, the chancery court of any county of the State of Mississippi, or any chancellor of any such court in vacation, may, on application of the State Fire Marshal, issue an attachment for such person and compel him to comply with such summons, citation, or subpoena and to attend before the State Fire Marshal or his designated employee and to produce the documents specified in any subpoena duces tecum and give his testimony upon such matters as he may be lawfully required. Any such chancery court, or any chancellor of any such court in vacation, shall have the power to punish for contempt, as in case of disobedience of like process issued from or by any such chancery court, or by refusal to testify therein in response to such process, and such person shall be taxed with the costs of such proceedings.

8. No decision of the State Fire Marshal made as a result of a hearing under the provisions of this section shall become final with respect to any party affected and aggrieved by such decision until such party shall have exhausted or shall have had an opportunity to exhaust all of his remedies provided for by this section; provided, however, any such decision may be made final if the State Fire Marshal finds that failure to do so would be detrimental to the public interest or public welfare, but the finality of any such decision shall not prevent any party or parties affected and aggrieved thereby to appeal the same in accordance with the appellate procedure set forth in this section.

9. The following procedure shall govern in taking and perfecting appeals:

i. Any person who is a party to any hearing before the State Fire Marshal and who is aggrieved by any decision of the State Fire Marshal with respect to any hearing before him, unless prevented by the provisions of paragraph 5 of this section, shall have the right of appeal to the chancery court of the First Judicial District of Hinds County. If any such person is a nonresident of this state, he shall have the right of appeal to the chancery court of the first judicial district of Hinds County, Mississippi. All such appeals shall be taken and perfected within sixty (60) days from the date

of the decision of the State Fire Marshal which is the subject of the appeal. The chancery court to which such appeal is taken may affirm such decision or reverse and remand the same to the State Fire Marshal for further proceedings as justice may require or dismiss such decision. All such appeals shall be taken and perfected, heard and determined, either in term time or in vacation, on the record, including a transcript of pleadings and evidence, both oral and documentary, heard and filed before the State Fire Marshal. In perfecting any appeal provided by herein, the provisions of law respecting notice to the reporter and allowance of bills of exceptions, now or hereafter in force, respecting appeals from the chancery court to the supreme court shall be applicable, provided, however, that the reporter shall transcribe his notes, taken stenographically or by machine, and file the record with the State Fire Marshal within thirty (30) days after approval of the appeal bond, unless, on application of the reporter, or of the appellant, an additional fifteen (15) days shall have been allowed by the State Fire Marshal to the reporter within which to transcribe his notes and file the transcript of the record with the State Fire Marshal.

ii. Upon the filing with the State Fire Marshal of a petition of appeal to the chancery court of the First Judicial District of Hinds County, it shall be the duty of the State Fire Marshal, as promptly as possible, and in any event within sixty (60) days after approval of the appeal bond, to file with the clerk of said chancery court to which the appeal is taken, a copy of the petition for appeal and of the decision appealed from, and the original and one (1) copy of the transcript of the record of the proceedings and evidence before the State Fire Marshal After the filing of said petition, the appeal shall be perfected by the filing of a bond in the penal sum of Five Hundred Dollars ($500.00) with two (2) sureties or with a surety company qualified to do business in Mississippi as surety, conditioned to pay the costs of such appeal, said bond to be approved by the State Fire Marshal or by the clerk of the chancery court to which such appeal is taken.

10. Nothing in this Regulation shall prohibit informal disposition by settlement or consent order, i.e., an order based upon an agreement in writing, between the parties in lieu of an administrative hearing.

Rule 10.09: Implementation

A. The State Fire Marshal may promulgate rules and regulations, pursuant to Section 25-43- 1 et seq., necessary to effectuate the purposes of this chapter.

B. The commissioner in the regular course of conducting inspections of wholesale dealers, agents and retail dealers, as authorized under Section 27-69-1 et seq., may inspect such

cigarettes to determine if the cigarettes are marked as required by Section 45-12-9. If the cigarettes are not marked as required, the commissioner shall notify the State Fire Marshal.

Rule 10.10: Inspection

To enforce the provisions of this chapter, the Attorney General, the commissioner and the State Fire Marshal, their duly authorized representatives and other law enforcement personnel, are hereby authorized to examine the books, papers, invoices and other records of any person in possession, control or occupancy of any premises where cigarettes are placed, stored, sold or offered for sale, as well as the stock of cigarettes on the premises. Every person in the possession, control or occupancy of any premises where cigarettes are placed, sold or offered for sale, is hereby directed and required to give the Attorney General, the commissioner and the State Fire Marshal, their duly authorized representatives and other law enforcement personnel, the means, facilities and opportunity for the examinations authorized by section 45-12-15 of the Mississippi Code.

Rule 10.11: Cigarette Fire Safety Standard and Firefighter Protection Fund

There is hereby established in the State Treasury a special fund to be known as the "Cigarette Fire Safety Standard and Firefighter Protection Fund." The fund shall consist of all certification fees paid under Section 45-12-7 and all monies recovered as penalties under Section 45-12-11. The monies shall be deposited to the credit of the fund and shall, in addition to any other monies made available for such purpose, be used by the State Fire Marshal to defray costs incurred by the State Fire Marshal in fulfilling his duties under this chapter, and to support fire safety and prevention programs.

Rule 10.12: Sale outside of Mississippi

Nothing in this section shall be construed to prohibit any person or entity from manufacturing or selling cigarettes that do not meet the requirements of Section 45-12-5 if the cigarettes are, or will be, stamped for sale in another state or are packaged for sale outside the United States and that person or entity has taken reasonable steps to ensure that such cigarettes will not be sold or offered for sale to persons located in this state.

Rule 10.13: Preemption

This chapter shall be repealed if a federal reduced cigarette ignition propensity standard is adopted and becomes effective.

Rule 10.14: Local regulation

Miss. Code Ann. §45-12-23 (Rev. 2012) preempts any local law, ordinance or regulation that conflicts with any provision of said chapter or any policy of the state implemented in accordance with said chapter and, notwithstanding any other provision of law, a governmental unit of this state may not enact or enforce an ordinance, local law or regulation conflicting with or preempted by said chapter.

History

• Source: Miss. Code Ann. §25-4-3.113 (Rev. 2024).
• Source: Miss. Code Ann. §45-12-1 et seq.
• Source: Miss. Code Ann. §45-12-1 et seq.
• Source: Miss. Code Ann. §45-12-1 et seq. (Supp. 2012)
• Source: Miss. Code Ann. §45-12-3 (Supp. 2012) Rule 10.05: Test method and performance standard
• Source: Miss. Code Ann. §45-12-5 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-7 (Rev. Supp. 2012)
• Source: Miss. Code Ann. §45-12-9 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-11 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-13 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-15 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-17 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-19 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-21 (Supp. 2012)
• Source: Miss. Code Ann. §45-12-23 (Supp. 2012)

19 Miss. Admin. Code Pt. 7, R. 10.15 Effective Date

This Regulation shall become effective thirty (30) days after adoption.

Part 7, Chapter 11: Notification Requirements Involving Ownership and Employee Changes

Rule 11.01: Purpose

The purpose of this Regulation is to set forth notification requirements that Liquefied Compressed Gas Dealers must follow when abandoning or assuming ownership of a Liquefied Compressed Gas Dispensing System and/or when certified employee turnover occurs.

Rule 11.02: Authority

This Regulation is promulgated by the Liquefied Compressed Gas Board with the approval of the Commissioner of Insurance, pursuant to Miss. Code Ann. § 75-57-105 (Rev. 2016), and in accordance with the Mississippi Administrative Procedures Law, Miss. Code Ann. § 25-43-1.101, et seq. (Rev. 2010 and Supp. 2016), and the Mississippi Insurance Department Regulation 19 Miss. Admin. Code, Part 1, Chapter 15, said Regulation being the “Rules of Practice and Procedure Before the Mississippi Insurance Department”.

Rule 11.03: Scope

This Regulation shall apply to all Liquefied Compressed Gas Dealers.

Rule 11.04: Definitions

For purposes of this Regulation, the following terms are defined as follows, unless the context clearly indicates otherwise:

a) “Certified employee” means a Liquefied Compressed Gas Dealer’s employee that has received applicable training and has become properly certified with the Mississippi Insurance Department’s Liquefied Compressed Gas Division for related Liquefied Compressed Gas activities.

b) “Certified employee turnover” includes, but is not limited to, when: (1) a certified employee either ends or begins his or her employment with a Dealer, and (2) when a non- certified employee is hired by a Dealer to perform Liquefied Compressed Gas activities that require certification with the Mississippi Insurance Department’s Liquefied Compressed Gas Division prior to engaging in said Liquefied Compressed Gas activities.

c) “Non-certified employee” means a Liquefied Compressed Gas Dealer’s employee that does not meet the definition of a certified employee.

Rule 11.05: Notification Requirements

To ensure the accuracy of the Mississippi Insurance Department’s Liquefied Compressed Gas Dispensing System ownership and certified employee records, and to ensure that only properly certified employees engage in related Liquefied Compressed Gas activities, all Liquefied Compressed Gas Dealers are required to promptly notify the Mississippi Insurance Department when abandoning or assuming ownership of a Liquefied Compressed Gas Dispensing System and/or when certified employee turnover occurs. Such notifications should be directed to the Mississippi Insurance Department’s Liquefied Compressed Gas Division by calling 601-359-1064 or by emailing lcgas@mid.ms.gov.

Rule 11.06: Date of Compliance

All Liquefied Compressed Gas Dealers shall comply with this Regulation from and after the Effective Date of this Regulation, as set forth in Rule 11.09 below.

Rule 11.07: Violations and Penalties

Failure of a Liquefied Compressed Gas Dealer to comply with the provisions of this Regulation shall be considered a violation of Miss. Code Ann. §§ 75-57-107 and 75-57-109 (Rev. 2016), and may result in a monetary penalty and/or revocation of the Dealer's Liquefied Compressed Gas permit.

Rule 11.08: Severability

If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of this Regulation which can be given effect without the invalid provision or application, and to this end the provisions of this Regulation are declared to be severable.

2016).

Rule 11.09: Effective Date

This Regulation shall become effective thirty (30) days after filing for final adoption with the Office of the Secretary of State.

History

• Source: Miss. Code Ann. §25-43-3.113, et seq. (Supp. 2012)
• Source: Miss. Code Ann. § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. §§ 75-57-105 (Rev. 2016) and 25-43-1.101, et seq. (Rev. 2010 and Supp. 2016); 19 Miss. Admin. Code, Part 1, Chapter 15.
• Source: Miss. Code Ann. § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. §§ 75-57-105, 75-57-107, and 75-57-109 (Rev. 2016).
• Source: Miss. Code Ann. §§ 75-57-105 (Rev. 2016), 45-11-101, et seq. (Rev. 2015 and Supp.
• Source: Miss. Code Ann. §§ 25-43-3.112 and 25-43-3.113 (Rev. 2010)

19 Miss. Admin. Code Pt. 7, R. 19 Rule 19

Mississippi Administrative Code, Part 7, Chapter 12: Rules of Practice and Procedures Before the State Liquefied Compressed Gas Board.

Rule 12.01: Statutory Authority

This Regulation is promulgated by the Department of Insurance (hereinafter “Department”) on behalf of the Liquefied Compressed Gas Board (hereinafter “Board”) in accordance with the Mississippi Administrative Procedures Law.

Rule 12.02: Purposes

The purpose of this Regulation is to set forth the rules and regulations regarding the procedural requirements which the Commissioner of Insurance (hereinafter “Commissioner”) deems necessary to carry out the provisions of the Mississippi’s Liquefied Compressed Gas laws found in Miss. Code Ann. §§ 75-57-1 et seq., and to provide the methods and procedures of the Board.

Rule 12.03: Applicability

This Regulation shall be of general applicability and shall apply in all cases except to the extent a statute of the State of Mississippi provides otherwise.

Rule 12.04: Liquefied Compressed Gas Duties

A. Department of Insurance - The Commissioner is vested with the sole and exclusive power and authority and is charged with the duty of administering the Liquefied Compressed Gas laws found in Title 75, Chapter 57. In administering the laws, the Commissioner shall employ an executive director and staff within the Department of Insurance (hereinafter “Department”) for the Liquefied Compressed Gas Division (hereinafter L.C. Gas Division). The Board is provided with a Board Attorney who is an attorney within the Department who shall provide legal advice to the Board. Matters regarding L.C. Gas violations that are investigated by the L.C. Gas Division and brought for administrative hearing before the Board shall be handled by the Attorney for the L.C. Gas Division, which shall be an attorney within the Department. The Board Attorney and the L.C. Gas Attorney shall not be the same person.

B. Liquefied Compressed Gas Division - The State Fire Marshal’s Office is an Office established within the Department. The L.C. Gas Division is a Division within the State Fire Marshal’s Office which enforces the laws and regulations regarding the distribution of liquefied compressed gases and the handling of liquefied compressed gas containers within Mississippi and other matters related to liquefied compressed gas. The L.C. Gas Division’s primary responsibility is to enforce the National Fire Protection Association (NFPA) Standards 54 and 58 pertaining to liquefied compressed gas and the State’s liquefied compressed gas laws and regulations. The L.C. Gas Division regularly inspects all domestic, commercial and industrial premises or buildings where liquefied compressed gases may be received, stored, transported, sold, offered or exposed for sale, manufactured, refined, distilled, compounded or blended, as well as any liquefied compressed gas container, system, pump, equipment, tank car, storage tank, or other vehicle in which any liquefied compressed gas is stored. The L.C. Gas Division is also responsible for investigating fires that occur within the State when liquefied compressed gas is the suspected cause. The L.C. Gas Division also investigates possible violations of NEPA Standards and the State’s Liquefied compressed gas laws and regulations when liquefied compressed gas is involved but no fire resulted. The L.C. Gas Division coordinates its investigations of suspected liquefied compressed gas-related fires with the State Fire Marshal’s Office, which is responsible for fire investigation in the State generally. The L.C. Gas Division’s responsibilities in a suspected liquefied compressed gas-related fire investigation include, but are not limited to, testing and inspecting the subject gas system for installation and operating compliance with NFPA Standards 54 and 58.

C. State Liquefied Compressed Gas Board - The Board is statutorily vested with the power to regulate matters pertaining to liquefied compressed gas, with the exception of administrative and enforcement duties which shall be retained by the Commissioner.

Rule 12.05: Investigations Conducted by the L.C. Gas Division

To insure that all fires are properly investigated, the following guidelines shall be followed by the L.C. Gas Division:

A. All fires reported to the Department shall be directed to the State Fire Marshal's Office.

B. The State Chief Deputy Fire Marshal will evaluate the facts and circumstances of all fires and determine how the fire investigation will be conducted.

C. Where the State Chief Deputy Fire Marshal, or his deputies, suspect liquefied compressed gas as the cause of the fire, the L.C. Gas Director will be notified. The liquefied compressed gas system will be tested and inspected by a liquefied compressed gas inspector to verify that the gas system was installed and operating in accordance with NFPA 54 and NFPA 58.

D. When a fire is under investigation by the State Fire Marshal's Office, the L.C. Gas Division will coordinate all their activities through the State Fire Marshal's Office.

E. The role of the State Chief Deputy State Fire Marshal or his deputies is to investigate the cause of every fire called to the attention of the Department and to establish the point of origin and cause of each such fire.

F. The role of the L.C. Gas Division is to verify all liquefied compressed gas systems, installations, and companies doing business in the State of Mississippi are in compliance with are in compliance with NFPA 54 and 58; the State’s liquefied compressed gas laws and regulations as set. forth under Miss. Code Ann. §§ 75-57-1 through 75-57-119; and any rules and regulations adopted by the Board.

Rule 12.06: State Liquefied Compressed Gas Board

A. Board Members - The board shall consist of seven (7) members appointed by the Commissioner of Insurance as follows:

1. Four (4) members, one (1) from each of the congressional districts, to be selected from a list of at least ten (10) individuals who are in the liquefied compressed gas industry doing business in the State of Mississippi;

2. Three (3) members from the state at large who have a rational relationship to the liquefied compressed gas industry.

3. At least three (3) members of the board must be dealers who sell less than two million five hundred thousand (2,500,000) gallons of propane per year.

4. No two (2) members may be selected from the same company.

5. Any member who fails to attend three (3) consecutive called meetings of the board may be removed by the Commissioner.

B. Chairman of the Board - The Chairman of the Board shall be elected by and from the membership of the board.

C. Terms - The appointments to the Board shall be for staggered and shall be for terms of five (5) years, except the three (3) members from the state at large shall serve for terms concurrent with the term of the Commissioner.

D. Vacancies - An appointment to fill a vacancy, other than by expiration of a term of office, shall be made by the Commissioner for the balance of the unexpired term.

E. Meetings - The Board shall regularly meet on the second Thursday of every odd numbered month. The Chairman many also call a meeting, or a meeting may be called upon the written request of any three (3) members of the Board. Notice of any such meeting shall be given in writing to members and the public by publication on the Department’s website at least fourteen (14) days in advance. Meetings shall be held at the State Fire Academy in Rankin County, Mississippi.

F. Emergency Meetings - An Emergency Meeting may be called by the Chairman when there are circumstances that could not have been reasonably foreseen which require immediate attention and possible action by the Board and which of necessity make it impossible to provide usual notice. The Chairman shall give twenty-four hours (24) notice prior to holding the emergency meeting. Emergency meetings shall be open to the public and notice will be provided with publication on the Department’s website at least twenty-four (24) hours in advance of the emergency meeting. The emergency meeting may be held via teleconference.

G. Quorum - A quorum shall be met if four (4) or more members of the board meet for the transaction of business.

H. Reimbursement of Expenses - Board members shall receive per diem compensation according to Miss. Code Ann. § 75-56-101(4). The Board members shall not be compensated for more than twelve (12) meetings per year.

I. Liability of Members - No member shall be liable to civil action for any act performed in good faith in the execution of his duties as a Board member.

Rule 12.07: Hearing Procedures

A. Hearings – In every case where the investigation by the State Fire Marshal’s Office has determined that there was a violation of the two (2) National Fire Protection Association Standards, NFPA 54 and 58; the State’s liquefied compressed gas laws as set forth under Miss. Code Ann. §§ 75-57-1 through 75-57-119; and any rules and regulations adopted by the Board, notice and hearing shall be held prior to any administrative action being taken.

B. Right To Counsel – Any person appearing before the Board shall have the right to be represented by counsel.

C. Impartiality – Every member of the Board present shall conduct himself in an impartial manner and the presiding official may withdraw if he deems himself disqualified. Any party may file an affidavit of personal bias or disqualification which shall be ruled upon by the Commissioner and granted if it is timely, sufficient and filed in good faith.

D. Power and Duties of Presiding Official – The presiding officer of the hearing shall be the Chairman of the Board, under the advice of the Board Attorney, and shall have power to:

1. Maintain order;

2. Rule on all questions arising during the course of the hearing;

3. Permit discovery by deposition or otherwise;

4. Hold conferences for the settlement or simplification of the issues;

5. Make or recommend decisions;

6. Generally regulate and guide the course of the proceedings.

E. Burden Of Proof – In administrative hearings before the Board, the Attorney for the L.C. Gas Division shall have the burden of proof.

F. Evidence – The Rules of Evidence shall not apply in an administrative matter; however, irrelevant, immaterial, and unduly repetitious evidence shall be excluded. Any other

evidence, oral or documentary, not privileged, may be received if it is a type commonly relied upon by reasonably prudent men in the conduct of their affairs.

G. Objections – Objections to the introductions of evidence may be made and shall be noted of record.

H. Evidence May Be Written – When a hearing can be so expedited and the interests of the parties will not be prejudiced any part of the evidence may be received in written form.

I. Cross-Examination – Parties shall have the right to conduct such cross-examination as may be required for a full, true disclosure of the facts.

J. Official Notice – Official notice may be taken of judicially cognizable facts and of generally recognized technical or scientific facts peculiarly within the Board’s specialized knowledge. Parties shall be afforded a reasonable opportunity to show the contrary.

K. Disciplinary Actions – After notice and hearing, the Board may take disciplinary actions and impose penalties in the manner as provided in Miss. Code Ann. §§ 75-57-107 and 75-57-109.

Rule 12.08: Appeal Procedure

Any individual aggrieved by a final decision of the Board shall be entitled to judicial review. Any appeal from the Board's decision shall be filed within thirty (30) days after notification of the action of the Board in the Circuit Court of Hinds County, Mississippi, in the manner set forth in Miss. Code Ann. § 75-57-117.

Rule 12.09: Public Records

Any person requesting a public record regarding the L.C. Gas Division or the Board shall submit a written request to the Department pursuant to the provisions of the Open Records Act.

Rule 12.10. Severability

If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application, and to this end the provisions of the Regulation are declared to be severable.

Rule 12.11. Effective Date

This Regulation shall be effective upon adoption.

Part 7, Chapter 13: Amendment of NFPA Standards Regarding the Use and Display of Nameplates on Stationary Liquefied Compressed Gas Containers

Rule 13.01: Purpose The purpose of this Regulation is to amend certain National Fire Protection Association (“NFPA”) standards regarding the use and display of nameplates on stationary liquefied compressed gas containers.

Rule 13.02: Authority This Regulation is promulgated by the Department of Insurance (“Department”) on behalf of the Liquefied Compressed Gas Board (“Board”) in accordance with Miss. Code Ann. §§ 75-57-105 and 75-57-9 (Rev. 2016), and in accordance with the Mississippi Administrative Procedures Law, Miss. Code Ann. § 25-43-1.101, et seq. (Rev. 2018).

2016).

