in-20251008-IR-760250163FRA: Adds 760 IAC 6 concerning fees, fines, and civil penalties assessed to entities regulated by the Department of Insurance (IDOI). Effective 30 days after filing with the publisher.

TITLE 760 DEPARTMENT OF INSURANCE Final Rule LSA Document #25-163 DIGEST FEES, FINES, AND CIVIL PENALTIES Adds 760 IAC 6 concerning fees, fines, and civil penalties assessed to entities regulated by the Department of Insurance (IDOI). Effective 30 days after filing with the publisher. HISTORY Notice of First Public Comment Period: 20250409-IR-760250163FNA Regulatory Analysis submitted with Notice of First Public Comment Period: 20250409-IR-760250163RAA Date of First Hearing: May 13, 2025 60 Day Requirement: 20250514-IR-760250163ARA Notice of Second Public Comment Period: 20250611-IR-760250163SNA Date of Second Hearing: July 14, 2025 CITATIONS AFFECTED: 760 IAC 6 SUMMARY/RESPONSE TO COMMENTS IDOI requested public comment from April 9, 2025, through May 9, 2025, from June 11, 2025, through July 11, 2025, and during the public hearings on May 13, 2025, and July 14, 2025. The comments received and IDOI's responses to the comments are summarized as follows: David Watkins, Indiana Economic Development Corporation Comment: IDOI’s provided analysis presents a reasonable justification and understanding of how the rule should be implemented and small business owners may experience an overall increase in transparency with their interactions with IDOI and the fees associated with IDOI. The Small Business Ombudsman is neutral on the rule. Response: IDOI appreciates the feedback from the Small Business Ombudsman. William Stroup, Callan and Associates Comment: The proposed rule did not specifically cite to each authority for the proposed fee, fine or civil penalty and urged IDOI to provide a line-by-line mapping of each proposed fee, fine, or civil penalty to the specific Indiana Code provision authorizing it. Response: IDOI appreciates the comment and would point to the proposed rule which cites each Indiana Code authority granting the proposed fee, fine, or civil penalty. Joseph Deems, National Risk Retention Association Comment: The proposed rule should remove the filing fee imposed on foreign risk retention groups as it is preempted by the Liability Risk Retention Act. Response: IDOI appreciates the comment and believes the proposed rule is aligned with IDOI’s statutory obligations. FINAL RULE Sec. 1. This rule applies to fees imposed by the department that are not otherwise set as a specific amount in Indiana Code or rule. Sec. 2. The commissioner may impose an administrative fee calculated under IC 27-1-6-21(c)(2) to a domestic insurer in an amount not less than twenty-five thousand dollars ($25,000), but not more than one hundred thousand dollars ($100,000) each year, after considering the following: Sec. 3. Insurance producer prelicensing fees are as follows: Sec. 4. Bail agent prelicensing and continuing education course provider license fees are forty dollars ($40) for each course application and renewal application. Sec. 5. Temporary emergency independent adjuster license fees are twenty dollars ($20) per application. Sec. 6. Insurance administrator fees are as follows: Sec. 7. Navigator and application organization fees are as follows: Sec. 8. Foreign risk retention groups shall submit a filing fee of one hundred ten dollars ($110) to accompany a statement of registration submitted to the department under IC 27-7-10-14. Sec. 9. (a) Beginning July 1, 2024, the annual surcharge for a physician electing to become a qualified provider is as follows: Class 0 $2,130 Class 1 $3,043 Class 2 $3,956 Class 3 $5,174 Class 4 $6,090 Class 5 $8,370 Class 6 $12,936 Class 7 $18,262 Class 8 $22,827 Class 9 $25,870 (b) Beginning July 1, 2024, surcharge calculations for a hospital electing to become a qualified provider are as follows: Hospital, Acute Care and Intensive Care (per bed) $1,048 Mental Health/Rehabilitation (per bed) $524 Extended Care/Intermediate Care/Residential (per bed) $53 Nursing Home/Critical Extended Care (per bed) $524 Health Institution/Assisted Living/Other (per bed) $210 Bassinets (per bed) $1,048 Emergency Room (per 100 visits) $104.80 Clinics/Others (per 100 visits) $52.40 Mental Health/Rehabilitation (per 100 visits) $26 Health Institution (per 100 visits) $21 Home Health Care (per 100 visits) $52.40 Births (per 100) $4,196 Outpatient Surgeries (per 100) $104.80 Inpatient Surgeries (per 100) $2,097 Sec. 1. This rule applies to fines and civil penalties imposed by the department that are not otherwise set as a specific amount in Indiana Code or rule. Sec. 2. For purposes of assessing fines and civil penalties, the commissioner shall: Sec. 3. The amount of a fine or civil penalty may be adjusted downward from the base amount set forth in section 5 of this rule to reflect particular mitigating factors. The commissioner may consider the following factors: Sec. 4. (a) The amount of a fine or civil penalty may be adjusted upward from the base amount set forth in section 5 of this rule to reflect aggravating factors. The commissioner may consider the following factors: (b) Whenever an aggravating factor is identified, the corresponding fine or civil penalty outlined under section 5 of this rule may be increased by any amount, up to and including five (5) times