R20-6-709. Repealed ................................................ page 56

ARTICLE 8. PROHIBITED PRACTICES, PENALTIES Section R20-6-801. Unfair Claims Settlement Practices....... page 56 R20-6-802. Emergency Expired ............................... page 58 ARTICLE 9. TERMINATION OR DISSOLUTION Section R20-6-901. Reserved ................................................ page 59 ARTICLE 10. LONG-TERM CARE INSURANCE Article 10, consisting of Sections R4-14-1001 through R4-14- 1016 and Appendices A through C, adopted effective August 10, 1992 (Supp. 92-2). R20-6-1001 through R20-6-1016 recodified from R4-14-1001 through R4-14-1016 (Supp. 95-1). Section R20-6-1001. Applicability and Scope......................... page 59 R20-6-1002. Definitions ............................................. page 59 R20-6-1003. Policy Terms.......................................... page 59 R20-6-1004. Required Policy Provisions ................... page 60 R20-6-1005. Unintentional Lapse............................... page 63 R20-6-1006. Inflation Protection................................ page 63 R20-6-1007. Required Disclosure Provisions............. page 64 R20-6-1008. Required Disclosure of Rating Practices to Consumers.................................................... page 64 R20-6-1009. Initial Filing Requirements.................... page 65 R20-6-1010. Requirements for Application Forms and Replacement Coverage; Prohibition Against Preexisting Conditions and Probationary Periods in Replacement Policies or Certificates; Reporting Requirements......................................... page 66 R20-6-1011. Prohibition Against Post-claims Underwriting... ................................................................page 68 R20-6-1012. Reserve Standards.................................. page 68 R20-6-1013. Loss Ratio.............................................. page 69 R20-6-1014. Premium Rate Schedule Increase .......... page 69 R20-6-1015. Premium Rate Schedule Increases for Policies Subject to Loss Ratio Limits Related to Original Filings .................................................... page 72 R20-6-1016. Filing Requirements for Group Policies............. ................................................................page 74 R20-6-1017. Standards for Marketing ........................ page 74 R20-6-1018. Suitability............................................... page 74 R20-6-1019. Nonforfeiture Benefit Requirement....... page 75 R20-6-1020. Standards for Benefit Triggers .............. page 77 R20-6-1021. Additional Standards for Benefit Triggers for Qualified Long-term Care Insurance Contracts.. ................................................................page 78 R20-6-1022. Standard Format Outline of Coverage... page 78 R20-6-1023. Requirement to Deliver Shopper’s Guide .......... ................................................................page 78 R20-6-1024. Availability of New Health Care Services or Providers ..................................................... page 78 R20-6-1025. Right to Reduce Coverage and Lower Premiums ................................................................page 79 R20-6-1026. Instructions for Appendices................... page 79 Appendix A. Long-term Care Insurance Personal Worksheet .. ................................................................page 80 Appendix B. Long-term Care Insurance Potential Rate Increase Disclosure Form...................... page 82 Appendix C. Notice to Applicant Regarding Replacement of Individual Health or Long-term Care Insurance . ................................................................page 84 Appendix D. Notice to Applicant Regarding Replacement of Health or Long-term Care Insurance..... page 85 Appendix E. Long-Term Care Insurance Replacement and Lapse Reporting Form........................... page 86 Appendix F. Long-term Care Insurance Claims Denial Reporting Form ..................................... page 87 Appendix G. Rescission Reporting Form for Long-term Policies .................................................. page 88 Appendix H. Things You Should Know Before You Buy Long-term Care Insurance..................... page 89 Appendix I. Long-term Care Insurance Suitability Letter....... ................................................................page 90 Appendix J. Long-term Care Insurance Outline of Coverage . ................................................................page 91 ARTICLE 11. MEDICARE SUPPLEMENT INSURANCE Article 11, consisting of Sections R20-6-1101 through R20-6- 1121 and Appendices A through F, repealed; new Section R20-6- 1101 made by final rulemaking at 11 A.A.R. 3671, effective November 12, 2005 (Supp. 05-3). Article 11, consisting of Sections R4-14-1101 through R4-14- 1120 and Appendices A through E, adopted again by emergency effective March 17, 1992, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 92-1). Article 11, consisting of Sections R4-14-1101 through R4-14- 1120 and Appendices A through E, adopted by emergency effective December 18, 1991, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 91-4). R20-6-1101 through R20-6-1120 recodified from R4-14-1101 through R4-14-1120 (Supp. 95-1). Section R20-6-1101. Incorporation by Reference and Modifications... ................................................................page 92 R20-6-1102. Repealed ................................................ page 93 R20-6-1102.01 Repealed ................................................ page 93 R20-6-1103. Repealed ................................................ page 94 R20-6-1104. Repealed ................................................ page 94 R20-6-1105. Repealed ................................................ page 94 R20-6-1106. Repealed ................................................ page 94 R20-6-1107. Repealed ................................................ page 94 R20-6-1108. Repealed ................................................ page 94 R20-6-1109. Repealed ................................................ page 94 R20-6-1110. Repealed ................................................ page 94 R20-6-1111. Repealed ................................................ page 94 R20-6-1112. Repealed ................................................ page 95 R20-6-1113. Repealed ................................................ page 95 R20-6-1114. Repealed ................................................ page 95 R20-6-1115. Repealed ................................................ page 95 R20-6-1116. Repealed ................................................ page 95 R20-6-1117. Repealed ................................................ page 95 R20-6-1118. Repealed ................................................ page 95 R20-6-1119. Repealed ................................................ page 95 R20-6-1120. Repealed ................................................ page 95 R20-6-1121. Repealed ................................................ page 95 Appendix A. Repealed ................................................ page 95 Appendix B. Repealed ................................................ page 96 Appendix C. Repealed................................................. page 96 Appendix D. Repealed................................................. page 96 Appendix E. Repealed................................................. page 96 Appendix F. Repealed................................................. page 96 ARTICLE 12. HIV/AIDS: PROHIBITED AND REQUIRED PRACTICES Section R20-6-1201. Definitions ............................................. page 96 R20-6-1202. Applications for Insurance..................... page 96 R20-6-1203. Testing for HIV; Consent Form............. page 96 R20-6-1204. Release of Confidential HIV-related Information; Release Form................................. page 97 R20-6-1205. Benefits; Prohibited Practices................ page 97 ARTICLE 13. MENTAL HEALTH PARITY Article 13, consisting of Sections R20-6-1301 through R20-6- 1305, and Exhibit A, made by final rulemaking at 28 A.A.R. 1824 (July 29, 2022), effective September 4, 2022 (Supp. 22-3). Section R20-6-1301. Definitions ............................................. page 98 R20-6-1302. Medical Necessity Criteria and NQTL Reporting ................................................................page 98 R20-6-1303. FR and QTL Reporting.......................... page 99 R20-6-1304. Additional Information or Data........... page 100 R20-6-1305. Confidentiality of Information............. page 100 Exhibit A. Medical Necessity Criteria and NQTL Reports . ..............................................................page 100 ARTICLE 14. INSURANCE HOLDING COMPANY Article 14, consisting of Sections R4-14-1401 through R4-14- 1408 and Appendices A through E, adopted effective February 22, 1993 (Supp. 93-1). R20-6-1401 through R20-6-1408 recodified from R4-14-1401 through R4-14-1408 (Supp. 95-1). Section R20-6-1401. Definitions ........................................... page 104 R20-6-1402. Acquisition of Control – Statement Filing ......... ..............................................................page 104 R20-6-1403. Annual Registration of Insurers – Statement Filing ........................................................ page 104 R20-6-1404. Summary of Registration – Statement Filing ..... ..............................................................page 105 R20-6-1405. Alternative and Consolidated Registrations ...... ..............................................................page 105 R20-6-1406. Disclaimers and Termination of Registration .... ..............................................................page 105 R20-6-1407. Transactions Subject to Prior Notice – Notice Filing ....................................................page 105 R20-6-1408. Enterprise Risk Report; Group Capital Calculation .......................................................page 106 R20-6-1409. Extraordinary Dividends and Other Distributions ..............................................................page 107 R20-6-1410. Adequacy of Surplus ...........................page 108 Appendix A. Form A - Statement Regarding the Acquisition of Control of or Merger with a Domestic Insurer ..............................................................page 108 Appendix B. Form B - Insurance Holding Company System Annual Registration Statement ............page 112 Appendix C. Form C - Summary of Changes to Registration Statement ............................................. page 116 Appendix D. Form D - Prior Notice of a Transaction ..............................................................page 118 Appendix E. Form E - Pre-acquisition Notification Form Regarding the Potential Competitive Impact of a Proposed Merger or Acquisition by a Non- domiciliary Insurer Doing Business in this State or by a Domestic Insurer 121 Appendix F. Form F - Enterprise Risk Report .........page 122 Appendix G. Instructions on Forms A, B, C, D, E and F ......... ..............................................................page 123 ARTICLE 15. RESERVED ARTICLE 16. CREDIT FOR REINSURANCE Article 16, consisting of Sections R4-14-1601 through R4-14- 1607 and Appendix A, adopted effective February 3, 1993 (Supp. 93-1). R20-6-1601 through R20-6-1607 recodified from R4-14- 1601 through R4-14-1607 (Supp. 95-1). Article 16, consisting of Sections R20-6-1601 through R20-6- 1608, renumbered to Article 16, Part 1, R20-6A1601 through R20- 6A1608; Article 16, consisting of Sections R20-6-1610 through R20-6-1612, renumbered to Article 16, Part 2; by final rulemaking at 28 A.A.R. 493 (March 4, 2022), effective April 9, 2022 (Supp. 22- 1). Section R20-6-1601. Renumbered .........................................page 124 R20-6-1602. Renumbered .........................................page 124 R20-6-1603. Renumbered .........................................page 124 R20-6-1604. Renumbered .........................................page 124 R20-6-1605. Renumbered .........................................page 124 R20-6-1606. Renumbered .........................................page 124 R20-6-1607. Renumbered .........................................page 124 R20-6-1608. Renumbered .........................................page 124 R20-6-1609. Repealed ..............................................page 125 R20-6-1610. Renumbered .........................................page 125 R20-6-1611. Renumbered .........................................page 125 R20-6-1612. Renumbered .........................................page 125 PART A. CREDIT FOR REINSURANCE Article 16, Part A, consisting of Sections R20-6A1601 through R20-6A1609, renumbered from Article 16, R20-6-1601 through R20-6-1608 and amended by final rulemaking at 28 A.A.R. 493 (March 4, 2022), effective April 9, 2022 (Supp. 22-1). Section R20-6-A1601. Credit for Reinsurance – Reinsurer Licensed in Arizona ................................................page 125 R20-6-A1602. Credit for Reinsurance – Accredited Reinsurers ..............................................................page 125 R20-6-A1603. Credit for Reinsurance – Reinsurer Domiciled in Another State .......................................page 125 R20-6-A1604. Credit for Reinsurance – Reinsurers Maintaining Trust Funds ..........................................page 125 R20-6-A1605. Credit for Reinsurance – Certified Reinsurers ..............................................................page 129 Table 1. Financial Strength Ratings .................. page 132 R20-6-A1606. Credit for Reinsurance - Reciprocal Jurisdictions; Credit for Reinsurance Required by Law ..............................................................page 132 R20-6-A1607. Asset or Reduction from Liability for Reinsurance Ceded to an Unauthorized Assuming Insurer not Meeting the Requirements of R20-6- A1601 through R20-6-A1606.............. page 135 R20-6-A1608. Trust Agreements Qualified under R20-6- A1607; Letters of Credit Qualified under R20-6- A1607 .................................................. page 135 R20-6-A1609. Other Security; Reinsurance Contract; Contracts Affected ...............................................page 139 Exhibit A. Form AR-1, Certificate of Assuming Insurer ..... ..............................................................page 140 Exhibit B. Form CR-1, Certificate of Certified Reinsurer... ..............................................................page 141 Exhibit C. Form CR-F Instructions....................... page 142 Exhibit D. Form CR-S Instructions....................... page 143 Exhibit E. Form