Rule 13.03: Scope This Regulation shall apply to all stationary liquefied compressed gas containers.

Rule 13.04: Amendment of NFPA Standards

NFPA 58 (2017) Section 5.2.8.3 is amended to include the following language:

A stationary container with the water capacity of 1,000 gallons or larger, that does not have a nameplate in accordance with NFPA 58 (2017) Section 5.2.8.3, may remain in service if:

(1) the Department’s Liquefied Compressed-Gas Division (“LC-Gas Division”) determines that an accurate nameplate replacement can be created and attached to the container, and the LC-Gas Division approves of such replacement and attachment; or (2) the LC-Gas Division is familiar with the container, has previously inspected and approved the container at its current location, and, at its discretion, issues an official determination

letter stating that the container is allowed to remain in service. However, if allowed to remain in service, the container cannot be moved to a different location; otherwise, it must be discontinued from service. The LC-Gas Division official determination letter discussed in this subsection shall remain at the property where the container is located and it shall be produced for inspection to any person upon request.

A stationary container with the water capacity of less than 1,000 gallons, that does not have a nameplate in accordance with NFPA 58 (2017) Section 5.2.8.3, may remain in service only if the LC-Gas Division determines that an accurate nameplate replacement can be created and attached to the container, and the LC- Gas Division approves of such replacement and attachment. Under no other circumstance shall such container remain in service.

Rule 13.05: Future Application of Amended NFPA Standards Section numbers, section titles, and chapter titles are subject to change in future versions of the NFPA 58 standards. Therefore, language included herein that amends NFPA 58 (2017) Section 5.2.8.3, shall apply to future versions of the NFPA 58 standards and shall be read as amending the most applicable code section in the version of those standards in order to fulfill the purpose and overall intent of this Regulation.

Rule 13.06: Violations and Penalties If a person services, places into service, and/or continues in service a stationary liquefied compressed gas container that is not in compliance with the provisions of this Regulation, such person shall be considered in violation of Miss. Code Ann. §§ 75-57-47, 75-57-107 and 75-57- 109 (Rev. 2016), and may be subject to monetary penalties and/or other disciplinary action as determined by the Board.

Rule 13.07: Conflicts If any section or portion of a section of this Regulation conflicts with current and/or future NFPA standards, this Regulation shall govern.

Rule 13.08: Severability If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of this Regulation which can be given effect without the invalid provision or application, and to this end the provisions of this Regulation are declared to be severable.

Rule 13.09: Effective Date This Regulation shall become effective thirty (30) days after filing for final adoption with the Office of the Secretary of State.

History

• Source: Miss. Code Ann. § 25-61-5 (Rev. 2011); § 75-57-105. (Rev. 2016)
• Source: Miss. Code Ann. § 25-61-5 (Rev. 2011); § 75-57-1, et seq. (Rev. 2016)
• Source: Miss. Code Ann. § 75-57-1, et seq. (Rev. 2016)
• Source: Miss. Code Ann. § 75-57-1, et seq.; § 75-57-101, et seq. (Rev. 2016)
• Source: Miss. Code Ann. § 75-57-1, et seq.; § 75-57-101, et seq. (Rev. 2016)
• Source: Miss. Code Ann. § 75-57-101 (Rev. 2016)
• Source: Miss. Code Ann. § 75-57-101, et seq. (Rev. 2016)
• Source: Miss. Code Ann. § 75-57-117 (Rev. 2016)
• Source: Miss. Code Ann. §§ 25-61-1, et seq. (Rev.2010)
• Source: Miss. Code Ann. § 75-57-1, et seq.; § 75-57-101, et seq. (Rev. 2016)
• Source: Miss. Code Ann. § 25-43-3.108 (Rev. 2010)
• Source: Miss. Code Ann. § 75-57-9; § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 25-43-1.101, et seq. (Rev. 2018); § 75-57-9; § 75-57-105 (Rev.
• Source: Miss. Code Ann. § 75-57-9; § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-9; § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-9; § 75-57-105 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-47; § 75-57-107; § 75-57-109 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-35 (Rev. 2016).
• Source: Miss. Code Ann. § 75-57-1, et seq.; § 75-57-101, et seq. (Rev. 2016).
• Source: Miss. Code Ann. § 25-43-3.112; § 25-43-3.113 (Rev. 2018).

Chapter 15 First Responder Health and Safety Act Claims Procedures

19 Miss. Admin. Code Pt. 7, R. 15.04 Eligible Claimants and Benefits

Eligible first responders who are diagnosed with certain occupational related cancers shall be entitled to receive the following benefits:

A. Lump sum benefits:

a. First responders with metastatic cancers that require surgery, radiation or chemotherapy or those diagnosed with terminal cancer will receive a payout of Thirty-five Thousand Dollars ($35,000.00), in lieu of pursuing workers compensation coverage, depending on the severity of the cancer and life expectancy, and upon providing proof of diagnosis by a board-certified physician in the medical specialty of the particular cancer.

b. First responders with nonmetastasized cancer will receive a payout of Six Thousand Two Hundred Fifty Dollars ($6,250.00) in lieu of pursuing workers compensation coverage, and upon providing proof of diagnosis by a board- certified physician in the medical specialty of the particular cancer.

c. The combined total of benefits received by any first responder under paragraphs (a) and (b) of this subsection during his or her lifetime shall not exceed Fifty Thousand Dollars ($50,000.00).

d. An eligible first responder who dies as a result of a compensable type of cancer, or circumstances arising out of the treatment of a compensable type of cancer, but does not submit sufficient proof of claim prior to the first responder’s death, is entitled to receive benefits specified in paragraphs (a) and (b) of this subsection and the benefits may be made available to the deceased first responder’s beneficiary or beneficiaries.

B. Disability benefits:

a. Nonvolunteer first responders may receive disability benefits beginning six months after the date of disability at 60% of their monthly salary up to Five Thousand Dollars ($5,000.00) per month, the first payment shall be made six (6) months after the total disability and shall continue for thirty-six (36) consecutive monthly payments unless the first responder regains the ability to perform his or her duties as determined by reevaluation under subsection (d) of this section, at which time the payments shall cease the last day of the month of reevaluation;

b. Volunteer firefighters may receive disability benefits beginning six months after the date of disability in an amount up to One Thousand Five Hundred Dollars ($1,500.00) per month, the first payment shall be made six (6) months after the total disability and shall continue for thirty-six (36) consecutive monthly payments unless the first responder regains the ability to perform his or her duties as determined by reevaluation under subsection (d) of this section, at which time the payments shall cease the last day of the month of reevaluation;

c. The monthly benefit shall be subordinate to any other benefit actually paid to the first responder solely for such disability from any other source, not including private insurance purchased solely by the first responder;

d. Any first responder receiving the monthly benefits may be required to have his or her condition reevaluated. In the event any such reevaluation reveals that such person has regained the ability to perform duties as a first responder, then his or her monthly benefits shall cease the last day of the month of reevaluation; and

e. In the event that there is a subsequent recurrence of a disability caused by a specified cancer, which precludes the first responder from serving as a first responder, he or she shall be entitled to receive any remaining monthly payments.

Any first responder who was simultaneously a member of more than one (1) fire or police department at the time of diagnosis shall not be entitled to receive benefits from or on behalf of more than one (1) fire or police department. The first responder’s primary place of employment shall maintain coverage for the eligible first responder. A first responder shall only be eligible for these benefits if the cancer diagnosis occurs on or after the first responder’s effective date of coverage, which shall be ten (10) years after their first date of employment or service.

Benefit payments will be paid to the eligible first responder on the first working day of each calendar month. Benefit payments made under the Mississippi First Responders Health and Safety Act are excluded from gross income and thus are not taxable.

Furthermore, an otherwise eligible first responder shall be precluded from the benefits listed under this section if he or she has filed for workers’ compensation for the same diagnosis of cancer.

Rule 15.05. Filing of Claims.

An eligible first responder shall file a claim form with the Mississippi Insurance Department, a copy of which is attached hereto as Exhibit “A”. The claim form must also provide written verification of the diagnosis by a board-certified physician in the medical specialty appropriate

for the type of cancer diagnosed that the cancer was caused by an occupational hazard.

The claim may be filed electronically or through the U.S. Mail.

If sent via U.S. Mail: Mississippi Insurance Department ATTN: First Responder Health and Safety Program P.O. Box 79 Jackson, MS 39205-0079.

If sent electronically: FirstResponderFund@mid.ms.gov

Within thirty (30) days of receipt, the claimant will be notified of the award of benefits, or that additional information will be needed in order to approve the claim. If a claim is denied, the reason for denial will be provided: to the claimant. Reasons for denial may include, but are not limited to, that the claimant was not eligible, that the cancer did not fall under the list of occupational cancer, or that the claimant has failed to submit the necessary documentation required to approve the claim.

Rule 15.06. Appeals

If the claim is denied, the claimant has the right to appeal within thirty (30) days of receipt of notification denying benefits. The appeals process consists of two steps: reconsideration and a contested hearing.

Reconsideration is intended to be an informal resolution of a claim. If the claimant disagrees with the original determination, he or she may request reconsideration by submitting a written request to the Mississippi Insurance Department’s Legal Division. The claimant will receive a written decision of reconsideration.

If the claimant disagrees with the decision of reconsideration, he or she may request a hearing within fifteen (15) days of the decision of reconsideration before a hearing officer appointed by the Commissioner. This hearing shall be governed by the Administrative Hearings provision in 19 Miss. Admin. Code, Pt. 1, Rule 15.08. The decision made by the hearing officer will be the final decision of the Mississippi Insurance Department.

Rule 15.07. Reevaluation of Disability Benefits

Any first responder receiving disability benefits may be required by the state, county, municipality or fire protection district for whom he or she works to have his or her condition reevaluated to determine if that first responder has regained the ability to perform the duties of a

first responder. If that reevaluation indicates that the first responder has regained the ability to perform the duties of a first responder, then the monthly disability benefits shall cease on the last day of the month the reevaluation was conducted. If there is no reevaluation performed, but the first responder’s treating physician determines that the first responder is again able to perform the duties of a first responder, then the disability benefits shall cease on the last day of the month that the physician made the determination.

History

• Source: Miss. Code Ann. §25-15-405 (Rev. 2018)
• Source: Miss. Code Ann. §25-15-409 (Rev. 2018)
• Source: Miss. Code Ann. §25-15-409 (Rev. 2018)
• Source: Miss. Code Ann. §25-15-405 (Rev. 2018)

19 Miss. Admin. Code Pt. 7, R. 15.08 Alternative Insurance Coverage

By January 1, 2024, the state, municipality, county or fire protection district is required to provide proof of insurance coverage that meets the requirements of the Act, or shall show satisfactory proof of the ability to pay such compensation to ensure adequate coverage for all eligible first responders to the Commissioner of Insurance. In an effort to assist the state, municipalities, counties and fire protection districts with funding these benefits, the Mississippi First Responders Health and Safety Trust Fund (“Fund”) was created by the Legislature in order to assist these entities with providing the benefits required under the Act, with the Commissioner of Insurance administering this Fund. However, while the state, municipalities, counties and fire protections districts may access these funds, they are not required to do so and may choose to provide funding for these benefits by using an alternative method.

Instead of using the Funds as administered by the Commissioner of Insurance, the state or any municipality, county or fire protection district may provide alternative methods to provide coverage that meets the requirements of the Act. If the state or any municipality, county or fire protection district decides to use another method to provide the required benefits, they must submit the form attached hereto as Exhibit “B” to the Commissioner of Insurance by January 1, 2024, and by January 1 st of each year thereafter, of their continued intention to use an alternative method.

Rule 15.09. Severability

If any provision of this Regulation, or the application of the provision to any person or circumstance shall be held invalid, the remainder of the Regulation, and the application of the provision to persons or circumstances other than those to which it is held invalid, shall not be affected

Rule 15.10. Effective Date.

This Regulation shall be in effect on and after January 1, 2024.

History

• Source: Miss. Code Ann. §25-15-409 (Rev. 2018)
• Source: Miss. Code Ann. § 83-5-1 (Rev. 2022)
• Source: Miss. Code Ann. § 25-15-409 (Rev. 2018)

19 Miss. Admin. Code Pt. 7, R. 15.11 Claims Form Exhibit “A”

MS Insurance Department Use Only: Application #: Receipt Date: _____Approved _____ Disapproved Claimant type: ___ Law Enforcement Officer ____ Fire Fighter

APPLICATION FOR BENEFITS FIRST RESPONDER HEALTH AND SAFETY ACT TRUST FUND

Mail to: MISSISSIPPI INSURANCE DEPARTMENT c/o LEGAL DIVISION – FIRST RESPONDER FUND P.O. Box 79 Jackson, MS 39205-0079

Email to: FirstResponderFund@mid.ms.gov

A. APPLICANT INFORMATION – to be completed and signed by the APPLICANT or legal representative.

Applicant’s Name:________________________ SSN:_____________________________

If applying on behalf of a deceased first responder, please provide your name and relationship to deceased first responder __________________________________________________ (Name) (Relationship)

Date of Birth (mm/dd/yyyy)__________________ Gender: _______Male ________Female

Street Address:______________________________________________________________ Street (Apt.#) City State Zip Code

Mailing Address:_____________________________________________________________ City State Zip Code

Home Phone Number_______________________ Cell/Other Number_________________

Email Address:_____________________________________________________________

Employer Name and Address (Fire District if Volunteer Fire Fighter):

Please indicate if you are a Firefighter:____________________ Volunteer:_______________

Law enforcement officer_________________________

Please indicate dates of service:___________________________________________

Date of diagnosis:_____//

Tell us about your diagnosis, type, and prognosis:

---

Have you filed or do you plan to file for Workers’ Compensation relating to this diagnosis?

_______________________Yes _________________________No

Physician/Healthcare Provider Information:

Physician Name:_______________________________________________________

Mailing Address:________________________________________________________

Phone Number: _________________________ Fax Number:__________________

Email Address:___________________________________________________________

Type of Benefits Requesting:

__________________Lump Sum

___________________Monthly Benefits

Certification: I hereby certify that the above information is true and complete to the best of my knowledge. I know that any misrepresentation herein may lead to a rejection of this application and the Mississippi Insurance Department has the right to pursue civil and/or criminal action for the misrepresentation of such information.

_________________________________________________ ________________________ Applicant’s Signature Date

_____________________________________________________ ________________________ Representative (If signing on behalf of a deceased first responder) Date

B. PHYSICIAN CERTIFICATION. To be completed and signed by the PHYSICIAN treating you for event.

Diagnois/Condition:____________________________________________________________

Does the applicant’s cancer diagnosis meet the following definition:

A disease caused by an uncontrolled division of abnormal cells in a part of the body or a malignant growth or tumor resulting from the division of abnormal cells. “Cancer” is limited to cancer affecting the bladder, brain, colon, liver, pancreas, skin, kidney, gastrointestinal tract, reproductive tract, leukemia, lymphoma, multiple myeloma, prostate, testicles and breast.

Yes__________________________________ No______________________________

If no, the applicant does not meet the criteria for benefits under the Fund.

Please identify if the cancer is metatstasized or nonmetastasized based upon the following definitions: __________ “Metastasized cancer” - the cancer is caused by an occupational hazard and that there are one or more malignant tumors characterized by the uncontrollable and abnormal growth and spread of malignant cells with invasion of normal tissue and that either: • There is metastasis, and surgery, radiotherapy or chemotherapy is medically necessary; • There is a tumor of the prostate, provided that it is treated with radical prostatectomy or external beam therapy; or • The first responder has terminal cancer, his or her life expectancy is twenty- four (24) months or less from the date of diagnosis, and will not benefit from, or has exhausted, curative therapy. ___________ “Nonmetastasized cancer” - the cancer is caused by an occupational hazard and: • There is carcinoma in situ such that surgery, radiotherapy or chemotherapy has been determined to be medically necessary; • There are malignant tumors which are treated by endoscopic procedures alone; or • There are malignant melanomas.

Has this patient been treated for the same/similar condition prior to this diagnosis? If so, list related diagnosis and dates of treatment: _______________________________________

Is this patient permanently disabled due to cancer? Yes_______________ No______________________

Is this patient temporarily disabled due to cancer? Yes_____________________ If yes, anticipated return to work date:________________ No______________________

Certification: I certify that the above information is true and complete to the best of my knowledge. I know that any misrepresentation herein may lead to a rejection of the patient’s application and the Mississippi Insurance Department has the right to pursue civil and/or criminal action for the misrepresentation of such information.

________________________________________________ _________________________ Physician Signature Date

_______________________________________________ __________________________ Physician Name (Please Print) Office Phone

_____________________________________________________________________________ Mailing Address City State Zip Code

Email Address: _________________________________________________________________

Fax Number: _____________________________ Tax ID.:_______________________

Patient ID#:_________________________________

NOTE: Please make a copy of the employee’s signed Authorization for Release of Records (Section D) for your records.

C. EMPLOYMENT INFORMATION. To be completed and signed by your EMPLOYER.

Name of Employer (Fire District if Volunteer Fire Fighter)

___________________________________________________________________________ Mailing Address City State Zip Code

Email Address:_________________________________________________________________

Phone Number:____________________________ Fax Number:_______________________

Employee’s Job Title:___________________________________________________________

Employee’s Dates of Service:______________________________________________________

For the purposes of determining eligibility for benefits, Section 25-15-405, Mississippi Code Annotated (1972) sets forth the following definitions:

“Fire fighter” means any firefighter who has ten (10) or more years of service and is employed by the State of Mississippi, or any political subdivision thereof, on a full-time duty status, and any firefighter who has ten (10) or more years of service and is registered with the State of Mississippi, or a political subdivision thereof, on a volunteer firefighting status.

“Law enforcement officer” means any officer who has been certified by the Mississippi Board on Law Enforcement Officer Standards and Training and has ten (10) or more years of service.

This employee ________ does ________ does not (check one) meet the criteria of one of the above definitions.

(Please attach a copy of the employee’s Professional Certificate as being qualified to be a Mississippi Law Enforcement Officer or Fire Fighter to this application.)

If Applicant is requesting monthly benefit payments, please provide the average hours per week the employee worked prior to this incident: ______________________ hours/week

Monthly salary $ ___________________________ Annual Salary $ ______________________________

Last work date:________________________

Has the employee returned to work?____Yes No If yes, please provide date employee returned to work:

Is Applicant receiving Workers” Compensation for this medical event?

______________________Yes ____________________________No

Please provide any other information you feel is pertinent to the Applicant/Employee’s application:

---

Certification: I certify that the above information is true and complete to the best of my knowledge. I know that any misrepresentations herein may lead to a rejection of the applicant’s application and the Mississippi Insurance Department has the right to pursue civil and/or criminal action for the misrepresentation of such information.

Furthermore, I will notify the Mississippi Insurance Department in writing the exact date this employee returns to work. This notification shall be submitted to the Department no later than ten days after the employee returns to work.

_______________________________________________ ______________________________ Employer Name (Please Print) Title

_________________________________________ ______________________________ Signature Date

NOTE: Please make a copy of the employee’s signed Authorization for Release of Records (Section D) for your records.

D. AUTHORIZATION FOR RELEASE OF RECORDS. To be completed by APPLICANT.

For the purpose of evaluating my eligibility for benefits including checking for and resolving any issues that may arise regarding incomplete or incorrect information on my application, I hereby authorize the disclosure of information from my physician/healthcare provider and from my employer to the Mississippi Insurance Department or its authorized representatives.

Health information may be disclosed by any physician or healthcare provider that has any records or knowledge about the incident referred to on this application. Non health information including earnings or employment history or any other facts deemed appropriate by the Mississippi Insurance Department or its authorized representatives to evaluate my application may be disclosed by any entity, person, or organization that has records about me, including but not limited to my employer, employer representative and compensation sources.

Any information the Mississippi Insurance Department or its authorized representatives obtain pursuant to this authorization will be used only for the purpose of evaluating and administering my application for benefits. The Mississippi Insurance Department or its authorized representatives will not disclose any information unless permitted by federal and/or state laws. I further authorize the Mississippi Insurance Department to notify my employer of any benefits received and any employer responsibilities as related to my claim.

This authorization is valid for two (2) years from its execution, and a copy is as valid as the original. I know that I may request a copy of this authorization to request this information. This authorization may be revoked by me at any time except to the extent the Mississippi Insurance Department or its authorized representatives have relied on the authorization prior to notice of revocation. If revoked, the Mississippi Insurance Department or its authorized representatives may not be able to evaluate my application for benefits. I may revoke this authorization by sending written notice to: Mississippi Insurance Department, c/o Legal Division - First Responder Fund, P. O. Box 79, Jackson, MS 39205.

You may refuse to sign this form; however, the Mississippi Insurance Department or its authorized representatives will not be able to evaluate your application or administer your claim for benefits. I am the individual to whom this authorization applies or that person’s legal representative.

_________________________________________________ ________________________ Applicant’s Signature Date

_______________________________________________ _______________________ Applicant’s Printed Name SSN

_____________________________________________________ ________________________ Representative (If signing on behalf of a deceased first responder) Date

STATE OF MISSISSIPPI

COUNTY OF ___________________________________

Personally came and appeared before me, the undersigned authority in and for said county and state, the within named _____________________________________________________, who acknowledged to me that he signed and delivered the above forgoing waiver on the date therein mentioned and for the purpose therein expressed.

Given under my hand and seal of office, this day of , 20______.

