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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

Minnesota State Regulations & NAIC Insurance Law

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Licensing

To apply for a Minnesota resident producer’s license, you must:

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

Pre-licensing course and exam

Minnesota requires 20 hours of prelicensing study for each major line of authority applied for (life, accident and health, property, casualty or personal lines) before the licensing examination (Minn. Stat. § 60K.36, subd. 4).

A candidate who fails the examination, or does not appear for it, must reapply and pay the required fees again before being rescheduled (Minn. Stat. § 60K.36, subd. 5).

Fingerprints/background check

An applicant for a resident Minnesota producer license must consent to a criminal history record check and submit a fingerprint card to the commissioner, and pay the fee for the state and FBI background check (Minn. Stat. § 60K.37, subd. 2a).

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 Minnesota nonresident license without taking Minnesota’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.

In Minnesota a temporary license lasts up to 180 days (Minn. Stat. § 60K.42, subd. 1).

Military service

A Minnesota producer who cannot meet license renewal procedures because of military service (or another extenuating circumstance, such as a long-term medical disability) may request a waiver of those procedures, including a waiver of any exam requirement or fine imposed for missing renewal (Minn. Stat. § 60K.38, subd. 4).

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.

A Minnesota producer license expires on the last day of the producer’s birth month, and each renewal is valid for 24 months (Minn. Stat. § 60K.55, subd. 2).

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

A producer whose license lapses may reinstate it within 12 months of the renewal fee’s due date without passing the examination again, but pays a penalty of twice the unpaid renewal fee (Minn. Stat. § 60K.38, subd. 3).

Continuing education

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

A Minnesota licensee must inform the Commissioner of a change of name or address within ten days of the change (Minn. Stat. § 60K.38, subd. 6).

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

Company regulations

An insurance company must be authorized by the Department of Commerce to conduct business in Minnesota. 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 Minnesota 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 Minnesota, the Commissioner orders a company whose capital or surplus falls below the minimum to restore the deficiency within a period the Commissioner sets, and may bar it from issuing new policies while the deficiency exists (Minn. Stat. § 60A.07, subd. 5e).

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. The lettered plans are the national standard, but Minnesota is one of only three states whose Medigap policies are standardized in a different way: Minnesota’s are a Basic Plan and an Extended Basic Plan, and insurers may add riders to the Basic Plan (Centers for Medicare & Medicaid Services, Choosing a Medigap Policy).

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 Commissioner of Commerce

The Minnesota Commissioner of Commerce is a state executive position in Minnesota state government and serves as head of the Minnesota Department of Commerce. The department is responsible for regulating the insurance industry.

The Governor appoints the Commissioner of Commerce with the consent of the state Senate. The Commissioner’s term expires at the end of the Governor’s term, or if the Governor vacates office.

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

  • The Commissioner examines the affairs and condition of every insurer licensed in Minnesota at least once every five years (Minn. Stat. § 60A.031, subd. 1).

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

  • Collect all fees associated with producers and insurers.

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

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

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

The commerce department is also responsible for enforcement of Public Utilities Commission (PUC) rules and orders, regulation of natural gas and electric public utilities, energy conservation standards and information programs, low-income home energy assistance and weatherization, regulation of telephone companies, the administration of Telecommunications Access Minnesota (TAM), petrofund, and unclaimed property programs.

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 it takes a law officer to arrest and a judge or court of law to 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.

  • 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.

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

  • Having pled guilty, pled nolo contendere, or been convicted of a felony, gross misdemeanor, or misdemeanor involving moral turpitude (Minn. Stat. § 60K.43, subd. 1(6)).

  • 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 Minnesota.

  • 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. In Minnesota, the Commissioner may order a person who has engaged or is about to engage in a violation to cease and desist, and a hearing must be held within ten days after one is requested (Minn. Stat. § 45.027, subd. 5a). 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 Minnesota law, and may ask a court to review the final order.

A licensee who wants to contest the Commissioner’s order must request a hearing within 30 days of receiving it; otherwise the order becomes final (Minn. Stat. § 45.027, subd. 7).

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.

The Commissioner may impose a civil penalty of up to $10,000 per violation of an insurance law, rule or order, unless another statute sets a different penalty (Minn. Stat. § 45.027, subd. 6).

