National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Notice of FY 2024 Arrangement
Notice.
Citation: "88 FR 12389"
Document Number: "Docket ID FEMA-2022-0051"
Page Number: "12389"
"Notices"
Agency: "
SUMMARY: The
DATES: Interested insurers must submit intent to subscribe or re-subscribe to the Arrangement by
FOR FURTHER INFORMATION CONTACT:
SUPPLEMENTARY INFORMATION:
I. Background The National Flood Insurance Act of 1968 (NFIA) (42 U.S.C. 4001 et seq.) authorizes the Administrator of the
Pursuant to this authority,
II. Notice of Availability
Insurers interested in participating in the
Prior participation in the WYO Program does not guarantee
Any private insurance company with questions may contact
III. Fiscal Year 2024 Arrangement
Pursuant to 44 CFR 62.23(a),
1. In Article III.A (Undertakings of the Company), under Operations Plan,
2. In Article III.A (Undertakings of the Company), under subsection (5) (Operations Plan),
3. In Article IV.C (Loss Costs, Expenses, Expense Reimbursement, and Premium Refunds),
4. In Article IV.D (Loss Costs, Expenses, Expense Reimbursement, and Premium Refunds),
5. In Article IV.D (Loss Costs, Expenses, Expense Reimbursement, and Premium Refunds),
The Fiscal Year 2024 Arrangement reads as follows:
Financial Assistance/Subsidy Arrangement
Article I. General Provisions
A. Parties. The parties to the Financial Assistance/Subsidy Arrangement are the
B. Purpose. The purpose of this Financial Assistance/Subsidy Arrangement is to authorize the Company to sell and service flood insurance policies made available through the National Flood Insurance Program (NFIP) and adjust and pay claims arising under such policies as fiscal agents of the Federal Government.
C. Authority. This Financial Assistance/Subsidy Arrangement is authorized under the National Flood Insurance Act of 1968 (NFIA) (42 U.S.C. 4001 et seq.), and in particular, section 1345(a) of the NFIA (42 U.S.C. 4081(a)), as implemented by 44 CFR 62.23 and 62.24.
Article II. Commencement and Termination
A. The effective period of this Arrangement begins on
B. Pursuant to 44 CFR 62.23(a),
C. Requesting Participation in WYO Program. Insurers interested in participating in the WYO Program, who have never participated in the program, or who are returning to the program after a period of non-participation, must submit a written request to participate.
1. Participation is then contingent on submission of both:
a. A completed application package, the requirements and contents of which
b. A completed operations plan, whose requirements and contents are outlined at Article III.A.5 of this Arrangement.
2. Insurers who are already participating in the program must submit their operations plan within ninety (90) days as outlined in Article III.A.5 of this Arrangement.
D. In addition to the requirements of Article II.B, in order to ensure uninterrupted service to policyholders, the Company must notify
1.
a. A plan for the orderly transfer to
b. All data received, produced, and maintained through the life of the Company's participation in the Program, including certain data, as determined by
c. All claims and policy files, including those pertaining to receipts and disbursements that have occurred during the life of each policy. In the event of a transfer of the services provided, the Company must provide
d. All funds in its possession with respect to any policies transferred to
e. A point of contact within the Company responsible for addressing issues that may arise from the Company's previous participation under the WYO Program.
2. Within ninety (90) calendar days of receiving the Company's data and supporting documentation,
3.
a. An assurance of uninterrupted service to policyholders.
b. A detailed transfer plan providing for either: (1) the renewal of the Company's NFIP policies by one or more other WYO companies; or (2) the transfer of the Company's NFIP policies to one or more other WYO companies.
c. A description of who the responsible party will be for liabilities relating to losses incurred by the Company in this or preceding Arrangement years.
d. A point of contact within the Company responsible for addressing issues that may arise from the Company's previous participation under the WYO Program.
E. Cancellation by
1.
a. Fraud or misrepresentation by the Company subsequent to the inception of the Arrangement.
b. Nonpayment to
c. Material failure to comply with the requirements of this Arrangement or with the written standards, procedures, or guidance issued by
d. Failure to maintain compliance with WYO company participation criteria at 44 CFR 62.24.
e. Any other cause so serious or compelling a nature that affects the Company's present responsibility.
