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Life and Health News January 2025
Life and Health News
January 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
New Mexico will implement amendments to several provisions in the state’s insurance licensing rules, effective April 1, 2025. These updates include changes to rules for resident and nonresident agents, surplus lines brokers, and adjusters, with notable clarifications such as removing provisions for pharmacy benefit managers and adjusting continuing education requirements. Additionally, the amendments address licensing criteria for insurance producers, business entities, and fraternal benefit producers. 13.4.2.1 NMAC
Pennsylvania replaced its existing insurance producer rule with a new one based on the Producer Licensing Model Act. The new rule streamlines the application process and offers greater transparency and efficiency. 31 PA. CODE CH. 37a
Rhode Island updated its regulations on licensing and renewal fees for insurance producers, third party administrators and others. The changes include the repeal of the annual contracted producer report, introduction of a new electronic appointment fee of $15 and updated fee schedule for business entity licensees. The regulation also streamlines the procedures for electronic filing of insurance producer appointments, renewals, and terminations through the National Insurance Producer Registry (NIPR). 230-RICR-20-50-5.1
ARTIFICIAL INTELLIGENCE
Massachusetts issued a Bulletin to insurers licensed to do business in Massachusetts regarding the use of Artificial Intelligence (AI). Insurers using AI systems must comply with applicable insurance laws, including those on unfair trade practices, corporate governance annual disclosure, insurance rate requirements and market conduct examinations. The guidance mandates that insurers develop written AI System programs to mitigate risks and ensure fairness, with oversight from the DOI. Bulletin 2024-10
AUTISM SPECTRUM DISORDERS
Illinois reminds insurers writing accident and health insurance and managed care plans, they cannot deny or refuse to otherwise provide covered services solely because of the location where the clinically appropriate services are provided. The bulletin specifically applies to treatments for autism spectrum disorder, including applied behavior analysis, and covers non-traditional settings. The DOI advised insurers to work with providers to avoid claim rejections or delays. Bulletin 2024-17
ELECTRONIC TRANSACTIONS
Puerto Rico amended its insurance regulation regarding electronic transactions effective January 10, 2025. The amendment establishes electronic delivery of policy contracts and related documents as the default method, with the option for insured parties to request physical copies. Key changes include renumbering the regulation from Rule 102 to Rule 110, revising procedures for electronic delivery, and clarifying conditions for online business practices. Rule CX Section 1+
Utah updated the required Dental Claim Billing Standard for electronic health insurance transactions. The amendment replaces the reference to the ADA Dental Claim Form J340 with the updated American Dental Association Dental Claim Form J43024. Rule R590-164-5
FILING REQUIREMENTS / PROCEDURES
Nevada Division of Insurance launched the 2025 Annual Company Renewal process. The Department provided information on how to obtain the renewal invoice on-line as invoices will not be mailed. Insurers are encouraged to keep contact information current. For companies required to submit financial filings, use the Financial Filing Submission Portal. The last day to pay invoices is March 1, 2025. Notice Dated December 26, 2024
FRAUD / ANTI-FRAUD
Federal Financial Crimes Enforcement Network (FinCEN) issued an alert warning financial institutions about scams involving the misuse of FinCEN's name and authority, including fraudulent schemes related to beneficial ownership reporting and misuse of FinCEN's Money Services business (MSB) registration tool. FinCEN requests these scams be reported through Suspicious Activity Reports (SARs). It clarifies that it does not charge fees for beneficial ownership filings or request payments in investigations. Financial institutions are urged to remain vigilant. FIN-2024-Alert 005 December 18, 2024
HEALTH INSURANCE
Colorado revised its guidance on the medical inflation trend calculation for premium rate reductions on the Colorado Option Standardized Health Benefit Plans. This updated Bulletin provides carriers with instructions to comply with premium rate reduction requirements under Colorado Insurance Regulation 4–2-85, applicable to small group and individual health plans. Amended Bulletin B-4.121
Federal Centers for Medicare & Medicaid Services (CMS) published FAQs to clarify the Good Faith Estimate (GFE) requirements for uninsured and self-pay individuals under the Consolidated Appropriations Act of 2021. It explains the obligation of health care providers and facilities to offer GFEs to individuals without health coverage, including those with alternative insurance plans, and expands the requirement to include dental and vision providers, among other FAQs. CMS Notice Dated 12/13/24
New York amended its Insurance Law to require health insurance plans to provide coverage for at least two medically necessary epinephrine auto-injector devices for individuals at risk of life-threatening allergic reactions. The law caps the insured's annual out-of-pocket cost for these devices at $100, with exceptions for high deductible health plans. SB 7114
