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Property and Casualty News September 2025
Property and Casualty News
September 2025
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!
ADVERTISING / SALES & MARKETING
New Mexico updated Bulletin 2025-006 to revise insurer notification requirements for offering value-added products or services, including adding inception and termination dates, clarifying that charges are not built into rates if free, and removing the need to specify separate charges when fees apply. Bulletin 2025-006 (Updated)
United States Federal Communications Commission (FCC) amended its regulations to comply with a court mandate that reinstates the prior version of 47 CFR 64.1200(f)(9), governing prior express written consent for telemarketing calls. This change requires telemarketers to obtain a signed, written agreement—electronic signatures included—that clearly authorizes automated or prerecorded telemarketing calls and discloses that signing is not a condition of purchase. 47 CFR 64.1200
United States Federal Trade Commission (FTC) issued a correction to the Telemarketing Sales Rule (TSR) fees, clarifying that the updated fees for accessing the National Do Not Call Registry will take effect on October 1, 2025, not October 1, 2024, as previously stated. This correction, effective immediately as of September 5, 2025, aligns with the Do-Not-Call Registry Fee Extension Act of 2007. 16 CFR 310.8
AUTOMOBILE INSURANCE
Colorado has amended its regulations to establish governance and risk management standards for insurers using external consumer data (ECDIS), algorithms, and predictive models in individual life, private passenger auto, and health benefit plans, with a focus on preventing unfair discrimination. Insurers must implement detailed oversight frameworks, conduct testing, and report compliance progress by June 1, 2024 (life insurers), and by December 1, 2025, for auto and health insurers. 3 CCR 702 Reg. 10-1-1 s 1
Colorado issued guidance to property and casualty insurers regarding House Bill 25-1179, which mandates coverage for the replacement of child restraint systems involved in motor vehicle accidents. Effective January 1, 2026, insurers must ask claimants if a child restraint system was present in the vehicle and, if so, cover its replacement under specified coverages—regardless of occupancy at the time of the loss. Bulletin B-5.52
Georgia updated its Department of Driver Services regulations to strengthen liability insurance requirements related to DUI offenses and probationary licenses in compliance with SB 121 passed in April 2025. Minimum coverage increases from standard amounts to higher thresholds for first DUI convictions and even greater amounts for subsequent DUIs. 375-3-3-.02
CAPTIVES
Alabama has extended its temporary moratorium on the licensing or registration of new captive insurers and domestic risk retention groups until June 30, 2026. The Department of Insurance advises affected entities not to submit applications or fees during this period, though applications submitted before March 1, 2025, will continue to be processed. Bulletin 2025-05
COMMERCIAL LINES INSURANCE
Michigan’s Department of Insurance and Financial Services updated the list of municipalities participating in the Fire Insurance Withholding Program, effective October 1, 2025. The program allows certain municipalities to escrow 25% of fire insurance settlements for specified property losses, with participation and coverage varying by municipality population and county size. Insurers must be notified at least 30 days before new municipalities apply the program’s provisions. Notice Dated 9/1/25
CROP HAIL INSURANCE
United States' Risk Management Agency (RMA) issued a bulletin outlining amendments to the Federal Crop Insurance Act under the One Big Beautiful Bill Act (OBBBA). Key changes include expanded benefits and premium subsidies for Beginning Farmers or Ranchers, increased coverage levels and subsidies for Whole-Farm Revenue Protection and Supplemental Coverage Option policies, and updated premium subsidy rates for various unit elections. Approved insurance providers must distribute the amendment to affected insureds within 30 days of the bulletin or prior to cancellation. MGR-25-006
FILING REQUIREMENTS / PROCEDURES
Delaware issued a revised bulletin clarifying its policy on miscellaneous fees in property and casualty insurance policies. The Department of Insurance specifies that only certain fees—such as installment, late payment, reissuance, and rejected payment fees—may be charged, and all such fees must be actuarially justified and included in rate filings. Carriers have six months from July 23, 2025, to bring filings into compliance, and transaction fees may only be passed to customers under strict conditions. Forms and Rates Bulletin 41 (Revised)
MISCELLANEOUS
