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Chapter 10a. Firemen's, Policemen's,or Peace Officers’ Benefit And Relief Associations of California Insurance Code >> Division 2. >> Part 2. >> Chapter 10a.
Firemen's, policemen's or peace officers' benefit and relief
associations now existing, or which may be formed hereafter for the
purpose of aiding their members or dependents of their members in
case of sickness, accident, distress, or death, shall be subject to
the provisions of this chapter. While such an association operates
strictly in accordance with this chapter, it shall not be subject to
any other provision of this code nor to any law of this State
relating to insurance, whether now existing or hereafter enacted,
except when expressly designated therein.
Such an association shall not operate or do business in this
state without a certificate of authority. The commissioner shall
issue a certificate of authority to any such association unless he
determines, after examination, that it does not comply with the
provisions of this chapter. The filing fee for the application for
the certificate of authority shall be five hundred ninety dollars
($590).
(a) (1) Each association that holds a certificate of
authority pursuant to this chapter and that issues long-term
disability or long-term care policies or contracts shall submit to
the commissioner the opinion of a qualified actuary as to whether the
reserves and related actuarial items that support the policies or
contracts issued pursuant to this chapter, including policies and
contracts issued by entities established by these associations that
provide benefits described in this chapter, are expected to be
adequate to satisfy contractual provisions, are based on reasonable
assumptions, and are based on actuarial standards of practice
published by the American Academy of Actuaries and the Actuarial
Standards Board. An association that holds a certificate of authority
pursuant to this chapter shall file its opinion no later than July
1, 2016. The opinion shall have been completed no earlier than
December 31, 2013.
(2) An association is considered to have issued a long-term care or disability policy or contract if it self-funds all or part of the resulting obligation. An association that markets long-term policies or contracts issued by an insurer that is admitted by the department to offer insurance products in the state is exempt from this reporting requirement.
(3) An association seeking a certificate of authority pursuant to this chapter shall file an opinion, to the extent feasible, that establishes that it would have adequate resources to provide benefits described in this chapter as required to satisfy its proposed contractual obligations.
(b) The opinion required by subdivision (a) shall include supporting memoranda from the same qualified actuary as to whether the reserves and related actuarial items held in support of the policies and contracts, when considered in light of the assets held by the association with respect to the reserves and related actuarial items, including, but not limited to, the investment earnings on the assets and the considerations anticipated to be received and retained under the policies and contracts, and shall make adequate provision for the association's obligations under the policies and contracts, including, but not limited to, the benefits and any administrative and operating expenses associated with the policies and contracts.
(c) The opinion required by subdivision (a) shall be governed by the following provisions:
(1) It shall include supporting memoranda consistent with actuarial standards of practice published by the American Academy of Actuaries and the Actuarial Standards Board.
(2) If the association fails to provide an opinion and supporting memoranda to the commissioner that meets the requirements of this section, the commissioner shall notify the association of the deficiencies in the filing, and shall make a specific request that identifies the issues that should be addressed in an amended filing. The requests shall be consistent with actuarial standards of practice published by the American Academy of Actuaries and the Actuarial Standards Board.
(d) If the commissioner determines, after a review of the filings from the associations, that the laws governing these associations are inadequate to protect the interests of the members of the associations, he or she shall, on or before July 1, 2017, develop and deliver recommendations to the Assembly Committee on Insurance and the Senate Committee on Insurance regarding changes in the law necessary to protect the interests of members of the associations.
(e) Documents, materials, or other information, including the opinion with supporting memoranda, submitted pursuant to this section that are in the possession or control of the Department of Insurance and that are obtained by, created by, or disclosed to the commissioner or any other person pursuant to this section, are recognized by this state as being proprietary and to contain trade secrets. Those documents, materials, or other information shall be confidential by law and privileged, shall not be subject to disclosure by the commissioner pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and shall not be subject to subpoena or discovery from the commissioner or admissible into evidence, in a private civil action if obtained from the commissioner. The commissioner shall not otherwise make those documents, materials, or other information public without the prior written consent of the association.
(f) This section shall remain in effect only until December 31, 2018, and as of that date is repealed, unless a later enacted statute, that is enacted before December 31, 2018, deletes or extends that date.
(2) An association is considered to have issued a long-term care or disability policy or contract if it self-funds all or part of the resulting obligation. An association that markets long-term policies or contracts issued by an insurer that is admitted by the department to offer insurance products in the state is exempt from this reporting requirement.
(3) An association seeking a certificate of authority pursuant to this chapter shall file an opinion, to the extent feasible, that establishes that it would have adequate resources to provide benefits described in this chapter as required to satisfy its proposed contractual obligations.
