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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

Maryland State Regulations & NAIC Insurance Law

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Licensing

Any individual applying for a Maryland resident producer’s license must be at least 18 years old and must be a Maryland resident before submitting an application.

Pre-licensing course and exam

Maryland does not have specific pre-licensing requirements, but an applicant must pass the licensing examination for the line of authority: since October 1, 2024, the law no longer requires a Commissioner-approved program of study before the examination (Maryland Insurance Administration Bulletin 24-19).

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 Maryland nonresident license without taking Maryland’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. In Maryland, a temporary license expires 15 months after its effective date (Md. Code, Ins. § 10-120(e)).

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 Maryland, have continuing education (CE) 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 Maryland must complete continuing education 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 Insurance Administration to conduct business in Maryland. 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 Maryland 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. In Maryland, the Commissioner must refuse to renew, suspend or revoke the certificate of an insurer that no longer meets its requirements because of a deficiency in assets or any other reason, and may impose a penalty of $100 to $125,000 per violation instead of or in addition to suspension or revocation (Md. Code, Ins. § 4-113(a)(2), (d)).

Medigap policies

To reduce confusion about the many types of Medicare supplement policies available, federal law requires national standardization of Medigap policies. Insurers must 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, before accepting any premium payment.

Duties of the Maryland Insurance Commissioner

The Maryland Insurance Commissioner is the head of the Maryland Insurance Administration, an independent agency within the state executive branch created in 1993. Before that, insurance was part of the Department of Licensing and Regulation.

The Commissioner oversees the department’s efforts to regulate the state’s insurance companies and producers and to investigate consumer complaints about insurance coverage.

The Commissioner is responsible for establishing and enforcing regulations in the Maryland 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.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but a law officer must make an arrest, and a judge or court of law must issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The Commissioner 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.

  • Having willfully violated Maryland’s insurance laws, or willfully failed to comply with or violated a proper order, subpoena or regulation of the Commissioner (Md. Code, Ins. § 10-126(a)(1), (11)).

  • 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.

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

  • Having been convicted by final judgment in any state or federal court of a felony or a crime involving moral turpitude (Md. Code, Ins. § 10-126(a)(8)).

  • 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 Maryland.

  • 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 Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner 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 Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by Maryland law, and may ask a court to review the final order. In Maryland, the Commissioner gives notice at least 10 days before a hearing, and a person aggrieved by an order may demand a hearing; a demand received before the order takes effect or within 10 days after it is served stays the order pending the hearing, except an order resulting from a hearing, an emergency order, or one based on an insurer’s impairment (Md. Code, Ins. §§ 2-210(a), 2-211(a)(1), 2-212(a)). Under Maryland’s unfair trade practices law the hearing comes first: the Commissioner holds a hearing, after giving notice of the hearing and the charges, before issuing a cease and desist order, and an order resulting from a hearing is not stayed by a demand (Md. Code, Ins. §§ 27-103(a), 2-212(a)(2)).

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. In Maryland, the Commissioner may impose on a licensed producer a penalty of $100 to $5,000 for each violation, instead of or in addition to suspending or revoking the license (Md. Code, Ins. § 10-126(c)).

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.

  • Intentionally obstructing or delaying claims payment, or delaying 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.

  • Failing to pay claims without conducting 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”). In Maryland, a life or health form is filed at least 60 days before delivery and is deemed approved unless the Commissioner approves or disapproves it within that period or an extension of up to 30 days (Md. Code, Ins. § 12-203(b)-(c)).

If a policy provision conflicts with Maryland 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.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Maryland, but has not passed the appropriate licensing examination, is in violation of regulation. This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in Maryland 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).

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

In Maryland, it is a fraudulent insurance act to knowingly or willfully make a false or fraudulent statement or representation in or with reference to an application for insurance (Md. Code, Ins. § 27-406(1)).

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. Maryland allows educational materials, promotional materials or articles of merchandise that cost no more than $50, as long as receiving them is not contingent on buying insurance (Md. Code, Ins. §§ 27-209(a)(4), (b), 27-212(d)).

