Title 31 — Subtitle 16. Miscellaneous
Chapter 01. Disclosure to Policyholders of the Possible Effects of Assessable Insurance Policies
Regulation .01 Disclosure Requirements.LinkCopy Citation
In order to inform and better protect the public, the following regulation is adopted:
A.
Every agent writing insurance business, or broker placing this business, with a mutual insurance company or reciprocal insurer issuing assessable policies shall clearly explain to the prospective policyholder the assessable nature of the policy and its possible effects in the event of insolvency.
B.
Every policy, renewal certificate, bill, statement, invoice, or premium receipt book issued by any agent, broker, mutual company, or reciprocal insurer relating to the sale of an assessable policy shall contain on it the following legend which shall be prominently displayed in bold red type:
C.
Exemption.
(1)
Section B of this regulation does not apply to any business written or placed in an insurer writing property and casualty insurance other than vehicle liability or vehicle physical damage insurance when the insurer writing the business:
(a)
Has a surplus of at least $200,000, as shown in its annual statement for the prior year and any examination as of a later date; and
(b)
Has premium writings during the prior year, net of reinsurance ceded, which do not exceed two times the amount of the insurer's surplus shown on the statement or examination.
(2)
However, whenever the insurer's net premium writings for a current year exceed two times its surplus as shown on the prior year's annual statement or later examination, the legend referred to in §B of this regulation shall be required to be affixed as aforesaid for the remainder of the current calendar year and during the following calendar year.
Chapter 02. Deposits on New Homes — Surety Bond or Escrow Account Requirements
Repealed
Chapter 03. Title Insurance Companies — MAHT Account
Regulation .01 General.LinkCopy Citation
The purpose of this chapter is to provide for the implementation and monitoring of accounts to be maintained by title insurers or title insurance producers for the benefit of the Maryland Affordable Housing Trust.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Act” means Insurance Article, §22-103, Annotated Code of Maryland.
(2)
“Beneficial owner” means a person, other than the buyer in a real estate transaction, for whose benefit a title insurer or title insurance producer is entrusted to hold trust money.
(3)
“Buyer” means a buyer in a real estate transaction.
(4)
“Commissioner” means the Maryland State Insurance Commissioner.
(5)
“Financial institution” means:
(a)
A financial institution located in the State; or
(b)
Subject to approval of the Banking Board in the Maryland Department of Labor, a financial institution outside the State that complies with the requirements of Insurance Article, Title 22, Subtitle 1, Annotated Code of Maryland.
(6)
Law Firm.
(a)
“Law firm” means an association of attorneys who are admitted to practice before the Court of Appeals of the State, and who:
(i)
Are primarily engaged in the practice of law; and
(ii)
Solicit, procure, or negotiate title insurance contracts only as an incident of the practice of law.
(b)
“Law firm” includes a sole practitioner.
(c)
“Law firm” does not include:
(i)
An attorney or an association of attorneys who own, operate, or share an interest in a title agency; or
(ii)
An attorney who is employed by a title agency as a title insurance producer or title insurance broker.
(7)
“MAHT account” means an account established with a financial institution for the benefit of the Maryland Affordable Housing Trust.
(8)
“Maryland Affordable Housing Trust (MAHT)” means the fund created under Housing and Community Development Article, Annotated Code of Maryland.
(9)
“Mortgage” includes a deed of trust.
(10)
“Person” means an individual, joint venture, partnership, corporation, trust, foundation, association, limited liability company, or any other legal entity.
(11)
Title Agency.
(a)
“Title agency” means a business formed for the primary purpose of acting as a title insurance producer.
(b)
“Title agency” includes a sole proprietor, partnership, corporation, or limited liability company.
(12)
Title Insurance Producer.
(a)
“Title insurance producer” means a person who, for compensation, in any manner solicits, procures, or negotiates title insurance contracts.
(b)
“Title insurance producer” includes a person who provides escrow, closing, or settlement services which may result in the issuance of a title insurance contract.
(c)
“Title insurance producer” does not include individuals employed and used by title insurance producers for the performance of clerical, stenographic, and similar office duties.
(13)
“Trust money” means a deposit, payment, or other money that a person entrusts to a title insurer or a title insurance producer to hold for a buyer or beneficial owner in connection with a real estate escrow, settlement, closing, or title indemnification.
Regulation .03 Establishment of MAHT Accounts.LinkCopy Citation
A.
Establishment.
(1)
Each title insurer or title insurance producer expecting to make trust money deposits, as set forth in §B of this regulation, shall establish one or more MAHT accounts with a financial institution.
(2)
The MAHT account:
(a)
May provide all of the financial services which may be required by a title insurer or a title insurance producer;
(b)
Shall be an interest-bearing account; and
(c)
Shall be an account which:
(i)
Is permitted to be held by a title insurer or title insurance producer under federal or State law; and
(ii)
Charges reasonable and customary service charges for commercial accounts.
B.
Trust Money Deposits.
(1)
Except as provided in §B(3) of this regulation, a title insurer or title insurance producer shall deposit all trust monies, as defined in Regulation .02B of this chapter, into a MAHT account as provided in §B(2) of this regulation.
(2)
Trust money from a particular transaction shall be deposited into a MAHT account only if, in the reasonable judgement of the title insurer or the title insurance producer, the money (if deposited into a separate MAHT interest bearing account) would earn:
(a)
$50 or less in interest; or
(b)
More than $50 in interest, if the reasonable and customary charges of the financial institution are anticipated to be more than the interest which would be earned on the trust money if separately deposited into a MAHT interest bearing account.
(3)
A law firm is not required to deposit trust monies into a MAHT account, but shall deposit those monies as may be required by any other applicable law, including the attorney trust accounts provisions of Business Occupations and Professions Article, Annotated Code of Maryland.
Regulation .04 Operation of MAHT Accounts.LinkCopy Citation
A.
Account Terms. The terms of a MAHT account require that:
(1)
The financial institution in which the MAHT account is maintained pays the interest earned on the MAHT account, less the reasonable and customary service charges of the financial institution, at least quarterly, to MAHT;
(2)
At the time of payment of interest earned to MAHT, the financial institution provides an itemized statement for each MAHT account maintained in that financial institution, which statement shall set forth:
(a)
The interest earned on each MAHT account, and
(b)
If requested by MAHT, an itemized statement of each service charge assessed against the MAHT account.
B.
Service Charges.
(1)
Reasonable and customary charges for commercial accounts may be deducted from interest on the MAHT account, except charges for:
(a)
Deposits of dishonored items;
(b)
Presentations against insufficient funds;
(c)
Overdrafts;
(d)
Certified checks;
(e)
Account reconciliations; and
(f)
Wire transfers.
(2)
If the aggregate service charges assessed against a title insurer or title insurance producer on all of its MAHT accounts held in a single financial institution exceed the aggregate interest earned on those MAHT accounts, the title insurer or title insurance producer is liable for payment of those service charges to the extent they exceed the earned interest.
(3)
The Commissioner or MAHT may authorize a title insurer or title insurance producer to close all of its MAHT accounts or not open a MAHT account or accounts if the title insurer or title insurance producer:
(a)
Demonstrates that it will cost or has cost more in reasonable and customary service charges for commercial accounts to maintain a MAHT account than will be or has been generated in interest by the MAHT account; and
(b)
Agrees to open a MAHT account or accounts if the condition described in §B(3)(a) of this regulation is no longer applicable.
(4)
These regulations do not preclude a financial institution from electing to waive service charges on a MAHT account.
Regulation .05 Separate Accounts.LinkCopy Citation
A.
Trust money which is not required to be deposited into a MAHT account may be deposited into any other deposit or investment vehicle:
(1)
Specified by the buyer or beneficial owner; or
(2)
Agreed upon by the buyer or beneficial owner and the title insurer or title insurance producer.
B.
An agreement referred to in §A of this regulation between a buyer or beneficial owner and a title insurer or title insurance producer shall be in writing and either be:
(1)
In a separate agreement; or
(2)
If part of another agreement between the parties, in conspicuous type and initialed by the buyer or beneficial owner.
Regulation .06 Annual Reports.LinkCopy Citation
A.
Filing. Each title insurer or title insurance producer who maintains a separate MAHT account shall file an annual report with the Commissioner and MAHT.
B.
Forms. The annual report shall be prepared on a form approved by the Commissioner and shall include the following information:
(1)
A list of all MAHT accounts and other bank accounts maintained by the title insurer or title insurance producer in which trust money was deposited at any time during the year, which list shall include the:
(a)
Name of the account holder;
(b)
Names of all persons who have access to the account;
(c)
Financial institution in which the account is maintained;
(d)
Account number; and
(e)
Purpose of the account;
(2)
Gross and net interest earned on each account;
(3)
A list of the types and amounts charged for services provided to each account, together with the total amount charged for services for each account; and
(4)
Any other information the Commissioner considers necessary.
C.
Date of Filing. A title insurer or title insurance producer shall file the annual report with the Commissioner and MAHT on or before March 31 for the immediately preceding year ending December 31.
Regulation .07 Review and Audit.LinkCopy Citation
A.
Review. The Commissioner and MAHT shall review the annual reports submitted by a title insurer or title insurance producer that maintains a separate MAHT account.
B.
Audit.
(1)
The Commissioner may audit a title insurer or title insurance producer for compliance with this chapter.
(2)
The Commissioner may examine, and a title insurer or title insurance producer shall produce for examination, any record or document of a title insurer or title insurance producer, including:
(a)
Books;
(b)
Records;
(c)
Financial statements;
(d)
Banking statements; or
(e)
Documents related to a real estate escrow, settlement, closing, or title indemnification.
(3)
Each title insurer or title insurance producer shall permit the Commissioner to investigate, review, and copy records or documents of a financial institution pertaining to an account of a title insurer or title insurance producer.
C.
Delegation.
(1)
The Commissioner may delegate the authority to audit a title insurer or title insurance producer to MAHT for compliance with this chapter.
(2)
If the Commissioner delegates its audit authority to MAHT, MAHT may audit the transactional files and related financial records of a title insurer or title insurance producer in connection with the sale or financing of real estate.
