806 KAR 9:340. Forms for application, appointment, prelicensing and continuing education course completion, examination retake, provider and course approval, filing fee submission, instructor approval, continuing education attendance roster and certificate of completion, specialty credit insurance producer supplement to license application, rental vehicle license supplemental application, continuing education certificate of completion, rental vehicle managing employee, continuing education certificate of completion, unlicensed employees and representatives of rental vehicle agent, record correction, and background check request

      Section 1. (1) Form CPL-01, "Certificate of Prelicensing Course Completion," shall be filed with the Department of Insurance by a prelicensing provider for each applicant that has completed a prelicensing course of study.

      (2) Form 8301, "NAIC Individual Insurance Producer License Application," shall be filed by an individual applicant with the Department of Insurance to initiate the licensing process for a resident and nonresident individual agent, surplus lines broker, consultant, temporary agent, rental vehicle managing employee, specialty credit managing employee, managing general agent, adjuster, apprentice adjuster, administrator, reinsurance intermediary manager, reinsurance intermediary broker, life settlement broker and life settlement provider.

      (3) Form 8301-BE, "NAIC Business Entity License Application," shall be filed with the Department of Insurance by a business entity applicant to initiate the licensing process for the business entity counterparts of the individual licenses.

      (4) Form 8302-AP, "Producer Appointment," shall be filed by an insurer to notify the Department of Insurance that an individual or business entity agent or agency has been appointed to represent the insurer.

      (5) Form 8202-TE, "Termination of Producer Appointment," shall be filed by an insurer with the Department of Insurance to terminate an agent’s appointment with an insurer.

      (6) Form VS, "Voluntary Surrender of License," shall be filed by an agent with the Department of Insurance to surrender his or her license.

      (7) Form 8305, "Business Entity Designation or Termination of Designation Form," shall be filed with the Department of Insurance by a business entity to designate individuals to be authorized to act under the business entity’s license and appointments.

      (8) Form 8307, "Request for Unlicensed Adjuster Representing an Insurer to Adjust Losses Resulting From a Catastrophe," shall be filed with the Department of Insurance by an insurer to give an adjuster that is not licensed in Kentucky temporary authority to adjust catastrophic claims.

      (9) Form 8304, "Examination Retake Form," shall be filed with the Department of Insurance by an applicant who fails an examination or fails to keep an appointment to take an examination to request the opportunity to retake the examination.

      (10) Form KYP-01, "Provider Approval Application," shall be filed by an applicant with the Department of Insurance to request certification as a continuing education or prelicensing provider.

      (11) Form CE/PL-100, "Course Approval Application," shall be filed by a provider with the Department of Insurance to request approval of continuing education and prelicensing courses.

      (12) Form KYF-01, "Filing Fee Submission Form" shall be filed by a provider with the Department of Insurance along with Form CE/PL-100 and Form CE/PL-200. It identifies the title of the course, the identity of the instructor and specifies the applicable filing fee.

      (13) Form CE/PL-200, "Instructor Approval Application," shall be filed with the Department of Insurance to request approval of continuing education and prelicensing instructors.

      (14) Form CE-300, "Continuing Education Course Attendance Roster," shall be filed by a certified provider with the Department of Insurance to certify licensees’ attendance at a continuing education course.

      (15) Form CE-301, "Approved Continuing Education Certificate of Completion," may be filed with the Department of Insurance to certify licensees’ completion of a continuing education course.

      (16) Form CA AFF 304, "Affidavit for Exemption from Continuing Education," shall be filed with the Department of Insurance by an agent that does not intend to sell any new insurance business to maintain his or her license to collect renewal commissions only.

      (17) Form 8301-SC, "Specialty Credit Insurance Producer Supplemental Application," shall be filed with the Department of Insurance by a specialty credit insurance producer to list the retail stores that are included under the license.

      (18) Form 8301-RV, "Rental Vehicle License – Supplementation Application," shall be filed with the Department of Insurance by a rental vehicle insurance producer to list the retail stores that are included under the license.

      (19) Form CE/RV-302, "Continuing Education Certificate of Completion, Rental Vehicle Managing Employee," shall be filed with the Department of Insurance to certify the completion of the managing employee’s continuing education.

      (20) Form CE/RV-303, "Continuing Education Certification of Completion, Unlicensed Employees and Representatives," shall be filed with the Department of Insurance to certify the completion of continuing education by all unlicensed employees.

      (21) Form 8303, "Record Correction Form," shall be filed with the Department of Insurance by a licensee to make a change to the licensee’s name or address.

      (22) Form 8301-BGC, "Licensing Request Form," shall be filed by an applicant with the Administrative Office of the Courts to request a criminal background check that is required prior to licensing.

      (23) Form MLW-01, "Request for Waiver of Renewal Procedures or Exemption from Examination or Extension for Continuing Education Due to Active Military Service Deployment," is the form that members of the Armed Forces who have been mobilized or deployed in support of their duties may use to request a waiver of renewal penalties and sanction, a waiver of continuing education requirements, an exemption of examination, or an extension of time for completion of continuing education requirements.

