DEPARTMENT OF INSURANCE
April 10, 2019
Bulletin 249
Indiana Life and Health Insurance Guaranty Association Disclaimer
IC 27-8-8-18 requires the Indiana Life and Health Insurance Guaranty Association (ILHIGA) to prepare a summary document for the Commissioner's approval. The summary document must describe the general purposes and current limitations of
IC 27-8-8 and contain the specific information required by
IC 27-8-8-18(c). Since the issuance of Bulletin 231, the ILHIGA has updated the Notice of Protection Provided by the ILHIGA. Therefore, it has filed a new summary document, which is attached to this bulletin, incorporating the updates. This bulletin replaces Bulletin 231, which is hereby withdrawn.
Member insurers may not deliver a policy or contract to a policy or contract owner unless the summary document is delivered to the policy or contract owner at the time of delivery of the policy or contract. The summary document also must be available upon request by a policy or contract owner. The distribution, delivery, or contents or interpretation of the summary document does not guarantee that the policy or contract or the owner of the policy or contract is covered in the event of the impairment or insolvency of a member insurer. ILHIGA member insurers may begin using the attached summary document as soon as reasonably practical.
INDIANA DEPARTMENT OF INSURANCE
_____________________________________
Stephen W. Robertson
Insurance Commissioner
NOTICE OF PROTECTION PROVIDED BY THE
INDIANA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION
This Notice provides a brief summary of the Indiana Life and Health Insurance Guaranty Association ("ILHIGA") and the protection it provides for policyholders. This safety net was created under Indiana law, which determines who and what is covered and the amounts of coverage.
ILHIGA was established to provide protection to policyholders in the unlikely event that your life, annuity or health insurance company becomes financially unable to meet its obligations and is taken over by its insurance department. If this should happen, ILHIGA will typically arrange to continue coverage and pay claims, in accordance with Indiana law, with funding from assessments paid by other insurance companies. (For the purposes of this Notice, the terms "insurance company" and "insurer" mean and include health maintenance organizations ("HMOs")).
Basic Protections Currently Provided by ILHIGA
Generally, an individual is covered by ILHIGA if the insurer was a member of ILHIGA and the individual lives in Indiana at the time the insurer is ordered into liquidation with a finding of insolvency. The coverage limits below apply only for companies placed in rehabilitation or liquidation on or after July 1, 2018. The benefits that ILHIGA is obligated to cover are not to exceed the lesser of (a) the contractual obligations for which the member insurer is liable or would have been liable if the member insurer were not an insolvent insurer, or (b) the limits indicated below:
• $300,000 in death benefits
• $100,000 in net cash surrender or net cash withdrawal values
• $500,000 for health plan benefits (see definition below)
• $300,000 in disability income and long-term care insurance benefits
• $100,000 in other types of health insurance benefits
Annuities
• $250,000 in present value of annuity benefits (including net cash surrender and net cash withdrawal values)
The maximum amount of protection for each individual, regardless of the number of policies or contracts, is $300,000. Special rules may apply with regard to health benefit plans and covered unallocated annuities.
"Health benefit plan" is defined in
IC 27-8-8-2(o), and generally includes hospital or medical expense policies, certificates, HMO subscriber contracts or certificates or other similar health contracts that provide comprehensive forms of coverage for hospitalization or medical services, but excludes policies that provide coverages for limited benefits (such as accident-only, credit, dental-only or vision-only insurance), Medicare Supplement insurance, disability income insurance and long-term care insurance.
The protections listed above apply only to the extent that benefits are payable under covered policy(s). In no event will the ILHIGA provide benefits greater than the contractual obligations in the life, annuity or health insurance policy or contract. The statutory limits on ILHIGA coverage have changed over the years and coverage in prior years may not be the same as that set forth in this Notice.
Note: Certain policies and contracts may not be covered or fully covered. For example, coverage does not extend to any portion(s) of a policy or contract that the insurer does not guarantee, such as certain investment additions to the account value of a variable life insurance policy or variable annuity contract.
Benefits provided by a long-term care (LTC) rider to a life insurance policy or annuity contract shall be considered the same type of benefits as the base life insurance policy or annuity to which it relates.
To learn more about the protections provided by ILHIGA, please visit the ILHIGA website at www.inlifega.org or contact:
| |
| | |
| Indiana Life & Health Insurance | Indiana Department of Insurance |
| Guaranty Association | 311 W. Washington Street, Suite 103 |
| 3502 Woodview Trace, Suite 100 | Indianapolis, IN 46204 |
| Indianapolis, IN 46268 | (317) 232-2385 |
| (317) 636-8204 | |
The policy or contract that this Notice accompanies might not be fully covered by ILHIGA and even if coverage is currently provided, coverage is (a) subject to substantial limitations and exclusions (some of which are described above), (b) generally conditioned on continued residence in Indiana, and (c) subject to possible change as a result of future amendments to Indiana law and court decisions.
Complaints to allege a violation of any provision of the Indiana Life and Health Insurance Guaranty Association Act must be filed with the Indiana Department of Insurance, 311 W. Washington Street, Suite 103, Indianapolis, IN 46204; (telephone) 317-232-2385.
Insurance companies and agents are not allowed by Indiana law to use the existence of ILHIGA or its coverage to encourage you to purchase any form of insurance or HMO coverage. (IC 27-8-8-18(a)). When selecting an insurance company, you should not rely on ILHIGA coverage. If there is any inconsistency between this Notice and Indiana law, Indiana law will control.
Questions regarding the financial condition of a company or your life, health insurance policy or annuity should be directed to your insurance company or agent.
Posted: 04/17/2019 by Legislative Services Agency
DIN: 20190417-IR-760190243NRA
Composed: May 02,2024 1:52:31AM EDT
A
PDF version of this document.
