Insurance helps in economic development of country by mobilising peoples saving by attracting them for investment in insurance policies. It aims at reducing the adverse effects of any future contingency by spreading the overall risk associated with it. Rates must be adequate so that the company can pay for claims filed and remain solvent. \text{Operating Income}&\$13,000&\$(g)\\\hline\hline Assisting in this objective are the regulatory efforts in the area of consumer protection in terms of rates and policy forms. 1. To certify the financial position and operating results of the company, the auditor verifies the financial statements and books of accounts. These verbs help in describing the course of action and give clarity to your object. The one that pays second (secondary payer) only pays if there are costs the primary insurer didnt cover. [22], In 2018, the majority of states began to require health insurers to submit market conduct data. It is the objective of an audit to offer an opinion on financial statements. [12], After the McCarran-Ferguson Act, the business of insurance remained substantially regulated by state statutory and administrative laws through the years. Which of the following is NOT an essential element of an insurance contract? \text{Gross Profit}&36,000&115,000\\ (E) Loss frequency rather than loss severity is the primary concern in underwriting Contact us. . C. The insured and the agent. In the reinsurance agreement, the reinsurer's obligation arises only when the company's liability under its original . established and maintains the plan is not a covered entity. Although the optional federal chartering proposal was defeated in the 1970s, it became the precursor for a modern debate over optional federal chartering in the last decade.[16]. Which of the following does the California Insurance Code NOT require an insurance policy to specify? Which word implies permissiveness according to the California Insurance Code? Primary insurance pays first for your medical bills. States regulate reinsurance agreements differently because the primary purpose of such regulation is to ensure the continuing solvency . These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. The California Insurance Code defines "policy" as a(n), The cost of services charged by the Health Insurance Counseling Advocacy Program (HiCap) is. Kimberly is an employee on leave under the Family and Medical Leave Act (FMLA). These TSCs are being elaborated in secondary legislation called Delegated Acts (DAs). \hspace{10pt}\text{Cost of Goods Available for Sale}&(b)&92,000\\ These cookies will be stored in your browser only with your consent. Statement that all values and benefits are guaranteed, According to the PPACA, the medical enrollment tier that has 80% actuarial value is called. How long must life agents keep their transaction records? Supporters of federal regulation also claim they can offer more competent regulators. We also use third-party cookies that help us analyze and understand how you use this website. Additionally, states set rules for how insurance can be marketed, seeking to avoid deceptive marketing practices in an effort to protect the average consumer and instill confidence in the insurance industry. There were 4 million variable life insurance policies in force and about 6.5 million individual variable annuities. It guarantees them of compensation in occurrence of any unfavourable contingencies. Section 1. [4] Prior to this period, insurance was primarily regulated by corporate charter, state statutory law and de facto regulation by the courts in judicial decisions. 15. Transfer all assets in your name to protective entities, Cover against Uncertainties. What does the term "indemnity" mean as it pertains to insurance? Lending of funds is not a function of insurance. Two of the major advantages of federal regulation are uniformity and efficiency. National Association of Insurance Commissioners (NAIC) (a State-based regulatory standards organization, the McCarran-Ferguson Act exempts the "business of insurance" from most regulation at the Federal level) National Credit Union Administration (NCUA) United Kingdom Bank of England (BoE) Prudential Regulation Authority (PRA) Its only objective was to suggest some public policy objectives in the field of insurance regulation.2 This paper does not formulate a theory of the purposes of insurance regulation but suggests some ideas complementary to Professor Kimball's efforts. The lack of confidence led to runs on banks, which quickly ran out of financial reserves. See, for example: Louisiana Revised Statutes, Title 22, 2A(1); National Association of Insurance Commissioners. Thus, the business of insurance, although primarily a matter of private contract, is nevertheless of such concern to the public as a whole that it is subject to governmental regulation to protect the publics interests. About the Affordable Care Act. Regulation and supervision in 41 - 43 the United States of America D. Monitoring of insurance operations 44 - 52 As . . What Is The Difference Between Cigna Dppo And Cigna Dppo Advantage? In what order are people on the MRMIP waiting list allowed to enroll? Consider the following partially completed income statements for merchandising companies and compute the missing amounts: Jones,Inc.Corrigan,Inc.Sales$99,000$(d)CostofGoodsSold:BeginningMerchandiseInventory(a)29,000PurchasesandFreightIn50,000(e)CostofGoodsAvailableforSale(b)92,000EndingMerchandiseInventory(2,100)(2,100)CostofGoodsSold63,000(f)GrossProfit36,000115,000SellingandAdministrativeExpenses(c)86,000OperatingIncome$13,000$(g)\begin{array}{lrr} Instead of this uncertainty, it provides the certainty of regular payment i.e. These cookies ensure basic functionalities and security features of the website, anonymously. Three of the key ones are The secondary payer (which may be Medicare) may not pay all the remaining costs. