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.

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, 304.3-230, 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(4), 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: 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 viatical settlement providers and viatical settlement brokers. KRS 304.15-720 authorizes the executive director to promulgate administrative regulations to implement KRS 304.15-700 to 304.15-720.

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

(2) Form 8301, "Individual Insurance Producer License Application," shall be filed by an individual applicant with the Office 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, viatical settlement broker and viatical settlement provider.

(3) Form 8301-BE, "Business Entity License Application," shall be filed with the Office 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, "Appointment Form," shall be filed by an insurer to notify the Office of Insurance that an individual or business entity agent or agency has been appointed to represent the insurer.

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

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

(7) Form 8305, "Business Entity Designation or Termination of Designation Form," shall be filed with the Office 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 Activity," shall be filed with the Office 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 Office 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 Office 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 Office 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 Office 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 Office 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 Office of Insurance to certify licensees’ attendance at a continuing education course.

(15) Form CE-301, "Continuing Education Certificate of Completion," may be filed with the Office 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 Office 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 Supplement to License Application," shall be filed with the Office 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 Office 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 Office 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 Representative of Rental Vehicle Agent," shall be filed with the Office of Insurance to certify the completion of continuing education by all unlicensed employees.

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

(22) Form 8301-BGC, "Background Check 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.

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

(a) Form CPL-01, "Certificate of Prelicensing Course Completion (5/2005 edition)";

(b) Form 8301, "Individual Insurance Producer License Application (5/2005 edition)";

(d) Form 8302-AP, "Appointment Form (5/2005 edition)";

(e) Form 8302-TE, "Termination of Producer Appointment (5/2005 edition)";

(f) Form VS, "Voluntary Surrender of License (5/2005 edition)";

(g) Form 8305, "Business Entity Designation or Termination of Designation Form (5/2005 edition)";

(h) Form 8307, "Request for Unlicensed Adjuster Activity (5/2005 edition)";

(i) Form 8304, "Examination Retake Form (5/2005 edition)";

(j) Form KYP-01, "Provider Approval Application (5/2005 edition)";

(k) Form CE/PL-100, "Course Approval Application (5/2005 edition)";

(l) Form KYF-01, "Filing Fee Submission Form (5/2005 edition)";

(m) Form CE/PL-200, "Instructor Approval Application" (5/2005 edition)";

(n) Form CE-300, "Continuing Education Course Attendance Roster (5/2005 edition)";

(o) Form CE-301, "Continuing Education Certificate of Completion (5/2005 edition)";

(p) Form CE AFF 304, "Affidavit for Exemption from Continuing Education (5/2005 edition)";

(q) Form 8301-SC, "Specialty Credit Insurance Producer Supplement to License Application (5/2005 edition)";

(r) Form 8301-RV, "Rental Vehicle License - Supplemental Application (5/2005 edition)";

(s) Form CE/RV-302, "Continuing Education Certificate of Completion, Rental Vehicle Managing Employee (5/2005 edition)";

(t) Form CE/RV-303, "Continuing Education Certificate of Completion, Unlicensed Employees and Representatives of Rental Vehicle Agent (5/2005 edition)";

(u) Form 8303, "Record Correction Form (5/2005 edition)"; and

(v) Form 8301-BGC, "Background Check Request Form (5/2005 edition)".

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