(3)
If the Commissioner delegates its audit authority to MAHT, MAHT shall conduct the audit and report its findings to the Commissioner.
(4)
The Commissioner may take appropriate action based upon the findings reported in the audit.
D.
Cost. The expense incurred in connection with an audit performed under this chapter shall be paid by MAHT.
Regulation .08 Enforcement.LinkCopy Citation
A.
The Commissioner may impose on a title insurer or title insurance producer any penalty, sanction, or other form of legal enforcement which the Commissioner has the authority to impose for failure to comply with the provisions of this chapter.
B.
The Commissioner may not charge a title insurer or a title insurer's producer with a violation of ethical or legal responsibilities when placing trust funds in accounts where the interest earned is paid to the Maryland Affordable Housing Trust in accordance with this chapter.
Chapter 04. Provision of Completed Premium Finance Agreement to Insured
Regulation .01 When Insured Is Present at Time of Signing.LinkCopy Citation
If the insured is present at the time a premium finance agreement is signed by or on behalf of the insured, the premium finance company, or an agent or producer, if applicable, shall provide the insured with, or cause the insured to be provided with, a legible copy of the fully completed and executed premium finance agreement at the time the agreement is signed.
Regulation .02 When Insured Is Not Present at Time of Signing.LinkCopy Citation
If the insured is not present at the time a premium finance agreement is executed on behalf of the insured, the premium finance company, or an agent or producer, if applicable, within 72 hours after the agreement is executed, shall mail or otherwise cause to be provided to the insured a legible copy of the fully completed and executed premium finance agreement.
Regulation .03 Records.LinkCopy Citation
A premium finance company shall maintain a record of all premium finance agreements provided to insureds in accordance with Regulation .02 of this chapter, and these records shall be open to examination by the Commissioner.
Chapter 05. Cancellation of Insurance Contracts by Premium Finance Companies
Repealed
Chapter 06. Bulk Reinsurance, Stock, and Mutual Insurers
Regulation .01 Reinsurance Agreement.LinkCopy Citation
A number of reinsurance treaties, particularly Quota-Share Treaties, provide for provisional commissions on a sliding scale which are adjusted periodically or on final settlement based upon the experience developed on business reinsured under these treaties. It is hereby ordered that when a company enters into such a reinsurance agreement the commission for which credit will be allowed in the preparation of your Annual Statements or any interim statements filed with this Administration will be the minimum guaranteed commission under the sliding scale provision. This, however, does not preclude the allowance as an asset of any commission in excess of the guaranteed minimum which may be due the company on final settlement of the Treaty.
Chapter 07. Holocaust Victims Insurance Claims and Reports
Repealed
Chapter 08. Privacy of Consumer Financial and Health Information
Regulation .01 Scope.LinkCopy Citation
A.
This chapter applies to all licensees of the Maryland Insurance Administration who possess nonpublic personal financial information or nonpublic personal health information about consumers.
B.
This chapter does not apply to information about persons who obtain products or services for business, commercial, or agricultural purposes.
Regulation .02 Purpose.LinkCopy Citation
This chapter:
A.
Requires a licensee to provide notice to individuals about its privacy policies and practices;
B.
Describes the conditions under which a licensee may disclose nonpublic personal health information and nonpublic personal financial information about individuals to affiliates and nonaffiliated third parties; and
C.
Provides methods for individuals to prevent a licensee from disclosing nonpublic personal financial information and nonpublic personal health information.
Regulation .03 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Affiliate” means a company that controls, is controlled by, or is under common control with another company.
(2)
“Clear and conspicuous notice” means a notice that is:
(a)
Reasonably understandable; and
(b)
Designed to call attention to the nature and significance of the information in the notice.
(3)
“Collect” means to obtain information that the licensee organizes or can retrieve by the name of an individual or by identifying number, symbol, or other identifying particular assigned to the individual, irrespective of the source of the underlying information.
(4)
“Commissioner” means the Maryland Insurance Commissioner.
(5)
“Company” means a corporation, limited liability company, business trust, general or limited partnership, association, sole proprietorship, or similar organization.
(6)
“Consumer” has the meaning stated in §C of this regulation.
(7)
“Consumer reporting agency” has the meaning stated in §603(f) of the federal Fair Credit Reporting Act, 15 U.S.C. §1681a(f).
(8)
“Control” means:
(a)
Ownership, control, or power to vote 25 percent or more of the outstanding shares of any class of voting security of the company, directly or indirectly, or acting through one or more other persons;
(b)
Control in any manner over the election of a majority of the directors, trustees, general partners, or individuals exercising similar functions of the company; or
(c)
The power to exercise, directly or indirectly, a controlling influence over the management or policies of the company, as the Commissioner determines.
(9)
“Customer” means a consumer who has a customer relationship with a licensee.
(10)
Customer Relationship.
(a)
“Customer relationship” means a continuing relationship between a consumer and a licensee under which the licensee provides one or more insurance products or insurance services to the consumer that are to be used primarily for personal, family, or household purposes.
(b)
“Customer relationship” includes a relationship between a licensee and a consumer who:
(i)
Is a current policyholder of an insurance product issued by or through the licensee; or
(ii)
Obtains financial, investment, or economic advisory services relating to an insurance product or insurance service from the licensee for a fee.
(c)
“Customer relationship” does not include a relationship between a licensee and:
(i)
A consumer who applies for insurance but does not purchase the insurance;
(ii)
A consumer who purchases from the licensee airline travel insurance in an isolated transaction;
(iii)
An individual who is no longer a current policyholder of an insurance product or who no longer obtains insurance services with or through the licensee;
(iv)
A consumer who is a beneficiary or claimant under a policy and who has submitted a claim under a policy choosing a settlement option involving an ongoing relationship with the licensee;
(v)
A consumer who is a beneficiary or a claimant under a policy and who has submitted a claim under that policy choosing a lump sum settlement option;
(vi)
A customer whose policy is lapsed, expired, or otherwise inactive or dormant under the licensee's business practices, if the licensee has not communicated with the customer about the relationship for a period of 12 consecutive months, other than annual privacy notices, material required by law or regulation, communication at the direction of a state or federal authority, or promotional materials;
(vii)
An individual who is an insured or an annuitant under an insurance policy or annuity, respectively, but is not the policyholder or owner of the insurance policy or annuity;
(viii)
An individual whose last-known address, according to the licensee's records, is deemed invalid because mail sent by the licensee to that address has been returned by the postal authorities as undeliverable and subsequent attempts by the licensee to obtain a current valid address for the individual have been unsuccessful;
(ix)
An individual solely because the individual is a participant or a beneficiary of an employee benefit plan that the licensee administers or sponsors or for which the licensee acts as a trustee, insurer, or fiduciary;
(x)
An individual solely because the individual is covered under a group or blanket insurance policy or group annuity contract issued by the licensee; or
(xi)
An individual solely because the individual is a beneficiary in a workers' compensation plan underwritten by the licensee.
(11)
Financial Institution.
(a)
“Financial institution” means any institution the business of which is engaging in activities that are financial in nature or incidental to the financial activities as described in §4(k) of the Bank Holding Company Act of 1956, 12 U.S.C. §1843(k).
(b)
“Financial institution” does not include:
(i)
Any person with respect to any financial activity that is subject to the jurisdiction of the Commodity Futures Trading Commission under the Commodity Exchange Act, 7 U.S.C. §1 et seq.;
(ii)
The Federal Agricultural Mortgage Corporation or any person charged and operating under the Farm Credit Act of 1971, 12 U.S.C. §2001 et seq.; or
(iii)
Institutions chartered by Congress specifically to engage in securitizations, secondary market sales (including sales of servicing rights), or similar transactions related to a transaction of a consumer, as long as the institutions do not sell or transfer nonpublic personal information to a nonaffiliated third party.
(12)
“Financial product” means a product that a financial holding company could offer by engaging in an activity that is financial in nature or incidental to a financial activity under §4(k) of the Bank Holding Company Act of 1956, 12 U.S.C. §1843(k).
(13)
Financial Service.
(a)
“Financial service” means a service that a financial holding company could offer by engaging in an activity that is financial in nature or incidental to a financial activity under §4(k) of the Bank Holding Company Act of 1956, 12 U.S.C. §1843(k).
(b)
“Financial service” includes a financial institution's evaluation or brokerage of information that the financial institution collects in connection with a request or an application from a consumer for a financial product or financial service.
(14)
“Health care” means:
(a)
Providing preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care, services, procedures, tests, or counseling that:
(i)
Relates to the physical, mental, or behavioral condition of an individual; or
(ii)
Affects the structure or function of the human body or any part of the human body, including the banking of blood, sperm, organs, or any other tissue; or
(b)
Prescribing, dispensing, or furnishing to an individual drugs or biologicals, or medical devices or health care equipment and supplies.
(15)
Health Care Provider.
(a)
“Health care provider” means a health care facility, physician, or other health care practitioner licensed, accredited, certified, or otherwise authorized to perform specified health services consistent with state law.
(b)
“Health care provider” includes the agents, employees, officers, and directors of a health care provider.
(16)
“Health information” means any information or data except age or gender, whether oral or recorded in any form or medium, created by or derived from a health care provider or the consumer that relates to:
(a)
The past, present, or future physical, mental, or behavioral health or condition of an individual;
(b)
The provision of health care to an individual; or
(c)
Payment for the provision of health care to an individual.
(17)
“Insurance product” means any product that is offered by a licensee pursuant to the insurance laws of this State.
(18)
Insurance Service.
(a)
“Insurance service” means any service that is offered by a licensee pursuant to the insurance laws of this State.
(b)
“Insurance service” includes a licensee's evaluation, brokerage, or distribution of information that the licensee collects in connection with a request or an application from a consumer for an insurance product or insurance service.
(19)
Licensee.
(a)
“Licensee” means a person licensed or required to be licensed, registered or required to be registered, or otherwise authorized or required to be authorized by the Commissioner.
(b)
“Licensee” includes an unauthorized insurer that accepts business placed through a licensed surplus lines broker in the State, but only in regard to the business placed pursuant to Insurance Article, §3-306, Annotated Code of Maryland.
