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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

Alaska State Regulations & NAIC Insurance Law

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Licensing

Any individual applying for an Alaska resident producer’s license must:

  • Be at least 18 years old
  • Be a bona fide resident of Alaska, actually residing in the state, before the license is issued (AS 21.27.020(b)(2))

Prospective insurance producers must pass a pre-licensing exam.

Fingerprints/background check

The Director reviews an applicant’s background before issuing a license. As part of the application, a resident applicant must furnish a full set of fingerprints, with the fees, for a state criminal justice information report and a national criminal history record check (AS 21.27.040(e)).

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.

Alaska will not license a person who uses or intends to use the license principally to write controlled business: insurance on the life, person or property of the licensee, the licensee’s spouse or relatives by blood or marriage to the second degree, the licensee’s employer or firm, or the licensee’s wards or employees. A licensee’s commissions and other compensation on controlled business in a calendar year may not exceed 50% of the compensation on all other insurance business (AS 21.27.020(b)(5); AS 21.27.030).

Non-resident license

A producer licensed in another state can obtain an Alaska nonresident license without taking Alaska’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

Under the NAIC’s model act, the regulator may also issue one in any other circumstance where it finds that the public interest will best be served.

Under the NAIC’s model act, the regulator may also limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts. Alaska’s statute sets its own limits: a temporary licensee may not be appointed by an insurer that had not appointed the producer at the time of the producer’s death or the start of the disability, and the designee of a producer entering active military service is licensed only for insurance with the insurers the producer was acting for (AS 21.27.390(a)(4), (c)).

The NAIC’s model act limits a temporary license to 180 days. In Alaska, a temporary license may not be in effect for more than 90 consecutive days and may be renewed or reissued for only one additional 90-day period (AS 21.27.390(b)).

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.

Each state sets its own renewal cycle.

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

Under the NAIC’s model act, a lapsed license may be reinstated within 12 months of the renewal due date, for a penalty of double the unpaid renewal fee. Each state sets its own window and fee, and after the window closes the person must qualify for a new license.

Continuing education

All states, including Alaska, have continuing education requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Many states also require continuing education of other licensees, such as adjusters or title or bail bond agents, while exempting producers who hold only certain limited lines; each state’s law says which. Individuals licensed in the state of Alaska must complete continuing education prior to 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 Division of Insurance to conduct business in Alaska. To receive a certificate of authority, the company applies to the Director 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 that has been authorized to conduct insurance business in Alaska must maintain minimum standards as a corporation. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In Alaska, the Director must suspend or revoke the certificate of authority of an insurer that no longer meets the requirements for the authority granted, on account of becoming impaired or insolvent or otherwise (AS 21.09.140(a)(2)).

Medigap policies

To reduce confusion about the many types of Medicare supplement policies available, federal law mandates national standardization of Medigap policies. The law requires insurers to offer a limited number of standardized Medigap plans developed by the NAIC.

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

In addition, 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, and the first 3 pints of blood). Its core benefits also include the Part A hospice care coinsurance or copayment. If an insurer sells any Medigap policies in the state, it must offer Plan A.

A Buyer’s Guide and an Outline of Coverage are delivered at the time of application, prior to accepting any premium payment.

Duties of the Director of the Division of Insurance

The Alaska Director of the Division of Insurance is a state executive position in the Alaska state government. The Director oversees the Division of Insurance, a subdivision of the Alaska Department of Commerce, Community, and Economic Development. The Division of Insurance is responsible for establishing and enforcing regulations of the insurance industry in Alaska.

The Director is appointed by the commissioner of commerce, community, and economic development. There are no term limits for the Director.

The Alaska DOI is responsible for enforcing and administering all laws pertaining to insurance in the state, including:

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

  • If the Director 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. Alaska’s Director must examine a domestic insurer at least once every three years (AS 21.06.120(g)).

  • Audit the books and records of any resident producer as frequently as necessary. Under the NAIC’s examination model, the regulator may examine any person subject to its authority, nonresident producers included, as often as it considers appropriate.

  • 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.

Additionally, the Director plays an important role in the Alaska government’s response to natural disasters by determining whether a catastrophe has occurred for insurance purposes. The Director may also take extraordinary measures to license insurance adjusters, etc., to ensure companies address and pay claims quickly following a disaster.

Sidenote
Know this...

The Director 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. Under the NAIC’s model act, the ground is broader: providing incorrect, misleading, incomplete or materially untrue information in the license application.

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

  • Committing fraud while attempting to obtain an insurance license.

  • Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business. In Alaska, money a licensee holds as a fiduciary also may not be commingled with other money, except as the statute allows (AS 21.27.360(b), (d)), and any violation of the insurance code is a ground (AS 21.27.410(a)(2)).

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

  • Having been convicted of a felony.

  • Having admitted or been found to have committed any insurance unfair trade practice 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 Alaska. Under the NAIC’s model act, a license denied in another state is also a ground.

  • 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. The recipient of a cease and desist order has not had their registration suspended or revoked, but must stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Director is entitled to notice and an opportunity for a hearing, within time limits set by Alaska law, and may ask a court to review the final order. In Alaska, a demand for a hearing received before an order takes effect, or within 10 days after it is delivered, stays the order until the hearing and the order made on it, except for an order made on or after a hearing or one based on an insurer’s impaired assets or unsound financial condition (AS 21.06.190(a)).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. In Alaska, a violation of the licensing law can bring a civil penalty of up to $10,000 for each violation, or up to $25,000 for each violation the Director finds wilful (AS 21.27.440(a)(2)). For a violation of the trade practices law, the Director may, after a hearing, order restitution and assess a penalty of up to $2,500 for each violation or $25,000 for a general business practice, and, if the person knew or should have known of the violation, a further penalty of up to $25,000 for each violation or $250,000 for a general business practice (AS 21.36.910(d), (e)). 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. In Alaska, a person may not commit any of the acts or practices listed in its unfair claim settlement statute (AS 21.36.125(a)).

  • Unreasonably delaying the investigation or payment of claims by requiring both a formal proof of loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form.

  • Failing, in the case of claims denials or offers of compromise settlement, to promptly provide a reasonable and accurate explanation of the basis for such actions.

  • Refusing to pay claims without conducting a reasonable investigation.

  • 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 or settling a claim for less than the amount a reasonable person would believe the insured or beneficiary was entitled to by reference to written or printed advertising material accompanying or made part of an application.

Policy forms

Insurers file their policy forms with the Director.

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”). In Alaska, a file and use filing must be filed with the Director for a waiting period of at least 30 days, which may be extended by 30 more, and may take effect at the end of the waiting period unless the Director disapproves it (AS 21.42.125(a)).

Under the usual conformity rule, which many states’ insurance codes write into law, a policy provision that conflicts with state law does not make the policy invalid: the policy is read as amended to conform to the law.

An individual health policy may also carry the optional uniform provision “Conformity with State Statutes”: a provision that, on the policy’s effective date, conflicts with the statutes of the state where the insured resides is amended to conform to their minimum requirements.

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 Director’s inspection.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Alaska, but has not passed the appropriate licensing examination, is in violation of regulation. Any means of public communication - including advertisements, letterheads, circulars, business cards, and other methods of representation - are included in the definition of impersonating a licensed producer.

A producer found guilty of conducting business in Alaska 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. Under the NAIC’s model act, the test is whether the policy, quote or illustration misrepresents the policy’s benefits, conditions or terms, not whether it was meant to.

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

  • Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (under the NAIC’s model act, twisting).

According to the Alaska Department of Law, penalties for insurance fraud can include imprisonment for up to 10 years and/or a fine of up to $100,000 for individuals, as well as potential civil penalties and restitution. Companies may also face fines and other sanctions if found guilty of insurance fraud.

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

Knowingly making or circulating a false statement of the financial condition of a person in the insurance business is prohibited in Alaska (AS 21.36.060(a)), and knowingly making a false or fraudulent statement in or with reference to an application for insurance, with intent to injure, defraud or deceive, is a fraudulent insurance act (AS 21.36.360(o)).

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. Alaska’s rebating statutes name no gift allowance: they bar giving, as an inducement, any valuable consideration not specified in the contract, in life, annuity and health insurance (AS 21.36.100) and, except as provided in a filing with the Director, in property, casualty and surety insurance (AS 21.36.120(a)).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

  • 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. Alaska’s own provision is a same-class test: it bars unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuities, of the same class and essentially the same hazard in health insurance, and between insureds or property having like insuring or risk characteristics in property and casualty insurance (AS 21.36.090(a)-(c)).

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

Alaska 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.

An unlicensed person may receive compensation for referrals to a licensee if the person does not discuss specific terms and conditions of a policy, does not give opinions or advice regarding insurance, and if the referral is nominal, on a one-time basis, and fixed in amount by referral. The compensation for the referral cannot depend on whether insurance is purchased or be contingent upon volume of insurance transacted.