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.

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. In Maryland, where a specific premium is required for the child, the policy may require notice of the birth or adoption and payment of the premium within 31 days to continue coverage beyond that period (Md. Code, Ins. § 15-401(g)). 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

Maryland 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

Splitting or sharing commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the commission is being 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

Misrepresenting a policy’s terms, conditions or benefits, or comparing policies incompletely, to induce a policyholder 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 are 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. Maryland’s twisting statute reaches a statement misrepresenting or incompletely comparing a policy’s terms, conditions or benefits to induce the policyholder to forfeit, surrender, retain, exchange or convert it or let it lapse (Md. Code, Ins. § 27-213); a misrepresentation about an insurer’s financial condition is prohibited separately (§ 27-202(3)), as is defamation (§ 27-204).

Unfair marketing practices

The Insurance Administration is responsible for establishing minimum standards for full and fair disclosure of policy content. It also requires 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 for 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. It 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 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 under federal rules; Maryland’s own law is narrower, barring telephone solicitations, including automated or recorded calls, between 8 p.m. and 8 a.m. in the called party’s time zone (Md. Code, Com. Law § 14-4502(c)(1))
  • 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

  • Minimum age: 18, must be Maryland resident
  • Must apply before… resident status required prior to submission

Pre-licensing course and exam

  • No mandatory pre-licensing course required (since Oct. 1, 2024, MIA Bulletin 24-19)
  • Must still pass licensing exam for line of authority

Fingerprints/background check

  • Commissioner reviews background before licensing
  • Many states require fingerprints for state/FBI criminal history check

Controlled business

  • Insurance written on producer’s own/family/employer/controlled business interests
  • License purpose: serve public, not primarily write controlled business

Non-resident license

  • Obtainable without Maryland exam if licensed elsewhere in good standing
  • Requires reciprocity between home state and Maryland
  • Change of address: file within 30 days
  • Moving to new state: apply for resident license within 90 days; no repeat of prelicensing/exam

Temporary license

  • Issued without exam to keep business serviced (e.g., producer death/disability, military deployment)
  • May require licensed sponsor
  • NAIC model: max 180 days; Maryland: expires 15 months from effective date

Military service

  • Waiver available for renewal requirements/exams/fines due to military service or long-term disability

Renewal and reinstatement

  • License requires timely fee payment + CE completion
  • Each state sets own renewal cycle
  • NAIC model: reinstatement within 12 months, penalty = double unpaid fee

Continuing education

  • Required in all states, including Maryland, for major lines
  • Hours set by state law/insurance department

Notice of change of name or address

  • Report address change within 30 days
  • Report administrative/criminal actions within 30 days of final disposition/initial hearing
  • Must notify regulator before using assumed business name

Company regulations

  • Insurer needs Insurance Administration authorization to conduct MD business
  • Certificate of authority requires charter, financials, capital/surplus proof, fees

Capital and surplus requirement

  • Insurer must maintain minimum capital/surplus to keep certificate
  • MD Commissioner must refuse/suspend/revoke for deficiency
  • Penalty: $100–$125,000 per violation (Md. Code, Ins. § 4-113)

Medigap policies

  • Federally standardized plans: A, B, C, D, F, G, K, L, M, N (E, H, I, J eliminated)
  • Plans C & F unavailable to new Medicare-eligibles since Jan. 1, 2020
  • Plan A = core benefits; insurers offering Medigap must offer Plan A
  • Buyer’s Guide & Outline of Coverage given at application, before premium accepted

Duties of the Maryland Insurance Commissioner

  • Heads Maryland Insurance Administration (est. 1993)
  • Investigates complaints/violations, monitors insurers, examines financial condition (every 5 years per NAIC model)
  • Audits producers as needed, collects fees, issues fines/reports, approves forms/rates
  • Cannot arrest, issue injunctions, or sentence jail time (law officers/courts do that)

