porter 3,4,5 Flashcards

1
Q

state insurance regulatory systems have 4 features

A

licensing requirements

reporting & fiilng requirements

periodic examinations

power to impose sanctions

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2
Q

What is NAIC

A

US standard setting & regulatory support organization

coordinates regualtions of insurers when operating in multiple states

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3
Q

NAIC mission FProProPro (5)

A
  1. Fair consumer treatment
  2. Protect public interest
  3. Promote competition
  4. Promote solvency
  5. improve state insurance regulation
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4
Q

NAIC functions

A
  1. Maintain databases to track solvency
  2. Value insurer securities
  3. Assist states w/ pricing
  4. Advise on regulation
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5
Q

Define NAIC model law

A

NAIC suggests law for all states to follow as an option

states can adopt, modify ,or not use it at all

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6
Q

Why state regulator support certain NAIC model law

A
  1. Efficiency → no need to make another law
  2. Uniform regulation across states → helps multi-state insurers keep compliance costs↓ → easier for company to do business in your state
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7
Q

Why state regulator oppose certain NAIC model law

A
  1. Redundancy – similar law already exists
  2. Irrelevancy – law doesn’t address states special need
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8
Q

NAIC grants state DOI financial accreditation

3 steps for state to get accredited

A
  1. State commissioner at DOI requests NAIC review
  2. NAIC choose team to review
  3. Review = interviews, review laws/reports/policies
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9
Q

4 types of rate regulation from strongest to weakest

A

Prior approval

File & use (file before using)

Use & file (used immediately but file w/ in x days)

No file

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10
Q

What does state DOI do? (5)

A
  1. Licensing (insurers, producers)
  2. regulate coverage and pricing
  3. Solvency (financial exams)
  4. market conduct examinations
  5. determine need for receivership
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11
Q

Describe DOI market conduct exams

A

marketing, advertising,soliciting, policy issuing, claim handling

use NAIC handbook→uniform across states

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12
Q

Advantages of use and file state regulation of rates

A
  1. use and file- insurer can change rates quickly based on market conditions + regulator can still review rates & modify
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13
Q

Disadvantages of use and file in state regulation of rates

A
  1. cost to comply w/ different regulations in each state
  2. unfair rates can hit market before regulator looks at them
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14
Q

Describe regulatory financial exam

A
  1. NAIC handbook →uniform across states
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15
Q

Characteristics of ‘business of insurance as defined by Group Life & Health Ins co VS Royal Drug Co

A
  1. insurance is any activity w/ at least 1 of following (contract b/w insurer and insured, specific to insurance industry, spreads risk,)
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16
Q

how did US vs South-Eastern UW Association (SEUA) (1944) clarify business of insurance

A

fixing rates is part of the busines of insurance

17
Q

how Robertson v Califonia clarified business of insurance

A

licensing agents/insurers is part of business of insurance

18
Q

how FTC v Natl Casualty Co clarified business of insurance

A

selling/advertising is part of business of insurance

19
Q

how SEC v Variable Annuity Life Ins Company clarified business of insurance

A

risk underwriting is part of business of insurance

20
Q

how Sec v Natl securities clarified busienss of insurance

A

company/stockholder relationship is NOT part of business of insurance

21
Q

ERISA – Employment Retirement Income Security Act

A

federal regulation impacting private pension & employee benefit plans

22
Q

OSHA- occupational safety and health act

A
  1. federal regulation
  2. requires employees/employers follow workplace safety & health standards
23
Q

Insurance is contract of adhesion

A
  1. 1 party must adhere as written by other party →courts interpret ambiguous provision in insurers favor
24
Q

Insurance Industry Trade Associations

A
  1. Fee paying members get access to lobbyists to help draft new laws
25
Q

Insurance Advisory Organizations

A
  1. ISO & NCC)
  2. work with insurers
  3. file rates & prospective loss costs
  4. develop rating systems,
  5. collect stats
  6. educate members, industry, regulators ,bulic
26
Q

Consumer Groups

A
  1. Watch dog/activist/files complaints w/ DOI
  2. public citizen advocated for seat belt laws