(20)
Nonaffiliated Third Party.
(a)
“Nonaffiliated third party” means any person except:
(i)
A licensee's affiliate; or
(ii)
A person employed jointly by a licensee and any company that is not the licensee's affiliate.
(b)
“Nonaffiliated third party” includes:
(i)
A company that is not the licensee's affiliate that jointly employs a person with the licensee; and
(ii)
Any company that is an affiliate solely by virtue of the direct or indirect ownership or control of the company by the licensee or its affiliate in conducting merchant banking or investment banking activities of the type described in §4(k)(4)(H) or insurance company investment activities of the type described in §4(k)(4)(I) of the federal Bank Holding Company Act, 12 U.S.C. §1843(k)(4)(H) and(i).
(21)
“Nonpublic personal information” means nonpublic personal financial information and nonpublic personal health information.
(22)
Nonpublic Personal Financial Information.
(a)
“Nonpublic personal financial information” means:
(i)
Personally identifiable financial information; and
(ii)
Any list, description, or other grouping of consumers and publicly available information pertaining to them that is derived using any personally identifiable financial information that is not publicly available.
(b)
“Nonpublic personal financial information” includes a list of individuals' names and street addresses that is derived in whole or in part using personally identifiable financial information that is not publicly available, such as account numbers.
(c)
“Nonpublic personal financial information” does not include:
(i)
Health information;
(ii)
Publicly available information, except as included on a list described in §B(22)(a)(ii) of this regulation;
(iii)
Any list, description, or other grouping of consumers and publicly available information pertaining to them that is derived without using any personally identifiable financial information that is not publicly available; or
(iv)
A list of individuals' names and addresses that contains only publicly available information, is not derived in whole or in part using personally identifiable financial information that is not publicly available, and is not disclosed in a manner that indicates that any of the individuals on the list is a consumer of a financial institution.
(23)
“Nonpublic personal health information” means health information:
(a)
That identifies an individual who is the subject of the information; or
(b)
With respect to which there is a reasonable basis to believe that the information could be used to identify an individual.
(24)
“Opt out” means a direction by the consumer that the licensee not disclose nonpublic personal financial information about that consumer to a nonaffiliated third party, other than as permitted by Regulations .14, .15, and .16 of this chapter.
(25)
Personally Identifiable Financial Information.
(a)
“Personally identifiable financial information” means any information:
(i)
A consumer provides to a licensee to obtain an insurance product or insurance service from the licensee;
(ii)
About a consumer resulting from a transaction involving an insurance product or insurance service between a licensee and a consumer; or
(iii)
The licensee otherwise obtains about a consumer in connection with providing an insurance product or insurance service to that consumer.
(b)
“Personally identifiable financial information” includes:
(i)
Information a consumer provides to a licensee on an application to obtain an insurance product or insurance service;
(ii)
Account balance information and payment history;
(iii)
The fact that an individual is or has been one of the licensee's customers or has obtained an insurance product or insurance service from the licensee;
(iv)
Any information about the licensee's consumer if it is disclosed in a manner that indicates that the individual is or has been the licensee's consumer;
(v)
Any information that a consumer provides to a licensee or that the licensee or its agent otherwise obtains in connection with collecting on a loan or servicing a loan;
(vi)
Any information the licensee collects through an Internet cookie (an information-collecting device from a web server); and
(vii)
Information from a consumer report.
(c)
“Personally identifiable financial information” does not include:
(i)
Health information;
(ii)
A list of names and addresses of customers of an entity that is not a financial institution; and
(iii)
Information that does not identify a consumer, such as aggregate information or blind data that does not contain personal identifiers such as account numbers, names, or addresses.
(26)
“Publicly available information” means any information for which a licensee:
(a)
Has a reasonable basis to believe is lawfully made available to the general public from:
(i)
Federal, state, or local government records;
(ii)
Widely distributed media; or
(iii)
Disclosures to the general public that are required to be made by federal, state, or local law; and
(b)
Has established the reasonable basis required by §B(26)(a) of this regulation by taking steps to determine:
(i)
That the information is of the type that is available to the general public; and
(ii)
Whether an individual can direct that the information not be made available to the general public and, if so, that the licensee's consumer has not done so.
C.
“Consumer” Defined.
(1)
“Consumer” means an individual:
(a)
Who seeks to obtain, obtains, or has obtained an insurance product or insurance service from a licensee that is to be used primarily for personal, family, or household purposes; and
(b)
About whom the licensee has nonpublic personal information.
(2)
“Consumer” includes:
(a)
The legal representative of a consumer;
(b)
An individual who provides nonpublic personal information to a licensee in connection with obtaining or seeking to obtain financial, investment, or economic advisory services relating to an insurance product or insurance service regardless of whether the licensee establishes an ongoing advisory relationship;
(c)
An applicant for insurance before the inception of insurance coverage;
(d)
If a licensee discloses nonpublic personal financial information about the individual to a nonaffiliated third party other than as permitted under Regulations .14, .15, and .16 of this chapter, an individual who is:
(i)
A beneficiary of a life insurance policy underwritten by the licensee;
(ii)
A claimant under an insurance policy issued by the licensee;
(iii)
An insured or annuitant under an insurance policy or annuity issued by the licensee; or
(iv)
A mortgagor under a mortgage insurance policy issued by the licensee;
(e)
A participant or a beneficiary of an employee benefit plan that a licensee administers or sponsors or for which a licensee acts as a trustee, insurer, or fiduciary if the licensee:
(i)
Does not provide the initial, annual, and revised notices under Regulations .05, .06, and .09 of this chapter to the plan sponsor; or
(ii)
Discloses to a nonaffiliated third party nonpublic personal financial information other than as permitted under Regulations .14, .15, and .16 of this chapter;
(f)
An individual who is covered under a group or blanket insurance policy or group annuity contract issued by the licensee if the licensee:
(i)
Does not provide the initial, annual, and revised notices under Regulations .05, .06, and .09 of this chapter to the group or blanket insurance policyholder or group annuity contract holder; or
(ii)
Discloses to a nonaffiliated third party nonpublic personal financial information other than as permitted under Regulations .14, .15, and .16 of this chapter; and
(g)
An individual who is a beneficiary in a workers' compensation plan underwritten by the licensee if the licensee:
(i)
Does not provide the initial, annual, and revised notices under Regulations .05, .06, and .09 of this chapter to the workers' compensation plan participant; or
(ii)
Discloses to a nonaffiliated third party nonpublic personal financial information other than as permitted under Regulations .14, .15, and .16 of this chapter.
(3)
“Consumer” does not include:
(a)
An individual who is a consumer of another financial institution solely because the licensee is acting as an agent for, or provides processing or other services to, that financial institution;
(b)
An individual solely because the individual is a beneficiary of a trust for which a licensee is a trustee;
(c)
An individual solely because the individual has designated a licensee as trustee for a trust;
(d)
An individual solely because the individual is a participant or a beneficiary of an employee benefit plan that a licensee administers or sponsors or for which a licensee acts as a trustee, insurer, or fiduciary if the licensee:
(i)
Provides the initial, annual, and revised notices under Regulations .05, .06, and .09 of this chapter to the plan sponsor; and
(ii)
Does not disclose to a nonaffiliated third party nonpublic personal financial information about the individual other than as permitted under Regulations .14, .15, and .16 of this chapter;
(e)
An individual solely because the individual is covered under a group or blanket insurance policy or group annuity contract issued by a licensee if the licensee:
(i)
Provides the initial, annual, and revised notices under Regulations .05, .06, and .09 of this chapter to the group or blanket insurance policyholder or group annuity contract holder; and
(ii)
Does not disclose to a nonaffiliated third party nonpublic personal financial information about the individual other than as permitted under Regulations .14, .15, and .16 of this chapter; or
(f)
An individual solely because the individual is a beneficiary in a workers' compensation plan underwritten by a licensee if the licensee:
(i)
Provides the initial, annual, and revised notices under Regulations .05, .06, and .09 of this chapter to the workers' compensation plan participant; and
(ii)
Does not disclose to a nonaffiliated third party nonpublic personal financial information about the individual other than as permitted under Regulations .14, .15, and .16 of this chapter.
Regulation .04 Exemption from Notice and Opt Out Requirements for Nonpublic Personal Financial Information.LinkCopy Citation
A.
A licensee is not subject to the notice and opt out requirements for nonpublic personal financial information of this chapter if:
(1)
The licensee is an employee, agent, or other representative of another licensee;
(2)
The other licensee otherwise complies with, and provides the notices required by, the provisions of this chapter; and
(3)
The licensee does not disclose any nonpublic personal information to any person other than the other licensee or its affiliates in a manner permitted by this chapter.
B.
A surplus lines broker or surplus lines insurer shall be deemed to be in compliance with the notice and opt out requirements for nonpublic personal financial information of this chapter if:
(1)
The broker or insurer does not disclose nonpublic personal information of a consumer or a customer to nonaffiliated third parties for any purpose, including joint servicing or marketing under Regulation .14 of this chapter, except as permitted by Regulations .15 or .16 of this chapter; and
(2)
The broker or insurer delivers a notice to the consumer at the time a customer relationship is established on which the following is printed in 16-point type:
"PRIVACY NOTICE
Regulation .05 Initial Privacy Notice for Financial Information to Consumers Required.LinkCopy Citation
A.
A licensee shall provide a clear and conspicuous notice that accurately reflects its privacy policies and practices for nonpublic financial information to:
(1)
An individual who becomes the licensee's customer, not later than when the licensee establishes a customer relationship, except as provided in §E of this regulation; and
(2)
A consumer, before the licensee discloses any nonpublic personal financial information about the consumer to any nonaffiliated third party, if the licensee makes a disclosure other than as authorized by Regulations .15 and .16 of this chapter.
B.