RJ-1, Certificate of Reinsurer Domiciled in Reciprocal Jurisdiction .................... page 145 PART B. TERM AND UNIVERSAL LIFE INSURANCE RESERVE FINANCING Article 16, Part B, consisting of Sections R20-6B1601 through R20-6B1603, renumbered from Article 16, R20-6-1610 through R20-6-1612, then repealed. New Sections R20-6B1601 through R20-6B1603 made by final rulemaking at 28 A.A.R. 493 (March 4, 2022), effective April 9, 2022 (Supp. 22-1). Section R20-6-B1601. Applicability; Exemptions; Definitions; Severability; Prohibition Against Avoidance.............. ..............................................................page 145 R20-6-B1602. The Actuarial Method.......................... page 147 R20-6-B1603. Requirements Applicable to Covered Policies to Obtain Credit for Reinsurance; Opportunity for Remediation......................................... page 148 ARTICLE 17. EXAMINATIONS Article 17, consisting of Sections R4-14-1701 through R4-14- 1704, adopted effective February 22, 1993 (Supp. 93-1). R20-6- 1701 through R20-6-1704 recodified from R4-14-1701 through R4- 14-1704 (Supp. 95-1). Section R20-6-1701. Definitions ........................................... page 149 R20-6-1702. Authority, Scope, and Scheduling of Examinations ..................................................... page 149 R20-6-1703. Conduct of Examinations .................... page 149 R20-6-1704. Examination Reports ........................... page 150 ARTICLE 18. PREPAID DENTAL PLAN ORGANIZATIONS Article 18, consisting of Sections R20-6-1801 through R20-6- 1813, made by final rulemaking at 8 A.A.R. 463, effective January 10, 2002 (Supp. 02-1). Section R20-6-1801. Definitions ........................................... page 150 R20-6-1802. Application for Certificate of Authority............. ..............................................................page 151 R20-6-1803. Chief Executive Officer....................... page 151 R20-6-1804. Dental Director .................................... page 151 R20-6-1805. Required Reporting.............................. page 152 R20-6-1806. Basic Dental Services .......................... page 152 R20-6-1807. System for Delivery of Services.......... page 152 R20-6-1808. Geographic Areas ................................ page 152 R20-6-1809. Contract Requirements ........................ page 153 R20-6-1810. Records ................................................ page 153 R20-6-1811. Quality Improvement........................... page 153 R20-6-1812. Confidentiality of Records................... page 153 R20-6-1813. Assignment of Members...................... page 153 ARTICLE 19. HEALTH CARE SERVICES ORGANIZATIONS OVERSIGHT Article 19, consisting of Sections R20-6-1901 through R20-6- 1911, made by exempt rulemaking at 7 A.A.R. 2769, effective July 1, 2001 (Supp. 01-2). Section R20-6-1901. Applicability........................................ page 154 R20-6-1902. Definitions........................................... page 154 R20-6-1903. Documentation .................................... page 155 R20-6-1904. Health Care Plan.................................. page 155 R20-6-1905. Geographic Area.................................. page 156 R20-6-1906. Chief Executive Officer....................... page 156 R20-6-1907. Medical Director.................................. page 156 R20-6-1908. Quality Assurance ............................... page 156 R20-6-1909. Evaluation of Network ........................ page 157 R20-6-1910. Process for Referral, Prior Authorization, Pre- certification, or Network Exception .... page 157 R20-6-1911. HCSO Communication with Providers ............... ..............................................................page 157 R20-6-1912. Network Directories ............................ page 157 R20-6-1913. Demographic Information Reports.......page 158 R20-6-1914. Access...................................................page 158 R20-6 1915. Alternative Access................................page 158 R20-6-1916. Availability Ratios............................... page 158 R20-6-1917. Geographic Availability in an Urban Area.......... ..............................................................page 158 R20-6-1918. Geographic Availability in a Suburban Area ...... ..............................................................page 158 R20-6-1919. Geographic Availability in a Rural Area............. ..............................................................page 159 R20-6-1920. Travel Requirements ........................... page 159 R20-6-1921. Enforcement Consideration................. page 159 ARTICLE 20. CAPTIVE INSURERS Article 20, consisting of Sections R20-6-2001 and R20-6-2002, made by final rulemaking at 8 A.A.R. 2478, effective July 1, 2002 (Supp. 02-2). Section R20-6-2001. Reserved .............................................. page 159