Life and Health News
We are celebrating over 25 years of providing selected items of current interest to our clients and friends. The items contained in this newsletter are derived from bulletins, regulations and legislative activity affecting the insurance industry. Please feel free to share this newsletter with others that may be interested. Contact our office for further details about any of the items contained in the newsletter.
ADVERTISING / SALES & MARKETING
Mississippi extended the Telephone Solicitation Act's repeal date from July 1, 2017, to July 1, 2021. Senate Bill 2165, 77-3-701+
Missouri amended its rule pertaining to the advertising of life insurance policies and annuity contracts. 20 CSR 400-5.100
New Hampshire readopted its rules establishing standards and requirements for the use of senior specific certifications and designations in the sale of life insurance or annuities. Ins 311.01+
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AFFORDABLE CARE ACT
Alabama published a bulletin continuing transitional relief in both the individual and small group market. Bulletin No. 2017-01
Connecticut issued a bulletin to all insurance companies, fraternal companies and others that deliver or issue individual and small employer health insurance policies subject to the Affordable Care Act, providing filing requirements for plan years beginning January 1, 2018. Bulletin No. HC-90-17
Connecticut issued a bulletin to set requirements and minimum standards for prescription drug formularies, which are to be filed for all plans (whether or not such plans are subject to the Affordable Care Act) annually with the Department, with the first filing due on May 1, 2017. The survey will be on the Department website under the tab "Forms and Applications." Bulletin No. HC-113-17
Louisiana issued a bulletin informing all health insurance issuers and health maintenance organizations, that any issuer may elect to continue "transitional" health insurance plans as authorized by the Center for Medicare and Medicaid Services (CMS) on February 23, 2017 as provided in the bulletin. Bulletin 2017-02
Maine issued a bulletin pertaining to the extension of transitional authorization to renew small group health plans. It approves the renewal of non-grandfathered small group plans issued before January 1, 2014 (colloquially known as "grandmothered" plans), for terms extending no later than December 31, 2018. Bulletin 420
Michigan issued an order regarding the Affordable Care Act 2018 transitional policy extension. Individual and small group plans that have been continuously renewed under the previous transitional periods and have been continuously in effect since January 1, 2014, are permitted to renew such coverage for a policy year starting on or before October 1, 2018, but only if the policy ends on or before December 31, 2018. Order No. 17-013-M
New Hampshire issued a bulletin to health carriers providing guidance of the extended transition period for non-grandfathered coverage in the individual and small group market. Bulletin of March 10, 2017
Ohio issued a bulletin regarding the extension of transitional policies for non-ACA-compliant plans through calendar year 2018 and provides the requirements. Bulletin 2017-03
Oklahoma issued a bulletin informing all health insurance carriers of requirements related to the bulletin released by the Center for Medicare and Medicaid (CMS) on 2/23/17 regarding the extension of transitional policies through calendar year 2018. Bulletin No. LH 2017-01
South Dakota issued a bulletin regarding extension of transition insurance policies. Bulletin 17-01
The Centers for Medicare and Medicaid Services (CMS) published a notice with deadlines for various filing activities related to Qualified Health Plan application submission. CMS Notice dated December 16, 2016
The Centers for Medicare and Medicaid Services published a notice extending transitional policies through the calendar year of 2018. CMS Notice dated February 23, 2017
Wisconsin published a bulletin extending transitional health insurance plans through December 31, 2018. Bulletin Dated March 6, 2017
AGENT / PRODUCER COMPENSATION
Oregon issued a bulletin to clarify expectations for producer compensation in the health benefit plan market. Bulletin 2017-2
Puerto Rico issued a bulletin regarding a new general standard for the payment of commissions on health and disability insurance. For health or disability insurance, where the insured makes a change and appoints a producer or changes the authorized representative, the new producer or authorized representative will be entitled to the commissions, from the month of the appointment and when the producer or representative begins to provide the service to the licensee and perform underwriting tasks. Letter No. CN-2014-D, dated July 10, 2014 is repealed. Ruling CN-2017-2016-D
AGENT / PRODUCER LICENSING AND APPOINTMENT
Montana amended its law regarding producer appointments. The changes address appointment by affiliation, appointment through business entity affiliation, and notice requirements. House Bill 138, 33-17-231+
Rhode Island issued an industry alert that the Department no longer mails license renewal reminders for producers, adjusters and appraisers as of March 1, 2017. For all renewals after March 1, 2017, the Department will send email reminders in place of mailing reminders. Licensees are obligated to keep their contact information current. Industry Alert 2017-1