New York enacted the "Dyslexia Diagnosis Access Act," which requires all policies providing coverage for physician services or comprehensive medical coverage to include coverage for neuropsychological exams to diagnose dyslexia. These policies must cover testing, diagnosis, and treatment for dyslexia, including comprehensive exams to evaluate the individual’s psychological, emotional, and educational needs and is effective for policies issued, renewed, or amended on or after January 1, 2025. AB 2898
HIV
Illinois reminds carriers that effective January 1, 2024, all individual and group health insurance policies, HMO plans, and voluntary health services plans must cover all FDA-approved HIV Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) drugs without cost-sharing. This includes coverage for off-label use, mandates the inclusion of these drugs in formularies, and applies preventive care guidelines for high-deductible health plans. Bulletin 2024-18
MANAGED CARE PLANS / HMOS
California's Department of Managed Health Care (DMHC) and the Department of Health Care Access and Information (HCAI) issued an All-Plan Letter encouraging health care service plans to integrate Certified Wellness Coaches into their services. This initiative, under AB 133, aims to provide prevention and early intervention behavioral health services to children, youth, and their families. Health plans are advised to consider using Wellness Coaches to reduce the demand on clinical resources while supporting behavioral health care for their members. DMHC APL 24-022
MEDICARE SUPPLEMENT INSURANCE
Maine reminded insurers of their obligations under Rule Chapter 275 regarding guaranteed issue rights for consumers whose Medicare Advantage Plans are discontinued in the Service Area. Affected consumers have a 90-day window to enroll in any Medicare Supplement plan of their choice, with no underwriting or pre-existing condition exclusions. Bulletin 481
Oklahoma reissued a bulletin concerning Medicare supplement regulations. The state requires Medicare Supplement issuers to offer new policies with the same or lesser benefits to policyholders who have not had a coverage gap greater than 90 days. Issuers must also provide a 60-day open enrollment period and waive medical underwriting for these new policies. Additionally, issuers must notify individuals under 65 with disabilities about open enrollment when they turn 65. Bulletin 2023-10 (Revised 12/13/24)
MENTAL HEALTH PARITY
Colorado amended its insurance rules to enhance parity between mental health and substance use disorder (MH/SUD) benefits and medical/surgical benefits in health plans. The regulation expands coverage for preventive care, prohibits stricter treatment limitations for MH/SUD benefits, and mandates new reporting requirements for insurance carriers. 3 CCR 702-4-2-64
Georgia directs health insurers to comply with the state's Mental Health Parity Act by submitting an annual Comparative Analysis Report (CAR) detailing mental health parity data. Insurers must submit the CAR by January 1 each year, with exemptions for companies that have filed an approved Attestation for Annual Reporting and received the DOI's approval. Bulletin 24-EX-9
MISCELLANEOUS
Colorado's Department of Labor and Employment adopted new regulations under the Paid Family and Medical Leave Insurance Act (FAMLI Act). The regulations amend definitions, clarify the coordination of FAMLI benefits with other benefits such as Workers' Compensation and Unemployment Insurance, and outline employer responsibilities, including maintaining health care benefits and handling overpayments. 7 CCR 1107-4
Maine's Department of Labor adopted regulations for the Maine Paid Family and Medical Leave Program. The program provides paid leave for family and medical reasons, covering employees earning wages in the state and self-employed individuals who opt for coverage. It outlines eligibility criteria, the application process, various types of leave, and premium payment requirements. Employers can substitute the state plan with equivalent private plans, subject to specific approval and reporting requirements. Rule 12-702 Section 1+
PHARMACY BENEFIT MANAGERS
Arkansas amended its PBM regulation to strengthen oversight of pharmacy benefits managers. The amendments expand the Commissioner’s authority over PBM licensing, introduce new reporting obligations for PBMs, including annual disclosures on rebates and cost savings, and establish a process for Maximum Allowable Cost (MAC) appeals. Rule 118
Virginia Bureau of Insurance announced updates to the pharmacy benefits management rebate reporting requirements under Insurance Code section 38.2-3468. Updated forms, instructions, and guidance will be released by January 17, 2025, for the 2024 rebate reports, which are due by March 31, 2025. The Bureau encourages entities to review the materials and sign up for notifications on the Virginia State Corporation Commission website for updates. Memorandum dated December 5, 2024
PREMIUM TAX
California announced the launch of the new Premium Tax Processing System (PTPS) portal, effective January 31, 2025. The system will streamline the filing of Insurance (Premium) Tax Returns for Admitted Insurers and Surplus Line Brokers. While filings for the 2023 tax year and earlier will still be accepted by email, all new filings must be submitted through the PTPS starting in 2025. Notice Dated 12/2/24
REPORTS - ANNUAL / QUARTERLY STATEMENT
