THE LIFE AND HEALTH INSURANCE
PROTECTION ASSOCIATION (COLORADO)

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The Life and Health Insurance Protection Association Act

10-20-101 - Short title

10-20-102 - Legislative declaration

10-20-103 - Definitions

10-20-104 - Coverage and limitations - coordination of benefits

10-20-105 - Construction

10-20-106 - Creation of the association

10-20-107 - Board of directors

10-20-108 - Powers and duties of the association

10-20-109 - Assessments

10-20-110 - Plan of operation

10-20-111 - Powers and duties of the commissioner

10-20-112 - Prevention of insolvencies

10-20-113 - Credits for assessments paid - tax offsets

10-20-114 - Miscellaneous provisions

10-20-115 - Examination of the association - annual report

10-20-116 - Tax exemptions

10-20-117 - Immunity

10-20-118 - Stay of proceedings - reopening default judgments

10-20-119 - Prohibited advertisement of association article in insurance sales - notice to policyholders

10-20-120 - Prospective application  

10-20-101 - Short title.    

This article shall be known and may be cited as the "Life and Health Insurance Protection Association Act". 

   Source: L. 91: Entire article added, p. 1256, § 1, effective July 1.  

10-20-102 - Legislative declaration.    

(1) The general assembly finds and declares that the purpose of this article is to protect, subject to certain limitations, the persons specified in section 10-20-104 (1) against failure by member insurers in the performance of their contractual obligations under life and health insurance policies and annuity contracts specified in section 10-20-104 (2), because of the insolvency of the member insurer that issued the policies or contracts.

   (2) To provide the protection specified in subsection (1) of this section, an association of insurers shall be created and shall exist to pay benefits and to continue coverages as limited pursuant to this article. Members of the association are subject to assessment to provide funds to carry out the purpose of this article. 

   Source: L. 91: Entire article added, p. 1256, § 1, effective July 1.  

10-20-103 - Definitions.    

As used in this article, unless the context otherwise requires:

   (1) "Account" means any of the three accounts created pursuant to section 10-20-106. 

   (2) "Association" means the life and health insurance protection association as established by this article. 

   (3) "Board" means the board of the association. 

   (4) "Commissioner" means the commissioner of insurance. 

   (5) "Contractual obligation" means any obligation under a policy, contract, or certificate under a group policy or contract, or portion thereof, for which coverage is provided pursuant to section 10-20-104. 

   (6) "Covered policy" means any policy or contract within the scope of this article. 

   (7) "Insolvent insurer" means a member insurer which after July 1, 1991, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency. 

   (8) "Member insurer" means any insurer licensed or who holds a certificate of authority in this state to write any kind of insurance for which coverage is provided pursuant to section 10-20-104 and includes any insurer whose license or certificate of authority in this state may have been suspended, revoked, not renewed, or voluntarily withdrawn; but "member insurer" does not include: 

   (a) A nonprofit hospital or medical service organization; 

   (b) A health maintenance organization; 

   (c) A fraternal benefit society; 

   (d) A mandatory state pooling plan; 

   (e) CoverColorado; 

   (f) A stipulated premium insurance company; 

   (g) A local mutual burial association; 

   (h) A mutual assessment company or any entity that operates on an assessment basis; 

   (i) An interinsurance exchange; and 

   (j) Any entity similar to those specified in this subsection (8). 

   (9) "Moody's average" means Moody's corporate bond yield average monthly average corporates as published by Moody's Investors Service, Inc., or any successor thereto. 

   (10) "NAIC" means the national association of insurance commissioners. 

   (10.5) "Owner" of a policy or contract for insurance, or "policy owner", or "contract owner", means the person who is identified as the legal owner under the terms of the policy or contract for insurance or who is otherwise vested with legal title to the policy or contract for insurance through a valid assignment completed in accordance with the terms of the policy or contract for insurance and properly recorded as the owner on the books of the insurer. The terms "owner", "contract owner", and "policy owner" do not include persons with a beneficial interest in a policy or contract. 

   (11) "Person" means any individual, corporation, partnership, association, or voluntary organization. 

   (12) "Premiums" means amounts received on covered policies or contracts less returned premiums, returned considerations, and returned deposits, and less dividends and experience credits thereon. "Premiums" does not include any amounts received for any policies or contracts or for the portions of any policies or contracts for which coverage is not provided under section 10-20-104 (2); except that assessable premiums shall not be reduced on account of section 10-20-104 (2) (b) (III) relating to interest limitations and section 10-20-104 (3) (b) relating to limitations with respect to any one life. 

   (13) "Resident" means any person to whom a contractual obligation is owed and who resides in this state on the date of entry of a court order that determines a member insurer to be an insolvent insurer. A person may be a resident of only one state, which in the case of a person other than a natural person shall be its principal place of business. Citizens of the United States who are residents of a foreign country, United States possession, United States territory, or United States protectorate, which country, possession, territory, or protectorate does not have an association similar to the association created by this article, shall be deemed residents of the state of domicile of the insurer that issued the policies or contracts. 

   (13.5) "Structured settlement annuity" means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant. 

   (14) "Supplemental contract" means any agreement entered into for the distribution of policy or contract proceeds. 

   (15) "Unallocated annuity contract" means an annuity contract or group annuity certificate that is not issued to and owned by an individual, except to the extent of any annuity benefits guaranteed to an individual by an insurer under the contract or certificate. 

   Source: L. 91: Entire article added, p. 1257, § 1, effective July 1. L. 2000: (10.5), (13.5), and (15) added and (13) amended, p. 1017, § 1, effective July 1. L. 2001: (8)(e) amended, p. 1051, § 38, effective July 1.    Editor's note: Section 42 of chapter 281, Session Laws of Colorado 2001, provides that the act amending subsection (8)(e) applies to health care coverage provided by the program on or after July 1, 2001.  

10-20-104 - Coverage and limitations - coordination of benefits.    

(1) This article shall provide coverage for the policies and contracts specified in subsection (2) of this section and to persons:

   (a) Who are owners of or certificate holders under such policies or contracts, other than structured settlement annuities, and who: 

   (I) Are residents; or 

   (II) Are not residents, but only under all of the following conditions: 

   (A) The insurer which issued such policies or contracts is domiciled in this state; 

   (B) Such insurer never held a license or certificate of authority in the states in which such persons reside; 

   (C) Such states have associations similar to the association created by this article; and 

   (D) Such persons are not eligible for any amount of coverage by such associations. 

