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Property and Casualty News February 2025
Property and Casualty News
February 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!
ADJUSTERS
California issued a notice reminding licensed public insurance adjusters of the legal requirements for soliciting business following the Southern California wildfires. The notice emphasizes that adjusters must wait seven days after the disaster or evacuation orders are lifted before offering services and must refrain from contacting policyholders between 6 p.m. and 8 a.m. Adjusters who violate these rules may face penalties or loss of licensure. Notice Dated 1/10/25
CANCELLATION / NON-RENEWAL / PREMIUM OR COVERAGE
California issued a bulletin enforcing a mandatory moratorium on the cancellation and non-renewal of residential property insurance policies in areas affected by a state of emergency, particularly due to the Palisades Fire. This moratorium prohibits insurers from canceling or non-renewing policies based on wildfire risk for one year, starting January 7, 2025, in the specified ZIP Codes. Insurers must also offer to rescind any such cancellations or non-renewals issued since the emergency declaration. Bulletin 2025-1
CLAIMS / CLAIMS ISSUES
California issued a reminder to insurers and adjusters handling claims from the Southern California wildfires, emphasizing the need for prompt claim payments to support wildfire survivors. The notice mandates advance payments for living expenses and contents, clarifies that policyholders are entitled to full replacement benefits without land value deductions when relocating, and ensures protections like extended ALE coverage and policy renewals after a declared disaster. Bulletin 2025-2
California issued the 2025 Annual Notice outlining key laws affecting residential property insurance policies in declared states of emergency, especially those related to wildfires. The notice emphasizes insurers' responsibilities to provide timely claim notices, details requirements for loss calculations, coverage extensions, and policyholder rights. It also addresses rules on wildfire risk scores, policy cancellations, and nonrenewals. Notice Dated 1/9/25
California issued this bulletin reminding property and casualty insurers of their obligation to adhere to the "efficient proximate cause" doctrine in wildfire areas. The notice clarifies that if a wildfire is found to be the efficient proximate cause of subsequent events like mudslides, insurers must cover the resulting damage, even if such events are typically excluded under the policy. It advises insurers to thoroughly investigate the cause of loss before denying claims related to these circumstances. Bulletin 2025-3
CORPORATE GOVERNANCE
New Jersey adopted new rules requiring insurers and related entities to submit a Corporate Governance Annual Disclosure (CGAD). The rules mandate the filing of a CGAD by June 1 annually, detailing governance structures, policies, and practices, with penalties for late submissions. NJAC 11:1-48.1
DISASTER / CATASTROPHIC EVENT
California's Insurance Department declared an emergency situation due to the Palisades fire, which caused widespread damage in Los Angeles and Ventura Counties. To address the surge in wildfire-related claims, the DOI allows insurers to employ nonlicensed adjusters under supervision, with registration required within 15 days of starting work. The DOI also mandates training on relevant insurance laws for all adjusters and holds supervisors accountable for nonlicensed adjuster actions. Notice Dated 1/13/25
FINANCIAL REGULATION
Arkansas issued a bulletin announcing its intent to approve the NAIC’s Accounting Practices and Procedures Manual (APPM). The DOI will implement amendments to the APPM in compliance with Ark. Code Ann. § 23-63-613, ensuring that domestic insurers and reporting entities adhere to the latest edition. The adoption of these changes will begin with the 2025 Annual Statement, due by March 1, 2026, and will supersede previous bulletins related to the APPM's use. Bulletin 1-2025
MISCELLANEOUS
Illinois' Department of Insurance announced the relocation of its Chicago office to 115 South LaSalle Street, 13th Floor, Chicago, Illinois 60603. The Department instructed all regulated entities to update public-facing communications, including forms and notices, to reflect the new address and ensure third parties also make necessary updates. The Department will accept filings with the new address via the System for Electronic Rate and Form Filing (SERFF). Bulletin 2025-1
NOTICE TO INSUREDS
Arkansas revised notice period requirements regarding premium increases. Insurers must notify both the insured and the insured's agent of premium increases of 25% or more. The notice period to an agent is extended from 30 days to at least 60 days before renewal. An insured must be notified by the insurer at least 30 days before the renewal (formerly 10 days) of the premium increase. SB 70
PREMIUM TAX
California issued guidance outlining the transition to mandatory electronic filing for 2024 Insurance Premium Tax filings. Surplus Line Broker filings are due by March 3, 2025, Insurer filings by April 1, 2025, and Ocean Marine filings by June 16, 2025. Beginning January 31, 2025, all filings must be submitted through the Premium Tax Processing System (PTPS). The bulletin also details filing requirements, prepayment conditions for high-liability entities, and the use of Electronic Funds Transfer (EFT). Notice Dated 1/29/25
New Hampshire issued 2024 premium tax instructions for property and casualty insurance companies and risk retention groups, highlighting the March 1, 2025, filing deadline for annual statements and March 15, 2025, for premium tax returns. The notice encourages electronic filing and outlines payment procedures, specifying that payments of $20,000 or more must be made via Electronic Funds Transfer (EFT), with penalties for late payments. Notice Dated 2/5/25
RATEMAKING
