Resources
Newsroom
Newsletter
Property Casualty News September 2023
Property & Casualty News
September 2023
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!
ADJUSTERS
Kentucky issued an advisory opinion clarifying permissible fees payable to a public adjuster. The collection of fees for claims paid prior to the execution of the written contract is only permitted in emergency situations at the Commissioner's discretion. In addition, the restriction of fees to 10%/15% applies to all fees collected by adjusters. Advisory Opinion 2023-07
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
Idaho announced that, beginning 9-1-2023, Pearson VUE will provide examination delivery service for all regulatory licensing for the Idaho Department of Insurance. This includes producer and adjuster licensing. Candidates interested in scheduling an examination should follow the links on the department's website. Notice Dated 8-24-2023
AUTOMOBILE INSURANCE
Massachusetts announces that the amendments proposed by the Commonwealth Automobile Reinsurer's ("CAR") to its Performance Standards for the Handling of Auto Insurance Claims are approved. The amendments include changes to the audit process, clarification of the claim screening and resolution practices, statutory changes to ensure payments are not subject to liens and a recommendation for NAIC standards. Order Docket C2023-01
CLAIMS / CLAIMS ISSUES
Colorado adopted new regulations, intended to simplify the claims process for homeowners insurance. The new rule sets out standards for submission of the policyholder inventory and expediting reimbursement for losses. 3 CCR 702-5, Regulation 5-1-23
Michigan published a bulletin providing updated guidance as a result of the Michigan Supreme Court decision in Andary v USAA Cas Ins Co, holding that the law does not apply to the cost of treatment provided to persons insured in accidents prior to June 11, 2019. The bulletin provides guidance on reprocessing of claims and refers to prior bulletin 2021-36-INS. Bulletin 2023-21-INS
COMMERCIAL LINES INSURANCE
Alaska announced that its Proof of Financial Responsibility Regulation is amended. The amounts of required coverage for discharge of oil have been increased. Memorandum of August 16, 2023; 18 AAC 75.205+
CONFIDENTIALITY / PRIVACY
California enacted an amended privacy law allowing for an abbreviated privacy notice when certain conditions are met. SB 793
DISCLOSURE REQUIREMENTS
Louisiana issued a revised bulletin to issuers of homeowner policies. Insurers are required to deliver the Catastrophe Claims Process Disclosure Guide when a homeowner makes a claim for damages due to a disaster or catastrophic event. Insurers are further required to maintain proof of delivery of the guide as described in the bulletin. Bulletin 2022-09
FILINGS: PROPERTY / CASUALTY
Colorado issued a bulletin providing guidance for insurers on the filing of underwriting methodologies for homeowners' policies. The department clarifies what constitutes underwriting methodologies and what information should be included in the filing. In addition, the department states that filings are to be made in SERFF no less than 30 days prior to the effective date. Bulletin B5.47
FRAUD / ANTI-FRAUD
New Mexico announced an extension of time to pay the New Mexico Fraud Assessment. Insurers have until October 2, 2023. After this date the fraud assessment and fee shall be subject to penalty. Notice 8-29-2023
Utah has repealed its mandatory fraud reporting rule because the reporting process has now been enacted by statute. R590-248
LIABILITY INSURANCE
Pennsylvania enacted a bill amending the Death by Wrongful Act law to raise the minimum amount of damages to $350,000. HB 5513
MARKET CONDUCT
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. SB 1440
MISCELLANEOUS