   (b) Regardless of where they reside, except for nonresident certificate holders under group policies or contracts, who are the beneficiaries, assignees, or payees of the persons covered under paragraph (a) of this subsection (1). 

   (1.3) Subsection (1) of this section shall not apply to structured settlement annuities. Except as otherwise provided in subsections (1.5) and (1.7) of this section, this article shall provide coverage to a person who is a payee under a structured settlement annuity or to a beneficiary of a deceased payee if the payee: 

   (a) Is a resident, regardless of where the contract owner resides; or 

   (b) Is not a resident, but only under both of the following conditions: 

   (I) Either: 

   (A) The contract owner of the structured settlement annuity is a resident; or 

   (B) The contract owner of the structured settlement annuity is not a resident, but the insurer that issued the structured settlement annuity is domiciled in this state and the state in which the contract owner resides has an association similar to the association created by this article; and 

   (II) Neither the payee, the beneficiary, nor the contract owner is eligible for coverage by the association of the state in which the payee or contract owner resides. 

   (1.5) This article shall not provide coverage to a person who is a payee or beneficiary of a contract owner who is a resident of this state if the payee or beneficiary is afforded any coverage by the association of another state. 

   (1.7) This article is intended to provide coverage to a person who is a resident of this state and, in special circumstances, to a nonresident. In order to avoid duplicate coverage, if a person who would otherwise receive coverage under this article is provided coverage under the laws of any other state, the person shall not be provided coverage under this article. In determining the application of the provisions of this subsection (1.7) in situations where a person could be covered by the association of more than one state, whether as an owner, payee, beneficiary, or assignee, this article shall be construed in conjunction with other state laws to result in coverage by only one association. 

   (2) (a) This article shall provide coverage to the persons specified in subsection (1) of this section for direct, nongroup life, health, annuity, and supplemental policies or contracts and for certificates under direct group life, health, annuity, and supplemental policies and contracts issued by member insurers pursuant to articles 7 and 8 and parts 1 and 2 of article 16 of this title, except as limited by this article. 

   (b) This article shall not provide coverage for: 

   (I) Any portion of a policy or contract not guaranteed by the member insurer, or under which the risk is borne by the policy or contract holder; 

   (II) Any policy or contract of reinsurance, unless assumption certificates have been issued; 

   (III) Any portion of a policy or contract to the extent that the rate of interest on which it is based, or the interest rate, crediting rate, or other factor employed in calculating returns or changes in value which may include, without limitation, an index or other external reference stated in the policy or contract: 

   (A) When averaged over the period of four years prior to the date that the member insurer becomes an insolvent insurer under this article, exceeds a rate of interest determined by subtracting two percentage points from Moody's average, averaged for that same four-year period, or for such lesser period if the policy or contract was issued less than four years before the member insurer becomes an insolvent insurer under this article; and 

   (B) On and after the date that the member insurer becomes an insolvent insurer under this article, exceeds the rate of interest determined by subtracting three percentage points from Moody's average as most recently available; 

   (IV) Any plan or program of an employer, association, or similar entity to provide life, health, or annuity benefits to its employees or members, to the extent that such plan or program is self-funded or uninsured, including but not limited to benefits payable by an employer, association, or similar entity under: 

   (A) A multiple employer welfare arrangement, as defined in section 514 of the federal "Employee Retirement Income Security Act of 1974", as amended; 

   (B) A minimum premium group insurance plan; 

   (C) A stop-loss group insurance plan; or 

   (D) An administrative services only contract; 

   (V) Any portion of a policy or contract to the extent that it provides dividends or experience rating credits or provides that any fees or allowances be paid to any person, including the policy or contract holder, in connection with the service to or administration of such policy or contract; 

   (VI) Any policy or contract issued in this state by a member insurer at a time when it was not licensed or did not have a certificate of authority to issue such policy or contract in this state; 

   (VII) Any unallocated annuity contract; 

   (VIII) Any annuity contract or group annuity certificate which is used by a nonprofit insurance company exclusively for the benefit of nonprofit educational institutions and their employees for the purpose of providing retirement benefits; 

   (IX) Any policy, contract, certificate, or subscriber agreement issued by a prepaid dental care plan as defined in parts 1 and 5 of article 16 of this title; 

   (X) Sickness and accident insurance as defined in section 10-16-102 (30) when written by a property and casualty insurer as part of an automobile insurance contract; 

   (XI) Any unallocated annuity contract issued to an employee benefit plan protected under the federal pension benefit guaranty corporation; 

   (XII) Any insurer which was insolvent or unable to fulfill its contractual obligations as of July 1, 1991; except that an annuity contract issued or assumed by such an insurer shall be covered under this article if such insurer was ordered into liquidation between July 1, 1991, and August 31, 1991; 

   (XIII) Any policy or contract covering persons who are not citizens of the United States; 

   (XIV) Any portion of a policy or contract to the extent it provides for interest or other changes in value to be determined by the use of an index or other external reference stated in the policy or contract but such changes have not been credited to the policy or contract, or to the extent the policy or contract owner's rights are subject to forfeiture, as of the date the member insurer becomes an insolvent insurer under to this article. If a policy's or contract's interest or changes in value are credited less frequently than annually, then for purposes of determining the values that have been credited and are not subject to forfeiture under this section, the interest or change in value determined by using the procedures defined in the policy or contract shall be credited as if the contractual date of crediting interest or changing values was the date of insolvency, and such interest or changes shall not be subject to forfeiture. 

   (XV) Any kind of insurance or annuity, the benefits of which are exclusively payable or determined by a separate account required by the terms of such insurance policy to be maintained by the insurer or by a separate entity. 

   (3) The benefits for which the association may become liable shall not exceed the lesser of: 

   (a) The contractual obligations for which the insurer is liable or would have been liable if it were not an insolvent insurer; or 

   (b) (I) With respect to any one life, regardless of the number of policies or contracts with that insurer: 

   (A) Three hundred thousand dollars in net life insurance death benefits, and no more than one hundred thousand dollars in net cash surrender and net cash withdrawal values for life insurance; 

   (B) For health insurance benefits: One hundred thousand dollars for coverages not defined as disability, basic hospital, medical and surgical, or major medical insurance, including any net cash surrender and net cash withdrawal values; three hundred thousand dollars for disability insurance; or five hundred thousand dollars for basic hospital, medical and surgical, or major medical insurance; 

   (C) One hundred thousand dollars in the present value of annuity benefits, including net cash surrender and net cash withdrawal values; or 

   (D) With respect to each payee of a structured settlement annuity, one hundred thousand dollars in present value annuity benefits, in the aggregate, including net cash surrender and net cash withdrawal values. 