North Dakota announced a change in the process for submitting and publishing the Company Abstract of Statement. Insurance companies are now required to submit their annual statement abstracts directly to the North Dakota Newspaper Association via a Self-Service Portal, instead of through the DOI. Carriers must ensure publication in the newspaper with the highest circulation in each judicial district in which they operate in North Dakota. Companies must also submit proof of publication to the DOI within four months of filing their annual statement. Bulletin 2024-1
REPORTS - DATA CALLS & OTHER REPORTS
Indiana adopted provisions under Rule 83, requiring health payers, including insurers and third-party administrators, to submit healthcare claims data to the state's all payer claims database. The regulation defines key terms, outline submission requirements, and set penalties for non-compliance, including daily fines. Health payers must register annually, submit monthly data in specific formats, and address any errors in submissions, with exemptions for smaller entities. 760 IAC 1-83
Massachusetts Division of Insurance advised domestic insurers, including health maintenance organizations and dental service corporations, to integrate climate risk management into their operations. Insurers must incorporate climate risks into their governance, financial risk management, and disclosure practices, ensuring board oversight and adherence to the NAIC's ORSA Guidance Manual. Full implementation is expected by July 1, 2025. Bulletin 2024-11
RESERVE VALUATION
Texas adopted the updated National Association of Insurance Commissioners (NAIC) valuation manual dated August 15, 2024. 28 TAC 3.9901
SUITABILITY
Utah's Insurance Commissioner issued a bulletin to life insurance and annuity licensees giving guidance regarding the Suitability in Annuity Transactions rule. The Commissioner highlights factors a producer should consider such as financial implications, surrender charges, and prior annuity exchanges required under the best interest standard. Non-compliance could potentially lead to penalties under Utah law. Bulletin 2024-12
TRADE PRACTICES
Federal Trade Commission (FTC) amended the Telemarketing Sales Rule effective January 9, 2025, to include inbound telemarketing calls made by consumers in response to an advertisement through any medium or direct mail solicitation in which technical support products or services are offered for sale. 16 CFR 310.2
UTILIZATION REVIEW - HEALTH CARE
Mississippi adopted permanent rules for utilization review agents, implementing SB 2140, the Prior Authorization Act. The rules establish standards for certification, timely reviews, appeals, and prior authorization procedures for health insurers and review agents. They emphasize transparency, requiring insurers to publish prior authorization statistics, ensure access to clinical personnel, and report data annually. The rules also include provisions for standardizing electronic prior authorization systems by 2027. 19-3-19.01
Newsletter
Property & Casualty News November 2024
Property & Casualty News
November 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!
AGENT / PRODUCER CONTINUING EDUCATION
Pennsylvania passed legislation that eliminates the pre-examination education program requirements for the insurance producer licensing exam. Requirements for continuing education have been added. SB 1241
AGENT / PRODUCER LICENSING AND APPOINTMENT
Kansas’ Insurance Department set the following application fees for insurance professionals: $15 for resident agents, $50 for nonresident agents, and $100 for public adjusters. Notice of Application Fee Amounts
AGENT / PRODUCER TERMINATION
Oklahoma's Insurance Department released its 2024 Producer Appointment Renewal Notification with key dates and outlining the process for renewal. Notice dated October 28, 2024
ARTIFICIAL INTELLIGENCE
Iowa issued a bulletin reminding insurance companies about the regulatory requirements surrounding the use of Artificial Intelligence (AI) in insurance decisions. AI systems used by insurers must comply with all applicable insurance laws, including those governing unfair trade practices and discrimination. Insurers must develop a written program (AIS Program) for the responsible use of AI, including risk management, governance, and testing for errors or bias. Bulletin 24-04
New York's Department of Financial Services issued guidance to executives and information security personnel at all regulated entities regarding managing cybersecurity risks arising from artificial intelligence and strategies to combat related risks. Industry Letter of October 16, 2024
AUTOMOBILE INSURANCE
Louisiana reminds insurers who write automobile liability insurance to give a required 25% premium discount for active-duty military personnel, reservists, and members of the Louisiana Air and Army National Guard. Insurers are also encouraged to offer discounts to veterans with a VA disability rating of 50% or more, and to retired military members. Bulletin 2023-04 (Revised and Reissued)
Montana's Commissioner of Securities and Insurance (CSI) issued an addendum on November 4, 2024, to its August 29, 2007, Advisory Memorandum regarding the amendment to Insurance Code 33-23-204, which covers motor vehicle liability definitions. The addendum rescinds the previous instructions and checklist for filing new rates to avoid stacking, as these are no longer valid. CSI now requires insurers to use a new certification titled Montana Certification of Compliance for UM, UIM, and Med-Pay Coverages, which is available on the CSI website. Advisory Memorandum of November 4, 2024
