Ins 6.55(4)(a)1.1. Refuse or cancel coverage or deny benefits on the basis of the sex of the applicant or insured; Ins 6.55(4)(a)2.2. Restrict, modify, or reduce the benefits, term, or coverage on the basis of the sex of the applicant or insured. Ins 6.55(4)(b)(b) Examples of unfair trade practices defined by par. (a) and prohibited by this rule are: Ins 6.55(4)(b)1.1. Denying coverage to females gainfully employed at home, employed part-time, or employed by relatives when coverage is offered to males similarly employed; Ins 6.55(4)(b)2.2. Denying benefits offered by policy riders to females when the riders are available to males; Ins 6.55(4)(b)3.3. Denying, under group contracts, dependent coverage to husbands of female employees, when dependent coverage is available to wives of male employees; Ins 6.55(4)(b)4.4. Denying disability income coverage to employed women when coverage is offered to men similarly employed; Ins 6.55(4)(b)5.5. Treating complications of pregnancy differently from any other illness or sickness under a contract; Ins 6.55(4)(b)6.6. Restricting, reducing, modifying, or excluding benefits payable for treatment of the genital organs of only one sex; Ins 6.55(4)(b)7.7. Offering lower maximum monthly benefits to women than to men who are in the same underwriting, earnings or occupational classification under a disability income contract; Ins 6.55(4)(b)8.8. Offering more restrictive benefit periods and more restrictive definitions of disability to women than to men in the same underwriting, earnings or occupational classification under a disability income contract; Ins 6.55(4)(b)9.9. Establishing different conditions by sex under which the policyholder may exercise benefit options contained in the contract. Ins 6.55(5)(5) Rates. When rates are differentiated on the basis of sex, the insurer must: Ins 6.55(5)(a)(a) File a brief letter of explanation along with a rate filing. Ins 6.55(5)(b)(b) Maintain written substantiation of such rate differentials in its home office. Ins 6.55(5)(c)(c) Justify in writing to the satisfaction of the commissioner the rate differential upon request. Ins 6.55(5)(d)(d) Base all such rates on sound actuarial principles or a valid classification system and actual experience statistics. Ins 6.55(6)(6) Penalty. Violation of this rule shall subject the insurer to the penalties set forth in s. 601.64, Stats. Ins 6.55 HistoryHistory: Cr. Register, May, 1976, No. 245, eff. 6-1-76; emerg. am. (1), eff. 6-22-76; am. (1), Register, September, 1976, No. 249, eff. 10-1-76. Ins 6.57Ins 6.57 Appointment of insurance agents by insurers. Ins 6.57(1)(1) Submission of an intermediary-agent appointment request shall initiate the appointment of an agent in accordance with s. 628.11, Stats. The appointment request shall be made in a manner prescribed by the commissioner within 15 days of the date the agent contract is executed or the date the first insurance application is submitted and shall show the lines of authority being requested for that agent. An appointment is valid only for the lines of insurance requested. The effective date of a valid appointment is the date on which the appointment request is submitted electronically in the format specified by the commissioner. Billing for the initial appointment shall be done at the time of appointment. Ins 6.57(2)(2) Notice of termination of appointment of an individual intermediary in accordance with s. 628.11, Stats., shall be filed prior to or within 30 calendar days of the termination date in a manner prescribed by the commissioner. Prior to or within 15 days of filing this termination notice, the insurer shall provide the agent written notice that the agent is no longer appointed as a representative of the company and that he or she may not act as its representative. This notice shall also include a formal demand for the return of all indicia of agency. “Termination date” means the date on which the insurer effectively severs the agency relationship with its intermediary-agent and withdraws the agent’s authority to represent the insurer in any capacity. Ins 6.57(2)(a)(a) If the reason for termination is one of the reasons listed as other criteria in s. Ins 6.59 (5) (d) or if the insurer has knowledge the producer was found by a court, government body, or self-regulatory organization authorized by law to have engaged in any of the activities listed in s. Ins 6.59 (5) (d), the insurer must submit complete explanations and documentation in writing to OCI within 30 days of the termination. Ins 6.57(2)(b)(b) If the insurer has knowledge of complaints received or problems experienced by the intermediary or the intermediary’s agency involving indebtedness, forgery, altering policies, fraud, misappropriation, misrepresentation, failure to promptly submit applications or premiums, or poor policyholder service that involved the intermediary being terminated, the insurer must submit complete explanations and documentation in writing to OCI within 30 days of the termination. This documentation need not prove violations, but should include any situation where possible violations exist. The Office of the Commissioner of Insurance will investigate these situations and take appropriate action based upon the investigation. Ins 6.57(2)(c)(c) The insurer or the authorized representative of the insurer shall promptly notify the insurance commissioner in writing if, upon further review or investigation, the insurer discovers additional information that would have been reportable to the insurance commissioner under par. (a) or (b) had the insurer then known of its existence. Ins 6.57(3)(3) In addition each insurer shall pay once each year, in accordance with an assigned billing schedule and in a payment type prescribed by the commissioner, the annual appointment fee defined in sub. (4). A billing schedule shall be adopted by the commissioner under which appointment invoices shall be available to insurers. Ins 6.57(5)(5) No insurer shall accept business directly from any intermediary or enter into an agency contract with an intermediary unless that intermediary is a licensed agent appointed with that insurer within 15 days of the date the agent contract is executed or the first insurance application is submitted, and the appointment shall show the lines of authority being requested for that agent.