California enacted legislation creating a clearinghouse program to allow those denied coverage or renewal to secure commercial insurance coverage. The legislation requires insurers participating in the program to follow existing privacy laws. SB 505
Delaware enacted the Pet Insurance Act. The act sets a comprehensive framework for pet insurance policies that may be marketed in the state and for the sale and disclosure to consumers. HB 156
Louisiana announced the second 30-day application period for insurance companies to apply for the Insure Louisiana Incentive Program. The program offers grants to insurers who write new policies to residents who cannot find affordable insurance coverage. Notice 9-1-2023
New York enacted a new bill amending the insurance law as it relates to, among other things, confidentiality, and information sharing. It addresses the sharing of information between the insurance department and the NAIC, with other departments and with third party consultants, as designated by the department. The bill also addresses group capital calculations (GCC) and liquidity stress testing. SB 7095
REPORTS - DATA CALLS & OTHER REPORTS
Hawaii has issued a data call requiring semi-monthly reporting of claims data related to the August 8, 2023, wildfire and wind damages. There are also two non-claims reporting schedules, including the Reinsurance Reporting schedule and the Total Insured Value Reporting by zip code. Memorandum 2023-4E
Hawaii issued notice of the annual reporting requirements for Homeowners Insurers. Each year, by October 1, Homeowners Insurers shall submit representative premium quotations to the Commissioner. Additional directions are included in the notice. Annual Reporting Requirements Homeowners (2023)
Texas issued a bulletin to all property and casualty insurers in the state notifying them of a mandatory data call for information about "disallowed expenses." The bulletin includes instructions for completing the data call. The completed report is due no later than 9-29-2023 for the period January 1, 2022, to December 31, 2022. Bulletin B-0011-23
THIRD PARTY ADMINISTRATORS
New Hampshire enacted a law requiring that an insurer must conduct, at least semi-annually, an on-site or virtual audit of the operations of administrators. SB 99
UNINSURED MOTORISTS / UNDERINSURED MOTORISTS COVERAGE
Maryland published a bulletin providing guidance on the new law for Enhanced Underinsured Motorist Coverage (EUIM). The law requires that insurers make the offer for EUIM "using the form required by the Commissioner" and the bulletin provides the final required form. Bulletin 23-12
WORKERS' COMPENSATION
Arizona published updated Statutory Average Monthly Wage Maximum Benefits. Workers Comp Notice of Monthly Benefit
Florida adopted a rule intended to streamline the process for an injured worker to apply for screening for assessment and reemployment. FAC 69L-22.006
Minnesota's Department of Commerce announced that it has approved the 2024 Minnesota Ratemaking Report, effective January 1, 2024. Average pure premium has decreased. Cir No. 23-1824
New York enacted an amendment to its Workers Compensation law, raising the weekly compensation for the year, 2024. SB 1161
Oregon published a bulletin, updating the "Request for Reimbursement of Expenses" form. Rates, including lodging and meal rates have been updated. Insurers must include a form for requesting reimbursement with each independent medical examination appointment notice they send. Bulletin 112 (revised)
South Carolina issued an advisory notice reporting that a number of forms have been updated to provide a place to identify requested amendments to pleadings. New forms are available on its website. Outdated forms will be accepted until 11-1-2023. After that, outdated forms will be returned. WC Notice 9-1-2023
Newsletter
Life and Health News September 2023
Life and Health News
September 2023
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!
