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Property & Casualty News December 2023
Property & Casualty News
December 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
Kansas published notice of producer application fees for 2024. Notice of Application Fee Amounts 11/09/2023
Wisconsin's Insurance Department announced the process for agent appointment renewals. The billings are available and payments may be submitted starting January 5, 2024. Bulletin dated November 14, 2023
Wyoming's Insurance Department published the timeline for 2024 agent appointment renewals and procedures. Posting to DOI website on December 13, 2023
AUTOMOBILE INSURANCE
North Carolina's Reinsurance Facility (NCRF) informed member companies of a commercial auto loss recoupment. A surcharge of 3.74% will be implemented on April 1, 2024, for all new and renewal commercial auto policies effective on or after April 1, 2024, through September 30, 2024. RF Circular Letter RF-23-17
CREDIT FOR REINSURANCE
Maryland amended its credit for reinsurance regulations. The revisions remove the Commissioner's authority to remove a reciprocal jurisdiction from its approved list when that jurisdiction is the subject of a covered agreement between the US and that jurisdiction. 31.05.08
CYBERSECURITY
New York’s State Department of Financial Services alerted carriers to the threat of a cybersecurity vulnerability known as "Citrix Bleed." Carriers are advised to assess their risk and act accordingly. Industry Letter dated November 14, 2023
FINANCIAL REGULATION
Kentucky published a bulletin notifying companies of the electronic filing requirements for all financial documents, including annual statements, effective immediately. Bulletin 2023-05
LIABILITY INSURANCE
Minnesota published a notice to all property casualty insurers of the adoption of the Family Protection Act. The act, effective 01/01/2024 (for auto insurance) and 05/01/2024 (for boat insurance) prohibits certain exclusions or limitations when the injured party is an insured other than the named insured or a member of the insured's household or family. The act also requires boat policies to offer a declination of coverage notification. Notice dated 11/01/2023
MISCELLANEOUS
Florida adopted amendments to statutes to amend the definition of "scrutinized company." The state Board of Administration will maintain a list of scrutinized companies with activities in Iran Terrorism Sectors. Domestic companies are required to annually file a list of companies in which they have investments which are on the Scrutinized Companies list. HB 5
Hawaii published a bulletin reminding insurers that all insurance companies are encouraged to work with residents who have lost homes, businesses, and employment due to the wildfires. Companies should continue to refrain from cancelling due to non-payment of premium, work with insureds on structured payment plans, waive late fees and penalties, extend timeframes, and otherwise cooperate with insureds through at least March 5, 2024. Memorandum 2023-7A
Michigan released the List of Michigan Municipalities Participating in the Fire Insurance Withholding Program effective January 1, 2024. Edition 162 released 12/01/2023
Michigan's Insurance Commissioner published the annual adjustment of the fire insurance maximum escrow under the Michigan Insurance Code. The adjustment is effective January 1, 2024. Bulletin 2023-22-INS
New York withdrew Circular Letter 6 (2001) and no longer requires fingerprinting. The submission requirements for biographical affidavits and independent third-party verification for officers have been updated. Notice dated December 1, 2023
PREMIUM TAX
New Hampshire's Insurance Department published 2023 premium tax instructions for property and casualty carriers and risk retention groups. Notice dated November 27, 2023
PROPERTY INSURANCE
California announced that a state court has upheld the Commissioner's order that the California FAIR Plan offer homeowners a more comprehensive insurance option. Press Release 11/29/2023
Louisiana issued an advisory letter, clarifying and restating an earlier advisory letter on the topic of storm and hurricane deductibles. The department clarifies that all insurers using a separate deductible to be applied in place of any other deductible resulting from a named storm or hurricane shall apply the deductible on an annual basis to all named storm or hurricane losses that year. The department further explains that a named storm is a storm that has been declared a named storm by the National Hurricane Center of the National Weather Service. Advisory Letter 2018-01 Revised and Reissued
REPORTS - DATA CALLS & OTHER REPORTS
Delaware issued a bulletin reminding property and casualty companies writing certain lines of business that the deadline to submit an action plan, detailing how to resolve reporting problems, was due 11/20/2023. Companies subject to the reporting requirements, who have not yet submitted a plan should do so immediately. Domestic-Foreign Bulletin 55 (REISSUED)
Texas Department of Insurance has issued a data call to carriers writing private passenger and commercial automobile, homeowners, workers' compensation, commercial and residential fire, and other lines of P&C insurance. This data call is due by February 2, 2024. Bulletin B-0014-23
SURPLUS LINES
Oklahoma's Insurance Commissioner announced the adoption of the Surplus Lines Information Portal (SLIP) for reporting and paying surplus lines premium taxes. This change is effective for policies and endorsements effective January 1, 2024. Bulletin 12-2023
TRADE PRACTICES
Alabama adopted amendments to its rebating limitations, including raising the limit of allowable value from $15 to $100 (non-cash), per family. 482-1-088
Illinois enacted amendments to the Consumer Fraud and Deceptive Business Practices Act, including required content and disclosures for postcards used to solicit contact from consumers. SB 1440
Michigan adopted the uniform power of attorney act. The act sets requirements for a power of attorney to be granted, guidelines for permissible acts and duties and penalties for violations. HB 4644
