Ins 6.785(6r)
(6r)
Disapproval of exempt forms. If the commissioner determines that a policy form subject to the filing exemption granted by sub.
(6g) does not meet the standards set forth in s.
631.20 (2), Stats., the commissioner may disapprove the use of a form.
Ins 6.785(7)
(7) Insurer records. An insurer using a rate subject to the exemption granted by sub.
(4) or a form subject to the filing exemption granted by sub.
(6g) shall maintain separate records and documentation for a period of 3 years after the rate or form is no longer used. This documentation shall include all details of the factors used in determining the rate or classification for a particular risk, including conditions used to qualify a rate for an exemption under sub.
(4). The insurer shall provide these records to the commissioner upon request.
Ins 6.785(8)
(8)
Policyholder notice. Any policy exempt from filing under sub.
(6g) shall include, at the time of issuance, a notice advising the policyholder that the policy includes forms and policy terms that have not been filed with or reviewed by the commissioner of insurance.
Ins 6.785 History
History: Emerg. cr. eff. 8-3-92; cr.
Register, February, 1993, No. 446, eff. 3-1-93;
CR 21-089: am. (title), (1), (3) (intro.), (c), (d), cr. (3) (e), (f), am. (4) (e), cr. (4) (i), (6g), (6r), am. (7), cr. (8)
Register July 2022 No. 799, eff. 8-1-22; correction in (6g) made under s.
35.17, Stats.,
Register July 2022 No. 799.
Ins 6.79
Ins 6.79
Advisory councils and committees. Ins 6.79(1)(1)
Purpose. The purpose of this section is to delineate the process by which the commissioner may create advisory councils and committees under s.
15.04 (1) (c), Stats., to assist in dealing with regulatory problems pursuant to s.
601.20, Stats., and may include assistance with rule-making pursuant to s.
227.13, Stats.
Ins 6.79(2)
(2) Duties. Each council or committee shall advise the commissioner on matters relating to specific issues or subjects presented to the members for study and review by the commissioner of insurance.
Ins 6.79(3)
(3) Expense reimbursement. Members of the councils and committees shall receive no salary or compensation for service on the councils or committees but shall be reimbursed for their actual and necessary expenses in attending meetings or while performing other duties as directed by the commissioner.
Ins 6.79(4)
(4) Meetings. The councils or committees shall meet as needed or at such times as requested by the commissioner.
Ins 6.79(5)
(5) Membership. For each council or committee created by the commissioner, membership may not exceed 15 members and shall be representative of the various interested parties and include persons who possess expertise or interest on the issue or topic of the council or committee.
Ins 6.79(6)
(6) Chairs. The commissioner shall appoint the chair, unless the commissioner authorizes a different process for selection. The commissioner shall appoint an employee of the office as a non-voting member to assist the council or committee with its duties. The commissioner or a designee shall keep a record of all proceedings, transactions, communications, and other official acts of the councils and committees. The commissioner or a designee appointed by the commissioner shall serve as a voting member when the council or committee is convened in accordance with s.
15.04 (1) (c), Stats. The files and records of the councils and committees shall be maintained at the office of the commissioner of insurance.
Ins 6.79(7)
(7) Term. Members of the councils and committees serve at the pleasure of the commissioner.
Ins 6.79 History
History: Cr.
Register, January, 1980, No. 289, eff. 2-1-80; correction in (1) under s. 13.93 (2m) (b) 7., Stats.,
Register, September, 1984, No. 348; r. (2) (c),
Register, November, 1991, No. 431, eff. 12-1-91; correction in (1) made under s. 13.93 (2m) (b) 7., Stats.,
Register, February, 2000, No. 530;
CR 08-064: r. and recr.
Register December 2008 No. 636, eff. 1-1-09.
Ins 6.80(1)(1)
Purpose. The purpose of this section is to establish standards for record retention by insurers and other persons subject to the regulation of the commissioner.
Ins 6.80(2)(a)
(a) This section shall apply to all insurers licensed under chs.
611,
612,
613,
614, and
618, Stats., and including the Local Property Insurance Fund, the State Life Insurance Fund, and the State Indemnity Fund.
Ins 6.80(2)(b)2.
2. Sections Ins 2.07 (5) (a) 2. d. and (b) 2. b. apply to life insurance.
Ins 6.80 Note
Note: Sections Ins 2.07 (5) (a) 2. d. and (b) 2. b. do not exist. Section Ins 2.07 was repealed and recreated eff. 3-1-82.
Ins 6.80 Note
Note: Section Ins 8.09 has been repealed.
Ins 6.80(3)(d)
(d) “Hard copy" means any information which is procured from an alternate storage facility such as microfilm, microfiche or electronic data processing and reproduced into proper form.
Ins 6.80(4)(a)
(a) Corporate records such as minute books, articles and by-laws, and stock and membership records shall be retained as permanent records.