   (II) The association shall not be liable to expend more than three hundred thousand dollars, in the aggregate, with respect to any one life under sub-subparagraphs (A) to (D) of subparagraph (I) of this paragraph (b); except that, with respect to benefits for basic hospital, medical and surgical, and major medical insurance under sub-subparagraph (B) of subparagraph (I) of this paragraph (b), the aggregate liability of the association shall not exceed five hundred thousand dollars with respect to any one individual. 

   (4) The liability of the association is strictly limited by the express terms of such covered policies and contracts and by the provisions of this article and is not affected by the contents of any brochures, illustrations, advertisements, or oral statements by agents, brokers, or others, used or made in connection with the sale of such covered policies and contracts. The association is not liable for any extracontractual, exemplary, or punitive damages, attorney fees, or interest other than as provided for by the terms of such covered policies or contracts. 

   Source: L. 91: Entire article added, p. 1258, § 1, effective July 1. L. 92: (2)(a), (2)(b)(IX), and (2)(b)(X) amended, p. 1725, § 11, effective July 1. L. 94: (2)(b)(XII) amended, p. 614, § 1, effective April 13. L. 2000: IP(1)(a), (2)(b)(III), (2)(b)(VII), (2)(b)(XIII), (2)(b)(XIV), and (3)(b) amended and (1.3), (1.5), and (1.7) added, p. 1018, § 2, effective July 1.

   C.J.S. See 46 C.J.S., Insurance, § § 1122, 1168. 

10-20-105 - Construction.    

This article shall be construed to effect the purpose set forth in section 10-20-102, which shall constitute an aid and guide to interpretation. 

   Source: L. 91: Entire article added, p. 1261, § 1, effective July 1.  

10-20-106 - Creation of the association.    

(1) There is hereby created a private nonprofit legal entity to be known as the life and health insurance protection association. All member insurers shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions pursuant to the plan of operation specified in section 10-20-110 and shall exercise its powers through the board of directors provided in section 10-20-107. For purposes of administration and assessment, the association shall maintain three accounts:

   (a) The life insurance account; 

   (b) The health insurance account; and 

   (c) The annuity account. 

   (2) The association is under the supervision of the commissioner and is subject to the applicable provisions of the insurance laws of this state. Meetings or records of the association may be opened to the public consistent with the provisions of the insurance laws of Colorado. 

   Source: L. 91: Entire article added, p. 1261, § 1, effective July 1.  

10-20-107 - Board of directors.    

(1) The board of directors of the association shall consist of not less than five nor more than nine member insurers serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term by a majority vote of the remaining board members, subject to the approval of the commissioner. To select the first board and initially organize the association, the commissioner shall give notice to all member insurers of the time and place of the organizational meeting. At the organizational meeting each member insurer shall be entitled to one vote in person or by proxy. If the board is not selected within sixty days after notice of the organizational meeting, the commissioner may appoint the initial members.

   (2) In approving selections or in appointing members to the board, the commissioner shall consider, among other things, whether all member insurers are fairly represented. 

   (3) Members of the board may be reimbursed from the assets of the association for expenses incurred by them as members of the board, but members of the board shall not otherwise be compensated by the association for their services. 

   Source: L. 91: Entire article added, p. 1262, § 1, effective July 1.  

10-20-108 - Powers and duties of the association.    

(1) In addition to any other powers and duties provided for in this article, the association has the following powers and duties:

   (a) If a domestic insurer is an insolvent insurer, the association shall, subject to the limitations of this article and subject to the approval of the commissioner: 

   (I) Guarantee, assume, or reinsure or cause to be guaranteed, assumed, or reinsured the covered policies of the insolvent insurer; 

   (II) Assure payment of the contractual obligations of the insolvent insurer; and 

   (III) Provide such moneys, pledges, notes, guarantees, or other means as are reasonably necessary to discharge such duties; or 

   (b) With respect to only life and health insurance policies, provide benefits and coverages in accordance with subsection (3) of this section. 

   (2) (a) If a foreign or alien insurer is an insolvent insurer, the association shall, subject to the approval of the commissioner: 

   (I) Guarantee, assume, or reinsure or cause to be guaranteed, assumed, or reinsured the covered policies of residents; 

   (II) Assure payment of the contractual obligations of the insolvent insurer to the residents; and 

   (III) Provide such moneys, pledges, notes, guarantees, or other means as are reasonably necessary to discharge those duties; or 

   (IV) With respect to only life and health insurance policies, provide benefits and coverages in accordance with subsection (3) of this section. 

   (b) This subsection (2) shall not apply if the commissioner has determined that the foreign or alien insurer's domiciliary jurisdiction or state of entry provides, by statute, protection substantially similar to that provided by this article for residents of the state. 

   (3) (a) When proceeding under paragraph (b) of subsection (1) or subparagraph (IV) of paragraph (a) of subsection (2) of this section, the association shall, with respect to only life and health insurance policies: 

   (I) Assure payment of benefits for premiums identical to the premiums and benefits, except for terms of conversion and renewability, that would have been payable under the policies of the insolvent insurer for claims incurred: 

   (A) With respect to group policies, not later than the earlier of the next renewal date under such policies or contracts or forty-five days, but in no event less than thirty days, after the date on which the association becomes obligated with respect to such policies; 

   (B) With respect to individual policies, not later than the earlier of the next renewal date, if any, under such policies or one year, but in no event less than thirty days, after the date on which the association becomes obligated with respect to such policies; 

   (II) Make diligent efforts to provide all known insureds, or group policyholders with respect to group policies, thirty days notice of the termination of the benefits provided; 

   (III) With respect to individual policies, make available to each known insured or owner if other than the insured, and with respect to group policies, make available to each individual formerly insured who is not eligible for replacement group coverage, substitute coverage on an individual basis in accordance with the provisions of paragraph (b) of this subsection (3), if the insureds had a right under law or the terminated policy to convert coverage to individual coverage or to continue an individual policy in force until a specified age or for a specified time, during which the insurer had no right unilaterally to make changes in any provisions of the policy or had a right only to make changes in premium by class. 

   (b) (I) In providing the substitute coverage required under subparagraph (III) of paragraph (a) of this subsection (3), the association may offer either to reissue the terminated coverage or to issue an alternative policy. 

   (II) Alternative or reissued policies shall be offered without requiring evidence of insurability and shall not provide for any waiting period or exclusion that would not have applied under the terminated policy. 