North Carolina’s Reinsurance Facility published revised basic limit premium rates for liability insurance for trucks, tractors and trailers, auto dealers, zone rated vehicles and certain private passenger types not eligible for rating under the North Carolina Personal Auto Manual. The updates are effective for all policies issued on or after April 1, 2025. Member insurers are encouraged to notify their agents of the new automobile rates. Circular Letter RF-24-18
CANCELLATION / NON-RENEWAL / PREMIUM OR COVERAGE
Maryland issued a bulletin clarifying that P&C insurers cannot cancel, non-renew, or refuse to underwrite a risk for which they have a filed rate, as outlined in Bulletin 03-16. If a risk is not covered by the insurer's filed rating plan, underwriting guidelines may be applied to decline coverage. Insurers must ensure their rates are actuarially sound and adequate, and must justify any cancellations, non-renewals, or refusals to underwrite when challenged. Bulletin 24-24
CAPTIVES
Ohio's Captive Insurance Company Rule was amended to revise various provisions regarding their formation, operation and financial statements. Rule 3901-11-01+
CREDIT INSURANCE
South Carolina approved 2025 rates for credit property insurance sold in conjunction with loans under the Consumer Protection Code. Order 2024-05
CYBERSECURITY
New York's Department of Financial Services issued a cybersecurity advisory to all regulated entities concerning remote technology workers who may have connections to North Korea. Suggested steps to protect information systems are included. Industry Letter of November 1, 2024
Oklahoma’s Insurance Commissioner issued a bulletin informing certain persons and entities authorized to do business in Oklahoma they must comply with the provisions of the Insurance Data Security Act. Bulletin 2024-10
DISCRIMINATION
Delaware updated the definition of "sexual orientation" in its state code. The law expands the definition to include asexuality and pansexuality alongside heterosexuality, homosexuality, and bisexuality. The law also revises the Delaware Insurance Code, specifically Section 2304, to prohibit unfair discrimination in the insurance industry based on sexual orientation, including the newly added categories. HB 275
FEE SCHEDULES
Hawaii issued a notice to all insurers, risk purchasing groups, and foreign retention groups regarding the annual service/extension fee for 2025. A penalty will be applied for late payments. Fees must be processed through the Options portal. Notice of September 24, 2024
FLOOD INSURANCE
Federal Emergency Management Agency (FEMA) issued a final rule that allows policyholders to pay their annual flood insurance premium in monthly payments instead of in a lump sum. This may allow the national flood insurance program to be accessible to more people. 44 CFR Parts 61 and 62
LIABILITY INSURANCE
Pennsylvania updated the Wholesale Prescription Drug Distributors License Act to add a virtual manufacturer definition and to require prerequisites for the license application process and a newly required surety bond with the application, among other items. HB 2084
MISCELLANEOUS
Michigan issued an updated list of municipalities participating in the Fire Insurance Withholding Program, effective December 1, 2024. The list specifies which sections of the program each municipality is participating in and supersedes all previous editions. Notice dated November 1, 2024
PERSONAL LINES INSURANCE
Michigan addressed concerns about the depreciation of non-tangible items, such as labor, in the calculation of Actual Cash Value (ACV) in personal lines homeowners or dwelling policies. Insurers must clearly disclose any depreciation of non-tangible items like labor, taxes, and overhead through a standalone endorsement, which must be optional and reflect a reduced premium. Insurers must also seek prior approval from the Department for their depreciation practices. Bulletin 2024-26-INS
New Mexico's Superintendent of Insurance notified Residential Property & Casualty insurers of a change in the Ft. Bayard and Santa Rita fire protection areas and a recent Public Protection Classification (PPC) survey. As a result, premiums may change depending on the PPC survey classes. Insurers are required to provide notice to its policyholders of potential premium changes. Bulletin 2024-23
POLICY LANGUAGE
Montana's Commissioner of Securities and Insurance issued an Advisory Memorandum on November 6, 2024, clarifying the limitations on Defense Within Limits (DWL) provisions in insurance policies. The memorandum revises previous guidance, stating that DWL provisions are prohibited in personal insurance policies but are allowed in commercial property and casualty insurance, provided they are clearly disclosed on the declaration page and application in bold, larger, and capitalized text. Advisory Memorandum of November 6, 2024
PREMIUM TAX
Delaware issued a revised bulletin updating premium tax payment requirements for surplus lines brokers. The bulletin sets specific due dates for premium tax payments. Domestic-Foreign Bulletin 147 (Revised)
SURPLUS LINES
Alabama mandates that nonresident surplus line brokers file a $50,000 bond in favor of the state to obtain or renew their license, effective January 1, 2025. The bond must remain in force for the duration of the broker's license, and the required bond form can be submitted by mail to the Alabama Department of Insurance. Bulletin 2024-05
Colorado amended its Regulation concerning surplus lines insurance issued by nonadmitted insurers effective January 1, 2025. Key changes include clarified disclosure requirements for policies, relaxed due diligence documentation for brokers, and new quarterly reporting requirements. The regulation also sets eligibility criteria for nonadmitted insurers, including a minimum capital and surplus of $15 million. 3 CCR 702 Reg.