AGENT / PRODUCER LICENSING AND APPOINTMENT
Idaho announced that, beginning September 1, 2023, Pearson VUE will provide examination delivery service for all regulatory licensing for the Idaho Department of Insurance. This includes producer and adjuster licensing. Producer candidates interested in scheduling an examination should follow the links on the department's website. News Release Dated August 24, 2023
ANNUITIES / ANNUITY CONTRACTS
Oklahoma adopted the NAIC Annuity Suitability and Best Interest Standard Model Act and issued a bulletin setting forth producer training requirements. OAC 365:25-17, Bulletin 6-2023
CAPITAL AND SURPLUS REQUIREMENTS
Delaware's Department of Insurance informed insurers of an increase to the minimum amount of capital stock or unimpaired basic surplus and free surplus an insurer must possess and maintain throughout the year. Domestic and Foreign Insurers Bulletin 140
CAPTIVES
Arizona enacted legislation amending its definitions of branch captive insurer and foreign captive insurer and regarding the examination of a foreign captive insurer. HB 2005
DENTAL INSURANCE
California enacted legislation requiring, beginning January 1, 2025, that dental coverage providers disclose whether coverage is state regulated. The disclosure may appear on the electronic or physical identification card, or both, and on the provider portal. AB 952
Maine adopted a new rule establishing standards for calculating loss ratios for dental plans, reporting those ratios to the Superintendent, and reviewing plan credibility. The rule provides for recognizing activities that improve overall dental care. Chapter 835
DISASTER / CATASTROPHIC EVENT
Florida issued a reminder to industry of the requirements of Section 252.358, Florida Statutes. Any health insurer, managed care provider or similar provider must allow early prescription refills when the Governor declares a state of emergency. OIR Notice Dated August 26, 2023
FILINGS: HEALTH
Delaware adopted regulatory amendments and removed the requirement that carriers quarterly file a list of exempt plan numbers with the department. 18 DE Admin Code 1316
FRAUD / ANTI-FRAUD
New Mexico's Superintendent of Insurance informed insurers that it is extending the deadline to pay the New Mexico Fraud Assessment until October 2, 2023. After that time, unpaid insurers will be assessed a penalty of $1,000 per month. Notice dated August 29, 2023
HEALTH INSURANCE / HEALTH RATES
Colorado adopted an emergency regulation to implement SB 23-284 to ensure that health plans and pharmacy benefit managers acting on behalf of carriers provide the required coverage for contraception in compliance with the Public Health Service Act, as amended by the Affordable Care Act. 3 CCR 702-4
Illinois enacted amendments to its statutes requiring accident and health insurance or managed care plans, which provide coverage for prescription drugs and are amended, delivered, issued, or renewed after 1-1-2025 provide coverage for prescription estrogen. HB 1565
Illinois enacted an amendment lowering, effective 7-1-2025, the maximum amount payable for a 30-day supply of prescription insulin from $100 to $35. HB 2189
Louisiana amended current regulations to increase the Medicaid reimbursement rate for services provided by licensed midwives and certified nurse midwives. It also amended rates for services rendered by freestanding birthing centers. LAC 50:IX.15161, LAC 50:IX.15163, LAC 50:XV.27101
Oregon amended its insurance code to prohibit a health benefit plan from requiring a deductible, co-payment, coinsurance, or other cost-sharing for the coverage of HIV post-exposure prophylactic drugs or therapies prescribed following a possible exposure to HIV. HB 2574
HOLDING COMPANIES
New York revised its law dealing with holding companies, annual group capital calculation, and liquidity stress testing. SB 7095
LIMITED BENEFIT CONTRACTS
The Federal Department of Labor (DOL), Health & Human Services (HHS), and the IRS jointly proposed regulations that would limit the permissible duration of short-term, limited duration health insurance (STLDI). The proposed regulation also would modify the conditions for certain fixed indemnity insurance, such as hospital indemnity, to be considered an excepted benefit. It further clarifies the tax treatment of certain benefit payments in fixed amounts received under employer-provided accident and health plans. Comments are requested. 29 CFR Part 2590
MEDICARE SUPPLEMENT INSURANCE
Maryland adopted amendments to its Medicare Supplement Policy standards. The amendments include an annual open enrollment period for the 30 days following a policyholder's birthday. COMAR 31.10.06