Unfair claims settlement practices

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

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

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

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

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

  • Denying a claim without conducting a thorough investigation.

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

Policy forms

Insurers file their policy forms with the Commissioner.

Life and health policy forms must be filed with the Commissioner before use, and a form the Commissioner has not disapproved within 60 days of filing is deemed approved. A property and casualty policy form likewise needs approval, or the lapse of 60 days without disapproval (a period the Commissioner may extend once, by up to 60 days), before it is used (Minn. Stat. §§ 61A.02, 62A.02, 70A.06).

If a policy provision conflicts with Minnesota 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.

Minnesota producers and agencies keep their financial transaction records (money received from clients, deposits and disbursements) for at least six years, available for the Commissioner’s examination (Minn. R. 2795.1400, subp. 3).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Minnesota, 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, that impersonate a licensed producer.

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

Misrepresentation

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

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

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

False advertising

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

Defamation

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

Boycott, coercion and intimidation

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

False financial statements

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

Illegal inducements

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

Minnesota prohibits rebating a premium, or giving any other valuable consideration not specified in the policy, as an inducement to buy insurance, apart from the exceptions the statute lists (Minn. Stat. § 72A.071).

A producer may give a customer noncash gifts, items or services, including meals or a charitable donation on the customer’s behalf, costing no more than the lesser of 5% of the policyholder premium or $250 per policy year, as long as the gift is not conditioned on buying or renewing a policy (Minn. Stat. § 72A.071, subd. 3).

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.

A Minnesota health policy that covers family members must cover a newborn from the moment of birth and an adopted child from placement for adoption, and may not require notice to the insurer as a condition of that coverage. Coverage continues past the age limit for a child who cannot support themselves because of a disability, if proof is given within 31 days of the child reaching that age (Minn. Stat. §§ 62A.042, 62A.27, 62A.14).

Rebating

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

Sidenote
Know this...

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

Sharing commission

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

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information 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.

Unfair marketing practices

The Department of Commerce is responsible for establishing minimum standards for the full and fair disclosure of policy content. The Department 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.

Under Minnesota’s insurance privacy law, an authorization signed with an application, a reinstatement or a request for a change in benefits remains valid as long as the person is continually insured with the insurer, and the insurer reminds the insured of it in writing at each renewal (Minn. Stat. § 72A.501, subd. 2).

Telemarketing

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

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

CAN-SPAM

A commercial email must:

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

Medical assistance (MA)

Although Medicaid is a federal program, states often use different names for their medical welfare programs. In Minnesota, Medicaid is called Medical Assistance (MA). For exam purposes, Medical Assistance (MA) and Medicaid are interchangeable terms.

Medical Assistance (MA) is a state-administered health care program for those in financial need. It is funded by federal and state money.

Licensing

  • Must be 18+ and a Minnesota resident before applying

Pre-licensing course and exam

  • 20 hours required per major line of authority before exam
  • Failed/no-show exam candidates must reapply and repay fees

Fingerprints/background check

  • Must consent to criminal history check, submit fingerprint card
  • Applicant pays state/FBI background check fee

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • States restrict licenses used mainly for controlled business

Non-resident license

  • Can get MN nonresident license without MN exam if:
    • Licensed & in good standing in home state
    • Applied and paid fees
    • Home state grants reciprocity
  • Address change: file within 30 days
  • Moving to new state: apply for resident license within 90 days, no repeat of exam/education

Temporary license

  • No exam required; issued to keep business serviced (e.g., death/disability of producer, military deployment)
  • May require licensed sponsor
  • MN temporary license lasts up to 180 days

Military service

  • Can request waiver of renewal procedures/exam/fines due to military service or long-term disability

Renewal and reinstatement

  • MN license expires last day of birth month; renewal valid 24 months
  • Lapsed license reinstated within 12 months without exam, penalty = 2x unpaid renewal fee

Continuing education

  • Required for renewal of major lines
  • Hours set by state law/published by insurance department

Notice of change of name or address

  • Must notify Commissioner within 10 days
  • Report administrative actions/criminal prosecutions within 30 days
  • Must notify before using any name other than legal name

Company regulations

  • Insurer must be authorized by Dept. of Commerce
  • Certificate of authority requires charter, financials, fees