Twisting

Alaska’s twisting rule is about the policy: it bars statements misrepresenting, or making incomplete comparisons of, a policy’s terms, conditions or benefits to induce a policyholder to lapse, forfeit, surrender, retain, exchange or convert it (AS 21.36.050). Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Unfair marketing practices

The DOI is responsible for establishing minimum standards for the full and fair disclosure of policy content. The DOI 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 parts of the Glass-Steagall Act of 1933 that kept commercial banks and securities firms apart, and allowed the 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(c)).

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.

Under the same model act, a person told of an adverse underwriting decision may ask in writing, within 90 business days of the notice, for the specific reasons for it, which must be given within 21 business days of the request.

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 give the caller’s name, the name of the company the call is made for, and a telephone number or address at which that company can be contacted

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

  • Alaska resident producer: must be 18+, bona fide Alaska resident before license issued
  • Must pass pre-licensing exam

Fingerprints/background check

  • Director reviews background before licensing
  • Resident applicants furnish fingerprints for a state and national (FBI) criminal history check (AS 21.27.040(e))

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • License intended for public sales; states restrict licenses used mainly for controlled business

Non-resident license

  • Nonresident license granted without Alaska exam if licensed in good standing at home, applies + pays fee, and reciprocity exists
  • Moving producers: file address change within 30 days; apply for new resident license within 90 days (no repeat of prelicensing/exam for held lines)

Temporary license

  • Issued without exam to keep business serviced (e.g., death/disability of producer, military service)
  • NAIC model: regulator may limit a temporary licensee and require a licensed sponsor; in Alaska, only insurers that appointed the producer may appoint a temporary licensee (AS 21.27.390(c))
  • NAIC model: max 180 days; Alaska: max 90 days, renewable once for additional 90 days

Military service

  • Producers may request waiver of renewal requirements/exam/penalties due to military service or extenuating circumstances (e.g., long-term disability)

Renewal and reinstatement

  • License requires timely fee payment + continuing education
  • Each state sets its own renewal cycle
  • NAIC model: lapsed license reinstated within 12 months for double the fee; after window, must requalify

Continuing education

  • Required in all states, including Alaska, to renew major lines licenses
  • Hours set by state law, published by state DOI

Notice of change of name or address

  • Report address change within 30 days (NAIC model)
  • Report administrative actions/criminal prosecutions within 30 days of final disposition/pretrial hearing
  • Must notify regulator before using any assumed business name

Company regulations

  • Insurer must be authorized (certificate of authority) by Alaska DOI
  • Must file charter, financial statements, and required fees/documents

Capital and surplus requirement

  • Insurer must maintain minimum capital/surplus to keep certificate of authority
  • Alaska Director must suspend/revoke certificate if insurer becomes impaired/insolvent (AS 21.09.140(a)(2))

Medigap policies

  • Federal law standardizes Medigap plans (NAIC-developed)
  • Current plans: A, B, C, D, F, G, K, L, M, N (E, H, I, J eliminated)
  • Plans C & F unavailable to those newly eligible on/after Jan 1, 2020
  • Plan A = core benefits; must be offered if insurer sells any Medigap plan
  • Buyer’s Guide & Outline of Coverage given at application, before premium accepted

Duties of the Director of the Division of Insurance

  • Appointed by commissioner of commerce; no term limits
  • Duties: investigate complaints, refer for prosecution, monitor insurers, examine financials (domestic insurers every 3 years in AK; NAIC model = 5 years), audit producer records as needed, collect fees, issue fines, approve forms/rates
  • Role in disaster response: declares catastrophes, may expedite adjuster licensing
  • Cannot arrest, issue injunctions, or impose jail time

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony conviction, unfair trade practices, misappropriating funds, forging signatures, cheating on exams, prior license revoked in another state
  • Alaska: fiduciary funds can’t be commingled (AS 21.27.360); any insurance code violation is grounds (AS 21.27.410)

Cease and desist

  • Ordered when producer violates insurance laws
  • Does not suspend/revoke license, but stops/limits specified activity

Hearing and penalties

  • Entitled to notice and hearing opportunity; can seek court review
  • Alaska: hearing demand before order effective or within 10 days stays order (except impaired-asset/post-hearing orders) (AS 21.06.190(a))
  • Civil penalties in addition to license action: up to $10,000 per violation, $25,000 if wilful (AS 21.27.440); trade practice violations up to $2,500 each, plus up to $25,000 each if the person knew or should have known (AS 21.36.910); some violations are crimes

Unfair claims settlement practices

  • Unfair claims practices under state law: delaying claims, failing to investigate, denying without investigation, altering application info, settling for less than the application’s advertising material led the insured to expect
  • Must provide prompt response and clear explanation of policy terms