MISCELLANEOUS
Georgia published a directive to producers and insurers providing notification that pet insurance may now be sold under the lines of life, accident and sickness, property and casualty or personal lines. Directive 23-EX-4
Illinois adopted amendments to its Illinois Adult Protective Services Act by changing certain definitions and clarifications. Additional changes pertain to the handling of suspicious deaths. HB 2858
Oregon amended its Death with Dignity Act to remove the requirement that the person be an Oregon resident. HB 2279
Oregon's Securities Law was amended to allow the Director to make a proper inquiry of a licensed broker-dealer, salesperson, investment adviser, etc. and to require the person to respond promptly and truthfully to the inquiry. HB 2274
PHARMACY BENEFIT MANAGERS
Kansas adopted a new regulation which details the information required to be included in the Pharmacy Benefits Manager network adequacy report. 40-1-54
Oregon amended its Pharmacy Benefit Manager (PBM) law to prevent a PBM from imposing a fee on a pharmacy after the point of sale. The law also does not allow a PBM to make a retroactive payment denial or reduction of payment on a claim for reimbursement, among other changes. HB 2725
REGULATORY REPORTING REQUIREMENTS
Missouri adopted a rule requiring the quarterly reporting of rates and charges by supplemental health care service agencies. The rule applies to agencies that participate in Medicare or Medicaid. 19 CSR 30-105.070
New Mexico's Superintendent of Insurance reminds major medical insurance carriers that the Prior Authorization Rule requires the reporting of their authorization policies and provider performance. The report is due by September 30 each year. Bulletin 2023-020
REPORTS - DATA CALLS & OTHER REPORTS
New Mexico's Superintendent of Insurance issued a data call to fully insured health insurance companies to report on the number of individuals in the state receiving health insurance coverage of substance use disorder treatment benefits. Bulletin 2023-019
Oregon requires a health insurer to file an annual report with the Department of Consumer and Business Services regarding drugs reimbursed by its health benefit plan. The law also requires a pharmacy benefit manager to file a report that includes the aggregated dollar amount of rebates, fees, price protections, and other payments received from drug manufacturers. SB 192
THIRD PARTY ADMINISTRATORS
New Hampshire revised the law that requires an insurer to conduct an audit of a benefit administrator who has more than 100 certificate holders of the insurer. The change states that an insurer must conduct, at least semi-annually, an on-site or virtual audit of the operations of the benefit administrator. Previously, one of the audits had to be on-site. SB 99
TRADE PRACTICES
Oregon revised its telemarketing law to make a person who knows or consciously avoids knowing that another person is violating a telephone solicitation practice subject to a penalty for violation to the same extent as the person engaged in the violation. HB 2759
Newsletter
Property Casualty News August 2023
Property & Casualty News
August 2023
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!
AGENT / PRODUCER TERMINATION
New Hampshire's Insurance Commissioner advised insurers that when an agent is terminated for cause, the carrier must notify the insurance department within 15 days of termination. The NHID urges all insurers doing business in the state to review their records to ensure that all terminations for cause over the previous 3 years have been reported to the NHID. All reports may be sent to enforcement@ins.nh.gov. Bulletin INS-23-024-AB
AUTOMOBILE INSURANCE
Massachusetts published a notice to all insurers designating certain 2024 model year vehicles as "high-theft" vehicles. The notice includes a list of all such designated vehicles. Property & Casualty Insurance Filing Guidance Notice 2023-A
CLAIMS / CLAIMS ISSUES
Colorado adopted a regulation to protect homeowners from unreasonable claims-handling delays during catastrophic disasters. The rule sets certain time limits and rules that insurers must follow in those situations. 3 CCR 702 Reg. 5-1-22
CROP HAIL INSURANCE
The Federal Risk Management Agency (RMA) announced its emergency procedures for crops damaged by excessive rainfall and catastrophic flooding in the Northeast United States. Managers Bulletin MGR-23-002
CYBERSECURITY
Oregon passed a law dealing with the protection of personal information of consumers. SB 619
LIABILITY INSURANCE