California adopts and amends regulations allowing insurers to use catastrophe models in rate calculations and to change the rate-making formula. The new rules provide guidelines for employing catastrophe models to project losses, determine catastrophe adjustments, and address wildfire exposure in designated distressed areas. They also introduce a Pre-Application Required Information Determination (PRID) process for insurers. Reg. Title 10 s 2644.4
California amended Title 10 of the Code of Regulations, making significant changes to insurance ratemaking and reinsurance. "Flood" was added as a new category of insurance. Adjustments were made to rate of return calculations to account for reinsurance costs, and the introduction of specific provisions for reinsurance in property catastrophe perils. New sections update variance request guidelines, among others. Reg. Title 10 s 2642.7
SURPLUS LINES
Louisiana issued an Advisory Letter to property and casualty insurers, including surplus lines insurers and producers, clarifying that policy fees are considered premium taxes under La. R.S. 22:855 et seq. The advisory reminds insurers that all fees related to insurance, unless specifically exempted by statute, must be included in the quoted premium and disclosed on the policy. Insurers and producers must itemize and clearly describe any fees in the quote and policy. Advisory Letter 2025-01
New Jersey published updated lists of eligible foreign and domestic surplus line insurers, including a revised list of eligible alien surplus line insurers from the NAIC Quarterly Listing of Alien Insurers. The updates highlight additions, deletions, name changes, and redomiciled insurers with corresponding changes to alien identification numbers. Notice Dated 1/1/25
Pennsylvania published the latest Eligible Surplus Lines Insurer List, replacing the previous list from January 20, 2024. Notice Dated 2/8/25
TRADE PRACTICES
Arkansas amended its Insurance Code to clarify the fees property, casualty, and surplus lines brokers can charge. The amendment permits brokers to charge fees in addition to premiums, provided these fees are separately disclosed and capped at 20% of the total gross premium. However, this cap does not apply when a licensed agent refers a risk to a surplus lines broker. SB 76
WORKERS' COMPENSATION
California's Division of Workers' Compensation (DWC) reminded claims administrators of the mandatory submission of the Annual Report of Inventory (ARI) for claims reported during 2024, due by April 1, 2025. The ARI must detail the number of claims at each adjusting location, even if no claims were reported. Late submissions may result in penalties up to $500 per location. Notice Dated 1/2/25
California's Workers' Compensation Commission announced that the statewide average weekly wage (SAWW) for the period from January 15 to July 14, 2025, is set at $1,452.68. This rate is used to determine the maximum and minimum weekly benefit levels for workers' compensation claims. Notice Dated 1/15/25
Nebraska's Workers' Compensation Court adopted a new fee schedule for medical services and updated the Medicare Diagnostic Related Groups (DRGs) for the inpatient hospital fee schedule. The Court also revised the informal dispute resolution process, offering various methods for resolving workers' compensation disputes. Additionally, the amendments updated life expectancy tables for 2021 and revised regulations under the Nebraska Administrative Rules and Regulations. Rule 26
Oregon Workers' Compensation Division (WCD) updated reimbursement rates for injured workers' travel, food, and lodging costs, setting the private vehicle mileage rate at 70 cents per mile effective January 1, 2025. Lodging and meal rates remain unchanged for the period from October 1, 2024, to September 30, 2025. Insurers must reimburse workers for these costs promptly and provide a reimbursement request form with independent medical examination appointment notices. Bulletin 112
Oregon Workers' Compensation Division issued guidance on determining "gainful occupation" for permanent total disability (PTD) evaluations, outlining examples for eligibility under labor and employment law 656.206. The bulletin updates the federal poverty guidelines for a family of three, noting that insurers and self-insured employers must use the most recent guidelines published on the HHS website. This bulletin replaces Bulletin No. 342. Bulletin 342 (Revised)
Pennsylvania announced that workers’ compensation insurance carriers must submit their Special Schedule “W” data to the Pennsylvania Compensation Rating Bureau (PCRB) by April 15, 2025. Carriers must now report all Special Schedule "W" information, including Coal Mine experience, through the PCRB’s Financial Data Manager (FDM) instead of directly to the DOI. Special Schedule W Letter
Pennsylvania released an update to the Workers’ Compensation Medical Fee Schedule to include a 1.7% increase in the fee schedule, changes to billing practices, and instructions for healthcare providers, including the use of National Provider Identifiers (NPIs) and Medicare guidelines. The update also provides the latest submission procedures and guidelines for out-of-state providers. WC Medical Schedule Update 1/1/25
Pennsylvania updated the Impairment Rating Evaluation (IRE) process under the Workers' Compensation Act. The changes clarify timing for IRE requests, introduce mandatory physician training, and adjust impairment rating criteria, including procedures for shifting disability status after 104 weeks of total disability benefits. Reg. 34 s 123.101+
Newsletter
Life and Health News March 2025
Life and Health News
March 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 LICENSING AND APPOINTMENT
California announced a partnership with Secure Screening Solutions Inc., operating as Capital Live Scan (CLS), to serve as the new Live Scan fingerprint vendor for resident license applicants in the insurance industry. Starting February 14, 2025, applicants, including agents, brokers, adjusters, and bail agents, must schedule fingerprinting appointments through CLS for a background check by the DOJ and FBI. Notice Dated 2/13/25
ARBITRATION
