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Textbook
1. General Insurance Concepts
2. Producer Roles and Receipt Types
3. Principles of Life Insurance
4. Underwriting
5. Term Life Insurance
6. Whole Life Insurance
7. Variable Insurance Products
8. Group Life Insurance
9. Life Insurance Provisions
10. Annuities
11. Taxation of Life Insurance Products
12. Qualified Retirement Plans
13. Health Insurance Basics
14. Required Policy Provisions
15. Optional Policy Provisions
16. Medical Expense Insurance
17. Group Health Insurance
18. The Affordable Care Act (ACA)
19. Disability Income Insurance
20. Accidental Death and Dismemberment Insurance
21. Long Term Care Insurance
22. Dental Insurance
23. Section 125 Plans and Limited Policies
24. Federal Government Programs
25. Medigap and Medicaid
26. Health Insurance Taxation
Wrapping Up
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Achievable Life & Health

Alabama State Regulations & NAIC Insurance Law

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Licensing

To apply for an Alabama resident producer’s license, you must:

  • Be at least 18 years old
  • Be a resident of Alabama before you submit your application

Under the Beason-Hammon Taxpayer and Citizen Protection Act, Alabama must verify the citizenship of all applicants. There are sixteen acceptable identifiers, including an official driver’s license (front and back). Any one of the approved identifiers may be used as proof.

Pre-licensing course and exam: Not required

Alabama does not have specific pre-licensing requirements.

Fingerprints/background check

The Commissioner reviews an applicant’s background before issuing a license, and many states require applicants to submit fingerprints for a state and FBI criminal history check as part of the application.

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

Non-resident license

A producer licensed in another state can obtain a Alabama nonresident license without taking Alabama’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

  • Is currently licensed as a resident, and in good standing, in the home state
  • Has applied (the home-state application or the Uniform Application) and paid the fees
  • Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

  • The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
  • A member or employee of a business entity producer, on the death or disability of its designated producer
  • The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The NAIC’s model act limits a temporary license to 180 days.

Military service

Under the NAIC’s model act, a producer who cannot meet license renewal requirements because of military service, or because of another extenuating circumstance such as a long-term medical disability, may request a waiver of those requirements and of any examination, fine or sanction for missing them.

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

An Alabama producer license is renewed every two years, based on the licensee’s month and year of birth (Ala. Admin. Code r. 482-1-110-.04).

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

An Alabama license not renewed by its expiration date may still be renewed during the first 30 days after it expires, retroactive to the expiration date, subject to a $50 late fee (Ala. Admin. Code r. 482-1-110-.04).

Continuing education

All states, including Alabama, have continuing education requirements that must be met to renew any major lines (life, health, property, liability) insurance license.

Individuals licensed in Alabama must complete continuing education (part of which must cover ethics) before renewing their license. The number of hours required is set by state law and published by the state insurance department.

Notice of change of name or address

Under the NAIC’s model act, the licensee reports a change of address to the regulator within 30 days of the change.

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Department of Insurance to conduct business in Alabama. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in Alabama must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required.

Medigap policies

Federal law requires national standardization of Medigap (Medicare supplement) policies to reduce confusion about plan differences. Insurers may offer only standardized Medigap plans developed by the NAIC.

Currently available plans are A, B, C, D, F, G, K, L, M, and N. Plans E, H, I, and J have been eliminated.

Plans C and F are not available to individuals who became newly eligible for Medicare on or after January 1, 2020.

Plan A includes the “core” benefits:

  • Parts A and B co-payments
  • 365 additional days of hospitalization
  • The first 3 pints of blood

If an insurer sells any Medigap policies in the state, it must offer Plan A.

A Buyer’s Guide and an Outline of Coverage must be delivered at the time of application, before accepting any premium payment.

Duties of the Commissioner of Insurance

The Alabama Commissioner of Insurance is a state executive position in the Alabama government. The Commissioner is the chief executive of the Alabama Department of Insurance, which regulates insurance companies operating in Alabama. The Commissioner of Insurance is appointed by the governor.

The Commissioner is responsible for establishing and enforcing regulations in the Alabama insurance market in a manner that protects consumers and encourages economic development.

Those duties include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.

  • Monitor transactions of all companies including domestic, foreign, and alien insurance companies.

  • Examine the financial condition of insurers; the NAIC’s model examination law calls for every insurer to be examined at least once every five years.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.

