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Contents
- Federal Liability Risk Retention Act, Legislative
Background
- Definitions and Provisions
- Risk Retention Groups
- Purchasing Groups
- Application of State Agent and Broker Licensing
- Oversight of Implementation
- Commentary
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Federal liability risk retention
act legislative background, definitions and provisions
The Committee on Commerce,
Science, and Transportation, during the 99th Congress,
conducted numerous hearings for the purpose of
examining the availability and cost of liability
insurance. As a result of these hearings and involvement
by the Committee, the United States Congress revised
the Products Liability Risk Retention Act of 1981
through the Risk Retention Amendments of 1986.
The final Act, which was signed into law by President
Reagan on October 27, 1986 is known as the Liability
Risk Retention Act of 1986.
Since its enactment, this federal law has been
the subject of numerous interpretations by various
legal bodies, groups, and individuals. To understand
all of the implications under the Liability Risk
Retention Act of 1986, it is necessary to review
the Congressional purpose for enacting the legislation,
as well as of the National Association of Insurance
Commissioners' (NAIC) Model Risk Retention Act.
To facilitate your understanding of the Risk Retention
Act (RRA), the following outlines the components
with deviations as they occur under the NAIC Model
Risk Retention Act.
The Committee, supported by the administration's
Tort Policy Working Groups' report, was convinced
that an expansion of the Products Liability Risk
Retention Act of 1981 was needed to facilitate
group insurance programs. It was presumed that
this expansion would reduce costs, provide alternative
mechanisms for coverage, and promote greater premium
competition among general liability insurers.
It was believed that this expansion would encourage
insurers to set premiums that would compete with
the new formations created under the revised law.
To accomplish these goals, the Congressional history
is very clear on the absolute need of preemption
from certain state laws which would hinder or
oppose the formation and interstate operation
of association captive insurance companies or
Risk Retention Groups (RRG). The record also reflects
the need for preemption of prohibitive or restrictive
state laws that would preclude insurers from giving
preferential rates, terms, and conditions to groups
seeking liability insurance coverage. Legislation
provides the following definitions to aid in gaining
an understanding of RRGs.
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General definitions
Insurance means primary,
excess, reinsurance, surplus lines, or any other
means for transferring risk under state or federal
law.
Liability is
defined as the legal liability for damages (including
legal fees and other claims expenses) resulting
in bodily injury, property damage, personal injury,
or other types of loss or damage arising out of
any business or governmental activity. The term
does not include personal risk liability of railroads
for injuries to their employees under the Federal
Employer' Liability Act (FELA).
Personal risk liability
is defined as liability for personal injury or
property damage resulting from personal, familiar
or household responsibilities, rather than from
business-type activities.
A hazardous financial condition
exists when a risk retention group appears to
be unable (1) to meet its policyholders obligations
regarding known claims and reasonably anticipated
claims, or (2) to pay other obligations of business
operations.
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Risk retention groups
A Risk Retention Group is a
corporation or other limited liability association,
functioning as a captive insurance company and
organized for the primary purpose of assuming
and spreading the liability risk exposure(s) of
its group members (member-owners). It must be
chartered and licensed as a liability insurance
company in one of the fifty states or the District
of Columbia. It can also charter as an industrial
or association captive under special state captive
laws such as Vermont, Delaware, Colorado, Illinois,
etc.
RRGs chartered or licensed under the laws of Bermuda
or the Cayman Islands that have met the capitalization
requirements of one state prior to January 1,
1985, can continue to operate as RRGs. These are
the only off-shore formations permitted.
Structuring of the RRG will conform to the laws
of the chartering state and can include formation
as a stock or mutual company, or as a reciprocal
exchange. Members of an RRG must be engaged in
businesses or activities which are similar or
related in regards to the liability exposures
created by virtue of common business or trade
practices, products, services, premises or operations.
In addition, an individual or firm that meets
this criteria cannot be excluded from the group
if the intent of the exclusion is to provide the
group with a competitive advantage.
Owners of RRGs must be both members of and insured
by the group. Indirect or secondary ownership
through a wholly-owned, single organization is
permitted as long as the organization's owners
are members of and insured by the RRG. Insurance
companies cannot have an ownership interest in
an RRG unless all members of the group are insurance
companies.
The ownership interests of an RRG are exempt from
filing registration statements under Federal Securities
Law and State Blue Sky Laws. However, in line
with the anti-fraud provisions of applicable State
and Federal laws, any solicitation for funds must
disclose all material facts regarding the RRG
and its insurance operations.
Except for the chartering state, an RRG is exempt
from any state law, rule or regulation that regulates
or makes an RRG unlawful except, any state can
require an RRG to:
Comply with unfair claim
settlement practices;
Pay applicable premium or surplus lines
taxes;
Participate in residual market mechanisms
(Joint Underwriting
Authorship's/Assigned Risk Pools);
Designate the insurance commissioner as
agent for service of process;
Submit to financial
examination by other state insurance commissioners
if the chartering state has not initiated such
an examination;
Comply with state deceptive, false, or
fraudulent trade practice laws;
Comply with lawful orders for delinquency
or dissolution proceedings;
Comply with an injunction for hazardous
financial condition;
Include a notice in insurance policies,
in 10-point type, stating the RRG is not subject
to all state laws and regulations, and that the
insolvency guaranty fund is not available for
the RRG.
The non-chartering state has no approval authority
over rates, coverages, forms, insurance-related
services, management, operation, investment activities,
or loss control and claims administration. In
addition, the Act prohibits states from otherwise
discriminating against RRGs.