Ins 6.80(4)(a)2.
2. Rate books, agents' handbooks, underwriting manuals, specimen forms, and related actuarial material, as well as reinsurance contracts, shall be retained as long as the related insurance coverage remains in force.
Ins 6.80(4)(b)
(b) Records of insurance company operations and other financial records reasonably related to insurance operations for the preceding 3 years shall be maintained and be available to the commissioner.
Ins 6.80(4)(c)
(c) Records maintained under par.
(b) may be in written form or in any other form capable of being converted to written form within a reasonable period of time.
Ins 6.80(4)(c)1.
1. Original documents, such as claim files, invoices, cancelled checks, underwriting information and other similar materials may be maintained on microfilm or microfiche so long as the records thus maintained are readily available to the commissioner and can be reproduced in hard copy.
Ins 6.80(4)(c)2.
2. Accounting records, policy master files, reserve inventories, and other similar records normally produced in hard copy may be maintained on electromagnetic tape provided such tapes are preserved and that the company can and will reproduce the appropriate hard copy within a reasonable period of time at the request of the commissioner.
Ins 6.80(4)(d)
(d) The statutes of limitations, escheat laws, and statutes regarding minors of the various jurisdictions in which the insurer does business shall control the retention of pertinent records, other than permanent records, beyond the period mentioned in par.
(b). These records may include, but shall not be limited to, claims files, supplementary contract files, records of uncashed checks, and underwriting files.
Ins 6.80(4)(e)
(e) Subject to this rule and applicable statutes and rules or regulations of this and other jurisdictions in which the insurer is licensed to do business, the insurer may set its retention of records to conform to its storage facilities.
Ins 6.80(5)(a)
(a) Records with regard to insurance company operations in the state of Wisconsin for the preceding 3 years shall be maintained in the form specified under sub.
(4) and be available to the commissioner, or the insurance regulatory agency of the insurer's state of domicile.
Ins 6.80(5)(b)
(b) The requirements of this rule pertaining to an insurer's operations in the state of Wisconsin may be met by compliance with the record retention law of its state of domicile. If no such law or regulation exists, an insurer may comply with this rule by presenting a statement attesting to the fact that its record retention system is acceptable to its state of domicile.
Ins 6.80(7)
(7) Penalty. Violations of this rule by any person shall subject the person to the penalties set forth in s.
601.64, Stats.
Ins 6.80(8)
(8) Effective date. As provided in s.
227.22 (2) (intro.), Stats., this rule shall take effect on the first day of the month following its publication.
Ins 6.80 History
History: Cr.
Register, June, 1981, No. 306, eff. 7-1-81; r. (6) under s. 13.93 (2m) (b) 16., Stats.,
Register, December, 1984, No. 348; correction in (8) made under s. 13.93 (2m) (b) 7., Stats.,
Register, May, 1987, No. 377; cr. (2) (b) 10.,
Register, November, 1993, No. 455, eff. 2-1-94; corrections in (3) made under s. 13.93 (2m) (b) 7., Stats.,
Register, February, 2000, No. 530; correction in (2) (b) 5. and 6. made under s. 13.93 (2m) (b) 7., Stats.,
Register January 2002 No. 553; correction in (2) (a) made under s. 13.92 (4) (b) 7., Stats.,
Register August 2014 No. 704.
Ins 6.85
Ins 6.85
Notification of a person's right to file a complaint with the commissioner. Ins 6.85(1)(1)
Purpose. This section interprets and implements s.
631.28, Stats., by specifying the contents of a notice insurers must provide to insureds about their right to file a complaint with the office of the commissioner of insurance. This section also describes when and the manner in which such notice must be provided.
Ins 6.85(2)
(2) Scope. This section applies to all policies or certificates in force, issued or renewed in Wisconsin on or after the effective date of this section.
Ins 6.85(3)
(3) Definitions. For purposes of this section, “insured" means the policyholder for individual policies and both the group policyholder and certificate holder for group policies.
Ins 6.85(4)
(4) Notice format. Every insurer shall disclose the insured's right to contact the office of the commissioner of insurance regarding an insurance problem by providing a notice which shall:
Ins 6.85(4)(a)
(a) Be in the form as prescribed in Appendix I or for policies subject to sub.
(5) (d) in form as prescribed in Appendix 2;
Ins 6.85(4)(b)
(b) Include the issuer's address, toll free phone number, if available, and phone number in no less than 12-point type and bold print.
Ins 6.85 Note
Note: The language in sub. (4) (b) applies to notices sent on or after March 1, 1995.
Ins 6.85(4)(d)
(d) Have the phrase “KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS," “PROBLEMS WITH YOUR INSURANCE?" in Appendix I and the “OFFICE OF THE COMMISSIONER OF INSURANCE" in Appendices I and 2 capitalized and in bold lettering.