Michigan amended its law governing producer practices. An agent will be considered a fiduciary for all money received and held by the agent. Effective 05/05/2024, the act provides for additional duties when acting as a fiduciary in the handling of funds. HB 4376
WORKERS' COMPENSATION
California announced it has opened registration for its next Workers Compensation Educational Conference, scheduled for March 7-8, 2024, in Los Angeles, CA. The event is open to claims administrators, attorneys, medical providers, employers, and others. Notice Dated 12/04/2023
Connecticut announced that, effective 1-1-2024, new workers compensation insurance rates will be reduced by 10%. The notice includes a chart of rate changes over the past 10 years. Notice Dated 11/15/2023
Nevada Workers' Compensation Section advised workers' compensation insurers and self-insured employers and associations of self-insured employers of a reporting requirement. Each entity must submit Fiscal Year 2023 WCS Workers; Compensation Claims Activity Report and Statement of Inactivity by January 12, 2024. Letter dated November 21, 2023
Oregon's Workers' Compensation Division informed workers' compensation insurers and self-insured employers of optional use of updated Spanish translations. Bulletin 315 (Revised)
Texas Division of Workers' Compensation adopted amendments pertaining to claiming death benefits. 28 TAC 122.100
Texas Division of Workers' Compensation released its annual change to the Medical Fee Guideline conversion factors based on the Medicare Economic Index (MEI). The MEI for 2024 reflects an increase of 4.6%. 28 TAC 134.203, Labor Code 413.011(a)
Wisconsin's Department of Workforce Development announced the maximum rates for Worker's Compensation for the year 2024. The rates will increase to $1,296 per week for temporary total disability, permanent total disability, and death benefits effective January 1, 2024. Insurance Letter 541
Newsletter
Life and Health News July 2025
Life and Health News
July 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!
AGENT / PRODUCER CONTINUING EDUCATION
Louisiana updated its licensure and continuing education requirements for insurance producers, consultants, adjusters, and public adjusters by mandating additional training on legislative updates in insurance law. The law also raises the claims threshold for unlicensed insurer employees adjusting property and casualty losses from $500 to $2,000. SB 40
New Mexico’s Office of Superintendent of Insurance announced the repeal of rule 13.10.34.24 NMAC on continuing education for producers selling excepted benefits plans, originally set to take effect April 1, 2026. The rule required specialized training and licensure compliance but will no longer apply once repealed. The OSI plans to introduce a replacement rule by the end of 2025. Notice Regarding 13.10.34.24 NMAC
AGENT / PRODUCER LICENSING AND APPOINTMENT
Maine will now be issuing 180-day apprentice insurance producer licenses without an exam. Sponsors must have a clean Maine license for at least a year and take full responsibility for their apprentices. Apprentices can only work on in-state risks under the sponsor’s license and cannot handle complex products or act as insurer agents unless appointed. Sponsors are limited to two apprentices per year. HP 567
BENEFICIARY
Texas amended its Insurance Code to clarify that caregivers at state supported living centers, assisted living facilities, intermediate care facilities, or group homes do not have an insurable interest in the lives of individuals with disabilities unless they are relatives—defined as a spouse, parent, stepparent, child, stepchild, sibling, stepsibling, or legal guardian. This applies to life insurance policies issued or renewed on or after January 1, 2026. HB 1041
CLAIMS / CLAIMS ISSUES
Oklahoma amended the Unfair Claims Settlement Practices Act to shorten the time limits for refund requests on paid claims. Insurers now have 6 months (down from 12), and health care providers have 12 months (down from 18) to request refunds after payment. SB 1050
Texas enacted new Insurance Code provisions requiring a uniform coordination of benefits questionnaire for health benefit plans. Beginning February 1, 2026, all health insurers using coordination of benefits provisions must adopt a single standardized form created by the Department of Insurance to streamline dual coverage determinations. HB 388
CREDIT INSURANCE
Illinois amended Part 1051 of its insurance regulations to update prima facie rates for credit life and credit accident and health insurance. The suicide exclusion period is reduced from one year to six months, and "war or any act of war" is added as an exclusion. The amendments also eliminate the triennial review and hearing requirements for rate adjustments. 50 Ill. Adm. Code 1051.50
DENTAL INSURANCE
Maine now prohibits insurers from requiring dental providers to charge fees for non-covered services and mandates that fees for covered dental services be set in good faith and not be nominal. These rules apply to individual and group dental insurance, as well as health maintenance organizations offering dental coverage. HP 1205
DISASTER / CATASTROPHIC EVENT
New Mexico’s Office of Superintendent of Insurance issued an Emergency Order in response to the Trout Fire, providing 90 days of enhanced insurance protections for affected residents. The order requires health insurers to offer premium grace periods, early prescription refills, out-of-network coverage, and waived cost-sharing, while property and auto insurers must allow premium and claims grace periods, waive deductibles, and cover additional living expenses for displaced homeowners. Emergency Order Dated 6/18/25
DISASTER PREPAREDNESS
New York issued updated disaster planning and response requirements for life and health insurers and related entities. The circular mandates annual business impact analyses and board-approved continuity and disaster response plans tailored to each entity’s operations. By August 15, 2025, entities must submit their plans and related documentation through the DFS portal. Insurance Circular Letter No. 4