   (III) The association may reinsure any alternative or reissued policy. 

   (c) (I) Alternative policies adopted by the association shall be subject to the approval of the commissioner. The association may adopt alternative policies of various types for future issuance without regard to any particular insolvency. 

   (II) Alternative policies shall contain at least the minimum statutory provisions required in this state and provide benefits that shall be reasonably related to the premium charged. The association shall set the premium in accordance with a table of rates which it shall adopt as approved by the commissioner. The premium shall reflect the amount of insurance to be provided and the age and class of risk of each insured but shall not reflect any changes in the health of the insured after the original policy was last underwritten. 

   (III) Any alternative policy issued by the association shall provide coverage of a type similar to that of the policy issued by the insolvent insurer, as determined by the association. 

   (d) If the association elects to reissue terminated coverage at a premium rate different from that charged under the terminated policy, the premium shall be set by the association in accordance with the amount of insurance provided and the age and class of risk, subject to approval of the commissioner or by a court of competent jurisdiction. 

   (e) The obligations of the association, with respect to coverage under any policy of the insolvent insurer or under any reissued or alternative policy, shall cease on the date such coverage or policy is replaced by another similar policy by the policyholder, the insured, or the association. 

   (4) When proceeding pursuant to subsection (2) (a) (II) or (2) (b) of this section, with respect to any policy or contract carrying guaranteed minimum interest rates, the association shall assure the payment or crediting of a rate of interest consistent with section 10-20-104 (2) (b) (III) (A) and (2) (b) (III) (B). 

   (5) Nonpayment of premiums within thirty-one days after the date required under the terms of any guaranteed, assumed, alternative, or reissued policy or contract or substitute coverage shall terminate the obligations of the association under such policy or coverage under this article with respect to such policy or coverage, except with respect to any claims incurred or any net cash surrender value which may be due in accordance with the provisions of this article. 

   (6) Premiums due for coverage after entry of an order of liquidation of an insolvent insurer shall belong to and be payable at the direction of the association, and the association shall be liable for unearned premiums due to policy contract owners arising after the entry of such order. 

   (7) In carrying out its duties under subsections (1) and (2) of this section, the association may, subject to approval by the court: 

   (a) Impose permanent policy or contract liens in connection with any guarantee, assumption, or reinsurance agreement, if the association finds that the amounts which can be assessed under this article are less than the amounts needed to assure full and prompt performance of the duties of the association under this article, or that the economic or financial conditions as they affect member insurers are sufficiently adverse to render the imposition of such permanent policy or contract liens to be in the public interest; 

   (b) Impose temporary moratoriums or liens on payments of cash values and policy loans, or any other right to withdraw funds held in conjunction with policies or contracts, in addition to any contractual provisions for deferral of cash or policy loan value. 

   (8) If the association fails to act within a reasonable period of time as provided in subsections (1), (2), and (3) of this section, the commissioner shall have the powers and duties of the association under this article with respect to insolvent insurers. 

   (9) There shall be no liability on the part of and no cause of action shall arise against the association or against any transferee from the association in connection with the transfer by reinsurance or otherwise of all or any part of an insolvent insurer's business by reason of any action taken or any failure to take any action by the insolvent insurer at any time. 

   (10) The association may render assistance and advice to the commissioner, upon the commissioner's request, concerning payment of claims, continuance of coverage, the performance of other contractual obligations of any insolvent insurer, or any member insurer's performance of its contractual obligations. 

   (11) The association shall have standing to appear or intervene before any court or agency in this state which has jurisdiction over a member insurer for which the association is or may become obligated under this article, or with jurisdiction over any person or property against which the association may have rights through subrogation or otherwise. Such standing shall extend to all matters germane to the powers and duties of the association, including but not limited to proposals for reinsuring, modifying, or guaranteeing the policies or contracts of the member insurer and the determination of the policies or contracts and contractual obligations. The association shall also have the right to appear or intervene before a court or agency in another state with jurisdiction over a member insurer for which the association is or may become obligated or with jurisdiction over any person or property against whom the association may have rights through subrogation or otherwise. 

   (12) (a) Any person receiving benefits under this article shall be deemed to have assigned the rights under, and any causes of action against any person for losses arising under, resulting from, or otherwise relating to, the covered policy or contract to the association to the extent of the benefits received because of this article, whether the benefits are payments of or on account of contractual obligations, continuation of coverage, or the provision of substitute or alternative coverage. The association may require an assignment to it of such rights and causes of action by any payee, policy, or contract owner, beneficiary, insured, or annuitant as a condition precedent to the receipt of any right or benefits conferred by this article upon such person. 

   (b) The subrogation rights of the association under this subsection (12) shall have the same priority against the assets of the insolvent insurer as that possessed by the person entitled to receive benefits under this article. 

   (c) In addition to paragraphs (a) and (b) of this subsection (12), the association shall have all common-law rights of subrogation and any other equitable or legal remedy which would have been available to the insolvent insurer, owner, beneficiary, or payee of a policy or contract with respect to such policy or contract, including without limitation, in the case of a structured settlement annuity, any rights of the owner, beneficiary, or payee of the annuity, to the extent the benefits received pursuant to this article against a person originally or by succession responsible for the losses arising from the personal injury relating to the annuity or payment therefor, excepting any such person responsible solely by reason of serving as an assignee in respect of a qualified assignment under section 130 of the federal "Internal Revenue Code of 1986", as amended. 

   (13) The association may: 

   (a) Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this article; 

   (b) Sue or be sued, including taking any legal actions necessary or proper to recover any unpaid assessments pursuant to section 10-20-109 and to settle claims or potential claims against it; 

   (c) Borrow money to effect the purposes of this article, and any notes or other evidence of indebtedness of the association not in default shall be legal investments for domestic insurers and may be carried as admitted assets; 

   (d) Employ or retain such persons as are necessary to handle the financial transactions of the association and to perform such other functions as become necessary or proper under this article; 

   (e) Take such legal action as may be necessary to avoid payment of improper claims; 

   (f) Exercise, for the purposes of this article and to the extent approved by the commissioner, the powers of a domestic life or health insurer, but the association shall not issue insurance policies or annuity contracts other than those issued to perform its obligations under this article; 

   (g) Negotiate and contract with any liquidator or ancillary receiver to carry out the powers and duties of the association; 

   (g.5) Request information from persons seeking coverage from the association in order to aid the association in determining its obligations under this article with respect to the person; and a person receiving such request shall promptly comply; 

   (g.7) Take other necessary or appropriate action to exercise its powers and discharge its duties and obligations under this article; 

   (h) With respect to covered policies for which the association becomes obligated after an entry of an order of liquidation, the association may elect to succeed to the rights of an insolvent insurer arising after the date of the order of liquidation under any contract of reinsurance to which the insolvent insurer was a party, to the extent that such contract provides coverage for losses occurring after the date of the order of liquidation. As a condition to making this election, the association shall pay premiums for coverage relating to periods after the date of the order of liquidation. 