2. If
3. As an alternative to the transfer of the policies to
F. In the event that the Company is unable or otherwise fails to carry out its obligations under this Arrangement by reason of any order or directive duly issued by the
1. An independent financial rating company downgrades its financial strength during its period of performance under this Arrangement; or
2. It receives a State department of insurance order or directive making it unable to carry out its obligations under this Arrangement, including but not limited to being placed in receivership or run-off status by a State department of insurance.
G. In the event the Act is amended, repealed, expires, or if
H. If
Article III. Undertakings of the Company
A. Responsibilities of the Company.
1. Policy Issuance and Maintenance. The Company must meet all requirements of the Financial Control Plan and any guidance issued by
a. Compliance with Rating Procedures.
b. Eligibility Determinations.
c. Policy Issuances.
d. Policy Endorsements.
e. Policy Cancellations.
f. Policy Correspondence.
g. Payment of Agents' Commissions.
h. Fund management, including the receipt, recording, disbursement, and timely deposit of NFIP funds.
2. The Company must provide a live customer service agent that (1) is accessible to all policyholders via telephone during business days, and (2) can resolve commonplace customer service issues.
3. Claims Processing.
a. In general. The Company must process all claims consistent with the Standard Flood Insurance Policy, Financial Control Plan, Claims Manual, other guidance adopted by
b. Adjuster registration. The Company may not use an independent adjuster to adjust a claim unless the independent adjuster:
i. Holds a valid Flood Control Number issued by
ii. Participates in the Flood Adjuster Capacity Program.
c. Claim reinspections. The Company must cooperate with any claim reinspection by
4. Reports. The Company must certify its business under the WYO Program through monthly financial reports in accordance with the requirements of the Pivot Use Procedures. The Company must follow the Financial Control Plan and the WYO Accounting Procedures Manual.
5. Operations Plan. Within ninety (90) calendar days of the commencement of this Arrangement, the Company must submit a written Operations Plan to
a. Private Flood Insurance Separation Plan. If applicable, a description of the Company's policies, procedures, and practices separating their NFIP flood insurance lines of business from their non-NFIP flood insurance lines of business, including its implementation of Article III.E.
b. Marketing Plan. A marketing plan describing the Company's forecasted growth, efforts to achieve that growth, and ability to comply with any marketing guidelines provided by
c. Policy Retention Plan. A retention plan describing the Company's efforts to retain and renew policies and methods of communicating with policyholders on renewals.
d. Customer Service Plan. A description of overall customer service practices, including ongoing and planned improvement efforts.
e. Distribution Plan. A description of the Company's NFIP flood insurance distribution network, including anticipated numbers of agents, efforts to train those agents, and an average rate of commissions paid to producers by state.
f. Catastrophic Claims Handling Plan. A catastrophic claims handling plan describing how the Company will respond and maintain service standards in catastrophic flood events, including:
i. Deploying mobile or temporary claims centers to provide immediate policyholder assistance, including submission of notice of loss and claim status information.
ii. Preparing people, processes, and tools for claims processing in remote work scenarios.
iii. Preparing communications in advance for readiness throughout the year including a suite of printed and digital materials (e.g., advertisements, educational materials, social media messaging, website blogs and announcements) that provide key messaging to stakeholders, including policyholders, agents, and the public following a catastrophic flood event.
iv. Identifying the core areas of information technology that need to be scaled pre-event or are scalable post-event.
g. Business Continuity Plan. A business continuity plan identifying threats and risks facing the Company's NFIP-related operations and how the Company will maintain operations in the event of a disaster affecting its operational capabilities.
h. Privacy Protection Plan. A privacy protection plan that describes the Company's standards for using and maintaining personally identifiable information.
i. System Security Plan. A system security plan that describes system boundaries, system environments of operation, how security requirements are implemented, and the relationships with or connections to other systems, including plans of action that describe how unimplemented security requirements will be met and how any planned mitigations will be implemented, prepared in accordance with either:
i.
ii. Another comparable standard deemed acceptable by
B. Time Standards. WYO companies must meet the time standards provided below. Time will be measured from the date of receipt through the date the task is completed. In addition to the standards set forth below, all functions performed by the Company must be in accordance with the highest reasonably attainable quality standards generally used in the insurance and data processing field. Applicable time standards are:
1. Application Processing--fifteen (15) business days (Note: if the policy cannot be sent due to insufficient or erroneous information or insufficient funds, the Company must send a request for correction or added moneys within ten (10) business days.