  • Approve documentation used by insurance companies such as forms and rates.

The Commissioner also oversees the state Fire Marshal’s Office, which investigates “suspicious fires and explosions,” and enforces the state’s fire code through building inspections.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The DOI has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Commingling policy owners’, insurers’, and beneficiaries’ money with the producer’s own money.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been convicted of a felony.

  • Having been convicted of violations in reference to unfair trade practices or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than Alabama.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the DOI finds that a producer has violated the state’s insurance laws, the DOI may order the producer to cease and desist.

A cease and desist order does not suspend or revoke the recipient’s registration. However, it does require the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A cease and desist order must be complied with immediately, but the action is not “final and binding”: a person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by Alabama law, and may ask a court to review the final order.

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes.

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

Depending on the line of insurance and the form, a state may require approval before a form is used, often with a period after which a filing that has not been acted on is deemed approved, or may allow the form to be used as soon as it is filed (“file and use”).

If a policy provision conflicts with Alabama law, the policy is read as amended to conform to the law.

The interest rate an insurer may charge on a life insurance policy loan is also limited by state law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Alabama law sets how long the records must be kept.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Alabama, but has not passed the appropriate licensing examination, is in violation of regulation.

Any means of public communication is included, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in Alabama in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information with the sole purpose of inducing lapse, exchange, conversion, forfeiture, or surrender is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited.

False financial statements

Any licensed producer who makes false statements containing any information that involves inaccurate material facts or false statements on an application for insurance is in violation of the state’s unfair trade practices law.

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

States differ on promotional gifts. The NAIC’s model act lets producers and insurers give customers non-cash gifts, meals or charitable donations up to an amount the state considers reasonable, as long as the gift is not conditioned on buying or renewing a policy and is offered without unfair discrimination. Each state sets its own limit.

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. State unfair trade practices laws, based on the NAIC’s model act, prohibit:

  • Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
  • Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
  • Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
  • In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind.

Errors & Omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers negligence and unintentional mistakes that cause financial harm to clients. It does not cover intentional misconduct, criminal acts, or regulatory fines.

Children covered as dependents

Under the Affordable Care Act, a plan that offers dependent coverage must make it available to an adult child until age 26, whether or not the child is married, a student or financially dependent on the parent.

State law generally requires a policy that covers dependents to cover a newborn from the moment of birth and an adopted child from placement, and may let the insurer require notice and any added premium within a set period to continue the child’s coverage. Policies also generally continue coverage past the age limit for a dependent child who cannot support themselves because of a mental or physical disability that began before that age.

Rebating

Alabama licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law.

Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Unfair marketing practices

The DOI is responsible for establishing minimum standards for the full and fair disclosure of policy content. It also requires the standardization and simplification of the terms used to describe insurance coverage.

Advertising may not involve the following:

  • Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions and insurance companies.

GLBA established a framework of responsibilities of federal and state regulators for these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories.

Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.

NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

  • When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
  • When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

In states that adopted the NAIC’s Insurance Information and Privacy Protection Model Act, an authorization to collect personal information signed with an application is valid for no more than 30 months for life, health or disability insurance and one year for property or casualty insurance.

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

  • May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
  • Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

  • Be identified clearly as an advertisement
  • Carry accurate header information and a subject line that is not deceptive
  • Include the sender’s valid physical postal address
  • Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Licensing

  • Must be 18+ and Alabama resident before applying
  • Citizenship verification required (16 acceptable IDs)
  • No pre-licensing course/exam required

Fingerprints/background check

  • Fingerprinting required via Fieldprint after passing state exam
  • Results valid for 30 days; must re-fingerprint if expired
  • Only for insurance license purposes

Controlled business

  • License cannot be obtained solely to write insurance for self/family
  • Selling to self/family allowed, but not as sole purpose

Non-resident license

  • Must hold resident license in good standing in home state
  • Reciprocity required; Alabama reciprocates with all states

Temporary license

  • Must be sponsored/appointed by insurer
  • Valid once per line, up to 6 months

Inactive status

  • Active military duty: license may be placed inactive
  • May receive residual commissions, but no new business

Renewal maintenance

  • License valid for 2 years; renew every 2 years by birth month
  • 30-day grace period with $50 late fee
  • Reissue within 12 months without retesting; after 12 months, must retake requirements