   (14) The association may join an organization of one or more other state associations of similar purposes to further the purposes and to administer the powers and duties of the association. 

   (15) Every insured or claimant seeking the protection of this article shall cooperate with the association to the same extent the person or entity would have been required to cooperate with the insolvent insurer. The association has no cause of action against the insured of the insolvent insurer for any sums the association has paid out except those causes of action the insolvent insurer would have had if the sums had been paid by the insolvent insurer. If an insolvent insurer operates on a plan with assessment liability, payments of claims by the association do not reduce the liability of the insured to the receiver, liquidator, or statutory successor for unpaid assessments. 

   (16) The receiver, liquidator, or statutory successor of an insolvent insurer is bound by settlements of covered claims by the association or a similar organization in another state. The association has a claim against the estate of the insolvent insurer to the extent of claims and expenses paid by the association in connection with the duties of the association as to the insolvent insurer. The court having jurisdiction shall grant these settled claims in the priority to which the claimant would have been entitled in the absence of this article against the assets of the insolvent insurer. The expenses, including legal fees of the association or similar organization in handling claims, shall be given the same priority as the expenses of the liquidator. 

   (17) The association shall periodically file with the liquidator of the insolvent insurer statements of the covered claims and associated expenses paid by the association and estimates of anticipated claims against the association. This periodic filing preserves the rights of the association for claims against the assets of the insolvent insurer. 

   (18) The association shall investigate claims brought against it and adjust, compromise, settle, and pay covered claims to the extent of the obligation of the association and deny all other claims. 

   (19) A person who has a claim against an insurer pursuant to a provision of an insurance policy, other than a policy of an insolvent insurer, that also is a contractual obligation under this article, must first exhaust his right under that policy. The amount of an approved claim under this article shall be reduced by the policy limits of, or amount paid under, that insurance policy, whichever amount is greater. If a claimant exhausts all rights under a policy other than a policy of an insolvent insurer, the insurer issuing that policy is not entitled to sue or continue a suit against the insured of the insolvent insurer to recover an amount paid to the claimant under the policy; except that a person having a contractual obligation, as defined by this article, under a life insurance policy or an annuity contract issued by an insolvent insurer is not required to exhaust other coverage for that claim, and the amount of an approved claim under a life insurance policy or annuity contract issued by an insolvent insurer may not be reduced because of that duplicate coverage. 

   (20) Where the association has arranged or offered to provide the benefits of this article to a covered person under a plan or arrangement that fulfills the association's obligations under this article, the person shall not be entitled to benefits from the association in addition to or other than those provided under the plan or arrangement. 

   (21) Venue in a suit against the association arising under this article shall be in the city and county of Denver. The association shall not be required to give an appeal bond in an appeal that relates to a cause of action arising under this article. 

   (22) In carrying out its duties in connection with guaranteeing, assuming, or reinsuring policies or contracts under this section, the association may issue substitute coverage for a policy or contract that provides for the calculation of returns or changes in value by the use of an interest rate, crediting rate, or similar factor determined by use of an index or other external reference, by issuing an alternative policy or contract in accordance with the following provisions: 

   (a) In lieu of the index or other external reference provided for in the original policy or contract, the alternative policy or contract provides for a fixed interest rate, payment of dividends with minimum guarantees, or a different method for calculating interest or changes in value; 

   (b) There is no requirement for the evidence of insurability, a waiting period, or any other exclusion that would not have applied under the replaced policy or contact; 

   (c) The alternative policy or contract is substantially similar to the replaced policy or contract in all other material terms. 

   Source: L. 91: Entire article added, p. 1262, § 1, effective July 1. L. 94: IP(3)(a) and (4) amended, p. 1650, § 93, effective May 31. L. 2000: (10), (11), (12)(a), and (12)(c) amended and (13)(g.5), (13)(g.7), (20), (21), and (22) added, p. 1020, § § 3, 4, effective July 1.  

10-20-109 - Assessments.    

(1) For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board shall assess each member insurer separately for each account at such time and for such amounts as the board finds necessary. Assessments shall be due not less than thirty days after prior written notice to the member insurers and shall accrue interest at the rate set forth in 28 U.S.C. sec. 1961 on and after the due date.

   (2) There shall be two assessments, as follows: 

   (a) Class A assessments shall be made for the purpose of meeting administrative and legal costs and other expenses and examinations conducted under the authority of section 10-20-112 (5). Class A assessments may be made whether or not related to a particular insolvent insurer. 

   (b) Class B assessments shall be made to the extent necessary to carry out the powers and duties of the association under section 10-20-108 with regard to an insolvent insurer. 

   (3) (a) The amount of any class A assessment shall be determined by the board and may be made on a non-pro rata basis. A non-pro rata assessment shall not exceed one hundred fifty dollars per member insurer in any one calendar year. The amount of any class B assessment shall be allocated for assessment purposes among the accounts pursuant to an allocation formula which may be based on the premiums or reserves of the insolvent insurer or any other standard deemed by the board in its sole discretion to be fair and reasonable under the circumstances. 

   (b) Class B assessments against member insurers for each account shall be in the proportion that the premiums received on business in this state by each assessed member insurer on policies or contracts covered by each account for the three most recent calendar years for which information is available preceding the year in which the insurer became insolvent, bear to such premiums received on business in this state for such calendar years by all assessed member insurers. 

   (c) Assessments for funds to meet the requirements of the association with respect to an insolvent insurer shall not be made until necessary to implement the purposes of this article. Classification of assessments under subsection (2) of this section and computation of assessments under this subsection (3) shall be made with a reasonable degree of accuracy, recognizing that exact determinations may not always be possible. 

   (4) The association may abate or defer, in whole or in part, the assessment of a member insurer if, in the opinion of the board, payment of the assessment would endanger the ability of the member insurer to fulfill its contractual obligations. In the event an assessment against a member insurer is abated, or deferred in whole or in part, the amount by which such assessment is abated or deferred may be assessed against the other member insurers in a manner consistent with the basis for assessments set forth in this section. 