for each violation. However, the amount assessed for each violation may not exceed the amounts set forth in applicable law. Sec. 5. The following are base violation fines and civil penalties, which may be adjusted to a higher or lower amount based on mitigating or aggravating factors set forth in sections 3 and 4 of this rule: Legal Citation General Description of Violation Base Violation Fine or Civil Penalty 760 IAC 1-73-2(c)  Professional employer organization failure to inform of material change $2,000 760 IAC 4-7-1(c); 760 IAC 4-7-1(d) Noncompliance with navigator/application organization law $50 to $10,000 per violation 760 IAC 1-6.2-11(f)(2) Bail agents/recovery agents; material alteration to certificate of completion $2,000 IC 27-1-3-20(f) Transacting insurance without a certificate of authority $5,000 IC 27-1-15.6-12(f) Noncompliance with insurance producer laws $2,000 IC 27-1-15.6-15(f) Noncompliance with termination of appointment notification $5,000 IC 27-1-15.9-16(b) Penalty for noncompliance with portable electronic insurance law $2,000 IC 27-1-16.1-15(b) Penalty for noncompliance with self-storage insurance law $2,000 IC 27-1-23-2.5(n) Violation of cease and desist order; competitive standards noncompliance $2,000 IC 27-1-23-2.5(o) Noncompliance with holding company filing requirements $10,000 IC 27-1-23-5(c)  Noncompliance with insurance holding company system examination requirements Up to $200 per day IC 27-1-23-8.1(c)  Officer, director, or employee of insurance holding company system making false statements $200,000 IC 27-1-23-8.1(d) Officer or director of an insurance holding company system intentional violations $2,000 IC 27-1-23-8.1(e)  Insurance holding company system noncompliance $200,000 IC 27-1-25-12.4(d) Noncompliance with insurance administrator law $5,000 IC 27-1-28-18(e)  Noncompliance with independent adjuster law $2,000 IC 27-1-33-10(a) Noncompliance with managing general agent law $1,000 IC 27-1-43.2-15 Noncompliance with service contracts law $2,000 IC 27-1-45-9 Noncompliance with health facility compensation law $200 IC 27-1-46-17 Provider facility failure to provide estimate or communication about right to estimate $200 IC 27-1-49-10 Noncompliance with individual prescription drug rebate law $2,000 IC 27-1-50-13 Noncompliance with group prescription drug rebate law $2,000 IC 27-2-17-6(c)  Discrimination in insurance $400 IC 27-2-25-16 Health carrier noncompliance with requirement to provide good faith estimates $200 IC 27-2-28-12 Noncompliance with requirement to provide notice to policyholder of material change to personal automobile or homeowner's policy $1,000 IC 27-4-1-6 Unfair competition; deceptive acts and practices $5,000 per act or violation / $10,000 per act or violation if the person knew or should have known of violation IC 27-4-1-12 Violation of cease and desist order; unfair competition; deceptive acts and practices $5,000 IC 27-5.1-2-28 Noncompliance with farm mutual insurance company law $2,000 IC 27-7-17.5-9(b) Dental plans setting fees for dental services; noncompliance with law $2,000 IC 27-8-5.7-8 Insurer failure to pay clean claim Between 85% and 95% of clean claims paid: $2,000 Between 60% and 85% of clean claims paid: $20,000 Less than 60% of clean claims paid: $150,000  IC 27-8-16-12(d) Noncompliance with medical claims review agent law $1,000 IC 27-8-17-17(d) Noncompliance with health care utilization review agent law $1,000 IC 27-8-19.8-19 Violations of viatical settlement provider law $2,000 IC 27-10-2-14(e) Noncompliance with requirement of insurers, bail agents, or firm or agency to file sworn statement relating to unpaid late surrender fees and judgments $2,000 IC 27-10-3-8(c)  Noncompliance with bail law by bail agents and recovery agents $2,000 IC 27-10-3-9(d) Noncompliance with bail law by bail agents and recovery agents $2,000 IC 27-13-24-1(b) Noncompliance with health maintenance organization law $5,000 IC 27-13-36.2-6 Health maintenance organization failure to pay clean claims Between 85% and 95% of clean claims paid: $2,000 Between 60% and 85% of clean claims paid: $20,000 Less than 60% of clean claims paid: $150,000 IC 27-17-14-1 Noncompliance with discount medical program law $10,000 IC 27-19-4-3(b) Noncompliance with navigator/application organization law $2,000 IC 34-18-5-2 Failure of hospital to carry out risk management system 10% of surcharge amount IC 27-7-2 Failure to comply with worker's compensation laws $200 per violation $2,000 per willful violation IC 27-6-9-25 Failure to comply with reinsurance intermediary laws $1,000 IC 27-13-34 Noncompliance with limited health maintenance organization laws $500 Sec. 6. Nothing in this rule requires the commissioner to assess a civil penalty for a violation. LSA Document #25-163 Notice of First Public Comment Period: April 9, 2025 Last Hearing Held: July 14, 2025 Approved by Attorney General: September 9, 2025 Approved by Governor: September 9, 2025 Filed with Publisher: September 9, 2025, 1:57 p.m. Documents Incorporated by Reference: None Received by Publisher State Budget Committee Agenda dated April 19, 2024: Received by Publisher Small Business Regulatory Coordinator: Claire Szpara, Senior Attorney, Indiana Department of Insurance, 311 West Washington Street, Suite 103, Indianapolis, IN 46204, (317) 232-5312, cszpara@idoi.in.gov