Continuing education

  • 24 hours CE required per renewal, including 3 hours ethics

Notice of change of name or address

  • Must report changes to DOI within 30 days
  • Failure may result in fines or suspension

Company regulations

  • Insurers must be authorized by DOI
  • Must submit rate tables, articles of incorporation, bylaws, fees

Place of business

  • Resident producers must maintain public-access business location in Alabama

Capital and surplus requirement

  • Insurers must meet minimum capital/surplus to keep certificate of authority

Medigap policies

  • Only standardized NAIC plans (A, B, C, D, F, G, K, L, M, N) allowed
  • Plans C/F not for new Medicare eligibles after Jan 1, 2020
  • Must offer Plan A if selling Medigap; deliver Buyer’s Guide/Outline of Coverage at application

Duties of the Commissioner of Insurance

  • Appointed by governor; chief regulator of insurance market
  • Investigates claims/complaints, audits domestic insurers (every 3 years)
  • Issues fines, suspensions, approves forms/rates
  • Oversees Fire Marshal’s Office
  • Cannot arrest, issue injunctions, or sentence jail time

Suspend, revoke or non-renew

  • Grounds: false info, fraud, commingling funds, felony, unethical practices, prior revocation, etc.
  • Includes cheating, misrepresentation, unfair trade practices

Cease and desist

  • DOI may order stop of activities violating regulations
  • Does not suspend/revoke license, but must be followed immediately

Hearing

  • Right to hearing for disciplinary actions
  • Notice given at least 20 days before hearing
  • Civil penalty up to $15,000 per violation

Unfair claims settlement practices

  • Delaying/obstructing claims, failing to investigate, denying without investigation
  • Settling for less than fair value, altering applications without consent

Policy forms

  • “File and use” state: forms filed, may be used immediately
  • Forms must comply with law; conflicting provisions amended to state minimums
  • Life policy loan interest rates regulated

Record maintenance

  • Keep records at business for minimum 3 years
  • Must include contracts, insureds, amendments, premiums
  • Subject to DOI inspection

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Applies to all forms of public communication
  • May result in suspension/revocation of all licenses

Misrepresentation

  • Prohibited to provide incomplete/inaccurate info about policies
  • Twisting: inducing lapse/exchange by misrepresentation

False advertising

  • Publishing false info about insurance in media is a violation

Defamation

  • Maliciously spreading derogatory info about insurers/competitors is prohibited

Boycott, coercion and intimidation

  • Prohibited to use these tactics to retain/monopolize business

False financial statements

  • Making false/inaccurate statements on insurance applications is a violation

Illegal inducements

  • Cannot offer/accept inducements >$10 to buy insurance
  • Violators face suspension and fines

Unfair discrimination

  • Discrimination by class, race, marital status, sexual preference prohibited
  • Denying coverage for blindness is a violation

Errors & Omissions

  • E&O insurance covers agent negligence/unintentional mistakes
  • Does not cover intentional/criminal acts or regulatory fines

Children covered as dependents

  • Newborns/adopted children covered from birth/legal adoption
  • Must enroll within 30 days; no pre-existing condition limits
  • Coverage until age 26; handicapped children covered indefinitely if not self-supporting

Rebating

  • Prohibited to give/receive premium reductions or extra compensation outside commission/salary

Sharing commission

  • Allowed only if both producers are licensed in the line of business

Twisting

  • Prohibited to use false info to induce policy lapse, surrender, or exchange

Unfair marketing practices

  • DOI sets standards for disclosure and simplification
  • Advertising cannot imply government/third-party endorsement or make false claims about claim payment timing

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall; allows banks, insurers, investment firms to merge
  • Sets regulatory framework for financial services industry

McCarran-Ferguson Act

  • Insurance regulated at state level
  • Limited exemption from federal antitrust laws

National Association of Insurance Commissioners (NAIC)

  • Sets standards/best practices for state insurance regulation
  • Composed of chief insurance regulators from all states/territories

Fair Credit Reporting Act of 1971

  • Regulates use of consumer reports in insurance underwriting
  • Adverse action: applicant notified within 3 business days; 60 days to dispute

Privacy Act of 1974

  • Regulates federal agency handling of personal info (not private insurers)
  • Insurance application consent valid for 30 months under FCRA