NOTARY PUBLIC

My Commission Expires:

History

• Source: Miss. Code Ann. § 25-15-409 (Rev. 2018)

19 Miss. Admin. Code Pt. 7, R. 15.12 Alternative Insurance Coverage Notification Form Exhibit “B”

NOTIFICATION OF ALTERNATIVE INSURANCE COVERAGE FIRST RESPONDER HEALTH AND SAFETY ACT BENEFITS

Mail to: MISSISSIPPI INSURANCE DEPARTMENT c/o LEGAL DIVISION – FIRST RESPONDER FUND P.O. Box 79 Jackson, MS 39205-0079

Email to: FirstResponderFund@mid.ms.gov

By January 1, 2024, the state, municipality, county or fire protection district is required to provide proof of insurance coverage that meets the requirements of the First Responder Health and Safety Act, or must show satisfactory proof of the ability to pay such compensation to ensure adequate coverage for all eligible first responders to the Commissioner of Insurance.

The state, municipalities, counties and fire protection districts may use the Mississippi First Responders Health and Safety Trust Fund (“Fund”) to provide the benefits required under the Act, with the Commissioner of Insurance administering this Fund. However, while the state, municipalities, counties and fire protections districts may access these funds, they are not required to do so and may choose to provide funding for these benefits by using an alternative method.

Completion of this form shall provide written notice to the Commissioner of Insurance of the entity’s proof of either insurance coverage or other ability to pay the compensation for any eligible first responder that they are responsible for providing said benefits.

Name of Entity

___________________________________________________________________________ Mailing Address City State Zip Code

Email Address:_________________________________________________________________

Phone Number:____________________________ Fax Number:_______________________

The above named entity is hereby advising the Commissioner of Insurance that it will not be accessing funds from the Mississippi First Responders Health and Safety Trust Fund to pay for any benefits it may owe to an eligible first responder for calendar year __________________. The entity has obtained the following funds in order to pay said benefits:

__________________________ Insurance Coverage • Proof of Insurance must be attached • Coverage amounts must be included

___________________________ Self-Funded • Proof of self-funded plan must be attached • Coverage amounts must be included

____________________________ Other Funding Mechanism • Proof of Funding must be attached • Coverage amounts must be included

Certification: I certify that the above information is true and complete to the best of my knowledge. I know that any misrepresentations herein may lead to the Mississippi Insurance Department pursuing civil and/or criminal action for the misrepresentation of such information.

_______________________________________________ ______________________________ Entity Representative Name (Please Print) Title

_________________________________________ ______________________________ Signature Date

History

• Source: Miss. Code Ann. § 25-15-409 (Rev. 2018)

Chapter 16 Testing of Liquefied Petroleum Gas Piping in School Facilities

19 Miss. Admin. Code Pt. 7, R. 16.01 Purpose

The Mississippi Legislature’s passage of Senate Bill 2787 (2026) created a requirement that each school facility “shall perform an annual pressure test on the liquefied petroleum gas piping system in the school facility.” The terminology of “pressure test” holds a specific meaning in the liquefied compressed gas industry, meaning a testing process described in detail in National Fire Protection Association (NFPA) 54, Chapter 8 (2024). Senate Bill 2787 further provides a description of the requirements for the testing process, requiring that the “testing shall be sufficient to determine whether the liquefied petroleum gas piping downstream of the school facility’s liquefied petroleum gas tank holds at least normal operating pressure over a specified period determined by the applicable codes, rules and regulations,” which is a testing process commonly referred to in the liquefied compressed gas industry and NFPA codes as a “leak check”. A “pressure test” and a “leak check” are two distinct processes for use in different circumstances pursuant to the provisions of NFPA 54.

The purpose of this Regulation is to clarify the appropriate annual testing process relative to ensuring the integrity of a school system’s liquefied petroleum gas piping system in compliance with the provisions in the National Fire Protection Association (NFPA) Liquefied Petroleum Gas Codes and Senate Bill 2787 (2026).

History

• Source: Miss. Code Ann. §75-57-105 (Supp. 2024); Mississippi Senate Bill 2787 (2026).

19 Miss. Admin. Code Pt. 7, R. 16.02 Authority

This Regulation is promulgated by the Liquefied Compressed Gas Board with the approval of the Commissioner of Insurance, pursuant to Senate Bill 2787 (2026), Miss. Code Ann. §75-57- 105, as well as the provisions of Title 19 Mississippi Administrative Code, Part 1, Chapter 15, said Regulation being the Rules of Practice and Procedure before the Mississippi Insurance Department.

History

• Source: Miss. Code Ann. § 75-57-3 and §75-57-105 (Supp. 2024)

19 Miss. Admin. Code Pt. 7, R. 16.03 Scope

This Regulation shall apply to all liquefied petroleum gas dealers, their agents and employees, and any installer or other person who performs pressure testing and leak testing of liquefied petroleum piping systems for school facilities in the State of Mississippi.

History

• Source: Miss. Code Ann. § 75-57-3 and §75-57-105 (Supp. 2024)

19 Miss. Admin. Code Pt. 7, R. 16.04 Requirements

A. Testing of newly installed liquefied petroleum gas piping systems shall be conducted as a “pressure test” in compliance with the provisions of NFPA 54, Chapter 8, paragraph 8.1 and its subparagraphs (2024) (Pressure Testing and Inspection).

B. Testing of liquefied petroleum gas piping systems that are already approved for service shall be conducted through use of the procedures for a “leak check”, which shall constitute the necessary pressure test described in Senate Bill 2787 (2026) when performed in the manner specified by NFPA 54, Chapter 8, paragraph 8.2 and its subparagraphs, as well as NFPA 54, Annex C(3)(2)(a) through (c) (2024). Leak checks must also be in compliance with the provisions of Title 19 Mississippi Administrative Code, Part 7, Chapter 14 (Leak Check Procedures and Requirements).

History

• Source: Miss. Code Ann. §75-57-105 (Supp. 2024); Mississippi Senate Bill 2787 (2026).

19 Miss. Admin. Code Pt. 7, R. 16.05 Effective Date

This regulation shall become effective thirty (30) days from the filing for final adoption with the Secretary of State.

History

• Source: Miss. Code Ann. §25-4-3.113 (Rev. 2024).

Part 8 Rules Regarding the Mississippi Safety Conveyance Act

19 Miss. Admin. Code Pt. 8 Rules Regarding the Mississippi Safety Conveyance Act

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Title 19, Part 8, Chapter 1: Rules Regarding the Mississippi Conveyance Safety Act.

Rule 1.1: Purpose Rule 1.2: Scope Rule 1.3: Exemptions Rule 1.4: Definitions Rule 1.5: Minimum Standards Adoption of Nationally Recognized Safety Codes Rule 1.6: Registration of Conveyances Rule 1.7: Variance, Exemption and Reconsideration Rule 1.8: Inspection and Testing of Conveyances Rule 1.9: Qualifications to be Licensed as an Elevator Mechanic Rule 1.10: Qualifications to be Licensed as an Elevator Contractor Rule 1.11: Qualifications to be Licensed as an Elevator Inspector or Elevator Inspection Agency Rule 1.12: Contractor and Inspector Insurance Requirements Rule 1.13: Renewal of License Rule 1.14: Emergency and Temporary Mechanics Licenses Rule 1.15: Permits Rule 1.16: Fee Schedule Rule 1.17: Reporting Requirements – Building Owner Rule 1.18: Reporting Requirements – Inspector Rule 1.19: Reporting Requirements – Contractor Rule 1.20: Standards of Conduct for Inspector or Contractor Licensees Rule 1.21: Responsibilities of the Department Rule 1.22: Responsibilities of the Building Owner Rule 1.23: Responsibilities of the Inspector – Inspection Procedures Rule 1.24: Responsibilities of the Inspector – Department Forms Rule 1.25: Responsibilities of the Inspector – Inspectors Equipment Decals Rule 1.26: Responsibilities of the Contractor – Compliance with Plan Review Rule 1.27: Plan Review – Required Rule 1.28: Plan Review – New Equipment Rule 1.29: Plan Review – Alteration of Existing Equipment Rule 1.30: Plan Review – Department Approval or Denial Rule 1.31: Plan Review – Amendments Rule 1.32: Complaints Rule 1.33: Initiating a Complaint against a Licensee Rule 1.34: Disciplinary Proceedings Rule 1.35: Appeal Procedures Rule 1.36: Administrative Penalties/Fines Rule 1.37: Responsibility of Liability Rule 1.38: Severability Rule 1.39: Effective Date

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Rule 1.1: Purpose

This purpose of this Regulation is to provide for the safety of conveyance equipment and personnel, and to promote public safety awareness pursuant to the provisions of the Mississippi Conveyance Safety Act (“Act”). This Regulation establishes the minimum standards for conveyance personnel and services. The use of unsafe or defective lifting devices imposes a substantial probability of serious and preventable injury to employees and the public. The prevention of these injuries and protection of employees and the public from unsafe conditions is in the best interest of the people of this state. Conveyance personnel performing work covered by this Regulation shall, by documented training and/or experience, be familiar with the operation and safety functions of the components and equipment. Training and experience shall include, but not be limited to, recognizing the safety hazards and performing the procedures required under this Regulation.

Source: Miss. Code Ann. § 45-45-1, et seq. (Supp. 2021)

Rule 1.2: Scope

This Regulation covers the design, construction, operation, inspection, testing, maintenance, alteration and repair of the following equipment, its associated parts, and its hoistways, except as provided by Section 3 of this Regulation;

(1) Hoisting and lowering mechanisms equipped with a car or platform that moves between two (2) or more landings. This equipment includes, but is not limited to, the following (also see ASME A17.1/CSA B44, ASME A17.7/CSA B44.7, ASME A17.3 and ASME A18.1):

a. Elevators;

b. Platform lifts;

c. Stairway chairlifts.

(2) Power-driven stairways and walkways for carrying persons between landings. This equipment includes, but is not limited to, the following (also see ASME A17.1/CSA B44, ASME A17.7/CSA B44.7, and ASME A17.3):

a. Escalators;

b. Moving walks.

(3) Hoisting and lowering mechanisms equipped with a car that serves two (2) or more landings and is restricted to the carrying of material by its limited size or limited access to the car. This equipment includes, but is not limited to, the following (also see ASME A17.1/CSA B44, ASME A17.7/CSA B44.7, and ASME A17.3):

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1. Dumbwaiters;

2. Material lifts and dumbwaiters with automatic transfer devices.

Source: Miss. Code Ann. § 45-45-5 and 13 (Supp. 2021)

Rule 1.3: Exemptions

(1) Equipment not covered by this Regulation includes, but is not limited to, the following:

a. Material hoists within the scope of ANSI A10.5;

2. Man lifts within the scope of ASME A90.1;
3. Mobile scaffolds, towers and platforms within the scope of ANSI A92;

d. Powered platforms and equipment for exterior and interior maintenance within the scope of ANSI A120.1;

e. Conveyors and related equipment within the scope of ASME B20.1;

f. Cranes, derricks, hoists, hooks, jacks and slings within the scope of ASE B30;

g. Industrial trucks within the scope of ASME B56;

h. Portable equipment, except for portable escalators that are covered by ASME A17.1/CSA B44 and ASME A17.7/CSA B44.7;

i. Tiering or piling machines used to move materials to and from storage located and operating entirely within one (1) story;

j. Equipment for feeding or positioning materials at machine tools, printing presses, or similar equipment;

k. Kip or furnace hoists;

l. Wharf ramps;

m. Railroad car lifts or dumpers;

n. Line jacks, false cars, shafters, moving platforms and similar equipment used for installing an elevator by and elevator contractor licensed in this state.

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o. Equipment which is located at an industrial facility that is not accessible by the general public and which is used in the construction, operation, or maintenance of the facility.

(2) The provisions of this Regulation shall not apply to any conveyance that is located in a private residence. For the purposes of this Regulation, a private residence is a single–family dwelling. This definition may also include multiple- family dwellings if an elevator is installed and used within a separate apartment that is not accessible to the general public or other occupants of a building.

Source: Miss. Code Ann. § 45-45-7 (Supp. 2021)

Rule 1.4: Definitions

For purposes of this Regulation, the following terms are defined as follows, unless the context clearly indicates otherwise:

(a) “Administrator” means the person or person designated by the Commissioner of Insurance.

(b) “ANSI” means the American National Standards Institute.

(c) “ASCE” means the American Society of Civil Engineers.

(d) “ASCE 21” means the American Society of Civil Engineers Automated People Mover Standards.

(e) “ASME” means the American Society of Mechanical Engineers.

(f) “ASME A17.1/CSA B44” means the Safety Code for Elevators and Escalators, an American National Standard.

(g) “ASME A17.3” means the Safety Code for Existing Elevators and Escalators, an American National Standard.

(h) “ASME A17.7/CSA B44.7” means the Performance-Based Safety Code for Elevators and Escalators, an American National Standard.

(i) “ASME A18.1” means the Safety Standard for Platform Lifts and Stairway Chairlifts, an American National Standard.

(j) “Automated people mover” means an installation defined as an “automated people mover” in ASCE 21.

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(k) “Building Owner” means the person or persons, company, corporation, authority, commission, board, governmental entity, institution, owner, lessee, or any other entity that holds title to the subject building or facility. For the purposes of this Regulation an owner may designate an agent.

(l) “Certificate of Operation” means a document that indicates that the conveyance has had the safety inspection and tests required by this Regulation.

(m) “Commissioner” means Commissioner of Insurance.

(n) “Conveyance” means any elevator, dumbwaiter, escalator, moving sidewalk, platform lift, stairway chairlift or automated people mover.

(o) “Department” means the Mississippi Department of Insurance.

(p) “Elevator” means an installation defined as an “elevator” in ASME A17.1/CSA B44.

(q) “Elevator contractor” means any sole proprietor, firm, corporation or other business entity engaged in the business of erecting, construction, installing, altering, servicing, repairing or maintaining elevators and other conveyances.

(r) “Elevator helper or apprentice” means a person who works under the general direction of a licensed elevator mechanic.

(s) “Elevator inspector” means any person who specializes in the design, testing and maintenance inspection of elevators and other conveyances. An elevator inspector does not perform maintenance on elevators or other conveyances.

(t) “Elevator mechanic” means any person who is engaged in erecting, constructing, installing, altering, servicing, repairing, testing or maintaining elevators or other conveyances. For the purposes of this chapter, a certified elevator technician is considered an elevator mechanic.

(u) “Escalator” means an installation as defined as an “escalator” in ASME A17.1/CSA B44.

(v) “Existing installation” means an installation defined as an “installation, existing” in ASME A17.1/CSA B44.

(w) “License” means a written license issued under this Regulation.

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(x) “Licensee” means the elevator mechanic, elevator contractor or elevator inspector who possesses a license issued under this Regulation.

(y) “Limited Elevator Contractor” means any sole proprietor, firm or company who employs individuals to carry on a business of erecting, constructing, installing, altering, servicing, repairing, or maintaining platform lifts, stairway chairlifts, and limited use / limited application lifts within any building or structure.

(z) “Limited Elevator Mechanic” means any person who is engage in erecting, constructing, installing, altering, servicing, repairing or maintaining platform lifts, stairway chairlifts and limited use / limited application lifts.

(aa) “Moving walk” or moving sidewalk” means an installation defined as a “moving walk” in ASME A17.1/CSA B44.

(bb) “Variance – Historical Character” means the approval of a different solution to compliance with the intent of this Regulation, including consideration of the impact to the historical character of the conveyance and/or building.

(cc) “Variance – New Technology” means the deferral of compliance with a requirement of A17.1/B44 ASME/ASCE Safety Codes and in conformance with A17.7/B44.7 ASME/ASCE Safety Codes to allow the installation of new technology if the component, system, sub-system, function or device is found to be equivalent or superior to the standards adopted in this Regulation. A new technology variance, once granted, may be applied to all like equipment installed in the state and a separate variance is not required for each installation. A variance applies to only one component, system, sub-system, function, or device. For example, one seeking a variance for a door system, a control system, and a suspension system would be required to file three separate variance application.

Source: Miss. Code Ann. § 45-45-9 (Supp. 2021)

Rule 1.5: Minimum Standards Adoption of Nationally Recognized Safety Codes

(1) If not previously adopted, the Administrator shall automatically adopt the latest editions of the following standards six months from their effective date:

(a) THE NATIONAL SAFETY CODE FOR ELEVATORS AND ESCALATORS (ASME A.17.1)

(b) THE NATIONAL SAFETY CODE FOR EXISTING ELEVATORS AND ESCALATORS (ASME A.17.3 [2011])

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(i) ASME A.17.3 [2011] shall only apply to a conveyance when an alteration is being performed pursuant to Section 8.7 of ASME A.17.1. If an alteration is not being performed, ASME A.17.1 shall apply and a conveyance shall be required to comply with the ASME A.17.1 edition that was in effect at the time the conveyance was installed.

(c) THE NATIONAL SAFETY STANDARD FOR PLATFORM LIFTS AND STAIRWAY CHAIRLIFTS (ASME A.18.1)

(d) THE NATIONAL SAFETY STANDARD FOR THE QUALIFICATIONS OF ELEVATOR INSPECTORS (ASME QEI-1)

(e) AUTOMATED PEOPLE MOVER STANDARDS (ASCE 21)

(2) Hydraulic elevators that have any portion of the cylinder buried in the ground and that do not have a double cylinder or a cylinder with a safety bulkhead shall:

(a) have the cylinder replaced with a double cylinder or a cylinder with a safety bulkhead protected from corrosion by one or more of the following methods:

(i) monitored cathodic protection;

(ii) a coating to protect the cylinder from corrosion that will withstand the installation process;

(iii) by a protective plastic casing immune to galvanic or electrolic action, salt water, and other known underground conditions; or

(b) be provided with a device meeting the requirements of Section 3.5 or a device arranged to operate in the down direction at an over speed not exceeding 125% of rated speed. The device shall mechanically act to limit the maximum car speed to the buffer striking speed, or stop the elevator car with rated load with a deceleration not to exceed 32.2ft/s2(9.8m/s2), and shall not automatically reset. Actuation of the device shall cause power to be removed from the pump motor and control valves until manually reset; or

(c) have other means acceptable to the authority having jurisdiction to protect against unintended movement of the car as a result of uncontrolled fluid loss; or

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(d) have hydraulic jacks pressure tested annually. Any elevator with a hydraulic jack determined to be leaking underground shall be immediately shut off until the jack unit is replaced.

(3) The following standards shall govern restricted openings of hoistway doors and/or car doors on passenger elevators.

(a) When a car is outside the unlocking zone, the hoistway doors or car doors shall be so arranged that the hoistway doors or car doors cannot be opened more than 4 in. (102 mm) from inside the car.

(b) When the car is outside the unlocking zone, the car doors shall be operable from outside the car without the use of special tools.

(c) The unlocking zone shall extend from the landing floor level to a point no greater than 18 in. (457 mm) above or below the landing floor level.

(d) All existing elevators that are not in compliance with this rule have six months after the inspection report is received by the department to be in compliance.

(4) The following procedures shall be followed for Temporary Certificates of Operation.

(a) A temporary certificate of operation may be issued at the discretion of the chief inspector if requested by the elevator contractor and the inspector. This request must be submitted by the inspector in the form of an inspection report, along with the required fee.

(b) The elevator must have all safety devices properly tested and tagged by a licensed elevator contractor and checked and witnessed by a licensed inspector.

(c) When the inspection report and fee are submitted to this office, the inspector is certifying the elevator is safe for this type service.

(5) In order to reduce the hazards associated with water on energized circuits from the activation of sprinklers in the elevator equipment room, new elevator installations, and modernizations/alterations will require the shunt trip to each elevator disconnecting means to be located outside the elevator equipment room.

(a) It shall de-energize both the line side and load side of the affected elevator’s disconnecting means.

(b) In cases of extreme difficulty in locating the shunt trip outside the machine room, and with prior written approval from the administrator, locating the

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shunt trip in the machine room may be approved, if the disconnect is a rainproof NEMA 3R or better enclosure.

(c) Control circuits to shut down elevator power shall be monitored for presence of operating voltage. Loss of voltage to the control circuit for the disconnecting means shall cause a supervisory signal to be indicated at the control unit and required remote enunciators.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.6: Registration of Conveyances

(1) On or before December 31, 2014, the owner or lessee of a conveyance not exempted by this Regulation shall register the conveyance with the department, pursuant to rules adopted by the Administrator. The registration shall include the type, rated load and speed, manufacturer, location, purpose, date of installation and any additional information the Administrator may require.

(2) Conveyances placed in service on or after July 1, 2013, shall be registered at the time they are completed and placed in service.

(3) On or after January 1, 2015, the Administrator may, after notice and hearing, assess an administrative penalty of no more than $500.00 per day against a building owner or lessee who fails to register a conveyance as required by this Regulation thirty (30) days after being directed to do so by the Administrator.

(4) A jurisdiction tag shall be furnished and shall be permanently attached on or near the conveyance’s crosshead by the inspector. On conveyances without a crosshead, jurisdiction tags shall be attached to the equipment on the car top. On conveyances also lacking car tops, the jurisdiction tag shall be attached on or near the control panel.

Source: Miss. Code Ann. § 45-45-19 (Supp. 2021)

Rule 1.7: Variance, Exemption and Reconsideration

(1) (a) Variance – Historical Character. The Administrator may grant a variance approving a different solution to compliance with the intent of this code. In considering a request for a variance, the Administrator may take into consideration the impact to the historic character of the conveyance and/or the building.

(b) In order for a variance or exemption request to be reviewed the owner or designated representative shall submit:

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(i) Evidence that the proposed or existing conveyance is not in compliance with this Code.

(ii) Evidence, letters, statements, test results, construction documents, or other supporting information as required justifying the request.

(iii) Evidence that strict compliance with the Code would entail practical difficulty, unnecessary hardship or is otherwise found unwarranted.

(iv) Evidence that any such variance or exemption secures the public safety and health and that the methods, means or practices proposed provide equal protection of the public safety and health.