A licensee is not required to provide an initial notice to a consumer under §A(2) of this regulation if:
(1)
The licensee does not:
(a)
Disclose any nonpublic personal financial information about the consumer to any nonaffiliated third party, other than as authorized by Regulations .15 and .16 of this chapter; and
(b)
Have a customer relationship with the consumer; or
(2)
An affiliated licensee has provided a notice to the consumer that:
(a)
Clearly identifies all licensees to whom the notice applies; and
(b)
Is accurate with respect to the licensee and the other institutions.
C.
When Licensee Establishes Customer Relationship.
(1)
A licensee establishes a customer relationship at the time the licensee and the consumer enter into a continuing relationship, including when the consumer:
(a)
Becomes a policyholder of a licensee; or
(b)
Agrees to obtain financial, economic, or investment advisory services relating to insurance products or insurance services for a fee from the licensee.
(2)
For purposes of §C(1) of this regulation, a consumer becomes a policyholder of a licensee:
(a)
If the licensee is an insurer, when the insurer delivers an insurance policy or contract to the consumer; or
(b)
If the licensee is an insurance producer or insurance broker, when the consumer obtains insurance through that licensee.
D.
When an existing customer obtains a new insurance product or insurance service from a licensee that is to be used primarily for personal, family, or household purposes, the licensee satisfies the initial notice requirements of §A of this regulation as follows:
(1)
The licensee may provide a revised policy notice, under Regulation .09 of this chapter, that covers the customer's new insurance product or insurance service; or
(2)
If the initial, revised, or annual notice that the licensee most recently provided to that customer was accurate with respect to the new insurance product or insurance service, the licensee does not need to provide a new privacy notice under §A of this regulation.
E.
A licensee may provide the initial notice required by §A(1) of this regulation within a reasonable time after the licensee establishes a customer relationship if:
(1)
Establishing the customer relationship is not at the customer's election; or
(2)
Providing notice not later than when the licensee establishes a customer relationship would substantially delay the customer's transaction, and the customer agrees to receive the notice at a later time.
F.
Manner of Delivery.
(1)
Except as provided in §F(2) of this regulation, a licensee subject to this regulation shall deliver an initial privacy notice in accordance with Regulation .10 of this chapter.
(2)
A licensee that uses a short-form initial notice provided for under Regulation .07K of this chapter may deliver its privacy notice in accordance with Regulation .07K(3) of this chapter.
Regulation .06 Annual Privacy Notice for Financial Information to Customers Required.LinkCopy Citation
A.
In General.
(1)
Except as provided in §B of this regulation, a licensee shall provide a clear and conspicuous notice to customers that accurately reflects its privacy policies and practices for nonpublic financial information at least once in each annual notice period during the continuation of the customer relationship.
(2)
A licensee may define the annual notice period as:
(a)
A calendar year; or
(b)
Any period of 12 consecutive months.
(3)
The licensee shall apply the annual notice period as defined under §A(2) of this regulation to a customer on a consistent basis.
B.
Exceptions.
(1)
Notwithstanding §A of this regulation, a licensee is not required to provide an annual privacy notice to a current customer if the licensee:
(a)
Provides nonpublic personal information to nonaffiliated third parties only in accordance with Regulations .14—.16 of this chapter; and
(b)
Has not changed its policies and practices with regard to disclosing nonpublic personal information from the policies and practices that were disclosed in the most recent disclosure sent to consumers in accordance with §A of this regulation or COMAR 31.16.08.05.
(2)
A licensee is not required to provide an annual notice to a former customer with whom a licensee no longer has a continuing relationship.
C.
A licensee required by this regulation to deliver an annual privacy notice shall deliver the privacy notice in accordance with Regulation .10 of this chapter.
Regulation .07 Information To Be Included in Privacy Notices for Financial Information.LinkCopy Citation
A.
Privacy notices required to be provided under Regulations .05, .06, and .09 of this chapter shall include the following information:
(1)
The categories of nonpublic personal financial information that the licensee collects;
(2)
The categories of nonpublic personal financial information that the licensee discloses;
(3)
The categories of affiliates and nonaffiliated third parties to whom the licensee discloses nonpublic personal financial information, other than those parties to whom the licensee discloses information under Regulations .15 and .16 of this chapter;
(4)
The categories of:
(a)
Nonpublic personal financial information about the licensee's former customers that the licensee discloses; and
(b)
Affiliates and nonaffiliated third parties to whom the licensee discloses nonpublic personal financial information about the licensee's former customers, other than those parties to whom the licensee discloses information under Regulations .15 and .16 of this chapter;
(5)
If a licensee discloses nonpublic personal financial information to a nonaffiliated third party under Regulation .14 of this chapter and no other exception in Regulations .15 and .16 of this chapter applies to that disclosure, a separate description of the categories of information the licensee discloses and the categories of third parties with whom the licensee has contracted;
(6)
An explanation of the consumer's right under Regulation .11A of this chapter to opt out of the disclosure of nonpublic personal financial information to nonaffiliated third parties, including the methods by which the consumer may exercise that right at that time;
(7)
Any disclosures that the licensee makes under §603(d)(2)(A)(iii) of the federal Fair Credit Reporting Act, 15 U.S.C. §1681a(d)(2)(A)(iii) regarding the ability to opt out of disclosures of information among affiliates;
(8)
The licensee's policies and practices with respect to protecting the confidentiality and security of nonpublic personal financial information; and
(9)
Any disclosure that the licensee makes under §B of this regulation.
B.
If a licensee discloses nonpublic personal financial information as authorized under Regulations .15 and .16 of this chapter:
(1)
The licensee is not required to list those exceptions in the initial or annual privacy notices required by Regulations .05 and .06 of this chapter; and
(2)
When describing the categories of parties to whom disclosure is made, the licensee is required to state only that it makes disclosures to other affiliated or nonaffiliated third parties, as applicable, as permitted by law.
C.
A licensee satisfies the requirement to categorize the nonpublic personal financial information that the licensee collects if the licensee categorizes the information according to the source of the information, including:
(1)
Information from the consumer;
(2)
Information about the consumer's transactions with the licensee or its affiliates;
(3)
Information about the consumer's transactions with nonaffiliated third parties; and
(4)
Information from a consumer reporting agency.
D.
A licensee satisfies the requirement to categorize the nonpublic personal financial information that the licensee discloses if the licensee:
(1)
Categorizes the information according to source, as described in §C of this regulation; and
(2)
Provides a few examples to illustrate the types of information in each category, such as:
(a)
Information from the consumer, including application information, such as assets and income and identifying information, such as name, address, and Social Security number;
(b)
Transaction information, such as information about balances, payment history, and parties to the transaction; and
(c)
Information from consumer reports, such as a consumer's creditworthiness and credit history.
E.
A licensee does not adequately categorize the information that it discloses if the licensee uses only general terms, such as transaction information about the consumer.
F.
If a licensee reserves the right to disclose all of the nonpublic personal financial information about consumers that it collects, the licensee may simply state that fact without describing the categories or examples of nonpublic personal financial information that the licensee discloses.
G.
Categories of Affiliates and Nonaffiliated Third Parties to Whom the Licensee Discloses.
(1)
A licensee satisfies the requirement to categorize the affiliates and nonaffiliated third parties to which the licensee discloses nonpublic personal financial information about consumers if the licensee identifies the types of businesses in which they engage.
(2)
Types of businesses may be described by general terms only if the licensee uses a few illustrative examples of significant lines of business, including the use by a licensee of the term financial products or services if the licensee includes appropriate examples of significant lines of businesses, such as life insurer, automobile insurer, consumer banking, or securities brokerage.
(3)
A licensee also may categorize the affiliates and nonaffiliated third parties to which it discloses nonpublic personal financial information about consumers using more detailed categories.
H.
If a licensee discloses nonpublic personal financial information under the exception in Regulation .14 of this chapter to a nonaffiliated third party to market products or services that it offers alone or jointly with another financial institution, the licensee satisfies the disclosure requirement of §A(5) of this regulation if it:
(1)
Lists the categories of nonpublic personal financial information it discloses, using the same categories and examples the licensee used to meet the requirements of §A(2) of this regulation, as applicable; and
(2)
States whether the third party is:
(a)
A service provider that performs marketing services on the licensee's behalf or on behalf of the licensee and another financial institution; or
(b)
A financial institution with whom the licensee has a joint marketing agreement.
I.
If a licensee does not disclose, and does not wish to reserve the right to disclose, nonpublic personal financial information about customers or former customers to affiliates or nonaffiliated third parties except as authorized under Regulations .15 and .16 of this chapter, the licensee may simply state that fact, in addition to the information it must provide under §§A(1), (8), and (9) and B of this regulation.
J.
Policies and Practices for Protection of Confidentiality and Security.
(1)
A licensee shall describe its policies and practices with respect to protecting the confidentiality and security of nonpublic personal financial information.
(2)
A licensee may satisfy §J(1) of this regulation if the licensee:
(a)
Describes in general terms who is authorized to have access to the information; and
(b)
States whether the licensee has security practices and procedures in place to ensure the confidentiality of the information in accordance with the licensee's policy.
(3)
A licensee is not required to describe technical information about the safeguards it uses.
K.
Short-Form Initial Notice with Opt Out Notice for Noncustomers.
(1)
A licensee may satisfy the initial notice requirements in Regulations .05A(2) and .08C of this chapter for a consumer who is not a customer by providing a short-form initial notice at the same time the licensee delivers an opt out notice as required in Regulation .08 of this chapter.
(2)
A short-form initial notice shall:
(a)
Be clear and conspicuous;
(b)
State that the licensee's privacy notice is available upon request; and
(c)
Explain a reasonable means by which the consumer may obtain that notice.
(3)
Delivery of Short-Form Initial Notice.
(a)
A licensee shall deliver its short-form initial notice in accordance with Regulation .10 of this chapter.
(b)
The licensee is not required to deliver its privacy notice with its short-form initial notice if the licensee provides the consumer a reasonable means to obtain its privacy notice.
(c)
The licensee provides a reasonable means by which a consumer may obtain a copy of its privacy notice if the licensee:
(i)
Provides a toll-free telephone number that the consumer may call to request the notice; or
(ii)
For a consumer who conducts business in person at the licensee's office, maintains copies of the notice on hand that the licensee provides to the consumer immediately upon request.