Telemarketing

  • DO NOT CALL registry blocks unsolicited sales calls
  • Calls only 8am–9pm; must disclose sales nature, caller identity, product, and broker/dealer
  • Prizes cannot be contingent on purchase

CAN-Spam

  • Unsolicited emails must state “advertisement”/“ADV” in subject
  • Must include sender’s physical location and opt-out option

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Alabama State Regulations & NAIC Insurance Law

Licensing

To apply for an Alabama resident producer’s license, you must:

  • Be at least 18 years old
  • Be a resident of Alabama before you submit your application

Under the Beason-Hammon Taxpayer and Citizen Protection Act, Alabama must verify the citizenship of all applicants. There are sixteen acceptable identifiers, including an official driver’s license (front and back). Any one of the approved identifiers may be used as proof.

Pre-licensing course and exam: Not required

Alabama does not have specific pre-licensing requirements.

Fingerprints/background check

The Commissioner reviews an applicant’s background before issuing a license, and many states require applicants to submit fingerprints for a state and FBI criminal history check as part of the application.

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

Non-resident license

A producer licensed in another state can obtain a Alabama nonresident license without taking Alabama’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

  • Is currently licensed as a resident, and in good standing, in the home state
  • Has applied (the home-state application or the Uniform Application) and paid the fees
  • Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

  • The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
  • A member or employee of a business entity producer, on the death or disability of its designated producer
  • The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The NAIC’s model act limits a temporary license to 180 days.

Military service

Under the NAIC’s model act, a producer who cannot meet license renewal requirements because of military service, or because of another extenuating circumstance such as a long-term medical disability, may request a waiver of those requirements and of any examination, fine or sanction for missing them.

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

An Alabama producer license is renewed every two years, based on the licensee’s month and year of birth (Ala. Admin. Code r. 482-1-110-.04).

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

An Alabama license not renewed by its expiration date may still be renewed during the first 30 days after it expires, retroactive to the expiration date, subject to a $50 late fee (Ala. Admin. Code r. 482-1-110-.04).

Continuing education

All states, including Alabama, have continuing education requirements that must be met to renew any major lines (life, health, property, liability) insurance license.

Individuals licensed in Alabama must complete continuing education (part of which must cover ethics) before renewing their license. The number of hours required is set by state law and published by the state insurance department.

Notice of change of name or address

Under the NAIC’s model act, the licensee reports a change of address to the regulator within 30 days of the change.

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Department of Insurance to conduct business in Alabama. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in Alabama must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required.

Medigap policies

Federal law requires national standardization of Medigap (Medicare supplement) policies to reduce confusion about plan differences. Insurers may offer only standardized Medigap plans developed by the NAIC.

Currently available plans are A, B, C, D, F, G, K, L, M, and N. Plans E, H, I, and J have been eliminated.

Plans C and F are not available to individuals who became newly eligible for Medicare on or after January 1, 2020.

Plan A includes the “core” benefits:

  • Parts A and B co-payments
  • 365 additional days of hospitalization
  • The first 3 pints of blood

If an insurer sells any Medigap policies in the state, it must offer Plan A.

A Buyer’s Guide and an Outline of Coverage must be delivered at the time of application, before accepting any premium payment.

Duties of the Commissioner of Insurance

The Alabama Commissioner of Insurance is a state executive position in the Alabama government. The Commissioner is the chief executive of the Alabama Department of Insurance, which regulates insurance companies operating in Alabama. The Commissioner of Insurance is appointed by the governor.

The Commissioner is responsible for establishing and enforcing regulations in the Alabama insurance market in a manner that protects consumers and encourages economic development.

Those duties include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.

  • Monitor transactions of all companies including domestic, foreign, and alien insurance companies.

  • Examine the financial condition of insurers; the NAIC’s model examination law calls for every insurer to be examined at least once every five years.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.

  • Approve documentation used by insurance companies such as forms and rates.

The Commissioner also oversees the state Fire Marshal’s Office, which investigates “suspicious fires and explosions,” and enforces the state’s fire code through building inspections.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The DOI has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Commingling policy owners’, insurers’, and beneficiaries’ money with the producer’s own money.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been convicted of a felony.

  • Having been convicted of violations in reference to unfair trade practices or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than Alabama.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the DOI finds that a producer has violated the state’s insurance laws, the DOI may order the producer to cease and desist.