Policy forms

  • Filed with Director; approval required or “file and use” allowed
  • Alaska: file and use requires 30-day wait (extendable 30 more days) unless disapproved (AS 21.42.125(a))
  • Conflicting provisions read as amended to conform to law
  • Policy loan interest rates limited by state law

Record maintenance

  • Producers keep transaction records (policies, insureds, premiums, changes)
  • Must be available for Director’s inspection

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Includes ads, letterheads, business cards, etc.
  • Violation can lead to suspension/revocation of other licenses

Misrepresentation

  • Prohibited: false/inaccurate policy info, incomplete comparisons, inducing lapse/surrender (twisting)
  • Alaska insurance fraud penalties: up to 10 years imprisonment and/or $100,000 fine for individuals; civil penalties/restitution possible

False advertising

  • Untrue, deceptive or misleading insurance ads = unfair trade practice (NAIC model)
  • Applies to all media forms
  • Test is truthfulness of statement, not intent to deceive

Defamation

  • False or maliciously derogatory statements about insurer’s financial condition = unfair trade practice
  • Example: spreading false rumor that competitor will fail

Boycott, coercion and intimidation

  • Prohibited: concerted acts creating unreasonable restraint or monopoly in insurance business

False financial statements

  • Illegal to knowingly make/circulate false financial statements about insurance businesses (AS 21.36.060(a))
  • Fraudulent application statements with intent to deceive = fraudulent insurance act (AS 21.36.360(o))

Illegal inducements

  • Prohibited to offer non-policy items of value to induce purchase, unless allowed by law
  • NAIC model allows reasonable non-cash gifts/meals/donations, not conditioned on purchase
  • Alaska bars any valuable consideration not in contract (life/health: AS 21.36.100; property/casualty: AS 21.36.120(a))

Unfair discrimination

  • Prohibited: differing treatment for same-class/equal-risk individuals in rates/benefits/terms
  • Cannot discriminate by sex, marital status, race, religion, national origin
  • Property/casualty: cannot deny based solely on geographic location (unless justified) or physical/mental impairment
  • Alaska’s rule uses same-class/equal-expectation test (AS 21.36.090(a)-(c))

Errors & omissions

  • E&O insurance = professional liability protection for producers
  • Covers negligence/unintentional errors; excludes intentional misconduct, crimes, fines

Children covered as dependents

  • ACA: dependent coverage required until age 26 regardless of marital/student/financial status
  • State law: newborns covered from birth, adopted children from placement
  • Coverage continues past age limit for disabled dependents (disability began before age limit)

Rebating

  • Prohibited: giving refunds/discounts/favors to induce insurance purchase
  • To “solicit”/“negotiate” implies licensure

Sharing commission

  • Allowed between licensed producers in same line
  • Can pay agency or unlicensed referral source (if referral is nominal, one-time, fixed amount, not contingent on sale)

Twisting

  • Prohibited: misrepresenting policy terms to induce lapse/surrender/exchange
  • Alaska rule focuses on policy terms/comparisons (AS 21.36.050)
  • Distinct from defamation (which targets insurer’s finances)

Unfair marketing practices

  • DOZ sets standards for disclosure and simplified terminology
  • Prohibited: implying government/organization endorsement falsely; false claims about claim payment timeframes

Gramm-Leach Bliley Act (GLBA)

  • Repealed key parts of Glass-Steagall; allowed merger of banks, investment firms, insurers
  • Established regulatory framework for combined financial services

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Grants limited antitrust exemption to insurers
  • Since 2021, exemption excludes health insurance (except narrow data-sharing activities)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body of state insurance regulators (50 states, DC, 5 territories)
  • Establishes standards, conducts peer review, coordinates regulatory oversight
  • Forms national system of state-based insurance regulation

Fair Credit Reporting Act

  • Regulates consumer reports (credit, MIB, investigative) used in underwriting
  • Investigative report request: must disclose to consumer within 3 days
  • Adverse action: must notify consumer + agency; consumer has 60 days for free report; may also dispute errors

Privacy Act of 1974

  • Governs federal agencies’ handling of personal info; doesn’t apply to private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid up to 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • National Do Not Call Registry restricts calls to listed numbers
  • Calls allowed only 8 a.m.–9 p.m. local time
  • Must disclose caller’s name, the company the call is made for, and a number or address for it

CAN-SPAM

  • Commercial email must be labeled as ad, have accurate headers/non-deceptive subject
  • Must include valid physical postal address
  • Must offer opt-out; honored within 10 business days

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Alaska State Regulations & NAIC Insurance Law

Licensing

Any individual applying for an Alaska resident producer’s license must:

  • Be at least 18 years old
  • Be a bona fide resident of Alaska, actually residing in the state, before the license is issued (AS 21.27.020(b)(2))

Prospective insurance producers must pass a pre-licensing exam.