New Jersey's Insurance Department updated its list of eligible foreign, domestic and alien surplus lines insurers. The list also contains additions, deletions, name changes as well as identification number changes. Notice dated October 30, 2024
Oklahoma’s Insurance Commissioner requests all surplus lines carriers to submit policy and premium information regarding the non-admitted insurance written in Oklahoma for the year 2024. The information is due by December 31, 2024. Special Notice dated November 7, 2024
TAX CREDITS
Louisiana adopted Regulation 130 to establish a refundable tax credit for retaliatory taxes paid by certain domestic insurers. This applies to insurers authorized to write insurance in Louisiana and at least one other state as of July 1, 2023. The regulation allows eligible insurers to claim a credit for retaliatory taxes paid to other states, with requests due annually by April 15. LAC 37 XIII.19901, Reg 130
WORKERS' COMPENSATION
Arizona announced a 9.1% reduction in Workers' Compensation rates, effective January 1, 2025, marking the 10th consecutive year of rate decreases. Notice dated October 25, 2024
California amended existing law regarding disability compensation and paid family leave. This law eliminates the provision that allows employers to require employees to use up to two weeks of earned but unused vacation before receiving these benefits during any 12-month eligibility period. AB 2123
California’s Division of Workers' Compensation released an updated DWC Form 7 (Notice to Employees-Injuries Caused by Work) on October 31, 2024. The updated form, effective January 1, 2025, informs injured workers of their right to consult an attorney about their workers' compensation claims and that attorney's fees will be deducted from their recovery. DWC Notice dated October 31, 2024
California's Division of Workers' Compensation posted an adjustment to the inpatient hospital section of the Official Medical Fee Schedule (OMFS) to align with updates to the Medicare payment system. These changes will take effect on December 1, 2024. DWC Notice dated November 4, 2024
California's Division of Workers’ Compensation announced the 2025 performance standards for Profile Audit Review (PAR) and Full Compliance Audit (FCA) for adjusting locations of workers' compensation claims. These audits, required every five years, assess areas such as payment timeliness for indemnity and disability benefits with performance thresholds with penalties for noncompliance. DWC Notice dated October 16, 2024
Colorado's Division of Workers' Compensation released PDF versions of the WC15 Workers' Claim for Compensation form and the WC18 Dependent's Notice and Claim for Compensation form on November 1, 2024. The updated versions retain the same format as previous forms but are enhanced for improved functionality. Notice of November 1, 2024
Iowa approved the National Council on Compensation Insurance (NCCI) rate filing as of November 1, 2024. The filing proposes a decrease in rates of 7.2% for voluntary compensation insurance and 9.6% for assigned risk policies, effective January 1, 2025. Regulatory Activity Notice dated November 1, 2024
Kentucky announced the discount rate for calculating lump-sum settlements of future periodic payments with regard to worker's compensation. For the calendar year 2025, the discount rate for weekly amounts of $40 or less is set at 3.875%, while for amounts greater than $40, the rate is 3.375%. Order of September 13, 2024
Maryland’s Workers' Compensation Commission updated the Maryland Specific Conversion (MSCF) / Multiplier for the Medical Fee Schedule, reflecting a 3.7% increase based on the Medicare Economic Index (MEI) for the first quarter of 2024, effective January 1, 2025. MSCF Multiplier Information dated 11/01/2024
Massachusetts' Department of Industrial Accidents is transitioning to a new payment platform for assessment payments, effective November 1, 2024. The new platform, Catalis Ncourt (nCourt), will handle all ACH debit payments for DIA assessments, and users must make payments through this updated system. The change includes a new Originator ID, payment instructions, and options for both ACH debit and credit card payments. WCRIBMA Circular Letter No. 2439
Massachusetts' Workers' Compensation Rating and Inspection Bureau announced the approval of updated pension tables by the Insurance Department. The new pension tables will apply to claims evaluated on or after July 1, 2025. These will be incorporated into the Massachusetts Workers' Compensation Statistical Plan, with updates available on the WCRIBMA website for compliance. WCRIBMA Circular Letter No. 2440
Mississippi's Workers' Compensation Commission published the revised base rate and Medicare threshold for the period from October 1, 2024, to September 30, 2025. The new base rate is set at $13,248.78, and the Medicare threshold is $46,217. The publication also includes data from prior years for reference. 2024-2025 Annual In-Patient Hospital Amounts
Nevada's Division of Industrial Relations provided detailed instructions on how to complete a D-35 Form used to request an impairment evaluation of a possible permanent partial disability. Important timelines are also set forth. Notice dated October 21, 2024
Nevada's Division of Industrial Relations, Worker's Compensation Section published a list of Frequently Asked Questions regarding changes related to SB 274 and Regulation R076-23. Notice dated October 21, 2024
Oklahoma's Workers' Compensation Commission released updated the weekly compensation rates for 2025 due to an increase in the state average weekly wage. Release dated October 29, 2024
Oregon's Workers' Compensation Division announced the workers' compensation premium assessment rate to be applied against premium earned by insurers, self-insured employers and self-insured employer groups during calendar year 2025. Bulletin 367 (Revised)
Pennsylvania amended its Workers' Compensation Law to allow benefits for post-traumatic stress injuries suffered by first responders. SB 365
Newsletter
Life and Health News February 2024
Life and Health News
February 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!
