Newsletter
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 50 years we are always excited to share the latest sampling of insurance compliance related bulletins, regulations and legislative activity. Please feel free to share this newsletter with others that may be interested. Contact Us with any questions on the items in this newsletter or with any other compliance related matter we can assist you with. Enjoy!
Maryland Insurance Commissioner has published the 2022 Affordable Care Act (ACA) Individual and Small Employer Form and Rate Filing Instructions. This bulletin applies to policy years beginning on or after January 1, 2022. Bulletin 21-04
South Carolina adopted the federal extension of the ACA transitional policy through calendar year 2022 for health insurance issuers with non-grandfathered health insurance coverage in the individual or small group markets. The transitional policy permits issuers to renew certain non-grandfathered policies that would otherwise be deemed out of compliance with the requirements of ACA. Bulletin 2021-01
Maine Bureau of Insurance announced it is discontinuing the issuance of temporary resident producer licenses due to the COVID-19 pandemic. Pearson VUE has resumed administering insurance examinations and online delivery of major lines exams. Bulletin 445 is superseded by this bulletin. Bulletin 455
Utah's Individual and Agency Licensing Requirements Rule has been changed. The changes require an insurance company and insurance agency to provide particular information to the insurance department when it is reported they have terminated their relationship with an agency or agent based on a violation of the insurance code. Rule R590-244-11, 12, 13
New Mexico's Superintendent of Insurance published the current interest rate applicable to unpaid claims 45 days after required proof of loss has been furnished. Bulletin 2021-001
Maryland's Insurance Commissioner is directing carriers to suspend health benefit cancellations and non-renewals for non-payment of premium due to COVID-19. This applies to individual health benefit plans unless certain conditions are met. This requirement is being renewed until March 26, 2021, based upon the Governor's renewal of the COVID-19 emergency declaration on January 26, 2021. Bulletin 21-05
Massachusetts Insurance Commissioner issued a bulletin outlining guidelines it expects carriers to follow in paying for or reimbursing the cost of administering the COVID-19 vaccine. Administrators of self-funded employer plans are encouraged to also implement these requirements. Bulletin 2021-01
Mississippi's Insurance Commissioner published guidance to all insurance companies regarding the appropriate coverage of vaccines for COVID-19. This includes foregoing any cost-sharing, reimbursing providers for administering the vaccine, and vaccines administered during other visits not associated with COVID-19 testing. Bulletin 2021-02
Maryland requires all life, health, HMO and other types of insurance companies licensed in Maryland to report information on their contacts for disaster, continuity of operations plan, and pandemic flu plan. The contact information must be furnished to the Maryland Insurance Administration no later than April 15, 2021. Bulletin 21-02
Connecticut issued health insurance rate filing submission guidelines for individual and group health insurance. All rate filings, including small group indemnity rate filings, must be filed pursuant to the requirements of the Department of Health and Human Services pursuant to PPACA. Bulletin-HC-81-21
Arkansas Insurance Commissioner issued a bulletin giving direction regarding the calculation of the number of employees for purposes of small group rating. This bulletin was issued to health insurance carriers, HMOs and health care producers. Bulletin No.: 2-2021
Illinois issued an updated bulletin regarding acceptable Association Health Plans in light of the decision in New York v. U.S. Department of Labor case, 363 F. Supp. 3d 109 (D.D.C. 2019). Company Bulletin 2020-20 (Updated)
New Hampshire issued a bulletin providing guidance to carriers regarding complying with Health Plan Loss Information under RSA 420-G:12-a. Carriers must provide certain claims information within 30 days after a large employer group requests it. Large employers are entitled to receive their specific medical claims for all physician, hospital, prescription drug and other covered medical claims. Bulletin Docket No.: INS 20-074-AB
Arkansas published updated Guaranty Notices for life and health policyholders. These can be found in Appendix A and Appendix B of Rule and Regulation 49. Rule & Regulation 49, Appendix A and Appendix B
Missouri updated the required Life and Health Guaranty Association notice to change addresses and other items. 20 CSR 400-5.600
District of Columbia passed a law that limits the total amount an insured is required to pay for a 30-day supply of insulin to $30, regardless of the quantity or type of covered insulin drug used to fill the insured's prescription. The total amount an insured is required to pay for a 30-day supply of medically necessary diabetes and diabetic ketoacidosis devices is $100. This law is effective January 1, 2022. Uncodified B23-920 s 2(d) (2021)
Maine's Superintendent of Insurance reminds health carriers of the Maine Surprise Emergency Medical Bill law effective March 18, 2020 which requires carriers to pay out-of-network providers for covered emergency services. However, emergency ambulance services are handled differently. A carrier must pay an out-of-network ambulance provider at the provider's usual out-of-network rate for covered emergency services provided before October 1, 2021. Bulletin 454
Colorado amended and readopted its Medicare Supplement regulation. The insurance department adopted the changes that are effective March 15, 2021. 3 CCR 702-4 Reg. 4-3-1
Ohio passed SB 284 dealing with insurers receiving credit for reinsurance, mental health and substance use disorder benefit parity, and the release of a telephone number of a person involved in a motor vehicle accident. This law is effective March 22, 2021. SB 284
Mississippi's Insurance Commissioner waived the requirement for an insurer to conduct a semiannual on-site review of a managing general agent or third party administrator through calendar year 2021. However, these reviews must be conducted through electronic means to satisfy the on-site review obligations under the law. Bulletin 2021-01
New Hampshire has clarified in a Q & A format the registration and licensure requirements for Pharmacy Benefit Managers. All Pharmacy Benefit Managers are newly required to register with the Department as of January 1, 2021. Bulletin INS 21-001-AB
Connecticut requires carriers to file network plans annually with the Insurance Department. In the past, all plans were due by April 1. However, for 2021 and thereafter, medical networks must file no later than April 1, 2021, vision networks by May 1, 2021 and dental networks by June 1, 2021. Bulletin No. HC-117-21
Colorado amended and readopted its "Premium Deficiency Reserve Standards for Individual and Group Health Benefit Plans." This regulation applies to major medical, long term care and disability insurance effective March 15, 2021. Amendments are to Sections 4, 6, and 7, among others. 3 CCR 702-3 Reg. 3-1-15
Colorado amended and readopted its "Prompt Investigation of Health Claims Involving Utilization Review and Denial of Benefits and Rules Related to Internal Claims and Appeals Processes" regulation. The insurance department adopted the changes that are effective March 15, 2021. Changes include the definition of physician under urgent care as well as changes in the first level of review in Section 11. 3 CCR 702-4 Reg. 4-2-17