(2) (a) Variance – New Technology. Prior to the installation of any device, equipment or technology not permitted by the currently adopted standards, a contractor or an equipment manufacturer must submit an application for new technology variance for approval by the Administrator.

(b) An application for a new technology variance shall contain the following, if applicable:

(i) An enumeration and description of all the requirements of the adopted standards for which a new technology variance is being requested;

(ii) Documentary evidence to support a claim of equivalence or superiority to the requirements of the adopted standards;

(iii) Documentary evidence that the new technology is being or may be considered by the ASME code committee(s) for inclusion in a future standard; and

(iv) Any additional supporting evidence deemed by the applicant to be necessary to assist in making a determination.

(3) The determination on the variance or exemption request shall be made in writing to the applicant and shall advise the applicant of the reconsideration process. This determination shall be made no later than thirty (30) days after the request is made.

(4) The Administrator may reconsider an interpretation or decision made pursuant to this Section. To request reconsideration the owner shall submit a written request to the Administrator including:

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(a) Evidence the proposed or existing conveyance is not in compliance with this Code.

(b) Evidence, letters, statements, test results, construction documents or other supporting information as required justifying the request.

(c) Evidence that the true intent of the Code has been incorrectly interpreted, or the provisions of the Code do not fully apply; or the decision is unreasonable or arbitrary as it applies to alternatives or new materials.

(d) The request for reconsideration shall be submitted no later than 30 days after receiving the variance or exemption determination.

(e) A request for variance, exemption, or reconsideration shall not relieve a person from complying with this Code, permit or occupancy requirements, unless the Administrator expressly authorizes an extension of compliance period pending review of the request.

(5) Any request for a variance must include the variance application fees as set forth in Section 10.16 of this Regulation.

(6) The Administrator shall make available a form which shall be used to submit applications for a variance from the adopted elevator code as authorized under this Regulation. However, the standards for the granting or denial of a variance as set forth in this Regulation are the standards applicable to the granting or denial of a variance and are not altered, amended, changed or diminished by the adoption of said form as an administrative requirement for the processing of the application for a variance. The applicant has the burden of proof to meet the standards set forth in this Regulation.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.8: Inspection and Testing of Conveyances

(1) It shall be the responsibility of the owner of all new and existing conveyances located in any building or structure to have the conveyance inspected annually by a licensed elevator inspector who shall supply the property owner or lessee and the licensing authority with a written inspection report that describes any and all code violations. Property owners shall have thirty (30) days from the date of the published inspection report to be in full compliance by correcting the violations.

(2) If the conveyance is an elevator that serves only two (2) adjacent floors, the owner may request an exemption from the annual inspection requirement described in subsection (1) of this Rule. The Administrator shall make available a form which shall be used for any application for exemption from the annual inspection requirement. The request for exemption may be denied by the

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Administrator where there are unusual circumstances which create a significant safety hazard. Furthermore, any exemption granted hereunder shall be subject to confirmation of the following by the building owner/manager:

a. The elevator being exempted from annual inspections has only two adjacent landings; b. The elevator must be registered with the Elevator Safety Division; c. The elevator will not be inspected by a licensed Elevator Inspector; d. No operating certificate will be issued for exempted elevators; e. The building owner will be responsible for having all ASME A17.1 code required annual and monthly testing performed by a licensed Elevator contractor; f. The building owner will be responsible for compiling and maintaining the ASME A17.1 code required onsite documentation of test results, maintenance, and call backs and repairs; g. The building owner shall be responsible for ensuring the unit remains in proper operating condition.

Source: Miss. Code Ann. § 45-45-27 (Supp. 2021)

Rule 1.9: Qualifications to be Licensed as an Elevator Mechanic

(1) No license shall be granted to any person who has not proven their qualifications and abilities. Applicants must demonstrate the following qualifications:

(a) An acceptable combination of documented experience and education credits of, within the last five (5) years, not less than four (4) years work experience in the elevator industry, in construction, maintenance and service/repair, as verified by current and previous employers, and satisfactory completion of a written examination approved by the Administrator on the most recent referenced codes and standards.

(b) Certificates of completion of an apprenticeship program for elevator mechanic, having standards substantially equal to those of this Regulation, and registered with the Bureau of Apprenticeship and Training, or U.S. Department of Labor.

(c) A license shall be issued to an applicant who holds a valid license from a state having standards substantially equal to those of this Regulation without examination and upon verification of qualification by the Administrator.

(2) Any person who furnishes the Administrator with acceptable proof that they have worked as an elevator constructor, maintenance, or repair mechanic shall upon making application and paying the fee shall be entitled to receive a license without an examination. They shall have worked without direct and immediate supervision

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as a mechanic for an elevator contractor registered to do business in the State of Mississippi. This employment shall not be less than four (4) years immediately prior to July 1, 2013. The person must make application on or before July 1, 2014.

(3) A license is not required for an elevator helper or apprentice; however, a licensed mechanic is limited to directly supervise only three (3) helpers or apprentices. For the purposes of this Regulation, direct supervision shall mean active supervision.

(4) A limited elevator mechanic must be certified by the manufacturer of the equipment he or she installs or an approved training program acceptable to the equipment manufacturer. This certification must accompany the application for license.

(5) A Temporary Elevator Mechanic License good for One Hundred and Eighty (180) days may be issued if the following procedures are followed:

(a) On company letterhead an applicant must request the temporary license and certify that the applicant has two (2) years minimum experience and an acceptable combination of documented experience and education to perform elevator work without direct and immediate supervision.

(b) The request must be notarized.

(c) The Temporary Mechanic License will state on its face that it is valid for One Hundred and Eighty (180) days from date of issuance and while the person is employed by the licensed elevator contractor who certified the individual as qualified. The license shall be renewable as needed for $300.00 each renewal.

(d) The Temporary Mechanic License must be present while the work is being performed.

(6) A licensee shall observe, test, install, service and maintain conveyances in compliance with the provisions and standards of the Mississippi Fire Prevention and Building Code.

(7) Continuing Education – Each Mechanic licensee must complete eight (8) hours of continuing education in the twelve (12) months immediately prior to license renewal. The following requirements must be followed:

(a) The eight (8) hours of continuing education certification must be provided at the time of renewal. Only the full hours will be accepted. Failure to submit this continuing education information could result in nonrenewal of the license.

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(b) Two hours of the continuing education must be on safety training courses and may be incorporated in the eight (8) hours.

(c) Courses approved by NAEC, NEIEP, IUEC, CET, or other courses approved by the Administrator, will be acceptable. Certificates of completion of these courses will be required as proof of completion.

Source: Miss. Code Ann. §§ 45-45-13 and 15 (Supp. 2021)

Rule 1.10: Qualifications to be Licensed as an Elevator Contractor

(1) No license shall be granted to any sole proprietor, firm, or corporation that has not demonstrated the requisite qualifications and abilities. Duly authorized applicants for an elevator contractor’s license must have in their employ licensed elevator mechanics who perform the work described herein and have proof of compliance with the insurance requirements as set forth in Section 10.12 of this Regulation.

(2) No license shall be granted to any sole proprietor, firm, or corporation that has not demonstrated the requisite qualifications and abilities. Duly authorized applicants for a limited elevator contractor’s license must have in their employ licensed elevator mechanics that perform the work described herein and have proof of compliance with the insurance requirements as set forth in Section 10.12 of this Regulation.

(3) A licensee shall observe, test, install, service and maintain conveyances in compliance with the provisions and standards of the Mississippi Fire Prevention and Building Code.

Source: Miss. Code Ann. §§ 45-45-13 and 15 (Supp. 2021)

Rule 1.11: Qualifications to be Licensed as an Elevator Inspector or Elevator Inspection Agency

(1) No inspector’s license shall be granted to any person unless he or she meets the current ASME QEI-1, as may be amended, Standards for the Qualifications of Elevator Inspectors or State standards as described in subsection (2).

(2) No license shall be granted to any entity that has not demonstrated the requisite qualifications and abilities. Notwithstanding any other provision, cities or municipalities wishing to engage in the safety inspections of existing elevators or related conveyances, the permitting and inspection of new or modernized elevators or related conveyances, may perform inspection programs on behalf of the Administrator, provided they meet the following requirements:

(a) The inspector shall meet the experience requirements noted in the qualifications for an inspector as set forth in ASME QEI-1 ;

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(b) The inspector must submit an application to the Administrator to be licensed elevator inspector;

(c) Subsequent to inspection, the inspector shall supply the property owner or lessee and the Administrator with a written inspection report describing any and all violations;

(d) Have proof of compliance with the insurance requirements as set forth in Section 1.12 of this Regulation, and

(e) The applicant or licensee must meet all other statutory requirements and rules and Regulations enforced by the Administrator.

(3) A licensee shall inspect and verify that testing and conditions for conveyances are in compliance with the provisions and standards of the Act.

Source: Miss. Code Ann. §§ 45-45-13 and 15 (Supp. 2021)

Rule 1.12: Contractor and Inspector Insurance Requirements

(1) Contractor Insurance Requirements

(a) A contractor must maintain general liability insurance at all times during a registration period to satisfy proof of financial responsibility of:

(i) Not less than $1,000,000 for each single occurrence of bodily injury or death; and

(ii) Not less than $500,000 for each single occurrence of property damage; or

(iii) A contractor may elect to purchase a general liability policy that provides a single-limit coverage of not less than $1,000,000.

(b) Insurance must be obtained from an insurance provider authorized or eligible to write general liability insurance in Mississippi.

(c) A contractor applicant or licensee must file with the department a completed certificate of insurance or other evidence satisfactory to the department when applying for an initial registration, renewing a registration, changing a business name or affiliation, and upon request of the department.

(d) A contractor must furnish the name of the insurance carrier, the policy number, and the name, address, and telephone number of the insurance

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agent with whom the contractor is insured to any customer who requests it.

(e) A contractor applicant or licensee must obtain a general liability insurance policy that contains a provision or an endorsement that gives the department 30 days prior written notice of cancellation.

(2) Inspector Insurance Requirements

(a) An inspector must maintain general liability insurance at all times during a registration period to satisfy proof of financial responsibility of:

(i) Not less than $1,000,000 for each single occurrence of bodily injury or death; and

(ii) Not less than $500,000 for each single occurrence of property damage; or,

(iii) A contractor may elect to purchase a general liability policy that provides a single-limit coverage of not less than $1,000,000.

(b) Insurance must be obtained from an insurance provider authorized or eligible to write general liability insurance in Mississippi.

(c) An inspector applicant or licensee must file with the department a completed certificate of insurance or other evidence satisfactory to the department when applying for an initial registration, renewing a registration, changing a business name or affiliation, and upon request of the department.

(d) An inspector must furnish the name of the insurance carrier, the policy number, and the name, address, and telephone number of the insurance agent with whom the contractor is insured to any customer who requests it.

(e) An inspector applicant or licensee must obtain a general liability insurance policy that contains a provision or an endorsement that gives the department 30 days prior written notice of cancellation.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.13: Renewal of License

(1) A license issued by the Administrator shall be valid for two years. The Administrator may renew a license, provided the applicant submits a written

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application for renewal accompanied by the required fee prior to expiration of the license.

(2) Applicants for license renewal shall provide evidence, satisfactory to the Administrator, of completion of eight hours of instruction approved by the Administrator, designed to ensure the continued qualifications of the applicant.

(3) If a license is allowed to lapse, it may be renewed at any point after its expiration date by:

(a) paying $100 in addition to the applicable license renewal fee; (b) proving the applicant satisfies the licensing criteria needed to obtain such license; and (c) proving the completion of continuing education requirements, if applicable. (4) A licensee with an expired license is considered an inactive licensee. An inactive licensee shall not work with an expired license. Violation of this subsection may result in the assessment of penalties detailed in Rule 1.36(1)(g) of this Regulation.

Source: Miss. Code Ann. § 45-45-15 (Supp. 2021)

Rule 1.14: Emergency and Temporary Mechanics Licenses

(1) Whenever an emergency exists in the state due to disaster, act of God, or work stoppage, as declared by the President of the United States or Governor of Mississippi, and the Commissioner of Insurance issues a finding that the number of persons in the state holding licenses granted by the Administrator is insufficient to cope with the emergency, the licensed elevator contractors shall respond as necessary to assure the safety of the public. Any person certified by a licensed elevator contractor to have an acceptable combination of documented experience and education to perform elevator work without direct and immediate supervision may seek an emergency elevator mechanic license from the administrator within five business days after commencing work requiring a license. The Administrator may issue emergency elevator mechanic licenses. The licensed elevator contractor shall furnish proof of competency as the Administrator may require. Each such license shall recite that it is valid for a period of One Hundred and Eighty (180) days from the date of issuance for particular elevators or geographical areas as the administrator may designate and shall entitle the licensee to the rights and privileges of an elevator mechanic license issued under this Regulation. The Administrator may renew an emergency elevator mechanic license during the existence of an emergency. A Three Hundred Dollar ($300.00) fee shall be charged for any emergency elevator mechanic license or renewal thereof.

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(2) For purposes of this Regulation, the phrase “acceptable combination of documented experience and education” shall mean at least two years of experience in performing elevator work and the completion of a least 288 hours of Administrator-approved education relating to the same.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.15: Permits

(1) An application for a permit shall be filed with the department in accordance with this Regulation for all elevator work covered under these rules.

(2) Each application for a permit shall be accompanied by copies of specifications and accurately-scaled and fully-dimensioned plans that clearly indicate location of the elevator in the building; the location of the machinery room and the equipment to be installed, relocated or altered; all structural supporting members, including foundations; and a specification of all materials to be used and all loads to be supported or conveyed. The plans and specifications shall be sufficiently complete to illustrate all details of construction and design.

(3) The applicable fees shall accompany each permit application.

(4) A permit may be revoked for any of the following reasons:

(a) Where any false statements or misrepresentations were made as to the material facts in the application, plans, or specifications on which the permit was based.

(b) Where the permit was issued in error and should not have been issued in accordance with this chapter.

(c) Where the work detailed under the permit is not being performed in accordance with the provisions of the application, plans, or specifications or with this chapter or conditions of the permit.

(d) Where the elevator contractor to whom the permit was issued fails or refuses to comply with a STOP WORK order.

(5) A permit expires if the work authorized by a permit is not commenced within twelve (12) months after the date of issuance.

(6) A permit is not required for a repair.

(7) The Administrator may allow an extension of time at his or her discretion.

Source: Miss. Code Ann. § 45-45-23 (Supp. 2021)

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Rule 1.16: Fee Schedule

(1) Fees shall be established as follows. Unless otherwise indicated, the fees shall be paid to the Department of Insurance:

(a) Elevator Contractor’s License............................................$300.00

(b) Elevator Contractor’s license renewal (biennial).......................$200.00

(c) Limited Elevator Contractor’s License..................................$300.00

(d) Limited Elevator Contractor’s License renewal (biennial)............$200.00

(e) Elevator Mechanics and Limited Mechanic’s License ..............................$100.00 (initial & biennial renewal)

(f) Six (6) month Temporary Mechanic’s License.........................$300.00

(g) Elevator Inspectors License (initial) and biennial renewal............$100.00

(h) Installation and Modernization Permits:

Elevator/Escalator installer will send $100.00 with the application for the installation permit per unit to the Department of Insurance. This will pay for the permit and the first annual operating Certificate to be issued after the unit passes the final inspection.

The final inspection will be billed directly by the inspection company to the elevator/escalator installer.

(i) Major Alteration Permits:

The elevator/escalator installer will send $100 with the application for the alteration permit per unit to the Department of Insurance, which will pay for the permit and the first operating Certificate issued after the unit passes the final inspection. There will be a $100.00 fee for each additional alteration to the Department of Insurance for the permit. The maximum alteration fee per unit is $500.00.

The final inspection will be billed directly by the inspection company to the elevator/escalator installers.

(j) Annual Operating Permits:

Annual certificate for existing unit paid to the Department of Insurance by the owner/manager per unit..............................................................$ 75.00

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(k) Annual Inspections on existing units by a licensed inspector shall to be billed directly by the inspector or inspection company to the building owner/manager.

(l) Variance Application Fees:

Historical Character.................................................................$250.00 New Technology..................................................................$2,500.00

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.17: Reporting Requirements – Building Owner

(1) To obtain a certificate of compliance, the building owner must submit to the department within sixty (60) days of the equipment inspection date, the following items:

(a) The application for certificate of compliance;

(b) Written documentation to verify that all violations of the applicable ASME Safety Codes or ASCE Standards as adopted in this Regulation;

(c) Any application(s) for delay or waiver if applicable; and

(d) All applicable fees.

(2) The owner shall notify the department, in writing and within thirty (30) days, of equipment that has been place out of service.

(3) The owner shall notify the department, in writing and within thirty (30) days, of an elevator that has had alterations converting the equipment to a material lift. The conversion shall comply with the applicable sections of this Regulation.

(4) The owner shall notify the department, in writing and within thirty (30) days, of a material lift that has had alterations converting the equipment to an elevator. The elevator must be inspected and brought into compliance with this Regulation as a new installation.

(5) When a delay has been approved, the owner shall notify the department, in writing within thirty (30) days of the date of correction.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.18: Reporting Requirements – Inspector

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(1) For new installations, the inspector shall provide a copy of the Equipment Inspection Form to the building owner and the Administrator not later than the 10 th calendar day after completing the inspection.

(2) For alterations, the inspector shall provide a copy of the Equipment Inspection Form to the department and the building owner not later than the 10 th calendar day after completing the inspection.

(3) Inspectors, by e-mail, fax, letter or telephone, shall report to the department, within 72 hours of discovery, all equipment they encounter that does not have a decal number.

(4) The inspector shall clearly note on the inspection report any equipment found with a reportable condition, and shall report it immediately by submitting a copy of the report to the building owner and by e-mail, fax, letter or telephone to the department within 24 hours.

(5) Inspectors, by e-mail, fax, telephone, letter, or by using the Online Inspection Reporting System, for each piece of equipment inspected, shall report to the department with 72 hours of completing an annual inspection, or an inspection of a new installation:

(a) the inspector’s Mississippi License number;

(b) the decal number of equipment; and

(c) the date of the inspection.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.19: Reporting Requirements – Contractor

(1) Contractors must submit to the Administrator reports as requested by the Administrator regarding installation, repair, alteration, or maintenance jobs on a format approved by the department.

(2) Contractors are not required to file reports as prescribed under subsection (1) for equipment that is exempt under this Regulation and for construction-use only elevators.

(3) Contractors shall, by e-mail, fax, letter or telephone, report to the building owner and the Administrator, within 24 hours of discovery, all equipment they encounter that has a reportable condition.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

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Rule 1.20: Standards of Conduct for Inspector or Contractor Licensees

(1) The provisions in this section apply to both inspectors and contractors, except where noted.

(2) Competency. The licensee, as applicable, shall be knowledgeable of and adhere to the Regulation, this chapter, the ASME Safety Codes or ASCE Standards as adopted in this Regulation, and all procedures established by the department for equipment inspections or performance of a contract to install, alter, repair, or maintain equipment. It is the obligation of the licensee to exercise reasonable judgment and skill in the performance of equipment inspections or performance of a contract to install, alter, repair, or maintain equipment.

(3) Integrity. A licensee shall be honest and trustworthy in the performance of equipment inspections or performance of a contract to install, alter, repair, or maintain equipment, and shall avoid misrepresentation and deceit in any fashion, whether by acts of commission or omission. Acts or practices that constitute threats, coercion, or extortion are prohibited. The licensee shall accurately and truthfully represent to any prospective client his/her capabilities and qualifications to perform the services to be rendered.

(4) Interest. The primary interest of the licensee is to ensure compliance with the Regulation, this chapter, and the ASME Safety Codes or ASCE Standards adopted in this Regulation, and all procedures established by the department. The licensee’s position, in this respect, should be clear to all parties concerned while conducting equipment inspections or completing the performance of a contract to install, alter, repair, or maintain equipment.

(5) Conflict of Interest. A licensee is obliged to avoid conflicts of interest and the appearance of conflicts of interest. A conflict of interest exists when an inspector performs or agrees to perform an equipment inspection for a building in which he has a financial interest, whether direct or indirect. A conflict of interest also exists when a licensee’s professional judgment and independence are affected by his/her family, business, property, or other personal interests or relationships.

(6) Specific Rules of Conduct. A licensee shall not:

(a) participate, whether individually or in concert with others, in any plan, scheme, or arrangement attempting or having as its purpose the evasion of any provision of the Regulation, this chapter, or the standards adopted by the commission;

(b) knowingly furnish inaccurate, deceitful, or misleading information to the department, a building owner, or other person involved in equipment inspections or equipment contracts;

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(c) state or imply to a building owner that the department will grant a delay or waiver;

(d) engage in any activity that constitutes dishonesty, misrepresentation, or fraud while performing equipment inspections or completing an equipment contract;

(e) perform equipment inspections or complete an equipment contract in a negligent or incompetent manner;

(f) perform equipment inspections in a building or facility in which the inspector licensee is an owner, either in whole or in part;

(g) perform equipment inspections in a building or facility wherein the licensee, for compensation, participated in obtaining an equipment contract for the building;

(h) indulge in advertising that is false, misleading, or deceptive;

(i) misrepresent the amount or extent of prior education or experience to any client; or

(j) hold out as being engaged in partnership or association with any person unless a partnership or association exists in fact.

(7) An inspector may not perform inspections upon equipment for which the inspectors’ employer also has a contract to perform installations, maintenance, repairs, replacements or alterations on that equipment.

