California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 2 - Policy Forms and Other Documents
Article 7 - Workers' Compensation Policy Forms
Section 2254 - Submission of Policy Forms, Endorsement Forms, or Ancillary Agreements

Universal Citation: 10 CA Code of Regs 2254

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) Only a rating organization shall submit policy forms, endorsement forms, or ancillary agreements on behalf of its insurer members. The Insurance Commissioner shall not act upon any policy forms, endorsement forms, or ancillary agreements that are directly submitted by an insurer, and the forms shall not be effective for use.

(b) California Code of Regulations, Title 10, Section 2216 notwithstanding, a rating organization shall transmit policy forms, endorsement forms, or ancillary agreements electronically, unless not technically feasible. The rating organization shall include a copy of the proposed policy form, endorsement form, or ancillary agreement and a detailed cover letter that explains the necessity for and purpose of the proposed form.

(c) Standard Policy and Endorsement Forms.

A rating organization may submit a proposed standard policy form, endorsement form, or ancillary agreement to the Insurance Commissioner for approval for use by all members of the rating organization.

(d) Non-standard Policy Forms, Endorsement Forms, or Ancillary Agreements.

(1) An insurer shall file all proposed non-standard policy forms, endorsement forms, or ancillary agreements with a rating organization. The insurer shall include a detailed cover letter explaining the necessity for and purpose of the proposed form and a copy of the proposed form.

(2) An insurer shall cite one or more of the grounds enumerated in Section 2259 of this Article in its cover letter as a basis for use of limiting and restricting endorsements or customized limiting and restricting endorsements.

(3) The rating organization shall review each insurer's filing for compliance with these regulations and California law and shall either:
(A) Submit the entire filing to the Insurance Commissioner if the filing is sufficient and in compliance with these regulations and California law, or

(B) Notify the insurer in writing that the filing is incomplete or not in compliance with these regulations or California law, setting forth the reasons in sufficient detail, and providing the insurer with the following options:
(i) Amend the filing so that it is complete or in compliance and submit it to the Insurance Commissioner, or

(ii) Withdraw the filing without submission to the Insurance Commissioner, or

(iii) Submit the filing with a written explanation to the Insurance Commissioner. The insurer shall identify the reasons why the rating organization determined that the filing is incomplete or does not comply with the regulations or California law, and the insurer shall state why it believes the filing does comply with the regulations or California law.

1. Amendment filed 8-12-54; designated effective 9-15-54 (Register 54, No. 17).
2. Amendment of section heading, repealer and new section and amendment of NOTE filed 2-2-2016; operative 4-1-2016 (Register 2016, No. 6).

Note: Authority cited: Section 12921(a), Insurance Code. Reference: Sections 11650, 11651, 11652, 11653, 11654, 11655, 11656, 11656.7, 11656.8, 11656.9, 11657, 11658, 11659, 11660, 11661, 11661.5, 11661.6, 11662, 11663, 11664, 11734, 11736, 11750.1(b), 11750.1(e) and 11751.5, Insurance Code.

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