DISCRIMINATION
Louisiana expanded anti-discrimination protections to prohibit employment discrimination based on military status, including in hiring, compensation, and training programs. The law defines military status and specifically bars insurers from discriminating when appointing or compensating insurance agents based on military status. SB 66
DRUG / PRESCRIPTION COVERAGE
Nevada caps cost-sharing for prescription insulin at $35 for a 30-day supply to improve affordability for people with diabetes, including type I, type II, and gestational diabetes. This limit applies to individual, group, and various health insurance policies and plans issued or renewed after October 1, 2025, with exemptions for certain Medicaid, CHIP, and government-related managed care plans. AB 555
FRAUD / ANTI-FRAUD
California updated its 2024 Special Investigative Unit (SIU) annual report requirements, setting a new submission deadline of September 15, 2025, for all licensed insurers. While report content remains unchanged, the Department will mail official notices in late June and offer training sessions on July 30 and August 20. The online portal will remain open until the deadline. SIU E-Blast 2025-12
GROUP HEALTH
Texas extends the automatic coverage period for newborns under certain health benefit plans from 32 to 61 days after birth. The state now requires notice of birth and any additional premium to be submitted by the 60th day, instead of the 31st, to continue coverage. These changes apply to plans delivered, issued, or renewed on or after January 1, 2026. SB 896
HEALTH INSURANCE - COMPREHENSIVE
Colorado amended its health insurance law to require health benefit plans with maternity coverage, issued or renewed on or after January 1, 2027, to cover up to three prenatal care visits without cost-sharing. This mandate does not apply to standardized health benefit plans under Section 10-16-1305. SB 118
Louisiana now requires health insurers to cover proton therapy for cancer patients, effective for new policies issued on or after January 1, 2026. Existing plans must comply upon renewal by January 1, 2027. Coverage may include standard cost-sharing but excludes limited benefit, excepted, and short-term plans of less than 12 months. SB 129
Nevada issued regulation prohibiting providers of vision insurance from controlling the professional judgment of vision care providers, employing them, or withholding payments based on their choice of labs or suppliers. It also bans conditioning a provider’s participation in one plan on their participation in other plans and requires disclosure of ownership or financial interests in suppliers. AB 448
MEDICARE SUPPLEMENT INSURANCE
Nevada now requires insurers to offer Medicare supplemental policies to individuals under 65 with disabilities or end-stage renal disease on the same terms as those aged 65 and older, including prohibiting denials or exclusions based on health status during specified open enrollment periods. The bill sets premium rate limits, mandates insurer notifications, and extends protections to nonprofit insurers, government employee plans, and self-insurance programs. SB 292
Wyoming introduced a “Birthday Rule” for Medicare Supplement Guaranteed Issue Periods. The Guaranteed Issue Period now begins on the insured’s birthday and lasts 63 days, allowing policyholders to switch to a Medicare Supplement plan with similar or lesser coverage without underwriting. Bulletin 06-2025
MISCELLANEOUS
Federal Department of Health and Human Services issued a Technical Assistance document clarifying procedures for reopening Federal IDR disputes under the No Surprises Act to correct certified IDR entity errors. The guidance allows correction of clerical, jurisdictional, and procedural mistakes through a streamlined process initiated via the Federal IDR portal CMS Notice Dated 6/6/25
Federal Financial Crimes Enforcement Network (FinCEN) issued updated guidance to help financial institutions detect and report Iranian sanctions evasion and related illicit activities. The advisory highlights red flags tied to oil smuggling, shadow banking, and weapons procurement, and coincides with OFAC sanctions on over 40 individuals and entities linked to Iran’s shadow banking networks. Financial institutions are urged to file Suspicious Activity Reports (SARs) using key term “IRAN-2025-A002” and remain vigilant under BSA obligations. FinCEN Notice Dated 6/6/25
PHARMACY BENEFIT MANAGERS
Alaska adopted new regulations outlining registration, operational requirements, and penalties for pharmacy benefits managers (PBMs), requiring detailed disclosures, financial documentation, and compliance with recordkeeping standards. PBMs must pay a $300 fee for registration or renewal and face civil penalties of up to $25,000 per violation for noncompliance. 3 AAC 31.020
Colorado enacted new regulations regarding pharmacy benefit manager (PBM) practices to reduce prescription drug costs by allowing flat-dollar service fees, banning income tied to drug prices, and mandating reimbursement for cost-saving efforts. PBMs must disclose drug cost information to health benefit plans, favor generics or lower-cost brands, and allow annual audits. HB 1094
Iowa enacted legislation strengthening oversight of pharmacy benefit managers (PBMs). The law requires PBMs to pass through 100% of rebates, reimburse pharmacies at NADAC plus a $10.68 dispensing fee, and submit quarterly reimbursement reports. It also establishes new appeal rights for pharmacies and mandates a state review of pharmacy services administrative organizations and the prescription drug supply chain. SF 383
Maine now prohibits carriers and pharmacy benefits managers from using spread pricing in contracts entered or renewed on or after January 1, 2026. They must certify compliance annually to the Department of Insurance starting December 31, 2026, with violations subject to enforcement. HP 1038