2. Renewal processing--seven (7) business days.
3. Endorsement processing--fifteen (15) business days.
4. Cancellation processing--fifteen (15) business days.
5. File examination--seven (7) business days from the day the Company receives the final report.
6. Claims draft processing--seven (7) business days from completion of file examination.
7. Claims adjustment--forty-five (45) calendar days average from the receipt of Notice of Loss (or equivalent) through completion of examination.
8. Upload transactions to Pivot--one (1) business day.
C. Policy Issuance.
1. The flood insurance subject to this Arrangement must be only that insurance written by the Company in its own name pursuant to the Act.
2. The Company must issue policies under the regulations prescribed by
3. The Company must issue all policies in consideration of such premiums and upon such terms and conditions and in such states or areas or subdivisions thereof as may be designated by
D. Lapse of Authority or Appropriation.
E. Separation of Finances and Other Lines of
1. The Company must separate Federal flood insurance funds from all other Company accounts, at a bank or banks of its choosing for the collection, retention and disbursement of Federal funds relating to its obligation under this Arrangement, less the Company's expenses as set forth in Article IV. The Company must remit all funds not required to meet current expenditures to the United States Treasury, in accordance with the provisions of the WYO Accounting Procedures Manual.
2. Other Undertakings of the Company.
a. Clear communication. If the Company also offers insurance policies covering the peril of flood outside of the NFIP in any geographic area in which Program authorizes the purchase of flood insurance, the Company must ensure that all public communications (whether written, recorded, electronic, or other) regarding non-NFIP insurance lines would not lead a reasonable person to believe that the NFIP,
b. Data protection. The company may not use non-public data, information, or resources obtained in course of executing this Arrangement to further or support any activities outside the scope of this Arrangement.
F. Claims. The Company must investigate, adjust, settle, and defend all claims or losses arising from policies issued under this Arrangement. Payment of flood insurance claims by the Company bind
G. Compliance with Agency Standards and Guidelines.
1. The Company must comply with the Act, regulations, written standards, procedures, and guidance issued by
a. WYO Program Financial Control Plan.
b. Pivot Use Procedures.
c. NFIP Flood Insurance Manual.
d. NFIP Claims Manual.
e. NFIP Litigation Manual.
f. WYO Accounting Procedures Manual.
g. WYO Bulletins.
2. The Company must market flood insurance policies in a manner consistent with marketing guidelines established by
3.
4. The Company must notify its agents of the requirement to comply with State regulations regarding flood insurance agent education, notify agents of flood insurance training opportunities, and assist
H. Compliance with Appeals Process.
1. In general.
a. All records created or maintained pursuant to this Arrangement requested by
b. A comprehensive claim file synopsis, redacted of personally identifiable information, that includes a summary of the appeal issues, the Company's position on each issue, and any additional relevant information. If, in the process of writing the synopsis, the Company determines that it can address the issue raised by the policyholder on appeal without further direction, it must notify
2. Cooperation. The Company must cooperate with
3. Resolution of Appeals.
a.
b.
c. The Company independently resolves the issue raised by the policyholder without further direction.
d. The policyholder voluntarily withdraws the appeal.
e. The policyholder files litigation.
4. Processing of Additional Payments from Appeal. The Company must follow established NFIP adjusting practices and claim handling procedures for appeals that result in additional payment to a policyholder when
5. Time Standards.
a. Provide
b. Provide
c. Responding to inquiries from
d. Inform
I. Subrogation.
1. In general. Consistent with Federal law and guidance, the Company must use its customary business practices when pursuing subrogation.
2. Referral to
3. Notification. No more than ten (10) calendar days after either the Company identifies a possible subrogation claim or
4. Cooperation. Pursuant to 44 CFR 62.23(i)(11), the Company must extend reasonable cooperation to
J. Access to Records. The Company must furnish to
K. System for Award Management (SAM). The Company must be registered in the System for Award Management. Such registration must have an active status during the period of performance under this Arrangement. The Company must ensure that its SAM registration is accurate and up to date.