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony/moral turpitude conviction, unfair trade practices, misappropriation of funds, forged applications, cheating on exams, prior out-of-state revocation

Cease and desist

  • Ordered for violations; stops/limits specific activity
  • Does not equal suspension/revocation

Hearing and penalties

  • Entitled to notice + hearing opportunity; MD requires 10-day notice
  • Civil penalties possible alongside license action
  • MD producer penalty: $100–$5,000 per violation (Md. Code, Ins. § 10-126(c))

Unfair claims settlement practices

  • Violations include: delaying claims, failing to investigate, altering applications without consent, denying claims improperly, settling below fair value
  • Must be flagrant/habitual to count as regulatory violation under NAIC model

Policy forms

  • Insurers file forms with Commissioner for approval or “file and use”
  • MD: life/health forms filed 60 days before use; deemed approved unless acted on (extension up to 30 days)
  • Conflicting provisions read as amended to comply with law
  • Policy loan interest rates limited by state law

Record maintenance

  • Producers must keep transaction records available for Commissioner inspection

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Applies to all public communications (ads, cards, letterhead)

Misrepresentation

  • Prohibits inaccurate policy illustrations/comparisons
  • Includes “twisting” — inducing lapse/surrender via false info

False advertising

  • Prohibits untrue, deceptive, or misleading statements about insurance business
  • Applies across all media; intent to deceive not required

Defamation

  • False or malicious statements harming insurer’s financial reputation
  • Classic example: spreading false insolvency rumors

Boycott, coercion and intimidation

  • Prohibited if resulting in unreasonable restraint or monopoly in insurance business

False financial statements

  • MD: knowingly making false statements on insurance applications = fraudulent act (§ 27-406(1))

Illegal inducements

  • Cannot offer extra value to induce purchase unless legally permitted
  • MD limit: gifts/merchandise up to $50, not contingent on purchase

Unfair discrimination

  • Prohibits differing treatment of equal-risk individuals
  • Cannot discriminate based on sex, marital status, race, religion, national origin
  • P&C: cannot deny based solely on geography or disability without sound actuarial basis

Errors & Omissions

  • Protects producers from negligence claims
  • Covers unintentional mistakes, not intentional/criminal acts or fines

Children covered as dependents

  • ACA: dependent coverage until age 26 regardless of marital/student/financial status
  • Newborns/adopted children covered from birth/placement
  • MD: notice + premium payment within 31 days to continue coverage
  • Disabled dependents may continue coverage past age limit

Rebating

  • Prohibited: giving refunds/discounts/favors to induce insurance purchase
  • Soliciting/negotiating implies licensure

Sharing commission

  • Allowed between licensed producers in same line
  • May also pay agencies or non-selling persons per NAIC model

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • MD statute covers misleading comparisons (§ 27-213); separate from financial misrepresentation (§ 27-202(3)) and defamation (§ 27-204)

Unfair marketing practices

  • Insurance Administration ensures full/fair disclosure and standardized terms
  • Prohibits false claims of government/organization endorsement
  • Prohibits false claims processing time statements

Gramm-Leach Bliley Act (GLBA)

  • Repealed key parts of Glass-Steagall; allows bank/insurance/investment consolidation
  • Establishes regulatory framework across financial sectors

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Grants limited antitrust exemption
  • Since 2021, exemption excludes health insurance (except historical loss data sharing)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body of state insurance regulators
  • Supports peer review, model laws, and national regulatory coordination

Fair Credit Reporting Act

  • Regulates consumer reports used in underwriting
  • Investigative report requests: disclose within 3 days
  • Adverse action: notify consumer; 60 days to request free report; may also dispute errors

Privacy Act of 1974

  • Applies only to federal agencies, not private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • National Do Not Call Registry protects consumers from unsolicited calls
  • Federal calling hours: 8 a.m.–9 p.m.; MD narrower: no calls 8 p.m.–8 a.m.
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

  • Commercial emails must be labeled as ads, have accurate headers/subject lines
  • Must include sender’s physical address
  • Opt-out required, honored within 10 business days

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Maryland State Regulations & NAIC Insurance Law

Licensing

Any individual applying for a Maryland resident producer’s license must be at least 18 years old and must be a Maryland resident before submitting an application.