California issued a bulletin outlining procedures for year-end review of corporate insurance filings requiring Department of Insurance approval by the end of 2025. General corporate filings must be submitted by September 15, and Holding Company Act applications by October 13, with strict requirements for completeness and deadlines for curing deficiencies. Notice Dated 8/15/25
New York's Governor declared a state of emergency from September 5 to October 5, 2025, enabling licensed physicians, nurse practitioners, and pharmacists to prescribe, order, and administer COVID-19 vaccines to patients aged three and older, with expanded authority for pharmacists to deliver vaccines via multiple methods under specific regimens. Executive Order 52
PERSONAL LINES INSURANCE
California reminds property and casualty insurers of their legal obligation to provide wildfire-related claim documents to claimants within 15 calendar days of a request. This notice, issued in response to complaints from 2025 Southern California wildfire survivors, reinforces that all materials related to damage evaluation—such as estimates, reports, and scopes of loss—must be disclosed, excluding privileged or exempt documents. Notice Dated 8/25/25
Hawaii’s Insurance Division issued guidance on Act 110, effective January 1, 2026, updating cancellation and nonrenewal notice requirements for insurance policies covering properties used for residential purposes. The amendments apply to both personal and commercial policies where the property is wholly or partially residential—including single-family homes, multi-family dwellings, condominiums, and mixed-use buildings with residential units. Memorandum 2025-6R
Rhode Island issued guidance on the use of aerial and satellite imagery in homeowners insurance underwriting and claims, requiring images to be clear, accurate, and no older than 15 months. Insurers cannot base cancellations, non-renewals, or claim decisions solely on low-quality or outdated images and must conduct further investigation when necessary. Best practices include notifying homeowners before non-renewal, sharing imagery, allowing disputes, and providing repair time; failure to comply may be deemed unfair trade or claims settlement practices. Bulletin 2025-3
REINSURANCE
New Jersey published updated lists of reinsurers—including accredited reinsurers, licensed out-of-state reinsurers, and those maintaining trust funds—allowing insurers to take full credit for reinsurance ceded to these reinsurers through September 1, 2026, in compliance with state credit-for-reinsurance laws. Notice Dated 9/1/25
REPORTS - DATA CALLS & OTHER REPORTS
Delaware now requires insurers and related parties to complete a liability insurance survey by September 18, 2025, in response to growing challenges faced by childcare and foster care businesses in securing coverage. The Department of Insurance seeks detailed information on various liability products—including general, professional, abuse and molestation, and foster parent liability—to assess market availability and inform future action. Bulletin 156
SURPLUS LINES
Alaska will hold a public hearing on October 15, 2025, to gather testimony on insurance types that are difficult to obtain from admitted insurers, aiming to update the surplus lines placement list under 3 AAC 25.040. The hearing will take place at Wedgewood Resort in Fairbanks, with options to participate via video conference or phone. Notice Dated 9/8/25
District of Columbia requires all licensed surplus lines producers to transition to the OPTins electronic filing system for surplus lines premium tax filings, effective January 1, 2026. Monthly reports of unauthorized business must be filed electronically only if there is activity, while semi-annual reports are mandatory regardless of activity. Bulletin 25-IB-002-
New Jersey published updated lists of eligible foreign, domestic, and alien surplus line insurers, including additions, deletions, name changes, and redomiciled insurers with updated alien identification numbers. Notice Dated 8/26/25
WORKERS' COMPENSATION
California's Division of Workers’ Compensation (DWC) posted additional adjustments to the Official Medical Fee Schedule for Hospital Outpatient Departments and Ambulatory Surgical Centers. The updated order is effective for services rendered on or after July 1, 2025, and is available on the DWC website. DWC Release 2025-86
Connecticut's Workers’ Compensation Commission updated the average weekly wage, maximum compensation rates, and cost-of-living adjustments. The new maximum compensation rate for total disability and dependent benefits is $1,716.00, while the rate for partial disability is $1,220.00, based on manufacturing sector earnings. Memorandum 2025-04