AGENT / PRODUCER LICENSING AND APPOINTMENT
Ohio updated its agent pre-licensing education law to bring it to NAIC national standards. It covers agents, licensing, continuing education and distance learning courses, among other items. Rule 3901-5-07
Wyoming's Department of Insurance notified carriers it will email the Annual Appointment Renewal Invoice and Detailed Appointment List to each insurer on February 1, 2024. Other pertinent dates and guidelines are included in the notice. Notice dated December 13, 2023; Memorandum 12-2023
ANNUITIES / ANNUITY CONTRACTS
Oregon amended its regulation dealing with annuities to establish disclosure and care obligations for annuity sales. It closely aligns with the NAIC Suitability in Annuity Transactions Model Regulation. OAR-836-051-0905
Utah updated its Suitability in Annuity Transactions rule to provide that recommendations made by agents and insurers must be in the best interest of the consumer. Rule R590-230-1
CREDIT INFORMATION
District of Columbia approved a bill requiring credit reporting companies to accept a personal statement from a consumer indicating the consumer experienced financial hardship resulting from a public health emergency. Insurers, and other users of credit reports are prohibited from taking adverse action in these situations. B 118
DISASTER PREPAREDNESS
Maryland published a bulletin to notify all insurers, non-profit health plans and dental organizations that they are to provide information about disaster preparedness no later than 04/15/24. Companies are also encouraged to sign up for the department’s mailing list to receive future notifications. Bulletin 24-2
DISCRIMINATION
Illinois issued a bulletin to remind insurers that categorically excluding coverage for medically necessary services to treat gender dysphoria is discriminatory and a violation of 50 Ill. Adm. Code 2603.35. Bulletin 2024-01
EXCEPTED BENEFITS
New Mexico's Insurance Department announced a data call to all insurers offering Excepted Benefits under 13.10.34 NMAC due by February 15, 2024. Insurers should pursue approval of forms and rates for Excepted products via SERFF by March 1, 2024, to be effective with the new rule on January 1, 2025. Bulletin 2024-002
FILINGS: HEALTH
Delaware issued a bulletin to provide filing guidance as carriers look to develop paid family and medical leave plans to satisfy private plan coverage standards established under 19 Del.C. § 3716. Domestic-Foreign Bulletin 144
Nebraska's Department of Insurance published guidelines for Medicare Supplement new business rate filings. Notice dated January 2, 2024
New Mexico's Insurance Department announced it will not accept any new Blanket insurance products for review and approval although rate adjustments may be made. The Department expects to promulgate a rule for Blanket insurance in the coming year. Bulletin 2023-038
GUARANTY ASSOCIATION
The District of Columbia adopted a bill to amend the Life & Health Insurance Guaranty Association Act of 1992. Changes include adding health maintenance organizations as member insurers, making life insurance subject to long term care assessments and other administrative changes. B-126
HEALTH INSURANCE - COMPREHENSIVE
New Hampshire reminds insurers that mandated blood lead testing for one- and two-year-old children is considered a preventive service under the Affordable Care Act, and cost sharing is prohibited. Bulletin INS 24-001-AB
New Jersey enacted changes requiring carriers to remove any age and dollar limits on medically necessary hearing aids and cochlear implants under medical insurance. SB 2535
West Virginia reminds carriers that any prescription written for an inpatient at the time of discharge cannot be subject to a health insurer's prior authorization requirements and must be immediately approved for not less than three days, provided that the cost of the medication does not exceed $5,000 per day. Civil penalties will be issued for non-compliance. Bulletin 24-01
MARKET CONDUCT
Florida adopted a regulation establishing a methodology for scheduling and conducting market conduct examinations. Priorities include, first, statutorily required exams, then post-hurricane required exams, then identified market concerns. FAC Rule 69O-138.003
MISCELLANEOUS HEALTH / ACCIDENT
Massachusetts published a bulletin to all health carriers regarding Behavioral Health Wellness Examinations. Requirements include covering annual mental health wellness examinations with no patient cost-sharing. Bulletin 2024-02
MISCELLANEOUS LIFE / ANNUITY
New York amended its law to allow insurers writing life insurance to establish a wellness program that is not unfairly discriminatory and with no increase in premium. Rewards and incentives are subject to certain guidelines. SB 5890
PHARMACY BENEFIT MANAGERS
New Jersey revised its law so that pharmacy benefit managers cannot prohibit or discourage use of a discount from an on-line pharmacy discount program. SB 3604
RATEMAKING