Fingerprints/background check

The Director reviews an applicant’s background before issuing a license. As part of the application, a resident applicant must furnish a full set of fingerprints, with the fees, for a state criminal justice information report and a national criminal history record check (AS 21.27.040(e)).

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.

Alaska will not license a person who uses or intends to use the license principally to write controlled business: insurance on the life, person or property of the licensee, the licensee’s spouse or relatives by blood or marriage to the second degree, the licensee’s employer or firm, or the licensee’s wards or employees. A licensee’s commissions and other compensation on controlled business in a calendar year may not exceed 50% of the compensation on all other insurance business (AS 21.27.020(b)(5); AS 21.27.030).

Non-resident license

A producer licensed in another state can obtain an Alaska nonresident license without taking Alaska’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

Under the NAIC’s model act, the regulator may also issue one in any other circumstance where it finds that the public interest will best be served.

Under the NAIC’s model act, the regulator may also limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts. Alaska’s statute sets its own limits: a temporary licensee may not be appointed by an insurer that had not appointed the producer at the time of the producer’s death or the start of the disability, and the designee of a producer entering active military service is licensed only for insurance with the insurers the producer was acting for (AS 21.27.390(a)(4), (c)).

The NAIC’s model act limits a temporary license to 180 days. In Alaska, a temporary license may not be in effect for more than 90 consecutive days and may be renewed or reissued for only one additional 90-day period (AS 21.27.390(b)).

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.

Each state sets its own renewal cycle.

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

Under the NAIC’s model act, a lapsed license may be reinstated within 12 months of the renewal due date, for a penalty of double the unpaid renewal fee. Each state sets its own window and fee, and after the window closes the person must qualify for a new license.

Continuing education

All states, including Alaska, have continuing education requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Many states also require continuing education of other licensees, such as adjusters or title or bail bond agents, while exempting producers who hold only certain limited lines; each state’s law says which. Individuals licensed in the state of Alaska must complete continuing education prior to 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 Division of Insurance to conduct business in Alaska. To receive a certificate of authority, the company applies to the Director 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 that has been authorized to conduct insurance business in Alaska must maintain minimum standards as a corporation. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In Alaska, the Director must suspend or revoke the certificate of authority of an insurer that no longer meets the requirements for the authority granted, on account of becoming impaired or insolvent or otherwise (AS 21.09.140(a)(2)).

Medigap policies

To reduce confusion about the many types of Medicare supplement policies available, federal law mandates national standardization of Medigap policies. The law requires insurers to offer a limited number of standardized Medigap plans developed by the NAIC.

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

In addition, 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, and the first 3 pints of blood). Its core benefits also include the Part A hospice care coinsurance or copayment. If an insurer sells any Medigap policies in the state, it must offer Plan A.

A Buyer’s Guide and an Outline of Coverage are delivered at the time of application, prior to accepting any premium payment.

Duties of the Director of the Division of Insurance

The Alaska Director of the Division of Insurance is a state executive position in the Alaska state government. The Director oversees the Division of Insurance, a subdivision of the Alaska Department of Commerce, Community, and Economic Development. The Division of Insurance is responsible for establishing and enforcing regulations of the insurance industry in Alaska.

The Director is appointed by the commissioner of commerce, community, and economic development. There are no term limits for the Director.

The Alaska DOI is responsible for enforcing and administering all laws pertaining to insurance in the state, including:

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

  • If the Director 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. Alaska’s Director must examine a domestic insurer at least once every three years (AS 21.06.120(g)).

  • Audit the books and records of any resident producer as frequently as necessary. Under the NAIC’s examination model, the regulator may examine any person subject to its authority, nonresident producers included, as often as it considers appropriate.

  • 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.

Additionally, the Director plays an important role in the Alaska government’s response to natural disasters by determining whether a catastrophe has occurred for insurance purposes. The Director may also take extraordinary measures to license insurance adjusters, etc., to ensure companies address and pay claims quickly following a disaster.

Sidenote
Know this...

The Director 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. Under the NAIC’s model act, the ground is broader: providing incorrect, misleading, incomplete or materially untrue information in the license application.

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

  • Committing fraud while attempting to obtain an insurance license.

  • Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business. In Alaska, money a licensee holds as a fiduciary also may not be commingled with other money, except as the statute allows (AS 21.27.360(b), (d)), and any violation of the insurance code is a ground (AS 21.27.410(a)(2)).

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

  • Having been convicted of a felony.

  • Having admitted or been found to have committed any insurance unfair trade practice 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 Alaska. Under the NAIC’s model act, a license denied in another state is also a ground.

  • 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. The recipient of a cease and desist order has not had their registration suspended or revoked, but must stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Director is entitled to notice and an opportunity for a hearing, within time limits set by Alaska law, and may ask a court to review the final order. In Alaska, a demand for a hearing received before an order takes effect, or within 10 days after it is delivered, stays the order until the hearing and the order made on it, except for an order made on or after a hearing or one based on an insurer’s impaired assets or unsound financial condition (AS 21.06.190(a)).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. In Alaska, a violation of the licensing law can bring a civil penalty of up to $10,000 for each violation, or up to $25,000 for each violation the Director finds wilful (AS 21.27.440(a)(2)). For a violation of the trade practices law, the Director may, after a hearing, order restitution and assess a penalty of up to $2,500 for each violation or $25,000 for a general business practice, and, if the person knew or should have known of the violation, a further penalty of up to $25,000 for each violation or $250,000 for a general business practice (AS 21.36.910(d), (e)). 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. In Alaska, a person may not commit any of the acts or practices listed in its unfair claim settlement statute (AS 21.36.125(a)).

  • Unreasonably delaying the investigation or payment of claims by requiring both a formal proof of loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form.

  • Failing, in the case of claims denials or offers of compromise settlement, to promptly provide a reasonable and accurate explanation of the basis for such actions.

  • Refusing to pay claims without conducting a reasonable investigation.

  • 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 or settling a claim for less than the amount a reasonable person would believe the insured or beneficiary was entitled to by reference to written or printed advertising material accompanying or made part of an application.

Policy forms

Insurers file their policy forms with the Director.

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”). In Alaska, a file and use filing must be filed with the Director for a waiting period of at least 30 days, which may be extended by 30 more, and may take effect at the end of the waiting period unless the Director disapproves it (AS 21.42.125(a)).

Under the usual conformity rule, which many states’ insurance codes write into law, a policy provision that conflicts with state law does not make the policy invalid: the policy is read as amended to conform to the law.

An individual health policy may also carry the optional uniform provision “Conformity with State Statutes”: a provision that, on the policy’s effective date, conflicts with the statutes of the state where the insured resides is amended to conform to their minimum requirements.

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 Director’s inspection.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Alaska, but has not passed the appropriate licensing examination, is in violation of regulation. Any means of public communication - including advertisements, letterheads, circulars, business cards, and other methods of representation - are included in the definition of impersonating a licensed producer.

A producer found guilty of conducting business in Alaska 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. Under the NAIC’s model act, the test is whether the policy, quote or illustration misrepresents the policy’s benefits, conditions or terms, not whether it was meant to.

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

  • Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (under the NAIC’s model act, twisting).

According to the Alaska Department of Law, penalties for insurance fraud can include imprisonment for up to 10 years and/or a fine of up to $100,000 for individuals, as well as potential civil penalties and restitution. Companies may also face fines and other sanctions if found guilty of insurance fraud.

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

Knowingly making or circulating a false statement of the financial condition of a person in the insurance business is prohibited in Alaska (AS 21.36.060(a)), and knowingly making a false or fraudulent statement in or with reference to an application for insurance, with intent to injure, defraud or deceive, is a fraudulent insurance act (AS 21.36.360(o)).

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. Alaska’s rebating statutes name no gift allowance: they bar giving, as an inducement, any valuable consideration not specified in the contract, in life, annuity and health insurance (AS 21.36.100) and, except as provided in a filing with the Director, in property, casualty and surety insurance (AS 21.36.120(a)).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

  • 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. Alaska’s own provision is a same-class test: it bars unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuities, of the same class and essentially the same hazard in health insurance, and between insureds or property having like insuring or risk characteristics in property and casualty insurance (AS 21.36.090(a)-(c)).

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

Alaska 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.

An unlicensed person may receive compensation for referrals to a licensee if the person does not discuss specific terms and conditions of a policy, does not give opinions or advice regarding insurance, and if the referral is nominal, on a one-time basis, and fixed in amount by referral. The compensation for the referral cannot depend on whether insurance is purchased or be contingent upon volume of insurance transacted.