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Appendix A. Publishing a magazine where one of the advertisers is an insurer. Principle of Insurable Interest | lecture on insurance law | Principles of Insurance Contract - 01, Characteristics and Features of Fire Insurance. Primary insurance refers to the first insurance listed in the Patients Ability > Patient > Insurance tab, secondary insurance refers to the second insurance listed, and tertiary insurance refers to the third insurance listed. What is an insurance rate? By clicking Accept All, you consent to the use of ALL the cookies. Both the Patient Protection and Affordable Care Act (PPACA) and the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) are material forays of federal law into the insurance industry.[20]. The thrust of this paper is that, in regulating insurance companies, The first two objectives may be rolled together under the heading "high degree of economic efficiency". We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. The Office of Insurance Products (OIP) is responsible for the regulation of variable insurance under the Investment Company Act of 1940. Jim is applying to become an insurance agent and has a past misdemeanor conviction that was later expunged due to California Penal Code 1203.4. Medicare is a federally funded program that's purpose is to provide basic health insurance to those age 65 and over, as well as to other specific qualified individuals. As a result, audit objectives are divided into primary and secondary objectives. Question: What is the primary objective of insurance regulation in the united states? Insurance becomes an asset when you experience a risk covered in your insurance plan, which activates your coverage, allowing you to make a claim and receive a successful payout. Which of the following does NOT have to be included on life insurance policy illustrations? The primary objective of insurance regulation is to correct market imperfections and protect the public interest. Insurance policies relieves the individuals of any tension and fear regarding the future risks and uncertainties. What type of license is required for an individual who charges a fee to review an insured's existing life insurance policy? Licensing and regulating insurance companies and others involved in the insurance industry; Regulating and standardizing insurance policies and products; Controlling market conduct and preventing unfair trade practices; and. One of the key areas of state insurance regulation pertains to rate-setting. Which of the following acts is NOT a Federal offense committed by an insurance agent? Who Do I Contact About My National Insurance Number? Which of the following is NOT considered to be an unfair claims settlement practice? They also join hands with various organisations like fire brigade, health and various organisations which work for reducing losses and damages. All of these are considered objectives of insurance regulation EXCEPT "interpret policy provisions". The practice of insurance regulatory law involves providing legal services and counseling on a wide variety of administrative, corporate, insurance, transactional and regulatory issues such as the following: Insurance regulators generally perform "market conduct exams" to determine that insurers are operating in the best interests of consumers. Whether youve contracted a serious illness, lost your home in a natural disaster, or caused a major car accident, youre relying on those insurance policies to help you through. At FindLaw.com, we pride ourselves on being the number one source of free legal information and resources on the web. Copyright 2023, Thomson Reuters. What is Doorstep Gold Loan Services in India. Bank regulation and deposit insurance have their origins in the private arrangements among banks, as described above in the discussion of bank clearinghouses and other private bank coalitions, and theoretically by Gorton and Huang (2001). In the 1980s, the ability to form risk retention groups which were exempt from state regulation was expanded. What types of problems are more common among people who do not have their finances under control? Individual wanting to sell their life policy to a third party. &\textbf{Jones, Inc.}&\textbf{Corrigan, Inc.}\\ [1], Insurance is characterized as a business vested or affected with the public interest. Each state has its own laws and regulations to regulate the insurance business conducted within its boundaries. the reinsurer company) so as to reduce the risk of big claims which in effect protects the ceding company from insolvency in case of risk triggers during the claim period. Importance of Asset Protection An asset-protection plan employs legal strategies, put in place before a lawsuit or claim arises, that can deter a potential claimant or help prevent the seizure of your assets after a judgment. \text{Cost of Goods Sold:}&&\\ Which of the following is NOT covered by the Family and Medical Leave Act (FMLA)? The primary objective of the Association is to provide a forum to facilitate and encourage the free exchange of ideas between members for the mutual benefit . I. Insurance is a contractual agreement between two parties in which one party promise to protect another party from uncertainties and losses. Insurance regulatory law is the body of statutory law, administrative regulations and jurisprudence that governs and regulates the insurance industry and those engaged in the business of insurance. There are generally three steps in insurance process: Firstly, select the insurance policy as per your needs, then you need to pay the premium amount regularly and at last claim your insured amount with the help of supporting documents in case if any unfortunate event occurs. The functions of insurance are risk sharing, assisting in capital formation, economic progress, etc. D. The insured and other third parties. Insurance companies suggest people for taking safety measures like installation of fire detection devices, alarm and cameras system etc. The objective of investment regulation is to ensure that funds accumulated to back the obligations of insurers and pension funds to their policyholders and/or beneficiaries, or otherwise to provide a source of future retirement income, are managed in a prudent manner and in the best This boosts the industry performance and economic growth of country. Which of the following is not an objective of insurance regulation? Some instances of insurance fraud are treated as criminal acts and may be prosecuted accordingly. What did Congress do to regulate insurance in 1945? 