Colorado amended its regulations, effective March 30, 2025, to establish a standardized arbitration request form for out-of-network providers disputing payments from carriers. The amendment outlines the arbitration process, including the appointment of arbitrators, timelines for final offers, and qualifications for arbitrators, with noncompliance resulting in penalties. It applies to health benefit plans for claims incurred on or after January 1, 2020, and includes forms for arbitration requests and decision reporting. 3 CCR 702 Reg. 4-2-65
ARTIFICIAL INTELLIGENCE
Delaware issued a bulletin reminding insurance carriers to ensure their use of Artificial Intelligence (AI) complies with existing laws, particularly those related to unfair trade practices and discrimination. Delaware emphasizes the need for fairness, ethical use, and accountability, requiring carriers to develop and maintain a written program for responsible AI use, including governance frameworks, risk management controls, and compliance with relevant insurance laws. Domestic-& Foreign Bulletin 148
New Jersey issued a bulletin to insurers emphasizing the need for compliance with insurance laws and regulations when using Artificial Intelligence (AI) in their operations. The bulletin outlines the Department's expectations for AI-driven decisions, ensuring they align with legal standards, particularly regarding fairness, discrimination, and transparency. Insurers must implement an AI Systems Program (AIS Program) with robust governance, risk management, and internal audits to mitigate risks. Bulletin 25-03
CLAIMS / CLAIMS ISSUES
Arizona issued a bulletin describing insurer obligations for timely claims processing and payment. Insurers must maintain records of provider grievances, submit semi-annual reports, and designate a primary contact for grievance matters. The bulletin also provides guidelines for resolving grievances and adjusting payments or denials within specific timeframes. Bulletin 2025-01
CONFIDENTIALITY / PRIVACY
New York issued a bill clarifying the requirements for notifying the Department of Financial Services (DFS) about data breaches. This amendment to General Business Law Section 899-aa specifies that only entities under the jurisdiction of the DFS are required to notify the Department in the event of a data breach. SB 804
DISCRIMINATION
Alabama enacted a new bill amending the Alabama Code to define key sex-based terms, mandating that entities who collect vital statistics identify individuals as either male or female based on biological sex observed at birth. SB 79
DRUG / PRESCRIPTION COVERAGE
Colorado amended its regulations, effective March 30, 2025, to standardize the drug benefit prior authorization process and require drug appeals for health carriers offering prescription drug benefits. The amendments introduce a uniform prior authorization form, impose timeframes for processing requests, and require that prior authorization approvals be valid for at least 180 days, with an extension to one year starting in 2026. The regulation also includes provisions for chronic maintenance drugs, substance use disorder treatments and requires secure electronic submissions for provider requests by 2027. 3 CCR 702 Reg. 4-2-49
Utah issued a bulletin requiring insurers to cap the price of insulin at $10 and $35 for a 30-day prescription supply in 2026. Insurers must comply with this mandate in policies issued or renewed in 2026. Bulletin 2025-3
West Virginia issued a bulletin addressing amendments to the Pharmacy Audit Integrity Act (PAIA), as updated by House Bill 2263 in 2021. The bulletin clarifies that health insurers must calculate the cost-sharing for prescription drugs at the point of sale to reflect 100% of any received rebates, using excess rebates to lower premiums. It also mandates that insurers report the total amount of prescription drug rebates and their effect on health insurance rates, highlighting the impact for the 2024 and 2025 plan years. Bulletin 2025-01
ESSENTIAL HEALTH BENEFITS
Nevada is seeking public input on potential revisions to its Essential Health Benefits (EHB) plan, which has been in place since 2017. The Division of Insurance is considering updating the EHB benchmark plan, including adding coverage for FDA-approved drugs for opioid use disorder, HIV, and hepatitis B and C. Stakeholders can participate in public meetings and submit feedback by March 19, 2025. Notice Dated 2/10/25
FILING REQUIREMENTS / PROCEDURES
California's Department of Managed Health Care (DMHC) released an All-Plan Letter (APL) outlining the filing requirements for Qualified Health Plans (QHPs), Qualified Dental Plans (QDPs), and Off-Exchange products for Plan Year 2026. The guidance outlines the regulatory submission process and ensures compliance with the Knox-Keene Act and DMHC regulations. DMHC APL 25-002
Colorado issued guidelines to insurance carriers regarding the form filing and annual certification requirements for short-term disability insurance products offered as part of the Paid Family and Medical Leave Insurance (FAMLI) program. Carriers must submit updated forms by March 31, 2025, including required documentation and certifications, and submit annual certifications by December 31 each year, starting with plan year 2025. Bulletin B-4.147
Massachusetts issued guidance to inform health insurance carriers of the requirements and deadlines for submitting rate filings for the Calendar Year 2026. Carriers must submit the 2026 Plan and Benefit Template, Plan ID Crosswalk Template, and rate filings via SERFF by May 15, 2025. Carriers are also encouraged to contact the DOI by April 15, 2025, regarding significant changes to cost-sharing or benefits before filing. Filing Guidance Notice 2025-B
Virginia issued SERFF filing instructions outlining requirements for insurers submitting form and premium rate filings. The guidelines detail compliance with Virginia's insurance laws and mandate specific submission formats, checklists, and the inclusion of a Certificate of Compliance. SCC Notice Dated 2/3/25
FINANCIAL REGULATION
Arkansas issued a bulletin announcing its intent to approve the NAIC’s Accounting Practices and Procedures Manual (APPM). The adoption of the new manual will apply to the Annual Statement for December 31, 2025, and must be submitted to the DOI by March 1, 2026. Bulletin 1-2025
HEALTH INSURANCE / HEALTH RATES