Twisting

Alaska’s twisting rule is about the policy: it bars statements misrepresenting, or making incomplete comparisons of, a policy’s terms, conditions or benefits to induce a policyholder to lapse, forfeit, surrender, retain, exchange or convert it (AS 21.36.050). Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Unfair marketing practices

The DOI is responsible for establishing minimum standards for the full and fair disclosure of policy content. The DOI 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 parts of the Glass-Steagall Act of 1933 that kept commercial banks and securities firms apart, and allowed the 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(c)).

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.

Under the same model act, a person told of an adverse underwriting decision may ask in writing, within 90 business days of the notice, for the specific reasons for it, which must be given within 21 business days of the request.

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 give the caller’s name, the name of the company the call is made for, and a telephone number or address at which that company can be contacted

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

  • Alaska resident producer: must be 18+, bona fide Alaska resident before license issued
  • Must pass pre-licensing exam

Fingerprints/background check

  • Director reviews background before licensing
  • Resident applicants furnish fingerprints for a state and national (FBI) criminal history check (AS 21.27.040(e))

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • License intended for public sales; states restrict licenses used mainly for controlled business

Non-resident license

  • Nonresident license granted without Alaska exam if licensed in good standing at home, applies + pays fee, and reciprocity exists
  • Moving producers: file address change within 30 days; apply for new resident license within 90 days (no repeat of prelicensing/exam for held lines)

Temporary license

  • Issued without exam to keep business serviced (e.g., death/disability of producer, military service)
  • NAIC model: regulator may limit a temporary licensee and require a licensed sponsor; in Alaska, only insurers that appointed the producer may appoint a temporary licensee (AS 21.27.390(c))
  • NAIC model: max 180 days; Alaska: max 90 days, renewable once for additional 90 days

Military service

  • Producers may request waiver of renewal requirements/exam/penalties due to military service or extenuating circumstances (e.g., long-term disability)

Renewal and reinstatement

  • License requires timely fee payment + continuing education
  • Each state sets its own renewal cycle
  • NAIC model: lapsed license reinstated within 12 months for double the fee; after window, must requalify

Continuing education

  • Required in all states, including Alaska, to renew major lines licenses
  • Hours set by state law, published by state DOI

Notice of change of name or address

  • Report address change within 30 days (NAIC model)
  • Report administrative actions/criminal prosecutions within 30 days of final disposition/pretrial hearing
  • Must notify regulator before using any assumed business name

Company regulations

  • Insurer must be authorized (certificate of authority) by Alaska DOI
  • Must file charter, financial statements, and required fees/documents

Capital and surplus requirement

  • Insurer must maintain minimum capital/surplus to keep certificate of authority
  • Alaska Director must suspend/revoke certificate if insurer becomes impaired/insolvent (AS 21.09.140(a)(2))

Medigap policies

  • Federal law standardizes Medigap plans (NAIC-developed)
  • Current plans: A, B, C, D, F, G, K, L, M, N (E, H, I, J eliminated)
  • Plans C & F unavailable to those newly eligible on/after Jan 1, 2020
  • Plan A = core benefits; must be offered if insurer sells any Medigap plan
  • Buyer’s Guide & Outline of Coverage given at application, before premium accepted

Duties of the Director of the Division of Insurance

  • Appointed by commissioner of commerce; no term limits
  • Duties: investigate complaints, refer for prosecution, monitor insurers, examine financials (domestic insurers every 3 years in AK; NAIC model = 5 years), audit producer records as needed, collect fees, issue fines, approve forms/rates
  • Role in disaster response: declares catastrophes, may expedite adjuster licensing
  • Cannot arrest, issue injunctions, or impose jail time

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony conviction, unfair trade practices, misappropriating funds, forging signatures, cheating on exams, prior license revoked in another state
  • Alaska: fiduciary funds can’t be commingled (AS 21.27.360); any insurance code violation is grounds (AS 21.27.410)

Cease and desist

  • Ordered when producer violates insurance laws
  • Does not suspend/revoke license, but stops/limits specified activity

Hearing and penalties

  • Entitled to notice and hearing opportunity; can seek court review
  • Alaska: hearing demand before order effective or within 10 days stays order (except impaired-asset/post-hearing orders) (AS 21.06.190(a))
  • Civil penalties in addition to license action: up to $10,000 per violation, $25,000 if wilful (AS 21.27.440); trade practice violations up to $2,500 each, plus up to $25,000 each if the person knew or should have known (AS 21.36.910); some violations are crimes

Unfair claims settlement practices

  • Unfair claims practices under state law: delaying claims, failing to investigate, denying without investigation, altering application info, settling for less than the application’s advertising material led the insured to expect
  • Must provide prompt response and clear explanation of policy terms