L. Cybersecurity.
1. In general. Unless the Company uses a compliance alternative pursuant to Article III.L.2, the Company must implement the security requirements specified by
2. Compliance alternatives. In lieu of compliance with Article IV.L.1, the Company may either:
a. Provide
i. ISO/IEC 27001, https://www.iso.org/isoiec-27001-information-security.html;
ii. NIST Cybersecurity Framework, https://csrc.nist.gov/publications/detail/sp/800-171/rev-2/final;
iii. Cybersecurity Maturity Model Certification (CMMC 2.0), https://dodcio.defense.gov/CMMC/;
iv. Service and Organization Controls (SOC) 2, https://www.aicpa.org/interestareas/frc/assuranceadvisoryservices/sorhome.html; or
v. Another comparable standard deemed acceptable by
b. Provide a plan of action that describes how unimplemented security requirements of NIST SP 800-171, rev. 2, (https://csrc.nist.gov/publications/detail/sp/800-171/rev-2/final) will be met and how any planned mitigations will be implemented as part of the system security plan required under Article III.A.4.h.
Article IV. Loss Costs, Expenses, Expense Reimbursement, and Premium Refunds
A. The Company is liable for operating, administrative, and production expenses, including any State premium taxes, dividends, agents' commissions or any other expense of whatever nature incurred by the Company in the performance of its obligations under this Arrangement but excluding other taxes or fees, such as municipal or county premium taxes, surcharges on flood insurance premium, and guaranty fund assessments.
1. Operating and Administrative Expenses. The Company may withhold, as operating and administrative expenses, other than agents' or brokers' commissions, an amount from the Company's written premium on the policies covered by this Arrangement in reimbursement of all of the Company's marketing, operating, and administrative expenses, except for allocated and unallocated loss adjustment expenses described in Article IV.C. This amount will equal the sum of the average industry expenses ratios for "Other Act.", "Gen. Exp." And "Taxes" calculated by aggregating premiums and expense amounts for each of five property coverages using direct premium and expense information to derive weighted average expense ratios. For this purpose,
2. Agent Compensation. The Company may retain fifteen (15) percent of the Company's written premium on the policies covered by this Arrangement as the commission allowance to meet the commissions or salaries of insurance agents, brokers, or other entities producing qualified flood insurance applications and other related expenses.
3. Growth Bonus.
C.
1.
2.
3.
D. Loss Payments.
1. The Company must make loss payments for flood insurance policies from federal funds retained in the bank account(s) established under Article III.E.1 and, if such funds are depleted, from Federal funds withdrawn from the
2. Loss payments include payments because of litigation that arises under the scope of this Arrangement, and the Authorities set forth herein. All such loss payments and related expenses must meet the documentation requirements of the Financial Control Plan and of this Arrangement, and the Company must comply with the litigation documentation and notification requirements established by
3. Oversight of Litigation.
a. Any litigation resulting from, related to, or arising from the Company's compliance with the written standards, procedures, and guidance issued by
b. The Company must conduct and oversee litigation arising out of the Company's participation in the NFIP in accordance with the National Flood Insurance Program Litigation Manual. If not addressed by the NFIP Litigation Manual, the Company should utilize its customary business practices for its defense of property and casualty litigation, including billing rates and standards.
c.
i. Grounded in actions by the Company that are significantly outside the scope of this Arrangement; or
ii. Involves issues of agent negligence.
E. Refunds. The Company must make premium refunds required by
F. Suspension and Debarment.
1. In general. The Company may not contract with or employ any person who is suspended or debarred from participating in federal transactions pursuant to 2 CFR part 180 (covering federal nonprocurement transactions) or 48 CFR part 9, subpart 9.4 (covering federal procurement transactions) in relation to this Arrangement.
2. Reimbursement.
3. Compliance. The Company may ensure compliance with Article IV.F.1 by:
a. Checking the System for Awards Management at sam.gov;
b. Collecting a certification from that person; or
c. Adding a clause or condition to the transaction with that person.
Article V. Undertakings of the Government
A.
1. Payment of claims, as described in Article IV.D.
2. Refunds to applicants and policyholders for insurance premium overpayment, or if the application for insurance is rejected or when cancellation or endorsement of a policy results in a premium refund, as described in Article IV.E.
