Applicability; compliance; disclosure requirement; reporting of violation; penalty

Sec. 13.6. (a) This section applies to the sale, solicitation, or negotiation by an insurance producer of the following: (1) A policy of accident and sickness insurance (as defined in IC 27-8-5-1) issued on a group, a franchise, or a blanket basis. However, this section does not apply to the types of insurance and coverage described in IC 27-8-5-2.5(a). (2) A group health maintenance organization contract entered into under IC 27-13. (b) An insurance producer shall comply with 29 U.S.C. 1108(b)(2). (c) Before or at the time of sale of a group policy, an insurance producer and a third party administrator shall do the following: (1) Provide the plan sponsor with a statement from the insurer or health maintenance organization that discloses the amount that will be paid to the insurance producer or third party administrator for the sale of the group policy. The plan sponsor shall sign the statement in acknowledgment of receipt of the statement. (2) Disclose any additional fees other than those disclosed under subdivision (1) that the insurance producer or third party administrator may receive, including any planning fee. (d) Before January 1, 2026, the department shall establish a process for a person to report a violation of this section. (e) Upon receiving a report of a violation under this section, the department shall: (1) issue a notice to the insurance producer of the report of a violation of this section; (2) investigate the report; and (3) if the department determines that the insurance producer has violated this section at least three (3) times in a twelve (12) month period, the commissioner shall assess the insurance producer with an appropriate penalty set forth in section 12 of this chapter.