Capital and surplus requirement

  • Must maintain minimum capital/surplus
  • Commissioner can order correction period, bar new policies if deficient

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 for Medicare on/after 1/1/2020
  • MN uses Basic Plan and Extended Basic Plan instead of standard letters
  • Buyer’s Guide & Outline of Coverage given at application, before premium accepted

Duties of the Commissioner of Commerce

  • Appointed by Governor with Senate consent
  • Regulates insurance market; protects consumers, encourages development
  • Examines insurers at least every 5 years
  • Audits producers as needed; collects fees; issues fines
  • Approves forms/rates; cannot arrest or issue injunctions (law enforcement/courts do that)

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony/gross misdemeanor conviction, misappropriation, unfair trade practices, prior license revocation elsewhere, forging signatures, cheating on exams

Cease and desist

  • Commissioner can order cessation of violations
  • Hearing must occur within 10 days of request
  • Does not equal license suspension/revocation

Hearing and penalties

  • Must request hearing within 30 days of order or it becomes final
  • Civil penalty up to $10,000 per violation

Unfair claims settlement practices

  • Violations include: delaying claims/investigations, failing to explain policy terms, denying without investigation, altering application info, settling below fair value

Policy forms

  • Life/health forms deemed approved if not disapproved within 60 days
  • P&C forms same, Commissioner may extend once by 60 days
  • Conflicting provisions read as amended to match law

Record maintenance

  • MN producers keep financial records at least 6 years

Fraudulent producer representation

  • Illegal to represent as licensed without passing exam
  • Applies to all public communications/advertising

Misrepresentation

  • Prohibited: inaccurate policy terms, inaccurate comparisons, inducing lapse/surrender (twisting)

False advertising

  • Untrue, deceptive or misleading statements prohibited regardless of medium
  • Test: statement’s truthfulness, not intent to deceive

Defamation

  • False/malicious statements about insurer’s financial condition intended to injure

Boycott, coercion and intimidation

  • Prohibited if results in unreasonable restraint/monopoly in insurance business

False financial statements

  • Prohibited: false statements on insurance applications

Illegal inducements

  • Prohibited unless law allows; agreements must be in policy
  • MN allows noncash gifts up to lesser of 5% of premium or $250/policy year, not conditioned on purchase

Unfair discrimination

  • Prohibited: different treatment of same-class/risk individuals
  • Prohibited factors: sex, marital status, race, religion, national origin
  • P&C: cannot discriminate solely by geographic location or disability without actuarial basis

Errors & omissions

  • E&O covers negligence/unintentional mistakes
  • Does not cover intentional misconduct, crimes, or regulatory fines

Children covered as dependents

  • ACA: dependent coverage available until age 26
  • MN: must cover newborns from birth, adopted children from placement
  • Disabled child coverage continues if proof given within 31 days of age limit

Rebating

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

Sharing commission

  • Allowed between licensed producers in same line
  • Can also pay agency or non-selling person under NAIC model

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • Related to defamation if statement is false/malicious about competitor

Unfair marketing practices

  • Dept. of Commerce sets disclosure/standardization rules
  • Prohibits false claims of government/organization endorsement
  • Prohibits false claims about claims payment timing

Gramm-Leach Bliley Act (GLBA)

  • Repealed key parts of Glass-Steagall; allows bank/insurance/investment consolidation
  • Establishes federal/state regulatory framework

McCarran-Ferguson Act

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

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body run by state insurance commissioners
  • Supports state-based regulation via best practices, peer review, coordination

Fair Credit Reporting Act

  • Regulates consumer reports (credit, MIB, investigative)
  • Investigative report request: disclose to consumer within 3 days
  • Adverse action: notify consumer; consumer has 60 days to request free report/dispute

Privacy Act of 1974

  • Governs federal agencies’ handling of personal info; not private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • MN: authorization valid as long as continually insured, reminded at each renewal

Telemarketing

  • National Do Not Call Registry protects listed numbers
  • Calls allowed 8am–9pm local time only
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

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

Medical assistance (MA)

  • MN’s name for Medicaid; terms interchangeable on exam
  • State-administered, federal/state funded program for financial need

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Minnesota State Regulations & NAIC Insurance Law

Licensing

To apply for a Minnesota resident producer’s license, you must:

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

Pre-licensing course and exam

Minnesota requires 20 hours of prelicensing study for each major line of authority applied for (life, accident and health, property, casualty or personal lines) before the licensing examination (Minn. Stat. § 60K.36, subd. 4).