   (5) The total of all assessments upon a member insurer for each account shall not in any one calendar year exceed one percent of the average premiums received by such insurer in this state on the policies and contracts covered by the account during the three calendar years preceding the year in which the insurer became insolvent. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in any of the accounts an amount sufficient to carry out the responsibilities of the association, the necessary additional funds shall be assessed as soon thereafter as permitted by this article. The board shall provide in the plan of operation a method of allocating funds among claims, whether relating to one or more insolvent insurers, when the maximum assessment will be insufficient to cover anticipated claims. 

   (6) The board shall, by an equitable method as established in the plan of operation, refund to member insurers, in proportion to the contribution of each insurer to that account, the amount by which the assets of the account exceed the amount the board finds is necessary to carry out, during the coming year, the obligations of the association with regard to that account, including assets accruing from assignment, subrogation, net realized gains, and income from investments. A reasonable amount shall be retained in each account to provide funds for the continuing expenses of the association and for future losses. 

   (7) It shall be proper for any member insurer, in determining its premium rates and policyholder dividends as to any kind of insurance within the scope of this article, to consider the amount reasonably necessary to meet its assessment obligations under this article. 

   (8) The association shall issue to each insurer paying an assessment for the life and annuity accounts under this article, other than a class A assessment, a certificate of contribution from the association, in a form prescribed by the commissioner, for the amount of the assessment so paid. All outstanding certificates shall be of equal dignity and priority without reference to amounts or dates of issue. Such certificate of contribution may be shown by the insurer in its financial statement as an asset in such form and for such amount, if any, and period of time as the commissioner may approve; but the insurer shall, at its option, have the right in any event to show such certificate of contribution as an admitted asset at percentages of the original face amount of the assessment for calendar years as follows: 

   (a) One hundred percent for the first year after issuance; and 

   (b) One hundred percent less any amount already taken as an offset against premium tax liability pursuant to section 10-20-113 for the second and subsequent years after issuance. 

   (9) Any member insurer whose certificate of authority has been terminated for any reason whatsoever shall be liable for any assessment based on insolvencies arising prior to such termination. 

   (10) An assessment is deemed to occur on the date upon which the board votes such assessment. The board may defer calling the payment of the assessment or may call for payment in one or more installments. 

   Source: L. 91: Entire article added, p. 1269, § 1, effective July 1. L. 2000: (8) amended, p.1022, § 5, effective July 1.  

10-20-110 - Plan of operation.    

(1) (a) The association shall maintain a plan of operation to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall be submitted to the commissioner and be effective upon the commissioner's written approval or after thirty days if said commissioner has not disapproved.

   (b) If the association fails to submit a suitable plan of operation or suitable amendments to the plan by January 1, 1992, the commissioner shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this article. Such rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner. 

   (2) All member insurers shall comply with the plan of operation. 

   (3) The plan of operation shall, in addition to any other provisions specified in this article: 

   (a) Establish procedures for handling the assets of the association; 

   (b) Establish the amount and method of reimbursing members of the board pursuant to section 10-20-107; 

   (c) Establish regular places and times for meetings including telephone conference calls of the board; 

   (d) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board; 

   (e) Establish the procedures whereby selections for the board will be made and submitted to the commissioner; 

   (f) Establish any additional procedures for assessments under section 10-20-109; 

   (g) Contain additional provisions necessary or proper for the execution of the powers and duties of the association. 

   (4) The plan of operation may provide that any or all powers and duties of the association, except those established pursuant to sections 10-20-108 (12) (c) and 10-20-109, are delegated to a corporation, association, or other organization which performs, or will perform, functions similar to those of the association established pursuant to this article, or its equivalent in two or more states. Such a corporation, association, or organization shall be reimbursed for any payments made on behalf of the association and shall be paid for its performance of any function of the association. A delegation pursuant to this subsection (4) shall take effect only with the approval of both the board and the commissioner and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this article. 

   (5) The plan of operation shall establish a procedure for protest by a member insurer of assessments made by the association pursuant to section 10-20-109. Such procedure shall require that: 

   (a) Any member insurer that wishes to protest all or any part of an assessment for any year shall first pay the full amount of the assessment as set forth in the notice provided by the association. Such payments shall be accompanied by a statement in writing that the payment is made under protest, setting forth a brief statement of the ground for the protest. The association shall hold such payments in a separate interest-bearing account. 

   (b) Within thirty days following the payment of an assessment under protest by any protesting member insurer, the association shall notify the member insurer in writing of its determination with respect to the protest unless the association notifies the member that additional time is required to resolve the issues raised by the protest. 

   (c) In the event the association determines that the protesting member insurer is entitled to a refund, such refund shall be made within thirty days following the date upon which the association makes its determination. 

   (d) In the alternative to rendering a decision with respect to any protest based on a question regarding the assessment base, the association may refer such protests to the commissioner for final decision, with or without a recommendation from the association. 

   (e) Interest on any refund due a protesting member insurer shall be paid at the rate actually earned by the association. 

   Source: L. 91: Entire article added, p. 1272, § 1, effective July 1.  

10-20-111 - Powers and duties of the commissioner.    

(1) In addition to any other powers and duties specified in this article, the commissioner shall:

   (a) Upon request of the board, provide the association with a statement of the premiums in this and any other appropriate states for each member insurer; 

   (b) Notify the board of the existence of an insolvent insurer not later than three days after a determination of insolvency is made by the commissioner, irrespective of limitations imposed upon the commissioner in section 10-3-401; 

   (c) In any liquidation proceeding involving a domestic insurer, be appointed as the liquidator. 

   (2) The commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the commissioner may levy a forfeiture on any member insurer which fails to pay an assessment when due. Such forfeiture shall not exceed five percent of the unpaid assessment per month, but no forfeiture shall be less than one hundred dollars per month. 

   (3) The liquidator of any insolvent insurer shall notify all interested persons of the effect of this article. 

   Source: L. 91: Entire article added, p. 1274, § 1, effective July 1.  

10-20-112 - Prevention of insolvencies.    

(1) To aid in the detection and prevention of insurer insolvencies, it shall be the duty of the commissioner:

   (a) To notify the commissioners of all the other states, territories of the United States, and the District of Columbia when action is taken in any of the following matters against a member insurer: 

   (I) Revocation of license; 

   (II) Suspension of license; or 

   (III) Issuance of a formal order that such member insurer restrict its premium writing, obtain additional contributions to surplus, withdraw from the state, reinsure all or any part of its business, or increase capital, surplus, or any other account for the security of policyholders or creditors. Such notice shall be mailed to all commissioners within thirty days following the action taken or the date on which such action occurs. 