California's Department of Managed Health Care (DMHC) issued an All-Plan Letter (APL) providing guidance on renewal notice requirements for large group contract holders, including In Home Supportive Services. It mandates that contract holders must be notified of rate changes or coverage modifications at least 120 days before renewal and allow a 60-day period for review of any proposed changes. DMHC APL 25-003
Louisiana now mandates health insurance issuers, health maintenance organizations, and self-insurers cover standard fertility preservation services under Act No. 299. This law ensures coverage for fertility preservation related to treatments that could result in infertility, particularly for cancer patients, without requiring preauthorization but allowing for reasonable cost-sharing. Directive 225
Maryland issued a bulletin addressing unfair discrimination in insurance practices and clarifying Bulletin 17-10. The bulletin mandates insurers avoid charging premiums that differ from rates filed with the Commissioner or the policy terms, and requires uniform access to credit card payment options for all insureds of a particular product, if such an option is offered. It further specifies criteria for determining the uniqueness of insurance products, including distinctions based on policy forms, rate filings, and underwriting guidelines. Bulletin 25-5
Massachusetts increased rates for vision care services. These amendments impact 101 CMR 315.00, which includes sections on general provisions, definitions, rate provisions, allowable fees for vision care services, and severability. 101 CMR 315.01
Massachusetts issued a set of Frequently Asked Questions (FAQs) to clarify reproductive access rights under An Act Expanding Protections for Reproductive and Gender-Affirming Care (Chapter 127 of the Acts of 2022). This law mandates that all fully insured health plans in Massachusetts, except for self-funded plans, cover abortion and abortion-related services, including emergency contraception, without cost-sharing. Notice Dated 2/12/25
Michigan issued a bulletin outlining the adjustments to deductibles for Qualified Health Coverage (QHC) in relation to no-fault coverage under Public Acts 21 and 22 of 2019. The bulletin confirms that the maximum deductible for QHC will remain at $6,579 for the fiscal year from July 1, 2025, to June 30, 2026. Bulletin 2025-06-INS
New York issued a Supplement to their Circular Letter to enforce mandatory health insurance coverage for Pre-Exposure Prophylaxis (PrEP) to prevent HIV infection. The update prohibits insurers from requiring prior authorization for PrEP medications and mandates coverage of all FDA-approved PrEP formulations without cost-sharing for policies issued or renewed on or after February 29, 2024. Circular Letter 2017-21 Supp. 3
Vermont has enacted changes to its health insurance market effective January 1, 2026, which include unmerging the individual and small group health insurance markets and updating provisions related to the Vermont Health Benefit Exchange. The amendments increase the maximum number of employees for qualifying employers from 50 to 100, redefine “health benefit plan” and “small employer,” and adjust the responsibilities of the Exchange. HB 35
MEDICARE SUPPLEMENT INSURANCE
Kentucky amended the minimum standards for Medicare supplement insurance policies and certificates. The amendment prohibits insurers from denying, conditioning coverage, or discriminating based on an applicant's health status, claims experience, or medical condition during the initial open enrollment period for individuals 65 and older. 806 KAR 17:570
MISCELLANEOUS
Delaware updated regulations for the Healthy Delaware Families Act and the Paid Family Medical Leave (PFML) Program. These updates clarify eligibility, benefit amounts, and duration, as well as procedures for filing claims, employer contributions, and appeals. The amendments also outline changes for small businesses, private plans, and reporting requirements. DIA 1401
Iowa has adopted Chapter 101, "Adjustment and Modification of Support," to streamline the process of reviewing and adjusting child support obligations. The new regulations introduce definitions and detailed procedures for financial information review. 441-101.1
PHARMACY BENEFIT MANAGERS
Texas' Attorney General issued an opinion regarding the enforcement of HB 1763 and HB 1919. These bills, part of Chapter 1369 of the Texas Insurance Code, regulate contracts with pharmacists, pharmacies, and certain referral and solicitation practices. The opinion clarifies that these regulations are not preempted by ERISA and apply to both Texas-domiciled plans and any plans covering Texas residents or engaging with Texas pharmacy providers. Additionally, the rule prohibits issuers and pharmacy benefit managers (PBMs) from reducing claim payments after adjudication. Opinion KP-0480
Virginia announced updates to the Rebate Reporting Workbook, including revised forms and instructions, in response to recent changes in the Pharmacy Benefits Management Law under subsection B of 38.2-34681 of the Code of Virginia. These updates affect carriers, Health Services Plans, HMOs, Life and Health Interested Parties, and Pharmacy Benefits Managers, who must submit their 2024 report by March 31, 2025. SCC Notice Dated 1/29/25
PREMIUM TAX
New Hampshire issued premium tax instructions for life, accident, and health insurance companies, with filings due March 1, 2025. The notice outlines the requirement for electronic funds transfers (EFT) for payments over $20,000, specifies filing requirements and tax computations, and outlines conditions for refunds and credits. Notice Dated 2/5/25
REPORTS - DATA CALLS & OTHER REPORTS
Illinois issued a data call for the creation of the Cost-Sharing Reduction (CSR) load for the 2026 benefit year, requesting data from insurance companies writing individual comprehensive major medical insurance. Companies must submit enrollment and experience data for 2022, 2023, and 2024 for all individual ACA Silver plans offered through the Exchange by March 14, 2025. Bulletin 2025-02