(8) A licensee shall withdraw from employment when it becomes apparent that it is not possible to faithfully discharge the duty and performance of services owed the client. A licensee shall provide reasonable notice to the client of the licensee’s withdrawal.

(9) An inspector must attend all mandatory training required by the executive director.

(10) A licensee shall notify the department in writing within 30 days of any changes to information submitted on the application or renewal application.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.21: Responsibilities of the Department

(1) When issuing certificates of compliance the department shall:

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(a) Assure that each certificate includes the decal number, building name, inspector’s registration number, the date of the last inspection, the due date of the next inspection, contact information at the department to report a violation, the executive director’s signature and date, and any other information required by the statute.

(b) Use the following procedures to issue a certificate of compliance:

(i) review inspection report and fees received by the department;

(ii) review certification submitted by building owner indicating which code violations have been remedied and which code violations are under contract to be corrected;

(iii) review waiver/delay application and fees received by the department;

(iv) notify building owner with a notice of incomplete submittal asking for any missing inspection documents and fees; and

(v) notify building owner of any denied waiver or delay requests and ask for certification that violations have been remedied or under contract to be corrected.

(vi) After a determination is made that the building owner submitted an inspection report with the correct amount of filing fees and all deficiencies in the inspection report have been corrected, or under contract to be corrected, or delay or waiver granted, then a certificate of compliance is issued for each unit of equipment.

(2) The department shall provide notification to building owners, architects, and other building industry professionals regarding the necessity of annually inspecting equipment through the department’s website, press releases, and group presentations.

(3) The department shall review and issue a decision on any applications for new technology variances in accordance with this chapter.

(4) The department shall perform the required application and plan review and may approve or deny the application and plans in accordance with this chapter.

(5) The department may periodically review inspection reports to determine compliance with the applicable statutes and administrative rules.

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(6) The department may require inspector attendance at periodic rules and/or law update seminars conducted by the department when the executive director determines such seminars to be necessary.

(7) The department may conduct inspector training seminars where attendance by inspectors is not mandatory.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.22: Responsibilities of the Building Owner

(1) The building owner shall:

(a) obtain the services of an inspector registered with the department to perform inspections in accordance with this Regulation;

(b) keep the equipment free from reportable conditions;

(c) have all violations cited on an inspection report:

(i) corrected within thirty (30) calendar days of the date of inspection;

(ii) have them under contract to be corrected and all work completed no later than the next inspection due date; or

(iii) have an approved waiver or delay.

(2) The owner of the building in which equipment is located shall have such equipment inspected at an interval not to exceed every twelve (12) months to determine compliance with the applicable standards adopted in this Regulation.

(3) The owner of the building in which the equipment is located must make available to the department and all elevator personnel all maintenance and inspection records and maintenance control programs for the equipment during the life of the equipment as required by the applicable standards adopted in this Regulation. These records and programs shall be available in the building.

(4) The building owner or the owner’s representative must report all accidents, involving equipment to the department, using a department-approved form, within 72 hours of the accident. If the accident results in serious bodily injury or a fatality, the equipment shall be removed from service and shall not be moved (except as necessary to extricate an injured party or effect a life-saving rescue) or returned to service until a representative of the department completes an investigation and issues an approval to return the unit to service.

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(5) The building owner shall ensure that all of the tests required by the applicable codes and standards adopted in this Regulation are performed.

(6) If any equipment is determined to have a reportable condition by inspection or other means, the building owner shall notify the department in writing within 24 hours, and shall place the unsafe equipment out of operation until repairs to correct the reportable condition(s) are completed. After repairs have been completed, the building owner shall have the equipment re-inspected and re- certified and submit written verification to the department that the reportable condition has been corrected before returning the equipment to service.

(7) New equipment installations must have plans reviewed by the department and must be inspected and tested to determine their safety and compliance with the requirements of the codes and standards as adopted in this Regulation before being placed in service. The equipment shall be free of any violations, unless a waiver, delay or new technology variance has been granted by the department in writing, before being placed in service.

(8) Altered equipment must have plans reviewed by the department and must be inspected and attested to determine its safety and compliance with the requirements of the codes and standards as adopted in this Regulation before being placed back in service. The equipment shall be free of any violations, unless a waiver, delay or technology variance has been granted by the department in writing, before being placed back into service.

(9) Equipment must be tested to determine its safety and compliance with the requirements of the codes and standards as adopted in this Regulation.

(10) The building owner must obtain a yearly certificate of compliance from the department evidencing that each unit of equipment in the building is in compliance with the Regulation and all applicable rules and standards. The building owner must have a current certificate of compliance in order to operate equipment located in the building.

(11) The building owner must display the current certificate of compliance in the following locations:

(a) if the certificate relates to an elevator:

(i) inside the elevator car not more than 7’0” or less than 3”0” above the finished care floor;

(ii) outside the elevator car in the main elevator lobby within 10 feet of the elevator call button; or

(iii) in a common area lobby or hallway location that is:

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(A) accessible to the public without assistance or permission during all hours in which any elevator is in operation; and

(B) identified by a plaque mounted in the elevator car or within 10 feet of the elevator call button in the main elevator lobby. The font size for letters on the plaque shall be at least 18 and the plaque must state that the elevator is regulated by the Mississippi Department of Insurance and include the department’s telephone number (800) 562-2957 for in-state calls and (866) 856-1982 for out of state calls and the building management’s telephone number.

(b) if the certificate relates to an escalator – in a common area lobby or hallway location that is:

(i) accessible to the public without assistance or permission during all hours in which any escalator is in operation; and

(ii) identified by a plaque mounted within 10 feet of entry or exit of escalator in the main escalator lobby. The font size for letters on the plaque shall be at least 18 and the plaque must state that the escalator is regulated by the Mississippi Department of Insurance and include the Department’s telephone number (800) 562-2957 for in-state calls and (866) 856-1982 for out of state calls and the building management’s telephone number.

(c) if the certificate relates to a chairlift, platform lift, automated people mover operated by cables, moving sidewalk, or related equipment – on the box containing the control circuitry.

(12) The building owner must display an inspection report until a current certificate of compliance is issued by the Administrator.

(13) The building owner must have equipment re-inspected and re-certified if the equipment:

(a) has been altered;

(b) has been determined to have a reportable condition;

(c) has had any alteration made to the interior of elevator car enclosures or flooring; or

(d) inspection report show an existing violation has continued longer than permitted in a delay granted by the executive director.

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(14) The building owner shall have copies of all current department issued waivers, delays and new technology variances posted in the machine room/machinery space in a readily accessible and visible location available to elevator personnel.

(15) Any building owner who shall violate any of the provisions of the Mississippi Conveyance Safety Act shall be fined an amount not to exceed One Thousand Five Hundred Dollars ($1,500.00).

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.23: Responsibilities of the Inspector – Inspection Procedures

(1) The inspector must inspect all equipment for compliance with the applicable ASME Safety Codes or ASCE Standards as adopted in this Regulation.

(2) Inspectors must use the currently published edition of ASME A17.2, and the “Guide for Inspection of Elevators, Escalators, and Moving Walks” to conduct inspections and witness tests for compliance with the ASME Safety Codes or ASCE Standards adopted in this Regulation.

(3) The inspector shall report to the building owner before beginning any inspections.

(4) The inspector and the building owner must sign and date the inspection report.

(5) The inspector shall not perform any of the tests.

(6) On new or altered equipment installations, the inspector may perform an inspection prior to the installation being completed. However, on these installations the department will only accept inspection reports for final inspections performed by the inspector after the installation is completed.

(7) For new installations or alterations to existing equipment, the inspector shall verify that approved applications and plans are on the site as specified in this Regulation and shall not proceed with the inspection without the approved application and plans.

(8) The inspector shall verify that the installation or alterations comply with the approved application and plans.

(9) New or altered units that fail to comply with the approved application and plans shall not be placed in-service without the prior written approval of the department.

(a) The inspector shall compare the installation to the approved application and plans.

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(b) The inspector shall not allow any installation that deviates from the approved application and plans to be placed into operation without the specific written authorization of the department.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.24: Responsibilities of the Inspector – Department Forms

(1) The inspector must use current department-approved forms for reporting inspections.

(2) The department forms shall be filled out completely, and shall be used to report the inspections of existing equipment and final inspections of new or altered equipment.

(3) The inspector must list all violations of the technical requirements by code number and code edition for each unit inspected, and include a written description of the violation on the department form. If the technical requirements refer to another code, the inspector must list both code numbers and include a written description of the violation.

(4) The inspector may not use the department equipment inspection form to report the results of an inspection to the owner of equipment that is exempt under this Regulation and for construction – use only elevators.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.25: Responsibilities of the Inspector – Inspectors Equipment Decals

(1) Each unit of equipment shall be identified with a unique identification number decal issued by the department, which the inspector must affix in a conspicuous place. The decal shall remain on the control panel for the life of the equipment.

(2) An additional department decal shall not be affixed to equipment that has a current department decal displayed.

(3) All correspondence and inspection reports shall reference the decal number and building ID number, as reflected on the certificate of compliance.

(4) If an inspector places a new decal on a unit of equipment to replace a lost or destroyed decal, the inspector must report the equipment’s location, old decal number, and new decal number to the department within ten calendar days of placing the new decal number upon the equipment.

Source: Miss. Code Ann. §§ 45-45-13 and 37 (Supp. 2021)

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Rule 1.26: Responsibilities of the Contractor – Compliance with Plan Review

(1) The contractor shall comply with the requirements for plan review as set forth in this chapter.

(2) The contractor shall provide the inspector a copy of the approved application and plans and, upon completion of the inspection, leave a copy of the approved application and plans in the machine room, machine space, control room, or control space.

Source: Miss. Code Ann. §§ 45-45-13 and 37 (Supp. 2021)

Rule 1.27: Plan Review – Required

(1) Prior to beginning the installation or alteration of equipment at any individual location, the contractor shall submit and have approved an application and plans describing the installation or alteration.

(2) The contractor shall submit two (2) copies of the plans to be reviewed to the department. These copies shall be submitted in a manner prescribed by the department.

Source: Miss. Code Ann. § 45-45-13 (Supp. 2021)

Rule 1.28: Plan Review – New Equipment

(1) A contractor must submit for review an application and plans for the installation of new equipment.

(2) To apply for a plan review for the installation of new equipment, a contractor must:

(a) submit a completed application on a department-approved form;

(b) pay the fee required by this Regulation; and

(c) submit layout drawings as specified in this Regulation for the specific type of equipment to be installed. These layout drawings shall also include:

(i) the rated speed of the equipment in feet per minute;

(ii) the rated capacity of the equipment in pound;

(iii) the total travel of the equipment in feet and inches;

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(iv) elevation drawings of the hoistway, runway, or wellway; and

(v) plan drawings indicating the arrangement of the equipment in a machine room, machine space, control room, or control space.

Source: Miss. Code Ann. §§ 45-45-13 and 37 (Supp. 2021)

Rule 1.29: Plan Review – Alteration of Existing Equipment

(1) A contractor must submit for review an application and plans for the alteration of existing equipment.

(2) To apply for a plan review for the alteration of existing equipment, a contractor must:

(a) submit a completed application on a department-approved form;

(b) pay the fee required by this Regulation; and

(c) submit a written description of the scope of work, which shall include a description of each alteration to be performed.

(3) In addition to submitting the items under subsection (2), a contractor must submit layout drawings as specified in this Regulation for the specific type of equipment, if the alteration described in subsection (2)(c) results in one or more of the following changes:

(a) the rated speed of the equipment in feet per minute

(b) the rated capacity of the equipment in pounds;

(c) the total travel of the equipment in feet and inches;

(d) the classification of the equipment, such as passenger elevator to freight elevator or freight elevator to passenger elevator; or

(e) the driving machine is re-located.

Source: Miss. Code Ann. §§ 45-45-13 and 37 (Supp. 2021)

Rule 1.30: Plan Review – Department Approval or Denial

The Administrator shall conduct a plan review of the installation of new equipment or the alteration of existing equipment and may:

(a) approve the application and plans as submitted;

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(b) approve the application and plans with conditions; or

(c) deny the application and plans and will provide the applicant with the reasons for denial.

Source: Miss. Code Ann. §§ 45-45-13 and 37 (Supp. 2021)

Rule 1.31: Plan Review – Amendments

(1) If the installation or alteration has already been completed, any changes to an approved application and plans for the installation of new equipment or the alteration of existing equipment must be resubmitted in accordance with this Regulation.

(2) If the installation or alteration has not been completed, a contractor may amend a previously approved application and plans for the installation of new equipment or the alteration of existing equipment.

(3) To apply for a plan of any amendments to a previously approved plan review under subsection (2), a contractor must:

(a) submit a completed application on a department-approved form;

(b) pay the fee require by this Regulation; and

(c) submit a written description of the scope of work which shall include a description of each alteration to be performed.

(4) In addition to submitting the items under subsection (3), a contractor must submit layout drawings as specified by this Regulation for the specific type of equipment, if the alteration described in subsection (3)(c) results in one or more of the following changes:

(a) the rated speed of the equipment in feet per minute;

(b) the rated capacity of the equipment in pounds;

(c) the total travel of the equipment in feet and inches;

(d) the classification of the equipment, such as passenger elevator to freight elevator or freight elevator to passenger elevator; or

(e) the driving machine is re-located.

Source: Miss. Code Ann. §§ 45-45-13 and 37 (Supp. 2021)

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Rule 1.32: Complaints

A person may file a complaint with the Administrator by doing so in writing, setting forth a full statement of the facts concerning the alleged infraction of the elevator licensing law or rules. In the event a complaint is filed with the Administrator, the Administrator’s investigation shall not be limited to the matter set forth in the request for investigation but may extend to any act coming to the attention of the Administrator which appears to violate the law or these rules.

Source: Miss. Code Ann. § 45-45-37 (Supp. 2021)

Rule 1.33: Initiating a Complaint against a Licensee

(1) Form of complaint filing. A person may register a complaint against a mechanic or inspector licensed by the elevator Administrator by filing a written complaint with the Department of Labor. The written complaint must set forth, at a minimum, the nature, date and place of the alleged violations. The Administrator may also initiate a license review procedure on its own motion by filing a complaint with the department.

(2) Verification. Upon receipt of a complaint, the department will verify the license number of the person against whom the complaint is lodged. If the person is unlicensed and the complaint alleges criminal conduct, the department will refer the complaint to the office of the Attorney General or the Office of the District Attorney having jurisdiction over the case. If the person is a licensee of the Administrator, the department will docket the complaint and open an investigation file under the name and license number of the person.

Source: Miss. Code Ann. § 45-45-37 (Supp. 2021)

Rule 1.34: Disciplinary Proceedings

(1) The Administrator may revoke or suspend a license. This shall not preclude the Administrator from taking lesser steps, including, but not limited to formal reprimand, required education, civil penalty, etc. The Administrator may act if any one or more of the following reasons exist:

(a) Any false statement as to material matter in the application.

(b) Fraud, misrepresentation, or bribery in securing a license.

(c) Failure to notify the administrator and the owner or lessee of an elevator or related mechanism of any condition not in compliance with this chapter.

(d) Violation of any provisions of this chapter.

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(2) The Administrator may take these actions only after hearing before the Administrator upon notice and hearing to the licensee or applicant of at least twenty (20) days at the last known address appearing on the license or application, served personally or by registered mail.

Source: Miss. Code Ann. § 45-45-17 (Supp. 2021)

Rule 1.35: Appeal Procedures

(1) Any person, sole proprietor, firm, or corporation whose license is revoked, suspended or subject to civil penalty, or whose license application is denied, may appeal from such determination to the Commissioner of Insurance, which shall within thirty (30) days thereafter, hold a hearing, of which at least fifteen (15) days written notice shall be given to all interested parties. The Commissioner shall, within thirty (30) days after such hearing, issue a decision.

(2) Any person, sole proprietor, firm or corporation whose license is revoked, suspended or subject to civil penalty, or whose license application is denied after appeal to the Commissioner, may appeal such determination to the Chancery Court of the First Judicial District of Hinds County, Mississippi, within twenty (20) days of the final ruling.

Source: Miss. Code Ann. § 45-45-17 (Supp. 2021)

Rule 1.36: Administrative Penalties/Fines

(1) In assessing the penalty for code violations the administrator or administrator’s designee shall consider the seriousness of the hazard, the number of people exposed to the hazard whether or not the violation was corrected after notification of its existence, and whether the person has been disciplined for the same or similar violation previously. When a monetary penalty is assessed the fine shall not exceed the following amounts:

(a) Operating equipment without an operating certificate.

First Offense................................................................$ 250.00 Further Offenses............................................................$ 500.00

(b) Operating Equipment in unsafe condition.

First Offense................................................................$ 500.00 Further Offenses............................................................1,000.00

(c) Owner/User not allowing free access for the purpose of inspecting or investigating the equipment.

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First Offense.................................................................$ 500.00 Further Offenses............................................................$1,000.00

(d) Placing unit back in service, which has been “Red-Tagged” and placed out of service by an inspector, without first having the unit pass inspection.

Any Offense................................................................$1,500.00

(e) Turning equipment over for use without a final acceptance inspection.

Any Offense...............................................................$1,500.00

(f) Any installer who installs equipment without a permit.

Any Offense...............................................................$1,500.00

(g) Any inactive licensee that works with an expired license.

Any offense.........................................................up to $1,500.00

(h) Any other violation of adopted Code, Standards, Rules, or Regulations.

First Offense................................................................$ 250.00 Further Offenses............................................................$ 500.00

(i) Any violation of these provisions by a Building Owner.

Maximum fine per violation...........................................$1,500.00

(2) Administrative penalties issued under these rules shall not be construed to limit the authority of the administrator to issue orders, revoke permits, revoke licenses or take any other appropriate enforcement action in addition to the administrative fines.

Source: Miss. Code Ann. § 45-45-37 (Supp. 2021)

Rule 1.37: Responsibility of Liability

This Regulation shall not be construed to relieve or lessen the responsibility or liability of any person, firm, or corporation owning, operating, controlling, maintaining, erecting, constructing, installing, altering, inspecting, testing, or repairing any elevator or other related mechanism covered by this chapter for damages to person or property caused by any defect therein, nor does the state assume any such liability or responsibility therefor or any liability to any person for whatsoever reason by the enactment of this Regulation or any acts or omissions arising hereunder.

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Source: Miss. Code Ann. § 45-45-37 (Supp. 2021)

Rule 1.38: Severability

If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application, and to this end the provisions of the Regulation are declared to be severable.

Source: Miss. Code Ann. § 45-45-1, et seq. (Supp. 2021)

Rule 1.39: Effective Date

This Regulation supersedes prior versions of Mississippi Administrative Code Title 19, Part 8, Chapter 1, and shall become effective thirty (30) days after final filing in the office of the Mississippi Secretary of State.

Source: Miss. Code Ann. §§ 25-43-3.112 and 3.113 (Supp. 2021)

Part 9 Part 9: Automobile and Ride Sharing

19 Miss. Admin. Code Pt. 9 Part 9: Automobile and Ride Sharing

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Title 19

Part 9 – Automobile and Ride Sharing

Part 9, Chapter 1: Transportation Network Company Law

Rule 1.01: Promulgation and Purpose Rule 1.02: Authority Rule 1.03: Scope Rule 1.04: Definitions Rule 1.05: Distinguished from Common Carriers, Taxicab and Limousine Rule 1.06: License Required Rule 1.07: Agent for Service of Process Rule 1.08: Fare Disclosure Requirements Rule 1.09: Driver Identification Process Rule 1.10: Electronic Receipt Rule 1.11: Automobile Insurance Requirements Rule 1.12: Required Notifications to Drivers Rule 1.13: Insurers’ Authority to Exclude TNC Activity from Coverage Rule 1.14: Driver Status as Independent Contractors Rule 1.15: Zero Tolerance Policy Rule 1.16: Driver Certification Requirements Rule 1.17: Solicitation and Street Hails Prohibited Rule 1.18: Cash Payments Prohibited Rule 1.19: Nondiscrimination and Service Animal Policy Rule 1.20: Customer Records Requirement Rule 1.21: Inspection and Audit Provisions Rule 1.22: Prohibition Against Competing Regulation; Airport Exceptions Rule 1.23: Violations, Hearings, and Appeals Rule 1.24: Severability Rule 1.25: Effective Date

Rule 1.01: Promulgation and Purpose

These Rules and Regulations for Transportation Network Companies are promulgated by the Commissioner of Insurance of the State of Mississippi in accordance with the Transportation Network Company Act, Mississippi House Bill No. 1381, 2016 Regular Legislative Session, to be codified in Title 77, Chapter 8 of the Mississippi Code of 1972, as Amended, and the Mississippi Administrative Procedures Act, Miss. Code § 25-43-1, et seq., and shall become effective after adopted and promulgated in accordance with the provisions of the Mississippi Administrative Procedures Act. This Regulation is being filed as a regulation pursuant to the provisions of H. B. No. 1381, 2016 Regular Legislative Session.

The purpose of these Rules and Regulations is to provide consistent regulation of Transportation Network Companies, and their operation, throughout the State of Mississippi, and to promote the

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safe and responsible operation of such companies with respect to their dealings with the public, as well as to ensure that drivers and companies are adequately insured to provide consumers with a means to recoup losses or damages incurred.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.02: Authority

This Regulation is promulgated by the Commissioner of Insurance pursuant to the authority granted to him by Mississippi House Bill No. 1381, 2016 Regular Legislative Session., as well as the provisions of 19 Miss. Admin. Code, Part 1, Chapter 15 (Rules Regarding the Administrative Practice and Procedure before the Mississippi Insurance Department, As Amended).