Kentucky's Department of Workers’ Compensation issued the 2026 Workers’ Compensation Benefit Schedule, reflecting an average weekly wage of $1,161.81 for 2024. As a result, the maximum weekly indemnity benefit for total disability or death in 2026 will increase to $1,277.99, and the minimum weekly indemnity benefit will rise to $232.36. A complete schedule of benefits accompanies the notice. Notice Dated 9/2/25
Michigan’s Compensation Advisory Organization (CAOM) announced that 2026 experience modifications will be issued starting October 15, 2025. Carriers must notify CAOM by October 8, 2025, to avoid revisions, and rating plan changes must be submitted at least 60 days before their effective date. Experience rating factors have shifted from the DCA Publication to the Facility Filing, and insurers must file rating plans with the DOI while separately notifying CAOM. Renewal modifications will be distributed starting October 16, and non-renewal quotes from November 1. WC Circular Letter 360 CAOM
Minnesota’s Department of Commerce updated the Minnesota Basic Manual in compliance with legislative changes to home care services workers under House File 3228, effective October 1, 2025. The issued circular revises Rule 3.D. and includes exhibits showing the updated language. WC Circular Letter 25-1865
Nebraska’s Workers’ Compensation Court updated its mandatory Release of Liability forms, now requiring exclusive use of the new General and future medical liability release forms without modifications or unauthorized attachments. Filings not adhering to these requirements will be rejected. WC Notice Dated 9/8/25
North Carolina's Rate Bureau announced their submission of a filing proposing a 7.8% average decrease in workers' compensation advisory loss costs and related rating values for policies effective April 1, 2026, with a 12.8% average decrease for classifications under the Longshore and Harbor Workers' Compensation Act. Circular Letter C-25-8
Ohio's Bureau of Workers' Compensation amended its rules to clarify that premiums for elective coverage are due by the invoice date and to allow employers to cancel elective coverage by phone. Rule 4123-17-07
Oregon's Workers' Compensation Division updated supplemental disability payment and reimbursement procedures, republishing Bulletin 325 with revised forms (3530, 3531, and 3504) that include updated logos, contact info, and terminology changes. These forms are required for elections not to pay benefits, physician authorization, and quarterly reimbursement requests, with specific rules on payment timing and benefit calculations. Bulletin 325 (Revised)
Newsletter
Life and Health News January 2026
Life and Health News
January 2026
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!
AFFORDABLE CARE ACT
New York released guidance clarifying grace periods, claims handling, and payment methods for ACA-compliant individual and small group plans in the NYSOH marketplace. Insureds receiving APTC have a 90-day grace period with specific claim payment rules, while those without APTC have a 30-day period; partial payments may be allowed under a 95% threshold, with shortfalls applied to future premiums. Plans must notify providers, prevent balance billing during grace periods, and accept multiple payment methods. Filing Guidance Dated 12/4/25
ARTIFICIAL INTELLIGENCE
Hawaii issued a memorandum providing guidance on the responsible use of Artificial Intelligence (AI) systems by insurers, emphasizing compliance with state laws on unfair trade practices, discrimination, and market conduct. Insurers are required to develop and maintain an AIS Program addressing governance, risk management, internal audits, transparency, and consumer protections, including oversight of third-party AI systems, documentation, and validation processes. Memorandum 2025-13A
DENTAL INSURANCE
Kentucky issued a bulletin guiding implementation of HB 210, establishing a uniform dental benefit assignment form that allows covered persons to assign dental insurance payments to out-of-network providers. The form outlines provider and insurer obligations, including notices, refunds, and revocation rights, while clarifying that carriers must honor assignments, but covered persons remain responsible for cost-sharing and uncovered charges. Bulletin 2025-05
FILING REQUIREMENTS / PROCEDURES
Hawaii announced the reorganization of the Insurance Division’s Rate and Policy Analysis Branch into two specialized units: the Life and Accident & Health Filings Branch and the Property and Casualty Filings Branch. The restructuring aims to improve regulatory oversight, enhance the timeliness and quality of filing reviews, and align the division’s operations with industry best practices. Memorandum 2025-12R
Maryland issued a bulletin providing guidance on form and rate filing requirements for student health benefit plans for the 2026–2027 school year. Insurers must submit filings for new or amended forms or rate changes by February 2, 2026, ensuring compliance with federal and state laws, including step therapy limits, preventive service guidelines, copay accumulator rules, MHPAEA, and PPACA rating requirements, while demonstrating essential health benefit coverage and minimum actuarial value. Bulletin 25-17