California enacted legislation which provides that a person who, in good faith and not for compensation, provides emergency care to a victim of an overdose is not liable for civil damages. AB 1166
Nevada's Division of Insurance provided guidance to insurers regarding passed law AB 398 which prohibits an insurer from issuing or renewing a liability insurance policy that contains certain provisions. This law is effective October 1, 2023, and applies to policies that provide third-party liability coverage. 2023 Assembly Bill 398 Guidance to Insurers
MISCELLANEOUS
Georgia published a directive to producers and insurers providing notification that pet insurance is included in the types of insurance which may to be sold by agents holding Life, Accident and Sickness, Property and Casualty, or Personal Lines. Companies can submit their insurance products for approval. Directive 23-EX-4
New Hampshire passed a law that sets regulatory standards for the sale of pet insurance. HB 249
South Carolina's Department of Insurance published tentative rates for credit property insurance for the year 2024. Bulletin 2023-05
NOTICE TO INSUREDS
Missouri updated a rule requiring additional information to be added to notices of cancellation, non-renewal, reduction, or adverse modification of standard fire policies. Additional information includes the insurer's address, toll-free number, and telephone number as well as the producer's name, address, and telephone number. It also updates the address for the Missouri Property Insurance Placement Facility and adds its website to the notice. 20 CSR 500-1.100
PERSONAL LINES INSURANCE
Michigan issued a bulletin announcing the annual adjusted maximum work loss benefit and maximum benefit payable for survivor's loss under policies of personal protection insurance. The new maximums will be payable effective 10-1-2023. Bulletin 2023-18-INS
PROPERTY INSURANCE
Colorado amended regulations aimed at improving the availability of fire insurance. It places restrictions on an insurer's ability to refuse to issue or renew a policy in certain, threatened areas. 3 CCR 702-5 Reg. 5-1-17
Louisiana published a bulletin notifying insurers of the requirements pertaining to premium discounts or credits provided to insureds who build or retrofit property consistent with the Fortified Home or Fortified Commercial standards. Affected insurers must submit rates and rating plans by 11-1-2023. Bulletin 2023-03
New Hampshire passed a law at the request of the insurance department which revises certain requirements for combined insurance coverage against fire and other perils. It applies to both personal and commercial lines insurance. HB 210
REGULATORY REPORTING REQUIREMENTS
Florida published an informational memorandum notifying residential property insurers of the requirements of 2023-172 regarding claims handling manuals. There is an annual requirement, due 8-1, to submit an attestation stating that they have created and use claims handling manuals that meet the requirements of the Florida Code and meet minimum, usual and customary practices. OIR-23-03M
REPORTS - DATA CALLS & OTHER REPORTS
Connecticut issued a notice reminding insurers that the annual data certification on technology and Big Data is due 9-1-2023. The annual certification form can be accessed on the state's website. Notice Dated 7-25-2023
Pennsylvania Insurance Department released its annual Private Passenger Automobile Data Call. The information is due no later than October 16, 2023. CALL FOR 2022 PENNSYLVANIA ACT 6 EXPERIENCE
THIRD PARTY ADMINISTRATORS
New Hampshire passed a law dealing with third party administrators. It provides that applicants for an administrator license may post a bond or other collateral acceptable to the Department instead of two years of audited financial statements. SB 31; 402-H:11
WORKERS' COMPENSATION
California issued a new, lower benchmark rate for Workers Compensation Insurance. The benchmark rate is lowered to $1.46 per $100 of payroll. Press Release Dated 7-11-2023
Delaware's Compensation Rating Bureau announced a new reporting requirement for a series of Calendar Accident Year Financial Data Calls. The first will be due 3-15-2024 and the DCRB will notify all reporters in the fall. Circular No. 1025
Indiana published a circular intended to clarify the impact of revisions to the workers compensation manual, including clarification of payroll inclusions and exclusions. Circular 2023-08
Maine enacted legislation to govern group self-insured reinsurance fronting arrangements. The fronting arrangement involves a fronting company, which issues a workers compensation policy, to a member of a group self-insurer, ceding premium and exposure for out-of-state employees. HP 886
