Title: S.L. 1963-1125
Category: Introduced Bill
Keywords: Bill ?

NORTH CAROLINA GENERAL ASSEMBLY
1963 SESSION

CHAPTER 1125
SENATE BILL 462

AN ACT AUTHORIZING AND REGULATING JOINT ACTION BY INSURERS IN INSURING PERSONS 65 YEARS OF AGE AND OVER AND THEIR SPOUSES AGAINST FINANCIAL LOSS RESULTING FROM ACCIDENT AND SICKNESS.

WHEREAS, it is desirable to provide a means of more adequately meeting the needs of residents in this State who are 65 years of age and over and their spouses for insurance coverage against financial loss from accident and sickness; and
WHEREAS, the hospitalization and medical insurance needs of such residents can be met effectively through joint action of insurers and by encouraging insurers to exercise their collective efforts in offering said insurance; and
WHEREAS, such joint action by insurers should be regulated by the State in accordance with the intent of Congress as expressed in the Act of Congress of March 9, 1945 (Public Law 15, 79th Congress), as amended: Now, therefore,

The General Assembly of North Carolina do enact:

Section 1.  Chapter 58 of the General Statutes of North Carolina is hereby amended by inserting therein a new Article immediately after Article 26 thereof, to be designated as Article 26A and to read as follows:
"ARTICLE 26A.
Over 65 Accident and Health Insurance.
§ 58-255.1.  Definitions. Wherever used in this Article, the following terms shall have the respective meanings hereinafter set forth or indicated, unless the context otherwise requires:
(a)	'Association' means a voluntary unincorporated association formed for the sole purpose of enabling joint and cooperative action to provide accident and health insurance in accordance with this Article in this or any other State having legislation enabling the issuance of insurance of the type provided in this Article.
(b)	'Insurer' means any insurance company which is authorized under this Chapter to transact accident and health insurance business in this State.
§ 58-255.2. Joint Action to Insure Persons 65 Years of Age and Over and Their Spouses Permitted. Notwithstanding any other provisions of this Chapter or any other law which may be inconsistent herewith, any insurer may join with one or more other insurers to plan, develop, underwrite, offer, sell and provide to or for any resident person of this State, or of another State if permitted by the laws of such other State, who is 65 years of age or over and to the spouse of such person, insurance against financial loss from accident or sickness, or both. Such insurance may be offered, issued and administered through an association of two or more insurers which association is formed for the purpose of offering, selling, issuing and administering such insurance, and may be in the form of a policy insuring a resident who is 65 years of age or older, and the spouse of such resident, if any, or in the form of a group policy insuring residents 65 years of age or older and the spouses of such residents, or in both forms. On such insurance each insurer shall be severally liable for a percentage of the risks determined under the articles of association of the association. The insurer members of such association may agree with respect to premium rates, policy provisions, commission rates and other matters within the scope of this Article. Notwithstanding the provisions of G.S. 58-44, any policy providing such insurance may be executed on behalf of the insurers or the association, as the case may be, by a duly authorized person and need not be countersigned by a resident agent.
§ 58-255.3.  Regional Plans Authorized. If 'Over 65' accident and health insurance plans exist or hereafter come into existence in other states pursuant to legislative authority similar to that herein given, North Carolina insurers may jointly participate with insurers of such other states in form ing a regional plan to carry out the purposes of this Article. Any association formed for the operation of a regional plan shall be exempt from the provisions of G.S. 58-36 and may engage in business in North Carolina through its insurer members only, without being separately licensed.
§ 58-255.4.  Forms of Policies Specially Approved by the Commissioner of Insurance. The forms of the policies, applications, certificates or other evidence of insurance coverage and the rate manual showing rates, rules and classification of risks applicable thereto shall be subject to the applicable provisions of G.S. 58-249. The Commissioner may disapprove the premium rates for such insurance, or any class thereof, if he finds that such rates are by reasonable assumptions excessive in relation to the benefits provided. In determining whether such rates by reasonable assumptions are excessive in relation to the benefits provided, the Commissioner shall give due consideration to past and prospective claim experience on such insurance, or other comparable insurance, within and outside this State, and to fluctuations in such claim experience, to a reasonable risk charge, to contribution to surplus and contingency funds, to past and prospective expenses, both within and outside this State, and to all other relevant factors within and outside this State, including any differing operating methods of the insurers joining in the issue of such insurance. In the event of any such disapproval, the decision of the Commissioner shall be subject to review under G.S. 58-9.3. In exercising the powers conferred by this Section, the Commissioner shall not be bound by any other requirements of this Chapter with respect to standard provisions required to be included in the forms of the policies, applications, certificates or other evidence of insurance coverage filed with the Commissioner.
§ 58-255.5.  Powers Conferred and Filing Required. An association formed for the purposes of this Article shall adopt articles of association for the organization, administration and regulation of its affairs, which articles of association and any amendments thereto shall be filed within thirty (30) days of adoption of same with the Commissioner of Insurance.
Such association may establish requirements for membership of insurers, hold title to property, incur expenses for advertising, soliciting and administering such insurance, including payment of salary or compensation to persons employed by it, enter into contracts, limit the liability of and among its members, and shall be subject to the provisions of G.S. 1-69.1.
Such association shall file annually with the Commissioner of Insurance, on such date and in such form as the Commissioner may prescribe, a statement with respect to its operations.
For the purpose of implementing joint action of insurers in furnishing accident and health insurance coverage to persons 65 years of age and older and their spouses, in accordance with the intent of this Act as expressed herein, insurers operating on a mutual plan, or on any other membership basis, may participate in such a plan, and the persons insured through the plan shall not be entitled to membership in any such insurer nor shall they be entitled to any dividend rights, voting rights, or any other rights peculiar to mutual insurance policyholders and participants in membership insurance plans.
§ 58-255.6.  No Special Licensing Required. Accident and health insurance authorized by this Article and offered by or through an association formed for the purpose of this Article may be solicited and offered directly by such association, any insurer member of such association, and by or through any person authorized by the North Carolina Insurance Department to sell accident and health insurance in this State, without any additional license being required."
Sec. 2.  All laws and clauses of laws in conflict with this Act are hereby repealed.
Sec. 3.  This Act shall be in full force and effect from and after its ratification.
In the General Assembly read three times and ratified, this the 24th day of June, 1963.