Each RRG must submit a feasibility study or plan
of operation for approval to the chartering state
before offering insurance. Under the Federal Act,
the plan or study must include coverages, deductibles,
coverage limits, rates, and rating classification
systems. The NAIC Model Act defines the feasibility
study as an "analysis which presents the
expected activities and results of a risk retention
group." The NAIC requires more information
including historical and expected loss experience
of the members, pro forma financial statements
and projections, an actuarial opinion defining
the minimum premium necessary to begin operations
and to avoid financial difficulties, information
on underwriting and claims procedures, reinsurance
agreements, investment policies, and management
and marketing methods. In addition, the NAIC also
requires that the RRG provide information identifying
the initial members, the organizers, the administrator
and anyone else who will otherwise influence or
control the RRG.
In each state in which the RRG is or plans to
do business, the RRG is required to submit a copy
of the feasibility study (including revisions)
and a copy of the annual financial statement.
The statement must be certified by an independent
accountant and include an opinion of loss and
loss adjustment expense reserves by an actuary
or a qualified loss reserve specialist. An RRG
cannot write coverage which is prohibited by state
statute or by the highest court in the state (ex:
punitive damage, intentional or criminal conduct).
This is not the same as coverage which is prohibited
by the state insurance department. However, the
states do have broad discretionary powers in deciding
whether coverage from an RRG is acceptable where
proof of financial responsibility is needed to
obtain a license to engage in certain activities
(i.e.: hazardous waste hauling, motor vehicle
operations).
If an RRG is found to be "in hazardous financial
condition," any state or U.S. District Court
may issue an order enjoining a RRG from soliciting,
selling insurance, or continuing operations.
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Purchasing groups
A Purchasing Group (PG) is
an organization which purchases liability insurance
on a group basis from an insurance company or
a Risk Retention Group (RRG) for its members.
Unlike an RRG, a PG is not an insurance company
and its members do not underwrite their own coverage.
However, like RRGs, PGs are subject to the same,
similar, or related tests pertaining to membership,
exposures, and types of coverage(s) offered.
A PG is exempt from any state
law, rule, regulation or order that would:
Prohibit the establishment of a PG
Make it unlawful for an insurer to provide
or offer insurance to, or to discriminate in favor
of the PG (based on loss experience)
Prohibit a PG or its members from purchasing
insurance on a group basis, regardless of a minimum
time in operation, the number of members or member
participation level, or otherwise discriminate
against a PG or its members.
Apart from these specified exemptions, a PG must
comply with all other state laws and regulations
regarding its operation and procurement of insurance.
A PG intending to do business in any state must
give notice of intent to the appropriate state's
insurance commissioner. The notice must identify
the state of domicile and principal place of business
for the PG, categorize the lines and classifications
of liability insurance to be purchased and provide
the name and domicile of the insurance company
from which insurance is to be purchased. In addition,
the PG must designate the commissioner of each
state as its agent of process. It should be noted
that the NAIC Model Act authorizes a monetary
filing fee in conjunction with this last provision
which applies to both PGs and RRGs.
The Federal Act allows for advantages in rates,
forms and coverages as long as they are based
on the PG's loss and expense experience. In addition,
it makes no reference to individual state authority
regarding approval of rates, forms, or coverages.
On the other hand, the NAIC Model Act gives individual
states the right of prior approval on rates, forms,
and coverages which are specifically designed
for PG members.
The Federal Act does not contain any provisions
regarding deductibles or aggregate limits for
PGs. The NAIC Model Act provides for separate
and individual deductibles. Group deductibles
are excluded. The NAIC Act maintains that the
purchase of aggregate limits is subject to the
same standards as all other group insurance purchases
within a state. For example, the Illinois Captive
Law does not allow for a group aggregate coverage
level, only individual aggregate coverage limits.
A PG may not purchase insurance from an insurer
that is not admitted in the state where the PG
is located, or from a RRG that is not chartered
in a state unless the purchase is through a licensed
broker acting pursuant to applicable surplus lines
laws
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Application of state agent
and broker licensing requirements
For both RRGs and PGs, chartering
and non-chartering states may require agents who
are acting on behalf of these entities to be licensed.
However, states cannot impose residency requirements
for licensing, nor can they require that the policy
be countersigned by a resident agent or broker.
Oversight of implementation
Under the Risk Retention Act, the Secretary of
Commerce is responsible for reporting to Congress
a summary of comments and conclusions regarding
the implementation of the Act.
Commentary
The following are representative of the major
areas of controversy surrounding this law today:
The interpretation of "location" for
a PG and the subsequent controversy over which
insurance department has authority (principal
place of business for the group vs. the state
where the members or insured risks reside).
The use of licensed brokers acting pursuant to
state surplus lines laws (using licensed E&S
brokers vs. individual compliance requirements
with state laws on using only admitted/approved
markets, etc.)
Whether or not RRGs and PGs are required to use
agents or brokers in their sales and solicitation
efforts (if a RRG/PG uses an agent or broker vs.
state requirements that the group must use agents
or brokers).
The Implementation Report of the U.S. Department
of Commerce has recommended that "location"
and the ultimate state authority on rate and form
approval, as well as primary regulation, rest
with the state in which the PG is domiciled or
has its principal place of business. While the
report acknowledges Congress' expectation that
agents or brokers would be used by RRGs and PGs,
this is not always the case.
FAQ #3 - What are the various state-by-state
regulatory and filing requirements?
You can find information about
various state-by-state regulatory and filing requirements
by contacting each state individually, or by linking
to each state's website and requesting the information.
Click
here.
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