Louisiana Revised Statutes 22:1569 – A. A material change made by a health insurance issuer to the terms and conditions of a contract between the health insurance issuer and a producer shall not become effective until t
Terms Used In Louisiana Revised Statutes 22:1569
- Contract: A legal written agreement that becomes binding when signed.
- Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
- Insurance: shall mean any of the lines of authority as specified in La. See Louisiana Revised Statutes 22:1542
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- producer: shall mean a person required to be licensed under the laws of this state to sell, solicit, or negotiate insurance, and includes all persons or business entities otherwise referred to in this Code as "insurance agent" or "agent" or "insurance broker" or "broker" or "insurance solicitor" or "solicitor" or "surplus lines broker". See Louisiana Revised Statutes 22:1542
- Right of survivorship: The ownership rights that result in the acquisition of title to property by reason of having survived other co-owners.
A. A material change made by a health insurance issuer to the terms and conditions of a contract between the health insurance issuer and a producer shall not become effective until the health insurance issuer has delivered to the producer, at least ninety days prior to the effective date of the change, written or electronic notice indicating the change or changes to the contract. For purposes of this Section, a “material change” is a change made to a provision of the contract affecting any of the following:
(1) Commissions, bonuses, and incentives paid to the producer.
(2) Right of survivorship.
(3) Indemnification of the producer by the health insurance issuer.
(4) Errors and omissions coverage requirements for the producer.
B. Subsection A of this Section shall not apply under either of the following circumstances:
(1) When the change to the contract is mutually agreed upon by the health insurance issuer and the producer.
(2) When the change to the contract is required by state or federal law.
C. For purposes of this Section:
(1) “Health benefit plan” means a policy, contract, certificate, or agreement entered into, offered, or issued by a health insurance issuer to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services. “Health benefit plan” shall not include a plan providing coverage for excepted benefits as defined in La. Rev. Stat. 22:1061 and short-term policies that have a term of less than twelve months.
(2) “Health insurance issuer” means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including through a health benefit plan as defined in this Section, and shall include a sickness and accident insurance company, a health maintenance organization, a preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits.
Acts 2016, No. 56, §1.