Colorado adopted regulation amendments, effective 2-1-2024, establishing a methodology for setting rates for the Colorado Option premium rate reduction requirements on standardized health benefit plans. 3 CCR 702-4
REPORTS - ANNUAL / QUARTERLY STATEMENT
Florida adopted regulations incorporating the NAIC electronic transmission filing instructions by reference. Florida further established a risk-based selection methodology for scheduling examinations of insurers. FAC Rule 690-137.001
Rhode Island's Insurance Division published its Summary of Annual and Quarterly Filing Requirements for 2024 for Life, Accident and Health and Fraternal Insurance Companies. Letter dated January 16, 2024
Utah's Insurance Department notified Fraternal, Health and Life carriers who report accident and health on the Utah state page of the NAIC Annual Statement that they are required to file an additional Utah Survey. Notice dated December 12, 2023
REPORTS - DATA CALLS & OTHER REPORTS
Maine amended its regulation specifying procedures for filing health care claims data sets from third party payors, administrators, Medicare health plan sponsors and pharmacy benefit managers. Changes are made to terms and definitions. 90-590 s 243-1
Missouri issued a bulletin reminding insurers of the annual statistical reporting requirements. Details and deadlines are available on the department's website. Bulletin 24-01
UNCLAIMED PROPERTY
Florida enacted rule amendments relating to the procedures for filing claims with the state for unclaimed property. Rule amendments include specific procedures for different categories of property. FAC Rule 69G-20.0021
Newsletter
Property & Casualty News September 2024
Property & Casualty News
September 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
Illinois published a bulletin providing guidance on compliance with the public adjuster regulations. The bulletin summarizes recent changes including a 10% cap on compensation in certain circumstances, allowance for cancellation process and timing. Bulletin 2024-16
Rhode Island's Superintendent of Insurance clarifies the continuing education requirement for resident independent adjusters, resident public adjusters and nonresident adjuster licensees. Bulletin 2024-7
AGENT / PRODUCER LICENSING AND APPOINTMENT
New Mexico's Producer Licensing Bureau announced a 90-day temporary insurance producer license is available while the Department is switching insurance examination vendors. Notice posted on August 29, 2024
Rhode Island's Superintendent of Insurance notified producers and insurers that all appointments and terminations must be filed through NIPR beginning January 1,2025. All persons who would have been reported on the ACPR that would have been due March 1, 2025, must instead have their appointment filed through NIPR in January, even if that individual is no longer appointed in January. Bulletin 2024-6
AUTOMOBILE INSURANCE
California adopted updates to its proof of insurance card requirements, including the option to offer optional electronic proof of liability and updated terminology. T 13 Section 82
CANCELLATION / NON-RENEWAL / PREMIUM OR COVERAGE
Mississippi published a bulletin providing guidance regarding SB 2130. The new law provides that an insurer may not cancel or deny coverage or non-renew coverage due SOLELY to the age of the roof. The age of the roof may be taken into consideration when considering whether to cancel coverage. Bulletin 2024-2
CLAIMS / CLAIMS ISSUES
Louisiana published guidance on recent legislative changes mandating fair practices in the insurance claims process. The definition of a fraudulent insurance act has been broadened to include false or misleading statements, estimates, invoices, bids, proposals, proof of loss or any other document that misrepresents the loss. Advisory Letter 2024-01
CYBERSECURITY
Alaska enacted SB 134, requiring insurers to develop a program and structure to address insurance data security. It also sets certain standards for handling a cybersecurity breach and providing notification. SB 134
Puerto Rico issued a regulation containing cybersecurity standards for the insurance industry. Rule 108
DISASTER / CATASTROPHIC EVENT
New Mexico's Insurance Department informs carriers that have issued P&C policies covering risks in areas impacted by the Salt and South Fork Fires that a catastrophic loss has been declared on September 6, 2024. Insurers must settle each catastrophic claim, property insurance claim or vehicle physical damage claim within 90 days from the declaration. Corrected Bulletin 2024-015
DISASTER PREPAREDNESS
Virginia's Bureau of Insurance now requires all property and casualty carriers writing in the state to update the new contact Information field in SIRCON for your company's Catastrophe Team Coordinator. A link is provided. SCC Notice dated August 27, 2024
FILINGS: PROPERTY / CASUALTY
Alabama published a bulletin updating the required filing fees and requiring the use of EFT for certain filings. Bulletin 2024-04