HEALTH INSURANCE / HEALTH RATES
Arizona released guidance to insurers marketing and selling Short-Term, Limited Duration Insurance (STLDI) plans, clarifying enforcement of federal notice requirements and compliance expectations following recent federal agency guidance and rule changes. The Department of Insurance will enforce enhanced consumer notice and disclosure requirements but will not enforce federal term and duration limits, while emphasizing transparency, consumer education, and prohibitions on marketing STLDI as comprehensive major medical coverage. Bulletin 2025-12 (INS)
New Jersey clarified that carriers must continue to cover childhood immunizations, including the hepatitis B vaccine at birth, as recommended by the New Jersey Department of Health, without cost-sharing or additional barriers. Carriers may not impose prior authorization, restrictive site-of-service policies, or other administrative requirements that limit access, and are expected to encourage plan sponsors of non-state-regulated plans to follow these standards. Bulletin 25-11
Vermont updated Bulletin 171 to clarify the application of out-of-pocket maximums for prescription drugs under Insurance Code Section T.8 §4092. The bulletin provides FAQs addressing which drugs and expenses count toward out-of-pocket limits, how the rules apply to HDHPs and Health Savings Accounts, plan applicability, and references IRS guidance for dollar thresholds. Bulletin 171 (Revised)
HOLDING COMPANIES
Mississippi amended its insurance holding company regulation to align with the NAIC Model, updating requirements for cost-sharing and management service agreements and establishing provisions for group capital calculations. Changes include exemptions and limited filings for the annual group capital calculation, criteria for recognizing non-U.S. jurisdictions, and renumbering provisions concerning adequacy of surplus, with all new and renewal reinsurance transactions after July 1, 2017, required to comply. 19-1-20.19
INTERNAL AND EXTERNAL REVIEW
California issued an All-Plan Letter notifying licensed health plans that Managed Medical Review Organization, Inc. (MMRO) has been added as a contractor, alongside MAXIMUS, Inc., to conduct Independent Medical Reviews under existing statutes and regulations. The IMR process itself remains unchanged, and plans must continue to provide required records and documents within applicable timeframes. DMHC APL 25-017
MEDICARE SUPPLEMENT INSURANCE
Colorado issued a bulletin addressing unfair trade practices related to Medicare Advantage and Medicare Supplement products, clarifying that actions restricting enrollment access or manipulating producer compensation may violate state insurance law. The bulletin applies to all carriers and producers and requires insurers to maintain accessible enrollment applications, avoid discouraging sales or enrollment, and adhere to approved compensation structures. Bulletin B-4.157
Vermont released a notice explaining guaranteed issue rights and Medicare Supplement plan options for individuals in different scenarios, as many insurers have exited the state’s Medicare Advantage marketplace. Coverage availability depends on when a person became eligible for Medicare and includes special rules for newly eligible individuals, who have a six-month guaranteed issue window around their 65th birthday (or 24 months after a disability determination). Notice Dated 11/25/25
MISCELLANEOUS HEALTH / ACCIDENT
California issued an All-Plan Letter addressing amendments to network adequacy standards and methodologies affecting the 2026 Annual Network Review, including updates for mental health network availability, out-of-network care arrangements, provider data accuracy, and block transfer requirements. The guidance clarifies definitions, updates regulatory citations, and instructs plans to revise documentation and submit required filings through the DMHC e-Filing portal. DMHC APL 25-
OMNIBUS LEGISLATION
Illinois updated multiple sections of its Insurance Code to expand preventive health coverage, mandate vaccination administration fee coverage, strengthen PBM contract and reporting requirements, clarify licensure and refund processes, define unfair insurance practices, update pharmacy practice definitions, and establish a pharmacy support grant program. The changes include cost-sharing protections for immunizations, restrictions on PBM practices and drug access, updated reporting and licensure obligations, and grants to improve pharmacy access in underserved areas. HB 767
PHARMACY BENEFIT MANAGERS