   (b) To report to the board when the commissioner has taken any of the actions set forth in paragraph (a) of this subsection (1) or has received a report from any other commissioner indicating that such action has been taken in another state. Such report to the board shall contain all significant details of the action taken or the report received from another commissioner. 

   (c) To report to the board when the commissioner has reasonable cause to believe from an examination, whether completed or in process, of a member company that such member company may be an insolvent insurer; 

   (d) To furnish to the board the NAIC insurance regulatory information system ratios and listings of companies not included in the ratios developed by the NAIC, and the board may use the information contained therein in carrying out its duties and responsibilities under this section. Such report and the information contained therein shall be kept confidential by the board until such time as made public by the commissioner or other lawful authority. 

   (2) The commissioner may seek the advice and recommendations of the board concerning any matter affecting said commissioner's duties and responsibilities regarding the financial condition of member insurers and companies seeking admission to transact insurance business in this state. 

   (3) The board shall, upon request of the commissioner, report and make recommendations to the commissioner upon any matter germane to the solvency or liquidation of any member insurer or germane to the solvency of any company seeking to do an insurance business in this state. Such reports and recommendations shall not be considered public documents. 

   (4) The board shall notify the commissioner when the board has actual knowledge that an insurer may be insolvent. 

   (5) The board shall request that the commissioner order an examination of any member insurer which the board in good faith believes may be insolvent. Within thirty days after the receipt of such request, the commissioner shall begin such examination. The examination may be conducted as an NAIC examination or may be conducted by such persons as the commissioner designates. The cost of such examination shall be paid by the association, and the examination report shall be treated confidentially. In no event shall such examination report be released to the board prior to its release to the public, but this shall not preclude the commissioner from complying with subsection (1) of this section. The commissioner shall notify the board when the examination is completed. The request for an examination shall be kept on file by the commissioner, but it shall not be open to public inspection prior to the release of the examination report to the public. For purposes of this subsection (5), a "request" is not a report or recommendation. 

   (6) The board may make recommendations to the commissioner for the detection and prevention of insurer insolvencies. 

   (7) The board may, at the conclusion of any insurer insolvency in which the association was obligated to pay covered claims, prepare a report to the commissioner containing such information as it may have in its possession bearing on the history and causes of such insolvency. The board may cooperate with the boards of directors of guaranty associations in other states in preparing a report on the history and causes of insolvency of a particular insurer and may adopt by reference any report prepared by such other associations. 

   Source: L. 91: Entire article added, p. 1274, § 1, effective July 1. L. 2000: (3), (4), (5), (6), and (7) amended, p. 1023, § 6, effective July 1.  

10-20-113 - Credits for assessments paid - tax offsets. 

(1) (a) A member insurer may offset against its premium tax liability to this state that amount of its class B assessment described in section 10-20-109 that was assessed for the association's life and annuity accounts pursuant to section 10-20-106 to the extent of twenty percent of the amount of such assessment for each of the first, second, third, fourth, and fifth calendar years following the year in which such assessment was paid.

   (b) To the extent the offsets specified in paragraph (a) of this subsection (1) exceed the member insurer's premium tax liability, they may be carried forward to offset premium tax liabilities in future years. In the event a member insurer should cease doing business, all uncredited assessments may be credited against its premium tax liability for the year it ceases doing business. 

   (c) In no event shall the total amount of all such offsets for all member insurers exceed four million dollars in any year. The association shall prorate the amount of such offset among all member insurers if the total amount of offset would otherwise exceed four million dollars in any such year and shall notify each insurer of the maximum amount of offset allowable for that year and the amount of the excess offset, if any, that may be carried forward to future years. 

   (d) (I) Each member insurer writing health insurance is required to recoup over a reasonable length of time a sum reasonably calculated to recoup the assessments paid by the member insurer under this article by way of a surcharge on premiums charged for health insurance policies to which this article applies. Amounts recouped shall not be considered premiums for any other purpose, including the computation of gross premium tax or agent's commission. 

   (II) The amount of the surcharge shall be filed as part of an insurer's rate filing pursuant to section 10-16-107 (1). Such surcharge must be shown in the rate filing as a separate component of the rate and shall include supporting documentation. 

   (III) Such member insurers who collect surcharges in excess of assessments paid pursuant to this article for an insolvent insurer shall remit the excess to the association as an additional assessment within one hundred twenty days after the end of the collection period as determined by the association. The excess shall be applied to reduce future assessments for that insurer in the appropriate category. 

   (IV) Any such member insurer may omit the collection of the surcharge in any year from its insureds when the expense of collecting the surcharge in any such year would exceed the amount of the surcharge. However, nothing in this paragraph (d) shall relieve the member insurer of its ultimate obligation to recoup the amount of the surcharge otherwise collectible from any such previous year. 

   (2) Any sums which are acquired by refund pursuant to section 10-20-109 (6) from the association by member insurers, and which have theretofore been offset against premium taxes as provided in subsection (1) of this section, shall be paid by such insurers to this state in such manner as the tax authorities may require. The association shall notify the commissioner that such payments have been made. 

   Source: L. 91: Entire article added, p. 1276, § 1, effective July 1. L. 92: (1)(d)(II) amended, p. 1726, § 12, effective July 1. L. 2000: (1)(a) and (1)(c) amended, p. 1023, § 7, effective July 1.  

10-20-114 - Miscellaneous provisions.   

(1) Nothing in this article shall be construed to reduce the liability for unpaid assessments of the insureds of an insolvent insurer operating under a plan with assessment liability.

(2) Records shall be kept of all negotiations and meetings in which the association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties pursuant to section 10-20-108. Records of such negotiations or meetings shall be made public only upon the termination of a liquidation proceeding involving the insolvent insurer, upon the termination of the insolvency of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this subsection (2) shall limit the duty of the association to render a report of its activities under section 10-20-115. 

   (3) For the purpose of carrying out its obligations under this article, the association shall be deemed to be a creditor of the insolvent insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as assignee or subrogee pursuant to section 10-20-108 (11). Assets of the insolvent insurer attributable to covered policies shall be used to continue all covered policies and pay all contractual obligations of the insolvent insurer as required by this article. "Assets attributable to covered policies", as used in this subsection (3), are that proportion of the assets which the reserves that should have been established for such policies bear to the reserves that should have been established for all policies of insurance written by the insolvent insurer. 