Florida updated its requirements for the submission of an actuarial memorandum, ensuring rates are not excessive or discriminatory. For companies averaging hurricane models, the company must include additional information in the memorandum, including an explanation of whether the same averaged model is being used throughout the state or if it is a weighted average. 69O-170.0135
Nevada's Insurance Commissioner reminds insurers that any mathematical model used in underwriting or rating of personal lines insurance must be filed for prior approval. Examples of models and rules required to be filed are given. Bulletin 24-002
MARKET CONDUCT EXAMINATIONS
Illinois enacted amendments to its market conduct regulation, including updated definitions, powers of the department and deadlines for responses, among other things. The amendments also address the confidentiality of findings. SB 1479
MISCELLANEOUS
Kentucky published a bulletin announcing new premium rates for the Mine Subsidence Insurance Program. The bulletin notifies companies that all insurers providing mine subsidence coverage will need to re-execute reinsurance agreements due to changes in the total insured value eligible for reinsurance. Bulletin 2024-07
New Hampshire passed a law requiring changes to retail installment contracts for motor vehicles. Any insurance included in the contract must adhere to certain premium limits. HB 1243
North Carolina codified the law of tenancy in common as recommended by the Bar Association. HB 556
Oklahoma's Insurance Commissioner informed all persons and organizations that all contact information must be kept current and a change in contact information must be submitted within 20 days of the change. Bulletin 2024-08
The Federal Trade Commission amended its Telemarketing Sales Rule by updating the fees charged to entities accessing the National Do Not Call Registry. 16 CFR 310.8
PROPERTY INSURANCE
California published a bulletin describing the process through which insurers may seek approval to recoup assessments under the FAIR Plan. The FAIR Plan is California's program to make basic property insurance available to California consumers who could not otherwise obtain coverage. Bulletin 2024-8
Maryland published a bulletin providing notice of amendments affecting the responsibility for providing coverage of various types of condominium units. Beginning 10/01/24, the homeowners association/council, for those developments with both attached and detached units, will be responsible for maintaining property insurance on the units as well as common areas. Bulletin 24-22
Michigan published a bulletin announcing the annual adjustment of the fire insurance maximum escrow. Effective 07/01/24, the new maximum is $24,000. Bulletin 2024-21-INS
PUBLIC RECORDS
Colorado published a bulletin updating public records procedures. The bulletin outlines when and how records may be requested as well as the fees for doing so. Amended Bulletin B-1.6
REINSURANCE
New Jersey published a list of accredited reinsurers for which insurers domiciled, licensed or eligible to write surplus lines are allowed to take full credit for reinsurance ceded until September 1, 2025. Notice dated September 6, 2024
REPORTS - DATA CALLS & OTHER REPORTS
Florida amended its rule updating the schedule of fines for late filed reports. It has added a list of mitigating or aggravating factors to be considered. Rule 69O-207.001
SERVICE CONTRACTS / WARRANTY INSURANCE
Oklahoma's Insurance Commissioner announced numerous revisions to the Service Warranty Act, including licensing requirements effective November 1, 2024, as a result of SB 541. Bulletin 2024-06
SURPLUS LINES
New Jersey published a list of active surplus lines foreign and domestic insurers. Notice dated August 27, 2024
THIRD PARTY ADMINISTRATORS
Puerto Rico passed a law requiring third party administrators to be registered. The law also covers the rules governing contracting with insurers, TPA responsibilities, and other requirements. HB 303
WORKERS' COMPENSATION
Indiana published a circular announcing the adoption of a new edition of the NCCI Experience Rating Plan Manual for Workers Compensation and Employer Liability. There were no changes that will result in premium impact. Updates include changes to intrastate and interstate rated risks, Loss limitations and others. Circular 2024-06
New Jersey increased the maximum allowable witness and reasonable attorney fees from 20% to 25% of the judgment in workers' compensation cases. SB 2822
New Mexico Workers' Compensation Administration published updated workers' compensation and occupational disease disability rates through December 2025. Notice dated July 22, 2024
Oregon's Workers' Compensation Division advised insurers and self-insured employers how to apply employer-reimbursed medical service costs for individual claims. It also provides updated maximum reimbursement amounts. Bulletin 345 (Revised)
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