Alaska issued a bulletin providing guidance on SB 132, updating licensing, fees, definitions, and examination requirements for Pharmacy Benefits Managers, Third-Party Administrators, Independent Adjusters, and other insurance entities to promote compliance and national uniformity. The bulletin establishes new PBM and TPA licensure standards, expands nonresident and designated home state licensing for independent adjusters, removes certain exemptions and physical location requirements, and updates lines of authority and compliance officer rules. Bulletin B 25-09
Arizona adopted Article 25 establishing licensing, operational, compliance, and recordkeeping standards for pharmacy benefit managers, including certificate of authority requirements, biennial renewals, utilization review obligations, and defined record-retention periods. The rules set a $500 non-refundable application and renewal fee, require notices for material modifications, and add specific licensing review timeframes to enhance transparency and regulatory oversight. R20-6-708 Table A
Colorado amended its regulations to require all pharmacy benefit managers operating in the state to register annually with the Division of Insurance and to clarify related compliance and enforcement procedures. The amendment updates the regulation’s effective date provisions and corresponding history section to reflect the revised implementation timeline. 3 CCR 702 Reg. 4-2-97 s 12
Illinois released a bulletin to provide guidance on the Prescription Drug Affordability Act, clarifying PBM reporting and fee obligations. PBMs must file annual reports on covered individuals and pay $15 per Illinois resident covered under administered plans, with enforcement temporarily deferred pending the enactment of HB 767, which further clarifies applicability, reporting requirements, and eligibility for credits or refunds. The bulletin specifies which plans are subject to the PDAA and provides instructions for submissions once HB 767 becomes law. Bulletin 2025-20
Kentucky amended its regulations to enhance licensure, renewal, and oversight requirements for pharmacy benefit managers, including updated fees, financial responsibility standards, and reporting obligations. PBMs must pay a $10,000 registration fee (with certain exemptions), maintain evidence of financial responsibility of at least $1,000,000, and comply with clarified renewal procedures. Additionally, the regulation incorporates the updated Pharmacy Benefit Manager License Application form. 806 KAR 9:360
Kentucky issued a revised bulletin providing guidance on the implementation and enforcement of SB 188 for pharmacy benefit contracts. The bulletin clarifies ERISA preemption, confirming that minimum pharmacy reimbursement rates are enforceable while anti-steering provisions are preempted. Bulletin 2025-03
Louisiana issued guidance on Act 474, establishing new reimbursement requirements for PBMs and health insurers contracting with PBMs. The law requires PBMs to use a reimbursement formula incorporating a prescription drug pricing benchmark (NADAC or an approved alternative), an adjustment factor to limit claim payment errors to 2% per drug, and a professional dispensing fee reflecting industry standards, with recommended markups and quarterly adjustments. Advisory Letter 2025-05
REGULATORY REPORTING REQUIREMENTS
Rhode Island summarized its 2026 annual and quarterly filing requirements for domestic and foreign health insurers. Insurers must follow the NAIC General Instructions, Health Insurers Checklist, and the Division’s Notes and Instructions, submitting required filings electronically to the Insurance Division (or Division of Taxation for premium taxes) by the specified due dates, while excluding unrelated items like annual statements, renewal fees, or retaliatory assessments. Filing Requirements 2026 Health
REPORTS - DATA CALLS & OTHER REPORTS
Colorado issued a revised bulletin requiring life, health, and private passenger auto insurers that do not use External Consumer Data and Information Sources (ECDIS), algorithms, or predictive models to submit annual attestations confirming non-use. Bulletin B-10.001
RISK-BASED CAPITAL
New York issued guidance for insurance companies on submitting Actuarial Opinions, Memoranda, and Risk-Based Capital Checklists, detailing filing requirements, deadlines, and submission procedures. Actuarial Opinions are due March 1, with checklists submitted by the Appointed Actuary via email for each legal entity, covering multiple regulations and specifying additional filings for MVA annuities, Universal Life with Secondary Guarantees, 2001 CSO Preferred Mortality Tables, and Variable Annuity Option Value Floor Reports. AOM and Risk Based Capital Checklist
Newsletter
Monthly P&C Newsletter
Property & Casualty News
October 2023
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 56 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!
