Resolution No. JPRF-S-2024-0116 — Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels

| Postal Code: 170507 | Quito - Ecuador |
THE FINANCIAL POLICY AND REGULATION BOARD
CONSIDERING:
That Article 82 of the Constitution of the Republic of Ecuador prescribes that the right to legal security is based on respect for the Constitution and on the existence of prior, clear, public legal norms applied by competent authorities; That Article 226 of the Magna Carta provides that state institutions, their agencies, dependencies, public servants, and persons acting by virtue of a state power shall exercise only the competencies and faculties attributed to them in the Constitution and the law; having the duty to coordinate necessary actions for the effective fulfillment of rights recognized in the Constitution; That Article 227 of the Supreme Norm establishes that Public Administration constitutes a service to the community governed by the principles of effectiveness, efficiency, quality, hierarchy, decentralization, concentration, coordination, participation, planning, transparency, and evaluation; That Article 13 of the Organic Monetary and Financial Code, Book I, created the Financial Policy and Regulation Board, part of the Executive Function, as a public law legal entity, with administrative, financial, and operational autonomy, responsible for the formulation of credit, financial, securities, insurance, and prepaid comprehensive health care services policy and regulation; That the Article numbered following the aforementioned Article 6 provides that organisms with regulatory, normative, or control capacity shall seek to adopt as a reference framework international technical standards related to the scope of their competence for the issuance of regulations, strictly adhering to the normative hierarchy established in the Constitution of the Republic of Ecuador; That Article 14 ibidem, in numbers 1 and 2, provides that it corresponds to the Financial Policy and Regulation Board within its scope of competence to formulate insurance and prepaid comprehensive health care services policies, as well as to issue regulations that allow maintaining the integrity, solidity, sustainability, and stability of insurance and prepaid comprehensive health care services systems; That numbers 1, 9, 14 letter b., 15 letters c. and d., 17, 25, and 27 of Article 14.1 of the aforementioned Organic Monetary and Financial Code, Book I, stipulate that it corresponds to the Financial Policy and Regulation Board, among other faculties, the following: i) regulate the creation, constitution, organization, activities, operation, and liquidation of financial entities, insurance, and prepaid comprehensive health care services; ii) issue the non-prudential regulatory framework for all financial entities, insurance, and prepaid comprehensive health care services; iii) authorize financial entities, insurance, and prepaid comprehensive health care services, new activities or operations that, without being prohibited, are necessary for the fulfillment of financial, insurance, and prepaid comprehensive health care services policy, according to the regulations issued for that
effect; iv) establish, within the framework of its competencies, any measure that helps promote financial inclusion, promoting the participation of financial entities, insurance, and prepaid comprehensive health care services; v) issue norms regulating insurance and reinsurance; vi) apply the provisions of said Code and resolve cases not provided for therein, within its scope of competence; and, vii) exercise the other functions, duties, and faculties assigned to it by the Organic Monetary and Financial Code and the law;

---

| Postal Code: 170507 | Quito - Ecuador |
That number 1 of Article 25.1 ibidem prescribes, as one of the functions of the Technical Secretariat of the Financial Policy and Regulation Board, the elaboration of technical and legal reports that support the regulation proposals that the Financial Policy and Regulation Board will issue; That the Fifty-Fourth Transitional Provision of the Organic Monetary and Financial Code, Book I, prescribes: “Transitional Regime of Resolutions of the Codification of the Monetary and Financial Policy and Regulation Board. The resolutions contained in the Codification of Monetary, Financial, Securities, and Insurance Resolutions of the Monetary and Financial Policy and Regulation Board and the norms issued by control organisms will maintain their validity until the Monetary Policy and Regulation Board and the Financial Policy and Regulation Board resolve what corresponds, within the scope of their competencies.”; That the Acting Technical Secretary of the Financial Policy and Regulation Board, through Memorandum No. JPRF-ST-2024-0073-M of July 2, 2024, submits to the President of the Board the Technical Legal Report No. JPRF-CTCJ-2024-010 of July 1, 2024, issued by the Technical Secretariat of this Board, which supports the recommendation to carry out reforms in Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions, as well as the respective draft resolution; That the Financial Policy and Regulation Board, in an extraordinary session held by technological means, convened on July 2, 2024, and carried out via video conference on July 4, 2024, reviewed Memorandum No. JPRF-ST-2024-0073-M of July 2, 2024, issued by the Acting Technical Secretary of the Board; as well as Technical Legal Report No. JPRF-CTCJ-2024-010 of July 1, 2024, in addition to the corresponding draft resolution; That the Financial Policy and Regulation Board, in an extraordinary session held by technological means, convened on July 2, 2024, and carried out via video conference on July 4, 2024, reviewed and approved the following Resolution; and, In exercise of its functions, RESOLVES:
ARTICLE FIRST.- In Article 2 of Section I “Scope and Definitions”, Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions, the following reforms are made:

