Ins 6.51(7m)(b)3.a.a. The date the individual becomes eligible under the coverage and under the circumstances described in par. (a). Ins 6.51(7m)(b)3.b.b. For each type of coverage, the date the individual’s coverage would terminate in accordance with the succeeding insurer’s group policy provisions regarding individual termination of coverage, such as at termination of employment or when ceasing to be an eligible dependent. Ins 6.51(7m)(b)3.c.c. For an individual who is totally disabled on the effective date of the succeeding group policy, under a type of coverage for which sub. (6) requires an extension of coverage, the end of any period of extended coverage required of the prior insurer or, if the prior insurer’s group policy was not subject to sub. (6), would have been required of the prior insurer had its group policy been so subject. Ins 6.51(7m)(c)(c) Pre-existing conditions. If the succeeding insurer’s group policy contains a pre-existing condition limitation, the coverage for these conditions of persons becoming covered by the succeeding group policy under par. (a) or (b), during the period the limitation applies under that group policy, shall be the lesser of: Ins 6.51(7m)(c)1.1. The coverage of the succeeding group policy determined without application of the limitation and Ins 6.51(7m)(c)2.2. The coverage of the prior group policy determined after application of any such limitation contained in the policy. Ins 6.51(7m)(d)(d) Deductibles and waiting periods. The succeeding insurer, in applying any deductibles or waiting periods contained in its group policy, including pre-existing condition waiting periods, shall give credit for the satisfaction or partial satisfaction of the same or similar provisions under the prior group policy, to the extent that the prior and succeeding group policies provide similar coverage. Deductible provision credit shall be given for the same or overlapping benefit periods for expenses incurred and applied against the deductible provisions of the prior group policy during the 90 days preceding the effective date of the succeeding group policy, but only to the extent that these expenses are recognized under the succeeding group policy and are subject to a similar deductible provision. Ins 6.51(7m)(e)(e) Determination of prior insurer’s coverage. Where a determination of the prior insurer’s coverage is required by the succeeding insurer, the prior insurer, at the succeeding insurer’s request, shall furnish a statement of the coverage available and a copy of pertinent group policy provisions to permit the succeeding insurer to verify the coverage statement or make its own coverage determination. Coverage of the prior group policy shall be determined in accordance with the definitions, conditions and covered expense provisions of that group policy rather than those of the succeeding group policy. The coverage determination shall be made as if coverage had not been replaced by the succeeding insurer. Ins 6.51(8)(8) More favorable provisions permitted. This section sets out minimum requirements. It does not prohibit a group policyholder and an insurer from agreeing to policy provisions which are more favorable to insured persons. Ins 6.51(9)(9) Effective date. As provided in s. 227.22, Stats., this section shall take effect on the first day of the month following its publication. Ins 6.51 HistoryHistory: Cr. Register, October, 1972, No. 202, eff. 11-1-72; emerg. am. (1) and (2), eff. 6-22-76; am. (1) and (2), Register, September, 1976, No. 249, eff. 10-1-76; am. (1), (2) and (7) (c), Register, March, 1979, No. 279, eff. 4-1-79; r. and recr., Register, March 1982, No. 315, eff. 4-1-82; am. (2), Register, April, 1988, No. 388, eff. 5-1-88; corrections in (7) made under s. 13.93 (2m) (b) 1. and 7., Stats., Register, June, 1997, No. 498; corrections in (3) (a) and (9) made under s. 13.93 (2m) (b) 7., Stats., Register, February, 2000, No. 530; corrections in (7m) (b) (intro.), 3. a. and (c) (intro.) made under s. 13.93 (2m) (b) 7., Stats., Register October 2006 No. 610. Ins 6.52Ins 6.52 Biographical data relating to company officers and directors. Ins 6.52(1)(1) Purpose. This rule is intended to implement and interpret ss. 611.13 (2), 611.54 (1) (a), 611.57, 618.11 (4) and 618.21 (1) (b), Stats., for the purpose of setting standards for the reporting of biographical data relating to company officers, directors, promoters and incorporators, or other persons similarly situated. Ins 6.52(2)(2) Scope. This rule shall apply to all persons proposing to form an insurer under the laws of this state and to all nondomestic insurers applying for admission to this state and to all insurers authorized to do business in this state except as follows: Ins 6.52(2)(c)(c) Nonprofit service plans, cooperative sickness care plans organized or operating under ss. 185.981 to 185.985, Stats., voluntary benefit plans organized or operating under s. 185.991, 1977 Stats., and motor club service companies organized or operating under ss. 616.71 to 616.74 and 616.76 to 616.82, Stats., and donor annuity societies. Ins 6.52(3)(3) Report of organization of a domestic insurer or admission of a nondomestic insurer. Biographical information in form and substance substantially in accordance with Form A, shown at the end of this rule, shall be furnished to the commissioner of insurance by all promoters, incorporators, directors, trustees and principal officers or proposed directors and principal officers, as the case may be, of an insurer being organized or of an insurer applying for admission. Financial and character reports of any such persons may be ordered by the commissioner and the cost or expense of such reports shall be paid by the incorporators as an organization expense or by the insurer applying for admission. Ins 6.52(4)(4) Definition. The term “officer” as used in this rule shall include the president, one or more vice presidents, secretary, treasurer, chief actuary, general counsel, comptroller and any person, however described, who enjoys in fact the executive authority of any such officers. Ins 6.52(5)(5) Reporting with respect to new officers and directors subsequent to organization or admission. A report shall be provided by each domestic insurer to which this rule applies with respect to the appointment or election of any new director, trustee or officer elected or appointed within 15 days after such appointment or election. Such report shall be prepared by the company in form and substance substantially in accordance with Form A, shown at the end of this rule. Ins 6.52(6)(6) Subsequent reports. When such a report has been provided to the commissioner by a company in accordance with subs. (3) and (5) of this rule, no further report concerning subsequent changes in his or her status as an officer or director of such company need be reported to the commissioner provided, however, the company shall promptly report to the commissioner any information concerning the conviction of an officer or director for a felony or the naming of a director, trustee or officer, other than as a party plaintiff or complainant, in any criminal action or in a civil action in which fraud was an issue. Ins 6.52(7)(7) Additional information. The commissioner may request from any company such additional information with respect to any of its officers or directors as he or she may deem necessary and such request shall be promptly complied with by the company to which such request is directed. FORM A
STATEMENT OF EDUCATION, PRIOR OCCUPATION,
BUSINESS EXPERIENCE AND SUPPLEMENTARY
INFORMATION
STATE OF :ss:
COUNTY OF :
The undersigned, being first duly sworn upon oath deposes and says:
1. The affiant’s full name is (initials not acceptable):
2. The affiant’s official title and principal duties with the insurance company is or will be:
3. The affiant’s business address is:
Telephone: __________