AGENT / PRODUCER LICENSING AND APPOINTMENT
The Texas Insurance Commissioner updated the list of criminal offenses considered when a person with a criminal background applies for or renews an insurance license. 28 TAC s 1.502
AUTOMOBILE INSURANCE
New York now requires a carrier to provide (rather than offer) supplemental spousal liability (SSL) insurance in personal and commercial automobile policies. However, the named insured can decline or refuse the SSL coverage. The amended law contains other requirements. 11 NYCRR 60-1.6
CLAIMS / CLAIMS ISSUES
Oklahoma's Insurance Department notified Property & Casualty carriers they must include the Insurance Adjuster's Report, Claim Settlement Report, or claims statement or estimate when issuing claim settlement checks. Failure to do this may be considered an unfair claims settlement practice. Notice dated September 14, 2023
CONFIDENTIALITY / PRIVACY
California enacted certain privacy protections for individuals receiving medical treatment related to gender affirming care, abortion, contraception, and related medical treatment. Requirements to protect information are aimed at certain providers that store or maintain that type of information. AB 352
CREDIT FOR REINSURANCE
New Jersey's Department of Insurance, Office of Solvency Regulation published an updated list of eligible surplus lines reinsurers. All insurers domiciled, licensed or eligible to write surplus lines insurance in New Jersey or another state that has substantially similar standards are allowed to take full credit for reinsurance ceded to the listed reinsurers until September 1, 2024. Notice dated September 1, 2023
DISASTER / CATASTROPHIC EVENT
Hawaii's Insurance Commissioner issued a Memorandum encouraging all insurers providing residential property insurance to give insureds in areas impacted by the Maui wildfires at least 36 months of Additional Living Expenses, subject to policy limits. Memorandum 2023-5A
FILINGS: PROPERTY / CASUALTY
Arkansas’ Insurance Department announced an assessment to the members of the Arkansas Rural Risk Underwriting Association of $200. The assessment is due by 12-31-2023. Bulletin 15-2023
Delaware amended its regulations pertaining to rate and form filings, including adding a requirement that filings be submitted to the department no less than 60 days prior to the proposed effective date. The commissioner may extend the review up to 90 days by giving notice within 45 days of receipt of the filing, and the filing will not become effective until the later of department approval or the expiration of the extended time period. HB 228
FRAUD / ANTI-FRAUD
California enacted an amendment relating to false and fraudulent insurance claims. The amendment requires the insurer to provide the fraud warning on a form used when the person applies for a policy, seeks to amend insurance coverage, or furnishes information relating to underwriting criteria affecting premium or eligibility for coverage, under an existing policy, instead of when that person applies for a policy or seeks to make a change to an existing policy. SB 743
MISCELLANEOUS
California's Governor issued an executive order directing the insurance commissioner to take regulatory action to strengthen and stabilize California's homeowners and commercial property insurance marketplace. The regulatory response shall include improving the efficiency, speed, and transparency of the rate approval process. Executive Order N-13-23
Michigan published an updated list of all municipalities that participate in the Fire Insurance Withholding Program. Notice Dated October 1, 2023
Oregon's Insurance Commissioner issued a bulletin to identify the most common notice and filing issues/deficiencies and to remind producers and applicants of their responsibility to furnish the division with complete, accurate, and truthful information in all filings. Bulletin 2023-3
PROPERTY INSURANCE
Maryland issued a bulletin notifying insurers and producers of changes to the requirements for homeowners insurance for owners of detached condominium units. Beginning October 1, the homeowners' council is no longer required to maintain property coverage for detached units, but may voluntarily continue to provide coverage. The bulletin advises producers to confirm whether coverage is provided before making a recommendation to purchase coverage. Bulletin 23-15
REPORTS - DATA CALLS & OTHER REPORTS
California enacted legislation requiring the insurance commissioner to conduct data surveys to measure the availability and affordability of insurance for specified trucks. The bulletin will be published on or before 2-1-2024 and responses will be required by 5-1-2024. Results will be published. AB 844
SURPLUS LINES
Oklahoma's Insurance Department advises surplus lines agents and direct procurement filers that Oklahoma adopted the Surplus Lines Information Portal (SLIP) for reporting and payment of surplus lines premium tax. This is effective January 1, 2024. Bulletin 12-2023
TRADE PRACTICES