A candidate who fails the examination, or does not appear for it, must reapply and pay the required fees again before being rescheduled (Minn. Stat. § 60K.36, subd. 5).

Fingerprints/background check

An applicant for a resident Minnesota producer license must consent to a criminal history record check and submit a fingerprint card to the commissioner, and pay the fee for the state and FBI background check (Minn. Stat. § 60K.37, subd. 2a).

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 Minnesota nonresident license without taking Minnesota’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.

In Minnesota a temporary license lasts up to 180 days (Minn. Stat. § 60K.42, subd. 1).

Military service

A Minnesota producer who cannot meet license renewal procedures because of military service (or another extenuating circumstance, such as a long-term medical disability) may request a waiver of those procedures, including a waiver of any exam requirement or fine imposed for missing renewal (Minn. Stat. § 60K.38, subd. 4).

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.

A Minnesota producer license expires on the last day of the producer’s birth month, and each renewal is valid for 24 months (Minn. Stat. § 60K.55, subd. 2).

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

A producer whose license lapses may reinstate it within 12 months of the renewal fee’s due date without passing the examination again, but pays a penalty of twice the unpaid renewal fee (Minn. Stat. § 60K.38, subd. 3).

Continuing education

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

A Minnesota licensee must inform the Commissioner of a change of name or address within ten days of the change (Minn. Stat. § 60K.38, subd. 6).

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

Company regulations

An insurance company must be authorized by the Department of Commerce to conduct business in Minnesota. 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 Minnesota 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 Minnesota, the Commissioner orders a company whose capital or surplus falls below the minimum to restore the deficiency within a period the Commissioner sets, and may bar it from issuing new policies while the deficiency exists (Minn. Stat. § 60A.07, subd. 5e).

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. The lettered plans are the national standard, but Minnesota is one of only three states whose Medigap policies are standardized in a different way: Minnesota’s are a Basic Plan and an Extended Basic Plan, and insurers may add riders to the Basic Plan (Centers for Medicare & Medicaid Services, Choosing a Medigap Policy).

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 Commissioner of Commerce

The Minnesota Commissioner of Commerce is a state executive position in Minnesota state government and serves as head of the Minnesota Department of Commerce. The department is responsible for regulating the insurance industry.

The Governor appoints the Commissioner of Commerce with the consent of the state Senate. The Commissioner’s term expires at the end of the Governor’s term, or if the Governor vacates office.

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

  • The Commissioner examines the affairs and condition of every insurer licensed in Minnesota at least once every five years (Minn. Stat. § 60A.031, subd. 1).

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

  • Collect all fees associated with producers and insurers.

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

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

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

The commerce department is also responsible for enforcement of Public Utilities Commission (PUC) rules and orders, regulation of natural gas and electric public utilities, energy conservation standards and information programs, low-income home energy assistance and weatherization, regulation of telephone companies, the administration of Telecommunications Access Minnesota (TAM), petrofund, and unclaimed property programs.

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 it takes a law officer to arrest and a judge or court of law to 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.

  • 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.

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

  • Having pled guilty, pled nolo contendere, or been convicted of a felony, gross misdemeanor, or misdemeanor involving moral turpitude (Minn. Stat. § 60K.43, subd. 1(6)).

  • 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 Minnesota.

  • 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. In Minnesota, the Commissioner may order a person who has engaged or is about to engage in a violation to cease and desist, and a hearing must be held within ten days after one is requested (Minn. Stat. § 45.027, subd. 5a). 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 Minnesota law, and may ask a court to review the final order.

A licensee who wants to contest the Commissioner’s order must request a hearing within 30 days of receiving it; otherwise the order becomes final (Minn. Stat. § 45.027, subd. 7).

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.

The Commissioner may impose a civil penalty of up to $10,000 per violation of an insurance law, rule or order, unless another statute sets a different penalty (Minn. Stat. § 45.027, subd. 6).