Nebraska Workers' Compensation Court announced the web-based data entry application for Diagnostic Related Group (DRG) reports is now activated. The Workers' Compensation law requires insurers, hospitals, self-insured employers, and risk management pools to report claim and stop-loss threshold counts by DRG to the Court. Notice dated August 1, 2023
Ohio's Industrial Commission revised the outpatient medicine formulary to add, remove and change certain medications. Rule 4123-6-21.3
Pennsylvania's Compensation Rating Bureau informed all its members of a new reporting requirement due on April 15, 2024. This new requirement is a series of Calendar-Accident Year Financial Data calls. PCRB Circular 1798
Pennsylvania's Insurance Department announced it has received from the Pennsylvania Compensation Rating Bureau a filing to revise its experience rating plan for 2024. The plan revises eligibility criteria which will result in more employers qualifying for the experience rating plan. Notice dated July 15, 2023(B)
Washington promulgated an order allowing the use of telemedicine exams when there is no approved examiner in the worker's community. The order sets forth the types of exams that may be conducted via telehealth. WAC 296-23-358; 296-23-359
West Virginia's rating and statistical agent filed a proposed workers' compensation loss cost decrease of 12.7% effective November 1, 2023. Notice dated July 26, 2023
Wisconsin's Insurance Commissioner approved an overall decrease in the workers' compensation rate level of 8.39%. The revised rates and rating values were released effective October 1, 2023, for new and renewal policies. Circular Letter 3254
Newsletter
Life and Health News August 2023
Life and Health News
August 2023
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
The Federal Departments of Labor, Health and Human Services, and Treasury jointly issued FAQs dealing with surprise medical bills under the No Surprises Act, transparency disclosures, and their interaction with the Affordable Care Act (ACA). Part 60 of ACA FAQ's
AGENT / PRODUCER LICENSING AND APPOINTMENT
Alabama made updates to its regulation governing producer licensing, including the removal of the service representative license and the removal of prelicensing education requirements. 482-1-147
ANNUITIES / ANNUITY CONTRACTS
New York’s Life Bureau issued a Filing Guidance Note regarding Withdrawal Rates for Guaranteed Living Withdrawal Benefits in Annuities. The standards under Section 50-2.9(h)(2) are effective January 1, 2024. Filing Guidance Note dated July 12, 2023
New York's Life Bureau published a Filing Guidance Note regarding Minimum Cap Rates for Non-Guaranteed Index Annuities under 50-2.9(d)(5) of Insurance Regulation 47. Filing Guidance Note dated July 12, 2023
CLAIMS / CLAIMS ISSUES
Nebraska changed its judgment interest rate to 7.494%. If a life insurer does not pay a death claim within 30 days of receiving proof of loss, the insurer must pay interest at the rate in effect on January 1 of the calendar year in which the proof of loss was submitted to the carrier. Memo dated July 6, 2023
CYBERSECURITY
Kentucky adopted regulations addressing the requirements for establishing a cybersecurity program for those subject to the act. The regulation also outlines the procedures for required filings and reports. 806 KAR 3:250
The Texas Department of Insurance advised all regulated entities of addresses to which cybersecurity incidents may be reported. Bulletin B--0009-23
DISCRIMINATION
New Jersey's Commissioner of Insurance notifies insurance companies authorized to issue health benefit plans of requirements concerning nondiscriminatory coverage for health services provided to transgender individuals. Bulletin 23-05
New York's Department of Financial Services, Life Bureau remind insurers they cannot engage in any unfair discrimination in the sale of life insurance or annuities. Circular Letter 2023-6
FILING REQUIREMENTS / PROCEDURES
Colorado adopted amendments to its form filing requirements for certain health benefit plans and dental plans. Changes include filing procedures and certifications. 4-2-41
The New York Life Bureau issued a Filing Guidance Note for life and annuity products. Life Bureau Filing Guidance of July 17, 2023
GROUP HEALTH
Texas passed a new law authorizing Group Family Leave Insurance as a type of disability income insurance. This law applies only to family leave insurance issued by a life, health, and accident insurance company. HB 1996