Maine now prohibits health insurance carriers and their contracted pharmacy benefits managers from reimbursing pharmacies at rates lower than those paid to affiliated pharmacies for the same prescription drugs or services. HP 113
Oregon now includes organizations acting as pharmacy services administrative organizations, or similar entities advising or representing member pharmacies, within the scope of third-party administrator activities. Third-party administrators must comply with other applicable licensing requirements when performing functions of insurance producers, adjusters, or insurance consultants. HB 3226
Texas now prohibits pharmacy benefit managers from limiting pharmacists or pharmacies from informing enrollees about out-of-pocket cost differences for prescription drugs with or without insurance claims. The state also voids any contract terms that restrict such disclosures and protects related communications with plan sponsors or administrators. SB 493
PRE-NEED CONTRACTS
Colorado updated the Revised Uniform Unclaimed Property Act to clarify reporting rules for legacy preneed contracts, define key terms like "cryptocurrency," and establish new timelines for presuming property abandoned. The law reduces compensation and record retention periods, mandates liquidation of virtual currency, and strengthens confidentiality protections for claimant information. HB 1224
Maine updated its regulations on pre-need funeral insurance and services by prohibiting contracts that mandate specific funeral providers and clarifying the use of life insurance for funeral payments. The law expands prearranged funeral plan definitions, removes commission prohibitions for procuring insurance, and restricts solicitation of prearranged plans by funeral establishments except when consumers initiate contact. HP 553
REPORTS - DATA CALLS & OTHER REPORTS
Arkansas issued a bulletin extending the Rule 128 data-reporting deadline for plan year 2026 from July 1 to July 31, 2025, allowing more time for health insurers, PBMs, and other entities to compile complete reports. The Insurance Department will review submissions for compliance and grant ten business days to correct any deficiencies. Bulletin 8-2025
Indiana released a bulletin notifying insurers, TPAs, and PBMs of new annual ownership reporting requirements under Public Law 239-2025. Entities must report detailed ownership information, excluding Social Security numbers, with fines of $1,000 per day for late submissions beginning in 2026. The Department plans to issue a follow-up bulletin with submission details. Bulletin 278
RESERVE VALUATION
New York issued a Special Considerations Letter outlining reserve and solvency requirements for life insurers, fraternal societies, and accredited reinsurers for the valuation date of December 31, 2025. It provides detailed actuarial guidance on asset adequacy analysis, assumptions, and filing deadlines under Regulations 126 and 147. Insurers must use conservative, historically validated assumptions and submit required filings between March and June 2026. Special Consideration Letter of 6/16/25
TRADE PRACTICES
New Hampshire’s Insurance Department issued a bulletin warning against misuse of the National Producer Number (NPN) override and improper “producer of record” designations in insurance sales. The bulletin highlights that listing a producer who did not interact with the consumer or using the NPN override to submit applications violates state law and may lead to fines, license suspension, or revocation. Bulletin INS 25-038-AB
UTILIZATION REVIEW - HEALTH CARE
Texas strengthened its health benefit plan preauthorization rules, now requiring utilization reviews to be directed by Texas-licensed physicians (excluding those with administrative-only licenses) and extending the preauthorization exemption evaluation period from six months to one year. The law enhances provider rights to independent reviews, limits rescission timing to January each year, and mandates public annual reporting by insurers. HB 3812
Newsletter
Property & Casualty News November 2023
Property & Casualty News
November 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
California amended the existing law requiring the license number of an organization to appear adjacent to or on the line below the organization's name. The amendment clarifies that the license number of an organizational licensee shall appear adjacent to or on the line below the organization's name if the email is sent from the organization and not an individual licensee and the communication involves an activity for which a license is required. AB 1578; Section 1725.5
Oklahoma's Insurance Department advised carriers of the process and deadline dates for renewal of producer appointments in a notice dated October 16, 2023. 2023 Appointment Renewal Notification
Washington amended its resident producer licensing rule to remove the condition that an applicant for a license complete a pre-licensure course of study for the lines of authority for which the person applied. WSR 23-21-103
AUTOMOBILE INSURANCE
California amended laws pertaining to the Bureau of Auto Repair, including an expansion of the definition of Automotive Repair Dealer. The definition now also includes a person who collects compensation for automotive repair services referred to someone other than the dealer or their employees. AB 1263
CLAIMS / CLAIMS ISSUES
Oregon's Administrator of the Workers' Compensation Division advised carriers that some workers are reporting that claims examiners have not responded in a timely manner to their inquiries. Carriers are reminded that all inquiries should be responded to within 48 hours. Notice dated October 31, 2023
CONFIDENTIALITY / PRIVACY
California adopted amendments to the California Right to Financial Privacy Act, including expanding the period of time in which a government agency may request information from a financial institution to investigate a crime. The bill also allows additional items to be included in the request. AB 386