New York requires all licensed life insurers and accredited life reinsurers to respond to the 2025 Liquidity and Severe Mortality Inquiry by May 1, 2025. The inquiry, to be completed by the Chief Financial Officer, aims to assess insurers’ ability to handle stress liquidity exposure and financial flexibility in the face of both expected and unexpected cash demands. Liquidity and Severe Mortality Inquiry 2025
THIRD PARTY ADMINISTRATORS
Puerto Rico's Office of the Commissioner of Insurance adopted Rule No. 111, which introduces standardized registration and licensing requirements for third-party administrators (TPAs) in the areas of life, annuities, health insurance, and stop-loss coverage. This rule aims to regulate entities wishing to operate as TPAs within Puerto Rico, with specific exemptions for certain entities. Rule CXI s 1
Newsletter
Life and Health News February 2025
Life and Health News
February 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
Puerto Rico approved Rule No. 109, "Rules on Advertising for Life Insurance and Annuities," which sets minimum standards for advertising life insurance policies and annuity contracts. It specifies requirements for presenting policy benefits, premiums, and changes, and ensures that advertisements clearly identify the insurer and the nature of the policy. Rule CIX s 1
AFFORDABLE CARE ACT
Michigan amended its Insurance Code effective April 2, 2025, by adding a new section to ensure health insurers comply with federal medical loss ratio (MLR) and rebate provisions under the PPACA. The new section requires insurers to issue rebates to policyholders if they fail to meet MLR requirements and report the MLR calculations and rebate details to both the U.S. Department of Health and Human Services and the Michigan Department of Insurance. HB 5825
AGENT / PRODUCER LICENSING AND APPOINTMENT
Oklahoma announced that all Insurance Producer and Adjuster licensing exams, as well as Kaplan Financial exam study manuals, will be available in Spanish. The exams and study materials will be offered in both electronic and printed formats and can be purchased through the Oklahoma Insurance Department's website. Notice Dated 12/23/24
ARTIFICIAL INTELLIGENCE
North Carolina issued a bulletin regarding the Use of Artificial Intelligence Systems in Insurance referencing the NAIC Model Bulletin. Bulletin 24-B-19
CERTIFICATE OF AUTHORITY FILINGS
Nevada announced the start of the 2025 Annual Company Renewal process, requiring insurers to submit payment by March 1, 2025, to continue operations in the state. Insurers must use the Division's Online Service Portal for invoice retrieval, contact updates, and financial filings, with invoices available starting January 3, 2025. Notice Dated 12/16/24
CLAIMS / CLAIMS ISSUES
Nebraska published the interest rate for death claims if a life insurer fails to pay within 30 days of receiving proof of loss. The insurer must pay interest at the rate effective on January 1 of the year the proof of loss is submitted. The judgment interest rate is 6.367% starting October 17, 2024, and 6.282% beginning January 16, 2025. Notice 2025-01
CORPORATE GOVERNANCE
New Jersey adopted new rules concerning the required filing of an annual Corporate Governance Annual Disclosure (CGAD). These rules outline filing procedures, content requirements, and penalties for non-compliance. Insurers must submit a CGAD by June 1 annually, detailing their governance structures, practices, and risk oversight. NJAC 11:1-48.1
CREDIT INSURANCE
Indiana updated its credit life and accident and health insurance rates. The minimum acceptable loss ratio is 55% and discount rates are adjusted, with 3.47% for life and 3.07% for accident and health policies. The DOI also established new prima facie rates, including a 32.5% increase for credit life insurance and a 6.1% decrease for credit accident and health insurance, with the adjusted rates for accident and health insurance to take effect by July 1, 2025. Bulletin 277
Nebraska issued an advisory document outlining requirements for insurers issuing credit life and credit accident and health insurance in the state. Effective April 1, 2025, insurers must file premium rates with the Director, with prima facie rates set at a 45-50 percent loss ratio. Compensation for creditors must not exceed 30 percent of premiums to maintain rate reasonableness. IGD -- A2 Amended
CYBERSECURITY
Alaska issued guidance for compliance with the enacted Insurance Data Security Law. The law establishes standards for data security as well as investigation and notification requirements in the case of a cybersecurity event. The law requires insurers and licensees to assess risks, create information security programs, and develop response plans for cybersecurity incidents. Bulletin B 24-11
DEPARTMENT OF INSURANCE
Illinois announced that the Department of Insurance's Chicago office relocated to 115 South LaSalle Street, 13th Floor. Regulated entities must update all public-facing materials, including forms and disclosure notices, to reflect the new address and ensure third parties conducting business on their behalf do the same. The Department will accept filings with the updated address through SERFF. Bulletin 2025-01
DISASTER / CATASTROPHIC EVENT
California asked the state's health insurers to submit a filing via SERFF within 48 hours of the Governor's declaration of a State of Emergency due to the Palisades Fire and windstorm. The filing should 1) detail the carrier's policies regarding suspending prescription fill or refill limitations and other barriers to access to prescription drugs; 2) plan to provide displaced insureds with access to medically necessary services; 3) plan for replacement of medical equipment and supplies; 4) arrange for in-network or other qualified provider to be available with the patent responsible only for the in-network cost sharing; and 5) plan for communicating with insureds. Notice Dated 1/8/25
California's Department of Managed Health Care (DMHC) issued an All Plan Letter (APL) to guide health plans in ensuring access to essential health services for enrollees affected by the Southern California Fires. Health plans were asked to notify the DMHC within 48 hours about service disruptions and actions taken to support impacted enrollees, including providing access to medical care and prescriptions without standard restrictions, setting up a toll-free number, and allowing access to out-of-network providers at no additional cost. DMHC APL 25-001