HEALTH INSURANCE / HEALTH RATES
Alaska enacted an amendment to its regulations repealing the 80th percentile rules for health care providers. As a result, insurers are no longer required to pay out-of-network providers at least the 80th percentile for services rendered. 3 AAC 26.110
Arkansas issued a bulletin confirming that the prior authorization law applies to non-physicians including physical therapists, occupational therapists, and speech pathologists when they are operating within the scope of their practice. Bulletin 12-2023
California amended numerous health care statutes, including prohibiting a health insurer from requiring preauthorization for behavioral health crisis services. AB118
Colorado adopted revisions to the Medical Assistance Rule Concerning Gender-Affirming Care to align policy with the most recent standards of care. MSB 22-12-13-A; 10 CCR 2505-10 s 8.735.1
Colorado enacted legislation requiring insurers and pharmacy benefit managers to count any amount paid by the patient or through a cost-sharing assistance program against the patients out of pocket limit. SB 195
Connecticut adopted a bill amending various sections of its health care laws, including a requirement for health insurers to disclose the standards used for assigning tiers to health care providers. HB 6669
Maine enacted legislation prohibiting the requirement that a patient obtain a second opinion from a provider practicing in the same office as the primary provider. The legislation further prohibits the payment of a higher deductible or coinsurance payment for an out-of-network second opinion when no in-network provider is available. HP 630
Nevada prohibits an insurer from contracting with a vision care provider that requires the use of a specific laboratory as the manufacturer of ophthalmic devices or materials provided to covered persons, among other items. SB 134
HEALTH MAINTENANCE ORGANIZATIONS
Illinois published a bulletin clarifying the requirements of a recent amendment to the HMO Act. P.A. 103-0104 provided that an HMO may voluntarily offer a referral system to contracted providers. The bulletin clarifies that this does not mean such a referral system is required. Bulletin 2023-07
LIFE INSURANCE / LIFE CONTRACTS
New Hampshire provided updated guidance regarding permissible wellness reward programs offered with life insurance products. Bulletin INS 23-023-AB
The New York Life Bureau issued a Filing Guidance Note regarding Universal Life Nonforfeiture Rate and Paid-Up Insurance Option Rate. Filing Guidance Note dated July 12, 2023
MEDICARE SUPPLEMENT INSURANCE
Rhode Island amended its Medicare Supplement Insurance law to allow individuals enrolled in Medicare Parts A and B to apply for a Medicare Supplement plan, regardless of age, and have guaranteed issue rights if certain conditions are met. SB 583
MISCELLANEOUS
Connecticut enacted legislation designed to protect against the financial exploitation of seniors, including immunity from liability for a "qualified person" who discloses suspected exploitation in good faith. Note that the definition of qualified person includes broker dealers and investment advisors. SB 1088
OMNIBUS LEGISLATION
Nebraska enacted an omnibus bill that creates the following: 1) limits reimbursement a covered individual is required to pay for each insulin prescription drug to $35 for a 30-day supply; 2) establishes the Insurance Regulatory Sandbox Act to enable carriers to temporarily test innovative insurance products without being licensed; 3) allows the plan sponsor to consent to all electronic communications for a covered person if certain conditions are met. LB 92
PHARMACY BENEFIT MANAGERS
Florida published a bulletin notifying pharmacy benefit managers of recent changes included in the Prescription Drug Reform Act. Changes include additional reporting requirements and biennial examinations. Informational Memorandum OIR 23-04M
New Jersey established additional data reporting requirements for Pharmacy Benefit Managers and insurers. SB 1615
New York amended Regulation 195 and added Regulation 222 which provides general duties, accountability, and transparency provisions for Pharmacy Benefit Managers. 11 NYCRR 6.2
REPORTS - DATA CALLS & OTHER REPORTS
The New Jersey Insurance Commissioner announced it is conducting the Climate Risk Disclosure Survey for reporting year 2022. Completed surveys are due August 31, 2023. Bulletin 23-06
UNCLAIMED PROPERTY
Illinois enacted legislation amending certain requirements and time frames for certain types of unclaimed property. HB 2224
- Category
- All
- Article
- Download
- Year
- 2026
- Archive
- All Dates