California updated the California Consumer Privacy Act to include, in the definition of "sensitive personal information" personal information that reveals a consumer's citizenship or immigration status. AB 947
CREDIT INSURANCE
South Carolina's Department of Insurance approved new rates for credit property insurance sold in connection with loans subject to the South Carolina Consumer Protection Code. Order 2023-04
CYBERSECURITY
Missouri issued a bulletin providing companies with more detail concerning their obligations to report cybersecurity breaches to the department of insurance. Any security breach should be reported to the department within 10 days of becoming aware of the breach. The bulletin provides additional instructions for making the notification. Bulletin 23-04
New York's Department of Financial Services amended its regulation dealing with cybersecurity requirements for financial services companies. 23 NYCRR 500.1+
DISCRIMINATION
Delaware issued a bulletin notifying insurers of the prohibition of certain underwriting and rating factors in homeowners and private passenger motor vehicle insurance including: non-pending arrests, charges and indictments that do not result in conviction; convictions, arrests, charges, or indictments that do not relate in any way to either fraud or to the type of risk being insured or evaluated for the insurance being sought; and suspension or revocation of a driver’s license when the suspension or revocation is for nondriving-related reasons unless otherwise permitted. DOMESTIC AND FOREIGN INSURERS BULLETIN NO. 143
Michigan expanded the meaning of "unfair methods of competition and unfair or deceptive acts or practices" to include a refusal to insure, to continue to insure or limit the amount of coverage based on race, creed, marital status, sex, national origin, gender identity or expression, or sexual orientation. HB 4619
ELECTRONIC TRANSACTIONS
California amended its Uniform Electronic Transactions Act to exempt certain transactions including authorization for release of information under the Confidentiality of Medical Information Act. The amendments also require the authorization to contain an expiration date or event, and limits the duration to one year or less. AB 1697
Mississippi issued an opinion clarifying that bail bonds are considered "court documents" and thus excluded from the Uniform Electronic Transactions Act. Opinion Dated October 2, 2023
FLOOD INSURANCE / NFIP
Alabama's Governor issued an executive order, ensuring that Alabama continues to participate in the National Flood Insurance Program. Executive Order 737
MISCELLANEOUS
Montana adopted the updated rules needed to implement HB 836, providing for a "regulatory sandbox" waiver. The rules address the process to apply for a waiver, requirements for reporting and the process for revocation of the waiver. 6.6.9001+
Rhode Island's Superintendent of Insurance clarified that carriers are not allowed to add fees to policies other than those charged for installments, late payments, or invalid or rejected payment methods. It is the Department's position that operating expenses for property and casualty policies are required to be included as part of the filed rates. Policy, inspection, issuance, administrative, credit card, etc. fees are not allowed. Bulletin 2023-5
PROPERTY INSURANCE
Kentucky issued an advisory opinion of their interpretation of 806 KAR 12:095 Sec 9(1)(b). The interpretation will be to require that, for any loss of damaged items, other items in the area will be replaced with uniform items. The Department considers an "area" to mean the entirety of a part for a specific purpose, i.e. an entire roof, interior carpet and such. Advisory Opinion 2023-08
REINSURANCE
West Virginia's Insurance Department issued a list of accredited reinsurers and trusteed reinsurers. Company Report dated September 30, 2023
REPORTS - DATA CALLS & OTHER REPORTS
Colorado adopted rules for any insurer doing business in the state that reports more than $100 million in direct written premium nationwide on their annual report. Insurers subject to this regulation will be required to complete a NAIC Climate Risk Disclosure Survey on or before August 31, 2024, and each year thereafter. Regulation 3-1-18
Florida identified required data calls including enhanced catastrophe reporting for Hurricane Idalia for November 2023. Notice Dated November 6, 2023
New York's Deputy Superintendent of the Property Bureau issued a call for a special report of commercial automobile liability insurers covering public auto classifications. The data call is due by December 20. 2023. Public Auto Classifications Data Call dated October 30, 2023
SURPLUS LINES
New York extended the Excess Line Association of New York (ELANY) for 5 more years to July 1, 2029. The law requires all records that an excess line broker must maintain to be open to examination by ELANY. AB 4984
Texas Insurance Department announced a decrease in the stamping fee collected by the Surplus Lines Stamping Office. The decrease is from .075% to .04% of gross premium resulting from surplus lines insurance contracts. It is effective beginning January 1, 2024. Order 2023-8310
WORKERS' COMPENSATION
Idaho published the updated Workers Compensation Benefit Table for 2024. Notice of Weekly Compensation dated October 20, 2023
New York's Chair of the Workers' Compensation Board announced it established its annual assessment rate for all employers to be 9.2% of the standard premium or premium equivalent. The new rate is effective January 1, 2024. Bulletin WC 046-1635
Oregon Department of Consumer and Business Service entered an order that the workers' compensation premium assessment rates for 2024 will remain the same as the 2023 rates. OAR 440-045-0020
Wisconsin announced its annual Worker's Compensation Administrative Assessment to carriers and self-insured employers. Interest will be charged for late payments. Insurance Letter 540
Newsletter
Life and Health News June 2025
Life and Health News
June 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!