The Virgin Islands enacted legislation entitled "Virgin Islands Producer and Adjuster Licensing Act” to update Chapter 31 of its statutes and be in compliance with NAIC accreditation standards. Bill No. 31-0445; T.22 s 751+
ANNUITIES / ANNUITY CONTRACTS
Missouri adopted a rule, which among other things, provide standards for the disclosure of certain minimum information about annuity contracts to protect consumers and foster consumer education. This rule specifies the minimum information which must be disclosed, the method for disclosing it, and the use and content of illustrations, if used, in connection with the sale of annuity contracts. It provides the Buyer's guide for deferred annuities and an annuity illustration example. 20 CSR 400-5.800, 20 CSR 400-5.800 Appendix A, 20 CSR 400-5.800 Appendix B, 20 CSR 400-5.900
New Jersey enacted the New Jersey International Arbitration, Mediation, and Conciliation Act which is effective May 7, 2017. Senate Bill 602, 2A:23E-1+
Arkansas enacted legislation amending its laws addressing captive insurance companies, adding definitions and revising several sections. House Bill 1476, 23-63-1601+
CONFIDENTIALITY / PRIVACY
Maryland amended its law to provide exceptions for the required annual privacy notice for financial information to customers. COMAR 31.16.08.06
Montana enacted the Corporate Governance Annual Disclosure Act which, among other things, is to provide a summary of an insurer or insurance group's corporate governance structure, policies, and practices. House Bill 120
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CREDIT FOR REINSURANCE
South Dakota enacted legislation updating its laws regarding credit for reinsurance. House Bill 1045
DISASTER / CATASTROPHIC EVENT
Iowa issued a bulletin to all insurers and producers. Effective immediately, Bulletin 16-01 that provided guidance for policyholders affected by flooding and previously declared disasters has been rescinded. Bulletin 17-02
West Virginia published a supplement to Informational Letter 191 from December 2014, retracting the requirement of an attestation by the proposed insured that they had purchased minimum essential coverage. Insurers who have a previously approved application used for hospital indemnity or other fixed indemnity insurance plans may remove the attestation from the application without having to refile, provided they follow the noted procedure. Informational Letter 191A
North Dakota amended its fee schedule and increased some of the fees. Senate Bill 2103
FILING REQUIREMENTS / PROCEDURES
Missouri adopted a rule applicable to health benefit plans that prescribes the form and content of the rate information required to be submitted and sets forth the standards of review applicable to such filings. 20 CSR 400-13.100
New Jersey readopted its rule that establishes informational rate filing requirements and procedures applicable to health benefits plans for small employers. NJAC 11:21-9.1+
Puerto Rico issued a ruling to insurers that write individual and small group health plans regarding form and rate filing requirements. Ruling CN-2017-218-AS
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Arkansas issued a bulletin to health insurers, HMOs and other domestic insuring entities announcing adoption of the NAIC Accounting Practices and Procedures Manual as of March, 2016. The Manual is to be used for annual statements as of December 31, 2017 and to be filed with the Department on or before March 1, 2018. Bulletin 1-2017
Iowa amended its law regarding allowable investments for life insurance companies. Insurance Code: 511.8
FRAUD / ANTI-FRAUD
North Dakota amended its law pertaining to producer fraudulent acts. The application or renewal for a license will be denied if the commissioner finds the applicant or licensee has been convicted of a felony involving dishonesty or breach of trust. House Bill 1112, 26.1-02.1-01
HEALTH CARE EXCHANGE / MARKETPLACE
Louisiana issued a bulletin to give notice to all health insurance issuers and health maintenance organizations (HMOS) of the rescission of Bulletin 2014-06. The LDI will continue to enforce limited portions of a final rule promulgated by the Centers for Medicare and Medicaid Services (CMS) on May 27, 2014, as the final rule on the Exchange and Insurance Market Standards for 2015 and beyond. Bulletin 2017-03
Nevada provided network minimum standards for issuers in the Federally-facilitated Marketplaces. NAC 687B s 9 (LCB File No. R049-14)
Oregon prepared timelines for submission of form, rate, and binder filings. The filing deadlines apply to health benefit plans and exchange certified pediatric dental offered on-exchange and off-exchange. Memo Dated February 28, 2017
HEALTH INSURANCE - COMPREHENSIVE
Arkansas enacted legislation to create the Telemedicine Act, updating definitions of terms related to telemedicine and stating that health benefit plans are to provide coverage for healthcare services provided through telemedicine on the same basis as the plan provides coverage for services provided in person. Senate Bill 146