(d)
Upon the request of a consumer, the licensee shall deliver its privacy notice according to Regulation .10 of this chapter.
L.
The licensee's notice may include:
(1)
Categories of nonpublic personal financial information that the licensee reserves the right to disclose in the future, but does not currently disclose; and
(2)
Categories of affiliates or nonaffiliated third parties to whom the licensee reserves the right in the future to disclose, but to whom the licensee does not currently disclose, nonpublic personal financial information.
Regulation .08 Form of Opt Out Notice to Consumers and Opt Out Methods.LinkCopy Citation
A.
Opt Out Notice Requirements.
(1)
A licensee required to provide an opt out notice under Regulation .11A of this chapter shall provide a clear and conspicuous notice to each of the licensee's consumers that accurately explains the right to opt out under that regulation.
(2)
A right to opt out notice required to be provided under §A(1) of this regulation shall state:
(a)
That the licensee discloses or reserves the right to disclose nonpublic personal financial information about its consumer to a nonaffiliated third party;
(b)
That the consumer has the right to opt out of that disclosure; and
(c)
A reasonable means by which the consumer may exercise the opt out right.
(3)
A licensee provides adequate notice that the consumer can opt out of the disclosure of nonpublic personal financial information to a nonaffiliated third party if the licensee:
(a)
Identifies all categories of nonpublic personal financial information that it discloses or reserves the right to disclose;
(b)
Identifies all of the categories of nonaffiliated third parties to which the licensee discloses the information as described in Regulation .07A(2) and (3) of this chapter;
(c)
States that the consumer can opt out of the disclosure of the nonpublic personal financial information; and
(d)
Identifies the insurance products or insurance services that the consumer obtains from the licensee to which the opt out would apply.
(4)
A licensee provides a reasonable means to exercise an opt out right if the licensee:
(a)
Designates check-off boxes in a prominent position on the relevant forms with the opt out notice;
(b)
Includes a reply form together with the opt out notice;
(c)
Provides an electronic means to opt out that includes the form required under §A(4)(b) of this regulation that can be sent via electronic mail or a process at the licensee's web site, if the consumer agrees to the electronic delivery of information; or
(d)
Provides a toll-free telephone number that consumers may call to opt out.
(5)
A licensee does not provide a reasonable means to exercise an opt out right if:
(a)
The only means of opting out is for the consumer to write the consumer's own letter to exercise that opt out right; or
(b)
The only means of opting out as described in any notice subsequent to the initial notice is to use a check-off box that the licensee provided with the initial notice but did not include with the subsequent notice.
(6)
A licensee may require each consumer to opt out through a specific means, as long as that means is reasonable for that consumer.
B.
A licensee may provide the opt out notice together with or on the same written or electronic form as the initial notice the licensee provides in accordance with Regulation .05 of this chapter.
C.
A licensee that provides the opt out notice later than required for the initial notice in accordance with Regulation .05 of this chapter shall also include a copy of the initial notice with the opt out notice in writing or, if the consumer agrees, electronically.
D.
Joint Relationships.
(1)
If two or more consumers jointly obtain an insurance product or insurance service from a licensee, the licensee may provide a single opt out notice. The licensee's opt out notice shall explain how the licensee will treat an opt out direction by a joint consumer.
(2)
Any of the joint consumers may exercise the right to opt out.
(3)
The licensee may either:
(a)
Treat an opt out direction by a joint consumer as applying to all of the associated joint consumers; or
(b)
Permit each joint consumer to opt out separately.
(4)
If a licensee permits each joint consumer to opt out separately, the licensee shall permit one of the joint consumers to opt out on behalf of all of the joint consumers.
(5)
A licensee may not require all joint consumers to opt out before it implements any opt out direction.
E.
A licensee shall comply with a consumer's opt out direction as soon as reasonably practicable after the licensee receives it.
F.
A consumer may exercise the right to opt out at any time.
G.
Duration of Opt Out Direction.
(1)
A consumer's direction to opt out under this regulation is effective until the consumer revokes it in writing or, if the consumer agrees, electronically.
(2)
When a customer relationship terminates, the customer's opt out direction continues to apply to the nonpublic personal financial information that the licensee collected during or related to that relationship.
(3)
If an individual subsequently establishes a new customer relationship with the licensee, the opt out direction that applied to the former relationship does not apply to the new relationship.
H.
A licensee required to deliver an opt out notice under this regulation shall deliver it in accordance with Regulation .10 of this chapter.
Regulation .09 Revised Privacy Notices for Financial Information.LinkCopy Citation
A.
Except as otherwise authorized in this chapter, a licensee may not, directly or through an affiliate, disclose any nonpublic personal financial information about a consumer to a nonaffiliated third party other than as described in the initial notice that the licensee provided to that consumer under Regulation .05 of this chapter, unless:
(1)
The licensee has provided to the consumer a clear and conspicuous revised notice that accurately describes its policies and practices;
(2)
The licensee has provided to the consumer a new opt out notice;
(3)
The licensee has given the consumer a reasonable opportunity, before the licensee discloses the information to the nonaffiliated third party, to opt out of the disclosure; and
(4)
The consumer does not opt out.
B.
Revised Notice.
(1)
Except as otherwise permitted by Regulations .14, .15, and .16 of this chapter, a licensee shall provide a revised notice before it discloses:
(a)
A new category of nonpublic personal financial information to any nonaffiliated third party;
(b)
Nonpublic personal financial information to a new category of nonaffiliated third party; or
(c)
Nonpublic personal financial information about a former customer to a nonaffiliated third party, if that former customer has not had the opportunity to exercise an opt out right regarding that disclosure.
(2)
A revised notice is not required if the licensee discloses nonpublic personal financial information to a new nonaffiliated third party that the licensee adequately described in its prior notice.
C.
A licensee required to deliver a revised privacy notice under this regulation shall deliver it in accordance with Regulation .10 of this chapter.
Regulation .10 Delivery of Privacy Notices for Financial Information.LinkCopy Citation
A.
Manner of Delivery.
(1)
A licensee required to provide a notice under this chapter shall provide any notice required by this chapter so that each consumer can reasonably be expected to receive actual notice in writing or, if the consumer agrees, electronically.
(2)
A licensee may reasonably expect that a consumer will receive actual notice if the licensee:
(a)
Hand-delivers a printed copy of the notice to the consumer;
(b)
Mails a printed copy of the notice to the last-known address of the consumer separately, or in a policy, billing, or other written communication;
(c)
For a consumer who conducts transactions electronically, posts the notice on the electronic site and requires the consumer to acknowledge receipt of the notice as a necessary step to obtaining a particular insurance product or insurance service; or
(d)
For an isolated transaction with a consumer, such as the licensee providing an insurance quote or selling the consumer travel insurance, posts the notice and requires the consumer to acknowledge receipt of the notice as a necessary step to obtaining the particular insurance product or insurance service.
(3)
A licensee fails to meet the requirements of §A(1) of this regulation if the licensee:
(a)
Only posts a sign in its office or generally publishes advertisements of its privacy policies and practices; or
(b)
Sends the notice via electronic mail to a consumer who does not obtain an insurance product or insurance service from the licensee electronically.
B.
A licensee may reasonably expect that a customer will receive actual notice of the licensee's annual privacy notice if the customer:
(1)
Uses the licensee's web site to access insurance products and insurance services electronically, and agrees to receive notices at the web site and the licensee posts its current privacy notice continuously in a clear and conspicuous manner on the web site; or
(2)
Has requested that the licensee refrain from sending any information regarding the customer relationship, and the licensee's current privacy notice remains available to the customer upon request.
C.
A licensee may not provide any notice required by this chapter solely by orally explaining the notice, either in person or over the telephone.
D.
Notice for Customers.
(1)
For customers only, a licensee shall provide the following privacy notices so that the customer can retain the privacy notices or obtain the privacy notices later in writing or, if the customer agrees, electronically:
(a)
The initial notice required by Regulation .05A(1) of this chapter;
(b)
The annual notice required by Regulation .06A of this chapter; and
(c)
The revised notice required by Regulation .09 of this chapter.
(2)
A licensee provides a privacy notice to the customer so that the customer can retain it or obtain it later if the licensee:
(a)
Hand-delivers a printed copy of the notice to the customer;
(b)
Mails a printed copy of the notice to the last-known address of the customer; or
(c)
Makes its current privacy notice available on a web site for the customer who obtains an insurance product or insurance service electronically and agrees to receive the notice at the web site.
E.
Joint Notice.
(1)
A licensee may provide a joint notice from the licensee and one or more of its affiliates or other financial institutions, as identified in the notice, as long as the notice is accurate with respect to the licensee and the other institutions.
(2)
A licensee also may provide a notice on behalf of another financial institution.
F.
If two or more consumers jointly obtain an insurance product or insurance service from a licensee, the licensee may satisfy the requirements of Regulations .05A, .06A, and .09A of this chapter by providing one notice to those consumers jointly.
Regulation .11 Limits on Disclosure of Nonpublic Personal Financial Information to Nonaffiliated Third Parties.LinkCopy Citation
A.
Except as otherwise authorized in this chapter, a licensee may not, directly or through an affiliate, disclose nonpublic personal financial information about a consumer to a nonaffiliated third party unless:
(1)
The licensee has provided to the consumer an initial notice as required under Regulation .05 of this chapter;
(2)
The licensee has provided to the consumer an opt out notice as required in Regulation .08 of this chapter;
(3)
The licensee has given the consumer a reasonable opportunity, before it discloses the information to the nonaffiliated third party, to opt out of the disclosure; and
(4)
The consumer does not opt out.
B.