AFFORDABLE CARE ACT
Federal Government updated the Transparency in Coverage Final Rules, which regards pricing disclosures, through "FAQs About Affordable Care Act Implementation Part 70" by adopting schema version 2.0 for machine-readable files, enhancing data accessibility and integrity for patients. CMS Notice Dated 5/22/25
AGENT / PRODUCER LICENSING AND APPOINTMENT
Missouri announced that insurance producer licensing exams must now be scheduled at physical testing centers, ending the use of PearsonVue’s OnVue online proctoring system for new reservations. The Department honored existing OnVue appointments through May 18, 2025, but requires all appointments from May 19 onward to be held in person. Bulletin 25-03
ARTIFICIAL INTELLIGENCE
California issued guidance on implementing SB 1120, focusing on the use of AI and decision support tools in utilization management by health insurers and their contracted entities. The guidance requires that determinations of medical necessity be made solely by licensed professionals and prohibits the use of decision support tools to deny, delay, or modify care based on necessity, among other requirements. Insurance Guidance SB 1120:1
Maryland issued a bill requiring carriers, pharmacy benefit managers, and private review agents using artificial intelligence, algorithms, or software tools for utilization reviews to base decisions on an enrollee’s individual medical history and clinical information, ensuring fairness and preventing discrimination. It mandates regular audits, quarterly reviews of these tools’ accuracy, and strict compliance with privacy laws. Insurers must also report to the Commissioner when AI or similar tools contribute to adverse decisions. HB 820
CAPTIVES
Arizona established a framework for certifying dormant captive insurers, allowing eligible insurers to apply for and renew a certificate of dormancy every five years, while prohibiting them from conducting insurance business until reactivated. The bill also revises definitions, reduces capital requirements for protected cell captive insurers, updates licensing procedures, and mandates Arizona residency for at least one board member of LLC-structured captive insurers. HB 2193
CLAIMS / CLAIMS ISSUES
Arizona now requires health care insurers to have a medical director individually review any denial of claims or prior authorizations involving medical necessity. The medical director must exercise independent medical judgment during each review and cannot rely solely on external recommendations. This applies to both claim denials and prior authorization decisions. HB 2175
CONFIDENTIALITY / PRIVACY
Virginia adopted a new law under the Consumer Data Protection Act, requiring social media platforms to use commercially reasonable methods to identify users under 16 and limit their usage to one hour per day. Parents may adjust this limit with verifiable consent. SB 854
DENTAL INSURANCE
Iowa now prohibits dental carriers from denying claims for services approved through prior authorization and requires reimbursement at contracted rates, with certain exceptions. It mandates dental carriers to disclose if a plan is state-regulated, including a “state-regulated” label on ID cards starting July 1, 2025. The act also sets procedures for recovering overpayments, requiring timely written notice, and allowing provider appeals. SF 470
Washington adopted a new law to address unfair and deceptive practices in dental-only insurance plans by prohibiting same-day procedure denials, unless justified by specific factors, like fraud or medical necessity. The law also requires advance notice and fee-free alternatives when reimbursing providers via credit card. SB 5351
DISASTER / CATASTROPHIC EVENT
Kentucky issued an Advisory Opinion regarding the May 2025 storms in Laurel, Pulaski, Russell, and Clay Counties, providing guidance on premium payment extensions, policyholder protections, and mail disruptions for insurers, producers, and adjusters. The Department of Insurance allows insurers to extend payment deadlines until at least June 17, 2025, urges insurers to avoid policy cancellations or rate increases without proper notice, and requires free policy copies upon request. Advisory Opinion 2025-01
Kentucky issued guidance requiring insurers to allow prescription drug refills, with provider or pharmacist approval, to ensure medication access after the May 2025 storms, especially in Laurel, Pulaski, Russell, and Clay Counties. Advisory Opinion 2025-02
Maryland issued emergency regulations requiring health carriers to waive time restrictions on prescription refills and replacements of durable medical equipment, eyeglasses, and dentures for residents of Allegany and Garrett Counties during the declared State of Emergency starting May 15, 2025. Bulletin 25-7 (Revised)
Maryland requires all property, casualty, life, and health insurers to provide a 60-day grace period for premium payments to policyholders and businesses in Allegany and Garrett Counties following the May 15, 2025 State of Emergency. Bulletin 25-8
Missouri issued a bulletin urging health carriers and pharmacy benefit managers to ensure continued access to prescription medications for individuals affected by the May 2025 tornado and storms. The order permits temporary waivers of certain rules to support medication refills and replacements, even when prescriptions were recently filled or prescribing physicians are unavailable. Health carriers are encouraged to work with enrollees to prevent disruptions in care. Bulletin 25-04
DISCRIMINATION
Maryland adopted a law prohibiting life and disability insurance carriers from unfairly discriminating based on medical information, including genetic test results, unless the information is actuarially relevant to the insurance risk. It also forbids insurers from accessing sensitive medical data without written consent or requiring genetic testing or full genome sequencing as a condition for coverage eligibility. HB 1007
FILING REQUIREMENTS / PROCEDURES
Colorado revised its rules governing the filing, certification, and reporting of limited benefit health plans, including updates for Paid Family and Medical Leave Insurance (FAMLI) policies. The regulation expands applicability, adds filing requirements for FAMLI, mandates clear disclosures for fixed indemnity products, and requires separate annual certifications for FAMLI policies, while adopting new forms and notices to support compliance. 3 CCR 702 Reg. 4-2-40