A cease and desist order does not suspend or revoke the recipient’s registration. However, it does require the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A cease and desist order must be complied with immediately, but the action is not “final and binding”: a person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by Alabama law, and may ask a court to review the final order.

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes.

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

Depending on the line of insurance and the form, a state may require approval before a form is used, often with a period after which a filing that has not been acted on is deemed approved, or may allow the form to be used as soon as it is filed (“file and use”).

If a policy provision conflicts with Alabama law, the policy is read as amended to conform to the law.

The interest rate an insurer may charge on a life insurance policy loan is also limited by state law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Alabama law sets how long the records must be kept.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Alabama, but has not passed the appropriate licensing examination, is in violation of regulation.

Any means of public communication is included, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in Alabama in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information with the sole purpose of inducing lapse, exchange, conversion, forfeiture, or surrender is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited.

False financial statements

Any licensed producer who makes false statements containing any information that involves inaccurate material facts or false statements on an application for insurance is in violation of the state’s unfair trade practices law.

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

States differ on promotional gifts. The NAIC’s model act lets producers and insurers give customers non-cash gifts, meals or charitable donations up to an amount the state considers reasonable, as long as the gift is not conditioned on buying or renewing a policy and is offered without unfair discrimination. Each state sets its own limit.

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. State unfair trade practices laws, based on the NAIC’s model act, prohibit:

  • Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
  • Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
  • Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
  • In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind.

Errors & Omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers negligence and unintentional mistakes that cause financial harm to clients. It does not cover intentional misconduct, criminal acts, or regulatory fines.

Children covered as dependents

Under the Affordable Care Act, a plan that offers dependent coverage must make it available to an adult child until age 26, whether or not the child is married, a student or financially dependent on the parent.

State law generally requires a policy that covers dependents to cover a newborn from the moment of birth and an adopted child from placement, and may let the insurer require notice and any added premium within a set period to continue the child’s coverage. Policies also generally continue coverage past the age limit for a dependent child who cannot support themselves because of a mental or physical disability that began before that age.

Rebating

Alabama licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law.

Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Unfair marketing practices

The DOI is responsible for establishing minimum standards for the full and fair disclosure of policy content. It also requires the standardization and simplification of the terms used to describe insurance coverage.

Advertising may not involve the following:

  • Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions and insurance companies.

GLBA established a framework of responsibilities of federal and state regulators for these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories.

Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.

NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

  • When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
  • When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

In states that adopted the NAIC’s Insurance Information and Privacy Protection Model Act, an authorization to collect personal information signed with an application is valid for no more than 30 months for life, health or disability insurance and one year for property or casualty insurance.

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

  • May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
  • Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

  • Be identified clearly as an advertisement
  • Carry accurate header information and a subject line that is not deceptive
  • Include the sender’s valid physical postal address
  • Offer a way to opt out, and the sender must honor an opt-out within 10 business days
Key points

Licensing

  • Must be 18+ and Alabama resident before applying
  • Citizenship verification required (16 acceptable IDs)
  • No pre-licensing course/exam required

Fingerprints/background check

  • Fingerprinting required via Fieldprint after passing state exam
  • Results valid for 30 days; must re-fingerprint if expired
  • Only for insurance license purposes

Controlled business

  • License cannot be obtained solely to write insurance for self/family
  • Selling to self/family allowed, but not as sole purpose

Non-resident license

  • Must hold resident license in good standing in home state
  • Reciprocity required; Alabama reciprocates with all states

Temporary license

  • Must be sponsored/appointed by insurer
  • Valid once per line, up to 6 months

Inactive status

  • Active military duty: license may be placed inactive
  • May receive residual commissions, but no new business

Renewal maintenance

  • License valid for 2 years; renew every 2 years by birth month
  • 30-day grace period with $50 late fee
  • Reissue within 12 months without retesting; after 12 months, must retake requirements

Continuing education

  • 24 hours CE required per renewal, including 3 hours ethics

Notice of change of name or address

  • Must report changes to DOI within 30 days
  • Failure may result in fines or suspension

Company regulations

  • Insurers must be authorized by DOI
  • Must submit rate tables, articles of incorporation, bylaws, fees