Connecticut published a bulletin to set the date for annual filing of health carrriers' (including Vision and Dental) networks, in order for the Department to determine the sufficiency of the networks. Carriers will be required to complete an annual filing for existing networks and should complete the Network Adequacy Survey as the submission. The Survey can be found on the Department website and is due no later than May 1, 2017 and annually thereafter. Bulletin No. HC-117-17
The District of Columbia enacted legislation called the "Specialty Drug Copayment Limitation Act of 2016," which defines the term "specialty drug" and places limits on the health benefit plan copayment and coinsurance applicable to such a drug such that they will not exceed $150 per month or $300 for a 90-day supply effective January 1, 2018. Bill 32
Virginia amended its Code by adding Section 38.2-3407.14:1 to prohibit plans that provide coverage for cancer therapy from holding proton radiation therapy to a higher standard of clinical evidence than other types of radiation therapy. House Bill 1656; Section 38.2-3407.14:1
HEALTH INSURANCE / HEALTH RATES
Connecticut issued a bulletin providing rate filing guidelines for all insurers, fraternals and others that deliver or issue individual and group health insurance policies in the state. Bulletin No. HC-81-17
Kansas issued a bulletin to call health insurers attention to the requirements found in 2014 House Bill No. 2668 effective July 1, 2017. Section 1 of House Bill No. 2668 is known as the predetermination of health care benefits act. The act requires that health plans that receive an electronic health care predetermination request provide to the requesting healthcare provider information on the amounts of coverage on the procedures specified in the request that is accurate at the time of the health plan’s response. Bulletin 2017-1
New Hampshire adopted new rules that apply to all health benefit plans providing prescription benefits through a network of participating pharmacies. Ins 2704.01+
New Hampshire issued a bulletin informing health carriers of the network adequacy procedure for 2018 plans. Bulletin of February 21, 2017
New Jersey enacted legislation that requires health insurance coverage for treatment of substance use disorders and places certain restrictions on the prescription of opioids and certain other drugs. Senate Bill 3, 17B:26-2.1hh, 17B:27-46.1nn, Bulletin 17-01
Oregon issued a bulletin to clarify expectations for insurers and third parties providing administrative or other functions when administering contraceptive coverage. It reminds insurers to monitor and control vendor relationships. Bulletin 2017-1
HEALTH MAINTENANCE ORGANIZATIONS
Maryland amended its law for HMOs to no longer require a peer review of the physical facilities and equipment during an external review. It also amends provisions concerning the access and availability of services and provides that each HMO enrollee must be given the opportunity to select a primary physician or certified nurse practitioner from among those available to the HMO. COMAR 10.07.11.04, COMAR 10.07.11.05, COMAR 10.07.11.09
Arkansas enacted legislation to modernize the Insurance Holding Company Regulatory Act. Senate Bill 344, 23-63-506+
Montana amended it law to require a controlling person of a domestic insurer seeking to divest its controlling interest in the domestic insurer in any manner to file a statement with the commissioner for approval of its proposed divestiture at least 30 days prior to the cessation of control. 33-2-1104
IIPRC / INTERSTATE COMPACT
The Interstate Insurance Compact Commission published a Filing Information Notice replacing 2008-05 and addressing the process for revisions to forms and supporting documentation in Compact filings. Filing Information Notice 2017-1
North Dakota amended its law relating to limitations on gifts that insurance producers may give to a person in connection with marketing, promoting or advertising the business. Senate Bill 2140, 26.1-04-03
LIFE INSURANCE / LIFE CONTRACTS
New Hampshire issued a bulletin providing guidance about permissible wellness reward programs that are offered with life insurance products. Bulletin of February 17, 2017
New Hampshire readopted its rules on life insurance illustrations with minimal changes. The rules provide for the delivery of illustrations, record retention and requirements for illustration actuaries. Ins 309.01+
LONG-TERM CARE INSURANCE
Maryland revised its law for long-term care to provide the annual rate certification requirements for rate schedules currently marketed and amended the requirements for the right to reduce coverage and lower premiums. It also amends the initial filing requirements and requirements for rate changes. COMAR 31.14.01.13, COMAR 31.14.01.24, COMAR 31.14.01.36, COMAR 31.14.02.04
Maryland revised its long-term care insurance Code to provide that the application should indicate that for applicants who are younger than 61, the applicant is required to purchase an inflation protection benefit of at least 1 percent (formerly 3 percent). COMAR 31.14.03.06
MEDICARE SUPPLEMENT INSURANCE
Montana advised that it is compiling data for the 2017-2018 Montana Medicare Supplement Rate Comparison Guide. If a company would like to have their rates published in the guide, they may complete a questionnaire at http://csimt.gov/wp-content/uploads/MedSupRateSurvey_2017_ext.xlsx. The questionnaire must be completed and returned by May 1, 2017. 2017 Montana Medicare Supplement Rate Guide