Pre-licensing course and exam

Maryland does not have specific pre-licensing requirements, but an applicant must pass the licensing examination for the line of authority: since October 1, 2024, the law no longer requires a Commissioner-approved program of study before the examination (Maryland Insurance Administration Bulletin 24-19).

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 Maryland nonresident license without taking Maryland’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. In Maryland, a temporary license expires 15 months after its effective date (Md. Code, Ins. § 10-120(e)).

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 Maryland, have continuing education (CE) 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 Maryland must complete continuing education 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 Insurance Administration to conduct business in Maryland. 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 Maryland 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. In Maryland, the Commissioner must refuse to renew, suspend or revoke the certificate of an insurer that no longer meets its requirements because of a deficiency in assets or any other reason, and may impose a penalty of $100 to $125,000 per violation instead of or in addition to suspension or revocation (Md. Code, Ins. § 4-113(a)(2), (d)).

Medigap policies

To reduce confusion about the many types of Medicare supplement policies available, federal law requires national standardization of Medigap policies. Insurers must 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, before accepting any premium payment.

Duties of the Maryland Insurance Commissioner

The Maryland Insurance Commissioner is the head of the Maryland Insurance Administration, an independent agency within the state executive branch created in 1993. Before that, insurance was part of the Department of Licensing and Regulation.

The Commissioner oversees the department’s efforts to regulate the state’s insurance companies and producers and to investigate consumer complaints about insurance coverage.

The Commissioner is responsible for establishing and enforcing regulations in the Maryland 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.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but a law officer must make an arrest, and a judge or court of law must issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The Commissioner 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.

  • Having willfully violated Maryland’s insurance laws, or willfully failed to comply with or violated a proper order, subpoena or regulation of the Commissioner (Md. Code, Ins. § 10-126(a)(1), (11)).

  • 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.

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

  • Having been convicted by final judgment in any state or federal court of a felony or a crime involving moral turpitude (Md. Code, Ins. § 10-126(a)(8)).

  • 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 Maryland.

  • 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 Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner 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 Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by Maryland law, and may ask a court to review the final order. In Maryland, the Commissioner gives notice at least 10 days before a hearing, and a person aggrieved by an order may demand a hearing; a demand received before the order takes effect or within 10 days after it is served stays the order pending the hearing, except an order resulting from a hearing, an emergency order, or one based on an insurer’s impairment (Md. Code, Ins. §§ 2-210(a), 2-211(a)(1), 2-212(a)). Under Maryland’s unfair trade practices law the hearing comes first: the Commissioner holds a hearing, after giving notice of the hearing and the charges, before issuing a cease and desist order, and an order resulting from a hearing is not stayed by a demand (Md. Code, Ins. §§ 27-103(a), 2-212(a)(2)).

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. In Maryland, the Commissioner may impose on a licensed producer a penalty of $100 to $5,000 for each violation, instead of or in addition to suspending or revoking the license (Md. Code, Ins. § 10-126(c)).

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.

  • Intentionally obstructing or delaying claims payment, or delaying 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.

  • Failing to pay claims without conducting 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”). In Maryland, a life or health form is filed at least 60 days before delivery and is deemed approved unless the Commissioner approves or disapproves it within that period or an extension of up to 30 days (Md. Code, Ins. § 12-203(b)-(c)).

If a policy provision conflicts with Maryland 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.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Maryland, but has not passed the appropriate licensing examination, is in violation of regulation. This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in Maryland 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).

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

In Maryland, it is a fraudulent insurance act to knowingly or willfully make a false or fraudulent statement or representation in or with reference to an application for insurance (Md. Code, Ins. § 27-406(1)).

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. Maryland allows educational materials, promotional materials or articles of merchandise that cost no more than $50, as long as receiving them is not contingent on buying insurance (Md. Code, Ins. §§ 27-209(a)(4), (b), 27-212(d)).