   (4) (a) Prior to the termination of any liquidation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders, and policyholders of the insolvent insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of such insolvent insurer. In such a determination, consideration shall be given to the welfare of the policyholders of the continuing or successor insurer. 

   (b) No distribution to stockholders, if any, of an insolvent insurer shall be made until and unless the total amount of valid claims of the association with interest thereon for funds expended in carrying out its powers and duties pursuant to section 10-20-108 with respect to such insurer have been fully recovered by the association. 

   (5) (a) If an order for liquidation of an insurer domiciled in this state has been entered, the receiver appointed under such order shall have a right to recover on behalf of the insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the insurer on its capital stock, made at any time during the five years preceding the petition for liquidation subject to the limitations of paragraphs (b) to (d) of this subsection (5). 

   (b) No such distribution shall be recoverable if the insurer shows that when paid the distribution was lawful and reasonable and that the insurer did not know, and could not reasonably have known, that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations. 

   (c) Any person who was an affiliate which controlled the insurer at the time the distributions were paid shall be liable up to the amount of distributions such person received. Any person who was an affiliate which controlled the insurer at the time the distributions were declared shall be liable up to the amount of the distributions such person would have received if said distributions had been paid immediately. If two or more persons are liable with respect to the same distributions, they shall be jointly and severally liable. 

   (d) The maximum amount recoverable under this subsection (5) shall be the amount needed, in excess of all other available assets of the insolvent insurer, to pay the contractual obligations of the insolvent insurer. 

   (e) If any person liable pursuant to paragraph (c) of this subsection (5) is insolvent, all of its affiliates which controlled it at the time the distribution was paid shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate. 

   (6) Nothing in this article shall be construed to make the state of Colorado in any way liable for the obligations of the life and health insurance protection association or the unpaid claims of impaired or insolvent life and health insurance companies. 

   Source: L. 91: Entire article added, p. 1278, § 1, effective July 1.  

10-20-115 - Examination of the association - annual report.    

The association shall be subject to examination and regulation by the commissioner. The board shall submit to the commissioner each year, not later than one hundred twenty days after the close of the fiscal year of the association, a financial report in a form approved by the commissioner, and a report of the activities of the board during the preceding fiscal year. 

   Source: L. 91: Entire article added, p. 1280, § 1, effective July 1.  

10-20-116 - Tax exemptions.                                                  

The association shall be exempt from payment of all fees and all taxes levied by this state or any of its subdivisions, except taxes levied on real and personal property. 

   Source: L. 91: Entire article added, p. 1280, § 1, effective July 1.  

10-20-117 - Immunity.    

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer, its agents, or its employees, the association, its agents, or its employees, members of the board or the commissioner or his representatives for any action or omission by them in the performance of their powers and duties pursuant to this article. Such immunity shall extend to the participation in any organization of one or more other state associations of similar purposes and to any such organization and its agents or employees. 

   Source: L. 91: Entire article added, p. 1280, § 1, effective July 1.  

10-20-118 - Stay of proceedings - reopening default judgments.    

All proceedings in which the insolvent insurer is a party in any court in this state shall be stayed for sixty days after the date an order of liquidation is final to permit proper legal action by the association on any matters germane to its powers or duties. As to judgment under any decision, order, verdict, or finding based on default, the association may apply to have such judgment set aside by the same court that issued such judgment and shall be permitted to defend against such suit on the merits. 

   Source: L. 91: Entire article added, p. 1280, § 1, effective July 1.  

10-20-119 - Prohibited advertisement of association article in insurance sales - notice to policyholders.    

(1) No person, including an insurer, agent, or affiliate of an insurer, shall make, publish, disseminate, circulate, or place before the public, or cause directly or indirectly to be made, published, disseminated, circulated, or placed before the public, in any newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio station or television station, or in any other way, any advertisement, announcement, or statement, written or oral, which uses the existence of the life and health insurance protection association for the purpose of sales, solicitation, or inducement to purchase any form of insurance covered by the "Life and Health Insurance Protection Association Act". However, this section shall not apply to the association or any other entity which does not sell or solicit insurance.

   (2) By December 1, 1991, the association shall prepare a summary document describing the general purposes and current limitations of this article, and such summary document shall be in compliance with subsection (3) of this section. Such summary document shall be submitted to the commissioner for approval. Sixty days after receiving such approval, each member shall, when delivering a policy or contract as described in section 10-20-104 (2) (a) to a policyholder or contract holder, deliver such summary document concurrently or prior to the delivery of such policy or contract, except when subsection (4) of this section applies. The summary document shall also be available upon request by a policyholder. The distribution, delivery, or contents or interpretation of the summary document shall not mean that either the policy or the contract or the holder thereof will be covered in the event of impairment or insolvency of a member insurer. The summary document shall be revised by the association pursuant to amendments to this article or as other circumstances may require. Failure to receive this summary document does not give a policyholder, a contract holder, or an insured any rights other than those stated in this article. 

   (3) The summary document prepared pursuant to subsection (2) of this section shall contain a clear and conspicuous disclaimer on its face. The commissioner shall establish the form and content of the disclaimer. The disclaimer shall: 

   (a) State the name and address of the association and the division of insurance; 

   (b) Prominently warn the policyholder or contract holder that the association may not cover the policy or, if coverage is available, such policy may be subject to substantial limitations and exclusions and shall be conditioned on the continued residence in the state by the policyholder or contract holder; 

   (c) State that the insurer and its agents are prohibited by law from using the existence of the association for the purpose of sales, solicitation, or inducement to purchase any form of insurance; 

   (d) Emphasize that the policyholder or contract holder should not rely on coverage by the association when selecting an insurer; 

   (e) Provide other information as directed by the commissioner. 

   (4) No insurer or agent may deliver a policy or contract described in section 10-20-104 (2) (a), but excluded under section 10-20-104 (2) (b) (I) from coverage under this article, unless the insurer or agent, prior to or at the time of delivery, gives the policyholder or contract holder a separate written notice which clearly and conspicuously discloses that the policy or contract is not covered by the association. The commissioner shall specify the form and content of the notice. 

   Source: L. 91: Entire article added, p. 1280, § 1, effective July 1.  

10-20-120 - Prospective application.    

This article shall not apply to any insurer which is declared insolvent before July 1, 1991. 

   Source: L. 91: Entire article added, p. 1282, § 1, effective July 1.