      (24) "NAIC Uniform Continuing Education Reciprocity Course Filing Form" is the form that continuing education providers may submit to request course approval if the course is being offered in multiple states.

 

      Section 2. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) Form CPL-01, "Certificate of Prelicensing Course Completion (9/2008 edition)";

      (b) Form 8301, "NAIC Individual Insurance Producer License Application (9/2008)";

      (c) Form 8301-BE, "NAIC Business Entity License Application (9/2008)";

      (d) Form 8302-AP, "Producer Appointment (9/2008 edition)";

      (e) Form 8302-TE, "Termination of Producer Appointment (9/2008 edition)";

      (f) Form VS, "Application for Voluntary Surrender of License (9/2008 edition)";

      (g) Form 8305, "Business Entity Designation or Termination of Designation Form (9/2008 edition)";

      (h) Form 8307, "Request for Unlicensed Adjuster Representing an Insurer to Adjust Losses Resulting From a Catastrophe (9/2008 edition)";

      (i) Form 8304, "Examination Retake Form (9/2008 edition)";

      (j) Form KYP-01, "Provider Approval Application (9/2008 edition)";

      (k) Form CE/PL-100, "Course Approval Application (9/2008 edition)";

      (l) Form KYF-01, "Filing Fee Submission Form (9/2008 edition)";

      (m) Form CE/PL-200, "Instructor Approval Application" (9/2008 edition)";

      (n) Form CE-300, "Continuing Education Course Attendance Roster (11/2008 edition)";

      (o) Form CE-301, "Approved Continuing Education Certificate of Completion (9/2008 edition)";

      (p) Form CE AFF 304, "Affidavit for Exemption from Continuing Education (9/2008 edition)";

      (q) Form 8301-SC, "Specialty Credit Insurance Producer Supplement to License Application (9/2008 edition)";

      (r) Form 8301-RV, "Rental Vehicle License - Supplemental Application (9/2008 edition)";

      (s) Form CE/RV-302, "Continuing Education Certificate of Completion, Rental Vehicle Managing Employee (9/2008 edition)";

      (t) Form CE/RV-303, "Continuing Education Certificate of Completion, Unlicensed Employees and Representatives (9/2008 edition)";

      (u) Form 8303, "Record Correction Form (9/2008 edition)"; and

      (v) Form 8301-BGC, "Licensing Request Form (9/2008 edition)"; and

      (w) Form MLW-01, "Request for Waiver of Renewal Procedures or Exemption from Examination or Extension for Continuing Education Due to Active Military Service Deployment (10/2007 edition); and

      (x) "NAIC Uniform Continuing Education Reciprocity Course Filing Form" (2004 edition).

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Department of Insurance, 215 West Main Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m., or on the Department of Insurance Web site, http://doi.ppr.ky.gov. (32 Ky.R. 442; 884; eff. 12-2-2005; 35 Ky.R. 1027; 1489; eff. 2-6-09.)

Notation

      RELATES TO: KRS 304.9-080, 304.9-105, 304.9-130, 304.9-140, 304.9-150, 304.9-160, 304.9-190, 304.9-200, 304.9-220, 304.3-230, 304.9-260(3), 304.9-270, 304.9-280, 304.9-295, 304.9-320, 304.9-430, 304.9-432, 304.9-480, 304.9-485, 304.9-505(4), 304.9-513, 304.9-705, 304.15-700

      STATUTORY AUTHORITY: KRS 304.2-110(1), 304.9-160(1), 304.9-230(2), 304.9-295(9), KRS 304.9-430(1), 304.9-485(2), 304.9-513, 304.15-700, 304.15-720

      NECESSITY, FUNCTION, AND CONFORMITY: EO 2008-507, signed June 6, 2008, and effective June 16, 2008, created the Department of Insurance, headed by the Commissioner of Insurance. KRS 304.2-110(1) authorizes the executive director to adopt reasonable administrative regulations necessary for or as an aid to the effectuation of the Kentucky Insurance Code as defined in KRS 304.1-010. KRS 304.9-160(4) authorizes the executive director to develop examinations in accordance with administrative regulations promulgated by the executive director. KRS 304.9-230(2) authorizes the executive director to establish requirements for the examination for limited lines licenses. KRS 304.9-295(9) authorizes the executive director to prescribe a form for the certification of continuing education hours. KRS 304.9-430(1) requires the executive director to prescribe forms related to the adjuster examination process. KRS 304.9-485(2) directs the executive director to prescribe application forms for specialty credit insurance producers and managing employees. KRS 304.9-505(4) authorizes the executive director to prescribe forms for the licensing of rental vehicle agents and managing employees. KRS 304.9-513 authorizes the executive director to promulgate administrative regulations to carry out the purpose of KRS 304.9-501 to 304.9-513. KRS 304.15-700(2) authorizes the executive director to prescribe forms for the licensing of life settlement providers and life settlement brokers. KRS 304.15-720 authorizes the executive director to promulgate administrative regulations to implement KRS 304.15-700 to 304.15-720.