Unfair claims settlement practices

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

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

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

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

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

  • Denying a claim without conducting a thorough investigation.

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

Policy forms

Insurers file their policy forms with the Commissioner.

Life and health policy forms must be filed with the Commissioner before use, and a form the Commissioner has not disapproved within 60 days of filing is deemed approved. A property and casualty policy form likewise needs approval, or the lapse of 60 days without disapproval (a period the Commissioner may extend once, by up to 60 days), before it is used (Minn. Stat. §§ 61A.02, 62A.02, 70A.06).

If a policy provision conflicts with Minnesota 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.

Minnesota producers and agencies keep their financial transaction records (money received from clients, deposits and disbursements) for at least six years, available for the Commissioner’s examination (Minn. R. 2795.1400, subp. 3).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in Minnesota, 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, that impersonate a licensed producer.

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

Misrepresentation

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

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

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

False advertising

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

Defamation

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

Boycott, coercion and intimidation

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

False financial statements

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

Illegal inducements

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

Minnesota prohibits rebating a premium, or giving any other valuable consideration not specified in the policy, as an inducement to buy insurance, apart from the exceptions the statute lists (Minn. Stat. § 72A.071).

A producer may give a customer noncash gifts, items or services, including meals or a charitable donation on the customer’s behalf, costing no more than the lesser of 5% of the policyholder premium or $250 per policy year, as long as the gift is not conditioned on buying or renewing a policy (Minn. Stat. § 72A.071, subd. 3).

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.

A Minnesota health policy that covers family members must cover a newborn from the moment of birth and an adopted child from placement for adoption, and may not require notice to the insurer as a condition of that coverage. Coverage continues past the age limit for a child who cannot support themselves because of a disability, if proof is given within 31 days of the child reaching that age (Minn. Stat. §§ 62A.042, 62A.27, 62A.14).

Rebating

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

Sidenote
Know this...

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

Sharing commission

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

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information 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.

Unfair marketing practices

The Department of Commerce is responsible for establishing minimum standards for the full and fair disclosure of policy content. The Department 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.

Under Minnesota’s insurance privacy law, an authorization signed with an application, a reinstatement or a request for a change in benefits remains valid as long as the person is continually insured with the insurer, and the insurer reminds the insured of it in writing at each renewal (Minn. Stat. § 72A.501, subd. 2).

Telemarketing

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

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

CAN-SPAM

A commercial email must:

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

Medical assistance (MA)

Although Medicaid is a federal program, states often use different names for their medical welfare programs. In Minnesota, Medicaid is called Medical Assistance (MA). For exam purposes, Medical Assistance (MA) and Medicaid are interchangeable terms.

Medical Assistance (MA) is a state-administered health care program for those in financial need. It is funded by federal and state money.

Key points

Licensing

  • Must be 18+ and a Minnesota resident before applying

Pre-licensing course and exam

  • 20 hours required per major line of authority before exam
  • Failed/no-show exam candidates must reapply and repay fees

Fingerprints/background check

  • Must consent to criminal history check, submit fingerprint card
  • Applicant pays state/FBI background check fee

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • States restrict licenses used mainly for controlled business

Non-resident license

  • Can get MN nonresident license without MN exam if:
    • Licensed & in good standing in home state
    • Applied and paid fees
    • Home state grants reciprocity
  • Address change: file within 30 days
  • Moving to new state: apply for resident license within 90 days, no repeat of exam/education

Temporary license

  • No exam required; issued to keep business serviced (e.g., death/disability of producer, military deployment)
  • May require licensed sponsor
  • MN temporary license lasts up to 180 days

Military service

  • Can request waiver of renewal procedures/exam/fines due to military service or long-term disability

Renewal and reinstatement

  • MN license expires last day of birth month; renewal valid 24 months
  • Lapsed license reinstated within 12 months without exam, penalty = 2x unpaid renewal fee

Continuing education

  • Required for renewal of major lines
  • Hours set by state law/published by insurance department

Notice of change of name or address

  • Must notify Commissioner within 10 days
  • Report administrative actions/criminal prosecutions within 30 days
  • Must notify before using any name other than legal name

Company regulations

  • Insurer must be authorized by Dept. of Commerce
  • Certificate of authority requires charter, financials, fees