A licensee provides a consumer with a reasonable opportunity to opt out if:
(1)
The licensee mails the notices required in Regulations .05 and .08 of this chapter to the consumer and allows the consumer to opt out by:
(a)
Mailing a form within 30 days from the date the licensee mailed the notices;
(b)
Calling a toll-free telephone number within 30 days from the date the licensee mailed the notices; or
(c)
Using any other reasonable means within 30 days from the date the licensee mailed the notices;
(2)
The following action is taken:
(a)
A customer opens an on-line account with a licensee and agrees to receive the notices required in Regulations .05 and .08 of this chapter electronically; and
(b)
The licensee allows the customer to opt out by any reasonable means within 30 days after the date that the customer acknowledges receipt of the notices in conjunction with opening the account; or
(3)
For an isolated transaction such as providing the consumer with an insurance quote, the licensee provides the notices required in Regulations .05 and .08 of this chapter at the time of the transaction and requests that the consumer decide, as a necessary part of the transaction, whether to opt out before completing the transaction.
C.
A licensee shall comply with this regulation regardless of whether the licensee and the consumer have established a customer relationship. Unless a licensee complies with this regulation, the licensee may not, directly or through an affiliate, disclose nonpublic personal financial information about a consumer that the licensee has collected, regardless of whether the licensee collected it before or after receiving the direction to opt out from the consumer.
D.
A licensee may allow a consumer to select certain nonpublic personal financial information or certain nonaffiliated third parties with respect to which the consumer wishes to opt out.
Regulation .12 Limits on Redisclosure and Reuse of Nonpublic Personal Financial Information.LinkCopy Citation
A.
If a licensee receives nonpublic personal financial information from a nonaffiliated financial institution under an exception in Regulation .15 or .16 of this chapter, the licensee's disclosure and use of that information is limited as follows:
(1)
The licensee may disclose the information to the affiliates of the financial institution from which the licensee received the information;
(2)
The licensee may disclose the information to its affiliates, but the licensee's affiliates may, in turn, disclose and use the information only to the extent that the licensee may disclose and use the information; and
(3)
The licensee may disclose and use the information pursuant to an exception in Regulation .15 or .16 of this chapter, in the ordinary course of business to carry out the activity covered by the exception under which the licensee received the information.
B.
If a licensee receives nonpublic personal financial information from a nonaffiliated financial institution other than under an exception in Regulation .15 or .16 of this chapter, the licensee may disclose the information only:
(1)
To the affiliates of the financial institution from which the licensee received the information;
(2)
To its affiliates, but its affiliates may, in turn, disclose the information only to the extent that the licensee may disclose the information; and
(3)
To any other person, if the disclosure would be lawful if made directly to that person by the financial institution from which the licensee received the information.
C.
If a licensee receives information from a nonaffiliated financial institution for claims settlement purposes, the licensee may disclose the information for fraud prevention or in response to a properly authorized subpoena.
D.
If a licensee receives information from a nonaffiliated financial institution for claims settlement purposes, the licensee may not:
(1)
Disclose that information to a third party for marketing purposes; or
(2)
Use that information for its own marketing purposes.
E.
If a licensee discloses nonpublic personal financial information to a nonaffiliated third party under an exception in Regulation .15 or .16 of this chapter, the third party may disclose and use that information only as follows:
(1)
The third party may disclose the information to the licensee's affiliates;
(2)
The third party may disclose the information to its affiliates, but its affiliates may, in turn, disclose and use the information only to the extent that the third party may disclose and use the information; and
(3)
The third party may disclose and use the information pursuant to an exception in Regulation .15 or .16 of this chapter in the ordinary course of business to carry out the activity covered by the exception under which it received the information.
F.
If a licensee discloses nonpublic personal financial information to a nonaffiliated third party other than under an exception in Regulation .15 or .16 of this chapter, the third party may disclose the information only:
(1)
To the licensee's affiliates;
(2)
To the third party's affiliates, but the third party's affiliates may, in turn, disclose the information only to the extent the third party can disclose the information; and
(3)
To any other person, if the disclosure would be lawful if the licensee made it directly to that person.
Regulation .13 Limits on Sharing Account Number Information for Marketing Purposes.LinkCopy Citation
A.
Scope. This regulation does not apply to the disclosure of a policy number, or similar form of access number or access code, that is in an encrypted form, as long as the licensee does not provide the recipient with a means to decode the number or code.
B.
Policy or Transaction Account Defined.
(1)
In this regulation, the following term has the meaning indicated.
(2)
Term Defined.
(a)
“Policy or transaction account” means an account other than a deposit account or a credit card account.
(b)
“Policy or transaction account” does not include an account to which third parties cannot initiate charges.
C.
A licensee may not, directly or through an affiliate, disclose, other than to a consumer reporting agency, a policy number or similar form of access number or access code for a consumer's policy or transaction account to a nonaffiliated third party for use in telemarketing, direct mail marketing, or other marketing through electronic mail to the consumer.
D.
Section C of this regulation does not apply if a licensee discloses a policy number or similar form of access number or access code to:
(1)
The licensee's service provider solely in order to perform marketing for the licensee's own products or services, as long as the service provider is not authorized to directly initiate charges to the account;
(2)
A licensee who is a producer solely in order to perform marketing for the licensee's own products or services; or
(3)
A participant in an affinity or similar program where the participants in the program are identified to the customer when the customer enters into the program.
Regulation .14 Exception to Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Service Providers and Joint Marketing.LinkCopy Citation
A.
In this regulation, “joint agreement” means a written contract pursuant to which a licensee and one or more financial institutions jointly offer, endorse, or sponsor a financial product or financial service.
B.
The opt out requirements in Regulations .08 and .11 of this chapter do not apply when a licensee provides nonpublic personal financial information to a nonaffiliated third party to perform services for the licensee or functions on the licensee's behalf, if the licensee:
(1)
Provides the initial notice in accordance with Regulation .05 of this chapter; and
(2)
Enters into a contractual agreement with the third party that prohibits the third party from disclosing or using the information other than to carry out the purposes for which the licensee disclosed the information, including use under an exception in Regulation .15 or .16 of this chapter in the ordinary course of business to carry out those purposes.
C.
The services a nonaffiliated third party performs for a licensee under §B of this regulation may include marketing of the licensee's own products or services or marketing of financial products or financial services offered pursuant to joint agreements between the licensee and one or more financial institutions.
Regulation .15 Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Processing and Servicing Transactions.LinkCopy Citation
A.
The requirements for initial notice in Regulation .05A(2) of this chapter, the opt out in Regulations .08 and .11 of this chapter, and service providers and joint marketing in Regulation .14 of this chapter do not apply if the licensee discloses nonpublic personal financial information as necessary to effect, administer, or enforce a transaction that a consumer requests or authorizes, or in connection with:
(1)
Servicing or processing an insurance product or insurance service that a consumer requests or authorizes;
(2)
Maintaining or servicing the consumer's account with a licensee, or with another entity as part of a private label credit card program or other extension of credit on behalf of that entity;
(3)
A proposed or actual securitization, secondary market sale, sales of servicing rights, or similar transaction related to a transaction of the consumer; or
(4)
Reinsurance or stop loss or excess loss insurance.
B.
Disclosure by a licensee is considered to be necessary to effect, administer, or enforce a transaction if the disclosure is:
(1)
Required, or is one of the lawful or appropriate methods, to enforce the licensee's rights or the rights of other persons engaged in carrying out the financial transaction or providing the product or service; or
(2)
Required, or is a usual, appropriate, or acceptable method:
(a)
To carry out the transaction or the product or service business of which the transaction is a part, and record, service, or maintain the consumer's account in the ordinary course of providing the insurance product or insurance service;
(b)
To administer or service benefits or claims relating to the transaction or the product or service business of which it is a part;
(c)
To provide a confirmation, statement, or other record of the transaction, or information on the status or value of the insurance product or insurance service to the consumer or the consumer's insurance producer;
(d)
To accrue or recognize incentives or bonuses associated with the transaction that are provided by a licensee or any other party;
(e)
To underwrite insurance at the consumer's request or for any of the following purposes as they relate to a consumer's insurance:
(i)
Account administration;
(ii)
Reporting, investigating, or preventing fraud or material misrepresentation;
(iii)
Processing premium payments;
(iv)
Processing insurance claims;
(v)
Administering insurance benefits including utilization review activities;
(vi)
Participating in research projects; or
(vii)
As otherwise required or specifically permitted by federal or state law; or
(f)
In connection with:
(i)
The authorization, settlement, billing, processing, clearing, transferring, reconciling, or collection of amounts charged, debited, or otherwise paid using a debit, credit, or other payment card, check, or account number, or by other payment means;
(ii)
The transfer of receivables or accounts, or interests in the receivables or accounts; or
(iii)
The audit of debit, credit, or other payment information.
Regulation .16 Other Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information.LinkCopy Citation
A.
The requirements for initial notice to consumers in Regulation .05A(2) of this chapter, the opt out in Regulations .08 and .11 of this chapter, and service providers and joint marketing in Regulation .14 of this chapter do not apply when a licensee discloses nonpublic personal financial information:
(1)
With the consent or at the direction of the consumer, if the consumer has not revoked the consent or direction;
(2)
To protect the confidentiality or security of a licensee's records pertaining to the consumer, service, product, or transaction;
(3)
To protect against or prevent actual or potential fraud or unauthorized transactions;
(4)
For required institutional risk control or for resolving consumer disputes or inquiries;
(5)
To persons holding a legal or beneficial interest relating to the consumer;
(6)
To persons acting in a fiduciary or representative capacity on behalf of the consumer;
(7)
To provide information to:
(a)
Insurance rate advisory organizations;
(b)
Guaranty funds or agencies that are rating a licensee;
(c)
Persons that are assessing the licensee's compliance with industry standards; and
(d)
The licensee's attorneys, accountants, and auditors;
(8)
To the extent specifically permitted or required under other provisions of law and in accordance with the federal Right to Financial Privacy Act of 1978 (12 U.S.C. §3401 et seq.), to law enforcement agencies (including the Federal Reserve Board, Office of the Comptroller of the Currency, Federal Deposit Insurance Corporation, Office of Thrift Supervision, National Credit Union Administration, the Securities and Exchange Commission, the Secretary of the Treasury, with respect to 31 U.S.C. Chapter 53, Subchapter II (Records and Reports on Monetary Instruments and Transactions) and 12 U.S.C. Chapter 21 (Financial Recordkeeping), a state insurance authority, and the Federal Trade Commission), self-regulatory organizations, or for an investigation on a matter related to public safety;
(9)
To a consumer reporting agency in accordance with the federal Fair Credit Reporting Act, 15 U.S.C. §1681 et seq.;
(10)
From a consumer report reported by a consumer reporting agency;
(11)
In connection with a proposed or actual sale, merger, transfer, or exchange of all or a portion of a business or operating unit if the disclosure of nonpublic personal financial information concerns solely consumers of the business or unit;
(12)
To comply with federal, state, or local laws, rules, and other applicable legal requirements;
(13)
To comply with a properly authorized civil, criminal, or regulatory investigation, or subpoena or summons by federal, state, or local authorities;
(14)
To respond to judicial process or government regulatory authorities having jurisdiction over a licensee for examination, compliance, or other purposes as authorized by law; or
(15)
For purposes related to the replacement of a group benefit plan, a group health plan, a group welfare plan, or a workers' compensation plan.