Place of business

  • Resident producers must maintain public-access business location in Alabama

Capital and surplus requirement

  • Insurers must meet minimum capital/surplus to keep certificate of authority

Medigap policies

  • Only standardized NAIC plans (A, B, C, D, F, G, K, L, M, N) allowed
  • Plans C/F not for new Medicare eligibles after Jan 1, 2020
  • Must offer Plan A if selling Medigap; deliver Buyer’s Guide/Outline of Coverage at application

Duties of the Commissioner of Insurance

  • Appointed by governor; chief regulator of insurance market
  • Investigates claims/complaints, audits domestic insurers (every 3 years)
  • Issues fines, suspensions, approves forms/rates
  • Oversees Fire Marshal’s Office
  • Cannot arrest, issue injunctions, or sentence jail time

Suspend, revoke or non-renew

  • Grounds: false info, fraud, commingling funds, felony, unethical practices, prior revocation, etc.
  • Includes cheating, misrepresentation, unfair trade practices

Cease and desist

  • DOI may order stop of activities violating regulations
  • Does not suspend/revoke license, but must be followed immediately

Hearing

  • Right to hearing for disciplinary actions
  • Notice given at least 20 days before hearing
  • Civil penalty up to $15,000 per violation

Unfair claims settlement practices

  • Delaying/obstructing claims, failing to investigate, denying without investigation
  • Settling for less than fair value, altering applications without consent

Policy forms

  • “File and use” state: forms filed, may be used immediately
  • Forms must comply with law; conflicting provisions amended to state minimums
  • Life policy loan interest rates regulated

Record maintenance

  • Keep records at business for minimum 3 years
  • Must include contracts, insureds, amendments, premiums
  • Subject to DOI inspection

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Applies to all forms of public communication
  • May result in suspension/revocation of all licenses

Misrepresentation

  • Prohibited to provide incomplete/inaccurate info about policies
  • Twisting: inducing lapse/exchange by misrepresentation

False advertising

  • Publishing false info about insurance in media is a violation

Defamation

  • Maliciously spreading derogatory info about insurers/competitors is prohibited

Boycott, coercion and intimidation

  • Prohibited to use these tactics to retain/monopolize business

False financial statements

  • Making false/inaccurate statements on insurance applications is a violation

Illegal inducements

  • Cannot offer/accept inducements >$10 to buy insurance
  • Violators face suspension and fines

Unfair discrimination

  • Discrimination by class, race, marital status, sexual preference prohibited
  • Denying coverage for blindness is a violation

Errors & Omissions

  • E&O insurance covers agent negligence/unintentional mistakes
  • Does not cover intentional/criminal acts or regulatory fines

Children covered as dependents

  • Newborns/adopted children covered from birth/legal adoption
  • Must enroll within 30 days; no pre-existing condition limits
  • Coverage until age 26; handicapped children covered indefinitely if not self-supporting

Rebating

  • Prohibited to give/receive premium reductions or extra compensation outside commission/salary

Sharing commission

  • Allowed only if both producers are licensed in the line of business

Twisting

  • Prohibited to use false info to induce policy lapse, surrender, or exchange

Unfair marketing practices

  • DOI sets standards for disclosure and simplification
  • Advertising cannot imply government/third-party endorsement or make false claims about claim payment timing

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall; allows banks, insurers, investment firms to merge
  • Sets regulatory framework for financial services industry

McCarran-Ferguson Act

  • Insurance regulated at state level
  • Limited exemption from federal antitrust laws

National Association of Insurance Commissioners (NAIC)

  • Sets standards/best practices for state insurance regulation
  • Composed of chief insurance regulators from all states/territories

Fair Credit Reporting Act of 1971

  • Regulates use of consumer reports in insurance underwriting
  • Adverse action: applicant notified within 3 business days; 60 days to dispute

Privacy Act of 1974

  • Regulates federal agency handling of personal info (not private insurers)
  • Insurance application consent valid for 30 months under FCRA

Telemarketing

  • DO NOT CALL registry blocks unsolicited sales calls
  • Calls only 8am–9pm; must disclose sales nature, caller identity, product, and broker/dealer
  • Prizes cannot be contingent on purchase

CAN-Spam

  • Unsolicited emails must state “advertisement”/“ADV” in subject
  • Must include sender’s physical location and opt-out option

Related readings

  • Producer Roles and Receipt Types
  • Underwriting
  • Term Life Insurance
  • Variable Insurance Products
  • Group Life Insurance