The Safety Net for Texas Insurance Policyholders
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1 The Safety Net for Texas Insurance Policyholders 1
2 PRESENTATION ITEMS History of State Guaranty Associations TLAHHSIGA Background Purpose & Membership Board of Directors, Operational Information & Financial Summary Powers & Duties Statutory Coverage Limits & Exclusions Policy Obligation Fulfillment Assessments Receivership Basics What s On the Horizon? 2
3 DISCLAIMER This presentation is for informational purposes only, and is subject to change without notice. You should consult Chapter 463 of the Texas Insurance Code for specific information about the Texas Life, Accident, Health, and Hospital Service Insurance Guaranty Association. 3
4 Brief History of the L&H Guaranty System 1941: 1971: 1973: New York Guaranty Fund created First NAIC Life & Health Insurance Guaranty Association Model Act TLAHHSIGA created 1983: NOLHGA formed under auspices of ACLI in response to the Baldwin-United Failure 1984: 1987: 1992: 2005: 34 states with guaranty laws NOLHGA independence from ACLI Colorado & Louisiana enact GA statutes Last significant revision of the TLAHHSIGA statute 4
5 ASSOCIATION BACKGROUND TLAHHSIGA is NOT a state agency Formed on August 27, 1973 by Texas Legislature Administered by the Liquidation Division of the Texas Department of Insurance Until Legislative Privatization in July 1992 Employee Managed from Managed by Consulting Firm from Returned to Employee Management in 2003 Governing statute is Chapter 463 of the Texas Insurance Code Operates in compliance with Texas Open Meetings Act 5
6 PURPOSE & MEMBERSHIP Purpose - To provide protection for Texas resident policyholders when their insurance company that is licensed to write the lines of business protected by the Association is found to be insolvent and ordered liquidated by a court. Who are the members? All insurance companies licensed to write the respective lines of business are automatically members. (Does not include HMOs, MEWAs, fraternals, reciprocals, pools or exchanges) Approximately 1,100 member companies based on licensing. 6
7 BOARD OF DIRECTORS STRUCTURE Nine Member Board of Directors Three Representatives of Top 50 Premium Writers Two Additional Insurance Company Representatives Four Public Members All Directors Appointed by the Texas Commissioner of Insurance Directors are Appointed for a 6 Year Term Terms of Three Directors Expire Each Odd Numbered Year Annual Texas Ethics Commission PFS Filing 7
8 CURRENT BOARD OF DIRECTORS Ronald J. Welch, Chair (American National Ins Co) Dr. Wilda F. Meixner, Vice-Chair (Texas State University-Retired Professor) John Henry McDonald, Secretary (Austin Asset Mgmt Co) Thomas A. Munson, Treasurer (Landmark Life Ins Co) David Hester (Harris County) James M. Harrison (Principal Life Ins Co) Deborah J. Long (Protective Life Ins Co) James G. Lewis (Central Security Life Ins Co) Dean Frigo (City of Amarillo) 8
9 OTHER OPERATIONAL INFORMATION Per statute, a non profit legal entity Internal Revenue Code 501c(6) organization Small Office in Austin Staff Executive Director Senior Accountant Claims Manager Staff Accountant Office Assistant
10 FINANCIAL SUMMARY Provided Protection for 133 Insolvent Members Assessment-as-Needed Organization $700.9 Million Assessed Since Creation in 1973 $132.6 Million Refunded Since 1992 $95.9 Million Applied to Assessment Obligations $26.8 Million Directly to Member Insurers $9.9 Million to the State of Texas (already offset) February 28, 2010 Financial Position -Cash & Cash Equivalents of $83 million -Obligations for Insolvencies of $254 million (aggregate) 10
11 POWERS & DUTIES OF THE ASSOCIATION Guaranty, assume, or reinsure policies or contracts of the insolvent insurer Can provide substitute policies May impose permanent policy or contract liens Impose moratorium on voluntary withdrawals/surrenders Assist Commissioner in the detection & prevention of insolvencies
12 HEALTH INSURANCE COVERAGE $500,000 for hospital, medical & surgical and major medical $300,000 disability and LTC insurance $200,000 all other health insurance (all per individual per insolvent company) 12
13 LIFE INSURANCE COVERAGE $100,000 of cash surrender value $300,000 of death benefits $5 million per owner of multiple non-group policies (i.e. COLI/BOLI) (all per insured life per insolvent company) 13
14 ANNUITY COVERAGE $100,000 of the present value of annuity benefits per insured life (individual and allocated group annuities) $100,000 per payee for structured settlement immediate annuities $5 million per owner of unallocated group annuity (all per insolvent company) 14
15 AGGREGATE COVERAGE LIMIT $300,000 of aggregate benefits for an individual per insolvent company (with the exception of the Major Medical health limit, which is $500,000 and COLI/BOLI life limit and unallocated annuity limit which is $5 million) This comes into play when a policyholder has multiple policies of different lines of insurance with the same company (i.e. life insurance policies and annuity contracts) 15
