in-20250604-IR-760250283INA: FEES, FINES, AND CIVIL PENALTIES

TITLE 760 DEPARTMENT OF INSURANCE Notice of Public Comment Period For Interim Rule LSA Document #25-283 FEES, FINES, AND CIVIL PENALTIES PURPOSE OF NOTICE The Department of Insurance (department) is soliciting public comment on a rule to be temporarily added concerning fees, fines, and civil penalties assessed to entities regulated by the department. The department seeks comment on the affected citations listed and any other provisions of Title 760 that may be affected by this rulemaking. ADDITIONAL DOCUMENTS Governor's Approval: 20250604-IR-760250283GAA Regulatory Analysis: 20250604-IR-760250283RAA CITATIONS AFFECTED: 760 IAC 6 AUTHORITY: IC 27-1-3-20; IC 27-1-6-21; IC 27-1-15.6-12; IC 27-1-15.6-15; IC 27-1-15.9-16; IC 27-1-16.1-15; IC 27-1-23-2.5; IC 27-1-23-5; IC 27-1-23-8.1; IC 27-1-25-11.1; IC 27-1-25-12.2; IC 27-1-25-12.3; IC 27-1-25-12.4; IC 27-1-28-11; IC 27-1-28-18; IC 27-1-33-10; IC 27-1-42-15; IC 27-1-43.2-15; IC 27-1-45-9; IC 27-1-46-17; IC 27-1-49-10; IC 27-1-50-13; IC 27-2-17-6; IC 27-2-25-16; IC 27-2-28-12; IC 27-4-1-6; IC 27-4-1-12; IC 27-5.1-2-28; IC 27-6-9-25; IC 27-7-2; IC 27-7-10-14; IC 27-7-17.5-9; IC 27-8-5.7-8; IC 27-8-16-12; IC 27-8-17-17; IC 27-8-19.8-19; IC 27-10-2-14; IC 27-10-3-7.1; IC 27-10-3-8; IC 27-10-3-9; IC 27-13-24-1; IC 27-13-34; IC 27-13-36.2-6; IC 27-17-14-1; IC 27-19-4-3; IC 34-18-5-2 OVERVIEW Basic Purpose and Background The department is tasked with enforcing Indiana's insurance laws and rules. IC 27 places insurance companies, insurance producers, and certain other persons and entities under the department's regulation. The department imposes application and filing fees to regulated entities to offset associated administrative expenses. The department may also assess fines and civil penalties for violations of law. Most fees, fines, and civil penalties are set forth in IC 27 or 760 IAC. The purpose of this interim rule is to establish the department's fees, fines, and civil penalties not currently set forth in IC 27 or 760 IAC in a rule. Entities regulated by the department will be impacted by the proposed interim rule. Statement Justifying Requirement or Cost The fees listed under the proposed interim rule are not an increase of current fees, nor are any of the fees new fees that have not been charged before. The fees are comparable to other similarly situated fees established by statute, and are intended to offset the department's administrative expenses in processing applications and other filings. The fines in this rule have previously been in place and were gauged to discourage regulated entities from violating Indiana insurance laws without being unduly burdensome. All fines and civil penalties are necessary to allow the department to carry out its statutory responsibilities for the regulation of the Indiana insurance industry. The department relied on the Patient's Compensation Fund Funding Analysis for the Policy Period July 1, 2024, to June 30, 2025, prepared by Milliman, to set the appropriate Patient's Compensation Fund surcharge rates. REQUEST FOR PUBLIC COMMENT The department is soliciting public comment on the proposed rule. Comments may be submitted in one of the following ways: COMMENT PERIOD DEADLINE All comments must be postmarked or time stamped not later than July 4, 2025. The rule, Regulatory Analysis, appendices referenced in the Regulatory Analysis and Statement Justifying Requirement or Cost, and materials incorporated by reference (if applicable) are on file at the Department of Insurance, 311 West Washington Street, Suite 103, Indianapolis, Indiana and are available for public inspection. Copies of the rule, Regulatory Analysis, and appendices referenced in the Regulatory Analysis and Statement Justifying Requirement or Cost are available at the Department of Insurance office. PROPOSED INTERIM RULE 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 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 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