Ins 6.85(5)(a)
(a) For policies issued prior to the effective date of this section, except for policies included under pars.
(c) and
(d):
Ins 6.85(5)(a)1.
1. The notice shall be provided on or before the insured's first renewal date after the effective date of this section or within one year after the effective date of this section, whichever is earlier, with a separate notice to the insured; or
Ins 6.85(5)(a)2.
2. For single premium policies, a separate notice shall be provided on or before the insured's next anniversary date or within one year after the effective date of this section, whichever is earlier.
Ins 6.85(5)(b)
(b) For policies or certificates issued on or after the effective date of this section, except for policies included under pars.
(c) and
(d), a separate notice shall be provided at the time the policy or certificate is issued.
Ins 6.85(5)(c)
(c) For surety and title insurance policies the notice must be given as a separate notice to each claimant at the time a claim is denied.
Ins 6.85(5)(d)
(d) For policies subject to s.
632.83, Stats., the insurer shall either give notice in the form as prescribed in Appendix 2 and as specified in pars.
(a) and
(b) or may include the language in Appendix 2 as part of the grievance procedure language in the policy and certificates issued after the effective date and, for policies issued prior to the effective date, provide a policy or certificate amendment on or before the first renewal date after the effective date or within one year after the effective date of this section, whichever is earlier.
Ins 6.85 History
History: Emerg. cr. eff. 2-1-93; cr.
Register, February, 1993, No. 446, eff. 3-1-93; correction in (5) (d),
Register, April, 1993, No. 448, eff. 5-1-93; am. (4) (b) and Appendix,
Register, January, 1995, No. 469, eff. 2-1-95; correction in (5) (d) made under s. 13.93 (2m) (b) 7., Stats.,
Register January 2002 No. 553.
Ins 6.90
Ins 6.90
Prohibited uses of senior-specific designations. Ins 6.90(1)(1)
Purpose. The purpose of this rule is to set forth standards to protect consumers from advertising and trade practices that are deceptive, misleading, or restrain competition unreasonably, with respect to the use of senior-specific certifications and professional designations in the advertising, solicitation, sale or purchase of, or advice made in connection with, life or health insurance, or an annuity product.
Ins 6.90(2)(b)
(b) Nothing in this rule shall limit the commissioner's authority to enforce existing provisions of law.
Ins 6.90(3)
(3) Scope. This rule shall apply to any advertising, solicitation, or sale or purchase of, or advice made in connection with, a life or health insurance policy, or annuity product by an insurance producer.
Ins 6.90(4)(a)1.
1. Printed and published material, audio visual material and descriptive literature of an insurer or intermediary used in direct mail, newspapers, magazines, other periodicals, radio and television scripts, billboards and similar displays, excluding advertisements prepared for the sole purpose of recruiting employees, intermediaries or agencies.
Ins 6.90(4)(a)2.
2. Descriptive literature and sales aids of all kinds authored, issued, distributed or used by an insurer, intermediary or third party for presentation to members of the public, including circulars, leaflets, booklets, depictions, illustrations and form letters. Descriptive literature and sales aids do not include material in house organs of insurers, communications within an insurer's own organization not intended for dissemination to the public, individual communications of a personal nature, and correspondence between a prospective group or blanket policyholder and an insurer in the course of negotiating a group or blanket policy, and general announcements from group or blanket policyholders to eligible individuals that a contract has been written.
Ins 6.90(4)(a)3.
3. Prepared sales talks, presentations and material for use by intermediaries and representations made by intermediaries in accordance therewith, excluding materials to be used solely by an insurer for the training and education of its employees or intermediaries; and
Ins 6.90(4)(b)
(b) “Health insurance" includes any policy of individual or group sickness and accident insurance, long term care insurance, Medicare advantage, Medicare supplement, and Medicare part D.
Ins 6.90(4)(c)
(c) “Insurance producer" means a person required to be licensed under chs.
600 to
655, Stats., to advertise, sell, solicit or negotiate insurance, including life insurance, health insurance and annuities.
Ins 6.90(5)
(5) Prohibited uses of senior-specific certifications and professional designations. Ins 6.90(5)(a)
(a) It is an unfair and deceptive trade practice under s.
628.34 (12), Stats., for an insurance producer to use a senior-specific certification or professional designation that indicates or implies in such a way as to mislead a purchaser or prospective purchaser that the insurance producer has special certification or training in advising or providing services to seniors in connection with the advertising, solicitation, sale, or purchase of a life or health insurance policy, or annuity product or in the provision of advice as to the value of or the advisability of purchasing or selling a life or health insurance policy or annuity product, either directly or indirectly, through publications or writings, or by issuing or promulgating analyses or reports related to a life or health insurance policy or annuity product as follows:
Ins 6.90(5)(a)1.
1. Use of a certification or professional designation by an insurance producer who has not actually earned or is otherwise ineligible to use such certification or designation.