16 COVERAGE EXCLUSIONS Portion in excess of Moody s adjustment (rollback and roll forward) Portion under which the risk is borne by the policyholder (not guaranteed by the insurer) Reinsurance (i.e. not direct policies) Self funded insurance plans PBGC protected annuities Dividends, voting rights, experience rating refunds Unallocated annuities not issued in connection with a benefit plan or governmental lottery Unauthorized insurance Extra contractual items not part of the express written terms of the policy, such as claims based on marketing materials, side letters/riders not part of the approved policy form, misrepresentation, etc. There are others 16
17 POLICY OBLIGATION FULFILLMENT Cancel Policies As Permitted and When Economically Advantageous Continue Coverage that Cannot Be Cancelled Administer and Directly Pay Policy Benefits Seek Assumption Reinsurance Transfer Multi-State Insolvencies Involve Coordination through the National Organization of Life & Health Insurance Guaranty Associations 17
18 TLAHHSIGA ASSESSMENTS Class A - Collects funds for administrative & general expenses not related to a specific insolvent insurer ($5.4 million since inception) Class B Collects funds for the expenses (admin and claims payments) related to a specific insolvent insurer ($701 million since inception) Assessed by line (Life, Health or Annuity) and limited to 2% annually of prior years premium Class A payments may be offset against examination expenses Class B payments may be offset against premium taxes (20% per year) 18
19 RECEIVERSHIP BASICS What is an insurance company receivership? Who is involved and what are their roles and responsibilities? What happens to the insurance policies and annuity contracts? What and when are policyholders told? What assistance can an agent provide for their clients?
20 WHAT IS A RECEIVERSHIP & WHO S INVOLVED? Receivership vs. Bankruptcy State court proceeding Governed by the domestic state s laws Court Domestic State Insurance Commissioner Creditors Will appoint a Deputy Liquidator or Special Deputy Receiver State Guaranty Associations Policyholders Agents Vendors Equity Holders/Owners
21 GUARANTY ASSOCIATIONS ROLE Protect policyholders Ensure continuation of certain policies Administer policies and fund covered claims Guarantee, assume, or reinsure policies Minimize assessment needs through asset recovery Collaborate with deputy receiver/liquidator on asset recovery and receivership closing Domestic vs. foreign company Single vs. multi-state insolvency
22 National Organization of Life & Health Insurance Guaranty Associations (NOLHGA) Coordination of guaranty associations activities in multistate insolvencies through task forces and the Members Participation Council (MPC) Speed resolution and control costs Oversight of task force consultants Advisor to industry groups and NAIC Collect assessable premium data Monitor estate activities Serve as information and communication center
23 NOLHGA INSOLVENCY TASK FORCE Multi-state insolvencies Represents interests of all affected GAs MPC decision-making but non-binding authority Resolutions developed are distributed to each GA for participation election Plans & budgets to handle covered obligations Resolves other major receivership issues Size and GA representation dependent on case
24 LIQUIDATOR/RECEIVER S ROLE Supervise seized company s activities Determine if/when insolvency occurs Develop Rehabilitation/Liquidation Plan Marshall assets Identify, classify and quantify creditor s claims Prosecute claims against third parties Distribute assets per statutory scheme
25 RECEIVERSHIP FOR THE POLICYHOLDER Guaranty associations always attempt to minimize the disruption of benefits and make the transition seamless (pay premiums and submit claims just as before with changes being made behind the scenes) Administration changes, if necessary, will be communicated in writing (discretion applied when confusion occurs) Fully covered versus partially or uncovered policies Uncovered amounts can be filed against the estate on a Proof of Claim and may receive a distribution in the future Agents can provide a conduit for distribution of information from Liquidator and the guaranty associations
26 WHAT S ON THE HORIZON? Current court ordered rehabilitations Penn Treaty Network America Insurance Company American Network Insurance Company Imerica Life & Health Insurance Company Standard Life Insurance Company of Indiana Shenandoah Life Insurance Company 2011 Session of Texas Legislature Federal Financial Services Reform 26
27 Texas Life, Accident, Health & Hospital Service Insurance Guaranty Association 6504 Bridge Point Parkway, Suite 450 Austin, TX (800)
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