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!
Alabama amended its Captive Insurance Company law and revised the requirements for an Alabama Coastal Captive Insurance Company. SB 23
New Mexico amended its claims payment law and now requires clean electronic claims from pharmacies for prescription drugs and related fees to be paid within 14 days. SB 124
Oklahoma amended its claims payment law to require written notice to an insured if a clean claim or any portion of a clean claim is denied for any reason, within 30 calendar days of receipt of the claim. This applies to claims under any accident and health insurance policy. SB 550
Alabama amended its reinsurance law making it similar to the Credit for Reinsurance Model Law developed by the NAIC. HB 32
Arkansas modified its Credit for Reinsurance Law to simplify the procedures that allow an insurer to apply for and receive credit for reinsurance. HB 1240
Colorado updated its Credit for Reinsurance Act to allow additional means by which credit for reinsurance may be allowed to a ceding insurer. HB 1063
Idaho revised is law dealing with the requirements that must be contained in a contract with a dental service provider. SB 1124
Indiana enacted a law that gives a dentist the authority to order and administer an immunization recommended by the federal Centers for Disease Control and Prevention Advisory Committee on Immunization Practices. In addition, a health plan cannot require a dentist to accept payment under the plan by virtual claim payments. Certain disclosures are required. HB 1079
North Dakota enacted a law relating to prior authorization of dental services, dental networks, and payment of dental claims. HB 1154
Minnesota passed a bill prohibiting life insurance carriers from using knowledge of a prescription for opiate antagonist solely when making an underwriting determination on whether to issue, renew, cancel or modify a life insurance policy. HF 652
Alabama passed a new law requiring any individual or group health benefit plan to cap the amount of any cost-sharing or co-pay that an insured or beneficiary is required to pay for prescription insulin. HB 249
Nebraska passed the Step Therapy Reform Act. Among other things, it provides that upon approval of a step override exception, the carrier or utilization review organization must authorize coverage of a prescription drug selected by the insured's health care provider if that drug is covered under the health plan. LB 337
Vermont issued a bulletin providing guidance on its interpretation of the monthly limit on an insured's out-of-pocket spending for prescription insulin medications. Bulletin 220
Colorado passed a law expanding the ability to conduct business activities electronically. HB 21-1124
Maine Insurance Department issued a bulletin informing carriers that the uniform rate and form filing deadline is June 15, 2021. This applies to all non-grandfathered health plans and stand-alone dental plans, subject to the Affordable Care Act, which will be offered with effective dates during 2022 in the individual and small group markets in Maine. Bulletin 456
Nebraska Department of Insurance gave notice to carriers writing individual and small group health insurance that transitional policies may continue until January 1, 2023. This follows the guidance issued by the Center for Consumer Information and Insurance Oversight of the states' option to extend transitional policies. Notice of April 21, 2021
Kentucky adopted the latest edition of the NAIC Buyer's Guide. A definition of "Current Scale of Nonguaranteed Elements" was added. 806 KAR 12:170
Massachusetts informs all commercial health carriers and HMOs that the department issued the "Massachusetts Consumer's Guide to Medicare." This document must be provided along with the annual federal publication “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare” to persons eligible for Medicare. Bulletin 2021-05
CMS released FAQs about Mental Health and Substance Use Disorder Parity Implementation and the Consolidated Appropriations Act, 2021 Part 45. These FAQs were prepared jointly by the Departments of Labor and Health and Human Services. CMS Notice dated April 2, 2021
Arkansas modifies the interest rate used in determining the minimum required nonforfeiture rate for individual deferred annuities. HB 1601
Arizona added a new section to its Pharmacy Benefit Manager Law that prohibits a PBM from charging a pharmacy for adjudicating, processing or transmitting a pharmacy benefit claim, or developing, managing or participating in an adjudication network. SB 1356
Arkansas amended the Pharmacy Benefits Manager Licensure Act and the Pharmacy Audit Bill of Rights laws dealing with network adequacy. Regulations will be adopted. HB 1804
West Virginia amends its Pharmacy Benefit Manager licensing law to clarify requirements for a PBM's network. It also amends reporting requirements, provides for consumer choice for pharmacies, requires rebates to be passed down and sets guidelines for pharmacy benefit plans. HB 2263
Wisconsin passed a law that requires Pharmacy Benefit Managers to be licensed effective January 1, 2022. The law also contains new reporting, disclosure, audit and claim requirements. SB 3
Kentucky published the 2021-2022 Kentucky Local Government Premium Tax Updates to Forms and Documents. Bulletin 2021-001
Kansas increased the monetary cap on irrevocable prearranged funeral agreements from $7,000 to $10,000 with an ongoing annual CPI increase each year. HB 2254
Kentucky established a limited preneed funeral agent license. 806 KAR 9:370
Nebraska amended its Protection in Annuity Transactions Act to adopt the latest updates to the NAIC's Annuity Suitability Model Regulation. LB 22
Arizona amended its law to provide that it is not considered to be a rebate or discrimination if a disability insurer pays implementation credits that offset expenses a group policyholder incurs when it initiates or changes new or existing group coverage. HB 2795
North Dakota allows a life, annuity or accident and health producer to conduct raffles or drawings. Under certain conditions they are not considered to be an unfair trade practice. SB 2072
Vermont issued a bulletin providing Implementation Credits and Rebating Guidance regarding group policyholders. Bulletin 219