B.
A consumer may revoke consent by subsequently exercising the right to opt out of future disclosures of nonpublic personal information as permitted under Regulation .08F of this chapter.
C.
The Commissioner may exempt a licensee from any of the notice requirements of this chapter if:
(1)
The licensee is in liquidation or receivership; and
(2)
The notice requirements could:
(a)
Negatively impact the ability of the liquidator or receiver to pay claims; and
(b)
Impose a financial burden on the licensee in liquidation or receivership.
Regulation .17 When Authorization Required for Disclosure of Nonpublic Personal Health Information.LinkCopy Citation
A.
A licensee may not disclose nonpublic personal health information about a consumer or customer unless an authorization is obtained from the consumer or customer whose nonpublic personal health information is sought to be disclosed.
B.
This regulation does not prohibit, restrict, or require an authorization for the disclosure of nonpublic personal health information by a licensee for the performance of the following insurance functions by or on behalf of the licensee:
(1)
Claims administration;
(2)
Claims adjustment and management;
(3)
Detection, investigation, or reporting of actual or potential fraud, misrepresentation, or criminal activity;
(4)
Underwriting;
(5)
Policy placement or issuance;
(6)
Loss control;
(7)
Rate-making and guaranty fund functions;
(8)
Reinsurance and excess loss insurance;
(9)
Risk management;
(10)
Case management;
(11)
Disease management;
(12)
Quality assurance;
(13)
Quality improvement;
(14)
Performance evaluation;
(15)
Provider credentialing verification;
(16)
Utilization review;
(17)
Peer review activities;
(18)
Actuarial, scientific, medical, or public policy research;
(19)
Grievance procedures;
(20)
Internal administration of compliance, managerial, and information systems;
(21)
Policyholder service functions;
(22)
Auditing;
(23)
Reporting;
(24)
Database security;
(25)
Administration of consumer disputes and inquiries;
(26)
External accreditation standards;
(27)
The replacement of a group benefit plan or workers' compensation policy or program;
(28)
Activities in connection with a sale, merger, transfer, or exchange of all or part of a business or operating unit;
(29)
Any activity that permits disclosure without authorization pursuant to the federal Health Insurance Portability and Accountability Act privacy rules promulgated by the U.S. Department of Health and Human Services;
(30)
Disclosure that is required, or is one of the lawful or appropriate methods, to enforce the licensee's rights or the rights of other persons engaged in carrying out a transaction or providing a product or service that a consumer requests or authorizes;
(31)
Any activity otherwise permitted by law, required pursuant to governmental reporting authority, or to comply with legal process; and
(32)
Any additional insurance functions determined by the Commissioner to the extent that they are:
(a)
Necessary for appropriate performance of insurance functions; and
(b)
Fair and reasonable to the interest of consumers.
Regulation .18 Authorizations for Disclosure of Health Information.LinkCopy Citation
A.
A valid authorization to disclose nonpublic personal health information pursuant to this regulation shall be in written or electronic form and shall contain all of the following:
(1)
The identity of the consumer or customer who is the subject of the nonpublic personal health information;
(2)
A general description of the types of nonpublic personal health information to be disclosed;
(3)
General descriptions of the parties to whom the licensee discloses nonpublic personal health information, the purpose of the disclosure, and how the information will be used;
(4)
The signature of the consumer or customer who is the subject of the nonpublic personal health information or the individual who is legally empowered to grant authority and the date signed; and
(5)
Notice of the length of time for which the authorization is valid and that the consumer or customer may revoke the authorization at any time and the procedure for making a revocation.
B.
An authorization for the purposes of this regulation shall specify a length of time for which the authorization shall remain valid, which may not be for more than 24 months.
C.
A consumer or customer who is the subject of nonpublic personal health information may revoke an authorization provided pursuant to this regulation at any time, subject to the rights of an individual who acted in reliance on the authorization before notice of the revocation.
D.
A licensee shall retain the authorization or a copy of the authorization in the record of the individual who is the subject of nonpublic personal health information.
Regulation .19 Authorization Request Delivery.LinkCopy Citation
A.
A request for authorization and an authorization form may be delivered to a consumer or a customer as part of an opt out notice pursuant to Regulation .10 of this chapter if the request and the authorization form are clear and conspicuous.
B.
An authorization form is not required to be delivered to the consumer or customer or included in any other notices unless the licensee intends to disclose protected health information pursuant to Regulation .17A of this chapter.
Regulation .20 Relationship to Federal Rules.LinkCopy Citation
Irrespective of whether a licensee is subject to the federal Health Insurance Portability and Accountability Act privacy rule as promulgated by the U.S. Department of Health and Human Services “Standards for the Privacy of Individually Identifiable Health Information”, if a licensee complies with all requirements of the federal rule except for its effective date provision, the licensee is not subject to the provisions of Regulations .17—.19 of this chapter.
Regulation .21 Relationship to Maryland Laws.LinkCopy Citation
This chapter does not preempt or supersede existing State law related to medical records, health information privacy, or insurance information privacy.
Regulation .22 Protection of Fair Credit Reporting Act.LinkCopy Citation
This chapter does not modify, limit, or supersede the operation of the federal Fair Credit Reporting Act, 15 U.S.C. §1681 et seq., and no inference shall be drawn on the basis of the provisions of this chapter regarding whether information is transaction or experience information under 15 U.S.C. §1681a.
Regulation .23 Nondiscrimination.LinkCopy Citation
A licensee may not unfairly discriminate against any consumer or customer because that consumer or customer:
A.
Has opted out from the disclosure of his or her nonpublic personal financial information pursuant to the provisions of this chapter; or
B.
Has not granted authorization for the disclosure of his or her nonpublic personal health information pursuant to the provisions of this chapter.
Regulation .24 Effective Date.LinkCopy Citation
A.
By April 1, 2002, a licensee shall provide an initial notice, as required by Regulation .05 of this chapter, to consumers who are the licensee's customers on January 1, 2002.
B.
Until July 1, 2002, a contract that a licensee has entered into with a nonaffiliated third party to perform services for the licensee or functions on the licensee's behalf satisfies the provisions of Regulation .14B(2) of this chapter, even if the contract does not include a requirement that the third party maintain the confidentiality of nonpublic personal information, as long as the licensee entered into the agreement on or before July 1, 2000.
Chapter 09. Registry and Report on Slavery Era Insurance
Regulation .01 Purpose.LinkCopy Citation
A.
This chapter sets forth standards for reporting slavery era insurance information pursuant Insurance Article, Title 30, Annotated Code of Maryland.
B.
This chapter requires insurers to provide information and data regarding slavery era insurance to the Maryland Insurance Administration.
C.
This chapter specifies how the Administration will distribute to the public the information provided pursuant to §B of this regulation.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Commissioner” means the Maryland Insurance Commissioner.
(2)
“Holding company system” includes:
(a)
An insurer that is a member of the holding company system; and
(b)
Any other member, subsidiary, or division of the holding company system, in each case regardless of whether it is a licensee.
(3)
“Insurer” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.
(4)
“Predecessor insurer” means an insurer associated with the reporting insurer that existed prior in time to the reporting insurer.
(5)
“Reporting insurer” has the meaning stated in Insurance Article, §30-101, Annotated Code of Maryland.
(6)
“Slave” has the meaning stated in Insurance Article, §30-101, Annotated Code of Maryland.
(7)
“Slaveholder” has the meaning stated in Insurance Article, §30-101, Annotated Code of Maryland.
(8)
“Slaveholder insurance policies” has the meaning stated in Insurance Article, §30-101, Annotated Code of Maryland.
(9)
“Slavery era” has the meaning stated in Insurance Article, §30-101, Annotated Code of Maryland.
Regulation .03 Reporting Insurers.LinkCopy Citation
A.
An insurer authorized to do business in the State shall file a report to the Commissioner regarding slaveholder insurance policies that it wrote either directly or through a predecessor insurer during the slavery era.
B.
If an insurer is a member of a holding company system, a consolidated report may be filed by one insurer in the holding company on behalf of all members of the same holding company that are required to file a report.
C.
A consolidated report allowed pursuant to §B of this regulation shall designate one insurer as the reporting insurer for purposes of compliance with this chapter and shall specify which insurers are included in the report.
D.
Insurers choosing to file a consolidated report pursuant to §§B and C of this regulation shall comply with all other requirements of this chapter.
Regulation .04 Report Format and Content.LinkCopy Citation
A.
The report required by Regulation .03A of this chapter shall be filed on letterhead of the insurer, dated, and certified and affirmed under oath by the chief executive officer, or comparable officer, of the insurer as:
(1)
Being true and not misleading; and
(2)
Containing the most accurate information available at the time of the submission of the report.
B.