• The text of the definition of “Bank Insurance” is replaced by the following:
  “Bank Insurance: Entities of the public financial sector, private financial sector, or popular and solidary financial sector, which, for the purposes of this norm, in addition to their main activity, may promote, offer, market, and contract insurance products through all their physical or digital channels, in accordance with current regulations.”

---

| Postal Code: 170507 | Quito - Ecuador |

• The text of the definition of “Beneficiary” is replaced by the following:
  “Beneficiary: Is who will be indemnified upon the occurrence of a claim or the person(s) designated in the prepaid comprehensive health care services contract or medical assistance insurance policy, who(ever) will enjoy the financing of prepaid comprehensive health care services or medical assistance coverage, in exchange for a fee or premium, the amount of which will depend on the contracted plan. In the case of insurance or plans from companies that finance prepaid comprehensive health care services marketed through alternative distribution channels, the policyholder or applicant cannot be the beneficiary.”
• The text of the definition of “Alternative Distribution Channel” is replaced by the following:
  “Alternative Distribution Channel: Those legal persons that are not part of the private insurance system or the companies that finance prepaid comprehensive health care services may act as an alternative distribution channel. For contracting through an alternative channel of the national financial system, the provisions in matters of financial user rights protection shall be observed.”
• The text of the definition of “Insurance or plans from companies that finance prepaid comprehensive health care services that can be marketed through alternative distribution channels” is replaced by the following:
  “Insurance or plans from companies that finance prepaid comprehensive health care services that can be marketed through alternative distribution channels: Are those that must be standardized to be offered massively to a given segment of the population. Simple products, easy to distribute, in which the design of the insurance or prepaid comprehensive health care services plan does not require individual underwriting for each case. They are of automatic sale and the conditions are those established in the offer prospectus at the time of sale to the insured or affiliate.”
  ARTICLE SECOND.- The text of letter a) of Article 3 of Section II “Requirements of Alternative Distribution Channels”, Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions is replaced by the following:
  “Have a valid tax registry RUC before the Internal Revenue Service (SRI);”
  ARTICLE THIRD.- In Article 5 of Section III “Obligations and Responsibilities of Insurance Companies, Companies that Finance Prepaid Comprehensive Health Care Services, and Alternative Distribution Channels”, Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions, the following reforms are made:
• The text of letter d) is replaced by the following:

---

| Postal Code: 170507 | Quito - Ecuador |
“Obtain the express acceptance of the insured or affiliate of each insurance or prepaid comprehensive health care services plan that they sell through alternative distribution channels.”

• The text of letter g) is replaced by the following:
  “Permanently train the personnel of the alternative distribution channel assigned to market insurance products or prepaid comprehensive health care services plans. This task may be delegated to the insurance producer advisor, in case they are part of the process. Insurance companies and companies that finance prepaid comprehensive health care services will annually inform the Superintendency of Companies, Securities, and Insurance of the training programs for alternative distribution channel personnel that guarantee the protection of the financial user. This information will be verified by the Superintendency of Companies, Securities, and Insurance.”
• The text of letter j) is replaced by the following:
  “Accept notifications of insurance termination by the insured or plan termination by the affiliate of the prepaid comprehensive health care services, by any means, whether digital, telematic, or physical means. The insurance company or the company that finances prepaid comprehensive health care services is obligated to proceed with termination only upon request of the insured or affiliate.”
  ARTICLE FOURTH.- In Article 8 of Section III “Obligations and Responsibilities of Insurance Companies, Companies that Finance Prepaid Comprehensive Health Care Services, and Alternative Distribution Channels”, Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions, the following reforms are made:
• The text of letter d) is replaced by the following:
  “Of confidentiality, through which the information of the insureds or affiliates shared between the alternative distribution channel and the insurance company or the company that finances prepaid comprehensive health care services is confidential, in order to avoid the use of client and/or user data for other purposes;”
• The text of letter h) is replaced by the following:
  “The obligation of the insurance company or the company that finances prepaid comprehensive health care services to provide the insureds or affiliates, through digital means or physically, the general and special conditions of the insurance contract or the prepaid comprehensive health care services plan.”
  ARTICLE FIFTH.- Following Article 10 of Section III “Obligations and Responsibilities of Insurance Companies, Companies that Finance Prepaid Comprehensive Health Care Services, and Alternative Distribution Channels”, Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions, the following unnumbered Article is incorporated:

---

| Postal Code: 170507 | Quito - Ecuador |
“Art....- For the case of prepaid comprehensive health care services, alternative distribution channels must deliver physically or digitally to the policyholders, together with the individual coverage certificate, a user guide in which clearly and briefly, at a minimum, the following appear: the covered risks, exclusions, and waiting periods, the grounds for contract resolution, the procedure, required documentation, and deadline to submit the reimbursement request, procedure to submit complaints or claims for user dissatisfaction with a service of the company, dispute resolution mechanisms, contact means of the company to handle user complaints and claims. In cases where the breadth of information warrants it, alternative distribution channels may refer to the prepaid comprehensive health care services provision contract, expressly indicating in the guide the content to which such information refers and the number of the corresponding article and/or clause, so that the policyholder has easy access to the provisions contained therein. Such guide must faithfully reflect the content of the prepaid comprehensive health care services provision contract. In the event that it is proven that conditions of the contract have been modified in the guide, the Superintendency of Companies, Securities, and Insurance will proceed in accordance with what is established in the Organic Law that Regulates Companies that Finance Prepaid Comprehensive Health Care Services and Insurance Companies that Offer Medical Assistance Coverage.”
ARTICLE SIXTH.- The text of General Provision First of Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions is replaced by the following:
“Accounting of commission payments. The Superintendency of Companies, Securities, and Insurance, through a circular letter, will determine the manner in which companies that finance prepaid comprehensive health care services will record the expenses generated by the associated cost or commissions paid to alternative distribution channels for the marketing carried out.”
ARTICLE SEVENTH.- General Provisions Third and Fourth of Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions are repealed.
ARTICLE EIGHTH.- General Provision Fifth of Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions is incorporated, as follows:
“FIFTH.- Insurance companies and companies that finance prepaid comprehensive health care services must submit to the Superintendency of Companies, Securities, and Insurance the information of the alternative distribution channels that market their insurance products or prepaid comprehensive health care services plans, which must at least contain the following information: Unique Tax Registry (RUC), corporate purpose, legal name,

---

| Postal Code: 170507 | Quito - Ecuador |
legal representative or attorney, domicile, date of constitution, telephone number, and email address.”
ARTICLE NINTH.- Transitional Provision Only of Chapter XII “Standards for the Promotion and Contracting of Insurance Policies and Prepaid Comprehensive Health Care Plans through Alternative Distribution Channels”, Title II “On the Constitution, Organization, Activities, and Functioning”, Book III “Private Insurance System” of the Codification of Monetary, Financial, Securities, and Insurance Resolutions is incorporated, as follows:
“TRANSITIONAL PROVISION ONLY.- The Superintendency of Companies, Securities, and Insurance, within a maximum period of six (6) months, will determine and inform the structure and content of the reports to be submitted by insurance companies and companies that finance prepaid comprehensive health care services regarding alternative distribution channels; the information supporting it must be reliable, sufficient, and updated; additionally, it will define within the established period, the periodicity and form of delivery of information by insurance companies and companies that finance prepaid comprehensive health care services.” GENERAL PROVISIONS FIRST.- The Superintendency of Companies, Securities, and Insurance will communicate to the respective controlled entities the content of this Resolution. SECOND.- In case of doubt regarding the content or scope of the provisions of this Resolution, it will correspond to the Superintendency of Companies, Securities, and Insurance to resolve them. FINAL PROVISION.- This Resolution will enter into force from the present date, without prejudice to its publication in the Official Register, and will be published on the institutional website of the Financial Policy and Regulation Board within a maximum term of two days from its issuance. NOTIFY.- Given in the Metropolitan District of Quito, on July 4, 2024. THE PRESIDENT, Mgs. María Paulina Vela Zambrano The aforementioned Resolution was processed and signed by Master María Paulina Vela Zambrano, President of the Financial Policy and Regulation Board, in the Metropolitan District of Quito, on July 4, 2024.- I CERTIFY. ACTING TECHNICAL SECRETARY Mgs. Luis Alfredo Olivares Murillo