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.

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. In Maryland, where a specific premium is required for the child, the policy may require notice of the birth or adoption and payment of the premium within 31 days to continue coverage beyond that period (Md. Code, Ins. § 15-401(g)). 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

Maryland 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

Splitting or sharing commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the commission is being 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

Misrepresenting a policy’s terms, conditions or benefits, or comparing policies incompletely, to induce a policyholder 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 are 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. Maryland’s twisting statute reaches a statement misrepresenting or incompletely comparing a policy’s terms, conditions or benefits to induce the policyholder to forfeit, surrender, retain, exchange or convert it or let it lapse (Md. Code, Ins. § 27-213); a misrepresentation about an insurer’s financial condition is prohibited separately (§ 27-202(3)), as is defamation (§ 27-204).

Unfair marketing practices

The Insurance Administration is responsible for establishing minimum standards for full and fair disclosure of policy content. It also requires 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 for 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. It 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 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 under federal rules; Maryland’s own law is narrower, barring telephone solicitations, including automated or recorded calls, between 8 p.m. and 8 a.m. in the called party’s time zone (Md. Code, Com. Law § 14-4502(c)(1))
  • 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

  • Minimum age: 18, must be Maryland resident
  • Must apply before… resident status required prior to submission

Pre-licensing course and exam

  • No mandatory pre-licensing course required (since Oct. 1, 2024, MIA Bulletin 24-19)
  • Must still pass licensing exam for line of authority

Fingerprints/background check

  • Commissioner reviews background before licensing
  • Many states require fingerprints for state/FBI criminal history check

Controlled business

  • Insurance written on producer’s own/family/employer/controlled business interests
  • License purpose: serve public, not primarily write controlled business

Non-resident license

  • Obtainable without Maryland exam if licensed elsewhere in good standing
  • Requires reciprocity between home state and Maryland
  • Change of address: file within 30 days
  • Moving to new state: apply for resident license within 90 days; no repeat of prelicensing/exam

Temporary license

  • Issued without exam to keep business serviced (e.g., producer death/disability, military deployment)
  • May require licensed sponsor
  • NAIC model: max 180 days; Maryland: expires 15 months from effective date

Military service

  • Waiver available for renewal requirements/exams/fines due to military service or long-term disability

Renewal and reinstatement

  • License requires timely fee payment + CE completion
  • Each state sets own renewal cycle
  • NAIC model: reinstatement within 12 months, penalty = double unpaid fee

Continuing education

  • Required in all states, including Maryland, for major lines
  • Hours set by state law/insurance department

Notice of change of name or address

  • Report address change within 30 days
  • Report administrative/criminal actions within 30 days of final disposition/initial hearing
  • Must notify regulator before using assumed business name

Company regulations

  • Insurer needs Insurance Administration authorization to conduct MD business
  • Certificate of authority requires charter, financials, capital/surplus proof, fees

Capital and surplus requirement

  • Insurer must maintain minimum capital/surplus to keep certificate
  • MD Commissioner must refuse/suspend/revoke for deficiency
  • Penalty: $100–$125,000 per violation (Md. Code, Ins. § 4-113)

Medigap policies

  • Federally standardized plans: A, B, C, D, F, G, K, L, M, N (E, H, I, J eliminated)
  • Plans C & F unavailable to new Medicare-eligibles since Jan. 1, 2020
  • Plan A = core benefits; insurers offering Medigap must offer Plan A
  • Buyer’s Guide & Outline of Coverage given at application, before premium accepted

Duties of the Maryland Insurance Commissioner

  • Heads Maryland Insurance Administration (est. 1993)
  • Investigates complaints/violations, monitors insurers, examines financial condition (every 5 years per NAIC model)
  • Audits producers as needed, collects fees, issues fines/reports, approves forms/rates
  • Cannot arrest, issue injunctions, or sentence jail time (law officers/courts do that)

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony/moral turpitude conviction, unfair trade practices, misappropriation of funds, forged applications, cheating on exams, prior out-of-state revocation