Florida issued a notice in response to the State of Emergency declared for the Florida Panhandle, reminding health insurers and related entities of their obligations under section 252.358, Florida Statutes. These entities must waive time restrictions on prescription refills, suspend "refill too soon" edits, and provide at least a 30-day supply of medications for those in affected areas. Notice Dated 1/20/25
FILING REQUIREMENTS / PROCEDURES
California's Department of Managed Health Care (DMHC) issued an All-Plan Letter advising health care service plans to review and update their plan documents to comply with 23 newly enacted bills from the 2024 Legislative Session. Plans must submit a filing by March 21, 2025, detailing their compliance. The letter provides guidance and filing instructions for each bill, covering topics including health care coverage, behavioral health and financial assistance. DMHC APL 24-023
Maryland issued a bulletin outlining the form and rate filing requirements for student health benefit plans for the 2025-2026 school year. The bulletin specifies the filing deadline of February 3, 2025, and highlights requirements for new or revised forms, rates, and compliance with recent law changes on cost-sharing and coverage. Bulletin 25-2
HEALTH CARE EXCHANGE / MARKETPLACE
California's Health Benefit Exchange amends various provisions regarding eligibility, enrollment, and appeals for the Individual Exchange to comply with federal law changes. Key amendments include changes to expand conditions for special enrollment periods and establish clear procedures for eligibility redetermination. T. 10 s 6408 +
Maryland published instructions for submitting individual and small employer form and rate filings for the 2026 plan year. The Department of Insurance provides guidance on essential health benefits, sets filing deadlines, and details requirements for plan forms, rate filings, and compliance with ACA regulations. It also includes specific instructions for stand-alone dental plans and limits on the number of plans per metal level for the Maryland Health Benefit Exchange. Bulletin 25-1
HEALTH INSURANCE / HEALTH RATES
Colorado issued guidance to insurers offering Independent, Non-coordinated Excepted Benefits Coverage. Revised processes were set forth in 89 Fed. Reg. FR 23338-01. Bulletin B-4.143
Connecticut issued amendments to clarify the coordination of benefits between insurers, particularly regarding Medicare coverage. The amendments ensure that both Medicare Part A and B are treated equally under the Medicare carve out and introduce technical changes for clarity. Key updates include refining the definition of "allowable expense" and eliminating terms that could reduce secondary carrier liability, with the goal of ensuring insured individuals receive full coverage from secondary insurers. Regulation 38a-480-3
Delaware revised and reissued their bulletin regarding the Delaware Health Insurance Individual Market Stabilization and Reinsurance Program. The bulletin outlines the procedures for health insurance carriers to pay an assessment by March 1, 2025, to fund the state's reinsurance program. The assessment, set at 2.75% of premiums subject to Delaware's insurance regulations, applies to most health insurance carriers, excluding certain plans like Medicare and Medicaid. Bulletin 113 (REISSUED)
New Hampshire implemented legislative changes to enhance consumer protections against balance billing. The new law aligns with the federal "No Surprises Act" and expands the state’s dispute resolution process to include disputes over emergency care and out-of-network services at in-network facilities. Bulletin INS 25-004-AB
New Hampshire issued guidance on prior authorization reporting following the enactment of SB 561. The law reduces decision time frames for prior authorizations, introduces peer-to-peer reviews, and requires health carriers to collect and submit specific data on authorization decisions. Health carriers must comply with the new timelines and submit annual reports starting in 2026, with interim quarterly reports encouraged for 2025. Bulletin INS 25-001-AB
HOLDING COMPANIES
Maryland adopted amendments to clarify reporting requirements for insurance holding company systems. These regulations specify when an ultimate controlling person must submit an annual group capital calculation, criteria for exemption, and conditions for a limited group capital filing. COMAR 31.04.18.02
LONG-TERM CARE INSURANCE
Colorado issued guidance to long-term care insurance carriers on offering Reduced Benefit Options (RBOs) for policyholders facing premium rate increases. Carriers are encouraged to offer a variety of RBOs, adjusting coverage aspects like elimination period, benefit period, and inflation protection, to help mitigate the financial impact of rate hikes. Carriers must also outline proposed RBOs in policyholder communications and actuarial filings. Bulletin B-4.144
MISCELLANEOUS
Maine adopted regulations to implement the Maine Paid Family and Medical Leave Program, which provides paid leave for family and medical reasons. The program covers employees earning wages in Maine and self-employed individuals who opt for coverage, with eligibility based on wage requirements. It outlines the application process, types of leave, fraud prevention, and employer obligations, including the option to substitute private plans. Employers must comply with reporting, cancellation, and plan approval requirements. 12-702-10-1
MISCELLANEOUS LIFE / ANNUITY
Michigan updated its administrative rules to provide exemptions from certain examination requirements for broker-dealers, agents, investment advisers, and representatives who have been unregistered for between two to five years, provided they participate in the Maintaining Qualifications Program (MQP) and the Investment Adviser Representative Examination Validity Extension Program (IAR EVEP). R 451.4.9