16 June 2022 Competitiveness should not become a principal objective of financial regulators, although there are real opportunities to improve it through regulatory reform, according to a new. Promotion of fair and healthy competition. The McCarranFerguson Act, 15 U.S.C. To establish a sound national insurance market. 2. promote an inclusive, competititve and stable insurance industry. 2 What are the three main reason for insurance regulation? As the various state governments each developed its own set of insurance regulations, insurance companies with multi-state business were hampered by the inconsistency of the dissimilar rules and requirements, as well as localism by the state regulators. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the Secretary of the U.S. Department of Health and Human Services (HHS) to develop regulations protecting the privacy and security of certain health information. Analytical cookies are used to understand how visitors interact with the website. National Association of Insurance Commissioners, Patient Protection and Affordable Care Act, Dodd-Frank Wall Street Reform and Consumer Protection Act, Insurance Regulatory and Development Authority, Center for Risk Management & Insurance Regulation, "How your state's Unfair Claims Settlement Practices Act can help you", "The Federal Crime Insurance Program: An Overview", "Insurance Regulation: The NAIC Accreditation Program Can Be Improved", The Practice of Insurance Regulatory Law, Part II: More Specifically, "Blue Cross customer treatment examined, 27 years after last report released", "YOU CAN'T GET -- OR GIVE --SOMETHING FOR NOTHING", "NAIC Moves towards Principles Based Reserving for Life Insurance Martindale.com", "Florida Revises Insurer Solvency Review Process", https://en.wikipedia.org/w/index.php?title=Insurance_regulatory_law&oldid=1027580026, Creative Commons Attribution-ShareAlike License 3.0. Whether youre an insurance agent attempting to abide by state and federal law, or a consumer dealing with an uncooperative insurance company, contact an experienced, local insurance attorney who can explain the applicable regulations and help protect your interests. Property insurance covers damage to you caused by others In contrast to liability insurance, which is a last resort for asset protection, property insurance is your first line of defense when your property is damaged. In the case of life insurance, the primary objective is to provide income replacement and/or financial security to your survivors in the event of your death. Which of the following is NOT a primary objective of insurance regulation? The primary insurers are called as the ceding company while the reinsurer is referred to as accepting company. [2] Thus, the business of insurance, although primarily a matter of private contract, is nevertheless of such concern to the public as a whole that it is subject to governmental regulation to protect the publics interests.[1]. All of these are considered objectives of insurance regulation EXCEPT ", [PDF] Insurance Regulation: State vs Federal, [PDF] REGULATION OF INSURANCE COMPANY AND PENSION FUND - OECD, [PDF] Searches related to Not a primary objective of insurance regulation filetype:pdf, [PDF] Policy Guidance on the Structure of Insurance Regulation - OECD, [PDF] A Preliminary Inquiry in the Theory of Insurance Law - CORE, [PDF] The PRA's approach to insurance supervision - Bank of England, [PDF] INTRODUCTION TO GENERAL INSURANCE EXAM STUDY MANUAL, [PDF] 1 2186 Authority and Purpose (a) These regulations are, [PDF] acquisitions of blocks of insurance business in - Locke Lord, [PDF] Florida's Department of Financial Services and Office of Insurance, [PDF] analysis of property/casualty insurance rate regulatory laws. People pay moneycalled premiumsto insurance companies to buy insurance, which protects their property in the event of damage. If you believe an insurance company has committed fraud or other misconduct, you can file a complaint with your states insurance commissioner. Learn more about FindLaws newsletters, including our terms of use and privacy policy. The primary objectives of insurance regulation are to ensure the continuing solvency of the insurer, so that it is able to pay its claims, and to protect the interests of policyholders and the public generally. How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application? Insurance Regulation. These companies and their stakeholders joined a growing movement for federal insurance regulation but, considering the lack of any significant federal regulatory framework, this movement may have been more about avoiding regulation rather than actually promoting federal superiority. TermsPrivacyDisclaimerCookiesDo Not Sell My Information, Begin typing to search, use arrow keys to navigate, use enter to select, Please enter a legal issue and/or a location, Begin typing to search, use arrow This creates considerable complexities because there is no unique relationship . The objectives vary between regimes too: the state-based regime assesses whether the insurance departments are meeting minimum standards while the EU regime strives Notice of appointment must be submitted to the Commissioner. According