Cease and desist

  • Ordered for violations; stops/limits specific activity
  • Does not equal suspension/revocation

Hearing and penalties

  • Entitled to notice + hearing opportunity; MD requires 10-day notice
  • Civil penalties possible alongside license action
  • MD producer penalty: $100–$5,000 per violation (Md. Code, Ins. § 10-126(c))

Unfair claims settlement practices

  • Violations include: delaying claims, failing to investigate, altering applications without consent, denying claims improperly, settling below fair value
  • Must be flagrant/habitual to count as regulatory violation under NAIC model

Policy forms

  • Insurers file forms with Commissioner for approval or “file and use”
  • MD: life/health forms filed 60 days before use; deemed approved unless acted on (extension up to 30 days)
  • Conflicting provisions read as amended to comply with law
  • Policy loan interest rates limited by state law

Record maintenance

  • Producers must keep transaction records available for Commissioner inspection

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Applies to all public communications (ads, cards, letterhead)

Misrepresentation

  • Prohibits inaccurate policy illustrations/comparisons
  • Includes “twisting” — inducing lapse/surrender via false info

False advertising

  • Prohibits untrue, deceptive, or misleading statements about insurance business
  • Applies across all media; intent to deceive not required

Defamation

  • False or malicious statements harming insurer’s financial reputation
  • Classic example: spreading false insolvency rumors

Boycott, coercion and intimidation

  • Prohibited if resulting in unreasonable restraint or monopoly in insurance business

False financial statements

  • MD: knowingly making false statements on insurance applications = fraudulent act (§ 27-406(1))

Illegal inducements

  • Cannot offer extra value to induce purchase unless legally permitted
  • MD limit: gifts/merchandise up to $50, not contingent on purchase

Unfair discrimination

  • Prohibits differing treatment of equal-risk individuals
  • Cannot discriminate based on sex, marital status, race, religion, national origin
  • P&C: cannot deny based solely on geography or disability without sound actuarial basis

Errors & Omissions

  • Protects producers from negligence claims
  • Covers unintentional mistakes, not intentional/criminal acts or fines

Children covered as dependents

  • ACA: dependent coverage until age 26 regardless of marital/student/financial status
  • Newborns/adopted children covered from birth/placement
  • MD: notice + premium payment within 31 days to continue coverage
  • Disabled dependents may continue coverage past age limit

Rebating

  • Prohibited: giving refunds/discounts/favors to induce insurance purchase
  • Soliciting/negotiating implies licensure

Sharing commission

  • Allowed between licensed producers in same line
  • May also pay agencies or non-selling persons per NAIC model

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • MD statute covers misleading comparisons (§ 27-213); separate from financial misrepresentation (§ 27-202(3)) and defamation (§ 27-204)

Unfair marketing practices

  • Insurance Administration ensures full/fair disclosure and standardized terms
  • Prohibits false claims of government/organization endorsement
  • Prohibits false claims processing time statements

Gramm-Leach Bliley Act (GLBA)

  • Repealed key parts of Glass-Steagall; allows bank/insurance/investment consolidation
  • Establishes regulatory framework across financial sectors

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Grants limited antitrust exemption
  • Since 2021, exemption excludes health insurance (except historical loss data sharing)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body of state insurance regulators
  • Supports peer review, model laws, and national regulatory coordination

Fair Credit Reporting Act

  • Regulates consumer reports used in underwriting
  • Investigative report requests: disclose within 3 days
  • Adverse action: notify consumer; 60 days to request free report; may also dispute errors

Privacy Act of 1974

  • Applies only to federal agencies, not private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • National Do Not Call Registry protects consumers from unsolicited calls
  • Federal calling hours: 8 a.m.–9 p.m.; MD narrower: no calls 8 p.m.–8 a.m.
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

  • Commercial emails must be labeled as ads, have accurate headers/subject lines
  • Must include sender’s physical address
  • Opt-out required, honored within 10 business days

Related readings

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