Mississippi enacted legislation to clarify the effect of payment by a life insurance company or an annuity issuer when the proceeds or payments under a policy or contract become payable. Senate Bill 2888, Uncodified SB 2888 s 1 (2017)
New York adopted regulations establishing cybersecurity requirements for financial services companies, which among other things requires insurers to maintain a cybersecurity program and to designate a Chief Information Security Officer. 23 NYCRR 500.0+
The National Association of Insurance Commissioners (NAIC) issued an Alert to all potential National Meeting attendees of a phishing scam that may be targeting them. It says that a firm identifying itself as "Convention Housing Planners" is attempting to make contact with future NAIC National Meeting attendees in an attempt to get credit card information. Research on the firm's website and telephone number show it to be a phishing scam. NAIC Alert
The Virgin Islands enacted legislation to update the Territory's insurance laws and adopt core standards and Model Laws and Regulations of the National Association of Insurance Commissioners (NAIC) for purposes of obtaining NAIC accreditation, placing the Territory on par with other United States jurisdictions. Bill No. 31-0442
Arkansas enacted omnibus legislation concerning prepaid funeral benefits law, policyholder's bill of rights, annual statements filed with the commissioner, navigator licensure, and mandatory insurance fraud reporting, among other subjects. Senate Bill 247
ORSA: OWN RISK AND SOLVENCY ASSESSMENT
Mississippi enacted legislation, which among other things requires insurers to conduct an Own Risk and Solvency Assessment (ORSA) and file an ORSA summary report. Senate Bill 2298
South Dakota enacted legislation to provide requirements for insurers' Own Risk and Solvency Assessments. House Bill 1060
Wyoming enacted legislation to update its laws addressing reinsurer requirements. House Bill 7, 26-5-112+
REPORTS - DATA CALLS & OTHER REPORTS
Alaska issued a bulletin requiring health insurers to complete a survey to provide the director with certain statistical information regarding health insurance. The report is due by May 5, 2017. The survey is available at https://www.commerce.alaska.gov/web/ins/Resources/Bulletins.aspx. Bulletin 17-02
Texas issued a mandatory health claims reimbursement rate report data call due on May 1, 2017, for reporting period January 1 2016 to December 31, 2016. Commissioner's Bulletin #B-0002-17
Wyoming enacted legislation to modify reserve requirements for specified insurers, require use of certain mortality tables under specified conditions and define nonforfeiture interest rates for specified policies. House Bill 6, 26-6-201+
The Virgin Islands enacted legislation entitled "The Virgin Islands Risk-Based Capital for Insurers Act,” to place the Territory on par with other United States jurisdictions and satisfy one of the NAIC requirements for bringing the Territory into compliance with the NAIC accreditation standards. Bill No. 31-0443
SMALL EMPLOYER GROUPS
Louisiana issued a bulletin to all health insurers and HMO's to provide notice that Bulletin 2013-02, pertaining to the definition of "small employer" has been rescinded. Bulletin 2017-01
Missouri amended a suitability regulation to only apply to the offer, sale, or exchange of variable life contracts. All language that relates to annuity recommendations has been removed and added to a proposed rule. 20 CSR 700-1.146, 20 CSR 700-1.147, 20 CSR 700-1.148
THIRD PARTY ADMINISTRATORS
Florida published a Memorandum to all insurers and HMOs using third party administrators, to note certain provisions of the Insurance Code. Among the notations: 1) all responsibility for competent administration of its programs remains with the insurer/HMO; 2) any premiums paid to the administrator are deemed to have been received by the insurer; and 3) payments from the insurer to the administrator are not deemed to have been paid to the insured/claimant. Also, a semi-annual review of the TPA operations is required. Informational Memorandum OIR-17-01M
Kansas amended TPA license requirements, annual reporting requirements and to provide requirements for the written agreement between the TPA and the insurer. Senate Bill 22, 40-3801+, Uncodified SB 22 s 3 (2017)
The Virgin Islands enacted legislation entitled "The Virgin Islands Third Party Administrator Act," updating its insurance laws to reflect the licensing requirements contained in the model laws of the NAIC. Bill No. 31-0446; T.22 s 1520+
Wyoming enacted legislation requiring registration of third party administrators. House Bill 14, 26-53-101+
TPA LICENSING CHOICES
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Louisiana revised and re-issued a bulletin in order to clarify prior guidance relative to "value added" services or things of value furnished by persons engaged in the business of insurance, as well as to common and ordinary marketing practices. Advisory Letter No. 2015-01 (Revised)
Delaware revised its statutes regarding unclaimed property, providing definitions of terms, timelines for reporting unclaimed property and penalties for failure to file reports. Senate Bill 13
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