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.03: Scope

This Regulation shall apply to all Transportation Network Companies and Transportation Network Drivers, as defined in Mississippi House Bill No. 1381, 2016 Regular Legislative Session, operating in the State of Mississippi.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.04: Definitions

As used in these regulations:

(a) "Personal vehicle" means a vehicle that is used by a transportation network company driver and is:

(i) Owned, leased or otherwise authorized for use by the transportation network company driver; and

(ii) Not a common carrier by motor vehicle, contract carrier by motor vehicle, or restricted motor carrier under Chapter 7, Title 77, Mississippi Code of 1972.

(b) "Commissioner" means the Commissioner of Insurance.

(c) "Department" means the Mississippi Department of Insurance.

(d) "Digital network" means any online-enabled technology application service, website or system offered or utilized by a transportation network company that enables the prearrangement of rides with transportation network company drivers.

(e) "Transportation network company" means a corporation, partnership, sole proprietorship, or other entity that is licensed under this act and operating in Mississippi that uses

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a digital network to connect transportation network company riders to transportation network company drivers who provide prearranged rides. A transportation network company shall not be deemed to control, direct or manage the personal vehicles or transportation network company drivers that connect to its digital network, except where agreed to by written contract.

(f) "Transportation network company driver" or "driver" means an individual who:

(i) Receives connections to potential passengers and related services from a transportation network company in exchange for payment of a fee to the transportation network company; and

(ii) Uses a Personal Vehicle to offer or provide a prearranged ride to riders upon connection through a digital network controlled by a transportation network company in return for compensation or payment of a fee.

(g) "Transportation network company rider" or "rider" means an individual or persons who use a transportation network company's digital network to connect with a transportation network driver who provides prearranged rides to the rider in the driver's personal vehicle between points chosen by the rider.

(h) "Prearranged ride" means the provision of transportation by a driver to a rider, beginning when a driver accepts a ride requested by a rider through a digital network controlled by a transportation network company, continuing while the driver transports a requesting rider, and ending when the last requesting rider departs from the personal vehicle. A prearranged ride does not include transportation provided using a common carrier by motor vehicle, contract carrier by motor vehicle, or restricted motor carrier under Chapter 7, Title 77, Mississippi Code of 1972. A prearranged ride does not include shared expense carpool arrangements or vanpooling as defined in Section 77-7-7, or any other type of arrangement or service in which the driver receives a fee that does not exceed the driver's costs associated with providing the ride.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.05: Distinguished from Common Carriers, Taxicab and Limousine

Transportation network companies or transportation network company drivers are not common carriers by motor vehicle, contract carriers by motor vehicle, or restricted motor carriers under Chapter 7, Title 77, Mississippi Code of 1972, nor do they provide taxicab or limousine services. A transportation network company driver shall not be required to register the vehicle the driver uses to provide prearranged rides as a commercial vehicle.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.06: License Required

(1) A person shall not operate a transportation network company in Mississippi without first having obtained a license from the department.

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(2) The Department shall issue a license to each applicant that meets the requirements for a transportation network company as provided for in the Transportation Network Company Act and these regulations, and pays an annual license fee of Five Thousand Dollars ($5,000.00) to the department.

(3) License applicants are to use the application prescribed and furnished by the Mississippi Insurance Department. License applicants may obtain licensing information and instructions at the Department’s website at the following link: http://www.mid.ms.gov.

(4) Licenses issued shall authorize the applicant to operate within the State of Mississippi, and shall be effective on the date of issue for a period beginning on October 1 through September 30 of the following year (the “License Period”). The license fee shall not be prorated in the event an applicant holds the license for only a portion of the License Period. License applications and renewals will be processed electronically via SIRCON or by paper. The license issued shall expire on September 30 unless properly renewed by obtaining a license for the subsequent License Period. License renewal notices will be mailed approximately 60 days prior to the license expiration.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.07: Agent for Service of Process

Each transportation network company shall maintain an agent for service of process in the State of Mississippi.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.08: Fare Disclosure Requirements

On behalf of a transportation network company driver, a transportation network company may charge a fare for the services provided to riders; however, if a fare is collected from a rider, the transportation network company shall disclose to the rider the fare or fare calculation method on its website or within the online-enabled technology application service. The transportation network company shall also provide riders with the applicable rates being charged and the option to receive an estimated fare before the rider enters the transportation network company driver's vehicle.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.09: Driver Identification Process

The transportation network company's online-enabled technology application or website shall display a picture of the transportation network company driver, and the license plate number of the motor vehicle utilized for providing the prearranged ride before the rider enters the transportation network company driver's vehicle.

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Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.10: Electronic Receipt

Within a reasonable period of time following the completion of a trip, a transportation network company shall transmit an electronic receipt to the rider on behalf of the transportation network company driver that lists:

(a) The origin and destination of the trip;

(b) The total time and distance of the trip; and

(c) An itemization of the total fare paid, if any.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.11: Automobile Insurance Requirements

(1) On or before the effective date of this act and thereafter, a transportation network company driver or transportation network company on the driver's behalf shall maintain primary automobile insurance that recognizes that the driver is a transportation network company driver or otherwise uses a vehicle to transport passengers for compensation and covers the driver:

(a) While the driver is logged on to the transportation network company's digital network; or (b) While the driver is engaged in a prearranged ride.

(2) A participating transportation network company driver who is logged on to the transportation network company's digital network and is available to receive transportation requests but is not engaged in a prearranged ride shall be covered by primary automobile liability insurance in the amount of at least Fifty Thousand Dollars ($50,000.00) for death and bodily injury per person, One Hundred Thousand Dollar ($100,000.00) for death and bodily injury per incident and Twenty-five Thousand Dollars ($25,000.00) for property damage and uninsured motorist to the extent required by Section 83-11-101.

(3) The coverage requirements of subsection (2) of this section may be satisfied by any of the following:

(a) Automobile insurance maintained by the transportation network company driver; or

(b) Automobile insurance maintained by the transportation network company; or

(c) Any combination of paragraphs (a) and (b) of this subsection.

(4) (a) While a transportation network company driver is engaged in a prearranged ride he must be covered by a primary automobile liability insurance that provides at least One Million Dollars

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($1,000,000.00) for death, bodily injury and property damage and uninsured motorist to the extent required by Section 83-11-101.

(b) The coverage requirements of this subsection may be satisfied by any of the following:

(i) Automobile insurance maintained by the transportation network company driver; or

(ii) Automobile insurance maintained by the transportation network company; or

(iii) Any combination of paragraphs (a) and (b) of this subsection.

(5) If insurance maintained by driver in subsections (3) or (4) of this section has lapsed or does not provide the required coverage, insurance maintained by a transportation network company shall provide the coverage required by this section beginning with the first dollar of a claim and the insurer shall have the duty to defend such claim.

(6) Coverage under an automobile insurance policy maintained by the transportation network company shall not be dependent on a personal automobile insurer first denying a claim nor shall a personal automobile insurance policy be required to first deny a claim.

(7) Insurance required by this section may be placed with an insurer licensed to do business in Mississippi or with a surplus lines insurer eligible under Miss. Code § 83-21-17 et seq.

(8) Insurance satisfying the requirements of this section shall be deemed to satisfy the financial responsibility requirement for a motor vehicle under the Mississippi Motor Vehicle Safety Responsibility Law, Miss. Code § 63-15-1 et seq.

(9) A transportation network company driver shall carry proof of coverage satisfying this section with him or her at all times during his or her use of a vehicle in connection with a transportation network company's digital network. In the event of an accident, a transportation network company driver shall provide this insurance coverage information to the directly interested parties, automobile insurers and investigating police officers, upon request. Upon a request, a transportation network company driver shall also disclose to directly interested parties, automobile insurers, and investigating police officers, whether he or she was logged on to the transportation network company's digital network or on a prearranged ride at the time of an accident.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.12: Required Notifications to Drivers

The transportation network company shall disclose in writing to transportation network company drivers the following before they are allowed to accept a request for a prearranged ride on the transportation network company's digital network:

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(a) The insurance coverage, including the types of coverage and the limits for each coverage, that the transportation network company provides while the transportation network company driver uses a personal vehicle in connection with a transportation network company's digital network; and

(b) That the transportation network company driver's own automobile insurance policy might not provide any coverage while the driver is logged on to the transportation network company's digital network and is available to receive transportation requests or is engaged in a prearranged ride, depending on its terms.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.13: Insurers’ Authority to Exclude TNC Activity from Coverage

(1) Insurers that write automobile insurance in Mississippi may exclude any and all coverage afforded under the policy issued to an owner or operator of a personal vehicle for any loss or injury that occurs while a driver is logged on to a transportation network company's digital network or while a driver provides a prearranged ride. This right to exclude all coverage may apply to any coverage included in an automobile insurance policy including, but not limited to:

(a) Liability coverage for bodily injury and property damage;

(b) Uninsured and underinsured motorist coverage;

(c) Medical payments coverage;

(d) Comprehensive physical damage coverage; and

(e) Collision physical damage coverage.

(2) The exclusions provided for in subsection (1) of this section shall apply notwithstanding any requirement under the Mississippi Motor Vehicle Safety Responsibility Law Section, Miss. Code § 63-15-1 et seq. Nothing in this section implies or requires that a personal automobile insurance policy provide coverage while the driver is logged on to the transportation network company's digital network, while the driver is engaged in a prearranged ride or while the driver otherwise uses a vehicle to transport passengers for compensation. Nothing shall preclude an insurer from providing coverage for the transportation network company driver's vehicle, if it chooses to do so by contract or endorsement.

(3) Automobile insurers that exclude the coverage described in Mississippi House Bill No. 1381, 2016 Regular Legislative Session, shall have no duty to defend or indemnify any claim expressly excluded. Nothing in this act shall invalidate or limit an exclusion contained in a policy including any policy in use or approved for use in Mississippi prior to the effective date of this act that excludes coverage for vehicles used to carry persons or property for a charge or available for hire by the public. An automobile insurer that defends or indemnifies a claim against a driver that is excluded under the terms of its policy, shall have a right of contribution against other

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insurers that provide automobile insurance to the same driver in satisfaction of the coverage requirements of Mississippi House Bill No. 1381, 2016 Regular Legislative Session, at the time of loss.

(4) In a claims coverage investigation, transportation network companies and any insurer providing coverage under Mississippi House Bill No. 1381, 2016 Regular Legislative Session, shall cooperate to facilitate the exchange of relevant information with directly involved parties and any insurer of the transportation network company driver if applicable, including the precise times that a transportation network company driver logged on and off of the transportation network company's digital network in the twelve-hour period immediately preceding and in the twelve-hour period immediately following the accident and disclose to one another a clear description of the coverage, exclusions and limits provided under any automobile insurance maintained under Mississippi House Bill No. 1381, 2016 Regular Legislative Session and Rule 1.11 of these regulations.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.14: Driver Status as Independent Contractors

Drivers shall be independent contractors and not employees of the transportation network company if all of the following conditions are met:

(a) The transportation network company does not prescribe specific hours during which a transportation network company driver must be logged into the transportation network company's digital platform;

(b) The transportation network company imposes no restrictions on the transportation network company driver's ability to utilize digital platforms from other transportation network companies;

(c) The transportation network company does not assign a transportation network company driver a particular territory in which to operate;

(d) The transportation network company does not restrict a transportation network company driver from engaging in any other occupation or business; and

(e) The transportation network company and transportation network company driver agree in writing that the driver is an independent contractor of the transportation network company.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.15: Zero Tolerance Policy

(1) The transportation network company shall implement a zero tolerance policy regarding a transportation network company driver's activities while accessing the transportation network company's digital platform. The zero tolerance policy shall address the use of drugs or alcohol

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while a transportation network company driver is providing prearranged rides or is logged into the transportation network company's digital network but is not providing prearranged rides, and the transportation network company shall provide notice of this policy on its website, as well as procedures to report a complaint about a driver with whom a rider was matched and whom the rider reasonably suspects was under the influence of drugs or alcohol during the course of the trip.

(2) Upon receipt of such rider complaint alleging a violation of the zero tolerance policy, the transportation network company shall suspend such transportation network company driver's access to the transportation network company's digital platform as soon as possible, and shall conduct an investigation into the reported incident. The suspension shall last the duration of the investigation.

(3) The transportation network company shall maintain records relevant to the enforcement of this requirement for a period of at least two (2) years from the date that a rider complaint is received by the transportation network company.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.16: Driver Certification Requirements

(1) Before allowing an individual to accept trip requests through a transportation network company's digital platform as a transportation network company driver:

(a) The individual shall submit an application to the transportation network company, which includes information regarding his or her address, age, driver's license, motor vehicle registration, automobile liability insurance, and other information required by the transportation network company;

(b) The transportation network company shall conduct, or have a third party conduct, a local and national criminal background check for each applicant that shall include:

(i) Multistate/multijurisdiction criminal records locator or other similar commercial nationwide database with validation (primary source search); and

(ii) United States Department of Justice National Sex Offender Public Website;

(2) The transportation network company shall review, or have a third party review, a driving history research report for such individual.

(3) The transportation network company shall not permit an individual to act as a transportation network company driver on its digital platform who:

(a) Has had more than three (3) moving violations in the prior three-year period, or one (1) of the following major violations in the prior three-year period:

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(i) Attempting to evade the police;

(ii) Reckless driving; or

(iii) Driving on a suspended or revoked license;

(b) Has been convicted, within the past seven years, of

(i) Any felony; or

(ii) Misdemeanor driving under the influence, reckless driving, hit and run, or any other driving-related offense or any misdemeanor violent offense or sexual offense;

(c) Is a match in the U.S. Department of Justice National Sex Offender Public Website;

(d) Does not possess a valid driver's license;

(e) Does not possess proof of registration for the motor vehicle used to provide prearranged rides;

(f) Does not possess proof of automobile liability insurance for the motor vehicle used to provide prearranged rides; or

(g) Is not at least nineteen (19) years of age.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.17: Solicitation and Street Hails Prohibited

A transportation network company driver shall not solicit or accept street hails.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.18: Cash Payments Prohibited

The transportation network company shall adopt a policy prohibiting solicitation or acceptance of cash payments for the fares charged to riders for prearranged rides and notify transportation network company drivers of the policy. Transportation network company drivers shall not solicit or accept cash payments from riders.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.19: Nondiscrimination and Service Animal Policy

(1) The transportation network company shall adopt a policy of nondiscrimination with respect to riders and potential riders and notify transportation network company drivers of the policy.

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(2) Transportation network company drivers shall comply with all applicable laws regarding nondiscrimination against riders or potential riders.

(3) Transportation network company drivers shall comply with all applicable laws relating to accommodation of service animals.

(4) A transportation network company shall not impose additional charges for providing services to persons with physical disabilities because of those disabilities.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.20: Customer Records Requirement

A transportation network company shall maintain the following customer records:

(a) Individual trip records for at least one (1) year from the date each trip was provided; and (b) Individual records of transportation network company driver customers at least until the one-year anniversary of the date on which a transportation network company driver's customer relationship with the transportation network company has ended.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.21: Inspection and Audit Provisions

(1) For the sole purpose of verifying that a transportation network company is in compliance with the requirements of this act and not more than annually, the commissioner shall have the right to visually inspect a sample of records that the transportation network company is required to maintain. The sample shall include required records pertaining to up to fifty (50) transportation network drivers, provided that the transportation network company shall undertake best efforts not to share records about the same transportation network company driver during consecutive reporting periods. If, after this initial review, the commissioner has a reasonable basis to conclude that the transportation network company is not in compliance with the requirements of this act, the commissioner may, upon reasonable notice, conduct a supplemental audit of records for an additional selection of transportation network company drivers. The audit shall take place at a mutually agreed location in Mississippi. The expenses of the examination shall be borne and paid by the transportation network company that is under examination.

(2) Documents, materials or other information, including, but not limited to, all working papers, and copies thereof, created, produced or obtained by or disclosed to the commissioner or any other person in the course of an examination made under this act shall be confidential by law and privileged, and shall not be subject to the Mississippi Public Records Act. The commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties.

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(3) In order to assist in the performance of the commissioner's duties, the commissioner may share confidential and privileged documents, materials or other information, with other state, federal and international regulatory agencies, and with state, federal and international law enforcement authorities, provided that the recipient agrees to maintain the confidentiality and privileged status of the document, material, communication or other information. The commissioner may enter into agreements governing the sharing and use of information consistent with this subsection.

(4) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in subsection (3) of this section.

(5) In response to a specific complaint against any transportation network company driver or transportation network company, the commissioner is authorized to inspect records held by the transportation network company that are necessary to investigate and resolve the complaint.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.22: Prohibition Against Competing Regulation; Airport Exceptions

(1) Transportation network companies and transportation network company drivers are governed exclusively by the Transportation Network Company Act, Mississippi House Bill No. 1381, 2016 Regular Legislative Session, and these rules promulgated by the commissioner consistent with said act. A county, municipality or other local entity may not:

(a) Impose a tax on, or require a license for, a transportation network company, a transportation network company driver or a vehicle used by a transportation network company driver where the tax or licenses relate to providing prearranged rides;

(b) Require a transportation network company or a transportation network company driver to obtain a business license or any other type of similar authorization to operate within the jurisdiction; or

(c) Subject a transportation network company or a transportation network company driver to any type of rate, entry, operational or other requirements.

(2) Notwithstanding subsection (1) of this section, a county, municipality or other local entity that owns or operates an airport, may adopt reasonable regulations relating to the duties and responsibilities on airport property of a transportation network company or transportation network company driver, including its ability to impose reasonable fees and vehicle tracking requirements on a transportation network company or its affiliated transportation network company drivers, but excluding its ability to impose other fees, taxes, registration, licensing or special insurance requirements on transportation network company drivers, and excluding its ability to impose requirements with respect to special markings or identification other than that provided for in Mississippi House Bill No. 1381, 2016 Regular Legislative Session, and Rule 1.09 of these regulations, and excluding its ability to impose requirements for equipment.

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Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.23: Violations, Hearings, and Appeals

(1) Failure of an applicant or licensee to comply with a material provision of the Transportation Network Company Act or this regulation is considered a violation of applicable laws. The Commissioner of Insurance may deny a license application or suspend or revoke a license, after giving notice of hearing to the applicant or licensee by serving a written statement of charges on the licensee or its registered agent at least twenty (20) days prior to a hearing, for any violation of the Transportation Network Company Act, Mississippi House Bill No. 1381, 2016 Regular Legislative Session, or this Regulation. Service shall be deemed accomplished three (3) days after the date of mailing, via certified mail, of the notice of hearing by the Mississippi Insurance Department, addressed to the licensee or its registered agent. In the case of personal delivery, service shall be deemed accomplished on the date of personal delivery to the licensee or its registered agent. The Mississippi Insurance Department is not required to provide a court reporter to make a record of the testimony given at the hearing, and the record of testimony may be taken through audio recording or other appropriate means, which may be transcribed by employees of the Mississippi Insurance Department, and will constitute the record of testimony in the event of an appeal. Any respondent may provide its own method of recording testimony, including retaining a court reporter, at the respondent’s own expense.

(2) The rules of order and procedure for any hearing held pursuant to subpart 1 of this Rule shall be in accordance with 19 Miss. Admin. Code, Part 1, Chapter 15 (Rules Regarding the Administrative Practice and Procedure before the Mississippi Insurance Department), unless in conflict with the specific provisions of this regulation.

(3) Any Transportation Network Company who is a party to any hearing before the Commissioner and who is aggrieved by any decision of the Commissioner with respect to any hearing before him, shall have the right of appeal to the Circuit Court of Hinds County, Mississippi, pursuant to the provisions of the Mississippi Uniform Circuit and County Court Rules. All such appeals shall be appeals on the record, including a transcript of pleadings and evidence, both oral and documentary, heard and filed before the commissioner.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Rule 1.24: Severability

If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application, and to this end the provisions of the Regulation are declared to be severable.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

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Rule 1.25: Effective Date

The Effective Date of this Regulation shall be October 1, 2016.

Source: Mississippi House Bill No. 1381, 2016 Regular Legislative Session.

Part 9, Chapter 2: Peer-to-Peer Car Sharing Program Rules and Regulations

Rule 1.01: Promulgation and Purpose Rule 1.02: Authority Rule 1.03: Scope Rule 1.04: Definitions Rule 1.05: Permit Required Rule 1.06: Agent for Service of Process Rule 1.07: Insurance coverage during car sharing period Rule 1.08: Notification of implications of lien Rule 1.09: Exclusions in motor vehicle liability insurance policies Rule 1.10: Recordkeeping; use of vehicle in car sharing Rule 1.11: Vicarious liability Rule 1.12: Contribution against indemnification Rule 1.13: Insurable interest Rule 1.14: Consumer protection disclosures Rule 1.15: Driver's license verification and data retention Rule 1.16: Responsibility for equipment Rule 1.17: Automobile safety recalls Rule 1.18: Inspection of Records and Response to Complaints Rule 1.19: Violations, Hearings, and Appeals Rule 1.20: Severability Rule 1.21: Effective Date

Rule 1.01: Promulgation and Purpose

(1) These Rules and Regulations for Peer-to-Peer Car Sharing Programs are promulgated by the Commissioner of Insurance of the State of Mississippi in accordance with the Peer-to-Peer Car Sharing Program Act, Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session, to be codified in Title _____, Chapter ______ of the Mississippi Code of 1972, as Amended, and the Mississippi Administrative Procedures Act, Miss. Code § 25-43-1, et seq., and shall become effective after adopted and promulgated in accordance with the provisions of the Mississippi Administrative Procedures Act. This Regulation is being filed as a regulation pursuant to the provisions of S. B. No. 2530, 2024 Regular Legislative Session.