3. Allocated and unallocated loss adjustment expenses, as described in Article IV.C.
B.
1. NFIP policy and history.
2. Clarification of underwriting, coverage, and claims handling.
3. Other assistance as needed.
C.
Article VI. Cash Management and Accounting
A.
B. The Company must remit all funds, including interest, not required to meet current expenditures to the United States Treasury, in accordance with the provisions of the WYO Accounting Procedures Manual or procedures approved in writing by
C. In the event the Company elects not to participate in the Program in this or any subsequent fiscal year, or is otherwise unable or not permitted to participate, the Company and
D. Upon
E. The Company must comply with the requirements of the False Claims Act (41 U.S.C. 3729-3733), which prohibits submission of false or fraudulent claims for payment to the Federal Government.
Article VII. Arbitration
If any misunderstanding or dispute arises between the Company and
The two arbitrators so chosen, if they are unable to reach an agreement, must select a third arbitrator who must act as umpire, and such umpire's determination will become final only upon approval by
This Article shall indefinitely succeed the term of this Arrangement.
Article VIII. Errors and Omissions
A. In the event of negligence by the Company that has not resulted in litigation but has resulted in a claim against the Company,
Article IX. Officials Not To Benefit
No Member or Delegate to
Article X. Offset
At the settlement of accounts, the Company and
All debts or credits of the same class, whether liquidated or unliquidated, in favor of or against either party to this Arrangement on the date of entry, or any order of conservation, receivership, or liquidation, shall be deemed to be mutual debts and credits and shall be offset with the balance only to be allowed or paid. No offset shall be allowed where a conservator, receiver, or liquidator has been appointed and where an obligation was purchased by or transferred to a party hereunder to be used as an offset.
Although a claim on the part of either party against the other may be unliquidated or undetermined in amount on the date of the entry of the order, such claim will be regarded as being in existence as of the date of such order and any credits or claims of the same class then in existence and held by the other party may be offset against it.
Article XI. Equal Opportunity
A. Age Discrimination Act of 1975. The Company must comply with the requirements of the Age Discrimination Act of 1975, Public Law 94-135 (42 U.S.C. 6101 et seq.) which prohibits discrimination on the basis of age in any program or activity receiving federal financial assistance.
B. Americans with Disabilities Act. The Company must comply with the requirements of Titles I, II, and III of the Americans with Disabilities Act, Public Law 101-336 (42 U.S.C. 12101-12213), which prohibits recipients from discriminating on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing entities.
C. Civil Rights Act of 1964--Title VI. The Company must comply with the requirements of Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), which provides that no person in
D. Civil Rights Act of 1968. The Company must comply with Title VIII of the Civil Rights Act of 1968, which prohibits recipients from discriminating in the sale, rental, financing, and advertising of dwellings, or in the provision of services in connection therewith, on the basis of race, color, national origin, religion, disability, familial status, and sex as implemented by the
E. Rehabilitation Act of 1973. The Company must comply with the requirements of Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), which provides that no otherwise qualified handicapped individuals in
Article XII. Access to Books and Records
A. Audits.
B. Nondisclosure by
C. Nondisclosure by Company.
1. In general. The Company, to the extent permitted by law, must safeguard and treat information submitted or made available by
2. Other protections. Article XII.C.1 shall not be construed as to limit the effect of any other requirement on the Company to protect information from disclosure, including a joint defense agreement or under the Privacy Act.
Article XIII. Compliance With Act and Regulations
This Arrangement and all policies of insurance issued pursuant thereto are subject to Federal law and regulations.
Article XIV. Relationship Between the Parties and the Insured
Inasmuch as the Federal Government is a guarantor hereunder, the primary relationship between the Company and the Federal Government is one of a fiduciary nature, that is, to ensure that any taxpayer funds are accounted for and appropriately expended. The Company is a fiscal agent of the Federal Government, but is not a general agent of the Federal Government. The Company is solely responsible for its obligations to its insured under any policy issued pursuant hereto, such that the Federal Government is not a proper party to any lawsuit arising out of such policies.
Authority: 42 U.S.C. 4071, 4081; 44 CFR 62.23.
Assistant Administrator (Acting) for
[FR Doc. 2023-03895 Filed 2-24-23;
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