Delaware enacted legislation that prohibits an insurer from using any of the following when underwriting homeowner or private passenger insurance: non-pending arrests, charges and indictments that do not result in conviction, convictions unrelated to fraud or the risk being insured, or driver's license suspensions or revocations for non-driving related reasons. Use of any of these factors will be treated as unfair competition and unfair or deceptive act. SB 184
WORKERS' COMPENSATION
Arizona's Department of Insurance and Financial Institutions announced a 10.3% reduction in Workers Compensation Rates effective 1-1-2024. Press Release Dated 10-5-2023
Connecticut published a Workers' Compensation Memorandum updating the average weekly wage, maximum compensation rate and cost-of-living adjustments. MEMORANDUM NO. 2023-05
Kentucky adopted a rule to establish the proper calculation of the Workers' Compensation special fund assessment, set procedures to be used to collect the assessment, to allow for audits and define penalties. 803 KAR 30:010
Massachusetts published a circular letter updating the cost of living adjustments, minimum and maximum weekly compensation rates, and reimbursement schedules for workers' compensation benefits. Circular Letter 359
Nevada's Department of Business and Industry Industrial Relations published instructions for completing a D-35 Form to request an impairment evaluation rating of a possible permanent partial disability (PPD). Notice dated September 1, 2023
North Carolina's Department of Insurance approved the Rate Bureau's loss cost reference filing to become effective on April 1, 2024. Circular Letter C-23-11
The Texas Department of Insurance published the maximum and minimum weekly benefits under the Workers' Compensation Act for the period October 1, 2023, through September 30, 2024. WC Notice of Weekly Benefits 2024
Vermont General Assembly made numerous changes to workers' compensation law that directly affects the day-to-day adjustment of claims. This includes: 1) a change in the method for calculating temporary partial disability benefits; 2) an increase in the weekly benefit for each dependent child under age 21; and 3) an expansion of the preauthorization process for medical treatment. HB 217
Virginia's Department of Insurance approved the revision to NCCI Basic Manual Rules related to workers' compensation service charge and automatic gratuities for new and renewal policies on or after January 1, 2024. Administrative Order 12178
Washington announced its workers' compensation reimbursement rates for lodging, meals, and privately-owned vehicle mileage effective October 1, 2023. WC 2023 Mileage Reimbursement Rates Sept 2023
Wisconsin's Commissioner of Insurance approved Workers Compensation State Special Rating Values pages effective October 1, 2023. Circular Letter 3255
Wisconsin's Compensation Rating Bureau published details concerning the 2024 Financial Calls and Fining Program. An assessment for delinquent responses is levied. General Circular Letter 667
Newsletter
Monthly L&H Newsletter
Life and Health News
October 2023
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 56 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!
AFFORDABLE CARE ACT
The Federal Department of Labor, Health and Human Services and Treasury issued FAQs on September 27, 2023, regarding transparency in coverage under the Affordable Care Act. FAQs About Affordable Care Act Implementation Part 61
AGENT / PRODUCER LICENSING AND APPOINTMENT
California enacted legislation requiring agent examinations be provided in additional, specified languages. The Commissioner will be required to report annually on the number of applicants taking the exam in each language and the pass rate. AB 451
The Texas Insurance Department amended a regulation regarding offenses and criteria to consider when licensing an individual with a criminal background. 28 TAC s 1502
CONFIDENTIALITY / PRIVACY
California enacted an amended privacy law allowing for an abbreviated privacy notice when certain conditions are met. SB 793
Delaware adopted the Delaware Personal Data Privacy Act. New protections include, among other things, the right of the consumer to confirm whether or not a business is processing the consumer's personal data, to correct or delete data, to obtain a copy or summary of the data and to delete data. The law establishes duties for companies. The law also includes an opt-out right. HB 154
CREDIT INSURANCE
Wisconsin Insurance Commissioner announced new prima facie credit life and credit accident and health rates effective for a three-year period beginning January 1, 2024. Bulletin dated September 28, 2023
DISASTER / CATASTROPHIC EVENT
Oregon's Insurance Commissioner issued a bulletin specifying expectations of health insurers with regard to medical claim payments for insureds affected by wildfires and other declared emergencies in Oregon going forward. Bulletin DFR 2023-2
DISCRIMINATION
Colorado adopted a regulation requiring all life insurers utilizing external consumer data and information sources (ECDIS), algorithms and predictive models using ECDIS, to adopt a risk-based governance and a risk management framework designed to determine whether the use of these tools results in unfair discrimination based on race and to remediate if discrimination occurs. 3 CCR 702-10; Regulation 10-1-1
FILING REQUIREMENTS / PROCEDURES
