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!
Texas increased the time that a temporary agent license is valid from 90 days to 180 days. This law also sets forth when the department of insurance can deny a temporary license application. HB 2819
Texas enacted legislation changing the interest rate used in determining the minimum nonforfeiture amount for annuity contracts. This bill also revised the existing annuity law to require an agent to act in the best interest of the consumer when making a recommendation of an annuity. An insurer must establish and maintain a system to supervise those recommendations. HB 1777
Utah issued a bulletin extending the compliance date on SB 79 by six months to November 5, 2021.SB 79 required insurers to demonstrate proof of delivery prior to termination of life insurance coverage, which includes a certified mail receipt, or an electronic read receipt. Bulletin 2021-3(a)
Colorado changed its child support law and added life and annuities to the list of insurance claim payments that are subject to administrative lien and attachment. HB 1220
Louisiana published a revised bulletin clarifying those carriers and entities that must develop and maintain a comprehensive written information security program by August 1, 2021. Bulletin 2021-04 (Revised and Reissued)
Texas modified cybersecurity provisions requiring additional information to be included in the notice of a security breach. HB 3746
Louisiana enacted legislation dealing with dental provider network leasing and administration. HB 387
New Mexico issued a new rule that contains minimum standards and sales practices relating to dental and vision plans. Regulation 13.10.35.1 NMAC
CMS published FAQs regarding implementation of the Affordable Care Act Implementation, Part 46. These questions relate to limitations on cost sharing. CMS Notice dated June 4, 2021
Colorado has changed the requirements for the Colorado Supplement to the Summary of Benefits and Coverage form. Regulation 4-2-20
Kentucky's Insurance Department issued an Advisory Opinion clarifying those items an insurer must cover, without patient cost, for a "complete colorectal cancer screening." Advisory Opinion 2021-0001
Louisiana amended the Health Care Consumer Billing and Disclosure Protection Act to allow a health insurer to pay a claim and consider a provider to be in-network in certain circumstances even though the provider is not yet credentialed. HB 595
Louisiana enacted legislation requiring a health insurer to cover several types of genetic or molecular testing for cancer. SB 84
Louisiana has changed the types and frequencies of mammograms which must be covered by a health insurance plan. SB 119
New Mexico updated its utilization review, prior authorization, and notice of adverse determination requirements. Rule 13.10.17.11 NMAC
North Carolina has added a new requirement on a health benefit plan member's ID card. The words, "fully insured" or "self-funded" must be on each card. This enables the DOI to know if they can provide assistance regarding regulation of the plan. SB 248
Texas passed a law expanding the testing or screening that must be covered as a minimum under a health benefit plan for ovarian cancer. Effective January 1, 2022, a health plan must cover a CA 125 blood test, a pap smear or screening using liquid-base cytology methods, alone or in connection with HPV and any other test or screening approved by the U.S. Food and Drug Administration for the detection of ovarian cancer. HB 428
Connecticut requires a pharmacy benefits manager to give credit for any discount or payment made by a third party for the amount of the coinsurance, copayment, deductible or other out of-pocket expense for the prescription drug benefit. SB 1003
Oklahoma's Insurance Department informed Health Insurers and Pharmacy Benefit Managers (PBMs) that the DOI will begin enforcing the Patient's Right to Pharmacy Choice Act, 36 O.S. 6958, for violations occurring on and after September 1, 2021. Legal actions were pending on this law and the 10th Circuit Court of Appeals is allowing enforcement of this law. PBM Notice dated May 28, 2021
Tennessee has a new law prohibiting PBMs and health insurance issuers reimbursing a 340B entity less than the rate paid for drugs dispensed by a pharmacy that is not a 340B entity. The law also contains requirements for the calculation of coinsurance or deductible for prescription drugs, disclosures to an enrollee, as well as other requirements. It does not revise the PBM licensing law. HB 1398
Texas enacted a new law relating to the contractual relationship between a pharmacist/pharmacy and a health benefit plan or pharmacy benefit manager (PBM). This does not impact licensing of a PBM. It prohibits reduction of certain claim payment amounts, reimbursement, network contract fee schedules, delivery of drugs, and other requirements. HB 1763
Texas enacted an extensive all payor claims database reporting and healthcare cost disclosure law. This impacts health benefit plan issuers and third-party administrators. HB 2090
Alabama promulgated a revised rule regarding individual and group health insurance (accident and sickness) reserves. The regulation sets forth minimum standards for claim reserves, premium reserves and contract reserves in accordance with the Standard Valuation Law. Rule 482-1-134
Pennsylvania notified life insurers and fraternal benefit societies that Principle-Based Reserving (PBR) was previously optional for life insurance contracts issued after January 1, 2017 but will be mandatory for certain types of life insurance contracts issued on and after January 1, 2020. Exemptions for domestic companies can be requested under certain circumstances. Notice dated May 28, 2021
Alabama adopted a new rule clarifying the Alabama code sections applicable to Captive Risk Retention Groups. Rule 482-1-138-.17.1