The report required by Regulation .03A of this chapter shall include the following:
(1)
A paragraph identifying the insurer, stating the insurer's:
(a)
Name;
(b)
Address;
(c)
Telephone number;
(d)
Fax number;
(e)
E-mail address; and
(f)
NAIC number and website URL, if any, for the main office of the insurer making the report;
(2)
A contact person with the insurer, including the contact person's:
(a)
Title;
(b)
Address;
(c)
Telephone number;
(d)
Fax number; and
(e)
E-mail address;
(3)
The research methodology used in generating and preparing the report, including:
(a)
A description of the methods employed by the insurer to identify and compile the records and information that are responsive to this chapter; and
(b)
A description of the research which was conducted at the insurer's own facility as well as a description of research which was conducted at other facilities known to the insurer;
(4)
If the insurer has found no responsive data, it shall so state;
(5)
The names of slaves, in alphabetical order, in the following order:
(a)
Last name;
(b)
First name;
(c)
The name of the slaveholder, beneficiary, policyholder, or all of them;
(d)
The county or parish in which the slave resided;
(e)
The state in which the slave resided; and
(f)
Any other identifying information;
(6)
The names of slaveholders, in alphabetical order, in the following order:
(a)
Last name;
(b)
First name;
(c)
The county or parish in which the slaveholder resided;
(d)
The state in which the slaveholder resided; and
(e)
Any other identifying information; and
(7)
The policy information, including:
(a)
Copies of all records and documents regarding insurance policies issued to slaveholders that provided coverage for injury to or death of slaves; and
(b)
Translations of any records or documents in any language other than English, along with a copy of the document together with a certified translation.
C.
An original plus one copy of the reports generated pursuant to §A of this regulation shall be filed on paper and mailed to the Maryland Insurance Administration, Slavery Era Insurance Registry, 200 St. Paul Place, Suite 2700, Baltimore, MD 21202.
D.
The sections of the reports outlined in §B(4) and (5) of this regulation, shall also be submitted in the electronic format approved by the Commissioner.
Regulation .05 Submission.LinkCopy Citation
A.
Each insurer shall file the report required by Regulation .04 of this chapter with the Commissioner on or before October 1, 2011.
B.
If the Commissioner determines that a report is incomplete, the Commissioner may require additional reports, as necessary, consistent with the requirements of this chapter.
C.
An insurer that files a report indicating that it has information responsive to the relevant statute and this chapter, which has not been provided, shall inform the Commissioner as to the reason that the required information has not been provided and when the required information will be filed.
Regulation .06 Availability of the Slavery Era Insurance Policy Registry and Report.LinkCopy Citation
A.
The report generated by the Commissioner pursuant to Insurance Article, Title 30, Annotated Code of Maryland, and this chapter, shall be known as the Slavery Era Insurance Policy Registry and Report.
B.
The Commissioner shall provide the Slavery Era Insurance Policy Registry and Report to the Governor and General Assembly on or before April 1, 2012.
C.
The Commissioner shall make available to the public a copy of the Slavery Era Insurance Policy Registry and Report on the Maryland Insurance Administration's website.
D.
The Slavery Era Insurance Policy Registry and Report shall be accessible to the public at the Thurgood Marshall Law Library at the University Of Maryland School Of Law and any other means that the Commissioner considers appropriate.
Regulation .07 Enforcement.LinkCopy Citation
The Commissioner may impose on an insurer any penalty, sanction, or other form of legal enforcement which the Commissioner has the authority to impose for failure to comply with the provisions of this chapter.
Chapter 10. Complaint Investigation and Determination Process
Regulation .01 Scope.LinkCopy Citation
A.
This chapter applies to carriers that issue or deliver insurance policies or health maintenance organization contracts in Maryland.
B.
This chapter does not apply to complaints filed under Insurance Article, Title 15, Subtitle 10A, Annotated Code of Maryland.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Administration” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.
(2)
“Carrier” means:
(a)
An insurer;
(b)
A nonprofit health service plan;
(c)
A dental plan organization;
(d)
A fraternal benefit society;
(e)
A health maintenance organization; or
(f)
The Maryland Automobile Insurance Fund (MAIF).
(3)
“Commissioner” means the Insurance Commissioner of Maryland or the Insurance Commissioner’s designee.
(4)
“Complainant” means a person who files a complaint with the Commissioner.
(5)
Complaint.
(a)
“Complaint” means any written communication received by the Commissioner that expresses dissatisfaction with a carrier.
(b)
“Complaint” includes an oral communication received by the Commissioner, which is subsequently converted to a written form.
(c)
“Complaint” does not include a dispute regarding a claim that is resolved by the Consumer Education and Advocacy Unit through the Rapid Response Program.
(d)
“Complaint” includes a dispute that is initially handled by the Consumer Education and Advocacy Unit that is not resolved and is referred for a complaint investigation.
(e)
“Complaint” does not include actions taken under Insurance Article, §27-1001, Annotated Code of Maryland.
(f)
“Complaint” does not include a dispute that is subject to the authority of the Workers’ Compensation Commission.
(6)
“Complaint investigation” means the process used by the Commissioner to determine if a carrier has violated a State statute, regulation, or order in its dealings or interactions with the complainant, to the extent the Commissioner has the authority to enforce that statute, regulation, or order.
(7)
Determination.
(a)
“Determination” means a decision by the Commissioner that requires the Commissioner to provide the opportunity for a hearing to a person aggrieved by the decision under Insurance Article, §2-210, Annotated Code of Maryland.
(b)
“Determination” includes:
(i)
A decision as to whether a carrier against whom a complaint has been received violated a law, regulation, or order; and
(ii)
An order or notice issued under Insurance Article, §2-204, Annotated Code of Maryland.
(8)
“Health care provider” means:
(a)
A hospital, as defined in Health-General Article, §19-301, Annotated Code of Maryland; or
(b)
A person who is:
(i)
Licensed under Health Occupations Article, Annotated Code of Maryland, or similar laws of another state, to render health care services; and
(ii)
The treating provider of the individual who is entitled to coverage under a contract issued or delivered in Maryland by a carrier.
(9)
“Market conduct action” has the meaning stated in COMAR 31.04.20.03.
(10)
“Person” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.
(11)
“Premium” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.
(12)
“Rapid Response Program” means the process designed by the Administration to help Maryland residents resolve personal property and casualty insurance claims directly with the individual’s insurer.
Regulation .03 Complaint investigation.LinkCopy Citation
A.
Upon receipt of a complaint, the Commissioner shall begin a complaint investigation.
B.
A complaint filed by a health care provider concerning a specific claim under a contract issued or delivered in Maryland by a life insurer, health insurer, nonprofit health service plan, dental plan organization, or health maintenance organization shall be considered to be filed on behalf of the individual who received the health care services for which the claim was filed, unless otherwise specified.
C.
The Commissioner shall acknowledge receipt of the complaint by sending a letter or a copy of the correspondence described in §D of this regulation to the complainant and the carrier.
D.
If the Commissioner determines information or documentation is needed from a carrier to conduct a complaint investigation, in accordance with Regulation .06 of this chapter:
(1)
The Commissioner shall request information or documentation; and
(2)
The carrier shall provide the information and documentation by the later of:
(a)
15 working days after receipt of the Commissioner’s request; or
(b)
The time period specified by the Commissioner in correspondence to the carrier.
Regulation .04 Determination.LinkCopy Citation
A.
Upon completion of the complaint investigation, the Commissioner shall document the findings of the complaint investigation in a determination letter and, if applicable, an order.
B.
The documented findings of §A of this regulation shall be provided to the complainant and the carrier that was the subject of the complaint.
C.
The Commissioner may send the determination letter and, if applicable, the order to the complainant or the carrier by first-class mail or by any other means permitted by law.
Regulation .05 Reporting.LinkCopy Citation
The Commissioner shall report data concerning the outcome of the complaint to the National Association of Insurance Commissioners.
Regulation .06 Information.LinkCopy Citation
A.
The Commissioner may request accounts, records, documents, files, logs, photographs, or other information necessary to complete a complaint investigation.
B.
Whenever a carrier receives a request from the Commissioner for information and documentation, the carrier shall provide the requested information and documentation:
(1)
On the date specified by the Commissioner, unless an extension has been granted by the Commissioner in accordance with §§D and E of this regulation; and
(2)
In the manner specified by the Commissioner.
C.
If the carrier does not have the information or documentation requested by the Commissioner under §A of this regulation, the carrier shall provide the reason the carrier does not have the requested information or documentation.
D.
Request for Extension of Time to Respond.
(1)
A carrier may submit a written request by first-class mail, facsimile, or electronic mail for an extension of time to respond to a request for information or documentation from the Commissioner.
(2)
The request for an extension shall:
(a)
Specify the reason an extension is needed; and
(b)
Be received by the Commissioner prior to the date the information or documentation was due.
E.
Upon receipt of a timely written request for an extension under §D of this regulation, the Commissioner shall:
(1)
Grant an extension and provide the requestor with a new date by which the requested information or documentation is to be provided; or
(2)
Notify the carrier that the request to extend the time is denied.
F.
Information related to a complaint investigation is subject to the Public Information Act, State Government Article, Title 10, Subtitle 6, Annotated Code of Maryland.
G.
A carrier submitting information to the Commissioner during a complaint investigation may submit a written request that the information not be disclosed under the Public Information Act.
H.
A request under §G of this regulation shall:
(1)
Identify the particular information that the carrier requests not be disclosed; and
(2)
Cite the statutory authority that permits denial of access to the information.
I.
The Commissioner may review a request made under §G of this regulation upon receipt of a request for access pursuant to the Public Information Act.
J.
The Commissioner may notify the carrier who made a request under §G of this regulation before granting access to information that was the subject of the request.
Regulation .07 Commissioner’s Actions.LinkCopy Citation
Based on the information or documentation reviewed during a complaint investigation, the Commissioner may, in the Commissioner’s sole discretion, take one or more of the following actions in addition to issuing a determination letter or, if applicable, an order:
A.
Initiate a market conduct action in accordance with COMAR 31.04.20; or
B.
Take any other action authorized by State law.
Regulation .08 Sanctions.LinkCopy Citation
If a carrier subject to this chapter fails to provide the information or documentation requested by the Commissioner in accordance with this chapter, the carrier may be subject to an administrative penalty not to exceed $500 per day, in addition to any other sanctions available to the Commissioner.
Regulation .09 Hearings.LinkCopy Citation
A person aggrieved by the determination of the Commissioner’s complaint investigation may request a hearing in accordance with the provisions of Insurance Article, §2-210(c), Annotated Code of Maryland, and COMAR 31.02.01.