Delaware amended its regulations pertaining to rate and form filings, including adding a requirement that filings be submitted to the department no less than 60 days prior to the proposed effective date. The commissioner may extend the review up to 90 days by giving notice within 45 days of receipt of the filing, and the filing will not become effective until the later of department approval or the expiration of the extended time period. HB 228
Illinois issued a bulletin reminding Accident and Health and Managed Care providers of the requirements of filing annual network adequacy filings. The bulletin further reminds carriers of the importance of the accuracy of their provider directories. Bulletin 2023-10
FRAUD / ANTI-FRAUD
California enacted an amendment relating to false and fraudulent insurance claims. The amendment requires the insurer to provide the fraud warning on a form used when the person applies for a policy, seeks to amend insurance coverage, or furnishes information relating to underwriting criteria affecting premium or eligibility for coverage, under an existing policy, instead of when that person applies for a policy or seeks to make a change to an existing policy. SB 743
HEALTH CARE EXCHANGE / MARKETPLACE
Rhode Island issued state-specific requirements for carrier notices of renewal and discontinuance in the Rhode Island Individual and Small Group Markets. Bulletin 2023-03
HEALTH INSURANCE - COMPREHENSIVE
Maryland's Insurance Administration informed carriers that the CARES Act requires coverage for COVID-19 vaccines, without cost-sharing, from an in-network provider no later than October 3, 2023. Bulletin 23-13
Nevada's Insurance Commissioner issued a bulletin reminding insurance companies of their obligation to provide COVID-19 vaccine coverage, including mRNA COVID-19 vaccine without cost-sharing obtained from a network provider. This is effective beginning October 3, 2023. Bulletin 23-002
MARKETING
Illinois adopted the Consumer Fraud and Deceptive Business Practices Act, which prohibits a business from sending a letter or postcard if the letter or postcard does not include the proper disclosures. All disclosures and disclaimers appearing on a postcard or letter must be conspicuously located at the top of the postcard or letter, be easily readable in clear and unambiguous language, and be printed in at least 14-point bold-face font in a black-outlined box. SB 1440
MEDICARE SUPPLEMENT INSURANCE
Oklahoma amended its Medicare Supplement regulations to create new enrollment opportunities for Medicare Supplement policyholders. Bulletin 10-2023
MENTAL HEALTH PARITY
Oklahoma made changes to its mental health parity law. The changes deal with denials of mental health and substance use disorder claims. Bulletin 11-2023; Senate Bill 557
MISCELLANEOUS
Kentucky adopted regulations establishing standards of conduct for agents and broker-dealers and describing a number of acts which will be considered unacceptable conduct or practices. 808 KAR 10:440
Maryland amended its regulations pertaining to the Prescription Drug Affordability Board. Amendments are intended to methods for paying the assessment, requesting an exemption from the assessment, address reconsideration of an exemption request and to clarify that health benefit plans are subject to the assessment. 14.01.02
New York revised its general business law to raise the maximum fine for persons violating the law regulating telemarketing to $20,000 for each violation. AB 4456
The U.S. Department of Treasury's Financial Crimes Enforcement Network (FinCEN) published a Small Entity Compliance Guide. This guide helps businesses determine if they are required to report their beneficial ownership information to FinCEN. FinCEN Notice dated September 18, 2023
PHARMACY BENEFIT MANAGERS
South Carolina amended its laws relating to Pharmacy Benefit Managers (PBM) and Pharmacy Services Administrative Organizations (PSAO). PSAOs must be licensed by January 1, 2024, in order to do business in the state. PBMs are prohibited from committing several additional acts included in Section 38-71-2230. Bulletin 2023-06; Section 38-71-2230
Tennessee's Department of Commerce and Insurance addressed concerns regarding the submission of wholesaler information by a pharmacy or pharmacy benefit manager (PBM) as part of the pharmacy's claim for reimbursement. Bulletin 23-05
REINSURANCE
New Jersey's Department of Insurance, Office of Solvency Regulation published a list of qualified accredited reinsurers. Notice dated September 1, 2023
REPORTS - DATA CALLS & OTHER REPORTS
Montana revised its regulation pertaining to Small Insurer Health Carriers to eliminate certain data reporting requirements. ARM 6.6.5050
RESERVE VALUATION
Kentucky adopted regulations pertaining to the valuation of life insurance and annuity reserves. The regulation sets out the framework for valuation standards and conditions under which the department actuary may verify insurance company reserves. 806 KAR 6:072
New York issued a Special Considerations Letter relating to December 31, 2023, reserves and other solvency issues. Special Considerations Letter dated September 8, 2023
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