Missouri eliminated registration exemptions for broker-dealers acting as investment advisers and for their agents as investment adviser representatives. However, the amendment to the regulation retains exemptions for solicitors and revises the criteria for private fund adviser exemptions, introducing new registration requirements and fees for affected individuals and firms. Registrants must now pay registration and renewal fees, as well as potential examination costs. 15 CSR 30-51.180
PHARMACY BENEFIT MANAGERS
Alaska enacted a law dealing with Pharmacy Benefit Managers (PBMs). The law includes registration requirements and guidelines for claims, grievances, and appeals. PBMs must use a new registration form for biennial renewals, and those without current registration must apply using this form starting in 2025. Bulletin B 24-12
Arkansas implemented Rule 128 to assess the fairness and reasonableness of pharmacy reimbursement programs by Pharmacy Benefit Managers for health benefit plans. Health plans must report data starting in 2025 to help the Commissioner evaluate if additional dispensing costs are needed. The bulletin covers reporting requirements, standards and procedures. Bulletin 18-2024
New Jersey issued guidance regarding requirements for pharmacy benefits managers (PBMs) and pharmacy services administrative organizations (PSAOs). PBMs must obtain licensure, comply with specific contract requirements, and adhere to regulations for compensation, payment structures, and reporting. Registration for PSAOs is mandated. The deadline for PSAO registrations is set for March 31, 2025. Bulletin 24-18
South Carolina reminds pharmacy benefits managers (PBMs) and pharmacy services administrative organizations (PSAOs) that their conduct and business practices will be examined starting January 1, 2025. Examinations for 2025 are being scheduled, and entities selected will receive a call letter and examination warrant in the coming weeks. Bulletin 2025-01
PREMIUM TAX
Louisiana implemented a new requirement for companies filing premium tax returns, mandating the submission of the Annual Premium Tax Statement (Form 1061) and the Annual Municipal Premium & Tax Report (Form 1076) online through the Industry Access Portal. Companies must also submit additional forms, such as the 2023 Form 1068C for the Investment Tax Credit and others. Notice Dated 12/16/24
REGULATORY REPORTING REQUIREMENTS
Kentucky issued new reporting requirements for pharmacies, now mandating ambulatory pharmacies to report annual cost-of-dispensing data, including labor, medication acquisition, and operational expenses, starting in 2026. Pharmacies may also submit optional prescription-level data. All submitted information will remain confidential and exempt from public disclosure. 201 KAR 2:416
Maryland requires insurers, health organizations, and premium finance companies to submit disaster and continuity of operations contact information by April 15, 2025. Contact details must be updated and "saved" to record that the information was reviewed, even if no change has occurred. The requested information must be submitted via the DOI’s designated link. Bulletin 25-3
Newsletter
Property & Casualty News October 2024
Property & Casualty News
October 2024
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
New Mexico's Superintendent of Insurance notified nonresident adjusters that the effective date for changes enacted under the administrative code will not be enforced until license renewals with expiration dates of April 2026 forward instead of April 1, 2025. Bulletin 2024-019
AGENT / PRODUCER LICENSING AND APPOINTMENT
Delaware amended its law to reinstate language that allows an insurance agent or broker to adjust claims on behalf of an insurer without obtaining an adjuster's license. HB 379
New Mexico's Superintendent of Insurance notified companies with New Mexico agent appointments of the renewal process and deadline dates for renewal of agent appointments in 2025. Annual Appointment Renewal Notice dated October 2, 2024
AUTOMOBILE INSURANCE
Delaware enacted a law that changes the liability insurance for rental vehicles. Under this law the minimum level of coverage required for a vehicle owner's policy of liability insurance is also required for a vehicle owner's rental of a vehicle. SB 257
CANCELLATION / NON-RENEWAL / PREMIUM OR COVERAGE
California amended the notice requirements for cancellation of automobile insurance policies due to nonpayment of premiums. This bill clarifies that the 10-day notice period for nonpayment will not commence until after the premium due date. A cancellation for nonpayment will become effective if the insured has not resolved the identified nonpayment by the end of the 10-day period. SB 1295
Delaware requires insurers to deliver any homeowners’ notices of cancellation or nonrenewal via USPS certified mail or USPS Intelligent Mail barcode, except in cases of nonpayment of premium. SB 200
Texas adopted a rule that requires a carrier to send notices in both electronic form and in paper or another nonelectronic form to a party when cancelling or terminating a policy. 28 TAC 21.501
CAPTIVES
Delaware amended a law regarding captive insurance to provide the Commissioner with greater flexibility in approving financial institutions authorized to hold the required capital and surplus for captive insurance companies. The amendments allow assets to be held in financial institutions other than banks and permit holdings outside of Delaware when the type of risk does not necessitate it. SB 249
CONFIDENTIALITY / PRIVACY
California amended its Consumer Privacy Act of 2018 to require businesses that receive consumer personal information as part of a merger, or other transaction, to comply with a consumer's opt-out request made to the original business. AB 1824
California enacted legislation to amend the California Consumer Privacy Act of 2018 (CCPA) by redefining "sensitive personal information" to include "neural data." Neural data is defined as information generated by measuring the activity of a consumer's central or peripheral nervous system and is not inferred from nonneural information. SB 1223
CYBERSECURITY