Capital and surplus requirement

  • Must maintain minimum capital/surplus
  • Commissioner can order correction period, bar new policies if deficient

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 for Medicare on/after 1/1/2020
  • MN uses Basic Plan and Extended Basic Plan instead of standard letters
  • Buyer’s Guide & Outline of Coverage given at application, before premium accepted

Duties of the Commissioner of Commerce

  • Appointed by Governor with Senate consent
  • Regulates insurance market; protects consumers, encourages development
  • Examines insurers at least every 5 years
  • Audits producers as needed; collects fees; issues fines
  • Approves forms/rates; cannot arrest or issue injunctions (law enforcement/courts do that)

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony/gross misdemeanor conviction, misappropriation, unfair trade practices, prior license revocation elsewhere, forging signatures, cheating on exams

Cease and desist

  • Commissioner can order cessation of violations
  • Hearing must occur within 10 days of request
  • Does not equal license suspension/revocation

Hearing and penalties

  • Must request hearing within 30 days of order or it becomes final
  • Civil penalty up to $10,000 per violation

Unfair claims settlement practices

  • Violations include: delaying claims/investigations, failing to explain policy terms, denying without investigation, altering application info, settling below fair value

Policy forms

  • Life/health forms deemed approved if not disapproved within 60 days
  • P&C forms same, Commissioner may extend once by 60 days
  • Conflicting provisions read as amended to match law

Record maintenance

  • MN producers keep financial records at least 6 years

Fraudulent producer representation

  • Illegal to represent as licensed without passing exam
  • Applies to all public communications/advertising

Misrepresentation

  • Prohibited: inaccurate policy terms, inaccurate comparisons, inducing lapse/surrender (twisting)

False advertising

  • Untrue, deceptive or misleading statements prohibited regardless of medium
  • Test: statement’s truthfulness, not intent to deceive

Defamation

  • False/malicious statements about insurer’s financial condition intended to injure

Boycott, coercion and intimidation

  • Prohibited if results in unreasonable restraint/monopoly in insurance business

False financial statements

  • Prohibited: false statements on insurance applications

Illegal inducements

  • Prohibited unless law allows; agreements must be in policy
  • MN allows noncash gifts up to lesser of 5% of premium or $250/policy year, not conditioned on purchase

Unfair discrimination

  • Prohibited: different treatment of same-class/risk individuals
  • Prohibited factors: sex, marital status, race, religion, national origin
  • P&C: cannot discriminate solely by geographic location or disability without actuarial basis

Errors & omissions

  • E&O covers negligence/unintentional mistakes
  • Does not cover intentional misconduct, crimes, or regulatory fines

Children covered as dependents

  • ACA: dependent coverage available until age 26
  • MN: must cover newborns from birth, adopted children from placement
  • Disabled child coverage continues if proof given within 31 days of age limit

Rebating

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

Sharing commission

  • Allowed between licensed producers in same line
  • Can also pay agency or non-selling person under NAIC model

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • Related to defamation if statement is false/malicious about competitor

Unfair marketing practices

  • Dept. of Commerce sets disclosure/standardization rules
  • Prohibits false claims of government/organization endorsement
  • Prohibits false claims about claims payment timing

Gramm-Leach Bliley Act (GLBA)

  • Repealed key parts of Glass-Steagall; allows bank/insurance/investment consolidation
  • Establishes federal/state regulatory framework

McCarran-Ferguson Act

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

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body run by state insurance commissioners
  • Supports state-based regulation via best practices, peer review, coordination

Fair Credit Reporting Act

  • Regulates consumer reports (credit, MIB, investigative)
  • Investigative report request: disclose to consumer within 3 days
  • Adverse action: notify consumer; consumer has 60 days to request free report/dispute

Privacy Act of 1974

  • Governs federal agencies’ handling of personal info; not private insurers
  • Insurer privacy governed by FCRA, GLBA, state law
  • MN: authorization valid as long as continually insured, reminded at each renewal

Telemarketing

  • National Do Not Call Registry protects listed numbers
  • Calls allowed 8am–9pm local time only
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

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

Medical assistance (MA)

  • MN’s name for Medicaid; terms interchangeable on exam
  • State-administered, federal/state funded program for financial need

Related readings

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