(2) The purpose of these Rules and Regulations is to create a framework for the administration and enforcement of the provisions of the Mississippi Peer-to-Peer Car Sharing Program Act consistent with the statutory provisions established by the Mississippi Legislature.

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Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.02: Authority

This Regulation is promulgated by the Commissioner of Insurance pursuant to the authority granted to him by Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session., as well as the provisions of 19 Miss. Admin. Code, Part 1, Chapter 15 (Rules of Practice and Procedure before the Mississippi Insurance Department and State Fire Marshal’s Office, As Amended).

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.03: Scope

This Regulation shall apply to all Peer-to-Peer Car Sharing Programs, as defined in Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session, operating in the State of Mississippi.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.04: Definitions

As used in these regulations, the following terms shall have the meanings defined herein unless the context clearly indicates otherwise:

(a) "Car sharing delivery period" means the period of time during which a shared vehicle is being delivered to the location of the car sharing start time, if applicable, as documented by the governing car sharing program agreement.

(b) "Car sharing period" means the period of time that commences with the car sharing delivery period or, if there is no car sharing delivery period, the period of time that commences with the car sharing start time and in either case ends at the car sharing termination time.

(c) "Car sharing program agreement" means the terms and conditions applicable to a shared vehicle owner and a shared vehicle driver that governs the use of a shared vehicle through a peer-to-peer car sharing program.

(d) "Car sharing start time" means the time when the shared vehicle becomes subject to the control of the shared vehicle driver at or after the time the reservation of a shared vehicle is scheduled to begin as documented in the records of a peer–to–peer car sharing program.

(e) "Car sharing termination time" means the earliest of the following events:

(i) The expiration of the agreed upon period of time established for the use of a shared vehicle according to the terms of the car sharing program agreement if the shared

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vehicle is delivered to the location agreed upon in the car sharing program agreement;

(ii) When the shared vehicle is returned to a location as alternatively agreed upon by the shared vehicle owner and shared vehicle driver as communicated through a peer–to–peer car sharing program, which alternatively agreed upon location shall be incorporated into the car sharing program agreement; or

(iii) When the shared vehicle owner or the shared vehicle owner's authorized designee, takes possession and control of the shared vehicle.

(f) “Department” means the Mississippi Department of Insurance. “Commissioner” means the Commissioner of Insurance.

(g) "Peer-to-peer car sharing" means the authorized use of a vehicle by an individual other than the vehicle's owner through a peer–to–peer car sharing program. This term shall not be construed to mean rental car or rental activity.

(h) "Peer-to-peer car sharing program" means a business platform that connects vehicle owners with drivers to enable the sharing of vehicles for financial consideration. This term shall not mean rental car company. An individual or business entity lawfully engaging in a peer–to–peer car sharing program shall not be considered as any of the following:

(i) As a "rental company" as that term is defined in Section 27-19-40(4);

(ii) As being engaged in renting a motor vehicle to another within the meaning of Section 63-1-67;

(iii) As a "transportation network company" as that term is defined in Section 77-8-1; or

(iv) As being engaged in the business of renting 85 motor vehicles under rental agreements within the meaning of Section 75-24-8.

(i) “Person” as used herein shall include individuals, groups of persons, partnerships, corporations, and legal entities of any type.

(j) "Shared vehicle" means a vehicle that is available for sharing through a peer-to-peer car sharing program.

(k) "Shared vehicle driver" means an individual who has been authorized to drive the shared vehicle by the shared vehicle owner under a car sharing program agreement.

(l) "Shared vehicle owner" means the registered owner, or a person or entity designated by the registered owner, of a vehicle made available for sharing to shared vehicle drivers

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through a peer-to-peer car sharing program. A shared vehicle owner shall not mean a person "renting a motor vehicle to another" as that activity is described in Section 63-1- 67. A shared vehicle owner is not "engaged in the business of renting motor vehicles under rental agreements" within the meaning of Section 75-24-8.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.05: Permit Required

(1) A person shall not operate a peer-to-peer car sharing program in Mississippi without first having obtained a permit from the Mississippi Department of Insurance.

(2) The Department shall issue a permit to each applicant that meets the requirements for a peer- to-peer car sharing program as provided for in the Peer-to-Peer Car Sharing Program Act and these regulations.

(3) Permit applicants are to use the application prescribed and furnished by the Mississippi Department of Insurance. Permit applicants may obtain information and instructions at the Department’s website at the following link: https://www.mid.ms.gov.

(4) Permits issued shall authorize the applicant to operate within the State of Mississippi, and shall be effective on the date of issue for a period beginning on January 1 through December 31 of the year of issuance (“Permit Period”). Permit applications and renewals will be processed electronically via SIRCON or by paper. Applicants applying electronically shall be responsible for payment of any fees due for the Electronic Government Oversight Committee (EOC fee) and for use of SIRCON. There is no fee charged for applicants using the “paper” option. The permit issued shall expire on December 31 unless properly renewed by obtaining a permit for the subsequent Permit Period. No renewal notices will be mailed prior to the permit expiration.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.06: Agent for Service of Process

Each peer-to-peer car sharing program shall maintain an agent for service of process in the State of Mississippi. Corporate entities must be registered with the Mississippi Secretary of State as required by the Mississippi Business Corporation Act in Title 79 of the Mississippi Code of 1972, as amended.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.07: Insurance coverage during car sharing period.

(1) Except as provided in subsection (2) of this section, a peer-to-peer car sharing program shall assume liability of a shared vehicle owner for bodily injury or property damage to third

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parties, or uninsured and underinsured motorist losses, during the car sharing period in an amount stated in the peer-to-peer car sharing program agreement, provided that the amount shall not be less than that set forth in Section 63-15-43.

(2) Notwithstanding the definition of "car sharing termination time" as set forth in this act, the assumption of liability under subsection (1) of this section shall not apply to any shared vehicle owner when:

(a) A shared vehicle owner makes an intentional or fraudulent material misrepresentation or omission to the peer-to-peer car sharing program before the car sharing period in which the loss occurred; or

(b) Acting in concert with a shared vehicle driver who fails to return the shared vehicle pursuant to the terms of the car sharing program agreement.

(3) Notwithstanding the definition of "car sharing termination time" as set forth in this act, the assumption of liability under subsection (1) of this section shall include any bodily injury or property damage losses by damaged third parties, or uninsured and underinsured motorist losses, as required by Section 63-15-1 et seq.

(4) A peer-to-peer car sharing program shall ensure that, during each car sharing period, the shared vehicle owner and the shared vehicle driver are insured under a motor vehicle liability insurance policy that provides insurance coverage in amounts no less than the minimum amounts set forth in Section 63-15-43; and

(a) Recognizes that the shared vehicle insured under 132 the policy is made available and used through a peer-to-peer car 133 sharing program; or

(b) Does not exclude use of a shared vehicle by a shared vehicle driver.

(5) The insurance described under subsection (4) of this section may be satisfied by motor vehicle liability insurance maintained by:

(a) A shared vehicle owner;

(b) A shared vehicle driver;

(c) A peer-to-peer car sharing program; or

(d) Both a shared vehicle owner, a shared vehicle driver and a peer-to-peer car sharing program.

(6) The insurance described in subsection (5) of this section that is satisfying the insurance requirement of subsection (4) of this section shall be primary during each car sharing period, and in the event that a claim occurs in another state with minimum financial responsibility limits higher than the minimum amounts set forth in Section 63-15-43, during the car sharing period,

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the coverage maintained under subsection (5) shall satisfy the difference in minimum coverage amounts, up to the applicable policy limits.

(7) The insurer, insurers or peer-to-peer car sharing program providing coverage under subsection (4) or (5) of this section shall assume primary liability for a claim when:

(a) A dispute exists as to who was in control of the shared motor vehicle at the time of the loss and the peer-to-peer car sharing program does not have available, did not retain or fails to provide the information required by Section 8 of this act; or

(b) A dispute exists as to whether the shared vehicle was returned to the alternatively agreed upon location.

(8) If insurance maintained by a shared vehicle owner or shared vehicle driver in accordance with subsection (5) of this section has lapsed or does not provide the required coverage, insurance maintained by a peer-to-peer car sharing program shall provide the coverage required by subsection (4) of this section beginning with the first dollar of a claim and have the duty to defend such claim except under circumstances as set forth in subsection (2) of this section.

(9) Coverage under an automobile insurance policy maintained by the peer-to-peer car sharing program shall not be dependent on another automobile insurer first denying a claim nor shall another automobile insurance policy be required to first deny a claim.

(10) Nothing in this act:

(a) Limits the liability of the peer-to-peer car sharing program for any act or omission of the peer-to-peer car sharing program itself that results in injury to any person as a result of the use of a shared vehicle through a peer-to-peer car sharing program; or

(b) Limits the ability of the peer-to-peer car sharing program to, by contract, seek indemnification from the shared vehicle owner or the shared vehicle driver for economic loss sustained by the peer-to-peer car sharing program resulting from a breach of the terms and conditions of the car sharing program agreement. Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.08: Notification of implications of lien.

At the time when a vehicle owner registers as a shared vehicle owner on a peer-to-peer car sharing program and before the time when the shared vehicle owner makes a shared vehicle available for car sharing on the peer-to-peer car sharing program, the peer-to-peer car sharing program shall notify the shared vehicle owner that, if the shared vehicle has a lien against it, the use of the shared vehicle through a peer-to-peer car sharing program, including use without physical damage coverage, may violate the terms of the contract with the lienholder.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

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Rule 1.09: Exclusions in motor vehicle liability insurance policies.

(1) An authorized insurer that writes motor vehicle liability insurance in the state may exclude any and all coverage and the duty to defend or indemnify for any claim afforded under a shared vehicle owner's motor vehicle liability insurance policy, including, but not limited to:

(a) Liability coverage for bodily injury and property damage;

(b) Uninsured and underinsured motorist coverage;

(c) Medical payments coverage;

(d) Comprehensive physical damage coverage; and

(e) Collision physical damage coverage.

(2) Nothing in this act:

(a) Invalidates or limits an exclusion contained in a motor vehicle liability insurance policy, including any insurance policy in use or approved for use that excludes coverage for motor vehicles made available for rent, sharing or hire or for any business use;

(b) Invalidates, limits or restricts an insurer's ability under existing law to underwrite any insurance policy; or

(c) Invalidates, limits or restricts an insurer's ability under existing law to cancel and nonrenew policies.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.10: Recordkeeping; use of vehicle in car sharing. A peer-to-peer car sharing program shall collect and verify records pertaining to the use of a vehicle, including, but not limited to, times used, car sharing period pick-up and drop-off locations, fees paid by the shared vehicle driver and revenues received by the shared vehicle owner and provide that information upon request to the shared vehicle owner, the shared vehicle owner's insurer or the shared vehicle driver's insurer to facilitate a claim coverage investigation, settlement, negotiation or litigation. The peer-to-peer car sharing program shall retain the records for a time period not less than the three-year limitation under Section 15-1-49.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.11: Vicarious liability. A peer-to-peer car sharing program and a shared vehicle owner shall be exempt from vicarious liability consistent with 49 USC Section 30106 and under any state or local law that imposes liability solely based on vehicle ownership.

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Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.12: Contribution against indemnification. A motor vehicle insurer that defends or indemnifies a claim against a shared vehicle that is excluded under the terms of its policy shall have the right to seek recovery against the motor vehicle insurer of the peer-to-peer car sharing program if the claim is:

(a) Made against the shared vehicle owner or the shared vehicle driver for loss or injury that occurs during the car sharing period; and

(b) Excluded under the terms of its policy.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.13: Insurable interest.

(1) Notwithstanding any other law, statute, rule or regulation to the contrary, a peer-to-peer car sharing program shall have an insurable interest in a shared vehicle during the car sharing period.

(2) Nothing in this section creates liability on a peer-to-peer car sharing program to maintain the coverage mandated by Section 3 of this act.

(3) A peer–to–peer car sharing program may own and maintain as the named insured one or more policies of motor vehicle liability insurance that provides coverage for:

(a) Liabilities assumed by the peer–to–peer car sharing program under a peer–to–peer car sharing program agreement;

(b) Any liability of the shared vehicle owner; or

(c) Damage or loss to the shared motor vehicle or any liability of the shared vehicle driver.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.14: Consumer protection disclosures.

(1) Each car sharing program agreement made in the state shall disclose to the shared vehicle owner and the shared vehicle driver:

(a) Any right of the peer-to-peer car sharing program to seek indemnification from the shared vehicle owner or the shared vehicle driver for economic loss sustained by the peer-to-peer car sharing program resulting from a breach of the terms and conditions of the car sharing program agreement;

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(b) That a motor vehicle liability insurance policy issued to the shared vehicle owner for the shared vehicle or to the shared vehicle driver does not provide a defense or indemnification for any claim asserted by the peer-to-peer car sharing program;

(c) That the peer-to-peer car sharing program's insurance coverage on the shared vehicle owner and the shared vehicle driver is in effect only during each car sharing period and that, for any use of the shared vehicle by the shared vehicle driver after the car sharing termination time, the shared vehicle driver and the shared vehicle owner may not have insurance coverage;

(d) The daily rate, fees, and if applicable, any insurance or protection package costs that are charged to the shared vehicle owner or the shared vehicle driver;

(e) That the shared vehicle owner's motor vehicle liability insurance may not provide coverage for a shared vehicle;

(f) An emergency telephone number to personnel capable of fielding roadside assistance and other customer service inquiries; and

(g) If there are conditions under which a shared vehicle driver must maintain a personal automobile insurance policy with certain applicable coverage limits on a primary basis in order to book a shared motor vehicle.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.15: Driver's license verification and data retention.

(1) A peer-to-peer car sharing program may not enter into a peer-to-peer car sharing program agreement with a driver unless the driver who will operate the shared vehicle:

(a) Holds a driver's license issued under Section 63-1-5 that authorizes the driver to operate vehicles of the class of the shared vehicle; or

(b) Is a nonresident who:

(i) Has a driver's license issued by the state or country of the driver's residence that authorizes the driver in that state or country to drive vehicles of the class of the shared vehicle; and

(ii) Is at least the same age as that required of a resident to drive; or

(c) Otherwise is specifically authorized under Title 63, Chapter 1, Mississippi Code of 1972, to drive vehicles of the class of the shared vehicle.

(2) A peer-to-peer car sharing program shall keep a record of:

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(a) The name and address of the shared vehicle driver;

(b) The number of the driver's license of the shared vehicle driver and each other person, if any, who will operate the shared vehicle; and

(c) The place of issuance of the driver's license.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.16: Responsibility for equipment. A peer-to-peer car sharing program shall have sole responsibility for any equipment, such as a GPS system or other special equipment that is put in or on the vehicle to monitor or facilitate the car sharing transaction, and shall agree to indemnify and hold harmless the vehicle owner for any damage to or theft of such equipment during the sharing period not caused by the vehicle owner. The peer-to-peer car sharing program has the right to seek indemnity from the shared vehicle driver for any loss or damage to such equipment that occurs during the sharing period.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.17: Automobile safety recalls.

(1) At the time when a vehicle owner registers as a shared vehicle owner on a peer-to-peer car sharing program and before the time when the shared vehicle owner makes a shared vehicle available for car sharing on the peer-to-peer car sharing program, the peer-to-peer car sharing program shall:

(a) Verify that the shared vehicle does not have any safety recalls on the vehicle for which the repairs have not been made; and

(b) Notify the shared vehicle owner of the requirements under subsection (2) of this section.

(2)

(a) If the shared vehicle owner has received an actual notice of a safety recall on the vehicle, a shared vehicle owner shall not make a vehicle available as a shared vehicle on a peer- to-peer car sharing program until the safety recall repair has been made.

(b) If a shared vehicle owner receives an actual notice of a safety recall on a shared vehicle while the shared vehicle is made available on the peer-to-peer car sharing program, the shared vehicle owner shall remove the shared vehicle as available on the peer-to-peer car sharing program, as soon as practicably possible after receiving the notice of the safety recall and until the safety recall repair has been made.

(c) If a shared vehicle owner receives an actual notice of a safety recall while the shared vehicle is being used in the possession of a shared vehicle driver, as soon as practicably possible after receiving the notice of the safety recall, the shared vehicle owner shall

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notify the peer-to-peer car sharing program about the safety recall so that the shared vehicle owner may address the safety recall repair.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.18: Inspection of Records and Response to Complaints

(1) For the sole purpose of verifying that a peer-to-peer car sharing program is in compliance with the requirements of the Peer-to-Peer Car Sharing Program Act, the Mississippi Department of Insurance shall have the right to visually inspect records that the peer-to-peer car sharing program is required to maintain. Upon reasonable notice, records requested by the Mississippi Department of Insurance shall be made available for review at the Offices of the Mississippi Department of Insurance or some other mutually agreed upon location in the State of Mississippi. The expenses of any examination shall be borne and paid by the peer-to-peer car sharing program that is under examination.

(2) In response to a specific complaint against any peer-to-peer car sharing program, shared vehicle owner, and/or shared vehicle driver, the Mississippi Department of Insurance is authorized to inspect records held by the peer-to-peer car sharing program that are necessary to investigate and resolve the complaint.

(3) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this section.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.19: Violations, Hearings, and Appeals

(1) Failure of an applicant or licensee to comply with a material provision of the Peer-to-Peer Car Sharing Program Act or this regulation is considered a violation of applicable laws. The Commissioner of Insurance may deny a permit application or suspend or revoke a permit, after giving notice of hearing to the applicant or permittee by serving a written statement of charges on the permittee or its registered agent at least twenty (20) days prior to a hearing, for any violation of the Peer-to-Peer Car Sharing Program Act, Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session, or this Regulation. Service shall be deemed accomplished three (3) days after the date of mailing, via certified mail, of the notice of hearing by the Mississippi Insurance Department, addressed to the permittee or its registered agent. In the case of personal delivery, service shall be deemed accomplished on the date of personal delivery to the permittee or its registered agent. The notice may also be served upon the permittee by electronic (email) delivery with a delivery receipt, if an electronic mail address has been provided. The Mississippi Insurance Department is not required to provide a court reporter to make a record of the testimony given at the hearing, and the record of testimony may be taken through audio recording or other appropriate means, which may be transcribed by employees of the Mississippi Insurance Department, and will constitute the record of testimony in the event of an appeal. Any respondent may provide its own method of recording testimony, including retaining a court reporter, at the respondent’s own expense.

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(2) The rules of order and procedure for any hearing held pursuant to subpart 1 of this Rule shall be in accordance with 19 Miss. Admin. Code, Part 1, Chapter 15 (Rules of Practice and Procedure before the Mississippi Insurance Department and State Fire Marshal’s Office), unless in conflict with the specific provisions of this regulation.

(3) Any peer-to-peer car sharing program that is a party to any hearing before the Commissioner and who is aggrieved by any decision of the Commissioner with respect to any hearing before him, shall have the right of appeal to the Circuit Court of Hinds County, Mississippi, pursuant to the provisions of the Mississippi Uniform Circuit and County Court Rules. All such appeals shall be appeals on the record, including a transcript of pleadings and evidence, both oral and documentary, heard and filed before the commissioner.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.20: Severability

If any section or portion of a section of this Regulation or the application thereof is held by a court to be invalid, such invalidity shall not affect any other provision of that section or application of the Regulation which can be given effect without the invalid provision or application, and to this end the provisions of the Regulation are declared to be severable.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

Rule 1.21: Effective Date

The Effective Date of this Regulation shall be January 18, 2025.

Source: Mississippi Senate Bill No. 2530, 2024 Regular Legislative Session.

MISSISSIPPI FIRE PERSONNEL MINIMUM STANDARDS AND CERTIFICATION BOARD MISSISSIPPI FIRE PERSONNEL MINIMUM STANDARDS AND CERTIFICATION BOARD

Part 101 Mississippi Fire Personnel Minimum Standards and Certification Board

Chapter 1 Rules and Regulations for Minimum Standards Certification (MSCB-1)

19 Miss. Admin. Code Pt. 101, R. 1.01 Rule 1.01

Purpose and Scope Rule 1.02 Authority Rule 1.03 Certification Rule 1.04 Scope of Certification Rule 1.05 Probationary Period for Completing Certification Requirements Rule 1.06 Certification Testing Rule 1.07 Process of Certification Rule 1.08 Equivalency Rule 1.09 Reciprocity Rule 1.10 Validity of Certification Rule 1.11 Recognition of Certification and Transportability Rule 1.12 Revocation of Certification Rule 1.13 Notifications and Status Changes Rule 1.14 Appeals Process Rule 1.15 Effective Date

19 Miss. Admin. Code Pt. 101, R. 1.01 Purpose and Scope

The purpose of this Regulation is to establish the minimum educational and training standards for, and the process for the certification of, fire personnel in the State of Mississippi.

History

• Source: Miss. Code § 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.02 Authority

This Regulation is promulgated in accordance with the authority granted by the Legislature to the Minimum Standards and Certification Board (hereinafter “MSCB” or “Board”) pursuant to Miss. Code §§ 45-11-251 and 45-11-253.

History

• Source: Miss. Code § 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.03 Certification

In accordance with Miss. Code § 45-11-253(b), the term “certify” shall imply the testing of an individual candidate’s knowledge and skill or the review of their training and education credentials through a standardized process of evaluation and approval. As such, the minimum standard established for fire personnel within the scope of the MSCB is the National Fire Protection Association (NFPA) 1001 Standard for Fire Fighter Professional Qualifications

Levels I and II. The MSCB may grant state certification to fire personnel who meet the requirements of this standard.

Under state law, the Mississippi State Fire Academy is the principle agency responsible for providing fire fighter training. Also, the Mississippi State Fire Academy is the only entity in Mississippi accredited by the International Fire Service Accreditation Congress (IFSAC) to provide certification-testing services. Based on these facts, the MSCB shall recognize the NFPA-based professional certifications issued by the Mississippi State Fire Academy as being equivalent to the minimum standards established by the Board.