Oregon requires insurers to submit complete rate and policy form filings electronically through SERFF, including all supporting documents and clear explanations of changes. Insurers must keep approval records for at least five years and get prior approval before withdrawing or discontinuing products. Filings that don’t meet requirements may be rejected, and all communications must go through SERFF, except certain “wrap-up” filings sent by email. Bulletin 2025-5
FRAUD / ANTI-FRAUD
Nevada issued its 2025 Fraud Assessment Notification requiring all insurers with a Certificate of Authority to pay an annual fraud assessment fee by July 15, 2025. The Division of Insurance will email invoices on May 30 and requires companies to update fraud contact details by May 23 to avoid penalties. Notice Dated 5/6/25
Oklahoma requires regulated entities to pay a $750 annual Anti-Fraud Assessment fee electronically through OPTins by July 1, 2025. Paper payments are no longer accepted, and entities must register on OPTins to submit forms and pay the fee. Special Notice 2025 Anti-Fraud Assessment
HEALTH CARE EXCHANGE / MARKETPLACE
Arkansas updated its health insurance rate filing requirements in response to new CMS directives, mandating two rate filings for Plan Year 2026 with new assumptions for the second-rate filing. Insurers must include clearly labeled alternative rate documentation in SERFF and are required to offer off-Exchange-only plans without CSR load to protect unsubsidized enrollees from inflated premiums. Bulletin 4A-2025
Colorado amended its rules for calculating premium rate reductions for Colorado Option standardized bronze, silver, and gold health plans effective January 1, 2026, and beyond. The regulation limits annual premium increases to no more than medical inflation and introduces adjustments based on cost-sharing changes and federal AV calculator updates. 3 CCR 702 Reg. 4-2-85
Illinois issued a bulletin to guide issuers through certification and recertification of individual, small group, dental, and student health plans for Plan Year 2026 on and off the ACA Marketplace. The bulletin outlines federal and state compliance requirements, deadlines, rate filing instructions, and network adequacy standards. Company Bulletin 2025-
North Carolina issued an advisory memorandum detailing submission procedures for 2026 Plan Year Single Risk Pool Rate Filings for non-grandfathered ACA-compliant individual and small group health plans. The memo outlines documentation requirements, deadlines, confidentiality rules, and amendment limitations to ensure state and federal compliance. Memorandum Dated 4/25/25
HEALTH INSURANCE - COMPREHENSIVE
Oregon issued a bulletin requiring health insurers to cover medically necessary gender-affirming treatments without denial or blanket exclusions. Insurers must ensure provider network adequacy and allow out-of-network access without extra costs if needed. Additionally, reviews denying coverage must be done by qualified providers trained in gender-affirming care. Bulletin 2025-4
HOLDING COMPANIES
Oklahoma revised its insurer subsidiary laws to align with NAIC standards by updating definitions, expanding registration and reporting requirements for insurers within holding company systems, and mandating enterprise risk reports, group capital calculations, and Liquidity Stress Test results. HB 1497
LIFE INSURANCE / LIFE CONTRACTS
Georgia amended its group life insurance law to prohibit policies from excluding or limiting coverage for service members' deaths, except when the death results directly or indirectly from war or related hazards. SB 109
LIFE INSURANCE AND ANNUITY SOLICITATION
Arizona enacted a new law to ensure transparency in the marketing and sale of life insurance policies. The law mandates formatting, content, and disclosure requirements for illustrations, requires annual reporting to policyowners, and imposes penalties for violations. It also defines key terms and outlines the role of illustration actuaries. HB 2076
LONG-TERM CARE INSURANCE
Oklahoma updated its long-term care laws by revising the nursing facilities quality of care fee, including transferring employment of fifteen ombudsmen from the Department of Human Services to the Office of the Attorney General. SB 947
MEDICARE SUPPLEMENT INSURANCE
Louisiana directs all health insurance issuers and HMOs authorized for Medicare Supplement policies to use the "Refund Filing Template" for annual refund filings, effective for filings submitted after April 30, 2025. Issuers must submit all required information through SERFF. Directive 227
Maryland now requires carriers to pay insurance producers the same commission rates for certain Medicare supplement policies regardless of whether the policies are sold during open enrollment, as underwritten policies, or under specific legal provisions. This applies to Medicare policies issued within 30 days after an individual’s birthday or to individuals aged 65 and older. SB 956
Utah implemented a new law to establish an annual election period for existing Medigap enrollees, beginning May 7, 2025. During the 60-day window starting on their birthday, enrollees may switch to a Medigap plan of equal or lesser value from their current insurer without re-rating or re-underwriting. Bulletin 2025-5
MISCELLANEOUS
Arizona revised the health care provider credentialing process by setting strict timelines for insurers to acknowledge, process, and load credentialing applications, including a 60-day limit to complete credentialing and a 30-day limit to update billing systems. The law mandates insurer communication at each stage, limits delays, protects providers' claims from denial due to timing, and requires patient disclosures when non-credentialed providers deliver care. SB 1291
Arizona authorized health insurers and Medicaid to limit coverage for organ transplants or post-transplant care involving procedures or organ procurement connected to the People's Republic of China or Hong Kong. The law applies to various insurance types, including disability, group, and subscription plans, and permits denials of coverage for valid reasons. It does not mandate transplant coverage, and requires federal approval for Medicaid implementation. HB 2109