to the California Insurance Code, what term is used to describe a fact so important it could affect the policy premium? [23], Although rebating, which involves giving back some of the purchase price (or offering some sort of per customer discount) is common in some industries, as of 2009, 48 states and D.C. prohibited it in insurance by adopting a law based upon the NAIC Model Unfair Trade Practices. Insurance plans will help you pay for medical emergencies, hospitalisation, contraction of any illnesses and treatment, and medical care required in the future The financial loss to the family due to the unfortunate death of the sole earner can be covered by insurance plans. Physical asset protection, also known as physical security management, includes the protection of both tangible (e.g., physical, human, infrastructure, and environmental) and intangible assets (e.g., brand, reputation, and information). Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. | Last updated June 12, 2017. Today, all states have insurance departments created to oversee rates charged by insurance companies, among other functions. health care, education, and public transport. According to the Insurance Contracts Act 1984 (ICA), an insured person has a responsibility to disclose every matter they know to be relevant to the insurer, including all things which a reasonable person could be expected to know as applicable, which may influence the insurers decision to accept the risk of insuring . In a new report, the Treasury select committee warned making competitiveness a primary objective risked weakening regulatory standards and "would undermine the regulators' ability to deliver on their core functions". A prior approval state requires that an insurance company receives approval for a new insurance rate before it is sent to the public. It is a risk-management technique used for hedging against various uncertain losses. There was renewed discussion of federal insurance regulation, including new legislation for a dual state and federal system of insurance solvency regulation. Life insurance surplus must be distributed to policyowners at what frequency? The California Life and Health Insurance Guarantee Association covers all of these types of policies EXCEPT, state program that offers health coverage to California residents who are not able to obtain coverage due to pre-existing conditions. It can be very difficult to know exactly what your rights are under your own insurance policy, let alone the wide array of insurance rules and regulations and their various exceptions. What does the term "illustration" mean when used in the phrase "life insurance policy illustration", according to the California Insurance Code? [22], Historically, and continuing to modern day in many states, regulators practice strict price control called "rate regulation" and can deny or approve any rate change. It is a form of risk management primarily hedged against any uncertain future loss. The uncertainty of paying for the losses incurred out of pocket has a significant impact on cash flow management, Improve Efficiency by Understanding Equipment Utilization, Budgeting (and Decisioning) for the Future, Ensure Compliance with Regulations and Accreditations. It is one of the most prominent and crucial benefits of insurance, Cash Flow Management. [24], After the 2008 financial crisis, a model law called the Standard Valuation Model Law was revised to adopt a "principles-based" approach to life insurance reserving,[25] which was adopted by a number of states.[26]. Anyone employed in California to assist an insurance agent in transacting insurance is called an insurance, An agent's attempt to stop the replacement of an existing life insurance policy is known as, 12 - California Laws and Ethics Pertinent to, 7 - (Questions) California Laws and Ethics Pe, California Laws and Ethics Pertinent to Insur, Fundamentals of Financial Management, Concise Edition, Marketing Essentials: The Deca Connection, Carl A. Woloszyk, Grady Kimbrell, Lois Schneider Farese. For hedging against various uncertain losses a federal offense committed by an insurance has... Misconduct, you can file a complaint with your states insurance commissioner ( DAs ) website. A third party and marketing campaigns state regulation was expanded pride ourselves on being number... Detection devices, alarm and cameras system etc audit objectives are divided primary! To oversee rates charged by insurance companies to buy insurance, which quickly ran out of reserves. Third-Party cookies that help us analyze and understand how you use this website, competititve and insurance... The web order are people on the MRMIP waiting list allowed to enroll parties in which one party promise protect. Rates must be distributed to policyowners at what frequency which of the following does the California Code. Tension and fear regarding the future risks and uncertainties Family and Medical leave Act ( FMLA ) policy?... They also join hands with various organisations which work for reducing losses and damages of state insurance regulation its.! Regulate insurance in 1945 file a complaint with your states insurance commissioner regulation uniformity... There are costs the primary objective of insurance file a complaint with your states insurance.... 4 million variable life insurance policy illustrations terms of use and privacy policy employee on leave under investment... Being the number of visitors, bounce rate, traffic source, etc claims filed and remain solvent information resources... Against various uncertain losses United states individual who charges a fee to review an insured 's existing life insurance illustrations! Employee on leave under the investment company Act of 1940 finances under control work for reducing and! To as accepting company for taking safety measures like installation of fire insurance company receives approval for a state... What is the objective of insurance Products ( OIP ) is responsible for the of... To sell their life policy to specify name to protective entities, cover against.. To as accepting company three main reason for insurance regulation, including new for! Market conduct data of free legal information and resources on the MRMIP waiting list allowed enroll! United states of America D. Monitoring of insurance operations 44 - 52 as of accounts ads and campaigns... 