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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.
AFFORDABLE CARE ACT
Alaska published a bulletin allowing insurers the option to renew non-ACA-compliant small group and individual coverage if it has been continuously in effect since December 31, 2013. Policies may continue to be renewed on or before October 1, 2017, provided the policy will terminate December 31, 2017. BULLETIN B 16-11
The IRS, Department of Labor and Department of Health and Human Services adopted a rule addressing excepted benefits, lifetime and annual limits and short-term, limited-duration insurance. 45 CFR Parts 144, 146, 147 and 148
Utah published a bulletin providing guidance regarding notices and requirements when applying employer contribution or group participation requirements to small groups. Bulletin 2016-4
Wisconsin published a bulletin providing guidance regarding auto re-enrollment through the federal healthcare exchange. Bulletin dated October 31, 2016
AGENT / PRODUCER LICENSING AND APPOINTMENT
Puerto Rico issued a circular letter providing guidance regarding the new online procedure when applying for examination for insurance and provisional licenses. Circular Letter CC-2016-1893-SR
Rhode Island issued a bulletin superseding Bulletin 2003-6, defining Managing General Agents (MGA) and providing additional information for applying for an MGA line of authority. Bulletin 2016-7
Rhode Island published a bulletin regarding voluntary insurance producer business entity licensing for resident and non-residents. Bulletin 2016-6
Delaware amended its law relating to arbitration of health insurance disputes between carriers and providers. 18 DE Admin Code 1313
Montana issued a bulletin to all insurers pertaining to insurance policy provisions that establish arbitration terms. The bulletin advises that policy forms that establish terms of a future arbitration will not be approved. Advisory Memorandum of November 4, 2016
CERTIFICATE OF AUTHORITY FILINGS
Colorado amended its regulation addressing issuance of a certificate of authority. Amended Regulation 2-1-7
IS YOUR COMPANY PLANNING TO EXPAND ITS AUTHORITY?
A name change, re-domestication, acquisition, merger, or adding a new line of business requires a state filing to change an insurance company's certificate of authority. Click here to see how First Consulting can help.
CONFIDENTIALITY / PRIVACY
South Dakota published a bulletin to relieve licensees of the requirement for annual privacy notices to customers so long as the licensee: 1) adheres to state rules providing nonpublic personal information to nonaffiliated third parties, and, 2) has not changed its policies and practices regarding such information since its most recent disclosure sent to consumers. Bulletin 16-06
Rhode Island promulgated regulations to set forth the procedures for filing the Corporate Governance Annual Disclosure (CGAD) and provide the required content of the CGAD. 161-RICR-200-45-11
WHAT REPORTS WILL YOU SUBMIT IN 2017?
Want help with CGAD, ORSA and other reporting readiness?
First Consulting has answers! Click here to learn more.
Maryland amended its law regarding credit life and credit health reinsurance requirements and revised the custodian agreement requirements. COMAR 31.13.02.04
South Carolina issued an order of final approval of rates for credit accident and health insurance. Order 2016-07
Colorado amended its regulation addressing network adequacy standards and reporting requirements for dental managed care plans. Regulation 4-2-57
DISASTER / CATASTROPHIC EVENT
North Carolina issued Executive Order No 109, Bulletin 16-B-07 and an amendment to the bulletin issued November 3, 2016 concerning a major disaster declaration beginning October 4, 2016 in certain counties. Specified entities are required to provide their customers adversely affected in the disaster area specific relief of the insureds payment, submission of claims and other responsibilities. Bulletin 16-B-7 (Second Amendment 11/3/2016), Executive Order No 109
Nebraska issued a notice pertaining to federal regulation of excepted benefits, lifetime and annual limits, and short-term, limited duration insurance. Notice of November 7, 2016
FILING REQUIREMENTS / PROCEDURES
Oregon issued a notification that the Division of Financial Regulation Rates and Forms is changing its URL for the Rates and Forms section of its website beginning November 5, 2016. Email Notice dated November 3, 2016
Arkansas issued a bulletin addressing timelines in the Department for health policy rate and form review. Bulletin 14-2016
THE SECRET TO STARTING FRESH IN 2017
Finish those 2016 project and start fresh! Click here to see how First Consulting can help.