Policy forms

  • Filed with Director; approval required or “file and use” allowed
  • Alaska: file and use requires 30-day wait (extendable 30 more days) unless disapproved (AS 21.42.125(a))
  • Conflicting provisions read as amended to conform to law
  • Policy loan interest rates limited by state law

Record maintenance

  • Producers keep transaction records (policies, insureds, premiums, changes)
  • Must be available for Director’s inspection

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Includes ads, letterheads, business cards, etc.
  • Violation can lead to suspension/revocation of other licenses

Misrepresentation

  • Prohibited: false/inaccurate policy info, incomplete comparisons, inducing lapse/surrender (twisting)
  • Alaska insurance fraud penalties: up to 10 years imprisonment and/or $100,000 fine for individuals; civil penalties/restitution possible

False advertising

  • Untrue, deceptive or misleading insurance ads = unfair trade practice (NAIC model)
  • Applies to all media forms
  • Test is truthfulness of statement, not intent to deceive

Defamation

  • False or maliciously derogatory statements about insurer’s financial condition = unfair trade practice
  • Example: spreading false rumor that competitor will fail

Boycott, coercion and intimidation

  • Prohibited: concerted acts creating unreasonable restraint or monopoly in insurance business

False financial statements

  • Illegal to knowingly make/circulate false financial statements about insurance businesses (AS 21.36.060(a))
  • Fraudulent application statements with intent to deceive = fraudulent insurance act (AS 21.36.360(o))

Illegal inducements

  • Prohibited to offer non-policy items of value to induce purchase, unless allowed by law
  • NAIC model allows reasonable non-cash gifts/meals/donations, not conditioned on purchase
  • Alaska bars any valuable consideration not in contract (life/health: AS 21.36.100; property/casualty: AS 21.36.120(a))

Unfair discrimination

  • Prohibited: differing treatment for same-class/equal-risk individuals in rates/benefits/terms
  • Cannot discriminate by sex, marital status, race, religion, national origin
  • Property/casualty: cannot deny based solely on geographic location (unless justified) or physical/mental impairment
  • Alaska’s rule uses same-class/equal-expectation test (AS 21.36.090(a)-(c))

Errors & omissions

  • E&O insurance = professional liability protection for producers
  • Covers negligence/unintentional errors; excludes intentional misconduct, crimes, fines

Children covered as dependents

  • ACA: dependent coverage required until age 26 regardless of marital/student/financial status
  • State law: newborns covered from birth, adopted children from placement
  • Coverage continues past age limit for disabled dependents (disability began before age limit)

Rebating

  • Prohibited: giving refunds/discounts/favors to induce insurance purchase
  • To “solicit”/“negotiate” implies licensure

Sharing commission

  • Allowed between licensed producers in same line
  • Can pay agency or unlicensed referral source (if referral is nominal, one-time, fixed amount, not contingent on sale)

Twisting

  • Prohibited: misrepresenting policy terms to induce lapse/surrender/exchange
  • Alaska rule focuses on policy terms/comparisons (AS 21.36.050)
  • Distinct from defamation (which targets insurer’s finances)

Unfair marketing practices

  • DOZ sets standards for disclosure and simplified terminology
  • Prohibited: implying government/organization endorsement falsely; false claims about claim payment timeframes

Gramm-Leach Bliley Act (GLBA)

  • Repealed key parts of Glass-Steagall; allowed merger of banks, investment firms, insurers
  • Established regulatory framework for combined financial services

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Grants limited antitrust exemption to insurers
  • Since 2021, exemption excludes health insurance (except narrow data-sharing activities)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body of state insurance regulators (50 states, DC, 5 territories)
  • Establishes standards, conducts peer review, coordinates regulatory oversight
  • Forms national system of state-based insurance regulation

Fair Credit Reporting Act

  • Regulates consumer reports (credit, MIB, investigative) used in underwriting
  • Investigative report request: must disclose to consumer within 3 days
  • Adverse action: must notify consumer + agency; consumer has 60 days for free report; may also dispute errors

Privacy Act of 1974

  • Governs federal agencies’ handling of personal info; doesn’t apply to private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid up to 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • National Do Not Call Registry restricts calls to listed numbers
  • Calls allowed only 8 a.m.–9 p.m. local time
  • Must disclose caller’s name, the company the call is made for, and a number or address for it

CAN-SPAM

  • Commercial email must be labeled as ad, have accurate headers/non-deceptive subject
  • Must include valid physical postal address
  • Must offer opt-out; honored within 10 business days

Related readings

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