(b) The opinion required by subdivision (a) shall include supporting memoranda from the same qualified actuary as to whether the reserves and related actuarial items held in support of the policies and contracts, when considered in light of the assets held by the association with respect to the reserves and related actuarial items, including, but not limited to, the investment earnings on the assets and the considerations anticipated to be received and retained under the policies and contracts, and shall make adequate provision for the association's obligations under the policies and contracts, including, but not limited to, the benefits and any administrative and operating expenses associated with the policies and contracts.
(c) The opinion required by subdivision (a) shall be governed by the following provisions:
(1) It shall include supporting memoranda consistent with actuarial standards of practice published by the American Academy of Actuaries and the Actuarial Standards Board.
(2) If the association fails to provide an opinion and supporting memoranda to the commissioner that meets the requirements of this section, the commissioner shall notify the association of the deficiencies in the filing, and shall make a specific request that identifies the issues that should be addressed in an amended filing. The requests shall be consistent with actuarial standards of practice published by the American Academy of Actuaries and the Actuarial Standards Board.
(d) If the commissioner determines, after a review of the filings from the associations, that the laws governing these associations are inadequate to protect the interests of the members of the associations, he or she shall, on or before July 1, 2017, develop and deliver recommendations to the Assembly Committee on Insurance and the Senate Committee on Insurance regarding changes in the law necessary to protect the interests of members of the associations.
(e) Documents, materials, or other information, including the opinion with supporting memoranda, submitted pursuant to this section that are in the possession or control of the Department of Insurance and that are obtained by, created by, or disclosed to the commissioner or any other person pursuant to this section, are recognized by this state as being proprietary and to contain trade secrets. Those documents, materials, or other information shall be confidential by law and privileged, shall not be subject to disclosure by the commissioner pursuant to the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1 of the Government Code), and shall not be subject to subpoena or discovery from the commissioner or admissible into evidence, in a private civil action if obtained from the commissioner. The commissioner shall not otherwise make those documents, materials, or other information public without the prior written consent of the association.
(f) This section shall remain in effect only until December 31, 2018, and as of that date is repealed, unless a later enacted statute, that is enacted before December 31, 2018, deletes or extends that date.
(a) An association that self-funds all or part of the
benefits provided under this chapter shall include the following
language, or other language approved by the commissioner, in all
contracts that are not regulated by the department, and in
certificates evidencing coverage under those contracts, in capital
letters and in a minimum of 12-point type:
"ALL OR A PORTION OF THE BENEFITS PROVIDED BY THIS CONTRACT ARE
NOT SUBJECT TO REGULATION BY THE CALIFORNIA DEPARTMENT OF INSURANCE,
AND THE CONTRACT IS NOT GUARANTEED BY THE CALIFORNIA LIFE AND HEALTH
INSURANCE GUARANTEE ASSOCIATION."
(b) This section shall remain in effect only until December 31,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before December 31, 2018, deletes or extends
that date.
Such association may be incorporated or unincorporated, but
if incorporated it shall neither issue nor be authorized to issue
shares of stock.
The membership of such association shall consist solely of
the following or any combination thereof:
(a) Members of police departments of municipal or public corporations or districts.
(b) Members of fire departments of municipal or public corporations or districts.
(c) Peace or law enforcement officers who are regular and salaried officers or employees of the state or of a single county or other political subdivision or public or municipal corporation.
(d) Persons who are emergency medical services personnel and employed by a fire department of a city, county, or district.
(e) Persons who at the time of becoming members of such association were qualified pursuant to subdivisions (a), (b), (c), or (d) of this section.
(a) Members of police departments of municipal or public corporations or districts.
(b) Members of fire departments of municipal or public corporations or districts.
(c) Peace or law enforcement officers who are regular and salaried officers or employees of the state or of a single county or other political subdivision or public or municipal corporation.
(d) Persons who are emergency medical services personnel and employed by a fire department of a city, county, or district.
(e) Persons who at the time of becoming members of such association were qualified pursuant to subdivisions (a), (b), (c), or (d) of this section.
Such association shall not pay, promise or agree to pay,
either directly or indirectly, any consideration of any nature for
the solicitation or procuring of members or applications for
membership.
The trustees, directors or governing body of such
association, by whatever name their office is known or designated,
shall be elected by the membership of the association.
Moneys or property directly or indirectly contributed to
such association by its members shall not be paid out as benefits to
any persons other than its members, their dependents, or
beneficiaries nominated in writing by them.
Such association shall be supported mainly by contributions
from its members, whether in the form of fees, dues, assessments, or
otherwise, and by donations made to it from time to time.