History

• Source: Miss. Code §§ 45-11-253; 45-11-201; 45-11-7 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.04 Scope of Certification

The requirement for MSCB certification applies to Mississippi fire personnel employed after January 1, 1991 in a full-time or less than full time capacity by a local governmental fire-fighting unit and working in a cumulative time of two thousand eight hundred (2800) compensated hours.

The term fire personnel shall be applied to any employee whose primary job function involves the delivery of fire suppression and rescue services. This definition does not include employees whose principle fire service duties involve the driving and operation of apparatus, supervision of other personnel, training, or department administration. A local governmental fire-fighting unit shall be defined as any organization established or contracted by a city, county, or state political authority to provide fire suppression and rescue services within a specific jurisdiction, district, or other legally recognized geographic boundary.

Miss. Code § 45-11-203 provides an exclusion or “grandfather clause” for fire personnel employed with a local fire-fighting unit prior to January 1, 1991. Such personnel are not required to meet the requirements of the MSCB. As the sole qualifying factor, this act does not provide for any exemption based on prior years of service. The local firefighting unit may request grandfather status for fire personnel employed prior to January 1, 1991, who worked a minimum of two thousand eight hundred (2800) compensated hours per year, for state certification equivalent to the appropriate level of NFPA Professional Qualification Standard. Grandfather status is not applicable to personnel employed after January 1, 1991.

The exclusion offered through the grandfather clause is valid so long as the eligible person does not have a break in service with a fire service agency for more than two (2) years. If a grandfathered or previously MSCB certified person leaves the fire service and does not serve with a fire service agency within two (2) years but no more than five (5) years, the person must successfully complete the Mississippi Trainee Agility Test (MSTAT) program and the MSCB approved certification examination. If a grandfathered or previously MSCB certified person leaves the fire service and does not serve with a fire service agency within five (5) years, the person will be considered a new entry and must successfully complete the entire minimum standards training and certification process.

Mississippi fire personnel who serve in a non-paid capacity may choose to voluntarily meet the MSCB certification requirements through the same procedures established for compensated fire personnel.

All Mississippi fire personnel meeting the minimum standard certification requirements shall be certified by the Board provided they have not been convicted of a felony. However, a felon may petition the Board for certification by providing evidence to demonstrate that such illegal act(s) are no longer detrimental to the public trust nor create an impairment or adverse perception of the fire fighter’s ability to perform his or her sworn duties, and are otherwise not specifically and directly related to the duties and responsibilities for the performance of fire-fighting and rescue services. After receipt of complete and appropriate documentation related to the felony conviction, to be provided by the petitioner, the Board shall make a determination whether certification of the individual would be detrimental to the public trust or create an impairment or adverse perception of the fire fighter’s ability to perform his or her sworn duties. The Board shall use the “clear and convincing standard of proof” in examining the following factors:

(a) The nature and seriousness of the crime for which the individual was convicted; (b) The passage of time since the commission of the crime; (c) The relationship of the crime to the ability, capacity, and fitness required to perform the duties and discharge the responsibilities of the occupation of fire-fighting and rescue services; and (d) Any evidence of rehabilitation or treatment undertaken by the individual that might mitigate against a direct relationship to the occupation of fire-fighting and rescue services.

Documentation for the felony criminal conviction(s) which must be provided to the Board by the petitioner should normally include, at a minimum, a copy of the felony indictment, order of conviction and sentencing, and evidence showing the successful completion of the sentence including any terms of probation or parole.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253; (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.05 Probationary Period for Completing Certification Requirements

In accordance with Miss. Code § 45-11-203, fire personnel eligible for MSCB certification must complete all certification requirements within one (1) year from their original date of hire. Under extraordinary circumstances, the MSCB may grant an extension of one (1) additional year beyond the original probationary period. Such request for extension shall be submitted in writing by the executive fire officer of the local fire-fighting unit with an explanation of circumstance and need.

Full-time Employees called to active military duty by Presidential order during their one-year probationary period may request a temporary suspension of the probationary period. If granted by the MSCB, the temporary suspension shall begin on the first official day of active military duty and extend to the last day of the employee’s one-year probationary period or conclusion of

military duty whichever comes first. In the event active military service extends beyond the employee’s probationary period, an additional request for temporary suspension may be submitted for consideration by the Board. No single suspension period shall exceed one-year and all requests must be supported by official military documentation. Notification to the MSCB shall be made within 15 calendar days of an employee’s completion of military duty. Any temporary suspension granted by the MSCB shall be rendered void upon completion of military service and the employee’s remaining probationary period reinstated.

If the number of days remaining in the employee’s original probationary period are insufficient to complete the MSCB certification process, the employee’s fire chief may request a one-year extension as authorized by Miss. Code § 45-11-203(1).

Full-time Employees who have been granted a suspension of their probationary period for military service and who have completed the Mississippi Trainee Agility Test (MSTAT) before starting active military duty shall also receive a suspension of the time their MSTAT results are valid. Such suspension shall begin on the first official day of active military duty and extend to the last day of the employee’s 365-day MSTAT period or conclusion of military duty whichever comes first. In the event active military service extends beyond the 365-day MSTAT period, an additional request for temporary suspension may be submitted for consideration by the Board.

If the number of days remaining in the employee’s original 365-day MSTAT period are insufficient to complete the MSCB certification process, the employee’s fire chief may request a one-year extension as authorized by Miss. Code § 45-11-203(1).

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.06 Certification Testing

In lieu of MSCB administered testing, the Board shall recognize all accredited NFPA-based Fire Fighter I and II certificates issued by the Mississippi Fire Academy after September 1, 2005 as being equivalent to the MSCB certification requirements. Furthermore, the MSCB shall utilize current NFPA fire service professional qualification standards and the basic fire fighter training curriculum (NFPA 1001 1&2) as used by the Mississippi Fire Academy and approved by MSCB as the official state standard and curriculum for basic fire fighter certification training. Policies regarding delivery of curriculum and certification testing shall be established by the Mississippi State Fire Academy in accordance with criteria set forth by the International Fire Service Accreditation Congress, subject to approval by MSCB.

Departments administering basic fire fighter training to their own employees must contract with the Mississippi State Fire Academy for delivery of curriculum materials and the certification examination process. In general, Mississippi Fire Academy entrance requirements set forth for minimum standards certification (Fire Fighter I and II) shall be established by the MSCB as recommended by the Academy’s Executive Director. Such entrance requirements shall not apply to fire personnel who fall outside the scope of Miss. Code § 45-11-203 and therefore, are not within the jurisdiction of the MSCB. Academy entrance requirements established for non-

minimum standard courses and other programs shall be set by the Executive Director in conjunction with the Academy’s Advisory Board.

The minimum standards certification process requires all candidates to successfully complete the Mississippi Trainee Agility Test (MSTAT) prior to entering an approved Fire Fighter I and II training program. In order to meet the entrance requirements for certification training and testing, the MSTAT exam must be administered at the Mississippi State Fire Academy or monitored by qualified Academy personnel at locations approved by the Board to conduct the MSTAT exam. The validity of any MSTAT qualification shall expire three hundred and sixty- five (365) days after successful completion of the exam. Candidates must have officially started an approved certification-training program within the 365-day period. Should any candidate’s MSTAT credentials expire before entering an approved certification-training program, the candidate must retake and successfully complete the MSTAT exam. All subsequent MSTAT qualifications shall remain valid for three hundred and sixty-five (365) days from the most recent test date.

Miss. Code § 45-11-7 provides the Mississippi State Fire Academy with the authority to assess a reasonable fee to account for the cost of providing off-campus certification testing and monitoring services. Such fees shall be directed to and paid by the entity or governing authority requesting the additional testing services.

History

• Source: Miss. Code §§ 45-11-7; 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.07 Process of Certification

All Mississippi fire personnel eligible for state certification must meet the following criteria by the starting date of any MSCB approved minimum standard certification-training program:

1. Be a minimum of eighteen (18) years of age; 2. Have obtained a standard high school diploma or possess a valid GED; 3. Be in good physical condition and capable of performing the duties of a fire fighter under conditions inherent to the profession as verified by a licensed physician; 4. Have met the minimum physical fitness requirements of the MSCB; and 5. Have met the minimum emergency medical care training requirements as set forth by the Board.

Qualified Mississippi fire personnel shall be deemed certified by the MSCB under Miss. Code §§ 45-11-203 and 45-11-251 by presenting their IFSAC accredited NFPA Fire Fighter I and II credentials as issued by the Mississippi Fire Academy and a valid MSCB Personnel Action Form (MSCB Form #02). The executive fire officer or director of the local fire-fighting unit shall submit all required documentation to the MSCB within thirty (30) days following a candidate’s successful completion of an approved minimum standards certification training program. The possession of any certificate other than one issued by the MSCB for NFPA 1001 Level I and II does not grant the holder automatic state minimum standard certification.

Upon verification of a candidate’s credentials, a state certificate will be issued by the MSCB to the qualified fire fighter. Furthermore, the Board will maintain a registry of all Mississippi fire personnel certified under this and any previous certification system at its physical office location. All Board actions made in accordance with Miss. Code § 45-11-253 and their applicable dates will be noted in the registry. A printed copy of the Mississippi Fire Personnel Certification Registry will be published at the conclusion of each calendar year and made available for public review at the MSCB office. An additional printed copy will be transferred annually to the Mississippi State Archives for permanent storage.

History

• Source: Miss. Code §§ 45-11-251; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.08 Equivalency

In accordance with Miss. Code § 45-11-253(b), the MSCB may grant certification based on a review of an individual’s training and education credentials through a standardized process of evaluation and approval. Should such documentation demonstrate that the training and education is valid and meets or exceeds the appropriate NFPA Professional Qualification Standard, then equivalent certification may be granted. Only the NFPA Fire-Fighter 1001 standard has been established as the minimum standard required for certification, and the MSCB shall limit its’ certifications to those relevant to a determination whether the minimum standards have been met. The minimum standard certifications shall include only NFPA 1001 (Levels I and II) and NFPA 472 (Hazardous Materials Awareness Operations).

History

• Source: Miss. Code § 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.09 Reciprocity

A. In accordance with Miss. Code § 45-11-253(b), the MSCB may grant reciprocity to Mississippi fire fighters who possess valid certification credentials issued by other approved fire service training entities. Such reciprocity may allow direct entry into the MSCB certification system or may require additional testing. A denial for reciprocity will require the candidate to successfully complete all existing requirements for certification.

1. Any candidate seeking reciprocity must show evidence that all required training was completed prior to employment with a Mississippi fire-fighting unit, or consisted of a course not offered by the Mississippi State Fire Academy that was completed out of state, or completed while serving in the armed forces. Fire service agencies are prohibited from sending employees to out-of-state training entities for the purpose of gaining individual MSCB certification through reciprocity.

2. Under this policy, Mississippi fire personnel that possess valid certifications from fire service training entities accredited by the International Fire Service Accreditation Congress (IFSAC) shall be granted reciprocity and allowed direct entry into the MSCB certification system. The MSCB also has discretion to grant reciprocity and allow direct entry into the MSCB certification system for candidates with certificates issued by out- of-state fire service training entities accredited by other organizations which the MSCB

deems sufficiently reliable to ensure training in compliance with the minimum standards, however, if the Board does not deem the accrediting organization sufficiently reliable, then candidates’ certificates shall be treated as being issued by non-accredited entities. Candidates with certificates issued by non-accredited entities may seek MSCB certification through an approved challenge testing system administered by the Mississippi State Fire Academy. Upon successful completion of the examination process, and proper submission of all required documentation, qualified candidates shall be granted MSCB certification.

B. Alternate Reciprocity Process pursuant to the Universal Recognition of Occupational Licenses Act:

1. Applicant Certified in Another State: The Board shall issue MSCB certification to a person who establishes residence in this state if, upon application to the Board, the applicant satisfies the following conditions:

a. The applicant holds a current and valid license or certificate in good standing in another state authorizing them to engage on a full time basis as a fire fighter who delivers fire suppression and rescue services, and that the applicant has held such license / certification for at least one (1) year;

b. The other state where licensed / certified had minimum education requirements and examination requirements in effect, and the other state verifies that the applicant met those requirements in order to be licensed / certified in that state; and

c. The applicant has not committed any act in the other state that would have constituted grounds for refusal, suspension or revocation of a license to practice that occupation in Mississippi at the time the act was committed, and the applicant does not have a disqualifying criminal record as determined by the MSCB under Mississippi law; and

d. The applicant did not surrender a license because of negligence or intentional misconduct related to the applicant’s work as a fire fighter in the other state; and

e. The applicant does not have a complaint, allegation or investigation pending before an occupational licensing board or other board in another state that relates to unprofessional conduct or an alleged crime. If the applicant has a complaint, allegation or investigation pending, the MSCB shall not issue or deny a license to the applicant until the complaint, allegation or investigation is resolved, or the applicant otherwise satisfies the criteria for licensure in Mississippi to the satisfaction of the MSCB; and

f. The applicant pays all applicable fees in Mississippi.

2. Reciprocity Based Upon Work Experience in Another State: The MSCB shall issue minimum standards certification to an applicant who establishes residence in this state based on work experience in another state, if all the following apply:

a. The applicant worked in a state that does not use a license / certification to regulate fire fighters who deliver fire suppression and rescue services;

b. The applicant worked for at least three (3) years in the lawful occupation on a full time basis; and

c. The applicant has not committed any act in the other state that would have constituted grounds for refusal, suspension or revocation of a license to practice that occupation in Mississippi at the time the act was committed, and the applicant does not have a disqualifying criminal record as determined by the MSCB under Mississippi law; and

d. The applicant did not have his employment as a fire fighter terminated because of negligence or intentional misconduct related to the applicant’s work as a fire fighter in the other state; and

e. The applicant does not have a complaint, allegation or investigation pending before an occupational licensing board or other board in another state that relates to unprofessional conduct or an alleged crime. If the applicant has a complaint, allegation or investigation pending, the MSCB shall not issue or deny a license to the applicant until the complaint, allegation or investigation is resolved, or the applicant otherwise satisfies the criteria for licensure in Mississippi to the satisfaction of the MSCB; and

f. The applicant pays all applicable fees in Mississippi.

3. Jurisprudential Examination: For persons applying based upon another state’s licensing / certification or work experience, where the other state did not utilize the National Fire Protection Association (NFPA) fire service professional qualification standards, the MSCB may require candidates seeking reciprocity to pass a knowledge and skills based examination to specifically establish competency in NFPA 1001 Fire Fighter Professional Qualification Levels I and II, which have been established by Miss. Code § 45-11-203 and 19 Miss. Admin. Code Part 101, Chapter 1, Rule 1.03, as the minimum knowledge and skills based educational standard for fire fighters in Mississippi.

4. For persons applying for certification under the alternate reciprocity provisions of the Universal Recognition of Occupational Licenses Act, residence may be established by demonstrating proof of a state-issued identification card or one (1) of the following:

a. Current Mississippi residential utility bill with the applicant’s name and address;

b. Documentation of the applicant’s current ownership or current lease of a residence in Mississippi;

c. Documentation of current in-state employment or notarized letter of promise of employment of the applicant or his or her spouse; or

d. Any verifiable documentation demonstrating Mississippi residency.

5. The MSCB shall issue or deny the license to the applicant within one hundred twenty (120) days after receiving an application. An application shall be deemed “received” by the MSCB upon the Board’s receipt from the applicant all completed application documentation, to include satisfactory evidence of compliance with all requirements of paragraphs (B)(1) or (B)(2) herein, as may be applicable. Pursuant to Miss. Code § 45-11-203, “no person shall be employed as a full-time fire fighter by any local government fire fighting unit for a period exceeding one (1) year, nor for a cumulative time exceeding two thousand eight hundred (2,800) compensated hours, unless that person is certified as completing the mandatory training requirements . . . .”

6. Appeal:

a. Applicants seeking reciprocity under the Universal Recognition of Occupational Licenses Act may appeal any of the following decisions of the MSCB to a court of general jurisdiction:

i. Denial of a license;

ii. Determination of the occupation;

iii. Determination of the similarity of the scope of practice of the license issued; or

iv. Other determinations under this section.

b. The court shall determine all questions of law, including the interpretation of a constitutional or statutory provision or a rule adopted by the MSCB, without regard to any previous determination that may have been made on the question in any action before the MSCB.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020); Miss. Code § 73-50-2 as codified in HB No. 1263 (2021 Session)

19 Miss. Admin. Code Pt. 101, R. 1.10 Validity of Certification

Certifications issued by the MSCB shall remain valid for the life of the individual provided there is not a break in service with a fire service agency for a period greater than two (2) years.

In cases where a certified individual separates from a local fire-fighting unit and does not serve with a fire service agency within two (2) years but no more than five (5) years, the person would

be eligible for recertification by completing the MSCB approved examination process including MSTAT. If a previously certified individual separates from a local fire-fighting unit and does not serve with a fire service agency for more than five (5) years, the person will be considered a new entry and required to meet all training and examination requirements established for minimum standards certification.

Certified Mississippi Fire Fighters called to active military duty by Presidential order for a period of time greater than two years shall not be considered to have a break in service provided the employer does not terminate the employee during the period of separation. The MSCB shall be notified of such circumstances by the employee’s governing authority (i.e. human resource or personnel office) and be provided with official military documentation to validate the separation. Likewise, the MSCB shall be notified within 15 calendar days of an employee’s completion of military duty.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.11 Recognition of Certification and Transportability

In regards to fire fighter certification in Mississippi, there are two primary documents that fire personnel may possess. The successful completion of fire fighter training and testing in accordance with NFPA Fire Fighter 1001 Standard Level I and II is noted by a certificate issued by the Mississippi State Fire Academy and validated by the seal of the International Fire Service Accreditation Congress. Likewise, a certificate issued by the MSCB to the individual fire fighter documents recognition of this accomplishment for the purpose of minimum standard certification. The official status of an individual’s certification is maintained by the Board through the Mississippi Fire Personnel Certification Registry.

Fire service agencies that employ MSCB certified fire personnel must notify the Board within thirty (30) days of the individual’s date of hire. Such notification shall be made available by submitting a Personnel Action Form (MSCB Form #02). The Board will review the certification status of the individual presented and notify the fire service agency of its findings. Fire personnel whose certification status is valid shall be eligible for continued employment.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.12 Revocation of Certification

The act of certification is based upon the testing of an individual candidate’s knowledge and skill or the review of their training and credentials through a standardized process of evaluation and approval. As such, the individual effort required to meet a given standard will be documented in the form of a state certificate issued by the MSCB to the qualified fire fighter. However, the official record of all Board actions pertaining to certification shall be documented in the Mississippi Fire Personnel Certification Registry.

All Board actions made in accordance with Miss. Code 45-11-253 and their applicable dates will be noted in this registry. The Board reserves the right to either reprimand a certified fire

personnel, suspend their certification upon conditions imposed by the Board, or nullify their certification when:

1. The certification was issued through an administrative error; 2. The certification was obtained through misrepresentation or fraud; 3. The recipient has been convicted of a felony or a crime involving moral turpitude and the Board, through application of the factors set forth in Rule 1.04, determines that continued certification would be detrimental to the public trust or create an impairment or an adverse perception of the fire fighter’s ability to perform his or her sworn duties; or 4. Other due cause as determined by the Board.

While an individual may possess a physical certificate, the official verification of certification or other Board action is made available through the Mississippi Fire Personnel Certification Registry. In all cases, local fire-fighting units must submit a Personnel Action Form or Change in Status Form within thirty (30) days of a certified individual’s separation from the department. Should the fire fighter transfer to another Mississippi fire-fighting unit, the new department must submit a Personnel Action Form within thirty (30) days of the certified individual’s date of hire. The process of notification allows the Board to verify the status and validity of any certificate issued. Verification of an individual’s certification shall be forwarded to the new employer within thirty (30) days following the receipt of the Personnel Action Form.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.13 Notifications and Status Changes

In order to maintain reliable certification records, fire service agencies must notify the MSCB of any changes in employment or training. Mandatory notifications shall be made within thirty (30) days of any specific occurrence. Such notifications shall be made by submitting a Personnel Action Form and any other required documentation. Mandatory notifications include:

1. The hiring of a compensated employee as a fire fighter by any local fire-fighting unit; 2. The successful completion of an approved minimum standard course of training; 3. The separation of any non-certified fire fighter from a local fire-fighting unit; 4. The separation of any Certified Mississippi Fire Fighter from a local fire-fighting unit; 5. The hiring or transfer of any Certified Mississippi Fire Fighter by a local fire-fighting unit.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.14 Appeals Process

Appeals to any certification issue shall be made to the Board and submitted within one (1) year of the date of the original action. Such appeals may be initiated by an individual or through the executive fire officer of the local fire-fighting unit. Once a written appeal has been filed, the individual may petition the Board in person at a regularly scheduled meeting of the MSCB.

Upon hearing the basis of the appeal, the chair may forward the appeal to appropriate committee for further investigation and a recommendation for action. The Board will communicate its final decision in writing within thirty (30) days following any action taken on the issue.

History

• Source: Miss. Code §§ 45-11-203; 45-11-253 (Supp. 2020)

19 Miss. Admin. Code Pt. 101, R. 1.15 Effective Date

This Regulation supersedes prior versions of Mississippi Administrative Code Title 19, Part 101, Chapter 1, and shall become effective thirty (30) days after final filing in the Office of the Mississippi Secretary of State.

History

• Source: Miss. Code §§ 45-11-253 and 25-43-3.113 (Supp. 2020)