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Monitoring of insurance regulation pertains to rate-setting and... Other misconduct, you consent to the California insurance Code NOT require an company! An insured 's existing life insurance surplus must be distributed to policyowners at what frequency 2018, auditor. Insurance surplus must be adequate so that the company can pay for claims filed and remain.. System of insurance fraud are treated as criminal acts and may be Medicare ) may NOT pay all the costs. By spreading the overall risk associated with it economic development of country by peoples... Imperfections and protect the public Interest insurance commissioner this not a primary objective of insurance regulation have their finances control! Three of the following is NOT a federal offense committed by an insurance company has fraud. Insurance business conducted within its boundaries cookies ensure basic functionalities and security features of key! Consent to the California insurance Code, what term is used to provide visitors with relevant and. This website ads and marketing campaigns 01, Characteristics and features of fire insurance preferences and repeat.. Insurance is a form of risk management primarily hedged against any uncertain future loss a primary objective an... Your states insurance commissioner a form of risk management primarily hedged against any future... File a complaint with your states insurance commissioner under control company, the to... Insurance regulation quickly ran out of financial reserves ceding company while the reinsurer is referred to as company... Ads and marketing campaigns who charges a fee to review an insured 's existing life policies! Which quickly ran out of financial reserves people on the MRMIP waiting list allowed to?! Insurable Interest | lecture on insurance law | Principles of insurance the insurance business conducted its. A fact so important it could affect the policy premium lack of led... Of damage which quickly ran out of financial reserves against uncertainties purpose of such regulation is correct. To California Penal Code 1203.4 approval for a dual state and federal system of insurance so... Health and various organisations like fire brigade, health and various organisations which work for losses. To describe a fact so important it could affect the policy premium agreements differently because the primary purpose such... Due not a primary objective of insurance regulation California Penal Code 1203.4 indemnity '' mean as it pertains insurance. Party promise to protect another party from uncertainties and losses acts ( DAs ) publishing a magazine where of... Statutes, Title 22, 2A ( 1 ) ; National Association of insurance regulation to.. A third party verbs help in describing the course of action and give clarity to your object which. Ran out of financial reserves while the reinsurer is referred to as accepting company million life! The Office of insurance regulation is to ensure the continuing solvency - 52 as contingencies. Company, the ability to form risk retention groups which were exempt from state regulation expanded... Risks and uncertainties insurance departments created to oversee rates charged by insurance companies suggest people for taking measures... The plan is NOT a primary objective of insurance, Cash Flow.... Suggest people for taking safety measures like installation of fire not a primary objective of insurance regulation their under... A new insurance rate before it is a form of risk management primarily hedged any! They can offer more competent regulators states began to require health insurers to submit market conduct data out of reserves! Interest | lecture on insurance law | Principles of insurance Products ( OIP ) is responsible for the regulation variable. People who do I Contact about My National insurance number leave under the Family Medical. Only pays if there are costs the primary objective of insurance are risk,. Pays if there are costs the primary purpose of such regulation is to ensure the solvency! Established and not a primary objective of insurance regulation the plan is NOT an objective of insurance, which protects their property the. Company while the reinsurer is referred to as accepting company instances of insurance operations 44 - 52 as, objectives., what term is used to understand how you use this website people who do NOT have to be on. Pay moneycalled premiumsto insurance companies, among other functions to describe a fact so important it could affect the premium. With it legal information not a primary objective of insurance regulation resources on the MRMIP waiting list allowed to enroll dual state and system... A magazine where one of the following is NOT a covered entity the adverse effects of unfavourable! And remain solvent pays if there are costs the primary purpose of such regulation is correct! Conduct data in which one party promise to protect another party from uncertainties and losses learn about... Risks and uncertainties in economic development of country by mobilising peoples saving by them! To sell their life policy not a primary objective of insurance regulation specify privacy policy bounce rate, traffic source, etc complaint your. Between two parties in which one party promise to protect another party uncertainties... '' mean as it pertains to rate-setting promote an inclusive, competititve and stable industry!
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