HEALTH CARE EXCHANGE / MARKETPLACE
New Jersey amended its law for carriers that are members of the Individual Health Coverage Program, which among other things, removes references to basic and essential health care service plans, removes the definition of pre-existing conditions, amends the triggering events that result in special enrollment periods and revises the effective date of replacement during the annual open enrollment period and the special enrollment period. NJAC 11:20-1.2+
HEALTH INSURANCE - COMPREHENSIVE
Colorado amended its regulation addressing standards and reporting requirements for health benefit plan provider directories. Regulation 4-2-55
Colorado promulgated a new regulation addressing network adequacy and continuity of care requirements for health benefit plans. 3 CCR 702-4, Regulation 4-2-56
Colorado published a bulletin providing carriers with the annual maximum benefit amount for early intervention services for grandfathered health benefit plans and other specified policies and contracts. Bulletin B-4.31
Colorado updated a previously issued bulletin addressing discontinuance of individual and/or small group health benefit plans. Bulletin No. B-4.50
Georgia enacted legislation to address certain health care provider network restrictions and requirements. Senate Bill 158
Georgia issued a Directive to all insurers writing comprehensive major medical insurance providing guidance and Departmental expectations regarding PPACA's in-network preventive care services relating to preventive colorectal screenings. Directive 16-EX-6
Massachusetts issued a bulletin concerning HIV associated lipodystrophy syndrome medical benefit requirements. Bulletin 16-14
HEALTH INSURANCE / HEALTH RATES
Massachusetts issued a bulletin concerning lyme disease medical benefit requirements. Bulletin 16-13
New York issued a circular letter regarding the coverage requirements for treatment of substance use disorders. Circular Letter 2016-6
Pennsylvania enacted legislation concerning the retroactive denial of reimbursements paid by insurers to health care providers. House Bill 2241, 40-3701+
Pennsylvania issued a notice providing guidance regarding parity in mental health and substance use disorder coverage. Notice 2016-15
Hawaii revised its regulations regarding insurance holding company systems. 16-14-1 +
Maryland issued a bulletin to all insurers advising of the new forms for use in compliance with the Insurance Acquisitions Disclosure and Control Act. Bulletin 16-31
IIPRC / INTERSTATE COMPACT
Montana adopted rules to opt out of the Interstate Insurance Product Regulation Compact group disability income uniform standards. Regulations 6.6.4703, 6.6.4701
LIFE INSURANCE AND ANNUITY SOLICITATION
Tennessee adopted a regulation governing the use of senior-specific certifications and professional designations in connection with a life insurance or annuity product. Chapter 0780-01-94
MEDICARE SUPPLEMENT INSURANCE
Ohio amended its law pertaining to the solicitation and sale of medicare supplemental accident and health policies by extending the definition to include solicitation through electronic means. Rule 3901-8-09
Connecticut issued a bulletin repealing and replacing Bulletin HC-116, to clarify that Dental and Vision carriers are included in requirements for sufficiency of a health carrier's network. Beginning January 1, 2017, carriers are to file with the Department each new network and access plan within 30 days prior to their being offered. Instructions for filing are provided. The bulletin also contains instructions and due dates for annual filings of the Network Adequacy Survey. Bulletin HC-117
New York issued a circular letter providing guidance to all domestic stock life insurers with respect to distributing and reporting ordinary dividends and providing notice of proposed extraordinary dividends for approval. Circular Letter 2016-5
Puerto Rico issued a circular letter advising that an insurer is expected to have personnel that capable of servicing policies in the language in which they were issued. Circular Letter CC-2016-1895-CM
Puerto Rico issued a circular letter advising that it has adopted a procedure and form for making changes to contact information for International Insurers and Reinsurers. Circular Letter CC-2016-1894-ARI
Rhode Island published a bulletin outlining 2016 legislative changes impacting insurance. Bulletin 2016-5
Colorado amended its regulation to recognize a new annuity mortality table for use in determining liabilities for annuities. 3 CCR 702-4, Regulation 4-1-7
Arkansas published a bulletin applicable to any insurer, health maintenance organization or other entity required to report and pay premium taxes, Anti-Fraud Fees, or Companies Financial Regulation Fees. Previously, these items were moved to OPTins on an optional basis. As of January 2017, such submissions via OPTins become mandatory. Bulletin 12-2016
REGULATORY REPORTING REQUIREMENTS
Colorado updated requirements concerning a company's annual audited financial reports, audit committee and internal control department requirements. Regulation 3-1-4
California published a bulletin providing the minimum reserve basis for life annuities issued by Grants and Annuities Societies. Bulletin 2016-6
New Jersey adopted new rules to provide a framework for the establishment of uniform risk-based capital and surplus requirements for all health maintenance organizations. NJAC 11:2-39A.1+
SMALL EMPLOYER GROUPS
Colorado issued a bulletin regarding calculation of employer size for the purpose of selling group health benefit plans. Bulletin B-4.95
STANDARD VALUATION LAW
Arizona published a bulletin announcing the operative date of the uniform valuations manual to be January 1, 2017. Bulletin 2016-03
Pennsylvania enacted legislation relating to unclaimed life insurance benefits. Insurers are required to implement procedures for comparing their insureds in-force life insurance policies, contracts, and retained asset accounts, against their death master files. House Bill 1403, 40-3701+
UTILIZATION REVIEW - HEALTH CARE
Mississippi amended fee requirements for private utilization review agent applications and renewals. R15-16-82
A name change, re-domestication, acquisition, merger, or adding a new line of business requires a state filing to change an insurance company's certificate of authority. The Uniform Certificate of Authority Application (UCAA) has streamlined the filings, but the process is still time consuming. Making such filings may be a one-time event for your staff and the experience may not be used again.
First Consulting can help!
We are experienced with the UCAA and we are also familiar with the various state-specific requirements. Our services include advising what materials are needed for each state’s filing, assembly of the filings, and follow up, as necessary, to secure approval of the filings. Having First Consulting provide these services can free your staff for other functions and projects.
Click here for information on how we can assist you with UCAA filings.
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Let First Consulting finish those 2016 projects!
As 2016 comes to a close it’s good to look back at the many accomplishments and achievements. However, many of our clients also have a few lingering projects that didn’t quite get completed as intended this year. Unfortunately business doesn’t wait for those projects to be completed before beginning new projects.
Get Your Projects Back On Schedule
Whether your projects include:
- Product development
- State variation drafting
- State filings
- Or that pesky research project/state survey that no one ever had time to get to!
First Consulting has the experience to complete the project quickly and accurately.
Contact me today to learn how First Consulting can get your projects back on track and give you a fresh start to 2017!