Iowa now requires health insurers to respond to credentialing requests from physicians, advanced registered nurse practitioners, or physician assistants within 56 calendar days and to provide written reasons if the request is denied. HF 875
Maryland revised its Family and Medical Leave Insurance Program by refining definitions, updating self-employed participation rules, adjusting reporting timelines, and modifying contribution rates and benefit calculations to enhance program administration. The bill defines "anchor date" for wage calculations, establishes optional self-employed enrollment regulations by 2028, sets claim submission windows from 2027 to 2028, and ties maximum weekly benefit amounts to the Consumer Price Index starting in 2029. HB 102
NONFORFEITURE
Arkansas amended its Standard Nonforfeiture Law for Life Insurance to allow insurers to defer payment of a cash surrender value for up to six months, provided the policy’s death benefit remains in force during that time. If the payment is delayed more than 45 days after the surrender request, insurers must pay interest on the amount due. SB 519
NOTICE TO INSUREDS
Maryland now requires health insurers to include a unique identifier for decision-makers in adverse decision notices starting June 1, 2025, and to clearly inform members of denial rights with contact info starting October 1, 2025. It also mandates quarterly reporting on significant increases in adverse decisions and requires private review agents to publicly post utilization review criteria. SB 474
PHARMACY BENEFIT MANAGERS
Montana updated its laws governing pharmacies and pharmacy benefit managers (PBMs), enhancing transparency, reimbursement fairness, and pharmacy protections from October 1, 2025, through June 30, 2029. The law prohibits recoupment based on drug purchase timing, mandates minimum reimbursement rates for independent pharmacies, bans various PBM-imposed fees, and bars the use of effective rate contracting. HB 740
South Dakota issued a bulletin clarifying that Pharmacy Benefit Managers (PBMs) using Discount Medical Plan Organizations in prescription drug claims must comply with Insurance Code Chapter 58-29E. PBMs linked to insured health plans are responsible for ensuring all reimbursement and fee rules under this code are followed. Bulletin 25-03
Tennessee enacted a new law requiring pharmacy benefits managers (PBMs) to follow the same prompt pay standards as health insurers for timely reimbursement of claims to pharmacists. It also removes penalty caps for PBM violations and aligns PBM sanctions with broader insurance law penalties for late payments. SB 881
PREMIUM TAX
Kentucky updated the Local Government Premium Tax rates, reporting requirements, and procedures for authorized insurers and surplus lines brokers for premiums collected through June 30, 2026. The issued bulletin mandates use of a Verified Risk Location system for large insurers, specifies tax disclosure and exemption rules, and sets penalties for late payments while allowing exemptions for due diligence. It also requires mandatory electronic filing of annual reconciliation reports and provides guidance on forms, refunds, and credits. Bulletin 2025-01
PRE-NEED CONTRACTS
Oklahoma tightened regulation of prepaid funeral benefit providers by requiring permits, electronic filings, and prior approval for ownership transfers and name changes. It also mandates funding disclosures, annual reporting, and increases penalties for violations. HB 1498
THIRD PARTY ADMINISTRATORS
Texas removed the requirement that insurers conduct on-site audits of third-party administrators. The state still mandates that insurers review and audit administrators biennially when managing benefits for over 100 individuals. SB 1151
TRADE PRACTICES
Montana revised its insurance laws to restrict who may present themselves as financial advisors or charge for financial planning services. The law bars insurance producers from using financial planner titles without proper credentials and mandates written, signed agreements for any planning fees. It also expands unfair trade practice rules for insurers and lead generators, and strengthens advertising and disclosure requirements. HB 114
UTILIZATION REVIEW - HEALTH CARE
Georgia enacted new requirements for insurers using prior authorization to establish programs that reduce requirements for high-performing providers who follow evidence-based care. Insurers must annually report program details to the Department of Insurance starting July 1, 2026. The law also strengthens compliance rules for private review agents, requiring them to attempt direct communication with treating providers before issuing adverse determinations. HB 197
Indiana updated its insurance code to tighten oversight of prior authorization by shifting authority to utilization review entities, prohibiting prior authorization for the first 12 physical therapy or chiropractic visits per care episode, and enhancing transparency and patient protections. The law mandates electronic submission options, preserves granted authorizations for up to a year, and requires automatic approval if entities miss response deadlines. SB 480
Montana adopted a new law governing health utilization reviews and prior authorization, requiring that only in-state licensed physicians make or review adverse determinations and grievances. The law prohibits those physicians from having prior involvement in or financial interest in the grievance outcome. It also bans prior authorization for FDA-approved substance use disorder medications when prescribed within labeled dosages. SB 446
Montana now requires health plans to honor existing prior authorizations for 90 days when enrollees switch plans and to approve discharge prescriptions for at least three days without prior authorization. The new law prohibits retroactive denial of approved services and mandates electronic acceptance and response to prior authorization requests, while also easing step therapy requirements for patients with prior use history. SB449
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