California passed a bill that requires automatic dialing-announcing devices to inform recipients if the prerecorded message uses an artificial voice. AB 2905
New York State Department of Financial Services alerted all regulated entities to take immediate action to thwart a cybersecurity threat currently being used to target IT help desks and call centers to convince them to reset passwords and divert multi-factor authentication to new devices. Industry Letter dated September 27, 2024
DISASTER / CATASTROPHIC EVENT
North Carolina's Insurance Department announced the activation of the Disaster Mediation Program to facilitate effective, fair and timely resolution of insurance claims arising out of damages to residential property as a result of Tropical Storm Helene disaster. Bulletin 24-B-14
HOLDING COMPANIES
Washington adopted a new regulation dealing with the group capital calculation for insurance holding company systems. WAC 284-18-447
MISCELLANEOUS
California passed a bill that requires a pet insurance carrier to disclose certain items that reduce coverage or increase premiums such as increased premiums based on age of pet, change in geographic location of the insured, and required medical examination to effectuate coverage or impose a waiting period. SB 1217
Michigan's Department of Insurance and Financial Services updated the list of municipalities participating in the Fire Insurance Withholding Program, effective November 1, 2024. This program allows municipalities to escrow 25% of fire insurance settlements to cover costs from fire and explosion losses. Regulatory Activity Notice dated October 1, 2024
Wisconsin's Commissioner of Insurance notified insurers, agents and other licensees that they are expected to provide accurate and up-to-date contact information for the Office of Insurance Commissioner on policy forms, notices and other described documents. As of November 4, 2024, the Commissioner's Office is relocating to a new address. Bulletin dated October 8, 2024
PREMIUM TAX
Delaware Department of Insurance issued a reminder to all admitted and approved domestic and foreign insurance companies including accredited reinsurers, surplus lines brokers and others about the statutory requirements for premium tax payments. Payments must be made through the OPTins system using the quarterly tax report form. Domestic and Foreign Bulletin No. 147
RATEMAKING
Pennsylvania's Insurance Commissioner informs property and casualty companies and rating organizations that product filings should not be submitted containing rate ranges, except schedule rating which is confined to commercial lines products. Rate ranges are not a substitute for the statutory requirement to file a classification plan. The Department adds that there are numerous non-compliant filings. Notice 2024-15 dated September 14, 2024
REPORTS - DATA CALLS & OTHER REPORTS
North Carolina's Insurance Department notified insurers writing nonfleet private passenger motor vehicle physical damage and homeowners residential property with not more than four housing units of the requirement to comply with a data call by October 28, 2024. Bulletin 24-B-11
SURPLUS LINES
California's Department of Insurance issued a bulletin to surplus lines brokers and admitted insurers regarding the Export List. The bulletin confirms that certain insurance coverages can be placed with non-admitted insurers due to a lack of adequate market among admitted insurers. Bulletin 2024-10
New Jersey notified surplus lines producers of an updated list of eligible domestic, foreign and alien surplus lines insurers in New Jersey. Notice dated October 8, 2024
Wyoming Insurance Department notified all surplus lines insurers doing business in Wyoming that requested policy data must be filed electronically via the SLIP system instead of via paper filing. Bulletin 09-2024
WORKERS' COMPENSATION
Arkansas Workers' Compensation Commission (AWCC) published the workers' compensation rates for 2025. The maximum compensation rates for Total Disability and for Permanent Partial Disability are set forth. AWCC Advisory 2000-1 dated October 1, 2024
California extended the authorization for employers to deposit workers' compensation disability indemnity payments into prepaid card accounts until January 1, 2027. AB 1239
California's Division of Workers’ Compensation (DWC) posted an order adjusting the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule to align with the 2024 updates in the Medicare payment system. DWC Notice dated October 2, 2024
Indiana's Department of Insurance approved and filed the 2025 Advisory Rate Filing, effective January 1, 2025, which decreases the overall advisory loss cost level by 6.8% and both the advisory and assigned risk rate levels by 7.2%. Circular 2024-08
Massachusetts’ Workers' Compensation Rating and Inspection Bureau announced a new payroll determination method for sole proprietors, partners in legal partnerships, and members of LLCs who elect to become employees to obtain workers' compensation insurance coverage. The Basis of Premium is $66,600. Circular Letter 2437
Massachusetts' Office of Labor and Workforce Development provided guidelines on workers' compensation-related adjustment for attorneys' fee schedule, cost-of-living adjustments and maximum and minimum weekly benefits. Circular Letter 361
New Jersey's Department of Labor and Workforce Development announced new 2025 rates for Workers' Compensation Benefits. Labor and Workforce Development Notice dated September 30, 2024
Oregon's Workers' Compensation Division notified workers' compensation insurers and self-insured employers of the annual increase in Retroactive Program benefits, the methods used calculate these benefits and determine the amount of Retroactive Program reimbursement. Bulletin 393
Rhode Island's Workers' Compensation Division announced that the Workers' Compensation assessment rate is 6.50% Information Letter 2024-05
The Texas Department of Insurance announced state average weekly wage maximum and minimum weekly benefits in the Texas Workers' Compensation Act for the period October 1, 2024 through September 30, 2025. Notice dated September 18, 2024
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