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!
Rhode Island's insurance commissioner issued its state specific carrier notice requirements for renewal and discontinuance in the Rhode Island Individual and Small Group Markets. Bulletin 2021-04
Idaho's Insurance Director issued guidance regarding compliance with HB 79 regarding Annuity Suitability, disclosures, advertisement filing requirements and standards for policy provisions. Bulletin 21-05
South Carolina notified insurers and HMOs writing accident and health coverage of an adjustment to the Autism Spectrum Disorder maximum benefit. Based on the Consumer Price Index, the adjusted maximum benefit for coverage of behavioral therapy is $62,100 beginning January 1, 2022. Bulletin 2021-07
Illinois enacted legislation requiring certain individual life insurers notify the applicant of his/her right to designate a secondary person to receive notice of cancellation for non-payment of premium. 215 ILCS 5/235.1; SB 2112
Illinois amended a law to provide that no health care recoupment or offset can be requested or withheld from future payments 12 months or more after the original payment is made (was 18 months), except in certain cases. SB 1974
Louisiana adopted the amendments to the NAIC Credit for Reinsurance Model Regulation. LAC 37:XIII Chapter 35 Reg 56
Tennessee's Insurance Commissioner issued a bulletin asking carriers to assist policyholders who suffered flooding in certain counties in Tennessee. Specific actions requested include a 60-day moratorium on cancellation and non-renewals of policies due to non-payment of premium from the date of loss, claims processing exceptions and replacement prescription refills, among others. Bulletin 21-02
Massachusetts reminds commercial health insurers, HMOs and Blue Cross of changes to state law and the prohibition on discriminating on the basis of gender identity or gender dysphoria. This includes medically necessary gender affirming care and related services, among other discriminatory practices. Bulletin 2021-11
Illinois passed a law requiring companies that issue group policies of accident and health insurance to offer such policies to local chambers of commerce. HB 3598; 215 ILCS 5/370d.1
Maryland's Life and Health Insurance Guaranty Corporation regulations added health maintenance organizations as member insureds and made other minor changes. As a result, the Guaranty Corporation's Life and Health Notice form has been revised. COMAR 31.04.14.03
Massachusetts reminds entities providing health insurance to comply with recent federal guidance requiring coverage without cost sharing of Grade A and B preventive services for HIV preexposure prophylaxis (PrEP) for certain individuals from the U.S. Preventive Service Task Force (USPSTF). Bulletin 2021-09
Alaska implemented OPTins (Online Premium Tax for Insurance). This is used to file documents and payments for UCAA application and amendment of additional documents, payment and market conduct exam reports, among other items. Bulletin B21-06
Louisiana Rule 12 was amended to add the use of private or commercial interstate carriers as a method that insurers and regulated entities may use for delivery of documents to the insurance department. LAC 37: XI Chapter 9
Illinois enacted a law requiring accident and health policies to provide coverage for treatment of port wine stains (nevus flammeus) in children age 18 and younger that are intended to prevent functional impairment. SB 2158; 215 ILCS 5/356z.43
Illinois passed a law requiring accident and health policies to provide coverage for medically necessary comprehensive cancer testing, and testing of blood or constitutional tissue for cancer predisposition as determined by a physician. HB 2109; 215 ILCS 5/356z.43
Maine's Insurance Superintendent reminds insurers subject to the Health Plan Improvement Act of several changes to the laws governing the payment of surprise emergency medical bills. Bulletin 460
Massachusetts issued a bulletin outlining the Division of Insurance expectations regarding continued access to telehealth services in 2021. Bulletin 2021-10
North Carolina passed a law that seeks to lower health care costs by permitting insurers to contract with exclusive provider organizations and to expand access by allowing small businesses to offer exclusive provider benefit plans. SB 228
Washington's Health Care Authority set a minimum covered person reporting threshold of 1,000 covered persons, below which a data supplier is not required to submit data to the all-payer claims database. WAC 182-70-040
West Virginia's Insurance Commissioner issued guidance on Electronic Prior Authorization forms, portals, timelines, appeals, Gold Card Program, and pharmacy benefit prohibitions at inpatient discharge. Bulletin 21-08
Wisconsin is requesting Health Plan Issuers to work with healthcare facilities facing capacity issues due to COVID-19 and workforce shortages. Specifically, carriers are being asked to remove or streamline prior authorization requirements, cover out-of-network facilities where in-network are unavailable, among other provisions for post-acute care. Bulletin dated September 22, 2021
Kentucky promulgated a revised regulation regarding the minimum interest rate used to calculate annuity nonforfeiture. 806 KAR 15:070
North Carolina has decreased the interest rate used in determining minimum nonforfeiture amounts for annuities from 1% to 0.15%. HB 366; 58-58-61
North Carolina passed a law promoting price transparency for patients and establishing standards for the regulation and licensing of pharmacy benefit managers. SB 257
West Virginia's Insurance Commissioner reminds insurers that a pharmacy benefit manager must maintain an adequate and accessible Specialty Drug network for a health benefit plan. A network cannot be comprised only of mail-order benefits but must have a mix of mail-order benefits and physical stores in West Virginia. Bulletin 21-07
Maryland developed an amendment template that carriers can use in drafting policy form and contract updates. This applies to changes required under the Consolidated Appropriations Act of 2021 and interim final regulations issued by the Department of Health and Human Services. Bulletin 21-24
New Mexico's Insurance Department issued a data call for information related to credit life and credit accident and health insurance. Bulletin 2021-019